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Home My WebLink AboutMiscellaneous - 11 BARCO LANE 4/30/2018 (3) _.�------ ___ -- _ �' - 11BARCOLANE 210/104��0000.0 'l1 1 No 16 o 4 Date.��-'-'':�1„1...... f NORTH "°off TOWN OF NORTH ANDOVER o PERMIT FOR WIRING ,ssACHUSE� This certifies that ............... ....... . .. .......... has permission to perform .... ....................................... wiring in the building of.rte....+. .... ........................................................ L..cr-r1 at..��........ ,North Andover,Mass. Fe�N<.................. Lic.N6`'3Z .!:r...... �� .............................. ,r _ELECTRICAL INSPECTOR 05/27/99 14:51 25.00 PAID WHITE: Applicant CANARY: Building Dept. PINK:Treasurer • �^�•• The Commonwealth of MO:llee Ur. tMlyassachusetts - (09 Sut '� ►.r.t c x... _ Dcparrmtmi of Public Safcy occup.,.e7 1 F.e taeeta4 BOARD OF FIRE PREVENTION RECULA710AiS 5�, CMR t 1/40 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Ali Wvck to be Per rmed in Accordance with the M.as.achLuerss Electrical code, Szj CMR IZ.00 ( EASE PSM-7 IN =,M OR. TME: AU THOR�A=OH) Date U �� City or Town of jl/!Z 71 of f!/GxE% TO the Inspector of Wires: the undersigned applies for s perait to perform this el e ct rical work de-scribed belay,. Location (S=eeL b Hrsaber)_ Ower or T. ",t L Z '�--a 4, Al x) Phone No. Owner's Address TI Is this pe-mit in cottiuncrIt= with a building pe-mit: Yes �No ❑ (Check Appropriate Box) Purpose of Building �sS� �t` ��[_ IIti3ity Au-�o:iaztian *1Q. Existing Service Maps / Volts Overhead ❑ Gndg_d❑ Ho_ of 2iete--s New`Service A"Ps / Vo1L Overhead ❑ Undgrd❑ Ho. of haters Hcmher of Feeders and Ampac4tT r Location and Nature of Proposed Electrical Stork No. of Lighting OutletsNo. of Rot Tubs IHo. of Iransformers Total ! RIA No, of Lighting Fizturrs ( Swimming Pool ode ❑ fid. ❑ IGeneracors r7A No. of Receptacle Outlets2{0. of Oil Burners INo. a! Emergency Lighz,ng Battery Unit No. of Switch Outlets no. of Gas Burners FIRE ALSO No. of Zones Iots1 No. of Detection and No. of Ransss No.-of Air Coed. tons Initiating Devices Beat Total Iotsl No. Qf Dispotsals ,. HO. of paws Ru No. of Sounding Devices No. of Self Contained No. of DIshwashers (Space/Area Beating XW Detection/Sounding Devices No.aof Dryers (Heating Devices l61 Local. rh:nicipal❑ Connection❑Other No. of Watts Beaters RZ7 No, of tic. oz (Low Voltage Suns Ballasts Fllrintr No. Hydro Massage Tubs I No. of Motors To cal HP QST: INSURANCE COVERACZ: .Pursuant to the requirements of Hassachnsetts General Laws I have a current L � Insurance Policy ryincluding Completed Operations Coverage or i substantial equivalent. =21 No I have submitted valid proof of same to this office. YES NO If You checked =, please indicate Le the of coverage type g by checkingthe appropriate box_ INSURANCE BOND ❑ OTHER❑ (Please Specify) � rxp>_ration uacz7 Estimated Value of Electrical Work S Work to Star.' Inspection Dace Requested: Rough Final Signed under th na ties f perjury: FIRM NAM � f/ '_ LicenseeSignature LIC. N0. C1zytT Address ,QS�ix /e-� mus. Iel. No. Alt. Iel. He. OWNER'S INSURANCZ WAIVER: I am aware that the License does not have the insurance coverage or >_cs 'sLo_ scancial equivalent as required by Massachusetts General revs, ane taut ray signature on this p ermic application waiverthis requirement. Omer Agent (Please check one) Telephone No. rte_ ` 2S icnarnre nr ar or oanr ELECTRICAL PERMIT FEES manay mLavw*sk Mau.Gen.L c343 s.3t,377 CMA 12.00,Or&nussn of N Cay of chei"s 14.30 Residemial Electrical Pamit Fees Cotnrnacial and Industrial Electrical Permit Fees P Fee Pemtit. Basic wiring-with 100 unp service(including mesa) S30.00 Each additional 23-100 amps 20.00 Services Each additional meta 20.00 Upgrading per 100 amps S25.00 Uodergamd trench itsspoctioc 20.00 101-200 amps 45.00 Basic wiring-2 inspectiotss 40.00 201-400 amps 65.00 (sub panel-additional charge) 401-600 amps 90.00 601-1200 amps 190.00 Services 1200 amps and over(per 100 amps) 20.00 Temporary service S25.00 Meta 25.00 Seryioe change(relocstioe) 25.00 Sub panels (with meter) 25.00 69/199 amps(each) S20.00 each additiorw 100 ampa 10.00 Service(3parade 240 volt machine J Per 100 amps s25.00 A/C unit-heat cool unit(each) S20.00 Etch additional 100 amps 20.00 Window air 000ditiorsrr 22.00 Add public paced 20.00 Ligating-outlets-devices Add public meas 25.00 1 -10 S15.00 11- 25 30.00 Aherstian-remodelin¢-miscellaneous 26 - 100 40.00 Sub-good S20.00 101 and over(each device) L00 Siding or signs 20.00 Transformers/Generators 0 - 10 KVA $25.00 Electrical Outlets-devices- fixtures.etc. 11 - 50 KVA 40.00 1 - 10 S10.00 31 and over 50.00 11 - 25 20.00 Vaults and cquipax= 60.00 =1 - Ovstr 30.00 Carnivals,faits,cirmis,etc. 40.00 Maior Electrical Anvliusoes Aiwual comiauous maintro,,, , permit $75.00 Dryer-eUx rie range-hot water heats-disposal (arneptiow major renovation) dmhwasbcr-window air conditions-other $15.00 Electric head-per KW 3.00 Demolition S40.00 Control Air conditioning or beat pumps 20.00 Gas or oil burner 20.00 Explanatory Nato y. Alanas,fire and burglar(2 ins carom) 1. if work is started and a permit is not obtained on or within five(5) (with panel)Phu devices 30.00 days or without the entreat of the wire inspector,the fee will be Fire and burglar detectors-each(without panel) 2.00 doubled Maas-each horsepower or&u:tiorW 2.00 2. Tenant wiring in a commercial,mixed use building requires a Gmeralos 23.00 separate Permit. Low Voltage Wiring - per device 2.00 3. Minimum wiring permit shall be S40.00 Swuntaias Pool Whin¢ Above Ground 25.00 Ground 30.00 e-0ver psmn vice- tough-ser -final(each) S 25.00 Rcin v ion permit for defective worst S25.00 Renewal Permit S23.00 Demolition permit S23.00 Explanatory Notes Minimum wiring permit fee shall be S25.00 Permits Expiration data are: New work-one 0)year Remodeling-six(6)months Pool-tbuee(3)months a MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) NORTH ANDOVER Mass. Date 2/27 19 97 Permit # ,?A s e Building Location 11 Barco Lane Owner's Name Flynn Type of Occupancy Residential New ❑ Renovation ❑ Replacement Plans Submitted: Yes ❑ No ❑ FIXTURES z Q rl r-I F- 0N O Z F N O W 'U W Y .. LLJ W U�. O Z ¢ x W F- W ¢ y Z 2 Z ` i4 Z O 7 ¢ N W ¢ Q W ? O Q fA Z F- F- UJIQ J ¢ 4. S H V a x 3 = a z S Y d O r z z a W w Y W �1 $4 > F- o � W v, F- z 0 0 0 W 0 r� r. Q -� ..J -a ¢ ¢ .a a O Q F49 - 3 x U. 0 D O Q 3 a_ m 0 rd 3 3 3 SUB—BSMT. BASEMENT 1 IST FLOOR 2ND FLOOR 3RD FLOOR i- 4TH FLOOR j STH FLOOR -6TH FLOOR ) o7. H. FLOOR ,CMLq n.:4C'. j -. 8TH FLOOR r r i Installing Company Name Heritage Htg &Plg. Co. Inc. Check one: Certificate Address 3Pleasant Street CX Corporation 714 Stoneham, Ma 02180 n Partnership Business Telephone 617-438-7776 F1 Firm/Co. Name of Licensed Plumber Gordon Switzer INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes K No ❑ If you have checked Les, please indicate the type coverage by checking the appropriate box. A liability insurance policy IN Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and.accurate to the best of m�yT ' knowledge and_that all plumbing work:and installations performed under the permit issued for this application will be in'compliance with all . _1 pertinent provisions of,the Massachusetts State Plumbing Code and,Chapter 142`of the General Laws. I i By Title '-"Signature o1-Licensed Plumber 14 — Type of License:Mnt6r[X Journeyman(] �� City/Town APPROVED—(OFFICE 3 2 2 (OFFICE USE ONLY) License Number f '! BELOW FOR OFFICE USE ONLY j FINAL INSPECTIONS SKETCHES PROGRESS INSPECTIONS ]I FEE NO. APPLICATION FOR PERMIT TO DO PLUMBING NAME &TYPE OF BUILDING LOCATION OF BUILDING PLUMBER PERMIT GRANTED iDATE 1g PLUMBING INSPECTOR .dti..i`ZYk�.3....c,.�ti, .i-...,- �,H��;; r, ._.�rn,._�+v .«.-.�-'.-..,... -mss....�s^.:. -.. .�..r-- ;'-`•. • ~ ..-- Date:�� 777 32 8, 7' 5J �'.".��T:��a TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING 4. - "SA HUS �h This certifies that ?' OL . . . . . .`. . . . • . . . . . . . . . . . . . . has permission to perform .,. . . . . . . . . . . . . . . . . . . . . . . . plumbing to the buildings of . . ./."��.,f!-�Al. . . . . . . . . . . . . . . . . . . . . at. ./.1. /3/-/./.).c . . . . . . . . . . , North Andover, Mass. Fee. .". . .Lic. No."ir . . . , . . . . . . . . . PLUMBING INSPECTOR 03/05/97 11:38 27.00 PAID WHITE: Applicant CANARY: Building Dept. PINK:Treasurer Date. y 4042 NpRTh TOWN OF NORTH ANDOVER O ��a°�•1ti0 PERMIT FOR PLUMBING �{�•O^arm�A�`,ry SSACMUS� �I This certifies that . . . o. . . . . . . . . . . . . . . . . has permission to perform . . .C. . . . .. . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . . . . . . . . /l at. . . . . . . . . . . . ., North Andover, Mass. FeJ). . Lic. No.. .2 z. ?/. . . . . . PLUMBING INSPECTOR C a 05/27/99 14:52 30.00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING �� Ste-\ (Print or Type) Mass. Date Z0 1 g `l% Permit # VOL/J— Building Locatlon_ g, L Owners Name L. Type of Occupancyr r dr New ❑ Renovation ❑ Replacement [aPlans Submitted: Yes ❑ No ❑ FIXTURES P Z y y Z Y < ►- y (n y O z ►- j to W Y J y Y� V < y Z W W W z y Cr < ' ~ z y ¢ M O y W y y = Val: IxUU W y Y z< y 0 O Z [L ~ rr W O O a < W CC a •( W z O 4 y Z rt a Q O 1r. W S ~ ~ W y O J y C G J _ p p J O f U < S 0 x Z S Y d C f' < Z d W LL X W Y J Dr( = H N U. 'V O < Q in o r SUB-13SMT. BASEMENT IST FLOOR coo A-1 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name Check one: Certificate Address_ - A-LW c � {d rh � C3 Corporation _ n rz n ✓ e.-s /�ci r s (17 2„7z ❑ Partnership Business Telephone_ 9 7 q- '7 y— G ai:arm/Co Name of Licensed Plumber INSIIAANrP COVER"kCE_ -, I have a current liability insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 9' No ❑ If you have checked Vis, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy 8'` Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General laws, and that my signature on this permit application waives this.requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ 1 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 the permit is,ued for this application will be in compliance with all. pertinent provisions of the Massachusetts Slate Plumbing Code and Chapter 142 of the General Laws. BY Title a+gnarure or ucensed Plumber Gly/Town Type of license: Master [3.— Journeyman C j 'QED (b I C-E USE 0NLY) License Number. j Z Z BELOW FOR OFFICE USE ONLY PROGRESS INSPECTIONS FINAL INSPECTIONS SKS$ FEE NO. APPLICATION FOR PERMIT TO DO PLUMBING NAME i TYPE OF BUILDING LOCATION OF BUILDING PLUMBER PERMIT GRANTED ! DATE...., ...1�➢ PLUMBING INSPECTOR 01 F�ri+iSllltIIl{WPIIl of JLitts�a[ j[�Pit Permit No. Use Only J� Department of Vttwit t1afettl i Occupancy 8 Fee Checker" /_er�i 3 BOARD OF FIRE PREVENTION REGULATIONS 527 CMR i2:OQ IL J190 (leave blank) - _ APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts =iectrical Cafe, 527CM�7_7_ 00 (PLEASE PRINT IN INK O YPE AL INFORMATION) Date _ City or Town of-- _ To the Inspector of Wires: The udersigned applies for a hermit top rforrn the stet Tical work described below. Location (Street & Number) �� Owner or Tenant Owner's Address r-� Is this permit in conjunction with a building permit: Yes ❑ No ; 1 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Gervice Amps _� Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps _ _/ —Volts Overhead ❑ Undgrnd 111 No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work C-11 i fry tau W `2-1-1 No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above❑ In- grnd. grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners ( Battery units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total No. of Detection and tons Initiating Devices No. of Disposals No.of Heat Total Total Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices No. of Dryers Heating Devices KW Local ❑ Municipal Other Connection ❑ No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts wring i No. Hydro Massage 7irbs No. of Motors Total HP 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_.� L I have submitted valid proof of same to the Office. YES _19--r4_0 L-_1 If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE 9-&�90NO G OTHER O (Please Specify) Estimated value of Electrical work $ (Erpiration Date) Work to Start Inspection Date Requesled: Rough Final _ Signed under the Penalties of perjury: FIRM NAME, Ot/N'C l ~"A/ LIC. NO. �l X. �7 Licensee f] LY LYl 1z 5 (� � r r pSignature _ LIC. NO. Address q,( iyvt l0) tryZ Trt g-Kop-A1 n,IXA4�019,30 Bus. Tel. No. Alt. Tel. No. OWNF_R'C INSURANCE WAIVEP: 1 WTI aware that the Licen88z dour not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Own Agent (Please check one) Telephone No_ — PERMIT FEE 5 _ /l,��d (Signature of Owner r Agent) �!_1/ 9 o ge t) X-6565 NEW ENGLAND CLAIMS SERVICE, INC. P ReP1Y To ❑ Reply To a/ Reply To ❑ P.O. BOX 345 100 CONIFER HILL DRIVE, SUITE 308 P.O. BOX 578 MANSFIELD,MA 02048 DANVERS, MA 01923 SHREWSBURY, MA 01545 TEL. (508) 337-8058 TEL. (978) 777-9900 TEL. (508) 842-3995 FAX (508) 339-5835 FAX (978) 774-9296 FAX (508) 842-7510 Form of Notice of Casualty Loss to Building rd'VV,4 OF(NORTH A NQ0'!ERi Under Mass. Gen. Laws, Ch. 139, Sec. 3D BOARD of HE STH , I MAY 5 2" TO: Building Commissioner or Board of Health or Inspector of Buildings Board of Selectmen addresses _ IM.h- 01245" _. RE: INSURED PROPERTY ADDRESS �� '� � L-,4)4 E_ POLICY NO.: n t1 4 C, LOSS OF: y FILE OR CLAIM NO.: Res 3IG)<_ Claim has been made involving loss,damage or destruction of the above-captioned property which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass Gen. Laws Chapter 139, Section 3D is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. TITLE On this date, I caused copies of this notice to be sent to the persons named above at the addresses indicated above by first class mail. 1 SIGNAT ND DATE cc: Fir ept. N2 351 2 Date... HOFT/� °f'"":•�"a TOWN OF NORTH ANDOVER PERMIT FOR WIRING . o, +,SSS^cHusE� r This certifies that .........I.b I.S.e......... -...�,p�..f ��..� ................................. has permission to perform ........ F.l ..v!.r.F r wiring in the building of......:.......n ' f \/,� i1 at...././.... ..........Z- /.,............ North Andover.,Masser. � . : ELECTRICAL INSPECTOR Check # 22 l WHITE: Applicant CANARY: Building Dept. PINK:Treasurer The Commonwealth of Massachusetts o==«e Use Only - uepamnenf of Public Safety BOARD OF FIRE PREVENTION REGUTAnONS S27 CMR 1200 Occupaac}& Fee Checked`__ 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRIC ALAll vmrk to be performed in accordance with the Masaachusetu Electrical Code. 527 CMR 12:00 WORK (PLEASE PRINT IN INK OR TXPE ALL INFORMATION ) I Date J;1- .2&-(at City or Town of tjcr-11, A.&,,,r To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described 2wa. Location (Street & Number) jl 64,-eo Lr-) Owner or Tenant ; CAN..e_ �(., ,,, Owner's Address Is this permit in conjunction with a building permit: Yes ❑ No� BUD P AP Purpose of Building -' Utility Authorization NO. Existing Service -(L?do=.____APs 2 / O Volts Overhead 'LJUndgrdo No. of Meters_ New Servfce Amps / Yolts Overhead ❑ Undgrd❑ No. of Meters r Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work 001C I No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total Ab No. of Lighting Fixtures AmmvINA 1:1NoSwiing Pool n- No. . of Receptacle Outlets gr gInd. ❑ Generators INA No. of Oil Burners No. of Emergency Lighting No. of Switch OutletsBatte Units No, of Gas Burners FIRE ALARIMS N e No. of Zones No, of Ranges No, of Air Cond. Total No. of Detection and tons Initiating Devices No. of Disposals Heat Total Total .� No. of No. of Sounding Devices Pum s T ns KW No, of Dishwashers Space/Area Heating KW No. of Self Contained i No. of Dryers Detection/Sounding Devices Heating DevicesKW Municipal No. of Water Heaters KW No, of Vo. o Local E] Connection❑Other i Si ns Ballasts Low Voltage Wirin No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liabilit Insurance Policy including Completed Operations Coverage or its substantial , equivalent. YES . NO[ I have submitted valid proof of same to this office. YES 8 NO 0 If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ® BOND ❑ OAR ❑ (Please Specify) `-0 �.61_�� Estimated Value of Electrical Work $ xpira —ion Date Work to Start - -•-U d- Inspection Date Requested: Rough Signed under -the -penalties of perjury- Final FIRM NAME LicenseeLIC. N0. 1yC8 ��cs Signature Address LIC. N0. ✓� ,� O �, S. Tel. No, f OWNER'S INSURANCE WAIVER: o. I am aware that the Licensee does not have the insurance c�erage o its7D� stantial equivalent as required by Massachusetts General Laws and that my signature on this or its application waives this requirement.9 Owner Aoanr /n,�___ ' U lease check one j "-- Signature of Owner or Asont Telephone No. P& /,f, 00 R1�fZT ssa g Date. . r TOWN OF NORTH ANDOVER ° PERMIT FOR PLUMBING SSACMOs� This certifies that. . . . . . . . ../. . . . . . . . .,- . . . . . . . has permission to perform .,rC (� ,. . . . .. . . . . . . J� plumbing/n,the buildings of .. f " /L-11 . . . . . . . . . . . . . . . at . . . ...... - . . . . . . . . . . ., North Andover, Mass. Feel , /Jj Check flPLUMBING INSPECTOR _��.�' / a 5855 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING / (Print or Type) 50 Mass. Date Permit # Building Location� ty G Owner's Name1 LI h n Type of Occupancy Residential i �4 New ❑ Renovation ❑ Replacement Plans Submitted: Yes❑ No ❑ FIXTURES 2N a r-f z Y rl to F% > b N O z w Y J to N V Q z 0 X V) ¢ f Fr z N a ¢ a r Z O Z y a •� �} J N W W N Y N ~ U W 0 Q tCL o 6 U z ¢ m N W ?- Q F V) D Q (1) ¢ Crcc W O r W a N O Q J N ¢ ¢ J Z O Q W W z a x 3 3 p z z F ° o z z W W LL x yG J (a N O D J 3 r F- N LL O O a O m rd rti r(f Rf 33 33 �i SUB—BSMT. BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR i 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR + Installing Company Name Heritage Htg, &Plg. Co. Inc. Check one: Certificate Address 35 Pleasant Street EX Corporation 714 Stoneham,' 'Ma 02180 ❑ Partnership Business Telephone '781 !-438-7776 n Firm/Co. Name of Licensed plumber Gordon Switzer INSURANCE COVERAGE: I 1 have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142: -Yes 91 No ❑ If you have checked yes, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy IN Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner ❑ Agent❑ Signature of.Owner or Owner's 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 the permit issued for this application will be in compliance with all . pertinent provisions of the Massachusetts Stale Plumbing Code and Chapter 42 of the General Laws. gynature of LicenseaPPlum—bet Title f t Type of License:Master[X Journeyman❑ City/Town. 8 3 2 2 { APP " O Ucense Number :f BELOW FOR OFFICE USE ONLY FINAL INSPECTIONS SKETCHES _ - PROGRESS INSPECTIONS FEE NO. - APPLICATION FOR PERMIT TO DO PLUMBING. NAME&TYPE OF BUILDING LOCATION OF BUILDING PLUMBER PERMIT GRANTED DATE 19 R PLUMBING INSPECTOR T ._ Date. 774 NORTh TOWN OF NORTH ANDOVER F PERMIT FOR WIRING SSACNuSE _ This certifies that .... ..... Q................... c.......c.........:............ .. .., a has permission to perform ,j� (( .a .....j(�A...{........�.'�`.�?.� .. � !..l.+C wiring in the building of....... ......... .......:. ...:.:..:...................... eZ o, .V at....... .. :....... ...:..... G ................. .North.Aridover,Mass. Fee....d...,1 :. J.. Li c.No fj 1 �..YY............................... ...........::..:.......,.. a ELECTRICALINSPECTOR, i WRITE:Applicant CANARY: Building Dept. PINK:Treasurer.