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HORTm
SAGMUS�
Date. /.—. .2 ").-. ?
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that .. f .."t1......4 .F '...............
has permission to perform .... ;I? ...� .. D. 1. S�
plumbing in the buildings of J1.. :.....................
at .. �. �.1.... ?G� l / .. �! ......... North Andover, Mass.
Fee . ). ... Lic. No... /( ? `. �. ....... . ct.- �?. ._...... .
/PLUMBING INSPECTOR
Check # t�
5119
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING `� r
(Print or Type) �h I I )Ck��,�, II
�
t L , Mass. Date j 20 Permit #
Building LocatlonVlD
�A\ VA i Owner's N /V�r+Fi11
TelephoneQ / a �Oc { Ty of Occupancy i Fa
V
New O Renovation O Replacement Plans Submitted: Yes O No O
FIXTURES
Check one: Certificate
❑ Corporation
❑ Partnership
`Business Telephone 3-()(? 'L/S �I �%5Z% Frmxo.
Fume of Licensed Plumber ( rct r -a k
INSURANCE COVERAGE:
1 have acurr
Yes;1liabilityInsuran
ra ce policy.or its substantial equivalent which meets the requirements of MGL Ch. 142.
If you have checked Yes, please indicate the type coverage by checking the appropriate box.
A liability Insurance policy 01 Other type of Indemnity ❑ Bond O
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 O
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 plurfibing work and installations performed under the permit issued for this application will be in compliance with all
pertinent provisions of the Massachusetts State Plumbi g Code and Chapter 142 ,t the neral Laws.
BY
na
Title gture Coen of um r
City/Town Type of Ucense: Master
,i O Journeyman O ��
(0 IC US NL Ucense Number I o : y a5 '
I N22267
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that...... ........
has permission to perform4--........
.................... .... . . ...................
wiring in the building of ....... &'�� . . .............................................
......... .........
Y
at...:/%z?.......?�. ............ . 4 e
1.. ........ North Andover, Mass.
Fee ............. Lic.Ndrma�Ilx........................
ELECTRICAL INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
� (>MCI Uw
The Commonwealth of Massachusetts
P..m ,t No.
Occup --c,+ L r— ChIck.d
Department of Public Safety 3/90 iw. blink)
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR t2:00
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All Work to be performed In accordance With the Ma"achusetts Electrical Code, S27 CMR 12:00
(PLEASE PRINT Ili INK OR TYPE ALL INFORHIATION) Date C3
Clcy or Tou-n of U / I C.GUVer To the Inspector of Wires: REG CRY
The undersigned applies for a permit to perform the electrical pork described below, QCT ACT
Location (Street S Nuc r) I� ..
Owner or Tenant T,r Ij- ( 4 U.h KI'ne,
Owner's Address
Is this per=ic in conjunc i with a building permit: Yes ❑ No (Check Appropriate Sox)
?1.a -pose of Building :4�511 _ Utility Authoritacion NO
r..x'_scing Service Aces / Volts Overhead ❑ Undgrd ❑
New Set -Tice Amps / Volts Overhead ❑ Undg-d ❑
N=t,cr of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
No. o: tteter-_
No. o: Yate -s
No.
o£ Lighting Ouclets
INo. of Hot Iubs
i
INo. of Transfo ^ars -oj'
No.
of Lighting Fixtures
ISwiing Pool Above (—i In-
mgrnd. L� grnd.
a
Generators i`n1A
No.
of Receptacle Outlets
�No. of Oil Burners
111111
INo. r Emergency Lighting
Bactery Units
No.
of Switch Outlets
INo. of Gas Burners
IFIRE
ALARMS No. of Zones
local
No. of Detection and
No.
of Ranges
g
No. of Air Cond. tons
Initiating Devices
No.
of Disposals
!ieac Total Total
No. of PuJos Tons KG
No. of Sounding Devices
No.
of Dishwashers
(Space/Area_Heating KW
No. of Self Contained
Detection/Sounding Devices
No.
of Dryers
(Heating Devices KW
_
Local[] Municipal ❑ Oche_
Connection
INo, of No. of
Low Voltage
(Wiring
No.
of Water Heaters
Sizns Ballasts
!✓" ( it 1"1l� ✓ M
No.
Hydro Massage Iubs
INo. of Motors Total HP
OTH:7 :
I;;SURANCE COVERAGE: Pursuant to the requirements of Nassachusects General Laws
I .'lave a current Liability Insurance Policy including Completed dperatlons Coverage or its substantial
equivalent. YES71 NO C] I have submitted valid proof of same to this office. YES ❑ NO 7
If you have checked YES, please indicate the type of coverage by checking the appropriate box.
INSURANCE lel BOND 717 (Please Specify)
lExpiration Dace
Estimated Value of Electrical Work S
Work to Start Inspection Date Requested: Rough Final
Signed under the penalties of perjury: [)' S_5 'O-t>OoS` S
FIRM ."E
NA_B T1 , ks (-.a rw,_ SL' LIC. N'). C IS I LI
Licensee /�&4,rk J Sy 1pe,S jar Signature LIC. N0.
,� � 4 -Bus e . o. ff(
Address jS5 WCS - S± Sti.jr �$ �..a�1,M,atw�► h `
Alt. Tel. No. rCLy�
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does noc have Che insurance coverage or its sub-
scancial equivalent as required by Massachusetts General Laws, and chat my signature on Chis per it
application waives this requirement. Owner Agent (Please check one)
Telephone No. PERMIT FEE S
Signature of Owner or Agenc)
8C.,14A
r
Date.
NO -47;0
TOWN OF NORTH ANDOVER
° PERMIT FOR PLUMBING
�'SSACNUS�
This certifies that .... �� ! ./�! S.Z.....��°t ..��.......... .
has permission to perform ... /`+. w.A t S ..... •� �•
plumbing in the buildings of ../? ._..0 .. %/.�. ./.c-:..; ...... .
at ..%7. 2 ...1.3.Fi� p. � r �(. (...........1 . , North Andover, Mass.
Fee. Lic. No... . 3. Z. ? ...... ...... .
�-LUIVIBING INSPECTOR
Check # 31 61
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Print or Type) /.
U C2 �1n�i�, Mass. Date
' Permit # -�
BuildingLocation r Owner'sName PQj/. /: l
jYA �r
Type of Occupancy Residential
New U Renovation 0 Replacement IN Plans Submitted: Yes 0 No O
FIXTURES
Installing Company Name Heritage Htg. &Plg. CO. Inc. Check one: Certificate
Address 35 Pleasant Street CX Corporation 714
Stoneham, Ma 02180 []. Partnership
Business Telephone 1_781 -43a-737-7-6— f-1 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 �9 No 0
If you have checked yes, please indicate the type coverage by checking the appropriate box.
A liability Insurance policy IN Other type of indemnity L7 Bond El
OWNER'S INSURANCE WAIVEn: 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 O Agent O
I hereby certify that all of the details and information 1 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 14 of the General Laws.
By ----
SAntuie Licensedlum er
Title
Type of License. Master [$ Journeyman [j
City/Town $ 3 2 2
APPROVEt) TFICE—QSE ONLY) License Number_____.____^__
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Installing Company Name Heritage Htg. &Plg. CO. Inc. Check one: Certificate
Address 35 Pleasant Street CX Corporation 714
Stoneham, Ma 02180 []. Partnership
Business Telephone 1_781 -43a-737-7-6— f-1 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 �9 No 0
If you have checked yes, please indicate the type coverage by checking the appropriate box.
A liability Insurance policy IN Other type of indemnity L7 Bond El
OWNER'S INSURANCE WAIVEn: 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 O Agent O
I hereby certify that all of the details and information 1 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 14 of the General Laws.
By ----
SAntuie Licensedlum er
Title
Type of License. Master [$ Journeyman [j
City/Town $ 3 2 2
APPROVEt) TFICE—QSE ONLY) License Number_____.____^__
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