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+ °',"��� •��° TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that ...31.7? G...••••••••••••••••
has permission to perform ... D .t.� ..........................
plumbing in the buildings of .14"71. .7. L ..............
at .. �..> .. �/! r r `� f o? /. � ....... North Andover, Mass.
Fee -73 .... Li c. No.. 5.3.5 ... ..........._...
P UMBING INSPECTOR
Check # % c" a
5649
Ifl
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Print or T —�'
Al. _D (J`P/Y`/.Mass. � �Permit # Cr
Building Location /`G.-Ir2taoo12qh Owner's Named/Y�lYL1i�S
A2 dO OeR-1 Ad Type of Occupancy '/2i✓ 5 ,D� - f j i I �'J (
New ❑ Renovation ❑ Replacement [5d' Plan s Submitt d Yes ❑ No ❑
I_■
FIXTURES
Installing. Company Name ��r�leT Q • �)�161MATAef) Check one: Certificate
Address C 04c H /Y 4K) AJ ❑ Corporation
/Y) E 744 0 C --AJ . Al A (/L.% ❑ Partnership
Business Telephone 597 1 Drrn/Co.
Name of Licensed Plumber '&6F,27- iq �A,►�rVl`4 tr(1 �
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes No ❑ '
If you have checked Yes, 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 ❑
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 installationsWormed under the permit issu for this application will be in compliance with all
pertinent provisions of the Massachusetts State PlumWfigj0ode and Chapter K of the oral Laws.
BY
Title
City/Town
APPROVED (OFFICE USE ONLY)
Type of License: Master Journeymah ❑
License Number 13 31
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BASEMENT
IST FLOOR
2ND FLOOR
3RD FLOOR
4TH FLOOR
STH FLOOR
6TH FLOOR
7TH FLOOR
STH FLOOR
Installing. Company Name ��r�leT Q • �)�161MATAef) Check one: Certificate
Address C 04c H /Y 4K) AJ ❑ Corporation
/Y) E 744 0 C --AJ . Al A (/L.% ❑ Partnership
Business Telephone 597 1 Drrn/Co.
Name of Licensed Plumber '&6F,27- iq �A,►�rVl`4 tr(1 �
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes No ❑ '
If you have checked Yes, 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 ❑
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 installationsWormed under the permit issu for this application will be in compliance with all
pertinent provisions of the Massachusetts State PlumWfigj0ode and Chapter K of the oral Laws.
BY
Title
City/Town
APPROVED (OFFICE USE ONLY)
Type of License: Master Journeymah ❑
License Number 13 31
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} t NORTH ,
D TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
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This certifies that ........ ....Y..........................................�u
has permission to perform .....�
wiring in the building of ....... ......................................................
" at (r �� p °� ` u! J ... l=c s 1 < ,North t�ndover'M SsS.
.../. ....... ..
Fee .l .5 ............... Lic. No�f ......................... `:`//��.......
ELECT RICALINSPECTOR
Check #
V
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
The Commonwealth of Massachusetts FOR OFFICE USE ONLY
Permit No. 23
Department of Public Safety
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Receipt No.
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work will be performed in accordance with the Massachusetts General Code. 527 CMR 12:00
(PLEASE PRINT IN INK ORI TYPE ALL INFORMATION) Date /0 f 6 (
City or Town of Notit'1 A Joy e To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical` work described below:
Location (Street and Number) �✓o �; �1 W uiot 94-s T `o," �- Map: Lot:
Owner or Tenant —I � w,O a5 14 G /OU q it/1 Zone:
Owner's Address -sem�-
Is this permit in conjunction with a building permit?
Purpose of Building b `^% `eM l Vl G)
Existing Service a0 0 Amps % Zo / ;7V0 ' Volts
Yes ❑ No l�
(Check Appropriate Box)
Utility Authorization No. 0 -7 -5 -Ivo
Overhead ❑ Underground Pi'___ No. of Meters
New'`ervice Amps / Volts Overhead ❑ Underground ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
I
trS `To
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers Total KVA
No. of Lighting Fixtures
Swimming Pool Above grnd. ❑ In-grnd. ❑
Generators KVA
No. of Receptacle Outlets
No. of Oil Burners
No. of Emerg. Lighting Battery Units
No. of Switch Outlets
No. of Gas Burners
FIRE ALARMS No. of Zones
No. of Detection and
Initiating Devices
No. of Sounding Devices
No. of Self -Contained
Detection/Sounding Devices
No. of Ranges
No. of Air Cond. Total Tons
No. of Disposals
No. of Total Total
Heat Pumps Tons xlv
,No. of Dishwashers
Space/Area Heating KW
a
k`Vo. of Dryers
Heating Devices KW
No. of Water Heaters KW
No. of Signs No. of Ballasts
Local ❑ Muncipal Connection ❑ Other
No. of Hydro Massage Tubs
No. of Motors Total HP
Low Voltage Wiring
OTHER:
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts Gener4l,Laws I have a current Liability Insurance Policy
including Completed Operations Coverage or its substantial equivalent. YES O ❑ I have submitted valid proof of same to this
office. YES ONO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box.
INSURANCE D BOND ❑ OTHER ❑ (Please Specify)
Estimated Value of Electrical Work $
Work to Start �/d� Inspection Date Requested: Rough
Signed ut
FIRM NA
Licensee
Address
(Expiration Date)
Final /6/)14/z/0/
— LIC. NO. /4 11g1S'
E-25 76
Vo. g7Y-757-bc/ O
Alt. Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee 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)
(Signature of Owner or Agent)
Telephone No.
PERMIT FEE $ _15 G 0