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HomeMy WebLinkAboutMiscellaneous - 25 SARGENT STREET 4/30/2018I Date ... :��/ F- ") -q ........................ TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .................. ......... 4 . . ........................... has permission to perform.... ... ............. ................... wiring in the building of ...... ......................................................................... at c,.;&..S ..... North Andover, Mass. .. F& .............. Lic. No:, ........... ELECTRICALI NSPEC41 Check # 8367 .f N Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. �<� i Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 9 — l q — dF City or Town of: NORTH ANDOVER To the Inspector of Wives: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street &Number)_ 4z, y,ey 2 v*% S Owner or Tenant Owner's Address Telephone No. Is this permit in conjunction with a building permit? Yes ❑ No ®, (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd ❑ No. of Meters No. of Meters Location and Nature of Proposed Electrical Work: " S �^ Yn G rP S ' ('mm�lotinn nffho f 17.,,..;,,,,+..1,1.,....,.., r......__.._at_..v_ r_________ _rv�• No. of Recessed Luminaires -- - «•g No. of Ceil: Susp. (Paddle) Fans • y y ene uw ecur v/ rrlrcAy. No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- ❑ rnd. rnd. o. o Emergency Lighting - Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of .Gas Burners No. of Detection and Initiatin Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number Tons _ KW "" No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local. umcipal ❑ Other `- Connection No, of Dryers No. of Water Heaters KW Heating Appliances KW No. of No. of Signs Ballasts Security Systems:* N o. of Devices or Equivalent a Wirin: DatN of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent FOTHER- Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE OVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE QS BOND ❑ OTHER ❑ (Specify:) I certify, under t pains nd penalti of pe jury, that t e information on this application is true and complete. FIRM NAM : h7C. LIC. NO.:_� a" Licensee: -h f Z.. Signature LIC. NO.: (If (If applicable, enter "exempt" in the is nse number in . Bus. Tel. No.: 15Address: fi�}� IZ1S.P��� f��s�' 64'x¢ G( Alt. Tel. No.: ^v3c�,30 *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent 2 Signature Telephone No. P ERMIT FEE: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Name (Business/Organization/Individual): Address: City/State/Zip: bl�£S� Phone #:!`78— bA r Qr:,�p Are you an employer? Check the appropriate obx: , 1.0.I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. I ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.0 Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other —.y aYY.,.. u,at cu " uux if i must also nu out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: PV Y J 1 'Policy # or Self -ins. Lic. #: Expiration Date: Job Site Address: P d� City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cert under the pains and penalties of perjury that the information provided above is true and correct Signature: QH (yI�5 Date: Official use only. Do not write in this area, to be completed by city or town official City or Town: Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Permit/License # Contact Person: Phone #: Date.. 2;31U �: This certifies that ..... 5 eq. 1 L. :'� ; f, .. P�- „ r .... . . has permission to perform.... }�-f�1............... . plumbing in the buildings of ... {- .4!.%? �. �. Via .................. at ...2. }— ...� /9 f? .7 <- .J�7 ............. . North Andover, Mass. U Fee 3. ° : Lic. No. It. PLUMBING INSPECTOR Check # 7845 TOWN OF NORTH ANDOVER 40 PERMIT FOR PLUMBING s � s SSACMUS� This certifies that ..... 5 eq. 1 L. :'� ; f, .. P�- „ r .... . . has permission to perform.... }�-f�1............... . plumbing in the buildings of ... {- .4!.%? �. �. Via .................. at ...2. }— ...� /9 f? .7 <- .J�7 ............. . North Andover, Mass. U Fee 3. ° : Lic. No. It. PLUMBING INSPECTOR Check # 7845 r A MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS j Date Building Location 2 S-efk lG, I s Owners Name ��ti� F64vhc� permit # Amount v �� Type of Occupancy �2 S New ri Renovation 1-3 Replacement "� Plans Submitted YesElNo FIXTUR F..0 (Print or type)tJ ; , L Check one: Certificate Installing Company Name q . Q i� Corp. Address t o ZiCo. usmess elephone 3 — Name of Licensed Plumber: Ke-�' n �c c Lei Insurance Coverage: Indicate the type of insurance coverage by checking theappropriate box: Liability insurance policy !� Other type of indemnity a 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 ❑ Agent M 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 installatitvns performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massac tate Plumb' de and Chapter 142 of the General Laws. By: Sign. Wre 01 j- ;enseu i luuluGl Type of Plumbing License Title "Z /* 9 5/6 City/Town icense um er Master ElJourneymanAPPROVED (OFFICE USE ONLY NORTH ANDOVER PERMIT' FOR GAS INSTALLA 9 < r This certifies that .... i. ......,( ......................... . has permission for gas installation . rA r4 { , in the buildings of ... F.�.�` { `"`. ``......................... at ....2.? S �" �� ..` r.:..... North Andover, Mass. Fee.3..... Lic. No. ! 5. Y.� .. ... �C\^' . GASINSPECTOR Check # tH L 6539 MASSACHUSETTS UNNDRM APPUCATON FOR PERMIT TO DO GAS FITTING . (Type or print) D 2 _ NORTH ANDOVER, MASSACHUSETTS ate % Building Logations 2� 51f eg., si- Permit # (• + ' Owner's Name Amount $ � i Uyl New ❑ Renovation ❑ Replacement Plans Submitted ❑ 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❑ Agent 13I 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 e-G•as Code _..anChapter 142 of the General Laws. (APPROVED (OFFICE USE ONLY) Signature of ❑ Plumber ❑ Gas Fitter ❑ Master ,Journeyman sed Plumber Or Gas Fitter 2[ 7 �© (cense Number 1:7 U z h EW+ F e a > a p o Z W C, w a z u m m v, z o a w G7 F Z F Z x F W F W y V °CA W F Z O W F F W O a F W a W O SUB -BASEMENT 3 O C7 a VO > a°. 1 1 - BASEMENT BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7T H. .FLOOR BTH. FLOOR (Print or type) n j "� ��1' Check Name e 1(' one: Corp. Certificate Installing Company Address f Cc, i✓� ❑ Partner. �+ t� it [� d 3 o Z Business 1 a ep one o3 _ _ .3S F—J-11imi/Co. Name of Licensed Plumber'or Gas Fitter K -,;w j yv��� INSURANCE COVERAGE 1 have a current liability Insurance, policy or it's substantial equivalent. If have Yes Cheone: you checked Yes, please indicate the type coverage by checking the appropriate box.No 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. Signature of Owner or Owner's Agent Check one: Owner❑ Agent 13I 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 e-G•as Code _..anChapter 142 of the General Laws. (APPROVED (OFFICE USE ONLY) Signature of ❑ Plumber ❑ Gas Fitter ❑ Master ,Journeyman sed Plumber Or Gas Fitter 2[ 7 �© (cense Number 1:7 j Datec:�.a."`.f TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that .. t.1..t-rte- aJ ............. has permission to perform ............ plumbing in the buildings of. •./.�........ ..................... .............� , North Andover, Mass. Fee3.3 Lic. No. ; �.. ,. �.... �� . PLUfv1Bd�1 INSPECTOR ..� r? Check ff 6554 [VIA' 5ACHUSETTS UNIFORM APPLICATION FOR TO DO PLUMBING (Print or ype) Mass. Date 2U Building Location Permit # Owner' m v ype of Occupancy New 0 Renovation ❑ Replacements Plans Submitted: Yes ❑ No ❑ FIXTURES B.P. # SEWER # SEPTIC # . to z LO z _ } 0 ¢ w � V~ z z 7�tD,!CL LU Li Ln LU cl�U a" m v=i ~ v w cn. V) o= w O w Q E¢ w Z 0 ��a ¢ > = a Z = O to v7 '� H Y Z d O Fes- crt QQ z =M n n Z ¢ _j Q Q� SUB-BSMT BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR :8TH FL00 Installing Company me 4ddress lC K J./n w: 3usiness Telephone lame of Licensed P Check one: Certificate ❑ Corporation ❑ Partnership tr-'Firm/co. Firm/Co. I have a current li bility insurance policy or its substantial equivalent, which meets the requirements of MGLCh. 142. Yes No.0 I• If you have checked Yes, please indicate the type of coverage by checking e appropriate b � thP , ox. A liability insurance policy lr� Other tvno ^f OWNER'S INSURNACE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 1 142 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 0 Agent 0 ereby certify that all of the details and information I have submitted for entered) In above•appilcatlon are true and accurate to the best of knowledge and that all plumbing work and Installations performed u r the permit Issued for thi a plication will be in compliance with pertinent provisions of the Massachusetts State Plumbing Code and h to 42 or e dGal Law . By Title Sign re of Licensed Plum 2r Cttyrrown APPROVED (OFFICE USE ONLY) Type of Licenser E7.M�ster 0 Journeyman License Number_ �c 3 �J a 1 w = � ; O � o z a G = O � v O � � P s ; 04 O O 0 r c t a A Date ... 0, r ... . TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that •. ........'..................... . has permission for gas installation . ;e/ -v ............... s in the buildings of .. ............................ at �......... , North Andover, Mass, Fee ... Lic. No... 4. .Z .. w .... . ASINSPECT Check # r� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASF TTINGaCi-� (Print or ypel ' ass. Date 20 Per It Building L anon owners m I Type of Occupancy New[) Renovation ❑ Replacement/ Plans Submitted: Yes ❑ No ❑ 1ST FLOOR 2ND FLOOR 3RD FLOOR . 4TH FLOOR STH FLOOR x CTHf FLOOR 7TH FLOOR 8TH FLOOR Installing Company NameiY, , Address .. Business Telephone ntame of Llcenseci Plumber, or das Fitter uj U 0 o m 0 a w LU 0 ' . W t _ ,,11 ❑ Corporation ❑ Partnership ------------ 5f'mm o. 1 have a current II blllty Insurance policy or its substantial equivalent, which meets the requirem142. Yes t No ❑ ents of MCL Ch If you have checked yes, please Indicate the type of coverage by checking the appropriate box. A liability Insurance policy &1/ Other type of indemnity ❑ Bond OWNER'S INSURNACE 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 fflTs7p-ermit application v1'ralves this requirement, S gna re a Owner or Owner's Agin Check one: Owner ❑ Agent ❑ hereby certify that all of the details and Information I have submitted for entered) In above application are true and accurate to the best of ,y knowledge and that all plumbing work and Installations performed under the permit Is e r this application be In compliance with it pertinent provisions of the Massachusetts S tate Gas Code and Chapter 142 of the 7M-A/3- Title Type of License: By ❑ Plumber ❑ GaslitterS lgnr2e of L tensed PIu b e r WasFetter City/Town ED APPROVE (OFFICE USE ONLY) ��� Lkense Number ❑ .1ourneyman 10 1 30r Z 0 v A O a 4 O Q A u u Z u e A O Z 40 w jo = O w �1~il Z A C � v 5 z P 'O = O :1 O O O 7 C s O 4 O Q A u u Z u e A O Z 40 w 'LT, �- MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFI ' 1 (Print or Type) C NORTH ANDOVER Mass. Date �W f Building Location i. -r -J14r(J-e, 111r.l Permit -10 L -c p T, Jdc. Owners Name Ax - et L .l • x _ New Renovation D ReplacementPlans Submitted S FI XTUR (Print or Type) Installing Company Name CJ Address �� /?1( il10,✓ /'n�_ Ly/✓4 Business Telephone: JI 9 L t J'3 Name of Licensed Plumber or Gas Fitter / f CA.,A-� /-� Check one: Certificate Q Corp. Insurance Waiver: I, the Partner. been made aware that Firm/Co- this application does not have any one of the above three insurance coverages. Y Y • OMEN No��» =Eztt=EN 'MEMO nlEom100101 INEEZININ�� EIREENEEMENEENE FEE FEE KNEEMINE (Print or Type) Installing Company Name CJ Address �� /?1( il10,✓ /'n�_ Ly/✓4 Business Telephone: JI 9 L t J'3 Name of Licensed Plumber or Gas Fitter / f CA.,A-� /-� Check one: Certificate Q Corp. Insurance Waiver: I, the Partner. been made aware that Firm/Co- Insurance Coverage_. Indicate the type of insura.ice coverage by checking the appropriate box: Liability insurance policy E� Other type of indemnity Q Bond 0 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 coverages. Signature of owner/agent of property Owner 0 Agent 0 1 hctcby certify that aU of the dctsils and information 1 have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and inSEAdations petfomted under Permit iueed to: this application will -be le compliance with sU pertlnent provisions of tho Massachusetts Slate Cat Code and Qapter 14I of the General Laws. .. M Title City/Town: APPROVED (OFFICE USE ONLY) TYPE LICENSE: ��'r'j a -. Plumber Gasfitter Signature of Licensed Master p1um3 o Gasfitter Journeyman License•Number i Date..................... Of NORTh TOWN OF NORTH ANDOVER , h PERMIT FOR GAS INSTALLATION ` s U This certifies that ..' ...................................... has permission for gas installation ............................... in the buildings of ......................................... at .................................... North Andover, Mass. Fee......... Lic. No......:.... GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File S\S MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING „�. (Print a Type) "v 0. �1.�� Mass. Date Q 3 19q Permit # i Building Location .�Jf C-C��Q1' Owner's Name&r ,sa,' Type of Occupancy G New p Renovation C@ Replacement ❑ Plans Submitted: Yes❑ No ❑ Kenneth F. Rhodes Installing Company Name p 1 umb i na & Heat ; n q Check one: Certificate Address 1.8 Richardson R d ❑ Corporation Lynn, MA. 01904 ❑ Partnership Business Telephone 617-59,9-2253 ❑ Firm/Co. Name of Ucensed Plumber or Gas Filter Kenneth F. Rhodes INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL CIS. 142. Yes ® No ❑ If you have checked M. please indicate the type coverage by checking the appropriate box A liability insurance policy ❑ Other type of indemnity O Bond O 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: OwnerO Agent O 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 permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the ral Laws. BY TvDe of license: 's Plumber Signature of Ucensed Plumber or Gas Fitter Title Gasfitter 9360 Master Uoense Number City/Town Journeyman CM Kenneth F. Rhodes Installing Company Name p 1 umb i na & Heat ; n q Check one: Certificate Address 1.8 Richardson R d ❑ Corporation Lynn, MA. 01904 ❑ Partnership Business Telephone 617-59,9-2253 ❑ Firm/Co. Name of Ucensed Plumber or Gas Filter Kenneth F. Rhodes INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL CIS. 142. Yes ® No ❑ If you have checked M. please indicate the type coverage by checking the appropriate box A liability insurance policy ❑ Other type of indemnity O Bond O 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: OwnerO Agent O 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 permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the ral Laws. BY TvDe of license: 's Plumber Signature of Ucensed Plumber or Gas Fitter Title Gasfitter 9360 Master Uoense Number City/Town Journeyman Uf W W O Z W W W a Z ul O Ci O w N N 1 Z J J m s ' Date ..................... n A C' o* ORT" TOWN OF NORTH ANDOVER t,,S�.° p PERMIT FOR GAS INSTALLATION s r� This certifies that :........... r .....� .............. has permission for gas installation ............................ in the buildings of..........................................r at .................................... North Andover, Mass. Fee......... Lic. No........... .......................... GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File Lwcation No. Date H011T►1 TOWN OF NORTH ANDOVER C�tt�o yeti p Certificate of Occupancy $ o : ; Building/Frame Permit Fee $ 0 �„�s ��' Foundation Permit Fee $ w -Permit Fee $ t✓ Sewer Connection Fee $ . Water Connection Fee $ TOTAL f'= 1 958 $ Building Inspector 0 Div. 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O C_ 1�s Go l� m m VV :: � �Y Q! c �3p �J G m = G N W to m CL V eo�mm �o CMO =0 z .��o ca 'S Z CL M m G m 30 = � m a r 6 W Gui mnom~ O r N rL H t- n... m M 0 a 0 z 0 U �% C`1 I cC O•— CO Q 'C O.— 'r m m .CD OC O � 3.0 ® Q 0 cc O a . CM< O c ev �v as CA Z CD CL V H O C c C. h D 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***************** APPLICANT: ��� U� Phone LOCATION: Assessor's Map NumberParcel 1/ Subdivision _ Lot (s) Street 21� St. Number 25 - Z " ************************Official Use Only************************ /REC/I,OEEN�DA(�TIONS OF TOWN_ AGENTS: Date Approved Soo 9 1 Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Food Inspector -Health Septic Inspector -Health Comments Public Works - sewer/water connections - driveway permit Date Approved Date Rejected Date Approved Date Rejected Fire Department Received by Building Inspector Date Name: Address: City: SwimmingPool Center 1 Directibns �v� Water Pool Distributors Permit 670 SOUTH UNION STREET jC.-'t /I/A/0 / Z 111,512, LAWRENCE, MASSACHUSETTS 01843 (508) 682-6916 �6 Date: State: �J Zip: 0/ Fes) r Home Phone: 6 � � .w ��5 ;20 Work Phone: —CONTyWlACT— We p pose to furnish one A D d , Vy ,�) Abo a -Ground Swi mmrny'NI for the sum Of $� �� and install above stated pool for the sum of $ ��' 0 U , This price is for normal swimming pool installation in a fairly level backyard: Access to the construction site and the location of the pool shall be the Buyer's responsibility. The Buyer agrees to obtain and assume the cost of reconstructing existing fence sections and supplying temporary fence, if needed, for the pool. We will remove and pile the sod In the immediate pool area and replace it with stonedust for the pool base. The Buyer agrees to obtain and assume the cost of any required permits; cost of blasting, jackhammer work, additional equipment and labor charges if ledge or objects too large for our equipment are encountered; stumping and removal of trees; additional gravel or stones if required, for the proper installation of the pool as advised by the job foreman; grading around the pool; all electrical and grounding cost; cost of water to fill the pool to operating level at the time of construction. Swimming Pool Center will not be liable or responsible for damage done to walkways, driveways, patios, lawns, shrubbery, trees, flowers, sprinkler systems, well lines, underground utilities, or drainage pipes. If the contract cannot be fulfilled by the Swimming Pool Center due to: 1) Buyers cancellation during construction; 2) having improper ground conditions for a proper installation; the Buyer agrees to assume the cost of labor and materials already provided by the Swimming Pool Center. LIMITED WARRANTY: Swimming Pool Center agrees that for a period of one (1) year from the date the pool is completed it will, without charge, provide the labor to remove and replace any component of the pool that is subject to an independent manufacturer's warranty, providing that the pool has been certified by the Swimming Pool Center. 1) At the option of the Swimming Pool Center, this warranty is voided if the swimming pool is used by anyone prior to certification by the Swimming Pool Center or the Buyer has not fulfilled all payment obligations including extra charges, if any. 2) This warranty does not include the cost of supplying water to refill the swimming pool in connection with the performance of any warranty service. 3) There are no warranties which extend beyond those described on the face hereof, including the warranty of merchantability. All aboveground pool packages include: D.E. Filter, DLX Thru-Walt Skimmer. Ladders) Printed Liner Motor: 3/4 HPDHP — OPTIONS — Light: Motor Upgrade: Automatic Vacuum: Solar Cover: Winter Package: Stair Unit: Heater: Misc: Vacuum Cleaner and Chemical Starter Kit. Filter: Sand — D.E. Ladder. afee In/Out — Deck Liner: Solid BlueAll Print Pool (Pkg.): $ Total Extras: $ 5OWMA Sales Tax: $ Total Price: $ Deposit Received Bal. of Contract: (due upon pool delivery' Installation: (due upon completion) The Buyer acknowledges that they have read and accepted all conditions of this contract and agree to honor the contract accordingly. SELLER: BUYER: ��� 0 MAY --02—LEMING ARID M I FAMOA. ID, 617 224 9703 Pf, 4 si ;3 X Q pp m 7-w Rk Fo �� aw qD Tf It A 12 K I V1 M M __4 ,0 r, F1 W D I -i`T-F:'MiN,7 rhD NIRANr-�A I rR 10 - G I -,,' 224 970 3 J,Tupj�,,r o -nm rit,, rvt, if MAY 2 - 1997 I !-ty fT!- THE I NFORMIA IN THIS, FAX TS iNTENDED INFORMATION TFAT I'S USE OF AD,,ESSfT IT AjjD MAY CONTATM OSLTRE UNDER APPLICABL" PRfVELEGEDt -oNF'lDENT72!-1 011, EXEMPT FROM DTISCL YOU ARE HEREBY LA W ARE NO - T +TE INTENDEDRMIPI-ENT, --STR-.r8U-PTF�"j0N, COPYING OR USE OF r 'FED THAT X11Y DTSzSE- -',',lATj*0N, D; L -i,�UHIBITFD- - IF 19 STRICTIEV J� _,OMMUNICATTAI.V, OR FORMATION E, C0MMTj—ql'C' 7"ON' 114 Er-a'WP, PlEAS NOTIFY THIS OFFI('L V Eli TIT I S -& tL I -J� 41, JRTELL' Y;)Y TPELEPHONL A4ND FETURN THE ORIGINAAL TP-ANSMISSION TO 1. ,r-IcE VIA "HE U - S, POSTAL SERVICE WT p Es THOUT IlkING ANY CO I yon, 5 L IA.IL,-NG CO T p EJ�SE CALL (61 L Ai TH I S IIT_ �SHALL RETMDUPSF TV YOU EXP-.EP,FEN(-`-I : ANY PROBL&MS. THjUiY YOUJJ . lid. in A, 4 of 4t crommonmento of filtt000r imjet#o . lepartmtttt of Vuhlic i6afttq BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 CK # X4,6 ---%-> pt 3-9. crp�> Office Use Only Permit No. 9 73 Occupancy & Fee Checked 3/90 (leave blank) 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 �3Qz s % QM or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (street &Number) o? E Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes Purpose of 'Building No ❑ (Check Appropriate Box) Utility Authorization No. Existing Service Amps __/ Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps _J Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No -.of Lighting Outlets No. of Hat Tubs No. of Transformers Total No. of Lighting Fixtures Swimming Pool Abo . n- grnd. grnd. ❑ I Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners 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 No. of Ranges No. of Air Cond. Total tons No. of Disposals No.of Heat Total Total Pumps Tons KW No. of Dishwashers I Space/Area Heating KW Detection/Sounding Devices Local Municipal [I Other ❑ Connection No. of Dryers Heating Devices KW No. of No. of Low Voltage No. of Water Heaters KW I Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws 1 have a current Liability Insurance Policy including Comolete Operations Coverage or Its substantial equivalent. YES _ NO = I have submitted valid p of of same to the Office. YES �O = If you have checked YES. please indicate the type of cc rage by checking the appy late box. 0 INSURANCE f BOND �_ OTHER (Please Specify) (Ex ation ate) Estimated Value of Electrical Work $ s O O ��� Work,(p Stan Inspection Date Requested: Rough Final Sighed under the Penalties of perjury: FIRM NAME LIC. NO. i Licensee c a Signatur LIC. NO. Bus. Tel. Address 2 el rt y, �t%lf �` 3 03 t Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- s. quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) �r�t!j Telephone No. PERMIT FEE 5 _, (Signature of Owner or Agent) x-5565 C041M0NW ���TN vr'�AS ASARC .pckNs,�,� ALTO �S �ga'g re'CI ANs N W HITCgCTRI� 1, a o B UERR y �x H 003038`028 .\ _, �;^-. « -..•+�f.-...K:-: _ ..,� �_,,,-two s�•:,.F....`�.'ti:�..-.—..,.+-^ -� ' ' -,- - _ .. -. �= 973 Of r40RT►i 1ti _ O �O P „,..••"� ;,SSACHuSf Date. 3`!'..!......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING 1 This certifies that .......11-N ..... .:.. .fit �K �....................................... --a has permission to perform .... ..1..47..An........................................................... wiring in the building of .. %1 ... U,' C. C> ti. N 0.2 ....................................... _ .......................... .North Andover, Mass. ,& Fee. z............... Lic. No28„v„ 1.0 ...............................................................14 ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer j