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210/045.17-0027-0000.0
1
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Date... ... .. . .... ... .....
NORTH TOWN OF NORTH ANDOVER
p PERMIT FOR GAS INSTALLATION
#
SACHUSEI
This certifies that . .,:.���.`. . f. . '! ''`y ?'r . . . . . . • • • • •
has permission for gas installation �� . . .!. . .`. •: . .
in the buildings of . . .l. . .. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . .
�l
at . . . . . . .. . �!''f'. . !.`:. . . . . . . North Andover, Mass.
Fee. . . . . . . . Lic. No.. . . .' . :. . . . . . . . . . . . . . . . . . . .
GAS INSPECTOR
WHITE:Applicant CANARY: Building Dept. PINK:Treasurer
MAP
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W PARCEL
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MASSACHUSETTS UNIFORM ORM APPUCATON FOR PERMIT TO DO GAS FITTING
"' S'0 y`o(Type or print) Date 19coo
NORTH ANDOVER,MASSACHUSETTS
f �j L
Building Locations � � aZPermit# ✓ � y
Amount$ J��
Owner's Name
New❑ Renovation ❑ Replacement tans Submitted
x H
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6 Er '" Vl W Z y w
xO Cal x W 3 A 0 U a > A a H O
SUB-BASEM ENT
B A S E M ENT
1ST. FLOOR
2ND. FLOOR
3RD. FLOOR
4TH . FLOOR
5TH. FLOOR
6TH . FLOOR
',grit . FLOOR
8TH . FLOOR
(Print or type f f. k one: Certificate Installing Company
i Corp.
Address ❑ Partner.
Z/ 0362
Business Telephone /-f 0� 3-C? ❑ Firm/Co.
Name of Licensed Plumber or Gas Fitter
INSURANCE COVERAGE Check one:
1 have a current iiabiiity Insurance poii r it's substantial equivalent. Yes ❑ No
If you have checked M,please in to the type coverage by checking the appropriate box
Liability insurance policy 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 Whave,,,dmitt (or entered)in above application are true and accurate to the
best of my knowledge and that all plumbing work and fo under Permit Issued for this cation will be in
compliance with all pertinent provisions of the Massaode Ch�apt ,;�of the ws.
By: ture of Licensed Plumber Or Gas Fitter
Title M Plumber /4—S go
City/Town ❑ G ltter License Number
Master
JAPPROVED(OFFICE USE ONLY) ❑ Journeyman
3373
Date. .� .. ........
NORTH TOWN OF NORTH ANDOVER
16
Of 4�.ao ,e,1.0
PERMIT FOR GAS INSTALLATION
1SgACeHUgEt
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This certifies that,.,. . . . . . . . . . . . . . . . . . . .
has permission for gas installation . . . . . . . . . . . . . . . . . .
in the buildings of . . . . . Y. . . . . . . . . . . . . . . . . . . . . . . . .
at ., North-Andover, Mass.
Fee,43 .�. . Lic. No%3 . . . . :��. L�� �. . . . . . .
GAS IN6ECTOR
V v
WHITE:Applicant CANARY: Building Dept. PINK:Treasurer
oi .y r- MAP 2
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PARCEL
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�< MASSACHUSETTS UNIFORM APPUCATON FOR PERNIIT TO DO GAS FITTING
0�
V�
(Type or print) Date fjt- 16 1-1000
NORTH ANDOVER,MASSACHUSETTS
Building Locations u Permit# c 7�
Amount$
Owner's Name a4le kzzo-�
New❑ Renovation ❑ Replacement lans Submitted
91 ° a z z o z
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x
d z w w
a ca z o o x
w > a w a z a d o o w o w H
x O x w D 3 A C7 U x > A
SUB-BASEM ENT
BASEM ENT
1ST. FLOOR
2ND. FLOOR
3RD. FLOOR
4TH . FLOOR
5TH. FLOOR
6TH. FLOOR
7TH . FLOOR
STH . FLOOR
(Printor type k one: Certificate Installing Company
Name i Corp.
t
Addreis ❑ Partner.
Business Telephone /p ®3•-` V3-!0`.5`/ ❑ Firm/Co.
Name of Licensed Plumber or Gas Fitter '
INSURANCE COVERAGE Check one:
I have a current liability Insuranc�p�olir substantial equivalent. Yes ❑ No❑If you have checked M,please ine coverage by checking the appropriate box.
Liability insurance policy 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 615mitt (or entered)in above application are true and accurate to the
best of my knowledge and that all plumbing work and i Rations erfo under Permit Issued for thiscation will be in
compliance with all pertinent provisions of the Massa usetts., a ode Chapt 'f the WS.
By: ture of Licensed Plumber Or Gas Fitter
Title Plumber
City/TownHIP�
itter IceLnse Nuum er
r
APPROVED(OFFICE USE ONLY) 0 Journeyman
Office Use Only
�
Permit No; A
Occupancy&Fee C teccedav
_
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00
U
(Please Print in ink or type all information) Date ,IS / �
To the Inspector of Wires:
Town of North Andover
The undersigned applies for a permit to perform the electrical
,twork described below.
Location(Street&Number �/ -- _ /��//'ca zqV-e "
Owner or Tenant 7 Cr= 6!7A-1
Owners Address 'lam
Is this permit in conjunction with a building permit Yes (g %No ❑ (Check Appropriate Box)
Purpose of Building �/f9ir!�P �/1�i//�/ �C i{�`/1 K Utility Authorization No.
Existing Service Amps_ �" Vaits Overhead ❑ Undgmd ❑ No.of Meters
New Service Amps Volts Overhead ❑ Undgmd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
Total
No.of Lightling Outlets No.of Hot fuse No.of Transformers KVA
Above ❑ In ❑
No.of Lighting Fixtures �� Swimming Pool qmd C gmd C Generators KVA
No.of Emergency Lighting
No.of Receptacles Outlets G No.of Oil Burners Battery Units
No.of Switch Outlets ,1 No of Gas Burners FIRE ALARMS No.of Zone
Total No.of Detection and
No.of Ranges / No of Air Cond Tons Initiating Devices
Heat Total Total
No.of Dioosal No. Pumas Tons KW No.of Sounding Devices
No./of Self Contained
No.of Dishwashers l Soace/Area Hearing KW OetectioniSounding Devices
Q Municipal ❑ Other
No.of Dryers Heating Devices KW Local Connection
No.of No.of Low Voltage
No.of Water Heaters KW Signs Batlases Wiring
No.H ro Massage Tuds No.of Motors Total HP
OTHER:
INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws
I have a current Uability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES= NO =
have submitted valid proof of same to the Office YES= NO = If you have checked YES please indicate the type of coverage by checking the appropriate box
INSURANCE = BONO = OTHER = (Please Specify)
(Expiration Date)
Estimated Value of Electrical Woric$
Work to Start Inspection Date Resquested Rough Final
Signed underthe PenaMea f
FIRM NAME i U �,z _C 7 C LIC.NO. /
I.Icensee \ /(J/7�� ®t°C� -sl LIC.LIC.NO. / ��
11
s.Tel No.
Address Aft Tei.No.
OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts
General taws.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)
ZOLOT2
a�:����i�® • C�RTIIFICA 'E OF IhISU;RANCE DATE(MM/DD/YY)
04/30/98
)DUCER j THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
.K. McCarthy Ins . Agcy. Inc . ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
)0 Cummings Center Suite4101F HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
averly, MA 01915-6105 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
COMPANY
URED ACommerce Insurance Companies
Zolotas Electric DBA John Zolotas COMPANY
154 Russell Street The Travelers Insurance Company
Peabody, MA 01960 COMPANY
C
COMPANY
D
IVERAGES
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE OLICY EXPIRATION
DATE(MM/DD/YY) DATE(MM/DD/YY) LIMITS
GENERAL LIABILITY J4 6 215 05/12/98 05/12/99
GENERAL AGGREGATE $1 000 OOO
TXPD
MERCIALGENERALLIABILI
PRODUCTS COMP/OP AGG $1 000
0 0 0 0 0
CLAIMS MADE X OCCUR
PERSONAL&ADV INJURY $5 O 0 O O O
ER'S&CONTRACTOR'S PROT
Ded: 2 5 0 EACH OCCURRENCE $5 O O 000 O O
FIRE DAMAGE(Any one tire) s50 , 000
MED EXP(Any one person) $5 1 O O O
AUTOMOBILE LIABILITY
ANY AUTO COMBINED SINGLE LIMIT $
ALL OWNED AUTOS
SCHEDULED AUTOS BODILY INJURY $
(Per person)
HIRED AUTOS
NON-OWNED AUTOS BODILY INJURY $
(Per accident)
PROPERTY DAMAGE $
GARAGE LIABILITY
EANY AUTO
AUTO ONLY-EA ACCIDENT $
OTHER THAN AUTO ONLY:
EACH ACCIDENT $
EXCESS LIABILITY
AGGREGATE $
UMBRELLA FORM
EACH OCCURRENCE $
OTHER THAN UMBRELLA FORM AGGREGATE $
WORKERS COMPENSATION AND IUB 6 71 Y2 6 4 7 9 8 01/23/98 0 1/2 3/9 9 STATUTORY LIMITS $
EMPLOYERS'LIABILITY
THE PROPRIETOR/ EACH ACCIDENT _$100 , 000
PARTNERS/EXECUTIVE INCL DISEASE-POLICY LIMIT $5 00, 000
OFFICERS ARE: EXCL
OTHER DISEASE-EACH EMPLOYEE $10 0, 0 0 0
•CRIPTIO I OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS
RTIFICATE HOLDER
„CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
Town of Andover EXPIR ATE EOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
Electrical Inspector DAY W I E TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
Town Hall B T FAIL SUC OTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
Andover , MA 0 1 8 1 0 F AN D ON E COMPANY, ITS AGENTS OR REPRESENTATIVES.
AUTH I R SE ATIVE
I
DRD 25-S(3193)1 of 1 525475 M25456 SAK OACORDCORPORATION 1993
1 -1 '1 7 Date... .'7'�p........
N2 0 ....... .... ........
koRTH
TOWN OF NORTH ANDOVER
0
PERMIT FOR WIRING
cmus
Thiscertifies that ... ........................................................................................
has permission torf/orm ...............................................................................
wiring in the building of...�-
..
112— —;-7 ........ ......................................
at............................................................................... I North Andover,Mass.
Fee. ............... Lic.No............... ...............................................................
ELECTRICAL INspE&crOR
05/07/98 11:53 75-00 PAID C-1104
WHITE:Applicant CANARY:Building Dept. PINK:Treasurer &
z
o MASSACHUSETTS UNIFORM APPLICATION FOR PER IT TO DO PLUMBING
3 Y,.
i r (Type or print)
1 G r NORTH ANDOVER,MTSACH ETTS , Date ^�
Building Locations ` /4 /� �l.y �� < Permit #
Amount 7" r
Owner's Name
New M Renovation Replacement Plans Submitted L..1
FIXTURES
z
z
a
Z
x w Q w. a z a a a a A x
a z
a x A A � F "a Q Rz d d a F
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WEWM
LSI:Rfm
?lam FUM
31x1 FLOQt
4IH FI."
SIH FUIR
6M RSM
7IH FRUM
SIH F1DCR
(Print or type) 9--/ c/ Check e: Certificate
Installing Company Name /` �h C!5 ./f fJ Corp.
Address Partner.
�9 ,4 cz)ly6cl
Business Telephone T 79'. �3d-—���3d� � Firm/Co.
Name of Licensed Plumber: 3d,b /7 moi) f/
Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity 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
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 Massachusetts Sta lum de 'dCh er 42 of General Laws.
By Signature Or ense u�Be,
T e of Plumbing Licee se—
Title
City/Town ric—ense NUMberMaster13 Journeyman
APPROVED(OFFICE USE ONLY ❑
Date. . .
'v 3697
f
NOR7q
?�.<���°;•'4,. TOWN OF NORTH ANDOVER
F
PERMIT FOR PLUMBING
i
t
This certifies that . . . . . . . . Q
has permission to perform . . . . . . . . . .--- . . . . . . . .
plumbing inthe buildings of . . . . . . . . . . . . . . .
at. . . . f. . . . . . . . . . . . . . . . . . . . . . . . . . .. North 2ndover., Mass.
Fee. . . . . Lic. No.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
PLUMBING INSPECTOR
05/07/98 13:50 PS.tH! PAID
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer
Location
No. Date
N�RTh TOWN OF NORTH ANDOVER
3?0: +ao Ia`�hOOL _ A
Certificate of Occupancy $ ::
` I ; ; Building/Frame Permit Fee $
�ss�►cHUsE�� Foundation Permit Fee $
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $ 90
TOTAL
12B 3 Building Inspector
35
Div. Public Works
Location
No. � Date
f f
NURTh TOWN OF NORTH ANDOVER
" op Certificate.of Occupancy $41
�q
Building/Frame Permit Fee $
s,cMU Eta Foundation Permit Fee $ io
Other'Permit Fee $
Sewer Connection Fee $
r- Water Connection Fee $ m
TOTAL $
4,
Building Inspector
Div. Public Works
PERMIT NO. � APPLICATION FOR PERMIT TO BUILD***** **NORTI-I ANDOVER, MA
MAP NO. 05 L,OT.NO. 7 2. RECORD OF OWNERSIIIP DATE BOOK PAGE
ZONE SLIBDIV. LOT NO.
LOCATION PURPOSE OF BUILDING �es rl�L
OWNER'S NAME Z' �e NO.OF STORIES SIZE
OWNER'S ADDRESS / �� BASEMENT OR SLAB No RD
ARCI IITECI'S NATE '„ SIZE OF FLOOR TIMBERS I ST 2 3
BUILDER'S NAME WWP D SPAN
DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS
DIS I'ANCE FROM STREET DIMENSIONS OF POST S
DISTANCE FROM LOT LINES-SIDES REAR DIMENSIONS OF GIRDERS
AREA OF LOT FRONTAGE IIEIGI IT Ok'FOUNDATION THICKNESS
IS BUILDING NEW SIZE OF FOOTING X
IS BUILDING ADDITION MATERIAL.OF CHIMNEY
IS BUILDING ALTERATIONJ IS BUILDING ON SOLID OR FILLED LAND
/ G e- 116e, ,�7,
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE , -IS BL111.DING CONNECI'ED"10 TOWN WATER 11
BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECIED TO TOWN SEWER >wl
IS BUILDING CONNECTED 10 NATURAL GAS LINE 4!
INS'I'11("I'IONS 3. PROPERTY INFORMATION LAND COST
EST. BLDG.COST
PAGE I FILL OUT SECTIONS 1-3 EST. BLD(J.COST PER SQ. FT.
EST. BLIX i.COS"L PER ROOM
ELECTRIC ME"PERS MUST BE ON OUTSIDE OF BUILDING SEP11C PERMIT NO.
A I'I'ACRED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS 4. APPROVED BY:
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR i LDING INSPECTOR
DALE FILED OWNERS TLI.H -6g� _ 7/yam
CON"1'R.TEI.H /�a- ZSC) W3N
i
CONTR.LIC# O�ypj 7
SIGNATURE OF OWNER OR AUTHORIZED AGENT q
FEI:
PERMIT GRANTED
19
tf
HOME J ROVEMENT CONTRACTOR
Regist.
ration 1OS029.
- TYPe '',INDIVIDUAL:
'ration 07/16/98
ExP
t
MICHAEL F. GOODWIN JR.
263 Andover St
o '�vers•MA 01923
ADMINISTRATOR
w 'P3.''�
S
09ARTMEIIT Of.p11B IC SAFETY
4! CONS�RUCIION SUPERVISbR IIDENSE
Nueber, Expires Birthdate �
CS 054861 08/08/1998 08/08/1965
Restricted Lo 1G
= .MICHAEL F G0001IN JR i
263 ANDOVER ST t
DANVERS, hA 01923
� 1 C �
r10RT
Town of - Andover
No. #qO - m
* o -
LAKE A over, Mass.,
19i
� '9 COCM ICNEW ICK i�'�`
•9 AO�.4
S E BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
/��
THIS CERTIFIES THAT....................................�T...lBUILDING INSPECTOR.............../.C��.�.�.A.1.J...........................:..............................:...............
Foundation
has permission to ered...... P!4.[lZ.......... buildings on .....Lt-4......:... !l./�- N..............1.!4W.�.............. Rough
�j g
t0 be OCCUpled as......................................... ./l !a r� .....................1 (.7. ..................................... Chimney
provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final
this office, and to the provisions of the Codes and By-laws relating to the Inspection, Alteration and Construction of
Buildings in the Town of North Andover. PLUMBING INSPECTOR
.VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
PERMIT EXPIRES IN 6 MONTHS Final
UNLESS CONSTRUCTION STTS ELECTRICAL INSPECTOR
Rough
........................... ..... ... ....... ...... ........ ...... ............................... Service
BUIL G INSPECTOR
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector.
Burner
Street No.
Smoke Det.