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HomeMy WebLinkAboutMiscellaneous - 25 GILMAN LANE 4/30/2018=; I \1 a° o In > T „ n -_4 0 ? a 0 c Z 0 a I o s s C o czi r A 0 Z a C v n >° z m C> o czi m a n m \ olo Z n s i r0 ! z m N Z n a ; A ^ o•> 2 n o n A " m C z C r°i a �1 z ; / n» M > A o> » Inn t 0> z> Z & 0 1 � 2 7 � a ;J v = n n li 0 All 1 A C Y�• ��; 1,1 i •:I; I 'r r ii;,%�..�. 0 • iii I?' 1 j �" �j 1 1 Q4 HA o rn a cif I• I � I �.,•.i �,� V,' 0 z \1 a° o In > T „ n -_4 0 ? a 0 c Z 0 a I o s s C o czi r A 0 Z a C v n >° z m C> o czi m a n m \ olo Z n s i r0 ! z m N Z n a ; A ^ o•> 2 n o n A " m C z C r°i a �1 z ; / n» M > A o> » a ^ > 0 Z 0> z> Z & 0 1 � 2 Z v = n n 0 0 1 A C x v a 0 O 4A IN Q4 o rn a 0 z I \1 a° o In > T „ n -_4 0 ? a 0 c Z 0 a I o s s C o czi r A 0 Z a C v n >° z m C> o czi m a n m \ olo Z n s i r0 ! z m N Z n a ; A ^ o•> 2 n o n A " m C z C r°i a �1 z ; / n» M > A o> » a ^ > 0 Z 0> z> Z & 0 1 � 2 Z x 0 O 4A IN Q4 o rn a s s m � m • Z O N • • z 0 7 a N c z c z c z z a r o s z fo z O r z s„ 0 ,0- , f1 0 >7 0 n 0 n. 0 0 0 0 n g z w o C » 0 g a 0 a M a N ,w • C A 0 z z z p Z i 0 z-�. >,D ; O 11 mA 4 O z a » » 00 ° 0 a Z > -4 o f o f r o ;xl_ a >» i Z 0 » p » a rnrn a O O N (� > ?- MGO 0 D 0 0 Cl H ,d CIOCD n n Z CO) E; . o �• d � O > =r c d= CO) )MOCO 0 0 CD CD O CL CD ONO CCD O CCD 0o vo � CD . CLD as —• o co CD ' C S, ?'o o d S CosCD v O y CD Z d .S O Sr O y m C09 a Z _C • N y �4 G a 0 � N 0 = � N CD =r � cD �� f m m ' C S, ?'o o d —1 co C7 m �o T m CO2 O CHtQ' y %3 O d .S O Sr O y m C09 a Z _C • N y �4 G a 0 � CD CL 0 = •�a m CD =r o �� f m m =0N o m —1 co C7 m �o T m CO2 o � a go m CA /n� .�CD VI CA 0 m O CD O� � ••oma z _a =1 o O 0 O ca %3 O b .S O Sr R r a a �.m� r G a 0 � :o M O rb� rb VJ C O y to Omc gr m O y �� o � a go m CA /n� .�CD VI CA 0 m O CD O� � ••oma z _a =1 �t 6 Inq 0 c o ►�y � z X17cn O b r,, n WM ro O ,b O 0 r G a 0 � G7 r 0 M O rb� rb "Ti 0 Q LwL 71 C O y �t 6 Inq 0 c 9a-i1)M FORM U - IDT REI.ASE FORM INSTRQCTIONS: This form is used to verifyf • approvals/permits from Boards and Departments that all necessary have been obtained. This does not relie ehaving Jurisdiction , landowner from compliance With any applicable localiaCa t and/or regulations or requirements, state law, ***************.*Applicant fills out this section***** kla"PLICANT: D (�• Phone $3 6� i CATION: Assessor's Map Number Parcel Subdivision Lot(s) -$tre'et —�� 1�2� St -f Number ************************Official Use Onl **** RECO , t DATIONS1 OF TOWN AGENT: OL nseanon Administrator Comments i �S w � Nu�tit �, Sia Town Planne Comments Food Inspector -Health i Inspector -Health Comments I ******************** s Date Approved49 I Date Rejected -24a2 IVVLKL�_k6 . Date Approved`" Date Rejected Date Approved Date Rejected Date Approved Date Rejected 01 00 v d( Public Works �a��'�/�-�d�%<. i -sewer/water connections ' ' O -Z; - driveway permit Fire Department Received by BuildingInspector nspector 9- - i7 e,, Date - ' W r .SL K_x> t --- �8 MORTGAGE INSPECTION PLAN 25 GILMAN LANE NO. ANDOVERMASS. , SCALE: I��- 60� FEB. 7 , 1995 WILLIAM G. TROY REO/STEREO LAND SURVEYOR 936 EAST STREET-TEWKSBURY, MASS. X89,32. r 53042. s.f. 88.85 , 1064 7-a w EFXIST. DWELL. 30 y N 4 l 159.014 GILMAN LANE I HEREBY CERTIFY TO THE TITLE INSUROR AND TO THE BANK THAT ��,® 4d�d THE DWELLING IS LOCATED ON THE LOT AS SHOWN AND THAT IT DOES , v ZH OF rv'A`` , c d CONFORM WITH THE TOWN OF NO. ANDOVER ZONING REGULATIONS REGARDING SETBACKS FROM STREETS AND LOT LINES. v y� n� I FURTHER CERTIFY THAT THIS DWELLING IS NOT LOCATED IN THE o V11Ll11ra1.4 ``\` FEDERAL FLOOD HAZARD A AS OW AON MAP DATED JUN. 151983!"` COM. PAN. NO. 250098 <! Ido 19 j 19 —� > �� t� 347 REGISTERED LAND `SURVEYOR °u Sol t-\ � .o �9 • yp d THIS'PLAN FOR MORTGAGE PURPOSES -NOT FOR BOUNDARY DETERMINATION. e�DA bU1l�aQ44 BOUNDARY INFORMATION TAKEN FROM.' N:E.R;O." PLAN 8`699. J Town of North Andover BUILDING DEPARTMENT Homeowner License Exemption (Please print) DATE q JOB LOCATION Number Street Address "HOMEOWNER" 6'1gkC, /'//70U 4 1?,3 -N Name Home Phone PRESENT MAILING ADDRESS-yliL� Section of town Work Phone City Town State Zip code The current exemption for "homeowners" was extended to include owner -occupied dwellings of.six units or less and to allow such homeowners to engage an individual.for hire who does not possess a license, provided that the,owner acts as supervisor. (State Building Code, Section 109.1.1) DEFINITION OF HOMEOWNER: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one to six family dwell- ing, attached or detached structures accessory,to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a hompowner. Such "homeowner" shall submit to the Building Official, on a form acceptable to the Bulding Official, that he/she shall be responsible for all such work performed under the ;wilding permit. .(Section 109.1.1) .:e undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other -applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town Horth Andover Building Department minimum inspection procedures and •equirements,and that he/she will comply with said procedures and quirements: ;HOMEOWNER'S SIGNATURE 6q APPROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0, Construction Control. 0 k G name: �/� /-r? location: city nhnne. # v �C-.;) 0� 0'I am a homeowner performing all work myself. M I am a sole proprietor and have no one workine in anv capacity I am a -sole proprietor, general contractor, or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation polices: rimM Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of $100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby ce ins and enalties perjury that a information provided above is true and correct Signature Date p G Print name ��—f_lj f1�1/ d�2 Phone # t7 L official use only do not write in this area to be completed by city or town official city or O check if immediate response is required contact person: (revised 3/95 PJA) permit/license # OBuilding Department C]Licensing Board (3Selectmen's Office C]Health Department phone #; 00ther Information and Instructions Massachusetts General Laws chapter 152 section 25 requires all employers to provide workers' compensation for their employees. As quoted from the "law", an employee is defined as every person in the service of another under any contract of hire, express or implied, oral or written. An employer is defined as an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual , partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs -persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant, thereto shall not because of such employment be deemed to be an employer. MGL chapter 152 section 25 also states that every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required. Additionally, neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority. Applicants Please fill in the workers' compensation affidavit completely, by checking the box that applies to your situation and supplying company names, address and phone numbers as all affidavits may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the "law" or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Millis City or Towns Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. The affidavits may be returned to the Department by mail or FAX unless other arrangements have been made. The Office of Investigations would like to thank you in advance for you cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, wlep',cnkk and EaX 1% 600 Washington Street Boston, Ma. 02111 fax 4: (617) 727-7749 phone 4: (617) 727-4900 ext. 406, 409 or 375 FORM U - IAT RELEASE FORM INSTRUCTIONS: This form is used to verify approvals/permits from Boards and Departmr� that necessary have been obtained. This does not relieve having jurisdiction landowner from compliance with an a the local and/or regulations or requirements, y applicable local or state lav, ******************Applicant fills out this segtion**************** VA PLICANT: Q LOCATION: Assessor's Map Number 1.Subdivision y � J11 Phone �3 - (,,, 41 Ll Parcel Lot (s) St. Number K_ Official Use Only*********************** RE"CO3 DATIONS OF TOWN AGENT ; Conse ation Administrator Comments I fi V �' v I� i S _ I w R,�i�P .� �� • S L Town: Planne Comments Date Approved Date Rejected 9L)49 lAr� �4-1� J - 11 20),L) Date Approved`' Date Rejected Food Inspector -Health Date Approved Date Refected i Inspector -Health Date Approved Date Refected Comments ILI IL CL 'Public` Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector 9 - - S7 ex- r � VLp Date -i7- DWELL IRON & STEEL Co'. 50 Tanner Street Lowell, Ma. 01852 (508)458-8476 Date:6/30/1997 Job name: Carl Melander G3044x3W Job Location: 25 Gilman Lane North Andover, MA Residential 30' x 44' garage with workroom over. The beams are supported at both ends. (three beam design) The beams are uniformly loaded over its entire length. The maximum unbraced lateral length shall be 24". The minimum bearing on each end of the beams shall be 31/2" x flange width. All information contained within has been supplied by the contractorlowner. All dimensions shall be confirmed by the contractor. Installation is by others. No site visit has been made to determine the suitability of such a beam installation. Design for steel beams only. three beams Beam design length(actual length may vary) Clear span/no columns L:=30 -ft Design for three beams evenly spaced apart. Wjg := O.ft Beams are supporting one floor + wall. .Loading Area: floor loading 1/2 joist length on either side of steel beam. LA :=11.•ft Uniform load: no roof or bearing wall loads contribute to the beam load. Dead load: wood joist 4lb/ft2 DL :=15• lb flooring 4lb/ft2 ft2 ceiling 5lb/ft2 insulation 2lb/ft2 Total dead load 151b/ft2 Live Load (storage/workshop room): LLW :=60 lb ' ft2 Beam weight(est):BW ;_ 48 lb ft Wall length:lb WLg = 0.ft 15• Wall weight:(walls 8' high) WL :_ ft 2 •8.ft•WLg WL = 0 •I L f Total loading: Beam characteristics: A-36 Steel A-36 Modulus of elasticity: Fiber Stress A-36 Steel W := (DL+ LLW)-LA+ BW+ WL W=873 --'b ft Es :=2.9.107• lb .2 in `tee fs :=22000•ll �. In n� It 'T ai lJ' 1 page 2 .:. 30 x 44 garage workroom three beams Compute the deflection, inertia and stress: Maximum allowable 1 deflection: Amax :=L•- 360 Maximum ' moment of WL•5-L3 • inertia: Imax :_ 384•Es-Amax 2 W-L Maximum Moment: Mmax := 8 Point of maximum deflection: Amax =1 -in at center of beam Points along the i:= 0.. 50 L beam: 50 Stress and bending moment: W.X. M. M� :_ '•(L- x�) S.:=—' Smax :_ Mmax 2 ' A A Stress diagram for beam Snm S. - O-ro3 ZI O A L Reaction at either end of the steel beam: (column loading) column_loading := ZL column loading =1.309.104 ,•1b Allowable column loads: 4" std lally 20,000 lbs @8' long 3" sch 40 pipe 34,000 lbs @8' long I Maximum moment developed: Mmax =1.179.1.06 •lb-in Maximum stress developed in beam: Smax = 53.57 •in3 Maximum m moment of inertia developed. - 4 Imax - 548.635 -in Steel beams required to support the above loads: . 3- W 16 x 45 x 7" S=72.7 in3 1=586 in4 Job 6 Tntss Truss Type qy PN 970913E 8 SCISSOR 8 1 j Carl Mader S79E530 Stwbskc 8 Sons, Inc. 3.3T s Feb 141997 UiNe InQu9� Fri Sep 2610:45:51 3.1397 PaA6.1 2-5 58.10 12-" SB 3fi 240.0 27-" p 6-&6 36-10 364 1 sx5= �2 r, nn Fi—q 3 "Anc, ` Ulu 11 Lut beFt TOP CHORD 2 X 6 SPF -S N0.2 BOT CHORD 2 X 4 SPFS N0.2 WEBS 2 Y.4 SSS Stud/Std SLIDER LIR 2 X 4 210OF 1.8E SPF 4-1-9, Right 2 X 4 210OF 1.8E SPF 3-1-4 REACTIONS (ms/3ue) 1=95M-5-8.6=1175/0-5-0 Matt Hort 1=-136(load case 2) Max UpW 1=-142(load case 4), 6=-218(bad case 4) FORCSS TOPCHORp 1•r 1563.2~3x•1107, 3 •1107, 45=-1707, 5 1563 BOTCHORD 6-7=1'126,7-8=1326, 84=1326, 1,881326 WEBS 2-9--78,2-8=-355,3-8=571, 5�=•355, 5.7=78 WACINA TOP CHORD Sheathed or 4-0-11 on center puffin spacing. BOT C`.HORD Rigsq Gelling directly applad, a 1 x:63-0 &8:63-0, T 8:6 3-0, 6-7:63-0 an Center tnich}, NOTES 1) This truss has been designed for the vend weds Wwated by 100.0 rrL p.h- winds at 25.0 feet alcove ground W tf, u" 10.0;>.&t top chord dud -bed and 10.0 p.sf bottom chord dead boo, 50.0 miles frorn hurricane oeeanw*. on a gtttgory I enclosed building, of dimensions 45.0 try 24,0 wRri e4osurn C (ASCE 7.93). Lumbef Increase = 1.33. Plate Inwaase 1.33. Both end verticals are e)gwsed. 2) This truss has been designed with ANSOPI 1,199$ agena. IAAD cA3EfS) Stancsard,*, !�� QF ME*NA, 9�+� yip. 9 I w. s �w . ` STEPHEN W. ;tj CABLER CABLER CAIL i f1 If ��Na.319270 No. 5548 e .� 4J L�. / i Qir � '4i''Q '.•. V .0 r FSS1a1iALENG4. A Waal "- V-* &*$A" P-W-"fY MW mc4D worse oI1 UU arm A>RVW= ME UM mass 0+09n YOM W u++ oftly with Abtek 00nnootom TMt d"Oh is breed " yppfl Pagmet#* dawn, dnd Y 1W out MWMduot bu3ding 00MOOnMtf to to kwtQW and 10W" wdk,,c v. AppMpapary of d+dgh par wiO10M Qncf PrOP*f IncoroorWk n at c rnpon t 4 rNporrlbaty dlb"ddtr g d+Kpn« -net "• d�upn+r. Brochp .nown : to iai�"W wP1W d 6XXV§; yry web manb+"s only. AddntOnaf "portly brAc}p t0 M"sw+ ttobry duhlp cOndNCt lon III= tesponsrbWy Of IMP-0IMP-0�tof. AdMX"l p+lfnOn+nt uo0kp 01 ill+ OV,06 dn.vtyy it ri"+ r4,00n bury 0t Ino t}r15dMb d+dpne". for w"+."d Ot+id otx W bbricetlbn, qua.ty conrool +taawce ^ de"ry, +r•6ilon and 4roong, cor" Qp-e6 CuoetY Standard, 035.60 U90ng • "rodMng ktdoMMW and arming MrcornM0F%k tten an"a3db♦♦ frau r" M PlotO VW*L fa, W D'OnoflW O"Ive, Madeon, W1 $3719. s}D+cMlccll0n and Nit -01 IY s 1,04 12 58 10 ! 12-0-0 58.3 6 5$50 ss 6 6 3 d 5-8-10 02.5 Plate OI[sets (XY): (i:0 -013,o a.7), Iz:O.1$,p•i•6), (5:01�,01�J, (6:0-2-1,0�7I LOADING (pst) SPACING 1,4-0 C3I OEM (in) (bc) Udell PLAM GRIP TOLL 40,0 Plates Increase 1.15 TC 0.31 Ved(LL) 0.10 817 999 M20(20ge) 1t;9V163 TOOL 10.0 Lumber Increase 1.35 } 9C 0139 Veft(tL) 0.15 8!7 9% BOLL 0.0 Rep Stress Incr YES WS 0,48 Hort(TL) 0.09 6 n/a BOOL 10.0 Code BOCA Mtn LtVh / LL deft = 300 l Weigtrt:156 (Ibs) Lut beFt TOP CHORD 2 X 6 SPF -S N0.2 BOT CHORD 2 X 4 SPFS N0.2 WEBS 2 Y.4 SSS Stud/Std SLIDER LIR 2 X 4 210OF 1.8E SPF 4-1-9, Right 2 X 4 210OF 1.8E SPF 3-1-4 REACTIONS (ms/3ue) 1=95M-5-8.6=1175/0-5-0 Matt Hort 1=-136(load case 2) Max UpW 1=-142(load case 4), 6=-218(bad case 4) FORCSS TOPCHORp 1•r 1563.2~3x•1107, 3 •1107, 45=-1707, 5 1563 BOTCHORD 6-7=1'126,7-8=1326, 84=1326, 1,881326 WEBS 2-9--78,2-8=-355,3-8=571, 5�=•355, 5.7=78 WACINA TOP CHORD Sheathed or 4-0-11 on center puffin spacing. BOT C`.HORD Rigsq Gelling directly applad, a 1 x:63-0 &8:63-0, T 8:6 3-0, 6-7:63-0 an Center tnich}, NOTES 1) This truss has been designed for the vend weds Wwated by 100.0 rrL p.h- winds at 25.0 feet alcove ground W tf, u" 10.0;>.&t top chord dud -bed and 10.0 p.sf bottom chord dead boo, 50.0 miles frorn hurricane oeeanw*. on a gtttgory I enclosed building, of dimensions 45.0 try 24,0 wRri e4osurn C (ASCE 7.93). Lumbef Increase = 1.33. Plate Inwaase 1.33. Both end verticals are e)gwsed. 2) This truss has been designed with ANSOPI 1,199$ agena. IAAD cA3EfS) Stancsard,*, !�� QF ME*NA, 9�+� yip. 9 I w. s �w . ` STEPHEN W. ;tj CABLER CABLER CAIL i f1 If ��Na.319270 No. 5548 e .� 4J L�. / i Qir � '4i''Q '.•. V .0 r FSS1a1iALENG4. A Waal "- V-* &*$A" P-W-"fY MW mc4D worse oI1 UU arm A>RVW= ME UM mass 0+09n YOM W u++ oftly with Abtek 00nnootom TMt d"Oh is breed " yppfl Pagmet#* dawn, dnd Y 1W out MWMduot bu3ding 00MOOnMtf to to kwtQW and 10W" wdk,,c v. AppMpapary of d+dgh par wiO10M Qncf PrOP*f IncoroorWk n at c rnpon t 4 rNporrlbaty dlb"ddtr g d+Kpn« -net "• d�upn+r. Brochp .nown : to iai�"W wP1W d 6XXV§; yry web manb+"s only. AddntOnaf "portly brAc}p t0 M"sw+ ttobry duhlp cOndNCt lon III= tesponsrbWy Of IMP-0IMP-0�tof. AdMX"l p+lfnOn+nt uo0kp 01 ill+ OV,06 dn.vtyy it ri"+ r4,00n bury 0t Ino t}r15dMb d+dpne". for w"+."d Ot+id otx W bbricetlbn, qua.ty conrool +taawce ^ de"ry, +r•6ilon and 4roong, cor" Qp-e6 CuoetY Standard, 035.60 U90ng • "rodMng ktdoMMW and arming MrcornM0F%k tten an"a3db♦♦ frau r" M PlotO VW*L fa, W D'OnoflW O"Ive, Madeon, W1 $3719. s}D+cMlccll0n and Nit -01 IY s Fmii: Daae §noncoA Steenbeke & Sons, Inc, Fax: (603)196.2601 Voice: (603)796.2914 To. Mark Desantis at, Steenbeke & Sons• Salem Page 2 of 3 Monday, September 29,19912.24:49 PM . SEP 29197 13:16 FR MITEK INDUSTRIES INC 314 434 9110 TO STEENBEKE SONS P.02iO3 3878 f NORTH 1 ; oo� TOWN OF NORTH ANDOVER ` PERMIT FOR PLUMBING lo :�_ •; 8 SA HU I This certifies tha . ¢ ............ has permission to perform . ............................ �„ plumbing in the Puildings of ........ at ..i ,North Andover, Mass. o cry CU Fee! .. Lic. No./Oy ...... .............................. ., PLUMBING INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS [DORM APPLICATON FOR PERMIT TO DO GAS FITTING or print) Date tvvxlH AIYDOVLN MnnASSACHUSETTS � r Building Locations S (�L/yl�i/S� 1"Permit # `J j Amount $ C x f Owner's Name �WL KFL440F, e New ©l--- Renovation ❑ Replacement ❑ Plans Submitted ❑ (Print or type) Check one: Certificate Installing Company Name's , �or.p. Address �� ` 6 AI ❑ Partner. 1vl 4-r97/1/a-tVM to/g7 Business Telephone Q?,93 -65"7-??/O ❑ Firm/Co. ,A Name of Licensed Plumber or Gas Fitter IINSURANCE COVERAGE Check one* �. have a current liability Insurance policy or it's substantial equivalent. Yes No ❑ If you have checked yes, please and a the type 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 ❑ I hereby certify that all of the details and information I have submitted (or entered) in above application are true ana 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 Stat?,61s C,gde �.qd chapter 142 of the General Laws. By: I City/Town APPROVED (OHICI:'USE ONLY) S, ure of Licensed Plumber Or Gas Fitter cl Plumber okf49�79 ❑ Gas Fitter License Number laster ❑ Journeyman U zCn Fes- C Cn Cn z est. ^ ^ �. ,z .t LrJ .' r Z T_ .moi v En ^ SU B-BASEM ENT BASE.M ENT 1ST. FLOOR 2ND. FLOGR 3RD. FLOUR 47 N. F L O O R 5T H. F L O U R 6T It . F L O O R 77 It. FLOOR 13T 11 . F L O O R (Print or type) Check one: Certificate Installing Company Name's , �or.p. Address �� ` 6 AI ❑ Partner. 1vl 4-r97/1/a-tVM to/g7 Business Telephone Q?,93 -65"7-??/O ❑ Firm/Co. ,A Name of Licensed Plumber or Gas Fitter IINSURANCE COVERAGE Check one* �. have a current liability Insurance policy or it's substantial equivalent. Yes No ❑ If you have checked yes, please and a the type 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 ❑ I hereby certify that all of the details and information I have submitted (or entered) in above application are true ana 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 Stat?,61s C,gde �.qd chapter 142 of the General Laws. By: I City/Town APPROVED (OHICI:'USE ONLY) S, ure of Licensed Plumber Or Gas Fitter cl Plumber okf49�79 ❑ Gas Fitter License Number laster ❑ Journeyman N° 2 1 6 2 Date........id NORT/ °f<<``°'•�"° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING This certifies that.. .................... has permission to perform ........... .............v: ............................. wiring in the building of ......... ............................................. j.::rt......... ............................. . North Andover, Mass. tFee IA.' ............................................................. ELECTRICAL INSPECTOR 12/10/98 13:35 40.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer THE' C0MM0NWE4LTH0FMA "CHUSETIS Office Use only DEPARTMENT0FPUBLICS4FM Permit No. BOARD OFMEPREVE MONRWU A770AS527CMR I. d Occupancy & Fees Checked UVPPLICATIONFOR PERMITTO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat Town of North Andover To the Insp or of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) Owner or Tenant Owner's Address �S: Al ec Is this permit in conjunction with a building permit: Yes m No M (Check Appropriate Box) Purpose of Building (x"19 29(y r4jy i lir-e00P Utility Authorization No. Existing Service ,2 d® Amps.4LE 11a volts Overhead a Underground No. of Meters New Service �Amps Volts Overhead r-1 Underground No. of Meters Number of Feeders and Ampacity I ation and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total 0 KVA a No. of Lighting Fixtures Swimming Pool Above Below Generators KVA ground ground No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets / No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No of Disposals No. of Heat Total Total Pumps Tons KW initiating Devices No. of Sounding Devices No of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local MunicipalQ Other No. of Dryers Heating Devices KW Connections No of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER Aa►+p X"yRo e44!1" 6j—u rc Coeage Pustmto & mquim niazofMassadtsellisGenaalLaws I have a arras Liability htstmtoe Policy arluding CoiTrk a Comagear its stabstarm movdiat YES [ZfNO I havesutxnatedva6dptoofofsametotheOff r- YES U NO r7 Ifjcuha%edvdcedYES, IlemertdcMethrWcf wWbYct gthe b INSURANCE d BOND r7 OTHER ft=Spady') , ; ; 6*dbon bet Xjs ValuedElecuical Work $ Work I)Start .2. •3 hWecticrl Delle Raged Rough (�' �t c C it[ Fria( Signed t AME �f FIRM NAME Lire /�%iF'�.f'� !tet / /�. • '<. G �',� Sig�tte LiwN . 5J -9Z L .No 1--,Xey0 _ Al�Tei Na Business ness Tel. No. - �L/ AAJ J; G[/Cz/� �?� % f/� d /1A7F1 .? �07 r -- OWNER'SINSURANCEWARIER;IW- the insm= ords sksmal e4avallffitas mqxiedbyMassadmeus Cierra!Laws and du my si muecn this pmnt appbc abm warA s this rtqmurratt (Please check one) Owner a Agent a Telephone No. PERMIT FEE