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HomeMy WebLinkAboutBuilding Permit #653 - 48 BAY STATE ROAD 5/5/2008BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Date Received TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Z Commercial air, replacement Assessory Bldg Others: Demolition Other Se tic' Well floodplain We#lands 1N-aterstted �stnct UU,aterlSevver .w ,, � - e1r^^V r%.r1A1.1 r1r u/A15V TA QC 00C0r%DRfiCJ1• Y I.%P%01% 1 I IVI• v• •• • v yr • .�...• �.�...��. / S`Ly` I 00 P-1 ' t,&4 Inti �.o d f eyi af I hd a � � In P w h (k 4: TC t Identification Please Type or Print Clearly) OWNER: Name: U- os P o h L. e v[ Phone: !J 2 -(, dR 7 272,? Address: ���0 Pieccso hf sfreef Lo t+/1 1ndOVOr ........,�.....-.�:,., .� �":#.'. � ! *)` _ _. �� ! .,,n ._ � t'"... ,.__ � .. "ni,.._..r.. f,:I.".y rl r ,(�„"'i '7: "iG ✓�; ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ ! R, O 0 & FEE: $ oc to Check No.:�� Receipt No.:1 2 NOTE: Persons contracting with unregistere�,eontractors do not have access to the guaranty fuo Locationfu 7h No. Date �oR,M TOWN OF NORTH ANDOVER �• : ; Certificate of Occupancy $ cNosE<� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # —— 2 ( 3 Building Inspector Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private (septic tank, etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS DATE REJECTED DATE APPROVED CONSERVATION COMMENTS DATE REJECTED DATE APPROVED HEALTH CGMMENTS Zoning Board of Appeals: Variance, Petition No: Planning Board Decision: Comments ing Decision/receipt submitted yes Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit Located at 384 Osgood Street Located at:124 MaJ •:Street.: r 7-7 Frre�Department s�gnatureldate Y P Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA — (For department use) ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ .Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 �Tk --ear toad wzeiI04 Board of Building Regulati ns and Standards One Ashburton Place - Room 1301 Boston, Massachusetts 02108 Home Improvement',Contractor Registration i Registration: 103772 Type: Individual Expiration: 7/9/2008 JOSEPH G. LEVIS 1' `.: �• JOSEPH LEVIS 160 PLEASANT STREET =! ' NORTH ANDOVER, MA 01845 l�-i;: .' ----------__. DPS -CAI 0 5OM-05106-PC8490 �e-0.1ta�rtnoo�✓�r!aaia�uvella Doard of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registratlori:—) 03772 Exipiratloq` 74 j2008 �1• `T e: dividual JOSEPH G. LEVIS';: F;'•:�+=--_'�I' JOSEPH LEVIS l- ! 160 PLEASANT STREET,`;; NORTH ANDOVER, MA 01845 Deputy Administrator Update Address and return card. Mark reason for change. ❑ Address E] Renewal [] Employment ❑ Lost Card License or registration valid for individul use only before the expiration date. if found return to: Board of Building Regulations and Standards One Ashburton Place Rm 1301 Boston, Ma. 02108 Not valid w' ho gnahtre k�n�,, �e Caa�nmzaoxeuea�li o../C�ac%uaella Board of Building Regulatio a and Standards Construction Supervisor License License: CS 30651 Expiration: 1/7/2010 Tr# 11968 RestHgtion: do;" JOSEPH G LEVIS.'`. 160 PLEASANT ST N ANDOVER, MA 01845 Commissioner ACO CERTIFICATE OF LIABILIT1( INSURANCEQP Io s DATE(?AMIDWYYrn -RD, LEVIS-1 10/25/07 PRODUCER THIS CERTIFICATE IS ISSUE 13 AS A MATTER OF INFORMATION ' 02/27/07 02/27/08 ONLY AND CONFERS NO RI: WS UPON THE CERTIFICATE Michaud, Rowe And Ruseak Ins. HOLDER. THIS CERTIFICATI : DOES NOT AMEND, EXTEND OR 198 Massachusetts Ave ALTER THE COVERAGE AN ORDED BY. THE POLICIES BELOW, North Andover MA 01845 1f Ij 1PECIAL ?RCVaCW Phone: 978 688 8824 Fax: 918 557 2130 ---- -- INSURERS AFFORDING COVE RAGE NAIC # INSURED —� INSURER A: Preferred Hatua] Te: iLranoo Co- 1so2-4 _ _ INSURER E: Guard Insuran.:e Gro Levis CLInc. es s JOS eph Levis INSUREgC rm.c Safety Inst e Co as 33618 160 Pleasant Street Korth Andover MA 01845 INSURER D: INaJRER E; COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PE• ;IOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS : ERTIFICATE MAY BE tMSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXC) USIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN (REDUCED BY PAID CLAIM$, LTR IN NSR TYPE OF INSURANCE T POLICY NU618ER I 1341�Erl I PDATE MbLfOPRpTfON l LIMITS l OENERALLIAQUTY EA :H OCCURRENCE $ 1000000 A :FI COMa�C,A1GExc.Rr-A^LUAB!urY CPF010059°OB9 Z6 .TF.0 S'( KE. 'ure 10/26/07 I 10/26/08 pF :�7IBE5(Eaaauranee) CLAIMS MACE I -- I OCCUR .1$50000 MI 0 FXP Any one parson) 1 5 5000 _ Pi !SONALBACV INJURY IS 1000000 GI'IERAI-AsrREGA7= 152000000 GEN•! AGGREGATEUMTTAPOUESPS?, FI,)DUCTS-COMPIOPACG 153,000000 I POLCY I J I —i LOC - /1 ,U TOMOBtLE I.IABILDi C I i .APrALITG 1821254 I 'FeINEu SINGLE UNIT 01/01/07 01/01/08 eccld° � ` A,L CWNED AUTOS SCF.ECLLEO AUTOS a .OILY IS1J!RY I � (F rpen;on) j $500000 X ,,RED AUTOG -- —� B OILY INJURY !;5500000 IR X NCN1:W%a-iA.ITLIS I :r.cciOET:) I - I ' -CPET rY DAMAGE l $250000 0 N acc.den(j GARAGE LIABILITY I A 'TO ONLY- E.A Au. CEhT S ANY AUTO I C 'NET THAN EA ACC S 1 ;-C ONLY, ACG I S j I EXCESSIUMBRELLA UABIUTY 1 ICH CCCJ4,4ENCc I ` j L I OCCUR C'—A SMS MAJF I 1 I ;3REr-ATE I I IS __ DE7U�"'T•3LE 5 I R�74TION f I I5 WORKERS COMPENSATION AND I B I EMPLOYER6'LIAEILITY ANY izrROPRIEiCR MAR'^i`r'RlL �grtLMVE I LZWC903625 ' 02/27/07 02/27/08 i CFRCERAIEMBSR G:CLUCEG7 yam, descaba under 1f Ij 1PECIAL ?RCVaCW OTHER _LT09Y I.47 3 1 R l L. JiCHACC:DENT is 3.00000 L. cisEasE . EA ar=LovEJ s 100 00 0 L. DISEASE - POL:CY UNIT ', S 500 00 O DESCRIPTION OF OPERATIONS I LOCATIONS! VEHICLES I.EXCLUS10Ne ADDED BY ENDORSEMENT! pPECIAL PPM1540t4 Residential Construction and Remodeling, Offico Bldg Remndeling- CERTIFICATE HOLDER CANCELLATION NORTHI3 SHOULD ANY OF THE ABOVE DE5CRIE•1) MUCIES BE CANCELLER BEFORE THE EXPIRATION DATE THFREOF. THE ISSUiN01NSURE i WILL ENDEAVOR TO MAIL lO DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDEF NAMED TO THE LEFT, BUT FAILURE TO 00 SO SHALL Town of North Andover 384 Osgood street IMPOSE NO OBLIGATION OR LIABILITI IF ANY KIND UPON THE INSURER, ITS AGENTS OR 14orth Andover MA 01845 REPRESENTATIVES. AUTHOR - E.SENTATI ACORLI 25 (2441108) 0 ACORO CORPORATION � f p0'O� aro ;x S 0 0 a" LEVIS;COMPANIES INC u' ,, General Contracting �� Residential & Commercial" Pb Box 952 Lawrence, MA 01842w��;, ;levisco@verizon.net .. (978) 687=2783 OFFICE; s,�3 L (978) 687-3042 FAX PHONE DATE JOB NAME / LOCATION c (00 Plea sa C,116 d JOB NUMBER JJOBPHONE We hereby submit specifications and estimates for: Sr �� exp S� rao �o� S c f r25 a h"-.�=0 5 1� K 54 0 year rd U-_ S'd ���1�_s a n K ylee (�(Jc u Gc)VPray-o We Propose hereby to furnish material and labor/— complete in accordance with the above specifications, for the sum of: 114 ht� `P i9 Thu L Ey 0 C-,;;;, dollars ($ �� �% C10 0 ✓ ). Pavmentt6be made as follows: All material is guaranteed to be as specified. All work to be completed in a professional manner according to standard practices. Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado, and other necessary insurance. Our workers are fully covered by Worker's Compensation insurance. Acceptance Of Proposal—The above prices, specifications and con- ditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Date of Acceptance: t �O Authorized Signature N his proposal may bdf• withdrawn us if not accepted within ([Y days. Signature Signature PRODUCT 13128M USE WITH 771 ENVELOPE NESS To Reorder: 1-800-225-6380 or www.nebs.com PRINTED IN U.S.A. 8 ( The Commonwealth of Massachusetts Department of Industrial Accidents v Office of Investigations a 600 Washington Street Boston, MA 02111 www.mass.gov/dia ' Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): l,, V !S l /� a n7 do L Address: I (o O Plea So k L Sf- rip .0 4 City/State/Zip: fj<j r,+ nd c) u -p r Phone. #: cl' Z t (gds? J Are -you an employer? Check tate appropriate box: 1. YI am a employer with4• I E]I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. F -1I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub -contractors have working forme in any capacity, employees and have workers' [No workers' comp. insurance comp. insurance.$ required.] 5. ❑ We are a corporation and its 3. ❑ 1 am a homeowner doing all work officers have exercised their myself. [No workers' comp, right of exemption per MGL insurance required.] t c. 152, §1(4), and we have no employees, [No workers' insurance Type of project (required):. 6. ❑ New construction 7. [lemodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the subcontractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. l Insurance Company Name: _&:U4 U Policy # or Self -ins. Lic. #: L to w C G 3 G 2 Expiration Date: 7-- G�F_ Job Site Address: l6 �_ &L7 � M City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure, to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investit=_ations of the DIA for insurance coverage verification. I do hereby certify under the pains pe s of perjury that the information provided above is true and correct. Si ature: Date: Phone #: C/ 2 to % 2 7 8-' 3 not write in this area, to be completed by city or town official City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6'.. Other, Contact .Person• Phone #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter, 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to,opera'te�a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required.,, ' Additionally, MGL chapter 152, §25C(7) states'"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for. the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if " necessary, supply sub-contiactor(s) name(s), address(es) and phone number(s) along with their cerdficate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. w The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 1122-06 Fax # 617-727-7749 www.mass.gov/dia b y! w q PQ -v w° U z A as u tC b w c�° a com U w V X, w a W u , W a°' cn w p a rA `� w W w a w co ? cn Q v cn :c E CD N CD cm cc cm m 0 c c CD z O Z 0 g f R CZ J cl 0 U) ceW W W U) ri W C H � C V C-2 44.1 mmml - - nc !O tip m C . Q cc:o` CD ;mac 4. LUCD ►-o o, °,C Q n Q Co4w o m 40 u CD C :c E CD N CD cm cc cm m 0 c c CD z O Z 0 g f R CZ J cl 0 U) ceW W W U) 5996 Date.................................. 0 TOWN OF NORTH ANDOVER 0 1 , p PERMIT FOR WIRING SAC Thiscertifies that ....................14,. E..........5.................................................... has permission to perform ............ ................. wiring in the building of.7.....'....... 4n. C--�Vzs ............................................ at .............. 41 .;Pd....... .. North Andover, Mass. Fee ..53; ............. Lic. NOK.7 ELECTRICAL INSPECTQR Check # 34/9 DEPAR W NIOFFOBlKMFEIY BQARDOFFREPREvnynUIVRBGVLA1XV 527( m aim APPLICATTONFOR PERMITTO PERFORMELECIR AL1. WORK TO BE PERFORMED BV ACCORDANCEITH STS EL w" THE MASSACHUSECMXAL CODE, 527 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street tit Number) 4u B G•� �� Owner or Tenant Owner's Address H11 G file- Q S-044 Is this permit in conjunction with a building permit Purpose of Building Existing Service a 00 Ampsolts New Service Ampa_..L.V olts --e— "CV No. WORK b race sr — I l�_d To the Inspector of Wires: Yes [3 No [Zr(Check Appropriate Bax) Utility Authorization No. Overhead 03 -underground Q No. of Meters ¢' Overhead M Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Wort P -moi r No. of Lighting Outlets No. of Hat Tubi NO. of Transfamee Total KVA No. of Lighting Fi:cores Swimmins Pooh Above 171 BelowGenerators KVA smund and No. of Receptacle Outlets No. of OU Burners No. of Emergency Lighting Bawy Units No. of switch Outlet No. of On Boman FIRE ALARMS No. of Zona Me. of Ranges No. of Air Cad. Total Tom No. of Deteclim and No. of Dispoais No. of Hat Total Total Pump Tom KW Initlauog Devices No. of Sounding Devices No. of Dishwasher Space Arm Heating KW No. of SW Conu rwd i Derecuonl3onnding Devices Local Municipal Other No. of Dryers Nesting Devices Kw a Connections No. of Water Hester KW Na d No. of slow silsais No. Hydro Massage Tuba No. of Motor Total HP its =veComV. A>aBtblhera�ana�aflrl�dl�seOGaaelLatYB Ihmaab%snxeFbkitdini$t7-n ai6At6hM VdW YE NO Itt=wbnirledv&ys3affafs3W1D e0 = M >f)ouhaepima•iraicaleQteWofwmvby B#mdan]DAM F dValredEhcBoca Whk s wadcuSM —� R,,,* aw Sigteduds Fhm*scfpgjq.. FittMNAlv1E T G L e vi c e L=-1 '-c 4 r c w _ LiatseNn tUoeretrr„ i1 1_ ✓ c (1. r U=eNo AM% —y2,4-6 7,4 7e ON TOUSM)RANMWAM341amawat dudzLi uwdmmt binaugnoeaaea�ar sub�n6de4ivala�tasae9iiadbyMessadaseeaGalaalF a stddArrW9gta wend k1XU1[appicatlatwam ism (Please check one) Owner � Agent Telephone No, PERMIT FEE S r ratsfrsx1MW,rur rvnwmpWy !t tPftTydtNo. D0FFREPRFV0RBG11A vsM7C&tny hFees Checked --nn� APPLICATION FOR PE &ff To PERFORM ELECTRICAL WORK ALL WORK TO BE PFRPORMED IN ACCORDANCE WrrH TM MASSACHUSSTS M.FCIRICAL CODE, S27 CMR 12:0 *)LEASE PRINT IN INK OR TYPE ALL INFORMATION) 527 0- U Town of North Andover To the Inspector of wirpe- The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) a U J; P,,-. , , C' -4 - Owner or Tenant Owner's Address I (" 0 01'e- a s - c;, Is this permit in conjunction with a building permit:(} Purpose of Building lS t "alp Existing Service el 0 C) Amps / Volta New Service Amps /� Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets I No. of Hot i No. of Ughdng Rivas iRi L� No. C/ V 1 YeS U No (Check Appropriate Boa) � � Utility Authorization No. Overhead [�ndergtound No. of Meters Overhead 0 Underground No. of Meters �� Bony ^� Tota Tone FIRE ALARMS No. of Detecdon sod. taidatiag Devices No. of Sounding Devic, No. of Self coumbW Detecdg Lard D � Hest Total T" Pun" Toro Kw Ares Heating Kw Devices Key Nn nI Conneetioro KVA Units No. of Zones ED ItardneCove� 8188tbtle=�cfMeaaedaa�C;a�llesvi Ihmeacu mtLWAkyhmzm?c yincuftcmt*—IE or�stlx:xlfYequiv YES IW%e& nifledvardpiwfofsametohO1ike M iflvuhmediad�d NO dmddrtgdte Mpkmhk tthlNedwmWby � BUM[:] O a WadcbsW —� >n orlDtreRec}rsbd Eftn*dV"dEbMWWadcs i Sigredurdt P =kksdpajtalc PrW FgiMNAME e ter) Li=No. A y 7 / Lioanoe_ tl �7 S f'.6J ' 1 c l C C grow Llcauem �� (G Gi lee, -;�'C, rLt S tIM- �� &tt iea TdNa �t r v v AXTdNa _�l Z-1'4� L Z} 77 F.�V^IFRSII�A1RAl�.EWA1VIIi,IamawaethattheI����ffi Mawsyn onmpmritsppic�tw®iretislegcimtes ear � br 1�IsOalsalLaws (Please check one) Owner Agent Signature o Telephone No,PERMIT FEE i a i S&CkoC- PU� 4 110 Date .. f%- aw- � ... . V 3�0`..ao ,• a OL TOWN OF NORTH ANDOVER ; o PERMIT FOR GAS INSTALLAT,IR This certifies that r.... l c...c ... ... - Y. � .... . has permission for gas instillation � ..... ?.. . in the buildings of ...... !............. at '?f .LS " :r`.... { ..4 �• �• � . .. , North,Andover, Mass. ~'� Fee �!/; ..... Lic. No.. . . 111Y .. eT ........... GASISOE Check # 5776 NIASSACHUSE"ITS UVIFORM APPLICATON FOR PERM TO DO GAS FUUNG (Type or print) NORTH ANDOVER, MASSACHUSETTS Date /O - a C-0 -6 Building Locations ` V !r ! 17 — Rj Permit# J'9110 tj�f®L� lu Amount $ t1 1 0 Owner's Name New Renovation ❑ Replacement ❑ Plans Submitted (Print or type) ffy / Che � one: Certificate Installing Company Name - i /i� iJilyo. Corp. Address B 00 Li � Partner. Business Telephoneq P& 5- Firm/Co. Name of Licensed Plumber or Gas Fitter s�9 l G /L X40 INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 0 No 0 If you have checked Les, please indicate the type coverage by checking the appropriate box. Liability insurance policy M Other type of indemnity 13 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 13 Agent 13 -j111-1 -11-1 ,.,.0 nuvu uv a uuvc JUUIIIIttcu kor entereu) In anove application are true and accurate to the hest of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all purtinent provisions of the Massachusetoto Qjs-Code and Chapter 142 of the General Laws. By: Title. City/Town 1,\PPROVED (OFFICE GSE ONLY) Signature of Licensed Plumber Or Gas Fitter E] Plumber l 36 ?y Gas Fitter trtenSC umber Master Journeyman 2ND. FLOOR 7TH. FL41OR (Print or type) ffy / Che � one: Certificate Installing Company Name - i /i� iJilyo. Corp. Address B 00 Li � Partner. Business Telephoneq P& 5- Firm/Co. Name of Licensed Plumber or Gas Fitter s�9 l G /L X40 INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 0 No 0 If you have checked Les, please indicate the type coverage by checking the appropriate box. Liability insurance policy M Other type of indemnity 13 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 13 Agent 13 -j111-1 -11-1 ,.,.0 nuvu uv a uuvc JUUIIIIttcu kor entereu) In anove application are true and accurate to the hest of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all purtinent provisions of the Massachusetoto Qjs-Code and Chapter 142 of the General Laws. By: Title. City/Town 1,\PPROVED (OFFICE GSE ONLY) Signature of Licensed Plumber Or Gas Fitter E] Plumber l 36 ?y Gas Fitter trtenSC umber Master Journeyman Date. oT . 01 ... TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBINGZ SSACMUS� his certifies that f, ..!"..`�` `� v ..`...... . as permission to perform ....... plumbing in the buildings of ................... at .. .... ..... . , North Andover, Mass. Fee ... Lic. No.,. . ............... (/ PLUMBING INSPECTOR Check it 7162 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, pMASSACHUSETTS � r �(�D �1�;�9/C� Owners Name / Date l0'�6'�C Building Location � � L?°y� Permit # 71 � `y Amount Type of Occupancy A New 1 Renovation ❑ Replacement ❑ Plans Submitted Yes ❑ No ❑ FIXTURES (Print or type) Installing Con r Address SI 1 � (/ R/Z/7c/ to" L��Check on l7 X `) 06 6 ❑ Partner. aa 06Y, Y L2g Firm/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 ❑ Bond ❑ Certificate 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 Massach=IC"s lumbi g Code and Chapter 142 of the General Laws. By:Signaum er Type of Plumbing License Title 9 y City/Town License Murnuer Master rg Journeyman ❑ APPROVED (OFFICE USE ONLY TOWN OF NORTH ANDOVER PERMIT FOR WIRING 0 CHU . ...................... ................................ This certifies that .... ........... has permission to performb ...... .............. wiring in the building of... .............................................................. .......... . North Andover, Mass. at .................. .................... ......... Lic. No..... ................ LEc-rRIf.A.L INSPECIbRte- Check # 1. 7032 Ilk .p J sr Commonwealth of Massachusetts Official Use only Permit No. r% 3oZ' Department of Fire Services Occupancy and Fee Checked,�J y BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/051 ocave 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: 11 _ Z -Q C City or Town of: k h(,aU - L 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) (`�o V Sf cj�p P a U✓ Owner or Tenant �� Q Mario yr A! P v G �' Telephone No. K7p&,P7d7�3 Owner's Address ( LQ su 4 ¢ St- YV tit d U u, Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 9 Vo t o p r L) -4Z41_0 "' - wot Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd ❑ t v p n .e w Gas No. of Meters No. of Meters _ aFvh Iter Completion o the following table may be waived bv the Inspector of Wires No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑In- ❑ rnd. rnd. o. o mergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS 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 g No. of Waste Disposers Heat Pump Totals: Number Tons No. o Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water KW Heaters o. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP TelecommunicationsWiring: No. of Devices or Equivalent OTHER: ry C/ Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: j - Z _U,6 Ins pec ions to be requested in accordance with MEC Rule 10, and upon completion. 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:) 1 certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: -J Cr L -e ucS IP r r CC/ LIC. NO.: %} y ? f Licensee: 3&&e 4,11 (,- L..e vC Signature LIC. NO.: (t(applicable, enter exempt" in the license number line.) n Bus. Tel. No.: !f %Lof%.J -7 C Address: ('N Alt. Tel. No.: *Security System Contractor License required for this work; if applicable, enter the license number here: 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: $ 'Zo e' SignatureturaTelephone No.