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HomeMy WebLinkAboutMiscellaneous - 17 ARDMORE COURT 4/30/2018 i I a i Date- f .................... -Y NORTH 0t�"`° °1" TOWN OF NORTH ANDOVER PERMIT FOR WIRING �,SSACMUS� This certifies that C has permission to perform V - ..�<s: .................................................. wiring in the building of...k:, ...................... at... ..............._........................ .. ................. ,North Andover,Mass. ���i. � Fee,—,k—.............. Lic.No...... .,.._ .. ................................f` ...................... ELECTRICALINS PECTO Check # 73l> 6457 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. �y�"7 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked 'Zv kv [Rev. 11/991 leave blank 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: 02/02/2006 City or Town of: North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 17 Ardmore Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 Owner's Address 10 Wood Ridge Drive,North Andover,MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residence 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: Replaced Light Switch ! Completion o the followin table may be waived by the Inspector of Wires. No.of Recessed Fixtures No.of Ceil: No.of Total Susp.(Paddle)Fans Transformers KVA i No.of Lighting Outlets No.of Hot Tubs Generators KVA AboveIn- o.o Emergency Lighting No.of Lighting Fixtures Swimming Pool rnd. ❑ rnd. ❑ Batte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 1 No.of Gas Burners No.of Detection and _ Initiatin Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons Heat Pump Number Tons KW No.of Self-Contained No.of Waste Disposers .................................................... Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal []'Other Connection pp KW No.of Dryers HeatingAppliances Security Systems: No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 of same to the permit issuing office. CHECK ONE: INSURANCE X BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Landers Electrical Co.,Inc. LIC.NO.: A5912 Licensee: Terrence J.Landers,Vice-President Signature LIC.NO.: 9743 (If applicable,enter "exempt"in the license number line.) Bus.Tel.No.: 978-686-3828 Address: 1000 Osgood Street,North Andover,MA 01845 Alt.Tel.No.: 978-686-3829 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 a ent. Owner/Agent PERMIT FEE. $20.00 Signature Telephone No. 6378 F` jj ` Date....¢..+2. .` .. NORTH "� TOWN OF NORTH ANDOVER V'f p PERMIT FOR WIRING ACMUS� ,- .41 Thiscertifies that ..........................`...... .............................................................................. has permission to perform .... . ..�..�U�.L.....�` ............ ...... ..... .. . ,p wiring in the building of � ��<.�.� e. tt—sV . .. f1. ,North Andover,Mass. 7 , F6e.... ?`�.©—^— ... Lic.No. ...'5..7t �.4..................... . .. . . - ELECTRICALINSPECTOR C .Check # _ Commonwealth of Massachusetts Official UsOnly Name a Department of Fire Services Permit No. (% BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked E' [Rev. 11/991 leave blank 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: 01/24/2006 City or Town oh North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 17 Ardmore Owner or Tenant Wood Ridge Homes Telephone No. 978423-7867 Owner's Address 10 Wood Ridge Drive, North Andover,MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residence Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters pNumber of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installed A/C Outlet Completion o the ollowin table may be waived by the Inspector of Wires. 1, No.of Recessed Fixtures No.of Ceil: No.of Total Susp.(Paddle)Fans Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA ( AboveIn- Wo-.—Or Emergency Lighting No.of Lighting Fixtures Swimming Pool rnd. ❑ rnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g E Heat Pump Number Tons J.KW No.of Self-Contained No.of Waste Disposers Totals: ...................... Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 of same to the permit issuing office. CHECK ONE: INSURANCE X BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) E Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: Landers Electrical Co.,Inc. A LIC.NO.: A5912 L Licensee: Terrence J.Landers,Vice-President Signature LIC.NO.: 9743 (Ifapplicable, enter "exempt"in the license number line.) Bus.Tel.No.: 978-686-3828 Address: 1000 Osgood Street,North Andover,MA 01845 Alt.Tel.No.: 9:78-686-3829 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 a ent. Owner/Agent PERMIT FEE. $5.00 Signature Telephone No. I 1r j � � �n it 1 - NDERS E4ECTRICAL CO.,INC. RECEIVED Wood Ridge Homes OCT 2 6 ATTN: Gary 2005 10 Wood Ridge Drive No. Andover, MA 01845 _ INVOICE October 24, 2005 INVOICE # 050319 07/19/2005 Installed A/C Outlet, 17 Ardmore Material & Labor: $ 210.89 TOTAL DUE THIS INVOICE: $ 210.89 TERMS: Net Due Upon Receipt of Invoice 2.0% Per Month Finance Charge On Balances Over 30 Days THANK YOU 1000 OSGOOD STREET PO BOX 783 NORTH ANDOVER, MA 01845 TEL(978)686-3828 FAX(978)682-1646 Date �.. . . .-. . b. . 4� "0a7 11 TOWN OF NORTH ANDOVER p 1 PERMIT FOR PLUMBING This certifies that . . . . . . . . . .- ". . . . . . . . . . . . . a has permission,to perform . . . . . . . . . ,,.� � �•. . . . . . . . . . . . . plumbing in the buildings'of1 �^ at . . . . . .. orth Andover, Mass. Fe d. .Lic. No.. � .6�' ��ZPLUM � : . . . . . . . .. . . . . d C INSPECTOR Check # 6822 I MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS �� Date Building Location �/� wners Name Permit# Amount A{a Type of Occupancy New Renovation 0 Replacement dans Submitted Yes No FIXTURES z Q ho z w a w z z N4.1 Cn z Q SUB-BM RASE i1\l ����m 1. i IST 1H7" z"1`LOy R i M 1'1_]lJl_.d\ 4M MOOR M HIM 6M 5 �MOOR 7M Ply LF OM HJDM 4— (Print or type) Check one: Certificate Installing Company Name ❑ Corp. Address CN,i-oXt. Partner. s s Businesse ep one Irm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy ❑ ❑ ,! Y P Y ther 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 I Signature Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted(or entere ove application rue and accurate to the best of my knowledge and that all plumbing work and installations per e. r P t Iss f is a plication will be in compliance with all pertinent provisions of the Massachusetts St o and Clter of e General Laws. By: is ure o se um er Title Type of Plat bing License Cit /Town rcenseum er Master ❑ Journeyman APPROVED(OFFICE USE ONLY ,r:.....-;«-.�..,-...ter...;...s•. +r.+.....,,� ..-..+,i'e,:...E.. ..>.--.K_ .n -r.. ,.,..,.�: ,.�..-,...s. .,....-.-_... .e...�*... _ Of HORTN �H TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION 9 a �9S CH � . This certifies that . . .t�.`:'�./'a.�. . . . . . . . . . . . . . has permission for gas installation . `. �- �- . . . . . . . . . . . in the buildings of . . . . at . l... . . . . . . . . . . . . . . . . . . . . . . . . . , North Andove"r,�Mass. Fe��. .�. Lic. nor . . . . . . GAS INSp�ECio Check it f 5442 f MASSACHUSETTS UNIFORM APPUCATON FOR PFRNIlT TO DO GAS G (Type or print) Date NORTH ANDOVER,MASSACHUSETTS Building Locations r' 1,a Permit# r / Amount$ O, e r s ame New❑ Renovation ❑ Replacement Plans Submitted ❑ F z faQd v� W W W V W a I o C7 F F F O O cF� Z � d o4 � O• O � O Gzl F 3 A O U 9 SUB -BASEM ENT BASEM ENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR i l (Print or type) �® C e one: Certificate Installing Company Name Corp. Address e�2 ❑ Partner. Business Teleph6ne Name of Licensed Plumber or Gas Fitter ' INSURANI CE COVERAGE• Check one: I have a current liability Insurance policy or it's s tial equivalent. Yes ❑ No❑ If you have checked yes,please indicate ype 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 ❑ t hereby certify that all of the details and information I have submitted(or entered)in bove a catio are true and accurat the best of my knowledge and that all plumbing work and installations performed un a Issued f appli tion w e in compliance with all pertinent provisions of the Massachusetts State Gas Co an C ter 1 e Gene r aws. Signature of Licensed Plum O F- Gas By. Title 1-3Plumber City/Town ❑ Gas Fitter License Number er Mast APPROVED,OFFtCE USE ONLY) oumeyman 3765 Date. ...... NORTH TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING CHUS Et .................. ....................................... This certifies that ..... .......U.6, (jQj has permission to perform ... ........... ........ .... 40............. ..................... wiring in the building of at..... ...........- North Andover, ass 0j. .......... ic.No/P ..... ..... Fee.,�......... ......... L ............. ELECM16AL INSP0&&R Check # Commonwealg o/tl/aeiacltulefli OTliciai Use Only (1 c� cc77 rvcee Permit No. 337v15 . k _L.JeParinten!`m�,.tire�ei �'- BOARD OF FIRE PREVENTION REGULATIONS Occupancy..and Fee Checked Rev. 11/991 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be perl'ormcd in accordance with the Massachusetts Electrical Code(Mr-C).527 ChIR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INrOXIL-1T'ION) Date: j � dCity or Town vP: A� loTo thelnspectorfYires: gives this application the undersigned ges notice of his or her intention to perfomi the electrical work described below. Location (Street& Number)___ Owner orTetrant (,()pvc4 fLtd t•anmt=f_ `�1fb6�ZOr�3 Telephone i\'o. Owner's Address /f) �i//JQe(tl il4t zz, Is this permit in conjunction'with n building permit? Yes ❑ No, r' -(Check Appropriate Box) Purliosc of Building (' es d•LK4t0.X Utility Authorization No. Existing Seri-ice 4jedd Antps 12 / Volts OverlicadEJ Uud r. d No..of Meters . 10 New Service S�yvL Antps /. Volts Overhead❑. Undgrd ❑ No,of Nleters. Number of Feeders and Ampacily 5 Location and Nature of Proposed Electrical Work: t C •G�i��tiriiti1'f �r9N�5( i Completion of the�o!lvuine table ma be naived b+the instaI'ector orivires No.of Recessed Fixtures No.of Ceii.-Susp.(Paddle)Fans 1 o•o b ` Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KAVA No.of Lighting Fixtures Stirimnting Pool A ove ❑ In- ❑ 1 0.o mergency Ig i nig gr id- rnd. Batte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARNIS No.of Zones No.of Sivitcltes No.of Gas Burners t o.o Detection and Iuiliatino Devices 1 ( No.of Ranges TonTots No.or Alerting Devices b No.or Air Cond. No.of Waste Disposers Heat Yump Number Ions h\ No.orSel- ontained Totals: Detection/Alerting Devices No.of Dishtivashers Space/Area Heating KW Local ❑ n unncipa Connection Other No. of Dryers Heating,Appliances Kw Securityof Devices or Equivalent Systems: t v.of Nater t`1 o.of No.of No. Heaters KWData 1Viringc Stotts Ballasts No.or Devices or E uivalent No.Hrdrotnassage BathtubsNo.oftllotors 'total�lIP I decommunicattons Wiring: No.of Devices or E OTHER: uivalent Attach additional detail ijdesired.or as required by the Inspector of!Vires. INSURAiNCE COVERAGE: Unless waived by the ourner,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 of same to the permit issuing office. CHECK ONE- INSURANCE Q/ BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: y municipal policy.)required re uen Whb (Exp. ation Date) ( q nt Work to Start: — .510 Z Inspections to be requested in accordance with MEC Rule 10,and upon completion. I cet•tif•, under the pains and penalties ojperjury,that the injornratiort otr this applicativtn is true and con ple�tc: F1101 NADIE: ell Nd �L -t .r n ` �J- . Licensee: y lLIC.NO.:_ iiG �tCh SignatuP- C LIC.�i0.• . (ljapplicable,enter"c.,c it in the license n umber fts _ dOSJe Address: i5ayt A r ( 3 Bus.Tel.No.. OWNER' Ii ISUR:��iCE WAIVER: I am aware that the Licensee docs not Gave the alt.Tel.No.; $ y Inability uisurance coverage normally required by law. By my signature below,I hereby naive this requirement. I am the(check one ow , Owner/Agent ❑ mer o��net's agent; Owner/Agent Signature Telephone No. P1:Rt1IIT FEL: Date. °'<".��T:��a TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING SAC14US� This certifies that . . . . . . t/"L f. . . . . .5. . . . . . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . P.r. . . - . . . . . . . . . . . . . .j '. , North An/dover, Mass. a� CD ` Fee. .3 . . . .Lic. No.. L. 5T . . . . . . . 4 . . . . . .: . . R'UM81NG INSPECTOR Check # 6764 e MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS nn Date 1XP Building Location l:f Owners Name Permit# ?6 11 1� Type of Occupancy Amount 3 L 4:1 L New Renovation Replacement Plans Submitted Yes ❑ No 0 FIX URES k t fYt !P a 3 w 3 a RASEM yr SE FIOCR M HDM 3M HBM 4M FLOOR 5M HiaR 6M It" V 7M HJOM Q \b oM RiaR1 y (Print or type) , Check one: Certificate Installing Company Name-le Corp. Address Jvstut-y- El Partner. iQ Business Telephone Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indica e t type of insuran a coverage by checking the appropriate box: Liability insurance policy 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 OwnerEl Agent ent 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 pe rrn d nder Permit Issued for this application will be in compliance with all pertinent provisions of the Massa husetts State o nd Chapter 142 of the General Laws. By: 1gna ae o se um er � Title ype of Plumbing License City/Town rc nse um Der Master Journeyman D APPROVED(OFFICE USE ONLY /f I R 0 WOLF ELUJG1BMG d HEA TMQ INVOICE NUMBER: 'WfY 25 INVOICE DATE: 7-SEP-05 P. O. BOX # 2229 SALEM, N.B. 03079 RAND LPH H. WOLF TEL: 603-$98-6505 MA. )WASTER PLUMBER # 1229-9 ERX:SAME CELL AHEAD CUSTOMER: WOODRIDGE HOMES CO-op TELEPHONE: ADDRESS: 10 WOODRIDGE DR. FAX: CITY,STATE.POSTAL CODE: NO. ANDOVER. MA. 01$45 PO NUMBER: 17 ARDMORE ORDER DATE GARY: T ® START END DATEt RANDY 2.50 $90.00 7-SEP-05 225.00 0.00 $0.00 a TOTAL.ACTIVITY COST: _.._.._. .. ..,... , $ 25:00 1)1/2CM INSTALL TUB AND WASTE 1.00 1) 1/2 C 90 RESET SHOWER VALVE 1.00 2) 1/2C MIL BANGER FOR REW TUB 3.00 2`) 1/2 COP TUBE 0 .0 1) BRASS TUB WASTE B22.00 0.00 0.00 0.00 0.00 0.00 TOTAL MATERIALS COST: $7k.00 NET_ 10 DAYS THANK YOU TOTAL BILLING: $297.00 Invoice 1 J // l/ D41 ate./,!. JJJ ,ORT TOWN OF NORTH ANDOVER ° PERMIT FOR PLUMBING SsACHU This certifies that . . . . . . . . . . . . . . . . . . . . has permission to perform . . T. . . . . _ plumbing in the buildings of ! L c-c r� at. . � � . . .��.!�.� . . . . -T. . . . . . . . . . . . . .. North Andover, Mass. Fee. Lic. No./<A. 7. s. }} . . -' ,^. )PLUMBING INSPECTOR Check # '` 6763 c MASSACHUSETTS U NIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) Date NORTH ANDOVER,MASSACHUSETTS 1 Permit# 7 6 3 Owners Name 1 Amount L - Building Location tolac f Occu anc ❑ ❑ ement , Plans Submitted Yes No New � Renovation 13 FIXTURES z 3 � 3 avot�tJocn 31n FLOCIt 4UI HDM 5M 1FI D� sn3&OCR SIH Certificate Check one: a Corp. (Print or type) Installing Company Name ❑ Partner. Address 0 Firm/Co. S Business a ep one �y( j/cchking the appropriate box: Name of Licensed Plumber: a of insurance overage by hec ❑ gond Insurance Coverage Indicat a tyP other type of indemnity Liability insurance policyone of the above Insurance Waiver: I the u ersigned,have been made aware that the licensee of this application does not have any three insurance 13Agent 13 Owner ignature d under Permit Issued for this application will be in details and information I have submitted(or entered)in above application are true and accurate to e I hereby certify that all of the work and installatio perform best of my knowledge and that all plumbing ode and Chapter 142 of the General La compliance with all pertinent provisions of the Massachusetts e 1 i u icense m e lu bing License By: Ty e? ✓Jv Master Journeyman ❑ Title i ense um er City/Town APPROVED(OFFICE USE ONLY R. It. WOLF PLU) BLNG d NEATVV6 INVOICENUMI3M lffftl23 INVOICE DATE: 31-AUG-05 P.0. BOX # 2229 SALEM, N.M. 03079 RANDOLPH H. GOLF TEL: 603-898-6505 MA. MASTER PLUMBER 12299 I:AX:SAM£CALL AHEAD CUSTOMER: WOODRIDC£ HOMES CO-OP TELEPHONE: ADDRESS. 10 WOODRIDUE DR. FAX: CrrY,STATE,POSTAL CODE: NO. ANDOVER, MA. 01645 PO NUMBER: 17 ARDMORE ORDER DATE GARY: > > 1 ® START ) DATE RANDY 3.00 $90.00 31-AU0-06 270.00 0.00 $0.00 V—r u ! LUu� ya d' TOTAL ACTIVITY COST: $270.00 �VDJAIWMMII • 7J1/2CMA INSTALL SYM014S SHOWER 1.00 2) 1/2C 90 VALVE 1.00 1) 1/2C SLIP Coin 0.50 2') 1/2 COP TUBE 2.00 0.00 0.00 0.00 0.00 .0.00 0.00 TOTAL MATERIALS COST. NET. 10 DAYS THANK YOU TOTAL BILLING: $274.50 Invoice Z x NORTH ANDOVER HEALTH DEPARTMENT 120 Main Street • North Andover, MA 01845 Telephone (508) 682-6483, Ext. 32 Housing Inspection Report ' COMPLAINT # � NdY9�V1 pm , � h��J (�y., COMPLAINANT pm& C,� Rt ADDRESS OF PREMISES OCCUPANT OWNER OWNER'S ADDRESS DATE OF INSPECTION HOUR ROOMS/VIOLATION: - unwnm _-WrA -112 -Wff VIX7 A0 K M . /y INSPECTOR Form#HIR•1 Actlon Press 885.7000 .9 • �. .• � 1 1, y , ,•1 '� c ,. �.. o .• .• �. �. .•• _ ,t.• + � < ' • � • � � � � � .� _ l J .. 1 � •Yi " •. Y ' /. • { • , • • , t • • �• • , • rtf• • •� � •�. IF � ♦ � . > ; • t. .�. ` � ' � + � ` � •'• • !, � Ali • � i 1 Address 47 /7-/<0Av,t,,�,g C T Title of File Page of Date File Open: Date file closed: [DDocument/Action Title Date of Refer to other Purpose of Document/Action and notes an Document/ document/ Nu:ni. Action Department Board of Appeals — Board of Health — Planning Board — Conservation Commission — Building Department G�