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HomeMy WebLinkAboutMiscellaneous - 135 COACHMANS LANE 4/30/2018 (3) 135 COACHMAN'S LANE 210/064.0-0070-0000.0 )S'�'-�'�l"'3,.,s.,+�a.�;..,'r'"lr.wstii1�,�r«.�,v'�.«'sk'�.�.,1-•_-'tia�..Y""`'-^'.--��.�-vr" .--�.-� No.: Date AORT11 04`"_` 0 TOWN OF NORTH ANDOVER ° ; A BUILDING DEPARTMENT * _ * qL ��'°•,,.o�°'� UBuilding/Frame Permit Fee $ SSACHSE `fel; LFounda ion P emit Fee $ w Ilkerm"t Fee $ — ,Vp_/Building Inspector ' 06/27/9612:03, -47.00 PAID �" , 17, .. PERMIT IVO. I APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE ,ply MAP 410. LOT NO. 2 RECORD OF OWNERSHIP JDATE BOOK iPAGE E '♦ ZONE I SUB DIV. LOT NO. �) 1 LOCATION - ( fA A-��� - PURPOSE OF BUILDING - b /roc n e e 2a�, OWNfp'S NAME �• ' ��•'� •'�i:.� NO. OF STORIES SIZE �y •-7'' OWNER'S ADDRESS BASEMENT OR BLAB Sift- �h ARCHITECT'S NAME SIZE JFFLOOR TIMBERS IST 2ND SRO BUILDER'S NAME �:z2 rjL N.N SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES - SIDES REAR GIRDERS AREA OF LOT FRONTAGE /IEIGHT•OF FOUNDATION THICKNESS IS BUILDINi NEW SIZE OFF 1:71NG X IS BUILDING ADDITION MATERIAL,OF„CHIMNEY IS BUILDING ALTERATION /,� IS BUILDING ION SOLID OR FILLED LAND WILL BUILDING CONFORM TO RE UtLR_EMENt9 OF CODE IS BUILDING CONNECTED TO TOWN WATER , BOARD OF APPEALS ACTION. IF ANY IS SUILDING;�CONNECTED TO TOWN SEWER 18 BUILDINd CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION a . LAND COST SEE BOTH BIDES . .. .. .. .. ', EST. BLDG. COST �f PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER,'SQ. FT. PAGE 2 FILL OUT SECTIONS I - 12 .. EBT. BLDG. COST PER ROOM ELECTRIC METEPB MUST BE ON OUTSIDE OF BUILDING SEPTIC PERMIT NO. 4 APPROVED BY S - ATTACHED GARAGES MUOT CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED ■UILDING INSPE(.'TOI SIGNATURE OF OWNER OR AUTHORIZED AGENT I� FEE `OWNER TEL N -�J tem 0 F0 . T PERMIT GRANTED CONTR.TEL 4 9 -2 2 ZCONTR.LIC./ H.I.C.r 1r BUILDING RECORD `r I OCCUPANCY 12 SINGLE FAMILY s�okl 5 THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES. _ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- '" APARTMENTS z i RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE a' I 7 7 CONCRETE BL K. PINE _ —_� _ BRICK OR STONE HARDW;D PIERS , PLASTER_ — — - l .DRY llALL �_——_ UNFIN. 3 BASEMENT AREA FULL FIN. 86M t* AREA _ 1/1 y, FIN. ATTIC;AREA _ N_O B M FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS 9 '-FLOORS CLAPBOARDS — ' B 1 2 ] DROP SIDING CONCRETE ' �_ WOOD SHINGLES EARTH ASPHALT SIDING HARDWi0 ASBESTOS SIDING COMI.LC:N VERT. SIDING ASPH. IIIE STUCCO ON MASONRY - — STUCCO ON FRAME ATTIC STRS:.F, FLOOR BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY VyIRING s , STONE ON FRAME ` SUPERIOR POOR _ AO EQUATE' I NONE $ ROOF TO PLUMBING A GABLE HIP BATH}j] FIX. — GAMB.EI I MANSARD TOILET RM. 2 FIX. — FLAT SHED WATR CLOSET — ASPHALT SHINGLES LAVATORY' � WOOD SHINGES KITCHEN SINK " SLATE NO QUMBING — TAR & GRAVEL STAII;:SHOWER ROTI ROOFING MOWAN FIXTURES TILE.iFLOC TILE '.tJADO- g fRAMING II 1 S HEATING W000 JOLT PIPEL'i FURNACE FORCED HOT AIR FURN. TIMBER BMS. 6 Cols. STEAPA STEEL BMS. 6 COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT*HEATERS . ....:.. GA - .:: '] NO. OF ROOMSOIL - B'M'T 2nd _ ELECTRIC ],d I NO HEATING ' .. .. ..-. •._ p�.ria..-_- .' OFFICES OF: _ R —Town of - - T r _— ...... ,.•� r � �-,,,,,,-Town._. . _ __ ,120 MaitlStzeet -__-- APPEALS a;�,y; - NORTH ANDOVER Nonh Andover. BUILDING t ��e - Mas.SaClitiSefts O 1845 CONSERVATION Dri1SION OF HE.-kLTH - P"N'INc PLANNING & COMMUNITY DEVELOPSIENT KAREN KP_`ELSUN. DIRECTOR .. . .- - - ---;1-"!- - ..,.. _� ,he ,.,• o Id c ._ �. .��..:.. ^. S � �r�+ir a of But ii::s Numbe; s cant ;^e �cc,s ressltine `rern this work shil.-be disposed c1r .., s prepe. scud ;rite ca-^sn. :ncii ns .�:..c: by %iGi. c iI', S i ne debris will be dispose:! c< i-: of Pc;, It ACPI1CRt LZ'r--Aq� Date :10TB: Demolition permit from the Torn of North Andover must be obtained for this project through the Office of the Building Inspector. ✓fie -Va7�7rcaru.�sea� o�./�aaaacfu,%ae�t Restricted To: 00 € irv'si�:y " -•._'.� DEPARTMENT OF PUBLIC SAFETY ,�a CONSTRUCTION.SUPERVISOR LICENSE + 00 - None Nui6er Expires: Birthdate.; lA - Masonry only . CS 012698 07/21/1997 07/27/1950 1 1G - 1 2 Faiily Hoaes Restricted;To: 00 BERTIN R ROY 123 NORTH ST ANDOVER, MA 01810 .. '� Gf1e�iommo�uveal!/"�✓l .�aelta NOME IMPROVEMENT CONTRACTOR Registration 105393 Type - DBA Expiration 01/17/98 BERTIN R. .ROY Bertin R. Roy North St. noMINIS — Andover MA 91810 _ - ... 4:. i .. -.. ... 1' i NORTH Town of OL over rt . dower, Mass., Z 19 g� COCM CMEWICK ADRATED � F 5 BOARD OF HEALTH Food/Kitchen Septic System PER • BUILDING INSPECTOR T T D THISCERTIFIES THAT ......... ........ ..... ............................... ............. ..... . . ................................................. Foundation in son ...... *r!S..... Rough has permission toy..... ....... 9 9�....•.• 4 to be occupied as........ '&..... Chimney provided that the person acc ting this permit shall in every respect c orm to the terms of the application or, file in Final this office, and to the provisuons 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 STARTS ELECTRICAL INSPECTOR � Rough ............0.*... ...... ... .... Service UILDIN°: INSPECT Final Occupancy Permit Required t0 Occupy Building GAS INSPECTOR la in a Conspicuous Place on the Premises — Do Not Remove Rough Display Y P y Fina'. No Lathing or Dry Wall To. Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. Smoke Det. Location ) acfi�sa4�►S �,1U' No. 317 Date 9 f of M°;r;�tia TOWN OF NORTH ANDOVER „ Certificate of Occupancy $ • dCI s, ; '► Building/Frame Permit Fee $ ,S t cNusE� Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water.Connection Fee $ TOTAL $ a g Building IrSpector 07/10/% 11:35 '25.40 POI a 3 10053 Div. Public Works ', PER'MIi NO. cJ APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP 4-40. LOT NO. 12 RECORD OF OWNERSHIP iDATE BOOK 'PAGE — ZONE I SUB DIV. LOT NO. LOCATION J�S /' S / PURPOSE OF BUILDING s / ^ � Lf OWNER'S NAMED-f_ r f/ 1L NO. OF STORIES SIZE al OWNER'S ADDRESS 4r BASEMENT OR SLAB -- ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME �e7"f 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 MATERSAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE 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 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR t DATE FILED -1. BUILDING INSPECTOR SIGNATURE OF OW s ``OR AUTHORIZED AGE F E E ox ej OWNERTELJ PERMIT GRANTED CONTR.TEL.N 19 / CONTR.LIC.# 06Z( cd H.I.C.# 105-373 BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES _ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE B 1 2 13 CONCRETE BL K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ '/, y, '/, FIN. ATTIC AREA _ N_O B MT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARDW'D ASBESTOS SIDING _ COMMON _ VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS: & FLOOR I_ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR I� POOR _ ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I I HIP BATH (3 FIX.) _ GAMBREL MANSARD 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 GASOI L B'M'T 2nd I_ ELECTRIC 1st 13rd NO HEATING NOFZTIy X46 F ToVM of 0 d O '; tIn No3i� ~ �A ll Fes. . - � <? 1`1rt dover, Mass., " 19 q COC WC HE WICK ADRATED pPF0 5 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT........... ...... .i.v�. .51�. ....................................................................................... _ � � / "" Foundation hasermission to erect...... ?..k:�.l.�..k..:.s....... buildings on ........ 5. '..... ..v.u.G.�t.. .�?5...,�-.V.. p ........... Rough to be occupied as .......... ... ... . . ..�4. ..��:.f s........ .... SL. .'.l" .... d.( ! ........................................................ Chimney _ �r provided that the person accepting th permit shall every respect conform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Final 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 STARTS ELECTRICAL INSPECTOR Rough /.....h....... BUILDING INSPECTOR Service Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough P Y P Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. 2 QC loo' `o' . -3 Smoke Det. :...,_,-�.,_,,y_��,•...`.._�r. ..��,"��r"^."Y""Y'v 4-b =•.^.....-..�"`ry" ''r"' i.t-- N.3.�Y`�c..r...�-+�•v----`-r.` Date. =` 4035 NORTH <.�•� .'tio TOWN OF NORTH ANDOVER 49 PERMIT FOR PLUMBING N SSACMUS� This certifies that . .!.`. . r`'. ... . . . . . . . . e has permission to perform . . . . . rr✓. . . . . . . . . . . . . . . . . . 3 N � z $plumbing in the buildings of . . . . . . . . . ... . . . . . . . . . at. . . ,/. . . . . . .. orthh Andover, Mass. $ o A,,� Fee! . :^.Lic. No.�?.�. . . ..;,�. . .. . . . PLUMBING INSPi� WHITE:Applicant CANARY: Building Dept. PINK:Treasurer A. MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date 5�- l�� 4 9 Building Location /3 5 GDacA Moo L on-e- Owners Name f20 j6 C r IL 11)!S///P& Permit# 1. 3-5 Amount Type of Occupancy 12(F S l d f12 C e New Renovation Replacement ❑ Plans Submitted Yes ❑ No FIXTURES z o w F � H U W o a W a d w H Q a z F z HCIA w � a s✓ � °a � 0 � 3 SLRE IST.Rfm 2N1 FIDM 3141 FLDQ2 4IH RfM 5M FUM 6IH FIDUR 7IH FIDUR SIH FLDQZ (Print or type) ` Check one: Certificate Installing Company Name W/141`,e �ci Plor�bcno �l/eabtlG Corp. /6 PV C Address acq �7 0 Partner. ala- Andover-,')i4(7. 01945 Business Telephone 9?5 0 Firm/Co. Name of Licensed Plumber: f O�, -e r( (��On Gf1 e//Q" Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: ❑ Liability insurance policy F71 Other type of indemnity ❑ 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 work and installations performed under Per#t Issued for this application will be in compliance with all pertinent provisions of the Massachu efts S to PI m 'ng Code an h 42 of the General Laws. By: Signature Ot Licenseaum er Type of Plumbing License Title Q s / City/Town ►cense mer Master Journeyman APPROVED(OFFICE USE ONLY Date. NORTH 0* 32 TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION AcHUS This certifies that . . q . . . . . . . . . . . . . . . . has permission for gas installation . . . . . . . . . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . at .. . . . . . . . . . . . . . . . North Andover, Mass. Feel. . . . . . Lic. NoJ). . ,GAS INSPECTOR Check# h,' 6 7 5465 MASSACHUSETTS UNIFORM APPLICATION FOR'PERMIT TO DO GASFITTING 25r (Print or Type) j r , Mass. Date ZO 20 0(V Permit y Building Locations Owners Name k►w►SLr,- Type of Occupancy NeW f Renovation❑ Replacement❑ Plans Submitted: Yes❑ N W a -{ 0 m Z uj zi Z > U� LU SUB-BSMT vof ° a 0. BASEMENT 1ST FLOOR 2ND FLOORTt 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR —ELL -Installing Company Name ' Check one: Certificate Address_ D g0� .72 Corporation Nv, r4�Ao„�. wt old S Business Telephone 'J� ,� �9 ❑ Partnership Name of Licensed Plumber.or Gas Fitter / - �(,rqN E"f� ❑ Firm/ca. INSURANCE COVERAGE: "1 have a current(lability insurance policy or its substa Yes No ntial equivalent, which rneets the requirement; of MGL CtL 142. � p If you have checked yes,please indicate the type of coverage by checking the appropriate box. � A liability insurance policy Other type of indemnity ❑ Bond OWNER'S INSURNACE WAIVER: 1 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 thisperm application Walves this requirement S gna re o 0 Wner or Owner's Agen Check one: Owner ❑ Agent ❑ I hereby certify that all of the detalis and information I have submitted for 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 State Gas Code and chapter 142 of the General Laws. Type of License: Bylumber Tide pCasfitter k9na reo�Cens�edPlum&er Gas Flt'ter APPROVn aster License Number APPROED(OFFICE USE ONLY) Journeyman 8597 9 D Date. . !!. . . . . . . . TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING �' +O+,rev•A�.(•7 ,SSACMUSf J This certifies that . . . . . . . has permission to perform . :z - 1 a. . . . . . . . . . . . . . plu bin i/n�the buil Ings of . . exf .... . . . . . . . . . . . . . . . at e !. GGD�� � ��/lj. . . � .f).C.�C.I1i rth Andover, Mass. Fee. . . ..�.•."�Lic. No..�-.��.�/�. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR Check # 6177 'MASSACHUSETTS UNIFORM APPLICATION FOR ERMIT TO.DO PLUMBING _ _ - - . fPrint or Type) 7 Mass. Date 54c T ©b Permit# �1 / •� - Buading Location G 1.� R� Owners Name t N Type of Occupancy (L�� New Renovation O Replacement. Plans Submitted: Yes O No . FIXTURES z as • rn � a o z _ > W 7• V < LU O Z N < C < ~ z O CC Z H d •'� C = fA J O W O C YH V W N Y < ca d 3 x (� S O y W } < N H E D < 0 C C d C O 16 z C Q < W _= r C O '7 < W W 0 N C .4 p y. O 0 2 ._ Y d Q F- < Y < W k Y W ya O all, Z! O O N Z Z .W H O v s F• < < S < < _ < -j .C W 3 ¢ m O suit—SSMT. BASEMENT s 1ST FLOOR 2NO FLOOR SRO FLOOR 4TH FLOOR STH FLOOR 6TH.FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name LAJ %I IZOCJC f LUM61fj!j {-IAC A'ltrfc, Check one:. Certificate Address P D $4�L' r/2$ Corporation I L00 No A r%/00 kat., V14 • 0_1 Lt O Partnership Business Telephone S 9'l .t �} O,Fh rm/Co. Nanje of licensed Plumber Qo�l(cIZT gLANGbI�`t`C iNSUAANCE COVERAGE: s I have a current liability Insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142: Yes. No ❑ i If you have checked Yes, please indicate the type coverage by checking the appropriate box A liabW Insurance policy Other type of Indemnity ❑ Bond O OWNER'S INSURANCE WAIVER:-1 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 O .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 State Plumbing Code and Chapter 142 of the General Laws. Signature of Licensed Plumber Type of License:Master'g Jourheyman❑ 5 C;tylr"own � <ci ( FIC US NL license Number 8517 E Date.. . . . NORTH 1 Of ..ao TOWN OF NORTH ANDOVER 49 PERMIT FOR GAS INSTALLATION _ 9 9 �9SSACHUSEtt certifies that . . .� . �• �. . . . . This cert has permission for gas installation./.x --. �. . � . . . . . . . . . . in the buildings of ... . . . . . . . . . . . . . . . . . • • • • • • at :l .L� F? ' 1- f: �'� . %�_I o th Andover, Mass. Fea6R.. . . Lic. No.. 517. . . . . . . . . . . . . . . . . . . . . . . . . . . GAS INSPECTOR J^, Check# `4845 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) F 00' Alk►QO�r<R Mass. Date SfiT 10 V-�DA Permit a + Building Location Co tM O L N E- Owner's Name K%N67SLlIL!/ — � T x_ Type of Occupancy RESIDENCE 7'�M 5vsy`0�� New Renovation ❑ ReplIc ent ❑ Plans Submitted: Yes ❑ No W vi to UZ CC cc Q W caH = ~ to O W ~QE cc } Z O ~ W a: m co W W O a O W W = Z H Cl) O ¢ > 0 H Z J Z W W 0 Q W LL W U J W � Q � � �, $ Z8Z g � = X X o _ U. D o 0 3 ° > o o o SUB-BSMT. BASEMENT 1ST FLOOR 1 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name VAi'rr F-,otK Pl.yv►nbt N4 *tlFaA'Citnt� Check one: Certificate # Address 20 ib q%= '728 Corporation (PO NO, 0N00\1kfi- MA 00346' ❑ Partnership Business Telephone P)o -1S-Lyzi 1 - ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter KOIF C-CE &AKA-Ak-r-t E INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YesNo ❑ i If you have checked Yes, please indicate the type coverage by checking the appropriate box. A 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 ❑ 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 installation performed under the permit issued for this application will be in compliance with all pertinent.provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By Type of License: Plumber Title ❑ Gasfitter Signature of Licensed Plumber or Gas Fitter ^ . City/Town ;K Master El Journeymen License Number APPROVED(OFFICE USE ONLY) • S 7 I ,r Date.................................. NORTq TOWN OF NORTH ANDOVER ' PERMIT FOR WIRING - SSACNUS� 3 This certifies that .............. . . ...... ....... ................ .....,............... has permission to perform ._. �'J(lztlt— .,........... _ ........... wiring in the buildig of.. . ....�.� ......... �T' rth Andover,Mass. }Fee...»..m)... Lic.Ngr 1,;;.l ,,`........... ........................................... 3 !�7 RICAL INSPECTOR Cck # 5484 THE COMMONWEALTH OFMAsumuSL+'T s Office Use only�'� DEPARTMENT0FPUBIICS4FMY rL �� Permit No. BOARDOFFMPREVE MONR CvUTAHONS527CMR12(BVI Occupancy&Fees Checked Jed APPLICA77ONFOR PERMIT TO PERF? WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACIU SSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) ( 3 5 6�G 6tl Owner or Tenant —0b (Irj ut le-)l Owner's Address 5 cc-,(m Is this permit in conjunction with a building permit: Yes E3 No r-1-71 (Check Appropriate Box) Purpose of Building ee--5 Utility Authorization No. 2= _ Existing Service Ampst/20/ Overhead Underground No.of Meters New Service Amps Volts Overhead Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work 7474 -1,'[,✓o 47 7777- 777 77 7777-77, 77777, c- No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total No.of Lighting Fixtures Swimming Pool Above Below Generators KVAKVA round round No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local 0 Municipal Other No.of Water Heaters KW No.of No.of Connections Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER• =C0Wrage.P►uWvYtothetegtmerna>tsofMasm�G=alI-aws Ihaveaa>aa�tLiat>�Yh>s�aarrePt�icYinch>c�gComPle� C0vW4p0r9ssubsWntalepvalat YES I I NO Ih�esubir&adV9d ofsametoft011ioe YES � LTJ F�'°t'�ri�YES,pleaseir�dicalethetypeofonvsageby box BOND r7 ORIfER M (Pl m may) - C-) FxpuaoonD* �✓t 1�C F/� Estim&d Valueofl7ecydcal W0d($ WodctoStatt �- 'c:;-c) hrspectionD&Regttesled Rough Final Signed under' rai)Aesofpaw.. p BRMNANIE J'i"Ak2 S ! ae r:�r"' Lioe=NO. Iicen�e J�tLyi�.� �et l C J� Sigmi uue — LioenseNo L .2� S BushmTeLNo. AkTei No. L 3E OWNER'SINSURANCEWAIVFR;IamaWatetudrLioe wdties theinmumcovwAperitsatsbrtialeq valatasmgtmadbyNb%admsmc x alLaws andel-atmysigraftaeon duspeunitapplicatim waives this reqmanat. (Plea(Se check one) Owner Agent Telephone No. PERMIT FEE$ signature of Owner or Agent