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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 147-6/
Q )Q or Town of NORTH ANDOVER To the Inspector of Wires:
.014t &mmnmut34 of Maggar4unttu
Beltartment of Vublic 1_56afetq
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00
Office Use Only Q
Permit No. �/ r)
Occupancy & Fee Checked .
3190 (leave blank)
The udersigned applies for a permit to perform the electrical work described below.
Location (Street & Number) �� 59 e5 Sf
Owner or Tenant
Owner's Address LI*V�-
El this permit in conjunction with a building permit: Yes 7,_ No (Check Appropriate Box)
Purpose of Building 17 �Utility Authorization No,
Existing Service Amps _J Volts Overhead ❑ Undgrnd C1
New Service Amps _J Volts Overhead ❑ Undgrnd ❑
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
No. of Meters
No. of Meters
Total
No. of Lighting Outlets 2, 1 No. of Hot Tubs No. of Transformers KVA
Above In -
No. of Lighting Fixtures I Swimming Pool grnd 11grnd. 11Generators KVA
No. Hvdro Massace Tubs I No. of Motors Total HP
OTHER: �6Z__ cSi /2lyfi��
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES = NO = I
have submitted valid proof of same to the Office. YES = NO _ If you have checked YES, please indicate the type of coverage by
checking the approgxtwe box.
INSURANCE BOND —_ OTHER - (Please Specify) (Expiration Date)
Estimated Value of Electrical Works
Work to Start Inspection Date Requested
Signed under the Penal/tigs of perjury:
FIRM NAME '11A /, �z��C.9L �1Tit�7Q
Licensee
Rough Final
LIC. NO.
,LIC. NO.
Address
.T56i All. Tel. No. .371/'77=
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent est`e-
quired by Massachusetts General Laws. and that my signature on this permit application waives this requirement. Owne 9
(Please check one) Q
Telephone No. PERMIT FEE 5 !!! VV
(Signature of Owner or Agent)
x-5565
No. of Emergency Lighting
No. of Receptacle Outlets
No. of Oil Burners
I Battery Units
No. of Switch Outlets L
No. of Gas Burners
FIRE ALARMS No. of Zones
Total
No. of Detection and
No. of Ranges
No. of Air Cond. tons
Initiating Devices
Heat Total
Total
No. of Disposals
No.of Pumps Tons
KW
No. of Sounding Devices
No. of Self Contained
No. of Dishwashers
Space/Area Heating
KW
Detection/Sounding Devices
I
No. of Dryers
Heating Devices
I
KW
Local Municipal ❑ Other
❑ Connection
No. of No. of
Low Voltage
No. of Water Heaters KW
Signs Ballasts
Wiring
No. Hvdro Massace Tubs I No. of Motors Total HP
OTHER: �6Z__ cSi /2lyfi��
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES = NO = I
have submitted valid proof of same to the Office. YES = NO _ If you have checked YES, please indicate the type of coverage by
checking the approgxtwe box.
INSURANCE BOND —_ OTHER - (Please Specify) (Expiration Date)
Estimated Value of Electrical Works
Work to Start Inspection Date Requested
Signed under the Penal/tigs of perjury:
FIRM NAME '11A /, �z��C.9L �1Tit�7Q
Licensee
Rough Final
LIC. NO.
,LIC. NO.
Address
.T56i All. Tel. No. .371/'77=
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent est`e-
quired by Massachusetts General Laws. and that my signature on this permit application waives this requirement. Owne 9
(Please check one) Q
Telephone No. PERMIT FEE 5 !!! VV
(Signature of Owner or Agent)
x-5565
- TO
14- 945
SA u
7h 7
Date...... ........... ... ......
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that
.. .. �, d ....... Z-7/
........ ..... .
has permission to perform ... /�..c o. i. 0 A � ..............
wiring in the building of ....... ....................................
at ........ ........... ..... 5T ............................ . North Andover,,Mass.
Fee-1A.—W .... Lic. No. �!�M�t ............................................................
ELECTRICAL INSPECTOR
C Lf 6/20/97 15:35 15. 00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS.
MAP 440. Q �r LOT NO
Y PAGE 1
'
2 :RECORD OF OWNERSHIP DATE BOOK PAGE
ZONE SUB DIV. LOT NO.
LOCATION
OWNER'S
PURPOSE
NAME
�1
NO. OF STORIES 812E
OWNER'S ADDRESS
SANG
BASEMENT OR SLAB
ARCHITECT8 NAME
SIZE OF FLOOR TIMBERS IST IND 3RD
BUILDER'S NAME 0.0
SPAN
DIMENSIONS OF SILLS
DISTANCE TO NEAREST BUILDING
DISTANCE FROM STREET
POSTS
DISTANCE FROM LOT LINES — SIDESi
REAR
GIRDERS r
HEIGHT OF FOUNDATION THICKNESS m 4
AREA OF LOT FRONTAGE
IS BUILDING NEW
SIZE OF FOOTING X
IS BUILDING ADDITION /wO
MATERIAL OF CHIMNEY
IS BUILDING ALTERATION
IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE
i
IS 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
SEE BOTH SIDES
PAGE 1 FILL OUT SECTIONS 1 - 3
PAGE .2 FILL OUT SECTIONS 1 - 12
ELECTRIC METEPB MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
DATE FILED����.
3 PROPERTY INFORMATION
LAND COST
EBT. BLDG. COSTOSO,
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
4
PERMIT GRANTED
2�� 22-
SEPTIC PERMIT NO.
4 APPROVED BY
BUILDING INSPECTOR
OWNER TEL #
CONTR. TEL N 6e 0 G'© '86
CONTR. LIC. # a4; -t [� Qz y/
H.I.C. IF
BUILDING RECORD
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R.S. Hebei
---T5_ aA_e:
102 Adams Ave.
No. Andover Ma. 01845
(508)686-0786
Customer
Ms.Allison Kirk
216 Stevens St.
North Andover Mass. 01845
40
Rs tip
058241 Rea#108450
Date 5/8/97
job:Repair walls and ceiling in hall & stairway.
Supply all material and labor required to complete
the following.
1. Remove all exsisting plaster from walls and ceiling
in 1st floor front hall,stairwell and 2nd floor
hall.
2. Remove exsisting trim moulding from window,doors,
wainscoating and ceiling.
3. Install fiberglass insulation in walls and ceiling
if needed.
4. Install 1/2" sheetrock to same walls and ceiling
and tape three coats and prime.
5. Reinstall lst floor door trim.
6. Install new plywood wainscoating to match exsisting
as close as reasonably possible.
7. Install new door and window and ceiling trim
to 2nd floor hall.
8. Replace exsisting basement door with same type.
9. Remove and replace exsisting bookcase with
same type.
10.Remove floor tile from 1st floor hall and refinish
exsisting wood floor.
ll.Work not included,electrical,painting,frameing
repairs.
Total Cost
Owner
Contractor --- -----------------------
__$_5050.00
a
AlO I
"IMP
41
CD
co
Date./�: ��2
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that .................................. ......
has permission to perform ...........
plumbing in the buildings of ................
at ..... ....... North Andover, Mass.
. V
Fee,..?c�V'!�. . Lic. No. 1'0�nl -A�' -T-0`R....
�4---IPLUMBING'- -
C/ PSPE
Check, 3S-31
5415
f
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS Date
Building Location r �� 5 ! -'yc-u S - Owners Name 15 ct Seg-ew QLe &ctPermit #
Amount
5 % Type of Occupancy. 5 cur c'(
New Renovation ReplacementER
Plans Submitted Yes ❑ No
FIXTURES
(Print or type)
Installing Company Name /LC C;.
Check one: Certificate
❑ Corp.
Partner.
ElFirm/Co.
Name of Licensed Plumber: r C P 1 �ayc r1�C
Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy 3- 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 1:1 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 Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts to Plurnbin ode �yi�pte�f the Laws.
By Signature Licenseu iriumDer
Type of Plumbing License
Title
42
g
City/Town icense um er Master Journeyman ❑
APPROVED (OFFICE USE ONLY
Date.
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that .......................
has permission for gas installation
in the buildings of, ..............
... ..... North Andover, Mass.
Fee�-� Lic. No.
-4 .........
GAS INSPECTd�
Check#
4176
MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FTITING
(Type or print) Date
NORTH ANDOVER, MASSACHUSETTS I
Building Locations 1 / S ?, Permit #
n Amount $ `C -D
Owner's Name S toL.S
New 0 Renovation Replacement [D Plans Submitted
(Print or type) ^ , one: Certificate Installing Company
Name / "� �-- Corp.
Address Q o k 7.s_Partner.
V
Business Telephone Firm/Co.
Name of Licensed Plumber or Gas Fitter 14 * L Gt% /� Q . [/C o u X
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes 0 Noo
if you have checked L, :please indicate the type coverage by checking the appropriate box.
Liability insurance policy Er Other type of indemnity 0 Bond 0
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
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 Massachusewt .Sete Gas Codq�and C.4ptey442 of the General Laws.
(OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
❑ Plumber /�l 9
Gas Fitter License um er
Master
Journeyman
�2ND. FLOOR
(Print or type) ^ , one: Certificate Installing Company
Name / "� �-- Corp.
Address Q o k 7.s_Partner.
V
Business Telephone Firm/Co.
Name of Licensed Plumber or Gas Fitter 14 * L Gt% /� Q . [/C o u X
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes 0 Noo
if you have checked L, :please indicate the type coverage by checking the appropriate box.
Liability insurance policy Er Other type of indemnity 0 Bond 0
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
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 Massachusewt .Sete Gas Codq�and C.4ptey442 of the General Laws.
(OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
❑ Plumber /�l 9
Gas Fitter License um er
Master
Journeyman