HomeMy WebLinkAboutMiscellaneous - 947 GREAT POND ROAD 4/30/2018 (2)�2 2778 Date.../. S�U....
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
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This certifies that ....... ��"r ..i ..... U i ......... I
Pas permission to perform ...... �✓. �Z .ln. � �Z. � w .1Z � �� j
.....................................
wiring in the building of .......... ...1!!!..,-..........................................................
c -7 �- l� �� , l "�.. , ,North Andover; Mass.
at...........1..../......��..........:..../....l..u.1c:...........
Fee ...... �.�.� Lic.No....�/..� ........<\`n,4. .'.:',:..P�..........
c� ELECTRICAL INSPECTOR
Check # 7 /
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
N THECUUMM11AI14VL:r9LIHUL''4mAa1r4(H#/JL110' Uttice Use only
DEPARTIILEM'OFPUBLICSAFBTY Permit No. 77k--",
BOARDOFFIREPREVEN'170NREGULATIOA{S527CMR12:00 Occupancy &Fees Checked
iPPUCATIONFOR PERMIT TO PERFORMHICI'RICAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSArn ve-rS ELECTRICAL CODE, 427 CMR 1200
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat �a' �3 /0a
Town of North Andover
`
The undersigned applies for a permit to perform the electrical work described below.
Location (Street 6
Owner or Tenant
Owner's Address
To the Inspector of Wires:
Is this permit in conjunction with a building permit:
Yes Q No F-1(Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service _ Amps/ Volts Overhead EFUnderground No. of Meters
New Service Amps / Volts Overhead Underground No. of Meters
Nthlnber of Feeders and Ampacity �—
Location and Nature of Proposed Electrical Work _/,air l r u =75- 07y—,-.76 �5'�c 7,w -
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers
Total
KVA
No. of Lighting Fixtures
Swimming Pool Above
Below
Generators
KVA
ground
ground
No. of Receptacle Outlets
No. of Oil Burners
No. of Emergency Lighting Battery Units
No. of Switch Outlets
No. of Gas Burners
..,rG
C -As
FIRE ALARMS
No. of Zones
No. of Ranges
No. of Air Cond. Total
Tons
No. of Detection and
No. of Disposals
No. of Heat Total Total
Pumps
Tons
KW
Initiating Devices
No. of Sounding Devices
1Io. of Dishwashers
Space Area Heating KW
No. of Self Contained
Detection/Sounding Devices
Local Municipal
Other
4No. of Dryers
Heating Devices KW
Connections
No. of Water Heaters KW
No. of No. of
Signs
Bailasis
No. Hydro Massage Tubs
No. of Motors
Total HP
OTHER
ter Pt
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Telephone No. �3sG- f . 'ERMIT FEE $
3 42 Z
Date.. .... ..... .....
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
.This certifies that d f . ................r?.`.
. .
has permission for gas installation .. ? .. ............... . .
in the buildings of .....::: .......................... .
at:... '............ . North Andover, Mass.
J /�• -rye• � .
Lic. No...-." ......1::f:.s .
GAS INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
1 ;
MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO G.As F=(;
Type or print) Date 12-- L 19
NORTH ANDOVER, MASSACHUSETTS
Building Locations: ��� T i/iakU iC, Permit 9 -'
CSz iii �� lAmount S'
Owner's Name
New ❑ Renovation. Replacement. ❑ Plans Submitted ❑ .+
(Print or rypE)
Name
Address
�. Uili GA 04
Business Telephone - I/ ---/7Y - 3 5-6e, -` 12- 2-
ivame of Licensed Plumber or Gas Fi
Check one: Certificate Installing Company
❑ Corp.
❑ Parmer.
47/'FirmiCo.
INSURANCE COVERAGE Check onp:
I have a current liability Insurance policy or it's substantial equivalent. Yes Nom
It you have checked ves, please indicate the type coverage by chec!cin-, the appropriate box.
Liability insurance policy 0 Other type of indemnity Q Bond ❑
Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the
Mass. General Laws, and that my signature on this permit application waives this requirement.
Check one:
Signature of Owner.or_Owners Agent Owner ❑ Agent ❑
herebv certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions ofthe Massachusetts t Gas Cycle and Chapter, 142 of the Laws.
By:
Title
C i ryi Tow n
APPROVED ri--u:usE!)Nl.v)
Signature of Lic:;nsed Plumber Or Gas Fitter
Plumber 42 5-'
Gas Fitter ic:nse;vumoer
Maste j
Journeyman
.r•
(Print or rypE)
Name
Address
�. Uili GA 04
Business Telephone - I/ ---/7Y - 3 5-6e, -` 12- 2-
ivame of Licensed Plumber or Gas Fi
Check one: Certificate Installing Company
❑ Corp.
❑ Parmer.
47/'FirmiCo.
INSURANCE COVERAGE Check onp:
I have a current liability Insurance policy or it's substantial equivalent. Yes Nom
It you have checked ves, please indicate the type coverage by chec!cin-, the appropriate box.
Liability insurance policy 0 Other type of indemnity Q Bond ❑
Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the
Mass. General Laws, and that my signature on this permit application waives this requirement.
Check one:
Signature of Owner.or_Owners Agent Owner ❑ Agent ❑
herebv certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions ofthe Massachusetts t Gas Cycle and Chapter, 142 of the Laws.
By:
Title
C i ryi Tow n
APPROVED ri--u:usE!)Nl.v)
Signature of Lic:;nsed Plumber Or Gas Fitter
Plumber 42 5-'
Gas Fitter ic:nse;vumoer
Maste j
Journeyman
No 4669
Date .........
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that(_ .... 7
has permission to perform-.'L...!'�-�,
plumbing in the buildings of'A-
................................. .
at ... ;
... ............
North Andover, Mass.
.
Fee. Lic. No��,�.V' Zt....... .......
t INSPECTOR
Check L-/
WHITE: Applicant CANARY: Building Dept- PINK: Treasurer
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS / /
Date r z (& l G�
Building Location �1- >��TO'0&/c�/4 Owners Name �� �� l� �P��v�2 U Permit # 'v
Amount U
Type of Occupancy �, N r
New Renovation Replacement ❑ Plans Submitted Yes No
FIXTURES I
(Print or type) Check one: Certificate
tCorp.Installing Company Namhn�- Py- K❑
Address - ❑ Partner.
461
77171577
Business Telephone Firm/Co.
Name of.Licensed Plumber: v h S /
Insurance Coverage: Indicate th type of insurance coverage by checking the appropriate box:
Li-jility insurance policy /0 Other type of indemnity ❑ Bond ❑
Insurance Waiver. I, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
signature Owner ❑ Agent ❑
I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the MassachusettsiPlumb' g dean hapf the General Laws.
y:
Title
City/Town
APPROVED (OFFICE USE ONLY
Type of Plumbing License
icense Number Master
Journeyman
dP
—
-.
(Print or type) Check one: Certificate
tCorp.Installing Company Namhn�- Py- K❑
Address - ❑ Partner.
461
77171577
Business Telephone Firm/Co.
Name of.Licensed Plumber: v h S /
Insurance Coverage: Indicate th type of insurance coverage by checking the appropriate box:
Li-jility insurance policy /0 Other type of indemnity ❑ Bond ❑
Insurance Waiver. I, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
signature Owner ❑ Agent ❑
I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the MassachusettsiPlumb' g dean hapf the General Laws.
y:
Title
City/Town
APPROVED (OFFICE USE ONLY
Type of Plumbing License
icense Number Master
Journeyman
Location qz-/
No. 41 Date
ca
TOWN OF NORTH ANDOVER
p Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $ —.
22g-
cs
Sewer Connection Fee $
Water Connection Fee $ _
TOTAL $ f�
1 9 5 9 Div. Public Works
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