HomeMy WebLinkAboutMiscellaneous - 1790 Salem Streetl�
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N°
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that .. ... ....... ... .!................... .
has permission to perform ..................
C�.
plumbing in the buildings of .. ...-.....!............... .
at ..� !:'... ..............:�� ...... ,North Andover, Mass.
Feer51...... Lic. No n: 1.' .... .....
# `7 � f ' PLUMBING INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Print or Type)
yG Mass. Date Jam' 0'�—!3b
Permitr#_ .
Building Location - 79D Owner's Name �FT7�/ /4s -e"d1c�
-'
Type of Occupancy
I'3
New O Renovation.❑ Replacement Ej',
FEATURES
Plan ubmitted Yes ❑ No 9-
Installing Company Naam�e/Jl /),'fJ%-L 0-00 j/ ,--;i rZala yye 0,07Check one: Certificate
Address 1-_� S� J"'✓C .� � C{�j� /'U S'
ElCorporation
S/ -/Q vet tJ _ 112762 91?,6 �� ❑ Partnership
BUb'Iness Telephone ! / � ^�� �� —/8 QQ
1
Nan#e of Licensed Plumber 1 -✓L /T�/ ( l7'Q� ����
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch 142.
Yes a-' No ❑
If you have checked yes, please indicate the type of coverage by checking the appropriate box.
A liability insurance policy Lam— Other type of indemnity 1-1 Bond
OWNERS INSURANCE WAIVER: l 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:
Sionature of Owner or Owner's Anent Owner ❑ Agent ❑
,a,o�y %--lly nine nu - trio ueians ana intormation 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 the permit Issued for this application will
be in compliance with all pertinent provisions of the Massachusett
By �' tate Plumbing Code and Chapter 142 of the General Laws.
Title
Clty/Town
APPROVED OFFICE USE ONLY)
Type of License: Mas tgr f3� Journeyman ❑
License Number -��/o a 19
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SUB-BSMT.
BASEMENT
1ST FLOOR. .
2ND FLOOR
3RD FLOOR
4TH FLOOR
5TH FLOOR
6TH FLOOR
TTH FLOOR
8TH FLOOR
Installing Company Naam�e/Jl /),'fJ%-L 0-00 j/ ,--;i rZala yye 0,07Check one: Certificate
Address 1-_� S� J"'✓C .� � C{�j� /'U S'
ElCorporation
S/ -/Q vet tJ _ 112762 91?,6 �� ❑ Partnership
BUb'Iness Telephone ! / � ^�� �� —/8 QQ
1
Nan#e of Licensed Plumber 1 -✓L /T�/ ( l7'Q� ����
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch 142.
Yes a-' No ❑
If you have checked yes, please indicate the type of coverage by checking the appropriate box.
A liability insurance policy Lam— Other type of indemnity 1-1 Bond
OWNERS INSURANCE WAIVER: l 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:
Sionature of Owner or Owner's Anent Owner ❑ Agent ❑
,a,o�y %--lly nine nu - trio ueians ana intormation 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 the permit Issued for this application will
be in compliance with all pertinent provisions of the Massachusett
By �' tate Plumbing Code and Chapter 142 of the General Laws.
Title
Clty/Town
APPROVED OFFICE USE ONLY)
Type of License: Mas tgr f3� Journeyman ❑
License Number -��/o a 19
P,
N2 2338
0
Date ........
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ...... .... ....................................................
has permission to perform ..... ................. .............................
wiring in the building of...--..'� '- -r
.........................................................................
at ...... ........... North Andover, Mass.
Fee,<.? .... ........ Lic. No�ff l...../ ................................
ELECTRICAL INSPECTOR
Check #
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
Y -
` The Commonu)ealth of Massachusetts °"`�",,"`•,�
Dcpartmcnt of PubliC Safety r"•`` `° �,(���
BOARD OF FIRE PREVENTION REGULA71ONs :'.27 CMR 12fl03/90 Oc.."—y 46 r.• a..ea.. _
ci.... ar...a)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
AL work to bt Performed Jn accordance virh rhe M""chuseru Eicurlcal Code; $27 CMR -,12;00 .
' (PLEASE PitI21T .IH I21K OK 1iPE
IO ._Date 3 ��
_... .. _ City or Tovu ofp,it/JDN=.P
To the Inspector of Kress
The undersized applies for a permit to perform the electrical work described below,
Location (Strset b Number) /%9`Q
Owner or Tenant
Owner's Address Si�1Y1E
Is this permit in conjunction with a building permits Yes
NO (Clieck,Ap'propriate Boz)
Purpose of Building
Utility Authorization N0.
Existing Service Asps / Volts Overhead Undgtd ❑ No. of peters
NewSerKce❑
Amps / Volts Overhead Undgrd ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
No, of Lighting Outlets Ho, of Hot TubsTo
No. of Iransformers o ol
Ha. of Lighting Fixtures Swimming Pool Above In-
❑ ❑
Kv
rnd. gTnd.
" No. of Receptacle Outlets No..of
Generators _ KVA
Oil Burners
No, of Emergency Ligbtinb
No. of Switch Outlets
BatterY Units
No, of Gas Burner*
FIRE ALARMS No, of Zones
No. of Ranges No. of Air Cond. Total
Nip. of Detection and
tons
No. of Disposals No. of Heats Total Total
Initiating Devices
- Tons KW
No. of Sounding Devices
No. of Dishwashers Space/Area Heating Xw
No. of Selg Contained
No. of Dryers
Detection Sounding Devices
Heating Devices XW
Local ❑ Municipal
mer
No. of Nater Heaters lei No, of o. or
Si
Connection❑
Low Voltage
s Ballasts
Wtrin
No. Hydro Massage Tubs No. of Motors Total HP
UIiD:R:
INSURANCE COVERAGE,Pursuant to the requirements of Hassachusetts General Laws
ti I have a current Lia t1r Insurance Policy including
equivalent. TEST Z have submitted valid g Completed Operations
If
Coverage or its substantial
broof of y to
you have checked YES, please indicate the type of
o NO
this cappropriaate.box.
coverage checking
INSURANCE 7 BOND ❑ oTYEEt ❑
the
(Please Specify)
-
Estimated Value of Electrical Work S ��j"Qp
piration at
Work to Start Inspection Data Requested: Rough Fiscal ,
Signed 4LAer the Penalties of perjur,:
FIRM NAME
LIC. NOZ �
Licensee Signature
Address —" !!OA& . NO.
6 /!76 Bus. Tel. No.
OWNUI S INSURANCY WAI i Z an aware that the Licansee does not have chs insurance coverage or ca su -
stantlal equivalent as required by Massachusetts Caneral wsi� and that my signature on this permit
application waives this requirement. Owner Agent
(?lass* check one)
Signa cure of Amer or Agent Telephone No. PSRHI% FEE S