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HomeMy WebLinkAboutMiscellaneous - 99 RALEIGH TAVERN LANE 4/30/2018N OO O V D 0 0 0 0 0 b Date ..... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that has permission to perform!! .. ..� :........l r�j wiring in the buildi of: , aw ...... Y odhAfifd6er, Mass. Fee .../ 5 t .Lic. No. -(12,4( . ..... ...... ................... .............. 6,7—EdCTRICAL INSPECrO Check # Commonwealth of Mas Department of Fire BOARD OF FIRE PREVENTION APPLICATION FOR All work to be performed in a( (PLEASE PRINT IN INK OR TYPE ALL City or Town of: By this application the undersigned gives no Location (Street & Number) q q Setts Official Use Only _ Permit No. 7 es Occupancy and Fee Checked LATIONS [Rev. 11/991 leave blank J TO PERFORM ELECTRICAL WORK he Massachusetts Electrical Code (MEC), 527 CMR 12.00 ION) Date: Id Olt To the Inspector of Wires: intention to perform the electrical work described below. Owner or Tenant Z;�ICN -11l r J% AJ Ad V Telephone No. Owner's AddresscSA/1,' Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building .�," e///,sv"��r' Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: e o s< R to !'n,nnlatien of the follmvinp table may be waived by the Inspector of Wires. Anach aaa(nOnat aemu y aeutreu, uF as ieyui— by ...--,........ 1 1, .• INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to themi-mit issuing office. CHECK ONE: INSURANCE Id BOND ❑ OTHER ❑ (Specify) f! (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains an penalties of perjury, that the information on this application is true and complete. FIRM NAME: , (/'> f' d7LIC. NO.: s � Licensee: z017A&1 Signatur AJlte4 LIC. NO.: (If applicable, enter "exenr t - in the license number line.) Bus. Tel. No. 1 -5YA ` f O Address: Alt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent I PERMIT FEE; $� Signature Telephone No. t Total No. of Recessed Fixtures No. of Ceil: Sus P• (Paddle) Fans sformers KVA Transformers s No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool rnd. Above ❑ In- rnd. El No.omergencyiging Batter, Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Detection andInitiating No. of Switches No. of Gas Burners Devices No. of Ranges No. of Air Cond. Tonsl No. of Alerting Devices Heat Pump Number Tons KW No. of Self -Contained No. of Waste Dis osers P Totals: Detection/Alerting Devices No. of Dishwashers S ace/Area Heating KW P g Local ❑ Municipal [:1 Other Connection No. of Dryers Heating Appliances Kms, Sec No of DevSteices or Equivalent No. of WaterKW No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent ! / Total HP��o Telecommunications Wiring: No. Hydromassage Bathtubs No. of Motors No. of Devices or Equivalent OTHER: Anach aaa(nOnat aemu y aeutreu, uF as ieyui— by ...--,........ 1 1, .• INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to themi-mit issuing office. CHECK ONE: INSURANCE Id BOND ❑ OTHER ❑ (Specify) f! (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains an penalties of perjury, that the information on this application is true and complete. FIRM NAME: , (/'> f' d7LIC. NO.: s � Licensee: z017A&1 Signatur AJlte4 LIC. NO.: (If applicable, enter "exenr t - in the license number line.) Bus. Tel. No. 1 -5YA ` f O Address: Alt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent I PERMIT FEE; $� Signature Telephone No. t 4. v ° \ Office Use Only 11 u P LIIIIIllIlIIt1UPEtiI Df �� IIES Permit No. �P�IIIZffitE212 Jif Itublic -,%fzt j Occupancy & Fee Checked 3190 (leave blank) BOARD OF FIRE PREVENTION REGULATIONS 521 VMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Cade, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 1-1411- �j�_� (i)Q or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) "le 1110 JeAl All • r Owner or Tenant Owner's Address d 4 `,v6f Is this permit in conjunction with a b ilding permit: Yes No r (Check Appropriate Box) Purpcse of Building'/V le d Utility Authcrization No. Existing Service Amos, /Vcits Overhead _ Unogrnd No. of Meters New Service Amos _J Voits Overrteac Uncyrna _ No. of Meters Numcer of Feeders anc Amoacity Location arc Nature of ?rccosee Eiec:r;cal :`lerx No. or LightiN ng Outlets / o. a. T bs No. Of Transformers KVA Above— In - No. of Lighting Fixtures i Swimming ?cel grno — crnc. _ I Generators KVA No. of Emergency Lighting No. at Fecectacie Cutlets No. of Cil _urners ; Barery Units No. of Sw tcn Outlets No. of Ranges No. of Discosais No. of Oisnwasners No. of Dryers iNo. cr Gas Burners FIRE ALARMS No. of Zones Total No. of Oetet:von arta No. at Air Card. tons Initiating Oavtces No. --t Heat Total Total Pu-cs Tons K'.v I i ScaceiArea Heating '1 Heating Cev:ces KW No. at No. of No. of '.Yater Heaters KW I Signs Ballasts No. Hvcro Massage Tubs OT-iER: No. of Motors Total HP s s • .-.– No. cf Sounding Oevices No. of Serf Contained De,ec;:aniScunding Devices — Municioat–Other Lccai Connection Law voltage winnc INSURANCE CCVEPAGE: Pursuant to the recuirements at '.`lassaCnuSeV*s ;enerai Laws _ I have a current Liaciiity Insurance Policy Inciucing Camc:e c Operations Caverage or -ts suostannal eeuivaient. YES NO – I have suomirea valid proof of same to the Office. YES Jr' NO ::If you nave cnecxee YES. please indicate :he type of coverage Cy cttecxing the app y9� riate pox. INSURANCE Y SCNO = OTHER = lP!ease Scec:ty) (Expiration Oatei Estimated value of E!ectncal Work S15 _ { Wcrx :o Start Inscect:on Gate Racuestec: Rougn. anal -. Signed under ;he Pe4E�Signat-.;re LIC. NO. FIRM NAME LIC. NO. Licensee j uBus. Tei. No. Q� �• ' �7� �• .�/oG" JS/ Alt. : "J el. o. Address tantiai eaurvalen OWNERS INSURANCE WAIVES: I am aware that the Licensee Saes not nave trio insurance coverage or is suosAt ente- auirea ov Massachusetts General Laws. and that my signature on :h:s permit appucanan waives this redwrement. Cwn r g (Pease cnecx ones V 'eiecnone No. PERMIT FEE 5 (Signature of Owner or Ageno TO 695 Date ......../i .... 1,- TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ....... Q..�. ..... (.f,)..5..0 ......... C-.. ................. has permission to perform ...... &.". ............ t�. P -L 1. i ................. wiring in the building of .... ............. *..0.t.'A.'A.'e ................................. at ........ . . North Andover, Mass. Fee &:A ... Lic. No. ..................................................................... ELECTRICAL INSPECTOR 4 WRAP .4 40.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer O O y r ►� *#t TokM r n�� �► ' C 0 A� is oa S o 4 1 CID oor Co =rc y m :3a 7 Q =� rCL0 C o > > 3 n cm Z w .+ O .+ n. - m (D > > cD 3 -o 0 ^. N C Z m CD CD CCD W 0 �D CD 7 o ca CDS. 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O CL CO) a� m O 0CD CD O CL cr CD OwM =r IMI CD O CD C CD y� _. tD CL v CO) CD CO) I O y O 'fl Z CD .Ot O � CD O CD -J C/) lJ 0 z C O � © C y O O 0 = � 0 0 a0 o 'n y ;-.-I a Ms Es o Z� C5 n . ::r an C) N -, m Z O CLCL a m CO) m -4 O o H �� -� N 0..�: > > oTo c 'Cal 2-4 m M0 0 I m 0 0 H CC.) i:Q 1.x..1 V C ;to CD =r a o m ;•� Co. to O ? ? CO N os Q CL m CO2 CA =r CL cer 0 ca Z Z C CA ; C 0 .-- o _� l ? N O q h �.C42 C7cy. V CD .� Vl �► o =: Ca m m n� C -J :� N 0 1 •� •i v o V/ �-' N W z.r •1 /, C /`i :1 0•1 � 0 0 'n � 0 M p- ::r w r x o O Omq 0 9 O C CD d MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) „ It o.-1 Mass. Date 19—ZL Permit # Building Location' ✓ wners NameZj- Dn✓�t,5 �\ ail -?e Eo v e-4,- Type of Occupancy New ❑ Renovation ❑ Replacement 02""' Plans Submitted: Yes ❑ No ❑ FIXTURES Installing Company Name s-S?(rr»,4?AL) Check one: Certificate Address A r� CO a C H oi4 ro y- J ❑ Corporation /71 E l N 0 - ) 41 A 0 t � ❑ Partnership Business Telephone (141 L -597 1 2-Krm/Co. Name of Licensed Plumber 'zLe3r=,/?r 1q SAwlryl�9 Tr4�t� INSURANCE COVERAGE: I have a current jabiiity insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes Er No ❑ If you have, checked ve, please x. Indicate the type coverage by checking the appropriate bo A liability insurance policy Q -/ Other type of indemnity ❑ 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: 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 wormed under the permit issu for this application will be in compliance with all pertinent provisions of the Massachusetts State Plum • g e and apter of the oral Laws. By I L Title re of LicensedPlumber Type of License: Master Joumeym-Tb ❑ City/Town - APPROVED 0 IC NL License Number 5 V • • • • • • Installing Company Name s-S?(rr»,4?AL) Check one: Certificate Address A r� CO a C H oi4 ro y- J ❑ Corporation /71 E l N 0 - ) 41 A 0 t � ❑ Partnership Business Telephone (141 L -597 1 2-Krm/Co. Name of Licensed Plumber 'zLe3r=,/?r 1q SAwlryl�9 Tr4�t� INSURANCE COVERAGE: I have a current jabiiity insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes Er No ❑ If you have, checked ve, please x. Indicate the type coverage by checking the appropriate bo A liability insurance policy Q -/ Other type of indemnity ❑ 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: 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 wormed under the permit issu for this application will be in compliance with all pertinent provisions of the Massachusetts State Plum • g e and apter of the oral Laws. By I L Title re of LicensedPlumber Type of License: Master Joumeym-Tb ❑ City/Town - APPROVED 0 IC NL License Number 5 z D m m O m c F v z O ``4y m Z D P 2 A N m A O O Z z N .r A O Z 0 m z o � •1 O O O r C Q7 z Q a 3668 Date. .4/ !els. el--. I TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING A 9 o This certifies that has permission to perform ..- .......................... . plumbing in the buildings of../.v..'??.:r.................... . N at ......... North Andover, Mass. Fee. c;l v,. Lic. No. `?. 3 �.? .. .............................. PLUMBING INSPECTOR ti WHITE: Applicant CANARY: Building Dept. PINK: Treasurer — -• • — v,xar%-d ivv Mf r"L^oA4 d%jn rVA rr-nra/ 1 s u uv f Lu4v4urr+v IPrinl or Typal C k� e C NORTH ANDOVER, Mast. gate Z 17 Building Location Perml 3�2 Owner's Pl Name ",M- /ZlOexie, New O Renovation L Replacement O Pians Submitted: Yes ❑ No. ❑ / -- _ riXTUREg ...._. a /r x ; , Installing Company Name LI;e gt�/t-- Business Teleahone cSD 9 - , -? `ZI — /_ -:2 ? / Name of Licensed Plumber Check one: ��• ❑ Partnership ❑ Firm/Co. INSURANCE COVERAGE: Mecx one 1 have a current liability Insurance policy or Its substantial equtMenL Yes ❑ No ❑ If you have checked y", please Indicate the type coverage by checking the appropriate box A liability Insurance policy Other type of Indemnity ❑ Bond O CertMicate OWNER'S INSURANCE WAIVER: 1 am aware that the licenses does not have the Insurance coverage required by Chapter 142 0l the Masa. General Laws, and that my signature on this permit application waives this requirement. Check one: a uta at et Of Owner's Agent Owner ❑ Agent ❑ I haraby o.rufy that ah of the datala and Inlamatbn 1 have arbrt�ittad for antaradl h above applcation are trw and aocurata to the best of my Inov�Aedge and that allplumbing work and Installations performed under the p nnA Issued thla application will be In compflance with an partinen provisions of • Massachusetts State Plumbing Code and Chapter 142 of By Cy Title ora cttylTown ser Number 9.3zn? Type of Plumbing license: Master �— Aii' KMD (OFFICE USE ONLY) Journeyman 0 �rr.r.r�r.rr.rrrrrrrrrrrrrrrrr��i rrrrrr�r.rr.�rrrrrrrrrrrrrrrrri .. �rrrrrrrr�rrr�r����,r�rrrrrrll . F�rFanilrrrr OEM NONE rrrrrrrrrrrr .. ■rrrrrr�rrrrrr�rrrrrrrrrrrrr�. .. ■rrrrrr�rrrrrrr���rrrrr�rrrr; .. ■rrr�rrr�rrrrrrrrrrrrrrrrrrrr� .. ■rrrrrr�rrrrrr��rrrrrrrrrrrrr .. ■rrrrrr�rrrrr�rrrrrrrrrr_�rrr, .. ■rr�rtrrrrr�rrrsrrrrrrrrrrtrrrr Installing Company Name LI;e gt�/t-- Business Teleahone cSD 9 - , -? `ZI — /_ -:2 ? / Name of Licensed Plumber Check one: ��• ❑ Partnership ❑ Firm/Co. INSURANCE COVERAGE: Mecx one 1 have a current liability Insurance policy or Its substantial equtMenL Yes ❑ No ❑ If you have checked y", please Indicate the type coverage by checking the appropriate box A liability Insurance policy Other type of Indemnity ❑ Bond O CertMicate OWNER'S INSURANCE WAIVER: 1 am aware that the licenses does not have the Insurance coverage required by Chapter 142 0l the Masa. General Laws, and that my signature on this permit application waives this requirement. Check one: a uta at et Of Owner's Agent Owner ❑ Agent ❑ I haraby o.rufy that ah of the datala and Inlamatbn 1 have arbrt�ittad for antaradl h above applcation are trw and aocurata to the best of my Inov�Aedge and that allplumbing work and Installations performed under the p nnA Issued thla application will be In compflance with an partinen provisions of • Massachusetts State Plumbing Code and Chapter 142 of By Cy Title ora cttylTown ser Number 9.3zn? Type of Plumbing license: Master �— Aii' KMD (OFFICE USE ONLY) Journeyman 0 Date.4eO... �� 7' 32 :, 1 �;.:�•� :�tio TOWN OF NORTH ANDOVER 0 p PERMIT FOR PLUMBING cMusE� t This certifies that has permission to perform A-: R�*! L ...... ?t T.�!'�/ . plumbing in the buildings of ...l�%�-7(� NI5 l� iu�v�t1� at .Fl. `TAvt tv X19...... t ..... ,/North Andover, Mass. . `l,3..q.e { No. ............................. . PLUMBING INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer ¢4 d S K; M CU 0