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HomeMy WebLinkAboutMiscellaneous - 241 PLEASANT STREET 4/30/20180 Date .. �� r �D ....... L-'-� ° ~O TOWN OF NORTH ANDOVER l 3 PERMIT FOR GAS INSTALLATION ,SSAC14USEt This certifies that ...... "............ . ,has permission for gas inst llation <f ...? f/ in the buildings of ..................... at ..,% .............. , North Andover, Mass. Fee'-:'! .. �J .. Lic. No..e:I t 1-:'fi/.. r'/ / / GAS INSPECTO,ij`�� Check # ��� d 7 V vv vvv I 6353 MASSACHUSETTS UNIFORM APPUCATON FOR PUMr TO DO GAS FITTING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Locations Date�(��Q Permit #3�� Amount $ Ei Owner's Name 2LZ �, XeJk 22 New Renovation D Replacement Plans Submitted (Print or type) NameU Check one: Certificate Installing Company 11 Corp. ElPartner. Firm/Co. Name of Licensed Plumber�or Gas Fitter i3 dl A / J/+ INSURANCE COVERAGE Check one: I have a current liability Insurance, policy or it's substantial equivalent. YesD� No� If you have checked ves, please indicate the type coverage by checking the appropriate box. Liability insurance policy El Other type of indemnity D 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. Signature of Owner or Owner's Agent Check one:Owner 13 Agent Cl 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 sued for this application will be in compliance with all pertinent provisions of the Massa se s S Gas Code and Chapter 42 of the G feral Laws. By:ignature of Licensed Plumber Or Gas Fitter Title Q Plumber 3 City/Town, [3 Gas Fitter(cense Number —Master APPROVED (OFFICE USE ONLY) D Journeyman Ed w V! V1 � O � z F V U W x Z FF o+> C > C GoG w w v� d x cz °C w q z e w w > < w = F, w Cw7 Q O LA. O U 9 �, s x rzzt w vFi SUB -BASEMENT u z > c F o BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR 8TH. FLOOR (Print or type) NameU Check one: Certificate Installing Company 11 Corp. ElPartner. Firm/Co. Name of Licensed Plumber�or Gas Fitter i3 dl A / J/+ INSURANCE COVERAGE Check one: I have a current liability Insurance, policy or it's substantial equivalent. YesD� No� If you have checked ves, please indicate the type coverage by checking the appropriate box. Liability insurance policy El Other type of indemnity D 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. Signature of Owner or Owner's Agent Check one:Owner 13 Agent Cl 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 sued for this application will be in compliance with all pertinent provisions of the Massa se s S Gas Code and Chapter 42 of the G feral Laws. By:ignature of Licensed Plumber Or Gas Fitter Title Q Plumber 3 City/Town, [3 Gas Fitter(cense Number —Master APPROVED (OFFICE USE ONLY) D Journeyman Location 7 /(j !j '' 7— .)7 No. _,/ Date 7 nA / r// TOWN OF NORTH ANDOVER r Ceicupancy $ 13411ding/Frame Permit Fee $ ,WANIIA4rmit Fee $ Other, Petrniit©f �' 4 $ C� 0491 nnection Fee $ �- Water Connection Fee $ TOTAL $ _ Building Inspector Div. Public Works PERMIT NO. "I A66�- of rA APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 Map d40. LOT NO. 12 RECORD OF OWNERSHIP IDATE BOOK PAGE ZONE SUB DIV. LOT NO. LOCATIOt�I* 7 �q/�S Jq 1�'T �� 3{ PURPOSE G 12 pU a OWNER"NAME 40*l✓ ���((j/IL NO. OF STORIES SIZE OWN5r ADDRESS ,24y/ BASEMENT OR SLAB AR HITECT'S NAME — SIZE OF FLOOR TIMBERS IST 2ND 3RD 'BUILDER'S NAME 14, /] /l N%z 1 SPAN --- DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES - SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND ILL BUILDING CONFORM TO REQUIREMENTS OF CODE A; -s 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 a SEE BOTH SIDES 1 PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS ,oLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR SIGNATURE OF OWNER OR/AUTHORIZED AGENT F E E /tq CONTR. TEL. #- CONTR. LIC. # PERMIT GRANTESR. s. / A) 19 3 PROPERTY INFORMATION LAND COST e EST. BLDG. COST % ,000 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN BUILDING INSPECTOR u 'NV"Id 101d S3OV1d3EI SIHl •a3S0dWJH3df1S •013 'S3ova -V9 'S3HOZI0d HlIM 'SEJNIa'11f18 40 SNOISN3W1a 1OVX3 aNV S3N11 10'1 WONA 3DNV.LSIa aNV 107 d0SNO1SN3WIa 1DVX3 MOHSiSf1W NOLUMS SIHl ZL I AONVdf1DD0 L CIOD311 JNIa7ins `JNIIV3H ON _I Pic I 4.L P-1 I.W.9 JIa15313 110 SWOON 10 'ON L svo S831V3H 11Nn `J.1.H INVIOVa `JNINOI110NOJ 81V aOdVA 80 b.I.M IOH _ Sa3ijyd OOOM 'SIO:) V 'SW9 13315 WV31S 'Ndnj aIV IOH 03J80d 3JVNanj SS313dId 'S10J'8 'SW9 839W11 1SIOf DOOM ONIIV3H LL II ONIWVad 9 OOVO 3111 aooli 3111 _ S3an1XIj N830OW JNHOOa 1108 _ a3MOHS 11VIS 13AV80 '8 8V1 9N19Wnld ON NNIS N3H511N 31V1s S30NIHS DOOM A8o1VAV1 S310NIHS 11VHdSV 13SOID 831VM 03HS IVIA 1'XIJ LI 'W8 131101 OaVSNVW 1lbawvJ 'XIJ E H1V9 dIH I I 319V0 ONiswnld OL 10011 9 3O80183da _ 3WVaj NO 3NOIS kNNOSVW NO 3NO1S 'N19 830NIJ 80 'JNOJ 11 good H s ONI111M .I 3WVH NO NJI89 _I a001j 8 S81S 511IV ABNOSVW NO NJIa9 3111 'HdSV N0l^lWOJ 0,lJ\OaVH H1aV3 E l 9 313aDNOJ 3WVVV NO 05551$ ABNOSVW NO 55551S JNIOIS '1835 `JNIOIS SOIS39SV ONIOIS 11VHdSV S310NIHS DOOM I09 080 S08V Slool1 6 SllvM v N3HJ11N N8300W S35Vld 3alj V3aV SIIIV 'NIJ V38V .1.W.9 NIJ W008 OV3H 1.W 9 ON '/c iQ Yi 11nj V3aV 1N3W3SV9 £ NIINn IIVIA Aa0 a31sv1d s631d O.MOaVH 3NO1S NO N51a9 3NId 'N.19 313a5NOD 313aJNOJ HSINIi VOINUNI $I NOIlVdNflOi Z NOuon HISNOD S1N3W18VdV s351jjo —_ A11wVj ulnw $318025 I I AIIWVJ 310NIS ZL I AONVdf1DD0 L CIOD311 JNIa7ins i h y _p 09 O Q r V u W v W C9 O Z W h •y E li Z Z Z W d W 0 Ou -A wl Z W 0 Z Z V o .rr L m L C W L _I L U t Y c a. C C DOC U ii COC ii COC ui U- ccii m CO c s E C640 W Z ar Z H •y E fl. 4 L C ri o .rr L a. E c a. i� O o C 04 V Z = �C c V � t C m eQ �' a. o0 Q •� Z Date. ........ TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ..... ......................... has permission for gas installation............... in the buildings of ... .......................... at ................................. North Andover, Mass. Fee. ... Lic. No.. ............. GAS INSPECTOR Check # is, 3 3 . —) MASSACHUSETTS UNIFORM APPUCATION FOR PERMIT TO DO GASFiTTING (Print or T%ZA LleAlll- Mass. Date/6r d -.?-P"3 Permit # Building Location / Owners Name/4 t !' va.c '!Yi),; i— Type of Occupancy 5i 7�QN Ti Q C!� New ❑ Renovation ❑ Replacement 2 Plans Submitted: Yes❑ No ❑ Installing Company Name A Cj A g T A . ` )M M A T A t2L Check one: Certificate Address 30 06A c H m A IJ -i-Nf . ❑ Corporation IYI E T H U e tj Al ri 0 .❑ Partnership Business Telephone 49 - 9 S "7 f 2-,firm/Co. Name of Licensed Plumber or Gas Fitter 'f' 0 nl E P. T A - 58 m r)1 tq i r412r � -- INSURANCE COVERAGE: I have a current I' bility insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you have checked ve, please Indicate the type coverage by checking the appropriate box 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 Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner❑ Agent ❑ Signature of Owner or Owner's 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 the pe i ed for this application be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of her Laws. By T of License: C� Plumber n ure of cen u _ or Fitter Title tter er License Number CitylTown O I Journeyman MENEM 01 Installing Company Name A Cj A g T A . ` )M M A T A t2L Check one: Certificate Address 30 06A c H m A IJ -i-Nf . ❑ Corporation IYI E T H U e tj Al ri 0 .❑ Partnership Business Telephone 49 - 9 S "7 f 2-,firm/Co. Name of Licensed Plumber or Gas Fitter 'f' 0 nl E P. T A - 58 m r)1 tq i r412r � -- INSURANCE COVERAGE: I have a current I' bility insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you have checked ve, please Indicate the type coverage by checking the appropriate box 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 Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner❑ Agent ❑ Signature of Owner or Owner's 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 the pe i ed for this application be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of her Laws. By T of License: C� Plumber n ure of cen u _ or Fitter Title tter er License Number CitylTown O I Journeyman z 0 D t - Z V W IL _Z N N W J W Q ¢ H C7 O O O Z c C61 N� W S 47 Wsu I Y N LL D Z P D N W J Q 2 H O O Z c W N O 0 ¢ F ~ W, O < V WU. W Q O O Z d Q ¢ p O {L W W 3 z G d N � J t - W < m V O - J 4. d 0 Q W W W N� W S 47 Wsu I Y N LL D W H Z < W ¢ F O < W � ¢ h' W W d N O - m 0 Q W m � = J