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HomeMy WebLinkAboutMiscellaneous - 30 UPLAND STREET 4/30/2018.� ,\ N O o v � �, v b � $ m o ,r"� 0 ,�� -rT Date.... I41-`.) ................... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION 4 _. r This certifies that .. e.. r?Q.........../.......................................... has permission for gas' stallation ...3?:`t:...... ....... `�.t17......... inthe buildings of ....... .... ... �....:.....................................................................:. at........'.......... nl. ::....C✓ ' 1 ...... U �... .:..........n.. ,'North Andover, Mass. Fee. !P....... Lic. No. �. �0�7 ....!�...................................................... GASINSPECTOR Check # 1 9W -` MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK -CITY a Rz �==otoz . E. ,- _ MA DATE .. d m C W- C W G S I� PERMIT- - JOBSITE ADDRESS ( U 414 S _ OWNER'S NAME �, a GOWNER ADDRESS TE FAX TYPE OR PRINT OCCUPANCY TYPE COMMERCIAL�]J EDUCATIONAL RESIDENTIAL CXXARLY NEW: i RENOVATION: [ REPLACEMENT: PLANS SUBMITTED: YES EQ NO [R- FLOORS- BSM 1. 2 1 3 4 5 6 7 8 9 10 11 12 13 14 APPLIANCES 1 BOILERS . BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER �— - DRYER FIREPLACE _ J FRYOLATOR _ FURNACE GENERATORh— GRILLE _ . _ - ._ ..._...... INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT IE- QVEN POOL HEATER ROOM /SPACE HEATER ROOF TOP UNIT - - TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHERfh-_TE0- vnole 00- INSURANCE COVERAGE have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES 010 I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY 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. CHECK ONE ONLY: OWNER AGENT SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate t "e st of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in complia c 'h II rti provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME �w to ri£ LICENSE# i56k5 IGNATURE MP E9'MGF E! JPEI JGF [I LPGI ® CORPORATION PARTNERSHIP LLC COMPANY NAME: ADDRESS c, 1 zZ CITY STATE' i►► A ZIP 2 I Z Z TEL FAX CELL ,s. �d6-IgQ4 EMAIL -k eeN� �f6 °La-,-- — V 1 9W s �? t'� s Date �'..).:... Q��..... TOWN OF NORTH ANDOVER PERMIT FOR WIRING t This certifies that ........... I......- h,.........�. G-- ............................... has permission to perform ..... d ........1....`t?. wiring in the building of ........,.. at ...: .<�%... v.10..16.!.' d.... .. 7 ........................ , North Andover, Mass. ......... Lic. No. ............. ........:� ?............................s ELECTRicALRINsPECTOR Check # 651 r� Commonwealth of Massachusetts Department of Fire Services x BOARD OF FIRE PREVENTION REGULATIONS Permit No. Occupancy and Fee Checked _ (Rev. 9 051 heave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All .wrk to be perfornlecl in accordance with the \lasachusetti FICctrical t_'o& 1 57, (AIR 121.00 1PLE,'ISE PRL\ T 1.1 /N& OR TYPE, ILL LST )RJ h (TION) Date: 3 v-, Citi or Town of: iib: � kjJA0��r TO /tic' /1�.v1�c'c•/O O/ I6'irr.`: By this application the undersigned -ives notice of his or her itcntion to perform the electrical work described below. Location (Street Sc Number) '7 � 0.� (honer or Tenant j !' l I K Z 4� e \rc rJ Owner's Address Telephone No. Is this permit in conjunctiop with a building permit? Yes [9 No ❑ (Check Appropriate Box)57� Purpose of Building Y M. I ly Utili y Authorization No. Existing Service;Amps / Volts Overhead Undgrd ❑ No. of 'Meters New Service Amps / Volts Overhead ❑ Llndgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: r e In c:: r C•ulnulclkm ohlit !r,l/rnl ins table nlery he iwA,J by the dllSjA)Ct l' r,/ II'ir, 111x, ll ,I, Idillinla 4cl.I I/ If ,I,',)'i l'Ctl, ul'tIs JV, .Jllll'c,.l l7b the 11 i.ld;('i 1,%I' Estimated Value of Electrical Mirk: 3060 ( \k hen required by municipal policy.' \kork to Start: 6-4, Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE C)VE AGE: Unless waived by the owner, no permit for the perlormancc of electrical work may issue unle< the licensee provides proof of liability insurance including "completed operation" covera.qc or its substantial equivalent. i he undersiLglcd certitics that such cup ra',c i:s in f01'l'e, ,rnd has e••.hibited proof of:,ame to the permit i::'Alin-o ofticc. l I IECK 0NF: I N S t 'R, \ N (T", 131;\I) ❑ ! )I fII R ❑ ttipccily:; d �rrtifj, rurrlcr the pains anr/ penudtie•v n/'prrjnm),, ldrut the in%urlitation lllr ?dris <rpplic•ntinrr is true am/ co,olp/eW. FIRM NAME: _ LIC. NO.: Licensee: �! Q>J�Q uvl � _ Y61)Il:nt111'L' � --- 1 IC. .'J(%.{ietS4%����� Itr/c, .,I,I l la' irr Ihr ;:rrn h. Bus. Tel. Nlo. �yicdt Address: G+� i i �toov M _ Alt. Tel. No.: "Security System Contractor License I—vquircd ['of this work; if applicable, enter the IICenSe IlUlllbll' here: _ OWNER'S INSURANCE WAIVER: I am aw;trc that the Licensee Jac,' rot harrc� the liability insurance c/werarc nCrmally Icquired by law. 13y my :;i'"naturc below, I hci—Lby waive this requirement. I ;mi the (check one) ❑ owner ❑ owner-:, 14cn Owner/Agent FWIT R;FF',F... :iignature T,_lLphor : ;`iso. No. of Recessed Luminaires No. of Ceil.-Sus (Paddle) Fans p• No.s Total Trsformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires i%bove In- Swimming Pool I—I El rnd. • i-nd. o.o mergency ig ung __Battery Units.___---___.___-___.__-___ No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS �No. of Zones No. etection and �n Dnitiating No. of Switches No. of Gas Burners IDevices No. of Ranges No. of Air Cond. Tons) No. of Alerting Devices Heat Pump Number Tons KW ; No. of Self -Contained No. of Waste Disposers p Totals: . ....._...._............ Detection/A lerting Devices No. of DishwashersMunicipal Space/Area Heating KW' Local ❑ Connection ❑ Other No. of Dryers Y Heating Appliances KW No. of DeSecurity S stems:* vices or Equivalent No. of Water KW No. of No. of Data Wiring: Heaters Signs Ballasts No, of Devices or Equivalent _ _ Telecommunications Wiring: No. H ydromassa a Bathtubs J g No. of Motors Total HP No. of Devices or Equivalent OTH ER: 111x, ll ,I, Idillinla 4cl.I I/ If ,I,',)'i l'Ctl, ul'tIs JV, .Jllll'c,.l l7b the 11 i.ld;('i 1,%I' Estimated Value of Electrical Mirk: 3060 ( \k hen required by municipal policy.' \kork to Start: 6-4, Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE C)VE AGE: Unless waived by the owner, no permit for the perlormancc of electrical work may issue unle< the licensee provides proof of liability insurance including "completed operation" covera.qc or its substantial equivalent. i he undersiLglcd certitics that such cup ra',c i:s in f01'l'e, ,rnd has e••.hibited proof of:,ame to the permit i::'Alin-o ofticc. l I IECK 0NF: I N S t 'R, \ N (T", 131;\I) ❑ ! )I fII R ❑ ttipccily:; d �rrtifj, rurrlcr the pains anr/ penudtie•v n/'prrjnm),, ldrut the in%urlitation lllr ?dris <rpplic•ntinrr is true am/ co,olp/eW. FIRM NAME: _ LIC. NO.: Licensee: �! Q>J�Q uvl � _ Y61)Il:nt111'L' � --- 1 IC. .'J(%.{ietS4%����� Itr/c, .,I,I l la' irr Ihr ;:rrn h. Bus. Tel. Nlo. �yicdt Address: G+� i i �toov M _ Alt. Tel. No.: "Security System Contractor License I—vquircd ['of this work; if applicable, enter the IICenSe IlUlllbll' here: _ OWNER'S INSURANCE WAIVER: I am aw;trc that the Licensee Jac,' rot harrc� the liability insurance c/werarc nCrmally Icquired by law. 13y my :;i'"naturc below, I hci—Lby waive this requirement. I ;mi the (check one) ❑ owner ❑ owner-:, 14cn Owner/Agent FWIT R;FF',F... :iignature T,_lLphor : ;`iso. No. of Recessed Luminaires No. of Ceil.-Sus (Paddle) Fans Date.... i .... ..................... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION CPUS�- This certifies that ....... ................................................. has permission for gas pstallation i .......... in the buildings of .... 41.z .. of� .............................................................................. 40 `A 1 .0 �k , at ...... 50 .......... .. ......... ... �I:AN-[`1 . North Andover, Mass. ................. ....................... . Fee JAP ........... Lic. No. 4 ............ M.fcr ............................. o ...................... GAS INSPECTOR Check #37-7 �I 09881 G TYPE OR PRINT CX,EA1<2LY APPLIANCES Z BOILER BOOSTER MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY.: IJa Rt N %a n�Do _. _ .Ii/IA DATE'S PERMIT JOBSITE ADDRESS OWNER'S NAME OWNER ADDRESS TE FAX OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL NEW: Q RENOVATION: [� REPLACEMENT: ®'" PLANS SUBMITTED: YES © NO FLOORS- ► I BSM 11 L....2 �I 3 4 1 5 1 6 1 7 1 8 1 9 1 10 1 11 1 12 1 13 1 14 CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM/ SPACE HEATER ROOF TOP UNIT TEST UNVENTED ROOM HEATER INSURANCE COVERAGE- have a current liability insurance policy or its substantial equivalent which meets the requirements of MOL. Ch. 142 YES 012 I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY BOND F 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. CHECK ONE ONLY: OWNER [3 AGENT 0 SIGNATURE OF OWNER OR AGENT . hereby certify that all of the details and_information I have submitted or entered regarding this application are true and a urate to be Amy knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compli a th all en r islon of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME L LICENSE# IS64 GNATURE IMP DMGF EI JP ® JGF © LPGI ® CORPORATION PARTNERSHIP ®#E= LLC COMPANY NAME:ee Bro Se2,, c e ADDRESS— CITY �as-�_ STATE' f11 A ZIP Z f Z 2=]TEL FAX r CELL S°� �d6-IRQq EMAIL 6f� e ® _ ., 4WP r 'Xis P4 1 Twl T"..,' I I O-t� - m ,SS UES THEA W ST _-Sf GAR- lowl, REXt- N" 03 LU In AA - log air 226442T> Date ... � �" -3:. Q k i' {R :.n f TOWN OF NORTH ANDOVER `yyy PERMIT FOR GAS INSTALLATION f This certifies that . .... , . �� , .................. . has permission for gas installation . z................ in the buildings of ....- ....... ................ at ...` 3 - .: .. . ... North Andover, Mass. Fees(Clic. No..�??.. .......... Gl` GAS INS TOR Check # e la? r, �` " f 5514 c ,vIASSACHi SETTS iJNZFORNi APP'LICATON FOR PERNIlT TO DO GAS FTIT NG (Type or print) Date A _ NORTH ANDOVER, MASSACHUSETTS Building Locations Uia�Q�d Permit # Amount S 01 ik4 i _—J e ge iA Owner's Name New Renovation �J Replacement Plans Submitted ❑ (Print or type) �G o 5 to t Name �,�� �" lc a� Address A i ' J , I,� `�-r S Business Telephone 777 Name of Licensed Plumber or Gas Fitter /%Gu% C e one: Certificate Installing Company Corp. Partner. imvco. LNSURANCE COVERAGE• Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes �''o D . If you have checked L> please indipA6 the type coverage by checking the appropriate box. Liability insurance policy 11 Other type of indemnity 13 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 13 Agent 13 t hereby certify that all of the details and information t have suomittea for enterea) in aoove appucat►on are true ana accurate to me best of my knowledge and that all plumbing work and installations performed a Permit Issued for this application will be in acmpliance with all pertinent provisions of the Massachusetts State Gas Code rid 7.apter 142,9f the General Laws. By: Title _ City; Town t\PPR01vrED;0FFICE (;SE ONLY) Signature of Licen. Plumbe Gas Fitter ® Plumber /- 4QC�L! Gas Fit IcC 'tom: mer. 1. er Journeyman sl�� Date.. ' •'�o TOWN OF NORTH ANDOVER ' PERMIT FOR PLUMBING '--This certifies that �.:.% .. ..................... has permission to perform ................ plumbing in the buildings of .`.• at .t)..... ` .........!.... . +/ , North Andover, Mass.' Fee.Y� ..... Lac. No.t"e �If ............ { PL UY8P.6 INSPECTOR Check # rg � 6912 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS _ Date Building Location n r� Permit # ff `` Amount Owner �'►7 KP i� New Renovation 01-� Replacement Plans Submitted Yes No (Print or type) Installing Company Name Address 0 Check one: Corp. Partner. FDFirm/Co. NName of Licensed Plumber: Insurance Coverage: Indicate the type ' surance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity D Bond Certificate 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 D 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 performe under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumb' Cod an hapter 42 of the General Laws. By: Igna ure 01 Licensean er Type of Plumbing License Title / /}OL.17-t' City/Town Mcense MOM Master Journeyman D APPROVED (OFFICE USE ONLY ��U % � Date.................................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ........... ........... ... ........... ,*.*. * has permission to perform .. .......... i ..................... wiring in the building of ... A-9 at.&.� . . .... ..... . ... .... ................. ,North Andover, Mass. 3 Fee—,� . ....... Lic. N0 .../7 ........................................................... ELECTRICAL INSPECTOR Ch—e c k it 5270 A Commonwealth of Massachusetts Official Use Only y Department of Fire hervices Permit No. / O BOARD OF FIRE PREVENT104 REGULATIONS Occupancy and Fee Checked J2� [Rev. 11/991 leave blank APPLICATION FORTERMIT TO PERFORM ELECTRICAL WORK All work to be performed inaccordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: (P -4 _ 6 City or Town of: P, W(1901e� To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) Owner or Tenant O-ZI.p,--N Telephone No. Owner's Address 7S0 [ ),2L -"J Sr Is this permit in conjunction with a building permit? Yes ❑ No El (Check Appropriate Box) Purpose of Building Utility Authorization No. (a 3 O -10 Existing Service I VU Amps 1 V / Zz'c')Volts Overhead Undgrd ❑ No. of Meters New Service 2fjO Amps )1 u / ZZo Volts Overhead Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion of thefollowing table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑In- El rnd. rnd. o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS I No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pum Totals Number Tons KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances Kms, Security Systems: No. of Devices or Equi alent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP ---[Telecommunications Wiring: No. of Devices or E uivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) On File Estimated Value of Electrical Work: (When required by municipal policy.) Feb/ 2,ob 5 (Expiration Date) Work to Start: - 2 --(2 Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains an penalties of perjury, that the information on this application is true and complete. FIRM NAME: LIC. NO.: Licensee: Kelly M. Casey Signature LIC. NO.: 37200 (If applicable, enter "exempt" in the license number line) Bus. Tel. No.: 978-697-4453 Address: 700 Robbins Ave Unit 3 Dracut, Mass 01826 Alt. Tel. 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 Signature Telephone No. PERMIT FEE. $ 5c> Date ..... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...... . ..... ..........i ...... ................... or m ............. . \has permission to perform wiring in the building of . . ..... ...................... at—�.() ... 42��T .................... . North Andover, Mass. Del) Fee -9 . ......... Lic. No . ............. ............................................................... 1,EcR1CALINSPECT0R � heck 30 5169 l IN Commonwealth of Massachusetts Department of Fire Services , BOARD OF FIRE PREVENTION REGULA APPLICATION FOR PERM All work to be performed in accordance (PLEASE PRINT IN INK OR TYPE ALL INFO] City or Town of: o o,, By this application the undersigned gives notice of h Location (Street & Number) Owner or Tenant Qt h� }AeYv Y"� Owner's Address 0 U0 Ga Js Is this permit in conjunction with a building permit? Purpose of Building Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Official Use Only ` Permit No. Occupancy and Fee Checked [Rev. 11/991 leave blank TO PERFORM ELECTRICAL WORK the Massachusetts Electrical Code (MEC), 527 CMR 12.00 TION) Date: 4 - -( To the Inspector ofWires: her intention to perform the electrical work described below. Telephone No. (e V-- (e X70 Yes ❑ No El- (Check Appropriate Box) Utility Authorization No. Overhead ❑ Undgrd ❑ No. of Meters Overhead ❑ Undgrd ❑ No. of Meters Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ In- ❑ o. o mergency ig ing rnd. rnd. Battery Units No. of Receptacle Outlets lNo. of Oil Burners JIFIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pum Number Tons KW No. of Self -Contained Totals Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW (Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) On File Feb/ z-bv:' (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: LIC. NO.: Licensee: Kelly M. Casey Signature LIC. NO.: 37200 (If applicable, enter "exempt" in the license number line.) 0 Bus. Tel. No.: 978-697-44.53 Address: 700 Robbins Ave Unit 3 Dracut Mass 01826 Alt. Tel. 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 Signature Telephone No. PERMIT FEE. $ a -S .cst? B� Date. la— �-�-o�..... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that X1-4 : .......... rhas permission for gas installation!�Z-:��� ............ in the buildings of ...��� � �"' ........................ . amt } 1..... ..... .......... , North Andover, Mass. Fee.' ...... Lic. No N GAS I-NS7CTOR -/`%/ Check # � 375-8 foulaw Locawl / /�/_�/ L /I '>Type of 4) J SuS-atSNT, aAiEMENT t ET FLOOR IND FLOOR 3110 FLOOR 4TH FLOOR STN FLOOR Ml PLOOR TTM FLOOR aTMFLOOR �� Instaqft Canpany Narm '*Rr2Ae t.S._.�,zjtun MA T kj a?Q Addrest,hi Q Lina r A u ....._ m E To ug nt 11 A ,�t1ht Num of UOwaW Plumber or On Fftw c Cts opts: O Co warollon © Parkwww ellkwco. Yes® No p INSURANCE COVERAGE: I hwe a cum 41 policy or poor RS vA*b meats Its of INCL CA. 142. Yes U No ❑ !I youhme theekod njS 8 9wtpecOvamWbychscWgVw&pprqxWv box A IWAity ftuwcs p oft Otter typo at mdovwft o Bard 0 A OWNER'S INSURANCE WAtNM: i on awats that the ftwdm doss CA hM the wee oavmrsgo requked 0y CtmPW 142 d the Maas. Oer1Nad lura, OW 00 nW SWdbim an title Poi. aWkWot1 wires this regnant. Check ons: Ownsr❑ Agett ❑ horsby omW that ail efthe detafs wul ipofra-Us ' I has submittd for s1ds - dl is -havegoftafts are ow sad aomaU to 1110 bad of my knavledQs sna ourt eM OM+R+bN+Q woAc and ilstato�ala owfo�ettad under lar oft awmalwa to ar we d psrtglent onvoma of 013 Minoduuetts Stet lies Code WA ChlPW 142 of Laws � T � sy talo L Nlnrow Q33� Cxy/�owriJOWWWAn w a a 8 o la ac 0 V W a p r •j x ___. s 111 w O z z O j O z t 'moi a 6 o 0 .0 w6 4 g o w ~ o c i > O Z $� a q EZ O Instaqft Canpany Narm '*Rr2Ae t.S._.�,zjtun MA T kj a?Q Addrest,hi Q Lina r A u ....._ m E To ug nt 11 A ,�t1ht Num of UOwaW Plumber or On Fftw c Cts opts: O Co warollon © Parkwww ellkwco. Yes® No p INSURANCE COVERAGE: I hwe a cum 41 policy or poor RS vA*b meats Its of INCL CA. 142. Yes U No ❑ !I youhme theekod njS 8 9wtpecOvamWbychscWgVw&pprqxWv box A IWAity ftuwcs p oft Otter typo at mdovwft o Bard 0 A OWNER'S INSURANCE WAtNM: i on awats that the ftwdm doss CA hM the wee oavmrsgo requked 0y CtmPW 142 d the Maas. Oer1Nad lura, OW 00 nW SWdbim an title Poi. aWkWot1 wires this regnant. Check ons: Ownsr❑ Agett ❑ horsby omW that ail efthe detafs wul ipofra-Us ' I has submittd for s1ds - dl is -havegoftafts are ow sad aomaU to 1110 bad of my knavledQs sna ourt eM OM+R+bN+Q woAc and ilstato�ala owfo�ettad under lar oft awmalwa to ar we d psrtglent onvoma of 013 Minoduuetts Stet lies Code WA ChlPW 142 of Laws � T � sy talo L Nlnrow Q33� Cxy/�owriJOWWWAn 'a s �n w s v v r A d O � 9 O $ T dA �1 C O two O O Z O F. a 4 1 O � 0 z 0 o v)—j z` Z � Q z W LPJ\0 1 A i 14 3" o= �Q 1 A i 14 3" o= f �ft LLJZ m cr- pp X cO 4 , y M I p0 .Z RE =TE ®� o� oy fy+� j vy a ui �a z� jw 3: g 0 Big LU J —J Z00 7dC�gLj{ R Q ry a L.i... <` Ly o. �— L 0 n ry �LJ-