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HomeMy WebLinkAboutMiscellaneous - 1029 JOHNSON STREET 4/30/2018 (2)�l w c� u� O w i v cn o w z a G o p w O aG x U G w w a p c� G w a a w p r� c� G w a 0 aGO d O w G u. z w a w w w 7 as z cn o Cl) umi CD F. ` C Q O m c = o � a C L O N A VO V •dam b0 CLc ea ev II = o o � CD A N � :EQ � • L c O � 0 • V Cf) y0� y � .rte o m U �cm `J � m c N R c` m • L L O ` S Z' 3 N (` m m m 2: .`,-, N /0 `. N •CD E m 0 CLC. L C. w c L CL O O �Z L H = m H m C H m : m_„ O N O a0+ r0+ .y �O. A c '� ca, N 60i O) ca O' CIO O O m = A CD L H C=c CD F. ` O = a A b0 II z� � O � • V Cf) � U co O co O v Z O CL O H D O W cm caI O 0 � H O O 'E m m co CD w CD 0 cc o a a- cm< c c c Cc Cc Pa J .fl O C Z CD V Ns O C CL C cc is W O LLI N 19W W w U) r 3'-10" i 7'-10" TITLE EASEMENT CONSTRUCTION PLAN DWG ��ROJECT FEDERICO RESIDENCE, 1029 JOHNSON STREET, NORTH ANDOVER, MA. Al L __ SCALE 3/16"=1'-O" DRAWN BY DATE 4-28-08 REF. zm� m Z O � azo Z p D .z A y Nc>p 0.2 C> \�'D C- Z >4 � O A 0 0 N Z m �mC70 Z C7 - S z p z m Z ;A 7 D m C Z O Z 18'-0" 3'-10" 7'-10" U I � o W rA Z = p CD X m Z G o N _ xm �Om ED Ay Z A y = mLnO z Q m z O co o m m O 0 0 O o o A � j r m Lr) D co O Z Z = O* m0 A A Dm NCL m W Z S `c I A-10 O � N -i O c) ~ O ApN A o N i � D O r Z N N v - � c D Z N N Z Z A N O m A C7 - m m - Z - _ O W m n o m� o z z o 0 3 No Cb m~ CD A D D o +»� o o co A S on rA-I o N Ln O A O N CD m m � O o �A A 3 -i 9,—o" i g'—o", rt1 I I 90 a O J m o Z x m m Z � N � O I Z mpr W A `zn D OOm OD -1 SrZi Z g Z Z� mrr Z.ZO7� OZN D� t -*'1 DDm?m_ F:= CD D A J Z O n N Z m N O m z m n N D m A = A A D Z C p O Z D Z Z m p vA � Am -ni �,�m C7 S mn ➢ AN � zo C D O O Z Q z -- > Og oO r R° ANrZi � A � 00p z � CD O co C-) 3->, m N m D NUI -i O N n c> m N A 0 I"Tl m o0 Z O 0 Q O O D . p O D NOC7 S Z= fN X N �W C O m A A m O CO N m O A O ovm O x OMNI m O Z zZG� TITLE UPPER LEVEL CONSTRUCTION PLAN I" f O Z X PROJECT FEDERICO RESIDENCE, 1029 JOHNSON STREET, NORTH ANDOVER, MA. A2 T SCALE 3/16"=1 '-0" I DRAWN BY S Z O REF: O O A D A W m OO m A z O Z O O ACD O = Z m m N a ` ➢ N O I W v 0 0 i � O AI O Z O : m O O Z m O n A O A 2 I O A Z O � N m ➢ A _A O ➢ D r AAA m o Z x m m Z � N � O I Z mpr W A `zn D OOm OD -1 SrZi Z g Z Z� mrr Z.ZO7� OZN D� t -*'1 DDm?m_ F:= CD D A J Z O n N Z m N O m z m n N D m A = A A D Z C p O Z D Z Z m p vA � Am -ni �,�m C7 S mn ➢ AN � zo C D O O Z Q z -- > Og oO r R° ANrZi � A � 00p z � CD O co C-) 3->, m N m D NUI -i O N n c> m N A 0 I"Tl m o0 Z O 0 Q O O D . p O D NOC7 S Z= fN X N �W C O m A A m O CO N m O A O ovm O x OMNI m O Z zZG� mg O TITLE UPPER LEVEL CONSTRUCTION PLAN I" f O Z X PROJECT FEDERICO RESIDENCE, 1029 JOHNSON STREET, NORTH ANDOVER, MA. A2 T SCALE 3/16"=1 '-0" I DRAWN BY S Z O REF: O O A D A W m OO m Z O O ACD O = Z m m N a G z m O A m AI O Z O : m O O z (D W � N m ➢ _A O ➢ D r AAA )S mg O TITLE UPPER LEVEL CONSTRUCTION PLAN DWG PROJECT FEDERICO RESIDENCE, 1029 JOHNSON STREET, NORTH ANDOVER, MA. A2 SCALE 3/16"=1 '-0" I DRAWN BY DATE 4-21-08 REF: 11 Y 0 TITLE ROOF PLAN DWG PROJECT FEDERICO RESIDENCE, 1029 JOHNSON STREET, NORTH ANDOVER, MA. A3 SCALE 3/16"=V-0" r., DATE 4-28-08 REF: X y Z D rn z - x m O N Z7 m D00 O N O m z7 m cl O Ln O Z . m M :Z O m Y 0 TITLE ROOF PLAN DWG PROJECT FEDERICO RESIDENCE, 1029 JOHNSON STREET, NORTH ANDOVER, MA. A3 SCALE 3/16"=V-0" DRAWN BY DATE 4-28-08 REF: x � --a z z � c� I W O co Z m O z 70 C D m < z D 7u O z � m O � O c O — O = z m 7d O x aN cn � z cn c� m n m o I TITLE EXTERIOR ELEVATION AT CALLED RIGHT SIDE DWG PROJECT FEDERICO RESIDENCE, 1029 JOHNSON STREET, NORTH ANDOVER, MA. A4 SCALE 1/4"=1'—O" DRAWN BY DATE 4-28-08 REF: emk 7/e /d/ se* \/% \ 7700 oy� % �� ~\ / \ 2 2 . y2y ebG e s32 m /y% / ase c \ GGe o < M:5- £ � /� rTl �%e \ S>3 0 z 0 %ƒ 3 c y& c \\� �� / > 2 >- o » \F- / �\\ / 9 ~ \\\ / <` 0 / \\ :. % Fli/ f CD Z c m « c- / . * c� / / /Fri » m/ g c c CC) \\ / / / :.: c \ 00 ms \/ \ \/ /s % . 5 Fri // c e 9R M\ C/) /\ � // zy Go ge_ J �� \% J 7% 20 o . S 2 Tun. -I TITLE EXTERIOR ELEVATION AT REAR DWG PROJECT FEDERICO RESIDENCE, 1029 JOHNSON STREET, NORTH ANDOVER, M%. A5 SCALE 1/4"= V-10" DRAWN BY DATE 4-21-08 REE moo zM* m _ ;:um r, i >< -, 00 CD z Z Bozo o- x :;;o z m X n O ;:7, 0 ➢ n D m 7Z m0 Z X o 70 Z - (ZDD m m C/) z ➢ O Fri- z z I _ r� � Z LTi i r� D O 00 Oz o UO z m x z D O z Fri x z c� I TITLE EXTERIOR ELEVATION AT LEFT SIDE DWG PROJECT FEDERICO RESIDENCE, 1029 JOHNSON STREET, NORTH ANDOVER, MA. A6 SCALE 1 /4"= 1 '—O" DRAWN BY DATE 4-28-08 REF: �oz 000 8P, W m p m ooh =Z 0 D m T mm� oO rn N W Z Z n 0 C:7 0 W D N Om Z m CW O K: m rn CD O o n N 2 N Z O m z O -0 m * W O A ti m rn = O y T Z m C 0 m A Fri DWo m N � A m o O Z m C7 nZiO D `L C) ➢ � O O A Z O O swil re) CD am ----------------------------- I - ---- T C r 4!.n0� 2�rn m 2 x O m I N I - 1 I O O i < O = I � I I i � re) CD am ----------------------------- I - ---- T C r 4!.n0� 2�rn m 2 x O m I 7 __110 O r N Zm PROJECT FEDERICO RESIDENCE, 1029 JOHNSON STREET, NORTH ANDOVER, MA. W pl i I SCALE 3/16"=1 '-O" O = I � REF: � � I m O O re) CD am ----------------------------- I - ---- T C r 4!.n0� 2�rn m 2 x O m I 7 __110 O r N Zm PROJECT FEDERICO RESIDENCE, 1029 JOHNSON STREET, NORTH ANDOVER, MA. A7 I SCALE 3/16"=1 '-O" DRAWN BY z N O O REF: � � I m O O D r co m m Z m O Z n�7 miT X O T O o N T c N m O -- p T -� m O O N D O I T O Z f O D m m0 N > A I I D N W m m Sr=m A➢ I D N ? O D W n n�o 2 Z O m .17 m S p N O D o O m D x O W Z I p<� Z m N I I I 0 m � I I L------------------------ r------------------------ I I m m a o 7 __110 PROJECT FEDERICO RESIDENCE, 1029 JOHNSON STREET, NORTH ANDOVER, MA. A7 m z Z Z SCALE 3/16"=1 '-O" DRAWN BY z N O O REF: � � I m O O D r co O S Z N m m O Z n�7 miT X O T O o N T c N m O -- p T -� m O O D(71 O N D O O m D O Z T O Z r Z � y m0 N > A vO�r C) m Sr=m A➢ O ? O D W n n�o 2 Z O m .17 m S p N O D o O m D x O W Z I N_p1T1� I Z O N r I I L- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ------ 1 I I 1_ ______________ 7 __110 PROJECT FEDERICO RESIDENCE, 1029 JOHNSON STREET, NORTH ANDOVER, MA. A7 SCALE 3/16"=1 '-O" DRAWN BY DATE 4-28-08 REF: � � I m O O D r co m O p p p T 1 � I T n Z 1 O 1 fTl Z p m I Z X I n O I -'ID G1 O Z O m X � � N Z O O O Z O � D N W = G7 m N Z N m m D m X m ZCD Z--4� z 0 0 < ZLn 0 C O D zi U) O D Z1 O m m 0 Z m m TITLE FOUNDATION PLAN DWG PROJECT FEDERICO RESIDENCE, 1029 JOHNSON STREET, NORTH ANDOVER, MA. A7 SCALE 3/16"=1 '-O" DRAWN BY DATE 4-28-08 REF: N X O "D m m N N C m rn m r+t D �n J f'l n L O U) D -1 01 TITLE FLOOR FRAMING PLAN DWG PROJECT FEDERICO RESIDENCE, 1029 JOHNSON STREET, NORTH ANDOVER, MA. A8 SCALE 3/16"=1'-O" DRAWN BY DATE 4-28-08 REF: TITLE CEILING FRAMING PLAN DWG A9 PROJECT FEDERICO RESIDENCE, 1029 JOHNSON STREET, NORTH ANDOVER, MA. SCALE 3/1 6"=1-0 DRAWN BY DATE 8-25-08 REF: z = D m I D mm �m to � Co �r O m D � no cn c m U O z O A n z O O m �l� 2x12 ROOF RAFTERS AT 16" O.C. D 2x12 RAFTERS AT 16" O.C. m X Z O .Z7 O O m m X Ln Z z 0 0 Lo D j m o m m ID D A X � � z Z m S m Z7 Z C:> m O O Z A O O TITLE ROOF FRAMING PLAN PROJECT FEDERICO RESIDENCE, 1029 JOHNSON STREET, NORTH ANDOVER, MA SCALE 316"=1'-0" DRAWN BY DATE 4-28-08 DWG A10 REF: N DWG All 1 REF: JOHNSON STREET, NORTH ANDOVER, M%. DATE 9-4-08 It TITLE BUILDING SECTION DWG PROJECT FEDERICO RESIDENCE, 1029 JOHNSON STREET, NORTH ANDOVER, MA. Al2 SCALE N.T.S. DRAWN BY DATE 4-2$-08 REF: ----- ---- --------------------------------------------- --------------------------------------------- W AO � A fTl n m= Z 0 Om Z z � O D D Z � � O O O O O Z A � O DD C7 � Op A 6'-8" ----- ---- --------------------------------------------- __________________________ ------------ _____ ____ _____________________________________________ _____________________________ ---- I z --------------------------------------------- __________________________ ----- _____ D � D mA m a z� O Z � m m A � Z � O G) O � O O A o_ Z m m �W N D ----- ---- ----------------- ------------------ -------- Amo m O co m O Rt A A O O O ri A O W O -< = m r 002 Z M a D A (n � m O m )> r p m T m Z N X C. v N m Ln W m 0 0 m -0 Z Z O m n -i 0 o i p a 0-9 v in m� A 0 o A p m A D m Az O -{rn m z m m A m = m m_ 0 _-_ m n G) S S m� x z I � n cn C) m - M> D W p m Z O co O O m z O O M x o N N Z x � N O z m CD p n Z = p m m Z T p A p D �I .Zm7 N � (-) � mm O � x - p z x � =cn X A o A m z rn � O N p p x p Ocu co A . o O m 'n n n O D O r o p U) U) p A m 0 n OLn �a z m = g� A Az A A D D A A A r -u m A m m o O N x p z p Z p x m D A m � A ( N 8" c�Wo p0 Lo (An O �� =p Ox .ZW7 no OA m 0 0 � z O x \ D O p y n z D ma' x �� W e p iT�i� O Or O )> A= - m m � m�ry ooW c 0O A O z� �D A D z � O m cN '2 > z` n mm A A o O Z E D z Z O z �< = �n n CD -_+ 0 c) U W N� D c _ Z A O (n N --A O X A co m y 00 o A z0 m 0\ 0 z O m � () 0 Z z N W ----- ---- --------------------------------------------- --------------------------------------------- W AO � A fTl n m= Z 0 Om Z z � O D D Z � � O O O O O Z A � O DD C7 � Op A 6'-8" ----- ---- --------------------------------------------- __________________________ _____ ____ _____________________________________________ _____________________________ ---- I --------------------------------------------- __________________________ ----- _____ D � D mA m a z� O Z � m m A � Z � O G) O � O O A o_ Z m ----- ---- ----------------- ------------------ -------- Date' 3-.......%... TOWN OF NORTH ANDOVER 0 ko Z PERMIT FOR PLUMBIN/G This certifies that ........... # ............ ... has permission to perform ...... .......................... ... . . plumbing in the buildings of ..� ..................... ........ at ...... ...... '., North Andover, Mass. Fee��11. . .;6c. No., --9,/ ................ eLU BING INSPECTOR Check 4t 14Y to 7977 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location IASLA -a of New Renovation Replacement El ' Ti TP7'TTT ren Date �vl� Permit # Amount Plans Submitted yesNo ❑ L ----------------- ❑ �trn1/Co. Name of Licensed Plumber. 01(n Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemni ty Bond 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 wM tallations performed under aboit'Issued for this application will be t compliance with all pertinent provisions of the OUMDtT Qin ode and Chapter 142 of the General Laws. By: of kens Title Typeof lumbirig License City/Town 2 4 License umoer Master ❑ Journeyman (, APPROVED ro�cE usE orn.Y L]y LAWRENCE H. OGDEN, P.E. 198 EAST MAIN STREET GEORGETOWN, MA 01833 978-352-8318 fax 978 —352-2858 cell: 978-502-5921 March 16, 2009 Mr. Rob Hardacre Boxford Street North Andover, Ma. 01845 RE: Federico Residence, 1029 Johnson Street, North Andover Dear Mr. Hardacre As you requested I visited the site to review certain conditions raised by Mr. Brian Leathe North Andover Building Inspector. � The first condition is the 2*1Os @ 16" 17 ft. span floor joist at the family room, these joist exceed the allowable span and are overstressed. As we discussed a bearing wall will be added in the crawl space below these joist. The second condition is the wall bearing on the bedroom joist, this wall supports the dead load of the ceiling above. The floor joist are 2* 10s @ 16 " o.c. I checked these and they are acceptable to support the load from the wall. Based on my site visit I can certify that to the best of my knowledge the as modified these conditions are acceptable to meet the loading conditions required by the 7u' Edition of the Massachusetts State Building Code. Should you have any questions please do not hesitate to call. Yours truly, Lawrence H. Ogden , P.E. Structural 27765 1H OF 4f. LAW CF icy o`S H tD H 3�/6lv 9 27765 G �SS��NAI E.NC'\l� Date....3.�..�..... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that 7V812� .C ........................ ....... ......... has permission to perform .....J,—,,2 (/l CF �L�•q//� l STQ/Lf ............................... _ ......................� wiringin the building of .................. . .................................................... at ........1 D. 0�'7�S asci Sj �, , North Andover, Mass. ........ ........ ............. Fee . A� ........ Lic. No..3,4...........1-2 ......................2 ............. 5 %O.Pw 6 ,WAE ELECTRICAL INSPECT NSPEC 105 Check # �G 9276 Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No, g� -7Z Occupancy and Fee Checked 'ev.1/07] (,__,,,,.,,, APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrica4Inspe ), 527 MR 12.00 (PLEASE PRINT WINK OR TYPE ALL INFORMATION) Date: City or Town of: NORTH ANDOVER To the f Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) //I 2.-j j��U�QT, Owner or Tenant Owner's Address Telephone No. Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Boz) Purpose of Building `5%h G 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: No, of Recessed Luminaires No. of Luminaire Outlets No. of Luminaires No. of Receptacle Outlets No. of Switches No. of Ranges No. of Waste Disposers No. of Dishwashers No. of Dryers O. Heaters KW o. Hydromassage Bathtubs OTHER: t;omp[etion o the No. of CeiL-Sure. (Paddle) Fans No. of Hot Tubs Swimming Pool Above ❑ �_ d. No. of Oil Burners 4;;;; al TotTons n — - Space/Area Heating KW Heating Appliances KW No. of No. of Signs Ballasts. No. of Motors Total HP table may be waived bV the Inspector of Wires. No. of Total Transformers KVA Generators KVA i,ll Vo,of Emergency lg gatter Units IRE ALARMS INo. of Zones Of Alerting Devices ❑inulapal Conneci;on ❑ Other No. of bevices or Data Wiring: No. of Devices or Devices or Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of El trical Work: Work to Start: (When required by municipal policy.) Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE CO GE: 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 Aseo the Mut issu' go ce. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Spec Afo) �2� I certify, under the pains and penalties o er'u that the ' ormation on this applicas true kndlontp!Iete. fP J ►Y,FIRM NAME: 4" (j /� � �� Licensee:At y1 `�,i �t Signature LIC. NO.: (If applicable, a exempt " to th license numb 1i /pp,,/// LIC. NO.: Address: lL tyt� ) , � 1 � 11 17011 Bus. Tel. No.: *Per M.G.L c. 147, s. 57-61, security ork requires Departme of Public Safety "S" License: AIL L ci 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 Signature Telephone No.PERMIT FEE: S Date... �.-.�. ��.... .l....... °.``° '• ."� TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that M... �.� C v .......................... ................... has permission to perform ....��l�lk��� wiring in the building of ....................................... at .... z.`..✓/lr��ti..... Sr ............... ..... . North Andover, Mass. oo ........... ...r.J......, ..�................... Fee..�Z.....J:... Lic. N�363D�%/�..� q ELECTRICAL if SPECTOR Check # �a 7z Commonwealth of Massachusetts Official Use Only Department of Fire Servides PemutNo. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS ev. 1/071 Qeaveblank 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: /— /3 &"I City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention toperform 77 the electri work described below. Location (Street & Number) 10Q 4 TOH-D5'>,y �-_, A),K Y &21 �W Owner or Tenant Owner's Address Is this permit in conjunction with a building permit? Yes Purpose of Building Mb111011) -T l Telephone No. No ❑ (Check Appropriate Bog) Utility Authorization No., Existing Service a00 Amps j 1 a l d a D Volts Overhead C Undgrd ❑ New Service Amps / Volts Overhead ❑ Undgrd ❑ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work - No. of Meters I- No. of Meters r' .,....ra.;,.,...{a.o r.,n..;&. thio maw 6e waived by the Insmcior of Wires. No. of Recessed Luminaires 1 ' ed No. of Ceil.-Susp. (Paddle) Fans _ j No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tabs Generators KVA No. of Luminaires Swimming Pool d e ❑'Znmd. ❑ NO. of Emergency Lipting BItterY Units No. of Receptacle Outlets �j No -of Oil Burners FIRE ALARMS No. of Zones No. of Switches - No. of Gas Burners No. o Detection Devices Initiatin D No. of Ranges No. of Air Cond. Tooas No. of Alerting Devices No. of Waste Disposers 1� eat P Totals: am ons et o ontam ed Detection/Alertin Devices No. of Dishwashers Space/Area Heating KW Local ❑ Counnecption ❑ Other' No. of Dryers Heating fiances gyp g App ec h' stems: No. of ces or Equivalent No. of WaterNo. Heaters o o. o slims Ballasts Data Wiring: No. of Devices or E uivalent Hydromassage Bathtubs o. of Motors Total Up ommaagg TekENo. No. of Devices orr aivaliceent OTHER: the Ins dor of Wires `/ Attach adaluonal detail rf dest-1, Or requrr by pe Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 1 13 -p`J 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 tate 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 eerdfy, under the ns and penalties of perjary, that the infonnadon on this applieadan is Prue a complete FIRM NAME: & n E 1 LIC. NO.:, E3lo 3 O 3 Licensee: (nA��4, A , Ceb LCn Signature C. NO.: 36 21__:> 3 (If a�licable, enter " in the license number ine. Bus. TeL No.• ;Per M.G.L c. 147, s. 57-61, security work requires Departmerrt 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 si below I hereby waive this requireme�. I am the (check one owner ❑ owner's a ent. Owner/Agent '' ��!! n PERMIT FEE: $ 8:5 ` � Signature Telephone No.. �tLfXa� I j 0 M. 1 F9