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HomeMy WebLinkAboutElectrical, Plumbing and Gas Permit - Permits #4933, 6246,5497 - 60 WENTWORTH AVENUE 11/8/2004 �'` (..O»srnesetcvaa�i-a�✓�� t1, �,1 F� a Only For Office Us y (Rev.11199 sjoar c irvoc ! PermitaNumberOccu � BOARD OF FIRE PREVENTION REWLATIONS p ney&lug Fee ' AEPLICATTON FOR E TOPBE—ORM ELECTRICAL"WORK (ALL WORK To HE PERPO WnEi THE MASSACHUS=M ELECTRICAL CODE 527 CMtt 12:00) NPC7RMATION Gate: PLEASE PRINT IN INK OR TYPE ALL t -2 s f ty By this o lication the undersigned notice of his or h / m To the Inspector of Wires: Y pp g g his—or--her intention to perform the electrical work described below, f � Location Street&Number) Owner or Tenant; 'Al Owner's Address; Is this permit in conjunction with a Building Permit? Yes a °ww o.,.ro (Check Appropriate Box) Purpose of Building, � r .-_ � rP 9:;a ����� „�' ��, Utility Authoriza�tian�:� r � �' Existing Service; Amps l_ _ Volts Overhead M Underground.0 #of Meters New Service ����"�: Am �" � � � ��°�" �� � Volts Overhead ©p - y Underground. #of Meters: Number of Feeders and Ampacity: Location and Nature of Proposed Electrical Work: '. � �� ��'" - .�-•- ��4� - No,of Recessed Fixtures b° No.of Ceil,-Susp.(Paddle)Fans No, of Transformers Total KVA No,Of Lighting Outlets No, of Hot Tubs Generators KVA No. of Lighting Fixtures ' f ' Swimming Pool: Above ground ❑ In Ground ❑ #of Emergency Lighting Battery Units No,of Receptacle Gullets No. of Oil Burners Fire Alarms #of Zones #of Detection&Initiating Devices No.of Switches d No.of Gas BurnersJr„ #of Sounding Devices: #of Self Contained ,—" No,of Ranges No. of Air Condlbcners TOTAL.TONS DetectioNSounding Devices 'k Local❑- Municipal Connection o Other ❑ Na, of Waste Disposals Heat Pump Totals: Security Systems: Number, TONS: KW: No.of Devices or Equivalent No.of Dishwashers, c Space/Area Heating: KW Data wiring,No.of Devices or Equivalent: No.of Dryers Heating Appliances KW Telecommunications wiring:No of Devices or Equivalent; No. of Water Heaters KW No. of Signs:_#-of Ballasts: OTHER; #of Hydro Massage Tubs No, of Motors_ �P Total HP 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"corn pleted operation'coverage or its substantial equl valent The undersigned certifies that such coverage is In farce,and has exhibited proof of same to the permit Issuingoffice. CHECK ONE: INSURANCE rb BOND ❑ OTHER D Please specify: Estimated Value of Electrical Work$ (When required by municipal policy) Work to Start:__✓ I certify, Inspections to be requested In accordance with MEC Rule 10 and pa under the pains and penalties o f perjury,that the Information an this application Is true and complete. 0 n completion, f _- Firm Firm Name: �✓f� � r Licensee. Signature: r r LIG. M s r ,: if applicable,enter ears t in the license nrlrnfier line) Address. Bus Te l..#� �',� .� �,�. � � ._"_ :�. �,..- � G✓" rM T 9 r F ; �„:::41t,Tel.# 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❑ OR Agent 0 Signature of Owner/Agent: Telephone# PERMIT FEE:5 y) r� r i r r r r i Date 0O TAI0 TOWN OF NORTH ANDOVER , r PERMIT I CH S s certifies that .............. JA permission to perform ........,, .,,......,�.. i ng in the building of ........................ • . North Andover, Mass. ... ................ Li . No. ............. ELE. c C** C°co ..... .......... i i i F ASSAC 4.TSETTS UNIFOR APPLICATION FOR PERMIT IT" TO DO PLUMBIP (Type or print) NORTH AND OVER,MASSACHUSBTTSDate �� .� Building Location C7wnrs Name }fermis# , — Amount Type of fOccu ancw�i � New Renovation Repl'4cenent ® Plans Submitted Yes lido -----FIXTURES Cr Cn 3MF"= 4M FL" 71H FLOOR gm Rpm (Print or type) Cheek one: Certificate Installing Company Name r I Corp. Address fit° U Partner. � uslness e eP one e "Firrn/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the,,type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity U Bond E 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 ,igna ure OwnerLi Agent Li 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 M each etts Sta h g Code and C ter 142 of the General Laws. By: agna ure ol Licenseuum er `Ty e of Plumbing License Title `,, City/Town License um er Master �' Journeyman El APPROVED(o>~EtCE USE 0Nt,Y 1 / i I/ ff l j %f � r N 0 , ;°� •14 , 0 ToWly o le � o98US % his c rtirle s tha t 4 IS Permission 10Perform / in the buildings o i 1 „ Andover, -.k # NOASpECTOR PLUMirl i i f 1 r J ate . . . . . . . . . . 0 'TOWN OF NORT PERMIT FOR ,,r2l'AS INSTALLATION i d SA,C H L115 its certifies that �� . ro,.,� '. � . . . � . . . . . , . . . . . i . . , ,. LS permission for gas installation the buildings o , . . . . . . . . . . . . . . . r. North Andover, Mass. . . . . . . a Lic. No.. !�'. � . . .e. ,. . . . . . . . . ws 65P" IC4? �i heck# i `o i i