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HomeMy WebLinkAboutMiscellaneous - 141 ROSEMONT DRIVE 4/30/2018 141 ROSEMONT DRIVE 210/098.6-0054-0000.0 i 0369 Date la 4/- /,1'- ....................... 40RTH TOWN OF NORTH ANDOVER 0 0 PERMIT FOR WIRING SS CHUS This certifies that ................. .......... has permission to perform .... 1-101..... ................ wiring in the building of..................���S4 .................................... at........ ........ ......... orth Andover,Mass. Fee.�.'J..-- .. Lic.No.5........................ ........ CTRIcAL INSP"'oR Check « i 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Ru le 8: In accordance with the provisions of M.G.L.c.143,§3L,the Permit application form to provide notice of installation of wiring shall b ,niform throughout the Commonwealth,and applications shall be filed "'+ on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166,§32,an electrical permit shall be issued to the person,firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall-be limited as to the time ofongoing construction activity,and may be_deemed_by.the Inspector_of_Wires abandoned_and_invalid.ifhe____. ._ or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. . The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit ExtensionAct furthers s thi purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property,With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008 and extending'through August 15,2012. ule i�—Permit/Date Closed:4 2, ",�.. � Note:Reapply for new permi rOPermit Extension Act—Permit/Date Closed:: � ConunonwaaLtli o�ec777//a�lac�uesabf, Official Use Only a(JePcufinenf o�}ire�eruiced Permit No. W ✓_ 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), 27 C 12.00 (PLEASE PRINT IN INK OR TYPE INF Iwovelr ION) Date: 2-C► 4 City or Town of: X� To the Inspect r of res: By this application the undersigned gives notice 7�� r intentioerfo the electrical work described below. Location(Street&Number) 1 Owner or Tenant t Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ 'Undgrd❑ No.of Meters I Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: yn� s Completion of the folioivin table nt be waived by the Inspector of 111res. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans o.of Tota Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above Ei In- No.or Emergency Lighting No,of Luminaires Swimming Pool rnd. grnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 9 No.of Gas Burners No.of Detection an Initiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers eat Pump Number ons K o.o e f= ontame p Totals: -� Detection/Alerting Devices No.of Dishwashers Space/Area Beating KW Local❑ Connecton F1Other No.of Dryers Beating Appliances Key Security ystems: j rY No.of Devices or E uivalent No.of Water KW 0.0 No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent jelecommunications Wiring No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: ) -e S _ Attach additional detail if desired,or as required by the Inspector of Iljires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: --ft— 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,' surance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cov ge is in force,and has exhibited proof of s e to the pe it issuing o ce. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) � b�'4 %Z J31 /'t:) I certify,under the acus altd pen f of erjury,t1 t the nt rntation ou us app Icatt is true and on ete ((�, FIRM NAME: vE'c� IC LIC.NO.: I �� � Licensee: <�.OAf h �✓tJ j Signature _ t -t, LIC.NO.: Wapplicable.ent "eeem i"in the license number 1' Bus.Tel.No.• Address: i li0/ Alt.Tel. "Per M.G.L.c. 147,s.57-61,security w requires Department of Public Safety"S"License: .Lic.No. OWNER'S INSURANCE WAIVER: 1 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 PERMIT FEE: $ Signature Telephone No. 78 , 9 Date. f.1Zf./.eY. .. .. .. .. ,4ORT" Of �.ao ,°1ti0 TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION �9SSACHUSES I. This certifies that . 6mg,5 . . . . . . . . . . . . . . . . v . .1 has permission for gas installation . s' �. . . . . . . . . . . . . . . . in the buildings or'<G. . . . . . . . . . . . . .ndover. . . . . .Mass. . . . . at . . AP . I4G4'.: . . . . . . . , North ; . Fee.4� c. No.. o. GAS INSPECTOR Check# MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING City/Town:-Norkh At.%1o.,ec MA. Date: g1jI Permit# Building Location: N1 Owners Name: l-n-c e' eco 1 Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional❑ Residential[k] New: ® Alteration: ❑ Renovation: ❑ Replacement: ❑ Plans Submitted: Yes❑ No EA FIXTURES co W Lu N U = of Z In W 0 LU W v N O = W W IN z1-- Z O tY W = Lu �, O �` t W F' w o ui CO Z W Z ° = O a W o J- X o W 1— IL > W W Z O J i— i— O Z —t 0 LL � = W � W W u O IY Q tL' W W m W O Z O N > Z 1— = t v o o U. c9 t7 x s � O a � H > > > ~O v M SUB BSMT. BASEMENT 1 FLOOR 2 ND FLOOR r 3 FLOOR 4 FLOOR STH FLOOR 6 FLOOR -i'FLOOR 8 FLOOR Installing Company Name: Mk4wifu Rof-tc, Check One Only Certificate# El Corporation Address: 3I romI•S1- City/Town:�1�� (�,�.. State: ,Yy} El Partnership Business Tel:_`176 X636 21 2) Fax: q 7e6 3bz lSaf� �?Firm/Company Name of Licensed Plumber/Gas Fitter: w kio INSURANCE COVERAGE: I have a current liabili insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes-f No❑ If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. 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 Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Signature of Owner or Owner's Agent Owner 1:1 Agent El By checking this box❑;I hereby certify that all of the details and information I have submitted(or entered)regarding this 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 provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Type of License: By ❑Plumber Title EJ Gas Fitter®Master Signa ure of LIcertsed Plumber/Gas Fitter _ Cityrrown ❑Journeyman License Number: L3SS� APPROVED OFFICE USE ONLY ❑LP Installer H M 7 f t CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number, ��P O Date 3 d 9 7 THIS CERTIFIES THAT THE BUILDING LOCATED ON MAY BE OCCUPIED ASG IWA" ICCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. PORT.'ap CERTIFICATE ISSUED TO / ADDRESS 49 ss�c«us� G Building Inspector NORTH Town of And . No.360 ° _ ° `= AKE dover, Mass., 7 19 �. Iw{�e COC MIC ME WICK •7S0RATED BOARD OF HEALTH DFood/Kitchen PER. MIT T Septic System THIS CERTIFIES THAT l� BUILDING INSPECTOR ..... ............... � `'ff . ........................................................ Fo dation has permission to erect.....:.....Q ?'1..�...:....:.. buildings on ............1..ej4.�.....:.�,e?,T. ... A-7':�"'..�I je 0 ....... �f E>....................z... .�.�.... Chimney to be occupied as......................:..................... G� !g . . provided that the person accepting this permit shall in every respect conform to the erms 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. PLUMBIN SP CTOR VIOLATION of the,Zoning or Build!-fig Regulations Voids this Permit. °ll �^'�� PPPk Arr WV-DTD T7c n.TT,r v V 1V10�V 1 r1S UNLESS CONSTRUCTION STAR ELECTRIC IN CT .............................. .... ..... .. ..................... Service BUILDING INSPECTOR to Occupancy Permit Required to Occupy Building GAS INSPE TOR Display in a Conspicuous Place on the Premises — Do Not Remove R°ugh F.n No Lathing or Dry Wall To Be Done Until Inspected-and Approved by the Building Inspector. FI DEPARTMENT Burner Street No.P,-, ,Z'b?7n SPS>'Ik/trs 9.0 iZ -97 �� $�►'? 4: Smoke Det. Mcation / �-. ljy5p"g4owO k oU Date 7-A V1 . "°"T" O TOWN OF NORTH ANDOVER CU a. ,.�.o .,tia Certificate of Occupancy $ Building/Frame Permit Fee $ M �1ss�cNus t Foundation Permit Fee $tw o' y Other Permit Fee $ Sewer Connection Fee $ 7 _ Water Connection Fee TOTAL. wldiIns . forsix � 91 .puc Works Y N `� DivI Location s . No. ?S '('� Date eta;° T" TOWN OF NORTH ANDOVER t ;, Certificate of Occupancy, ,Building/Frame Permit Fee $ .Foundations Permit Fee $ � s�cMus t- r` Other Permit Fee $ — — `Sewer Connection Fee $ � Water Connection Fee $ TOTAL $ �� (Building IhsQector Div. Public Works o as . '_.. •�--..-...,:amt*+pieyi�yl,.:,�.�,:,-'y-,iw:r9-..^..-s:xiP�.trd, ra-+n'.Y" Location ? ¢� /h d� f No. , Date pORTH, TOWN OF NORTH ANDOVER F ; Certificate of Occupancy $ a ' Building/Frame Permit Fee $ cMUSEt Foundation Permit Fee $ ` z,. Other Permit Fee $ Sewer Connection Fee $ C : ; .t -`Water Connection Fee $ , TOTAL IlBuilding Inspector , zV2 _01:t Div.Public Works PERMIT*NO. - APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. V/ PAGE 1 MAP 4-40. 0<19 I LOT NO. 00 sq 2 RECORD OF OWNERSHIP ;DAT BOOK ;PAGE — ZONE SUB DI1. V. LOT NO. z LOCATION St'�1 r PURPOSE OF BUILDING OWNER'S NAMf f lir `T NO. OF STORIES -21 SIZE OWNER'S ADDRESS Jl/ /J,w? P BASEMENT OR SLAB Gyi•'f M OYL(1/Pp/7 GJ H yT ARCHITECT'S NAME 7 j 1-/Via&-j!; 'T. C' SIZE OF FLOOR TIMBERS IST n�/� 2ND ry 3RD BUILDER'S NAME --7-,,V �S�'7G�pYs Li-f-CQ SPAN •l R DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS --- DISTANCE FROM STREET s P✓ "' POSTSl�— DISTANCE FROM LOT LINES-SIDES REAR //�J) GIRDERS T AREA OF LOT /JJA'pFRONTAGE /,,p � HEIGHT OF FOUNDATION THICKNESS `t f� IS BUILDING NEW ,L` s, SIZE OF FOOTING X IS BUILDING ]ADDITION _ `� MATERIAL OF CHIMNEY A�/Y G IS BUILDING ALTERATION /~! ® IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE t IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY f� Y / IS BUILDING CONNECTED TO TOWN SEWER �Y IS BUILDING CONNECTED TO NATURAL GAS LINE p INSTRUCTIONS 3 PROPERTY INFORMATION SEE BOTH SIDES LAND COST EST. BLDG. COST PAGE t FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS i - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS S PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE D BUILDING INSPCCTOR GNATU E dF OWNER OR AUTHORIZED AGENT �y F E E OWNER TEL.# PERMIT GRANTED CONTR.TEL.# 19 - J— -- I Ct�11n. DUE FRAME PERMIT$ ` H.Lc.# 91100 c>? -3, /0109 --- /6v .6"1 � U < < o T T_ ' BUILDING RECORD , 1 OCCUPANCY 12 SINGLE FAMILY s"oRlEs 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 d 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ _ DRY WALL _ UNFIN. 3 BASEMENT. AREA FULL FIN. B M AREA _ '/ 1/2 FIN. ATTIC AREA ' NO BMT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARD%fJ'D _ ASBESTOS SIDING _ COMMON VERT. SIDING ASPH. TILE STUCCO ON MASONRY ` STUCCO ON FRAME BRICK ON MASONRY,-, ATTIC STIRS. 8 FLOOR _ BRICK ON FRAME I r CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR ADI� POOR EQUATE NONE 5 ROOF 10 PLUMBING GABLE HIP BATH 13 FIX.) _ GAMBREL I MANSARD TOILET RM. 12 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 FORGED HOT AIR FURN. TIMBER BMS. b COLS. STEAM , STEEL BMS. &COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITION I 1 RADIANT H' UNIT HEATERS 7 NO. OF ROOMS GAS .Alm OIL +�.�.�.. X i Tf #��V -m B'M'T 2nd _ ELECTRIC 1it 13rd NO HEATING 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: �� .l�� Phone ZPN-- LOCATION: Assessor's Map Number Parcel Subdivision i✓,7tA AhJvrr- r�4Lot(s) Street q 2�r�%Ad St. Number a�a ************************Official Use Only************************ RECO NDATI S OF O GENTS: Date Approved Conservation Administrator Date Rejected Comments 0 OK Ad Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected C1/y\-tblt �n 9 wl�p 4% Date Approved 2Z I g Co Septic Inspector-Health /44LAA_A, � Date Rejected Comments Public Works - sewer/water connections �0 7- 17- - - f7- driveway permit 71T L10 ?`f 7^ 9 Fire Department r� OF Received by Building Inspector Date LOT 27 66.00' i s 3B4-` '' �c�NLOT 32/� cmLo h 380pa 31m IST 370 -- 360 L 0 T 31 �6 - -- - l �� ;r— 350 346 LOT 33 ao J54 Z co O�SF .o. 1 h� Tc=357.00 ? f GAR=356.00 EXIST. HOUSE SLA13=349.20 INV.=346.77 1 6x0x >- ix � w 360 — , ,8� a /3� w N 23.7' > 89 -� �. --� 2 0 ' ' - w �� RO,�SEMON T DRIVE 1 1 - RCn SMH \, DRAIN DMH \ 0010Q RAI i INV-344.27 g` R =0.09 CB INV-:44.27 WATER IN \ �\ \(50 WIDE APpRO VED WAY) NOTE: ALL UTILITY LOCATIONS ARE TO BE FIELD VERIFIED BY THE GRADING / SITE PLAN SITE CONTRACTOR. DOVER 47LLIAMSBURG LDCATSD AT LOT 32 SETBACK: F-20' S-0' R-20' OTHER-20' BETW. BLDG. NORTH ANDOVER ESTATES NORTH ANDOVER, MA LAND PLANNING, INC. "` ° FOR CML ENGINES • LAND SURVEYORS TOLL BROTHERS, INC. ER ENVIRONMENTAL CONSULTANTS 321 COMMONWEALTH ROAD, SUITE 102 167 HARTFORD AVENUE, BELLINGHAM, MA 02019 WAYLAND, MA 01778 (508) 966-4130 FAX (508) 986-5054 5/13/96 1"=40' NAE-3,2 ;: - -- '- G"� Ccryruirruvruue l`z a�,���czeaacjuueCZ`. 1 DEPARTNENT OF PUBLIC SAFETY v ,- TRUCTION SUPERVISOR LICENSE NSE CONS Birthdate Expires. C5 043221 08!16/1997 08/16/1959 Restricted To; . DO DANIEL BERNATAS ;} 1301 UNION 51 NANCNESiER, NN -03104 I I V Restricted To: 00 .183 00 None 1R Masonry only 1G 1 & 2 Fatilr Hoes s Failure to possess a current edition of the Massachusetts State Buiilding.Code is cause for vocatio is lice se. _.. • N°RTH ToVM of t 4 over No.360 ° .�� dover, Mass., 7 _1016 LAKEj, COCMICEWICK V �ADMRATED P`faL '9S BOARD OF HEALTH Food/Kitchen PERR11T T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..............:......................r...4 ..//.........`.��.����,t�' s............:........................................... Foundation has permission to erect...........(7'7..x........... buildings;on ............,1 ...... , .! . -' ` J� Rough • Chimney tobe occupied as.......:..............:..............................:.....I .L ..........Lc!``!1..1....,.................:.................................. provided that the person accepting this permit shall in every respect conform to the ferms 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 Final • PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STAR Rough ...... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR gh Display in a Conspicuous Place on the Premises — Do Not Remove F nal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner qr00 _ Street Na w! Smoke Det. office use only —� t uhz Tnmmnnwadth of Ainsadmifts Permit No. Epartmin2 of Public —Anf tq Occupancy&Fee Checked3190 BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CM 12:00 (PLEASE PRINT 1N INK OR TYPE ALL INFORMATION) Date e (%)) or Town of NORTH ANDOVER To the IM/Pecy6r of Wires: The udersigned applies for a permit to pe22rform the eiectricai work described below. Location (Street & Number) p Owner or Tenant Owner's Address ` Is this permit in conjunction with a uildin permi : Yes (L l_No (Check Appr Puroose of Suildina ��/� Utility Authorization N _ Existing Service Amps _J Volts Overhead '_ Undgrndr- �No. of Meters New Service Amps �"�� Voits Gverhe d _ Undgrnd !G No. of Meters Numoer of Feeders and Ampacity Lccaticn and Nature of Preoosed Electrical :^Doric y �/ �. y No. of Transformers Total No. of Lighting Outlets No. of ':bs KVA A No. of Lighting Fixtures i Swimming Pool g...none= erne. _ I Generators KVA ` No. of Emergency Lighting No. of Recectacie Cutlets No. of Oil turners I Battery Units No. of Switch Outlets i No. of Gas Sumers FIRE ALARMS No. of Zones 'otat No. Detection and No. oNo. of Air Core.f Ranges � +,chs Initiating Devices .-!I No.of year Tc:al Total No. of Disoosais Pumas Tons K\V No. of Bouncing Devices No. of Seif Contained No. of Dishwashers SoaceiArea Heatir.g KW Oetect,oniSouneing Devices Devices Local MuniciDai ^Othar No. of Orvers Heating Devices KW Connec:.on No. of No. at Low voltage No. of Water Heaters KW I Signs Saiiasts Winnc No. :Hvaro Massage Tubs I No. of Molars Total lP OTHER: INSURANCE COVERAGE. Pursuant:o the reeuirements of 1.1-ss-cnusens general Laws I have a current Liaoiiity Insurance Policy inducing Cc m^: 0aerations Coverage or its substantial ecuivaient. YES NO = I have suominee valid orgo,of same to the Office. YES _ NC = If you nave checxee YES. please moicate the type of coverage Dy checKing the aoproo a Dox. INSURANCE SCND = OTHER = (P!ease Scec:fv) (Excitation Oatet Estimates Value of E!e .tical ' orK 5 '1Vorx to Start Inspec:ton Date Racues: F tial ec: Rough Signeo unser :he enar s of p lury: , Z_,�e LIC. NO. i=!RM NAME Licensee Sii!c^�:;:re LIC. NO. Aggress Le Alt. Te « l. No. OWNER'S INSURANCE WAIVER: I am aware that the . see toes not have the insurance coverage or its suostantiai eeutvale t as e euirea by Massachusetts General Laws. ane that my signature on :r:s :ermtt application waives this reewrement. 0 Agent tP!ease cnecK ones / Q^ eiecnone No. PERMIT FEE 5 ((Jv iSionature of Owner or Agenn x-65E5 Date. .1.. //.. NJ2 588 L . f NORT" TOWN OF NORTH ANDOVER PERMIT FOR WIRING ` . _ ,SSACMUSEt .v,. .1 .C�This certifies that f�.! �t s ..�..' �� t 7�/�•�'" .... « has permission to perform wiring in the building of....... ,�<lc .............. at....1..7.. .. .1..�:�.. .�.ru�r.f. j.7................... .North Andover,Mass. Fe AKX".. Lic.No.A.. JKAK ......................................... ELECTRICALINSPECTOR { J&/c!q 13:17 358.00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer . v. .of—— -; -.& valet vgisvi nrru..nra%jai r%jr-s rcasavue ... v.+ . -y— (Print Typal NORTH ANDOVER, , Mau. Oats ov Building ,/ PermK Location � /�� ��s���4 ilk Na mer,a ,/��G� $ New ❑ nenovallon ❑ Replacement ❑ Plant Submitted: Yea❑ No ❑ FIXTURES � « s : W rte. J w O Is shr w ti a M u s M O ac R C = M 1t- s ` ~ w R O = I s 0- 1a- • ,+ M y M M x R h U M M at n 0 .4 s .t s N R M O s r s 71 1.!- y » 10 A -4 let so s es a \ o Y M o16 89 Iso �e 1r i w e o jr s rte- esa >` i p e i i on i o OUK—ftMT. -- KASKMKNT 1sT PLOO" IMO FLOOR ai10 FLOOR 4TH FLOOR aTH FLOOR OTH PLOOR TTH ►LOO" OTHPLOO" Ch k one: Cerlklule Installing Company Name ANDOVER PLG. & IIEATING Co. , INC. Corp. 2122 Address_ 573 112 SQ- UNION ST ❑Partnership LAWRENCE , MA. 01843 ❑Firm/Co. ©usineis Telephone 508 685-8383 Nan-la d Ucensed Plumber GEORGE LAROSE INSURANCE COVERAGE: Checx one I have a current liability Insurance policy or Re substantlal aq uNWent. Yet 11No ❑ If you have checked yam, please Icale the type coverage by checking the appropriate box. A IlablAy Insurance pdIcI Other type d kde n R y Bond ❑ , OWNER'S INSUnANCE WAIVER: I am aware that the licensee dg&jnQt have the Insurance coverage required by Ch-arAer 142 oil Ilse Masa. GeneW laws, and that my signature on this permit application waives this requirement. Check one: Owner ❑ Agent ❑ lj�nai ol fanner a Owner a ens I h+iaby c*01fy that sA or the details and Inlovai0on I have subrMtsd for snla(ecD In sbow appkadon we true and accurate to the best of my krv7w4dge end that all plumbing wodk and Inslallallons Worm+d under the parmA lau►ad fot We appikation will bo in compliance with aN Pertlnenl provi0ons of the Msssachusstta Stale Plumbing Coda and Chaplet 112 of tt>• r LAWS. Ry �-- lilts %gp4txo of Umudumber- -- Ucense i,jumbw 9983 sty/Town A!' I'K?A0 IN FX:E USE ONO) Type of Plumbing Lianas. Journeyman l�J Date. . . .U6.- X394 ttk- 0fNO`OT . '� TOWN OF NORTH ANDOVER ..� .°40 p PERMIT FOR PLUMBING ,SSACMUS� - This certifies that tt . . . x.' J . . has permission to perform plumbing in the buildings of! ,.` at. . / i .�!s /,/7t . North Andover, Mass. Fee. No.. _ _ . . . 1 PLUMBING INSPECTOR f 06/09197 13:27 25.00 PAID ,t WHITE: Applicant CANARY: Building Dept. PINK:Treasurer