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HomeMy WebLinkAboutMiscellaneous - 240 Holt RoadQ t7 N° 3 1 6 Q Date........ �I TOWN OF NORTH ANDOVER PERMIT FOR WIRING � � L This certifies that .........0?. �,.,. ,, tj ? a.� tl u.........�.. ..�.' ...� �..`................. has permission to perform ....�' wiring in the building of ........�- .....1 _ %T.� ? ��<Ji� �... ........................ at .......(Aorth Ando r,�IVlasS. c�v .:..... Lic. Now ..1. ). Fee.v./ .................. �._«,................................... Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. / ?ic) lug BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/99] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7/6/01 City or Town of: North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) Lawrence Municipal Airport, North Andover, MA Owner or Tenant Michael Arcidi Telephone No. 978 556-5858 Owner's Address 25 Railroad Square, Haverhill, MA 01830 Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate Box) Purpose of Building Commercial/Aircraft Hanger Utility Authorization No. 102353 Existing Service Amps Volts Overhead ❑ Undgrd ❑ No. of Meters New Service 200 Amps 120/240 Volts; Overhead ❑ Undgrd ® No. of Meters 1 Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Lawrence Municipal Airport Installation of primary single phase feeder to transformer on airport property, installation of 200A single phase service r Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ rnd. In- ❑ rnd. o. o cy ig mg Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS I No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump I .... ...... Number Tons **** ­ * KW * ........... No. of Self -Contained Totals: I Detection/Alerting Devices No. of Dishwashers S ace/Area Heating KW p g Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or E uivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. 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 the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) On File 10/15/2001 (Expiration Date) Estimated Value of Electrical Work: When required by municipal policy.) Work to Start: 7/2001 Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Youneblood Electric Co.. Inc. LIC. NO.: MR785 Licensee: Neil Miller Signatu LIC. NO.: 34103 (If applicable, enter "exempt" in the license number line) Bus. Tel. No.: 978 372-5885 Address: 32 Ashland Street, Haverhill, MA 01830 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 PERMIT FEE. $250.00 Signature Telephone No. 0 6 e oiayS Date. . / //. .G /..G ....... !3�pii..ao ,see pL TOWN OF NORTH ANDOVER FO P a . PERMIT FOR GAS I TALLATION SACHUS h This certifies that ...� s .f i. Z. F.. f ...........:........... . has permission for gas installation .... I n. p in the buildings of ................. at ..� �� ;' ..,��.� .'..../.2 ..r. �% , North Andover, Mass. Fee. . ! >.. l . Lic. No. 3,) . Y.. .. G S INSPECTOR Check # 5820 MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Locations L wN V fob Date //_ 20-0 r/o 2 `YF hT 7- /�� /vyr'Permit # p -z0 �yX�' Amount $ Owner's Name 7Wysr sCa7- New El Renovation ❑ Replacement ❑ Plans Submitted ❑ (Print or type) r Check one: Certificate Installing Company .S Name DS 7 P aTj(l--- ❑ Corp. Address r s7 ❑ Partner. 774 077= iness a ep one cj 3 - �,� icy ® Firm/Co. Bus Name of Licensed Plumber or Gas Fitter :3o-5,el-14 -Du7 INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes No 13 If you have checked ves, please indicate the type coverage by checking the appropriate box. Liability insurance policy a 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: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certity 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 Massachusetts State�WCode and Chapter 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) ignature of 1 ElPlumber ❑ Gas Fitter E9Master ❑ Journeyman s z z a a 0 a c4 U w z 04 off, O Ca w C7 F 7 F Z F F azl C5 a0 > W Fw W d w d >- n m Z O z O Z a x o' 3 a U a> o a 4 0 SU B-BASEM ENT B A S E M E N T 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7T H. F L O O R 8 T H. F L O O R (Print or type) r Check one: Certificate Installing Company .S Name DS 7 P aTj(l--- ❑ Corp. Address r s7 ❑ Partner. 774 077= iness a ep one cj 3 - �,� icy ® Firm/Co. Bus Name of Licensed Plumber or Gas Fitter :3o-5,el-14 -Du7 INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes No 13 If you have checked ves, please indicate the type coverage by checking the appropriate box. Liability insurance policy a 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: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certity 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 Massachusetts State�WCode and Chapter 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) ignature of 1 ElPlumber ❑ Gas Fitter E9Master ❑ Journeyman sed Plumber Or Gas Fitter (cense Number