HomeMy WebLinkAboutMiscellaneous - 179 COVENTRY LANE 4/30/2018L
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Date .... zz� .... :� .......
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that /... f .. `!
...................................................................
has permission to perform ......................................................
wiring in the building of ...................................
.A1 ..........
at ........................... North Andover, Mass.
......................
Feem'�-..:n ......... Lic. ... ............ I .............................................
ELECTRICAL INSPECTOR
07/16/9811:24
WHITE: Applicant CANARY: Building Dept. PINK: TreasW
?"£ e0iily1t0nr<i 44-rw &I,; 7s
Dowr"--e 4 F-1& s4ay
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00
Office Use Only,
ly �—
Permit Na
—41�2—
Occupancy & Fee Checked C22 V�dl.
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00
(Please Print in ink or type all information)
Date r ,��
To the'lnsp6cior ofWires:
Town of North Andover
The undersigned applies for a permit to perform the electrical work described below.
Location (Street & Number 1,117 L`D o C xl
Owner or
Owners Address 12 7 Co 61g -,u1'9 5;,
Is this permit in conjunction with a building permit Yes Q/ No ❑
(Check Appropriate Box)
Purpose of Building /.(_!�� Utility Authorization No.
asting Service Amps Voits 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
OTHER: 1�-J 1 C' 4= XPi /; 2 Cr Cl7 /J .ri /- /-
INSURANCE COVERAGE. Pursuant to the repuiremen6ts of Massachusetts General Laws
I have a curent Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO =
ubmttted 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
SURANCE __ONO = OTHER = (Please Specify)
Estimated Value of Electrical Work$ % "4 (Expiration Date)
Work to Start -Z'P%3 e--4 'Inspection Date Resquested Rough Q Final
Signed under the Penalties of-perjury�
FIRM NAME / t1 G� 6a y%`�,� C G U it % LIC. NO. �v� VG
NO.
Bus. Tel No. 78/ G �� - J,9 6-:sr'Add—t- �.i/�f// V�G�� //��/dx Alt Tel. No.
OWNER'S INSURANCE WAIVF-Rr I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts
General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one)
Telephone No. PERMIT FEE $------ --
(Signature of Owner or Agent)
Total
No. of Ught8nq Outlets
No. of Hot fuse
No. of Transformers KVA
Above ❑
In ❑
No. of Lighting Fixtures
Swimming Pool qmd C
gmd ❑
Generators KVA
No. of Emergency Lignting
No. of Receptacles Outlets
No. of Oil Burners
Battery Units
No. of Switch Outlets
No of Gas Burners
FIRE ALARMS No. of Zone
No. of Detection and
Total
No. of Ranges
No of Air Cond
Tons
Initiating Devices
Heat Total Total
No. of Oioosal
No. Pumos
Tons
KW
No. of Sounding Devices
No./ of Self Contained
No. of Dishwashers
Soace/Area Heating
KW
DetectionrSounding Oevices
❑ Municipal ❑ Other
No.bf Drvem
Heating Devices
KW
Local Connection
No. of
No. of
Low Voltage
No. ;' Water Heaters KW
Si ns
Batlases
Wiring
No. Hydro Massage Tuds
No. of Motors
Total HP
OTHER: 1�-J 1 C' 4= XPi /; 2 Cr Cl7 /J .ri /- /-
INSURANCE COVERAGE. Pursuant to the repuiremen6ts of Massachusetts General Laws
I have a curent Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO =
ubmttted valid proof of same to the Office YES = NO = If you have checked YES please indicate the type of coverage by checking the appropriate box
SURANCE __ONO = OTHER = (Please Specify)
Estimated Value of Electrical Work$ % "4 (Expiration Date)
Work to Start -Z'P%3 e--4 'Inspection Date Resquested Rough Q Final
Signed under the Penalties of-perjury�
FIRM NAME / t1 G� 6a y%`�,� C G U it % LIC. NO. �v� VG
NO.
Bus. Tel No. 78/ G �� - J,9 6-:sr'Add—t- �.i/�f// V�G�� //��/dx Alt Tel. No.
OWNER'S INSURANCE WAIVF-Rr I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts
General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one)
Telephone No. PERMIT FEE $------ --
(Signature of Owner or Agent)
Location
No. 3 Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Pealait Fee $
Other Permit Fe 6d $ 23
,.—
Sewer Connection Fee $
Water Connection Fee $
TOTAL$ _!
PRiging inspector
07/13/95 13.33 123.00
T'
_ .
8572 Div. Public Works
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_ _._ .___..__....._...--...-_. _._. __...... .-_ ._.... .,,--�.... ...ter-----
.
'TI -Paw��.
HOME IMPROVEMENT CONTRACTORS REGISTRATION
Board of Building Regulations and Standardsl
One Ashburton Place - Room 1301 I
Boston, Massachusetts 02108 i
I
HOME IMPROVEMENT CONTRACTOR L --------------------------------------
Registration 105084 Expiration 07/16/96
Type - PRIVATE CORPORATION
HOME IMPROVEMENT CONTRACTO
Registration 105084
Custom Uuality Pools Inc. I Type - PRIVATE CORPORATIO
Robert A. Bent i Expiration 07/16/96
16 Wyman Road I
Billerica MA 01821 ° I Custom Quality Pools Inc.
° I Robert A. Bent
G� to �'Of6 Wyman Road
ADMINISTRATOR Billerica MA 01821
COMMONWEALTH
OF
OF MASSACHUSETTS
EXPIRATION DATE
01/10/1997
RESTRICTIONS
NONEa.'..
SS 4 023-44-1846
PHOTO (BLASTING OPR ONLY)
ii S� M • P�T+�'
OT _•,}�l1MB PRINT
FT
00.00 00
HEIGHT:
DOB:
01/10/1953
THIS DOCUMENT MUST BE
CARRIED ON THE PERSON OF
THE HOLDER WHEN EN-
GAGED IN THIS OCCUPATION.
DEPARTMENT OF PUBLIC SAFETY � �
ONE ASHBORTON PLACE
BOSTON, MA 02108
LICENSE
CONSTR. SUPERVISOR
EFFECTIVE DATE LIC -N0.
06/30/1994 040192
ROBERT A BENT
16 WYPEN RD
BILLERICA MA GIP21
NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY
STAMPED . OR . SIGNATURE OF THE COMMISSIONER
zefv
I / L�v
ySIGNATURE OF LICENSEE
Failure to Fom R^P! * R arrroot
!lntarRmtRe�t•;c "gate pLoifelov
Ado i, ttA+��Wvoaa'on
or Ler., ��;,..L, n.
FOR PROTECTION AGAINST
THEFT, PUT RIGHT THUMB
PRINT IN APPROPRIATE
BOX ON LICENSE.
� I
jV OBLAST N. OPERI RS '
UST�IfI( LUDE P TO. !,
F i ` MAY 12 1994
L!
SIGN NAME IN FULL 9 AATU�&J
-,............. ,,.-,-,.,.....,.. ..,.....+
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*****************
** 1
"PPLICANT 1 / , d 12i Phone L,
LOCATION: Assessor's Map N er Parcel
Subdivision Lot(s)
P�—'Street A0�C St. Number `5"_
************************Official Use Only************************
RECO I NS F AGENTS:
Date Approved
Cons _ a oAd inistrator Date Rejected
Comments
Town Planner
Comments
Food Inspector -Health
eptic Inspector -Health
Comments
Public Works - sewer/water connections
- driveway permit
Fire Department
Date Approved
Date Rejected
Date Approved
Date Rejected
Date Approved %/�
Date Rejected
Received by Building Inspector Date
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Location
No. Date
M°RTS
TOWN OF NORTH ANDOVER
p
i 1
Certificate of Occupancy
$
t ; :
Building/Frame Permit Fee
$
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Foundation Permit Fee
$
Other Permit Fee
$
Sewer Connection Fee
$
w
Water Connection Fee
$
TOTAL
$
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Building Inspector
2M00 ARID
Div. Public Works
.r'
Location '
No.
Date
14ORTH TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $-
Foundation Permit Fee $
w
s^CHUSE
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL $
Building Inspector
GJ ... .: E12, Ca MID
Div. Public Works
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Date .7:.
3754
$,;�c TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that .
has permission to perform sf G. ...... ;' .. , , ,
plumbing in the uildings of ..................
1
at./.7.,9 . .. .. .. .....INorth Andover, Mass.
FQ?W- .. Lic. No. JJ . .. 7. .
PLUMBING INSPECTOR
07/10/98 13:15
WHITE: Applicant CANARY: Building Dept.
35.00 PAID
PINK: Treasurer
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
Cype or print)
NORTH ANDOVER, MASSACHUSETTS
Building Locations I % 9 Gv (APA'� `J
�*
sit 7 Owner's Name
New 0 Renovation Replacement 0
FIXTURES
Plans Submitted ' J
Date 071/d
11 t -
Permit #
Amount
(Print or type) //�� �J
Installing Company Name !tel (/7Y2✓ J,, AhayW�)4414--,
�ddress '''�''� '�
fil
c siness Telephone — 7 7 9
Name of Licensed Plumber: ! K!/"eZJ / w'il(�✓fr;�
Insurance Coveraee: Indicate th a of insurance coverage by checking the
Liability insurance policy Other type of indemnity 11
Check one: Certificate
Corp.
Partner.
Firm/Co.
ate box:
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 11 Agent El
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 Massac S Plu &ie and Chap r 142 of the General Laws.
BY i re Ot Licenseaum er
Type of Plumbing License
TitleJZZ/>r7
City/Town License um e • Master Journeyman ❑
APPROVED (OFFICE USE ONLY ,■
40
•
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nnnnnnnnnnnnnnnnnnnnnnnnn
(Print or type) //�� �J
Installing Company Name !tel (/7Y2✓ J,, AhayW�)4414--,
�ddress '''�''� '�
fil
c siness Telephone — 7 7 9
Name of Licensed Plumber: ! K!/"eZJ / w'il(�✓fr;�
Insurance Coveraee: Indicate th a of insurance coverage by checking the
Liability insurance policy Other type of indemnity 11
Check one: Certificate
Corp.
Partner.
Firm/Co.
ate box:
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 11 Agent El
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 Massac S Plu &ie and Chap r 142 of the General Laws.
BY i re Ot Licenseaum er
Type of Plumbing License
TitleJZZ/>r7
City/Town License um e • Master Journeyman ❑
APPROVED (OFFICE USE ONLY ,■
IS
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
Cype or print)
NORTH ANDOVER, MASSACHUSETTS
Building Locations -
Owner's Name
New Renovation ri Replacement 1:1 Plans Submitted n
FIXTURES
Date
Permit # ,
Amount
(Print or type) Check one: Certificate
Installing Company Name Corp.
Address Partner.
Business Telephone Firm/Co.
Name of Licensed Plumber:
Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy 0 Other type of indemnity 0 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 11 Agent 11
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 State Plumbing Code and Chapter 142 of the General Laws.
By: Z51gnatUre ot Licenseaum er
Type of Plumbing License
Title
City/Town License Number Master Journeyman ❑
APPROVED (OFFICE USE ONLY
Y