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HomeMy WebLinkAboutMiscellaneous - 101 ELMCREST ROAD 4/30/2018N O I O � O r O n o m o � o p North Andover Board of Assessors Public Access O� 4O oTH 9 0,00 i 9'Ou ,ew 'ti w.r.o .r•�`S0 9SSACHUSES Click Seal To Retum Search for Parcels Search for Sales Summary Residence Detached Structure Condo Commercial Page 1 of 1 s1roperty Record Card Location: 101- 103 ELMCREST ROAD Owner Name: ZHONG, XIAOYING QI, SU Owner Address: 101 ELMCREST ROAD City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 5 - 5 Land Area: 0.33 acres Use Code: 104 -TWO -FAM -RES Total Finished Area: 2388 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 413,800 384,900 Building Value: 244,700 210,800 Land Value: 169,100 174,100 Market Land Value: 169,100 Chapter Land Value: http://csc-ma.us/PROPAPP/display.do?linkld=2255005&town=NandoverPubAcc 9/17/2013 rnv 00 (14 N M M u O r �ox(1) coN M a) m U C UU am@ a N a) C O w C�wU M O N LL a� Q O H ~ '0 L- N maw 3 V Of�co m H�cn J w M 00 N O a U) p ° (J) 0 cow 0cam U ll� mdU °Q Z a) Of J c O D LU mU cr Q 0 Q noG.}x as f� U Q-= . . 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QN Qo Z oo Z co Z Q O N N .LL Z 04 Q Q CO) V 0 o r � m m /. �� " �� f - I'll N 4) �U) Z 0� 4 U (1) _M It 00 Op It M W Ln O w 13 4) m m O c 0 F- m ^� O Z =3a U M - o co ti 00 M � I N N N r Q3� -.. >x'c i i Q C V '0 m L.:.L 0\o V m v y Q'CLL m O �_ �_ w'.� N U 0`0 O N Q m LL m Q' ,2 (n U Q'.Q R Z co o v Ln . co 00 0o w v v m O N N �e0-Q� O e H (L d� oe N co ai Lit c �,a) _ +Q)L\L x N i d N O C Q.0 Q,C .Cr •O C m W ` m m 00 o0 Z C LC C tL .0 :0.i O W _ _ C M a-0 C O' a)�fD O U o U �Z)QZ' W1 C7Upfo LnZ04 tY N � `O F- .� - Q QCA ci fn : X M LL u X x cr 0E ws ��'1M� a03v I u 0 M MiEQ CD CD co 0mmmL`cY' \ (� i mLL=Win w mmQ f—F.I vI nNi o !Ln.z w a U. M UMP z z Cc aye' Q SO d M >M Ui � c° ~ �-'a W 0 cncnQ'W�LL LL LL 4- 0 N CD cu CL 10227 : Date ... A. -.Z:.' v!> TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that .......... �..R.................. ......... .............................. has permission to perform ... a... H. ek . .....�.. .......`.... ....'. S plumbing in the buildings of ...5..0o%K 7.....'T3 .... s ............................................. at ....�'..1.... !!�'! c �(t�¢;�t ................. Fee .0 Q-- 4. Lic. No. .Q3 Check # 76w ....../........... ............:f,. North Andover, Mass. UMBING INSPECTOR �P ******'* .... - -- .... *'***'**'**'**"*"**' N IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY L, 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE BOX ONLY: OWNER ❑ AGENT ❑ nature of Owner or Owner's I hereby certify that all of the details and information I have submitted (or entered) regarding this 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 provision of the Massachusetts State Plumbing Code and Chapter 42 of he General Laws. PLUMBERNAME STEPREP C- GAL-INS10 SIGNATURE i LIC # 103 y S MP Rr JP ❑ CORPORATION X# -319 to PARTNERSHIP ❑ # v LLC ❑ # COMPANY NAME &Al-1J3SKY PL0M0i►Jb 4- RVAT+O ADDRESS: P.0• GGX 1701 CITY h1AVERI+ILL STATE m•A- ZIP 01131 EMAIL VVyyw. mrplumbe� � Govt TEL Ofi- 371-17+t 3 CELL 0S - 509 - SgDiI FAX a7$- :Sal - N 131 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK POWNER TYPE OR C PEARLY RINT CITY rV (" A4-044.MA. DATE N Q - 2-3 ^ClS PERMIT # I JOBSITE ADDRESS _ 101 OWNER'S NAME SGo N l_ �� S ADDRESS TEL FAX OCCUPANCY TYPE: COMMERCIAL ❑ EDUCATIONAL ❑ RESIDENTIAL �] NEW. ❑ RENOVATION: Q REPLACEMENT: El PLANS SUBMITTED: YES ❑ NO El FIXTURES Z FLOOR-- BSMT 1 1 2 1 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYS DEDICATED GAS/OIL/SAND SYS DEDICATED GREASE SYS DEDICATD GRAY WATER SYS DEDICATED WATER RECYCLE SYS DRINKING FOUNTAIN DISHWASHER FOOD DISPOSER FLOOR / AREA DRAIN INTERCEPTOR (INTERIOR) KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SERVICE I MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES Z, WATER PIPING OTHER INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which, meets the requirements of MGL Ch. 142. Yes RN- ❑ IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY L, 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE BOX ONLY: OWNER ❑ AGENT ❑ nature of Owner or Owner's I hereby certify that all of the details and information I have submitted (or entered) regarding this 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 provision of the Massachusetts State Plumbing Code and Chapter 42 of he General Laws. PLUMBERNAME STEPREP C- GAL-INS10 SIGNATURE i LIC # 103 y S MP Rr JP ❑ CORPORATION X# -319 to PARTNERSHIP ❑ # v LLC ❑ # COMPANY NAME &Al-1J3SKY PL0M0i►Jb 4- RVAT+O ADDRESS: P.0• GGX 1701 CITY h1AVERI+ILL STATE m•A- ZIP 01131 EMAIL VVyyw. mrplumbe� � Govt TEL Ofi- 371-17+t 3 CELL 0S - 509 - SgDiI FAX a7$- :Sal - N 131 7� O c x r C z n z 0 z z 0 a r m m — - D � Y Y N ~ h � �* o -71 c � o GO ❑CD fn O z r I h t7. a 0 z z 0 a ts1 Date... . �........Z.3 ` k.3........ .................. TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that .....�5............................................... has permission for gas installation .....52.... ................................... in the buildings of ......`�.t o �' Fa 1 ��i �,-c,�,, ............................................................................................... at .... D..... L-1�� �s.1:..........................................- , Nortlf Andover, Mass. Fee .._.4.Gv.... Lic. No. 403.x: P �G S INSPECTOR Check # hereby certify that all of the details and information I have submitted (or entered) regarding this 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 willin compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUM BER/GAS FITTER NAME: STEPHEN C. GALIN5KY LICENSE# 103q' SIGNATU COMPANYNAME: GAI_4S:5K'1 PLQMAlr,96 -+ IIC-4f-W& ADDRESS: P.Q. Nox 1701 CITY: 0 AV E7PZH I L,L, STATE: m • A • ZIP: 01231 FAX: 1979 - 5,11— 21131 TEL: 979- 274- 17y3 1 CELL: 5'Vq — Sofj- 5gog1 EMAIL: MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK Lo1 ,M TYPE OR PRINT CLEARLY CITY: MA. DATE: PERMIT # 1 JOBSITE ADDRESS: �� L�G'V� C- OWNER'S NAME:.G OWNER ADDRESS: TEL: FAX: OCCUPANCY TYPE: COMMERCIAL ❑ EDUCATIONAL ❑ RESIDENTIAL 7� NEW: ❑ RENOVATION: REPLACEMENT: ❑ PLANS SUBMITTED: YES ❑ NO ❑ APPLIANCESZ FLOOR- 3 4 5 6 7 8 9 10 11 12 13 14 jBsmtJ12 BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCK MAKEUP AIR UNIT OVEN POOL HEATER ROOM / SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER ' WATER HEATER INSURANCE COVERAGE 1 have a current iiabili insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box below. LIABILITY INSURANCE POLICY 9 OTHER TYPE INDEMNITY ❑ BOND ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ❑ AGENT ❑ SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information I have submitted (or entered) regarding this 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 willin compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUM BER/GAS FITTER NAME: STEPHEN C. GALIN5KY LICENSE# 103q' SIGNATU COMPANYNAME: GAI_4S:5K'1 PLQMAlr,96 -+ IIC-4f-W& ADDRESS: P.Q. Nox 1701 CITY: 0 AV E7PZH I L,L, STATE: m • A • ZIP: 01231 FAX: 1979 - 5,11— 21131 TEL: 979- 274- 17y3 1 CELL: 5'Vq — Sofj- 5gog1 EMAIL: W VVw'. Mrp f U in beff Lo1 ,M MASTER 12� JOURNEYMAN ❑ LP INSTALLER CORPORATION # ❑ � -3 I (it. PARTNERSHIP ❑ # LLC ❑ O C O x c� a b n H O z z 0 H h m m m N 0 � D O r U h z m o m th -o L41' •� C m > � m � o � z ❑ `° p z r ❑ a ►C , ® a r b v✓ n H O z z o H Location /0/ r Ii'_G TI f 1t y No. 231 Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ TOTAL �5S 983. $ CW -5 crL wilding Inspector Div. Public Works on Permit Fee rmit Fee We $ $ S • oil Sewer Connection Fee $ Water Connection Fee $ �•�_ TOTAL �5S 983. $ CW -5 crL wilding Inspector Div. 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TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING Thiscertifies that.. ................. . I ...................................................... has permission to perform ......:?...I.......... ................................. oo ................. wiring in the building of ... ........................................... at ..... 1Z).1 ....... North, Andover, Mass. Fee (;�.............. Lic. No.............. ....... s— .................... .. ....................... ELECTRICAL I Sp. =R Check # 4--52 WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Office Use Only The Commonwealth of Massachusetts Department of Public Safety Permit :70. Occupancy 6 Fee Checked BOARD OF FIRE PREVENTION REGULATIONS S27 CMR 1200 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELEGTRICAL WORK All work to be performed In accordance with the Massachusetts Electrical Code. S27 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INF RHATION) Date City or Town of �i�(�� �Ao To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) \ Q \ C -k (yx c Owner or Tenant on,cl, C(3 Owner's Address S `A (VQ Is this permit in conjunction with a building permit: Yes ❑ Nola (Check Appropriate Box) Purpose of Building �A Utility Authorization NO. Existing Service Amps / Volts Overhead Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work \t, 2 Q nt ` S `1�l.' H,n.ii-vv ai�l A.0 \�_ :� 7 ;l(\ No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total INA No. of Lighting Fixtures Swimming Pool Above In-. grnd. 1:1 grnd❑ Generators INA No. of Receptacle Outlets p No. of Oil Burners No. of Emergency Lighting Battery Units No. of.Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Initiating Devices of Sounding Devices No. of Self Contained Detection/Sounding Devices Local E] Municipal ❑ Other Connection No. of Ranges No. of Air Cond. Total tons No. of Disposals eat No. of Pumps Total Total Tons KWNo. No. of Dishwashers Space/Area Heating KW No. of Dryers Heating Devices KW No. of Water Heaters KW No, nof Ballasts No. of -Sig Low WirVoltage ng No. Hydro Massage Tubs No. of Motors Total OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES 0- NO ❑ I have submitted valid proof of same to this office. YES— NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropr ate box. INSURANCE & BOND ❑ OTHER ❑ (Please Specify) Exviration Date Estimated Value o/ Electrical Work S Work to Start Z5 O Inspection Date Requested: Rough Signed under the penalties of perjury: FIRM NAME ��.� �ti�c�p (_ a, h 1 R(-) License Final �Ln`b 7 LIC. NO. 19 Y P 1 h� t / 'n l t LIC. NO. Address_ "I ��Z�'� i� Dili! �ly �IL� %s. Tel. No. 7KI-1 i2 3' uS� Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE S Signature of Owner or Agent z 0 Q U_ J CL CL Q J Q U_ F- U W J W 0 W F- W Z "J Q a � � (, Z I U F- O0 � W -1 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance -with the provisions of M.G.L. c. 143, § 3L, the Permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed on the prescribed form. Ager a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166, § 32, an • `, electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L. c. 143, § 3L. - Permits shall -be limited as to the time of.ongoing construction activity, and may 7)e_deemed_bytheJnspector--of-Wares abandoned_and_invalid-.iflre—.. _ or she has determined that the authorized work has not commenced or has not progressed during the preceding 12 -month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or.the installing entity stated on the permit application. The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of vv " the Acts of 2012. The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effect or existence" during the qualifying period beginning on August 15, 2008 and extending1hrough August 15, 2012. 12 Rule 8—Permit/Date Closed: �Z—f ***No : Reapply for new penq� ermitExtension Act — Permit/Date Closed: l�—�� YL, Date.... � .-1 _ 0.7..... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that t �'r L . ........................................................................ has permission to perform ............. .. ....%........ f�.yr`r............................... wiring in the building of ........ J�.�..... �K.�............................................ C:L✓�'1 CSJ at..,....1..0..�.......................r.�.�. .............................. ,North Andover, Mass. Fee .......... Lic. No.;�.(.!`T�:........................................... :... ELECTRICAL INSPECTOR Check # T 7423 Commonwealth of Massachusetts Official Use OnlyJ Department of Fire Services Permit Na 72V F^r� Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank) F. 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: 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) /o/ %-i C2 eST Owner or Tenant SU Q 1" Telephone No. Owner's Address /o / Is this permit in conjunction with a building permit? Yes ❑ No dD (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion of the following table may be waived by 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- F1o. rnd. rnd. o Emergency 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 i 1Z No. of Air Cond. f Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number I " ' Tons KW No. of 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 No. o No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of N"ires. Estimated Value of EI ctrical Work: ��/ 0 © (When required by municipal policy.) � Work to Start: 4 Inspections 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 EJ BOND ❑ OTHER ❑ (Specify:) I certify, under the ams and penalties of perjury, that the information on this application is true and complete. FIRM NAME: oFo!f ez,T C�,�,., / LIC. NO.: Zu CZ 372 Licensee: X 6 —,,,, y— Signature z� �� LIC. NO.: 2 a 6 Z f/C (If applicable enter "exempt" in the license number line.) Bus. Tel. No.:6o3—�'/T— 2� 70 Address: ;0O• QvX 33� /ilcc✓��f/✓�`(/%>< /tl, 03o 2/ Alt. Tel. No.:6o3—S'62-s� ' *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, 1 hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent PERMIT FEE. $ Signature Telephone No. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street t Boston, MA 02111 s� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): fly/j e� GPwA-G 1 Address: 1 6. & � 3 3 City/State/Zip: Nu✓kSur1zV II1A coo V Phone # e03_F71� —2?7o Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. 1 am a sole proprietor or partner- listed on the attached sheet. + ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.0 Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13.[Z Other /�, G, *Any applicant that checks box #I 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. ♦Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Poticy # or Self -ins. Lic. #: Expiration Date: Job Site Address: 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 Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and and correct. x S/-' Sinature:/� Date: Phone #: G 63 — P 7� — Z F_ Tb <f"-- `� -S_e� Z — f .T' Z 7 Official use only. Do 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 #: Date J _ . 2 . `.' N° 4 5 ? 6 NORTM TOWN OF NORTH ANDOVER 00 - PERMIT FOR PLUMBING ,'ISAcmusE This certifies that C14 J. U...�'.�. !f ............. . has permission to perform ...ee . «'..". ! ............. . plumbing in the buildings of .................. at ...� !1. 1. �`.� �� .� `................. . , North Andover, Mass. Fee ...Lic. No..: t . .. ..... .. �.. !>:�. ,V........... PLUMBING INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION (Print or Tye) 3 SUB-BSMT. BASEMENT 1S1STFLOOR �— 22 HO FLOOR �— 3RD FLOOR 4TH.FLOOR STSTHFLOOR .�_ 6TH FLOOR 7TH -FLOOR STH FLOOR Installing Company Nam4 Address Business Telephon +J Name of Licensed Plumber Renovation ❑ Q W N cc F W to F- A S < Q* cc 3: c a 3 S a Z S `_2 0 a Replacement FDCTURES Z a Z Y o z U < !- � = W Z ~ N Z D < i a }' Y Z d v c p f' a < z1= O < F- J m J W < a Plans Submitted: Check one: Corporation ❑ Partnership ❑ han/Co. aN 12 Certificate INSURANCE COVERAGE: I have a current liability insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you have checked Yes, please indicate the type coverage by checking the appropriate box A liability Insurance polity Other type of lndemnrty ❑ Sand ❑ 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 ❑ Signature of Owner or Owners Agent I hereby certify that all of the details and information 1 have submitted (or wdered) in above application are true and accurate to the best of mya knowledge and that all pluinbing work and installations performed under the permit iss:ned for this ap I I be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and 142 of 'S Signature of licensed Plumber Title Type of License: Maste0< Journeyman, n License # O tv/Town - N 2 2 3 9 Date ........J...A.d/ w. NORTH TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �7SgAC11USEi This certifies that �� �y% � C� �' C``tr r F S ..................................... .................. .................. has permission to perform ........ 5....�. v/}.`..� .......................... wiring in the building of ...... t(.�......('.if w. .................................... .......[ �...:............... . North Andover+Mass. /7 Fee ..... 3 � d.. Lic. No.l.../..X4.......: Q� �.. ;. .............. // ELECTRICAiINSPEGTOR C � ✓ t x v// WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 77EOOA %IONWE4LTHOFMMSSA(2RS= Office Use only DEPARTMENT OFPUBLICSAFEI'Y Permit No. BOARD 0FMEPREYE0ONRD9JlAT1011NV701R 12-* UV4 Occupancy &Fees Checked PPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 L i}�,� (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 3 �� Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street J Owner or Tenant Owner's Address To the Inspector of Wires: Is this permit in conjunction with a building permit: Yes 0 No ED (Check Appropriate Box) Purpose of Building yf Utility Aute tion Existing Service Amps�iVolts Overhead r7q-LTderground 1:3 No. of Meters New Service Amps / Volts Overhead Underground No. of Meters Number of Feeders and Am aci P tY � �l %Z(-X7�' /51,7?s k,,ocation and Nature of Proposed Electrical Work L=4 No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA A No. of Lighting Fixtures Swimming Pool Above Below Generators KVA ground and No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps ' Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices LocalMunicipal Other No. of Dryers Heating Devices KW Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP lnsuar=Co�eage Pt><suatmlhetecltmarratsafMassad>t Gat®Iiaws Ihaveammrt iabtlityhmm=PcbcyedufiigCanpide Co&apergssi statiale*uvalat YES M NO M Iha%e%bmadvalidpoof0fsarnebthe0ffi= YES F1 NO r7 lfj uhatedaiwdYES,PI mm&*theNxofcotmeagebydakrtgthe ExpizatimDaie Esti i*dVahred DeNi al Wait $ Wo&tt)sut 3— hgxxfimDaieFxWe oed Fz* FrW Signed trrdam Rvaltim cf n FIRM NAME A LioawNa- Lioensee sigr. — IiMrWNo BramTd.No.— AM, NT)VA) AIIR-Iln 10'L #14 42;L" AkTeLNa t� �-7�`2l S OWNER'S MURANCEWAIVER;IarnzweredittheLioense themmaxeomeaForissibombale*u%ekrtasra medbyMamdxsmGm=Staws aodthatmysig�><emtt>spa�app�onwai�esthist�tmerrat< (Please check one) Owner a Agent Telephone No. PERMIT FEE $ ��/ r