The URL can be used to link to this page

Home My WebLink AboutMiscellaneous - 27 PUTNAM ROAD 4/30/2018L-11 H.1 I.q .......................... Date ....... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION a4l 0 This certifies that.p C()Ik ur?�— ........................... .......... ........................................ ............. .................... has permission for gas installation V"Aj k C -P in the buildings of .......... ....................... k� ... .............. . .......... .. .................... ..... .. . ... at ..... ............... Nort h Andover M a s s. ...................................................... GASINSPECTOR Check # MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY I North Andover MA DATE 13/24/2014 PERMIT # JOBSITE ADDRESS 1474�& OWNER'S NAME T–V— G OWNER ADDRESS I Same TE I --J, IFAXI TYPE OR OCCUPANCYTYPE COMMERCIALF1 EDUCATIONAL RESIDENTIAL[j PRINT CLEARLY NEW: L] RENOVATION: Ej REPLACEMENT: PLANS SUBMITTED: YESE] NOE] APPLIANCES FLOORS, BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE r -------- I INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN 1, POOL HEATER —ROOM / SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHER f&Iace Gas Meter 3nd-Pipin eded -q as Nei INSURANCE COVERAGE I have a current liabili!y insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES E] NO [j I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Ej OTHER TYPE INDEMNITY [j BOND OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. SIGNATURE OF OWNER OR AGENT CHECK ONE ONLY: OWNER[] AGENT I hereby certify that all of the details and information I have submitted or entered regarding this 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 i c mpliance with all Pertinent provision ofthe Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME I Joseph Marino LICENSE# 8736 ATURE MP El MGFEI JPE3 JGF[:] LPGI[:] CORPORATION Ej# PAR RSHIPEJ# LLC [J# COMPANY NAME: ruction Co ADDRESS CITY I Auburn STATE � ZIPI 01501 ]TEL (508=832-3295 FAX 1508-926-4347 CELLI 508-832-4614 1EMAIL flte.corn -Al I I , V-" 0 F] u) Fl LLI a - LU Cl) < LLI U) LU > w ui z 0 I -- L) CL CL LU LL 0 cn LL. .0 7 10 Wfu <Z.C)- LL CDW ..Lu H .0 > 0 :c ZO CD U) uj< LU Nz , tl, I 5 04/03/2014 14:04 5088326751 RH WHITE CONSTRUCT PAGE 02/02 ACCORD DATE (MMIDDINYYYI 081 0 CERTIFICATE OF LIABILITY INSURANCER... 08/291/020131 THIS CERTIFICATE IS ISSUED ASAMATTEROF INFORMATION ONLYANDCONFLRS NO RIGHTS UPONTHE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEWD OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SU13ROGATION IS WAIVED, subject to the terms and conditions of the policy, certain polici M y require an endorsement. A statement on this certificate does not confer rights to the cortificat@ holder in lieu of such endorsement($')"' I willia Of Massachgootts, Inc. C/o 26 co-Atury Blvd, P. 0. Boy 305191 K19hville, TH 37230-SIPI R- K- Whit8 COnstruction Company, Znc. 41 Cdmeraa Street P. 0. Bcx 257 AUbUrA, MA 01.901 INSURERA! The chartor Oak Fire XnBuranco CO �--y _�;_6 15 __0 0 1 INSURERS: Tr1LVQ:LMrS Property Cagualty Coqpany of Am _i5674-001 IMSURERC-NAtiOMAI Union Piro Insuranca CQmpauy of 3.9445-001 INSURERI);TravelexB Ind&=ity CoMpIny 2SG98-Dai INSURER F; VVr.KAUr_U CERTIFICATE NUMBER: 20287680 REVISION NUMBER; THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN [$SUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OFSUCH POLICIES, LIM17S SHOWN MAY HAVE BEEN REDUCED 13YPAID CLAIMS. 51 - A GENERAL LIABILITY X cOMMPRCIAL GENERAL LIAFIII.ITY — CLAIMS-MADE50 OCCUR GEN'LAGGRGGATE LIM17APPLIES PrR; 13 1 AUTOMOBILE LIABILITY ANY AUTO ALI OWNED SCHEDULED A )S AUTOS U'to X WIRED�UTOS X NON -OWNED AUTOS X CO Dad X C911 C UMEIRELLAUAS �Xj OCCUR r=XCSSS LIAS CLAIMS -MADE I DED I X IRETENTIoNS :LO,O0O D WORMERS COMPENSATION ANDEMP LOYERTLIABILITY Y N ANY PROPRIETORIPARTNERIEXECUTIVE N(A OFFICER/MEMSER EXCLUDED? f Mandatog In NH) Irs Mdenibb undnr U Kfil UN Ul- UPURATIONS below CE QF Evidence of InNurance 5)77X9948-13 19/l/2013 1'9/1/203.4 JEACH VTJCAP 977K955A-13 19/1/2a:L3 19/1/2014 BE8766140 19/1/2o:L3 � 9/1/20-14 PERSONAL &ADV INJURY GENERAL AGGREGATE S 2 onn,()00 S 4,.200,00 PRODUCTS-COMPIOPAGG j_4,000,000 &OMBGI�ED SINGLE LIMIT E10 Elent) s 2,000,000 BODILY INJURY(Parpemon) $ 13ODiLY I NJ U RY(Per accident) % r�.PFRTY "'c'ld'�"TAM 9 - - EACH OccuRRENCE $ q"000 000 -A AGGREGATIH F�' " 11 11 � . VTRKUB 820SA105-13 9/1/.203.3 -9/1/203,4 x VTC2XUB 9203A71A-13 19/3,/2D13 19/1/2014 JE.L. speco [ADENT s 1,000,000 - EA EMP!,QYEE S 1,000,000 -POLICYLIMIT M 1,000,000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES 8E CANCELLEC) BEFORE THE EXPIRATION DATE THERSOF, NOTICE WILL 13E DEL(VERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED RePRESENTAT111E . __ .1-i i Coll. -4197604 Tpl:16;4012 Cert:20267680 @ 1988-2010 ACORD CORPORATION. All rights reserved. ACORD25 1 (2010/05) The ACORD name and logo are registered marks of ACORD it Location No. o..2�7 A,," a,�- Date �3-3 -d3s— TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ AN D- 3 Check # Jc 181- 4 z Building Inspector I Property Address: 2.1 Owner of Record "T-C)",e, n S 0 " 1,, T4 1� k u� Name (Prini) 0�1'm� 04 u I S 1.2 Assessors Map and Parcel Map Number Number: Parcel Number - 2.2 Qwner of Record: N�me Print 1.3 Zoning Information: Zoning District Proposed Use Signature Te ephone 1.4 Property Dimensions: Lot Area (sf) Frontage (tt) 1.6 BURDING SETBACKS (ft) 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Front Yard Side Yard Rear Yard Required Provide Required —+ Provided Required Provided Company Name Registration Number 1.7 Water Supply NiG.L.C.40. 54) public 0 Privata_ _ 0 zone 1.5. Flood Zone Infonudion: 1.3 — Outside Flood Zone 0 FM Sewerage Dbposal System 0 On Site Disposal System D SECTION 2 - PROPERTY OWNERSEEIP/AUTHORIZED AGENT LUI 1C UICt.rict: '11"'r 2.1 Owner of Record "T-C)",e, n S 0 " 1,, T4 1� k u� Name (Prini) 0�1'm� 04 u I S 0\-4 P1,AJ Pj Address for Service 1— 2 ]- St ature' Telephone - 2.2 Qwner of Record: N�me Print Address for Service: Signature Te ephone SECTION 3 - CONSTRUCT70N SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Not Applicable 1`\ License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable 0 Company Name Registration Number Address Expiration Date Signature Telephone I SECTION 4 - WORKERS COMPENSATION (KG.L C 152 1 2506) 1 Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buildinst permit. Signed affidavit Attached Yes ....... 0 No ....... 0 SECTION 5 Description o Proposed Work (chMftck alpomlde) L New Construction 0 Existing Building q Repair(s) 9S( I Alterations(s) 7-7i� on 0 Accessory Bldg. 0 Demolition 0 Other 0 Specify Brief Description of Proposed Work: SECTION 6 - ESTV"TED CONSTRUCTION COSTS Itern Estimated Cost (Dollar) to be Completed by permit applicant 0MCL4L USE ONLY I . Building (a) Building Permit Fee MultiRlier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Buil Permit fee (a) x (b) Alp 4 :- Mechanical (HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERAUT L as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature ot'Owner Date SECTION 7b OWNERJAUTHORIZED AGENT DECLARATION li— :� —'� as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are Lrue and accurate, to the best of my knowledge and belief Print N Signature of ywnedUent Date NO. OF STORIES SIZE BASENENT OR SLAB SIZE OF FLOOR TUvMERS I 2"qD 3RD SPAN DMIENSIONS OF S111S DMIENSIONS OF POSTS DMNSIONS OF GIRDERS HEIGHT OF FOUNDATION TFUCKNESS SIZE OF FOOTING X MATER1AL OF CHNMY IS BUILDING ON SOLID OR FffLED LAND IS BUELDING CONNECTED TO NATURAL GAS LINE TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI!6 RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING AW ON"- BUELDING PERMIT NUMBER: DATE ISSUED: SIGN Building CommissionerfIgELwor of Buildings Date SECTION I- SITE INFORMATION 1. 1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Area (sf) Frontage (ft) 1.6 BURDING SETBACKS (ft) Front Yard Side Yard Rear Yard Required Provide Required Provided Required :J Provided 1.7 WaW Supply NCO.L.C.40.1- 54) 1.5. Flood Zone Inforroation: public 0 PrMft 0 zone Outside Flood Zone 0 1.9 Sewerap Disposal System - municipal 0 On Site Disposal System 13 SECTION 2 - PROPERTY OWNERSEEIP/AUTHORIZED AGENT Ui��trict: N,,'r,,3 2.1 Owner of Record Name (Print) Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Not Applicable 0 License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable 0 Company Name Registration Number Address Expimtion Date Signature Telephone �4 tq--* 0 FE04 0 W M Cd r 1.1 ",2 ::V"- 0 �2 u x UW C.3 C3 mmiCc Z �o Ch C/) ::V"- 0 C.3 C3 mmiCc CL �14(10 IV- T : 0: = = V : A-511� A ts mi %a Je oil: g Nirj s Go .0 =0 =C COD 40 cc 0 loo 73 'C'm 4 D V"A A .00 CCm -Illlr� CD"a C C ULW < M =0 L =0 ICIL 0 CD =0 act .2 CL IC2 CD Lu ui I-.- LA CZLS z U=J E U-0 L) &- 11,4D CD CIO COL 0 a CL m as -0, 1 m 2 C* P 2, .2 CL.= a — 0.- M Nis C/) z 0 C/) Cf) C/) 12 4-J z 0 Cm I CA CD C40 .7 E CD am CL 0 cc M CIO C.3 GO C.3 cc CL Cos CL 0 C CM cc Ca Inc L- t 0 CL Cmox cc .3mo 0.2 z Q CD CL CO3 w Cl 0) w C4 LLI Ce North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM in accordance with the provision of IVIGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal faci . lity as defined by IVIGL c 11, S 150 A. The debris will be disposed of in: CA ,f,� P U"�i3 fk (Location of Facility) ignature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the office of the Building Inspector ViORTH TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 400 Osgood Street North Andover, Massachusetts 0 1845 D. Robert Nicetta, Telephone (978) 688-95454 Building Commissioner Fax (978) 688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE:— JOB LOCATION:— J 3 PL, k W V\ I-\ �Af �R A - Number Street Address Map/Lot HOMEOWNER T44�Ryoh 77e Name Home Phone Work Phone PRESENT MAILING ADDRESS .,A6,x �0,,,C� B �-k� r City Town /11 State a/ (O*T Zip Code The current exemption for "homeowne&' was extended to include owner -occupied dwellings to two 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 108.3.5. 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 or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned "homeowner" assumes responsibility for compliances with the State Building Code and other Applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNA APPROVAL OF BUILDING OFFICIAL BOARD OFMPEALS 688-95,41 CONSFIRVATION 688-9M 11KAL Hi 688-9540 PJANNINO 088-9535 0 �F�? N 0 Date ... ................. 0 TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING This certifies that ...................................... has permission to perform-r��-:-'-.-x 01 wiring in the building of ... (?�,.A ................................................. at.J .................. ..... .... . North Andover, Mass. ..... .. ......... ......................... Fee . ..... Lic. No.��. /,&,4 - .-. - -, -1 -d' A..' '-' -, t/,/ '-- ELECrRICAL INspEcrOR 08/10/99 14:38 15.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 01 4e Tommonwrnit4 of Aasriar4utntts Office Use Only Department of Public Saj�ty Permit NO. J710 BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 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 T PE �Ll- Il`JFO$MATI9KQ Date City or Town of N—?�Ouu "thpector of Wires: T e Inspect The undersigned applies Or a permit to perform thV �.�l wQrj( described below. Location (Street & Number) Owner or Tenant Owner's Address Lm— Is this permit in conjunction with a building permit: Yes L—J N c, L—i (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead 1:1 Undgrcl No. of Meters New Service --Amps volts Overhead 1:1 Undgrd No. of Meters Number of Feeders and Ampacity Iocation a nd Nature of Proposed Electrical Work I OTHER: INSURANCE COVERAGE: Pursuant to the requirements*ot Massachusttes General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES 0 NO 0 ! have submitted valid proof of same to this office. YES 11 NO 0 if you have checked S, please indicate the type of coverage by checking the appropriate box. INSURAN - =BOND F-1 OTHERE] (Please Specify) Estimated Value of Electrical Work $ Work to !Start (9 Inspection Date Requested: Signed under the nenafties of neriurv: FIRM NAME Rough (Expiration Date) Final --71,44,0 1.2 !V -03W LIC. NO. Alt. Tel. No. OWNER'S INSUR</NCE 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) Telephone No. PERMIT FEE $ (Signature of Owner or Agent) TOTAL No. of Lighting Outlets No. of Hot Tubs No. of Transformers KVA Above. No. of Lighting Fixtures gr1n- Swimming Pool grnd nd. Generators KVA No. of Emergency Lighting No. of Receptacip Outlets N!'., Cf Oil Burners Ba i n1tL —J No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Total No. of Ranges No. of Air Conditioners Tons Initiating Devices No. of Sounding Devices - Heat Total Total No. of Disposals No. of Pumps Tons KW No. of Self Contained Detection/Sounding Devices. No. of Dishwashers Space/Area Heating KW Municipal LocalF, Connection FOther No. of Dryers Heating Devices KW .... .... No. of No. ot Low Voltage 16 .N o. of Water Heaters KW Signs Ballasts Wiring �,q2. Hydro Massage Tubs No. of Motors Total HP I OTHER: INSURANCE COVERAGE: Pursuant to the requirements*ot Massachusttes General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES 0 NO 0 ! have submitted valid proof of same to this office. YES 11 NO 0 if you have checked S, please indicate the type of coverage by checking the appropriate box. INSURAN - =BOND F-1 OTHERE] (Please Specify) Estimated Value of Electrical Work $ Work to !Start (9 Inspection Date Requested: Signed under the nenafties of neriurv: FIRM NAME Rough (Expiration Date) Final --71,44,0 1.2 !V -03W LIC. NO. Alt. Tel. No. OWNER'S INSUR</NCE 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) Telephone No. PERMIT FEE $ (Signature of Owner or Agent) Location C;2 V No. Date ehhq TOWN OF NORTH ANDOVER 0 Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL Building Inspector a/64/99 11:48 45.00 PAID Div. Public Works Z LA L^ rr, Ln m m m r - Z> r) z m L) 0 z z m rr, m 0 M. rr, ;a Cz m z M V. V. V., Z z 767;zzz rr, P. -, = m rr. rr. z > 7 z x L-1 m > m rr, 7. C\l LA L^ rr, Ln m m m r - Z> r) z m L) 0 z z m rr, m 0 M. rr, ;a Cz m I L.) >= V. V. V., Z z 767;zzz e) m P. -, = m rr. rr. z > 7 z x L-1 m > m rr, 7. PC z rr, m C) rr, m ME CM. Qmmmz Z; Z Z; z v z �n LA m z Pr-: Lr C) 7 Z m w 7 rr, ;c LA W-0 rTl I L.) Cl) m m 7) m m m U) m Cl) 0 m 1= CA CA Cl) 10 0 CD Z co) CL r— C') MM C CL >Cc -0 CD CD CL cr =r Cm CD CD 0 CD mm 9. CD CA CD ca Cc CD CA 10 CD z cl) CD CD 0 uml lb 21: W: z CD cc CD CC) c CD cc CO2 CA -a UP 0 C7 CA '0 -COI, CC." to =m 'w Rt cp CO. -n =r 0 C. t rr " = F -n 40 0 CO3 .* 0 -*.-0: 0 -4 co c=D 4;D; 't cD a,R =0 0 M.c lu o L-: CS, CD C2 =r = -0 CL 0 .4t CD CD 0 CD C2. CD C, sl r -r C.Dc CD ft H co C) 0 A44.0 CD 0. W* f 'A CD C-3 =r = CD 0 f ful CD CA CD 4 0 CU 0 Cm IW CD cw, 0 CD 0 cn 3 0 cp ,z m 'It -qi m n cn CIO n 0 - 0 cn C� cn Z cn m z RL r 21: W: z CD cc CD CC) c CD cc CO2 CA -a UP 0 C7 CA '0 -COI, CC." to =m 'w Rt cp CO. -n =r 0 C. t rr " = F -n 40 0 CO3 .* 0 -*.-0: 0 -4 co c=D 4;D; 't cD a,R =0 0 M.c lu o L-: CS, CD C2 =r = -0 CL 0 .4t CD CD 0 CD C2. CD C, sl r -r C.Dc CD ft H co C) 0 A44.0 CD 0. W* f 'A CD C-3 =r = CD 0 f ful CD CA CD 4 0 CU 0 Cm IW CD cw, 0 CD 0 cn 3 0 cp ,z m 'It -qi m n CIO - 0 Z 0 r- aq m z RL r M 91 0 rD =7" eD GQ :T" CL F CL C/) -< rD C) > n rD It 0 m P.- n C n n z m 0 441� CD pq I N2 2 , t--'7 Date.A.--5�.z ........ TOWN OF NORTH ANDOVER PERMIT FOR WIRING L6 CU ............................ This certifies that ..... ..... Ln has permission to perform .... z ........... co wiring in the building of,! -c ...... ...... ..... t r"-� ..................................... ch . . . ..... ...... at ... ::;n.'7 ..... ................. . North Andover, Mass' Fee��S ............... Lic. NZ??�e44 . . ...................................................... ...... ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer TIMCOAMNWEALTHOFARSUCHUMM Office Use only DEPAR7MMT0FPUB1JCS4FM Permit No. C;:71"7,7 VIIBIOARDOFMEPR&EMONREGJLMOASR70MIZO UV4 Occupancy & Fees Checked APPUCATION FOR PIRW TO XWORM E-ECMCAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUsSTS ELECTRICAL CODF, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) DatL.& Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Sftd A Owiner or Tenant Owiner's Address - SA,,Me Is this permit in conjunction with a building permit: Yes M No (Check Appropriate Box) Purpose of Building ,_f/AVX- 7-7--AMIJ�14 Utility Authorization No. I - Existing Service Amps Volts Overhead Underground New Service Amps Volts Overhead Underground No. of Meters No. of Meters Number of Feeders and Arnpacity Location and Nature of Proposed Electrical Work '24gla Ammig AL& --AIA 41 No- of Lighting Outlets No. of Hot Tubs No. of Transformers Total q KVA No. ofLighting Fixtures Swimming Pool Above Below Generators KVA ground zround No. ofReceptacle Outlets No. ofOil Burners No. ofEmergency Lighting Battery Units No. ofSwitch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No- of Ranges No. of Air Cond. Total Tons No. ofDetection and No- of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. ofSounding Devices No- of Dishwashers Space Area Heating KW No. ofSelfContained Detection/Sounding Devices Local Municipal Othrr No- of Dryers Heating Devices KW E]Connections E] No- of Water Heaters KW No. of No. of gns Bailasis No- Hydro Massage Tubs No. of Motors Total HP 0 1 FHER- 111&==COM� ft'suA1ol1hemRrmenlsdMw&hBftG=4Laws �hmaomatLiabifitybur&=Pobcym&AgCjmo*Opwdfi*omCo&WcritsmbftMe*ivalat YES NO E3 IhawWhn1ftdMWPr00f0fS3W10thr,OffM YES M NO ff�cutaedai=l YES, pk=wdcNethetSxo6wmWby&xf%g#e [D BOND M OUER [—] / / &.,2 / -?,? Wakt)Sht 141-10192r- Sig=dMdW&P&Rkies4i0W. FWMNAME vmespoffy) B*ddm Dat F&n*dVakrdEkd"Wdk $ FmW Liww�lh I Limmilb A"m- 7 7- � �s e- OWMR'StZURV-XEWMVM-ImmmbtteLimmftot (Ple.ase check one) Owner 1:3 Agent ED Telephone No. PERMIT FEE $ ULM-* This certifies that 3 -C?d 04 -- Date ............. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING has permission to perform ............ plumbing -i -n the buildings of ..... ..................... at ....... North Andover, Mass. .......... Fee. '-//`��-7—. Lic. No:-� /,0, -qs� * PLUMBING "'N"PECTOR Check # // � :1 -. k MASSACHUSETTS UNIFORM (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location TION FOR PERMIT TO DO PLUMBING ate P Amount New Renovation ReplUment Plans Submitted Yes 0 FIXTURES 000 (Print or type) Check one: Certificate Installing Company N=4&z_,� �Pze"Wz�x� � r, Corp. 0 Partner. 12 Firm/Co. Name of Licensed Plumber: LA -)I '�:Sc Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy El Other type of indemnity El Bond Insurance Waiver: 1, 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 � �esu d (or entered) in above application are true and accurate to the I hereby certify that all of the details and information 1 .1 u pii e best of my knowledge and that all plumbing woLkr sued for this application will be in compliance with all pertinent provisions of the ter 142 of the General Laws. By: Title Type of Plumbing License City/Town License INUMDer Master Journeyman APPROVED (OFFICE USE ONLY 11 BOARD OF FIRE PREVENTION REGULATIONS (Rev. il/99) For Office U39 Only Pertrilt Number occupancy & Fee [ON FOR PERMIT TO PERFORM ELECTRIcAL WORK (AU WORK To U PWOUM WrM *nM MAS&kQl[U=M EMCnUCAL CODE 527 CMR 12.00) PLEASE PRINT IN INK OR TYI�E A ILL IN F0RmA-n0N Date: City or Townof: — -ii /V To the Inspectorof Wires:` By this applicatic Undersigned gives notice of his or her intention to perform' the electrical work described below. Location: (Street & Number 2` Owner or Teriant: y -7- Owner's Address:— 2 3 Is this permit in conjunctio I n with a . Building Permit? Yes sa�No 0 (Check Appropriate Box) . Purpose of Building: UtIllty Authorization Existing Service: Z!L�Amps 12-- 1 Z5,- VoftS Overhead 'Meters Underground.0. # of New Service: —Amps Volts Overhead CI Underground,C] of Meters: Number of Feeders and Ampacity:. Location and Nature a f Proposed Electrical Work:. 7� No. of Recessed Fixtures No. of Call.-Susp. (Paddle) Fens No. of Transformers Total KVA No. Of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool: Above ground 0 In Ground a # of Emergency Ughtin' g Battery Units No. of Receptacle 0 utlets No. of Oil Burners No. of Switches No. of Gas Bumers No. of Ranges No. of Air Conditioners TOTAL T -ONS: No. of Waste Disposals Heat Pump Totals: Number. TONS:. KW: No. of Dishwashers Space /Area Heating:. KW No. of Dryers -Heating Appliances KW No. of Water Heaters KW -No. of Signs: of Ballasts: of Hydro Massage Tubs of Motors Total HP Fire Alarms # of Zones # of Detection & Initiating Devices of Sounding Devices: # of Self Contained Detection/Sounding Devices Security Systems: No. of Devices or Equivalent Data Wiring, No., of Devices or Equivalent: Telecommunications Wiring: No of Devices or Equivalent OTHER; INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electAcal work may issue ; unless the licensee provides proof of liability insurance including 'Completed operation' coverage or Its substantial equivale The undersigned certifies that such coverage is In force, and has exhibited proof Of Same to the permit Issuing office. CHECK ONE, INSURANCE a BOND 0 OTHER 13 Please specify: Estimated Value of Ele . ctrical Work $ (When required by municipal policy) Work to Start. inspections to be requested In a=ordanca with MEC Rule 10, and upon completion. I carlify, under the pains and penalties of perjurY, that the information on this application Is true and complete. Firm Name: LIC.0 Licensee:- Slanature: LIC (if applicable, enter G#t-inthe —1 -3 icons-- _IL11U_kZ_r tin _.) Address: �ftus. Tel. # AJt.Tel.# OWNER'S INSURANCE WAIVEW I am aware that the Licensee F09s _n0thave the liability insurance coverag i normally requ—ired by law. By my sjg;Wu_re �below, waive this requirement. I am the (check one) Owner 13 OR Agent 13 1 hereby Signature of Owner/Agent Telephone X I PERh9T FEL- S AOU541 ril 4100�4- C PT C