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HomeMy WebLinkAboutMiscellaneous - 102 MEADOWOOD ROAD 4/30/2018�c �/ Date ........................................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies thaA T....... .R ............................................................................................................. has permission to perform ....... ........... yx wiring in the building of.... /...r?. ers..C,.�, .................................................... -rth ndover, Mass. at Fee Lic. No. 2 .......... ................... ELECTRICAL INSPECTOR Check # 12584-1 ��-Z 2 ckt, 04- 0. -Form { Official Use �ly, CommonweI a&ofaacleo Permit No.Apadrnto/- ire Seruice6 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev -1/07] 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 I1V INK OR qPE ALL INFORMATION Date: City or Town of: NOTtIS ffnJ O'712 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) 10Z l7Qt..10a j� l2� Owner or Tenant ` 01LI p 1 f eQIJ lei 1-11L— Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes a No Q (Check Appropriate Box) f 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 Natur"f Pro orl Electrical Work: W SLS L iG,,, PV SyS '1 Completion of thefollowing 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- El o. o mergency Lighting rnd. rnd. 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 anl— Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pumpumber Tons _.._.._........__. KW _...-.-...._....__. No. of Self -Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑�, Connection No. of Dryers Heating Appliances KW ecurity Systems:* No. of Devices or Equivalent No. of Water KW No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or E uivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications icing No. of Devices or E uivalent OTHER: Attach additional detail if desired, or as required by the Inspector of 6i7ires. Estimated Value of Electrical Work: -43900- (When required by municipal policy.) Work to Start: 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 ❑✓ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties ofperjury, that the information on tleis a lication is true and complete FIRM NAME: SolarRair Energy, Inc. J LIC. NO.: 16209A Licensee: Jeff Constantine SignatureaaA LIC. NO.: (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.,• 508-293-4293 Address: 190 Pleasant St., Ashland, MA 01721 Alt. Tel. No.: 508-400-6805 *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. 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. 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APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEP6 MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR C DAT FILED ` SIG ATURE OF OWINEN OR AUTHORIZED AG iF' E E -tom . ()8 PERMIT GRANTED -19 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST, �//� - 00 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY OWNER TEL. # CONTR. TEL. N CONTR. LIC. # H.I.C. # I LOT NO.� `s 2 RECORD OF OWNERSHIP IDATE BOOK ;PAGE ZONE SUB DIV. LOT NO. — LOCATION 1 O Z rA PURPOSE OF BUILDING AAct t)c--w Sun„ S IC is 'X I I--' OWNER'S NAME NO. OF STORIES SIZE OWNER'S ADDRESS����©�����, lC BASEMENT OR SLAB ARCHITECT'S NAME -- SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME \ _ IV��csVv�w SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES — SIDES REAR " " GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION �P /' ^�_ 1/ 5o MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE .�J I—� j G•. IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEP6 MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR C DAT FILED ` SIG ATURE OF OWINEN OR AUTHORIZED AG iF' E E -tom . ()8 PERMIT GRANTED -19 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST, �//� - 00 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY OWNER TEL. # CONTR. TEL. N CONTR. LIC. # H.I.C. # BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES MULTI. FAMILY OFFICES APARTMENTS _ _ CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH d 1 2 13 PINE CONCRETE CONCRETE BL'K. BRICK OR STONE HARDW D _ PIERS PLASTER DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ 1/1 1/2 '/, FIN. ATTIC AREA _ N_O 8 M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS DROP SIDING WOOD SHINGLES B _ 1 2 3 _ _ CONCRETE EARTH ASPHALT SIDING ASBESTOS SIDING VERT. SIDING _ HARDVJ'D COMMCN ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME _ BRICK ON MASONRY BRICK ON FRAME ATTIC STRS. & FLOOR _ CONC. OR CINDER BILK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR I� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE GAMBRELMANSARD I 11 HIP BATH 13 FIX.) TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING _ RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd_ ELECTRIC to 13rd NO HEATING r THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. L4 cr CN . .--4 N W) W t me O :oma � •W J o H , •� � Z :,loci v C7 tt oCIS :p O CO 5 W n- v� O y c O CMp z u.l ca m <i G c •�LU y `o m 0 y O O U) w U •� mm z co CD ri CL. �S m • L 75 y m 3 Ocm �' O o.3 � wN/0 0 m zipO �V V L CLCc CC2 CLL 4-1 CD E m 1-`i . U E y C o -w o C/) cc Q =moo Ilt t � m o = •o ►-� C3 1= C* � O J ti ca ZZco_ cva H o V V ca t t_ cc o �1 C CX W C w�� �"• CD W Cc CIO IRA W= cj CM C.3 m n• o F-' F a o.o o g Q Z, W 1� W W O W w Z a O V � C7 C v CG cn a C-0 � v W W o Q o a isa, 0 ° v ° ° E w° U w ° c�° ii u: V") w rs: w m cn cn me O :oma � •W J o H , •� � Z :,loci v C7 tt oCIS :p O CO 5 W n- v� O y c O CMp z u.l ca m <i G c •�LU y `o m 0 y O O U) w U •� mm z co CD ri CL. �S m • L 75 y m 3 Ocm �' O o.3 � wN/0 0 m zipO �V V L CLCc CC2 CLL 4-1 CD E m 1-`i . U E y C o -w o C/) cc Q =moo Ilt t � m o = •o ►-� C3 1= C* � O J ti ca ZZco_ cva H o V V ca t t_ cc o �1 C CX W C w�� �"• CD W Cc CIO IRA W= cj CM C.3 m n• o F-' F a o.o o g Q Z, W 1� se pr�nt; Town of North Andover BUILDING DEPARTMENT Homeowner License Exemption Stre-er- Address \a: -E Hc,, -,IE "one r SEc�ien 01 tc•.:n 6 a sod'— 6s �00 rl0r r"GnC- _ a,. State ZC fCr tthcmE�',dnEers t was e` tE^.de^_ �0 1nC'_L•C Owi e- OL S"`C un'S or less and to allo suc^ hGiIEC'.�nE_" t� for h -re wno d.oes not posses a License . pro% -c== ac_S as su;erviso_. (State Bui'd_nS Lode. SECt_on 77 v.. owns a parcel of Land on which 'IE/Slie Or- `�E or is intended to be. a one to s- --ac- is i c - d struc..ures acce..soUs- r, �eC 0L CIEtaC:iE r;. to Si:C:� --S who construC=s In more than One c-ne in a t''; •c._ - :t - be considered a nOmeowner. SuC:z homie .JI"iEr nae_.., -- Y=_` bra plca!, on a form accaDLaD1E to the BuLd_n_ -•- _ - _ s de re�ronsibiE "o_ all suc'n �c_.._ 0Erior Ec u:;c__ ec rtt as -- -_ o `'Er 'n _C.._ 't c _ t a.. L-1 E,' _%_ 1n - _G �E Gr ( -- 0_ LG____ r--_ . ;.. � rx6.t.� „c � .;.. � .i.+ .:t � a � a 4 E Y ;�. '��' g .''• k1r f _. —wV_�_. „-. .. E.oScwcvT i - [a 0 ^OP �� moa D S �S/EPEBY �E.�T/fY TO T.�E T/T�' /.t/SrirD.�,v.VO 7?7 TivE B.a.vr T.s�gT r,�E' oa-E�ci.�ec n toc�.erE-v ov TiS�E GDT AS S.SbAr.V ANO T.4G47-17-OACr GGu/FGtp�f l l,rll YW-- ts...�' 0�.�/O.A.V4aK--4 Z&W1,VG ..CE6!/GAT,t�t/S -fW"-,CP/.W JETd.ICi!'S FXO.t/ .STREC'T•S f fOT e,'.vE,S S FG,�T1YGt tE.e'TifY T.tGITT't'�,S OA"E"/,v6 LOGOTd'O /A.0 T.s�E FEGtE'.PAG FiCAC/O �%o�EO �14EA. Syew,v ew Fc 2S009g 4010 B JEFFREY /N /v4. �iNOQV�.e/ to i lr s . O,PAsYiV FO.P /� �,E•9GOe✓c�p /cEACTy �-O.eio • __ / �r 4d � w _ >y cW Bor/.vo v eY j�yicp.P�f TA,�/flfP.f/rll.4Gt' E. f/6ft el 6 7,SE.Pi�/lES AT/O�f/ `ES/ F.�.H EX/JT/�f/G V �1.4.SS.4CAO: E1?.5�-� 7/1 Ila 5'7 Top View' Outdoor Plan 17'3 34'2 6'9 4'7 Tt'• �1A06WL Lower Deck Height from Ground is: 20" F APPaAX �u v-ILI 6 Location %�� �1 No. i .5 Date pt NOR7h"TOWN OF NORTH ANDOVER t•o .,h0 3? � • O L � F . p Certificate of Occupancy $ " Building/Frame Permit Fee $ Hca S- - . _ . Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ VulfConnection Fee $ TOTAL $ 862, UU Building Inspector 6118 � i A �� l� � Div. Public Works cation / Od 'Z6e��-u.� .1 No. 13, Date TOWN OF NORTH ANDOVER p Certificate of Occupancy $ L-0, U 0 Building/Frame Permit Fee $ '---� Foundation Permit Fee ) Other Permit Fee Sewer Connection Fee �Q w �ater Connection Fee �. � TOTAL $ O. v C Building Inspector TO 6047 Div. Public Works Location No. Date //— 3 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ �63 Sewer Connection Fee $ so 4' W-2water Connection Fee $ TOTAL $ 0?0 640 #0/j Div. Public L OTs i 4.40. PAGE 1 APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE .P LOT N O. 2 RECORD OF OWNERSHIP (DATE BOOK 'PAGE ZONE SUB DIV. LOT NO. LOCATION % -� l PURPOSE OF BUILDING %r7 OWNER'S NAME NO. OF STORIES E OWNER'S ADDRESS - ,b (� -BASEMENT OR SLAB ARCHITECT'S NAME% t C SIZE OF FLOOR TIMBERS 1ST 2x /O2'NCD/ ///� 3RD / L� BUILDER'S NAME '7 SPAN DISTANCE TO NEAREST BUILDING & / DIMENSIONS OF SILLS DISTANCE FROM STREET /J/1 / POSTS l/L_ DISTANCE FROM LOT LINES - SIDES �/ REAR I GIRDERS ✓ /� AREA OF LOT 2 FRONTAGE_ t751 HEIGHT OF FOUNDATION 5%� THICKNESS O IS BUILDING NEW SIZE OF FOOTING /` X .IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION - IS BUILDINGSOLID -. FILLED LAND IS BUILDING CONNECTED TO TOWN WATER WILL BUILDING CONFORM TO REQUIREMENTS OF CODE BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINk �4, INSTRUCTIONS SEE BOTH SIDES I = pats fm � PAGE 1 FILL OUT SECTIONS 1y= 3 FMZ) PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING�i ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED_ g /-3 PERMIT GRANTED d. �r /,e / %7S-/�Z C'orrir LSC GzI232_9 ._� i -1 1!! 3 PROPERTY INFORMATION LAND COST _ �J�j/ (J/IOD EST. BLDG. COST , EST. BLDG. COST PER SQ. FT EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN OVIWImw imwr616TVR BUILDING RECORD 1 ;OCCUPANCY 12 SINGLE FAMILY I_X I STORIES MULTI. FAMILY--- I_.OFFICES APARTMENTS CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH. CONCRETE 3 1 2 CONCRETE BL'K. PINE BRICK OR STONE HARDW D PIERS PLASTER_ DRY WALL I-6NFIN 3 BASEkNi,'�,\ AREA FULL Pl , B M T 'AREA'�, 1/1 1/2 FIN. ATTIC AREA NO BMT FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS FLOORS CLAPBOARDS Vihj I B 1 X 2 3 DROP SIDING WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING VERT. SIDING CONCRETE EARTH 14TRDW D COMIACN ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY; j BRICK ON FRAME, ATTIC STRS. & FLOOR CONC. OR CINDErBLK. WIRING STONE OWt4ASQNRY% STONE ON FAAME"- SUPERIOR I I POOR I NONE ADEQUATE I X' HE 10 PLUMBING BATH 13 FIX.) 5 ROOF GABLE I HIP GAMBREL l MANSARD TOILET RM. 12 FIX.) FLAT SHED WATER CLOSET ASPHALT SHINGLES X LAVATORY WOOD SHINGES_ KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM STEEL BMS. & COLS. HOT W T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS S OIL B*M'T 2nd ELECTRIC 3rd NO HEATING THIS SECTION MUST SHOW EXACTDIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS.' WITH PORCHES. GA- RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CD O 0c) �dv+�CDAT/O.V �6Gq T/OA! EASe'in�.VT- ' r VF f66)' CECT/FY TO Tye T/TGE /,t/S!/.PO.P ANO 717 7/WE BR.V.r r44 7* /S LOCATED O.v ,r+'e GCT .9S 7A,1vT lr .0arS cO,vFae.,f lY/T/! T6/E4VFNO.A.V4VK--4 20N/.vG .te64lZ,4rAV-VS ,4E6M4�P0/.✓G SETBA0rX --SOW STrPEET,S :-F" LOT ONES. 0 I FU.rTyC.e' CECT/FY T.yi4T TifUS O�t►EGL/N6 /S.t/OT LOG4TE0 /.S/ T.YE FEOE.PAL FLO�OO HAZ.4.P0 A.PE.4. Sryew,v O/V Ff .yuv/TY P-*.�/GG "r q�ZH a` .h 2SU0 98 GYM/O B y14, /-�'� hn� DATED 6�5�83 JEFFREY s� i RL or /N ��..9,voclvE•t'� /l.9ss. O,PAir,V FO.P . /7%E.9oo�oQO /CEgG7\/ �.G� /99,3 N P! : S GATE U,�FSS`��l 7?//S PGA S.yh(� GE' P!/,o�SES - tioT FD.P �E.��/��� ��G/�EE.P/•(/6 SE.PI�/CES Bovvo.Py �- /ov_ 8ouvO.oeY ,4r/o v ri4.rE.y �,Po t� Exrsr�.vc .eEco,Pos. 66 10,4.Pir J7-e.-E7- A.VOOI�E�C, ifJ.4SS,4C.f///SETTS O/8/O k k 0 W. fA rb te 0 0C4 u 0 E u 0 F-4 u z A C-0 "a C: U m x 0 E-4 u z z it 0 H u w u E-4 C2 > Vu) 0 0 —cz �-q 6 6 z V w 1-w C/) 0 E V) �s SS C -i cci 4z) iWgb� ts .2 C2 C.1) a C7 CL cc uiu i C-3 s CD CL Nw g ll�v N E = -0 —CD v�y�o� � o 0 C.2 C3 t; cm low CD 3: 0 Cf) N co 44i Bo CA 0 3 1 . ftCD CA E - it Nk- CD 0 CM 0-4 Cl) CO) CD CD = C 'M to 4%. C�4 CO = cc �u C.3 0 0 CIO Z ID CD CL S CA 0,x- ui K= 3: C) LLJ .- 0 N tan 0 cc 0=3 'm LL. MD 16 cc 0 UQ . CL= -.— Z = *- E U g rY LLI CD 0'D tm L3 CA CD ca -C.O.Lo) C) cc 'o L-= = @.. CL..*... CCI CD 0 E CD Z 0 ca 0 Ag E co co O co Q m CL CO2 O O CO) O O CL CO2 r�l C co >% Co 0CL 0. cm< Cc O CO Z ts co O. CA LL - cc LU CL cc 7. 2 LU cc LU cj) ;7 :> 0 cmcc C.) Lj- U- CD FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section******�*y******�*/*** APPLICANT: PeOd Jl c / /�t°cr . / r Phone—? 75 7 �� LOCATION: Assessor's Map Number Parcel SubdivisionL,C�D(.c��'J��Y Lot(s) StreetP_C(�.�� LF,D�/l St. Number ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Date Approved Conservation Administrator Date Rejected Comments lj�� Rr Date Approved Town Planner Date Rejected Comments 'J " Date Approved ��=1 Hea th Agent Date Rejected Comments Public Works - sewer/water connections driveway permit Fire Department Received by Building Inspector "' "I .DING DElaA i IMEN-T ; Date �i 10 CERTIFICATE OF USE & OCCUPANCY Town of North Andover 11 Building Permit Number 135 Date .JULY 15, 1993 THIS CERTIFIES THAT THE BUILDING LOCATED ON 102 MEADOWOOD RD. (LOT #16) MAY BE OCCUPIED AS SINGLE FAMILY DWELLING W/0NE CAR 9W* ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. �NOR71{ CERTIFICATE ISSUED TO Meadowood Realty Corp. 04 733 Turnpike St. - #209 ADDRESS Nnrth Andover. MA sAcmus Bui ding Inspector E z O z cv CC2,m .opo . C i 2 �1 ca C.) CL %70 `O C LL. oh Ea C � W � `. CD O a o m V :w000� m E L y r.+ CD Onco y C 44 C ea Co C10 3 �y m 2.v � m y m ; cm cs •o %0S 0 aS m V C3cc •�Z O. C O` C C d m N O C •C = m �m=CD p N CL rte+ y m CA) W � r•+ � L HE C3 C.3 •y O.Z O C Z C+' O•y O LU V .m p m� C CO2 CO2= O L. o.� m O KR WA A�� �\ �� Ci) x is co °° co a o O v O .G C U w C n\ G q w J) w" pw 1:4cn V)cn z O z cv CC2,m .opo . C i 2 �1 ca C.) CL %70 `O C LL. oh Ea C � W � `. CD O a o m V :w000� m E L y r.+ CD Onco y C 44 C ea Co C10 3 �y m 2.v � m y m ; cm cs •o %0S 0 aS m V C3cc •�Z O. C O` C C d m N O C •C = m �m=CD p N CL rte+ y m CA) W � r•+ � L HE C3 C.3 •y O.Z O C Z C+' O•y O LU V .m p m� C CO2 CO2= O L. o.� m O KR co � z E LL ~ L LU a_ Z v. ca Z cc Z C co cm_ Q w ca c L E CD CO m Z W > i C C-) im No CD L o- n CM< o = s o = ca v� CJ J� z .CL O J LL c Z co z n `..' y Li cc C •� r Lu �J C- F -- CO) V) Z z � � J w W Ci- U) • � Date...t. ...... of NORDT e TOWN OF NORTH ANDOVER PgRFOR GAS INSTALLATION This certifies that ...../ ...............': has permission for gas installation . ........... . in the buildings of ........:� 1':`! ...:' �.......... . at ...... :.............. r.i......... , North Andover, Mass. Fee. ! =... Lic. No....f._-�. X .. .......................... L GAS INSPECTOR WHITE: Applicant CANARY: Building Ddpt. PINK: Treasurer GOLD: File MASIACHUSETTS UNIFORM APPLICATION FOR PERMIT TO 00 GASFIT•TING (Print or Type) NORTH ANDOVER Mass. Date building Location /-/�' - 1qe,d(,wo-,J QJ_ Perm Ow ers. Name ��" • :f New '7 Renovation D Replacement Plans Submitted c C> (Print or Type)�¢ Installing Company Name o/ v�� �`9 eo Address Business Telephone: des-Y3'Y3 Name of Licensed Plumber or Gas Fitter Check ne: Certificate orp. c"'-5^ I Partner. D Firm/Co. Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 26ther type of indemnity Q Bond Insurance Waiver: 1, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner 0 Agent El 1 hereby certify, that aU 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 stl plumbing .cork and Installations perfomted under' Permit issaed for this applieathoo will -be In complhanoa with allttnen provisions of the Massachusetts State Gas Code and tluptet 142 of the Genual Lws. / City/Town: Y APPROVED (OFFICE USE ONLY) PE LICENSE: ) lumber asfitter Signature of Licensed. (Master Plumber or Gasfitter Journeyman ? 9 License tdtunber Y • REINER � .. ... �������������t���■«inn■ .. ■EMMMEMEMEMMEN FEE 0n1111011110111111 NEMESES sommmossummossono • . • i■»���������������tI����if■ (Print or Type)�¢ Installing Company Name o/ v�� �`9 eo Address Business Telephone: des-Y3'Y3 Name of Licensed Plumber or Gas Fitter Check ne: Certificate orp. c"'-5^ I Partner. D Firm/Co. Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 26ther type of indemnity Q Bond Insurance Waiver: 1, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner 0 Agent El 1 hereby certify, that aU 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 stl plumbing .cork and Installations perfomted under' Permit issaed for this applieathoo will -be In complhanoa with allttnen provisions of the Massachusetts State Gas Code and tluptet 142 of the Genual Lws. / City/Town: Y APPROVED (OFFICE USE ONLY) PE LICENSE: ) lumber asfitter Signature of Licensed. (Master Plumber or Gasfitter Journeyman ? 9 License tdtunber