HomeMy WebLinkAboutMiscellaneous - 32 MONTEIRO WAY 4/30/2018 32 MONTEIRO WAY
I 210/060.0-0143-0000.0
J
Location
��
No. ate
NaRTM TOWN OF NORTH ANDOVER
3: • 0
F A
Certificate of Occupancy $
�'�s''^°•Eta Building/Frame Permit Fee $
JACHUS
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # A-1 ��7/e;'
Building Inspector;/
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
lan
T113< 08,(i�1¢"f1Ni5iv1I77
BUILDING PERMIT NUMBER: DATE ISSUED.
SIGNATURE: AJ-41
Buildin Commissioner/Ing-Xe-or of Buildings Date
SECTION 1-SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map and Parcel Number:
Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning District Proposed Use Lot Area sf) Fronta e ft
1.6 BUILDING SETBACKS ft
Front Yard Side Yard Rear Yard
Required Provide Required Provided Rupired Provided
1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System:
Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal D On Site Disposal System ❑
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M
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: Not Applicable ❑
Licensed Construction Supervisor:
License Number
Address
Expiration Date
Signature Telephone
3.2 Registered Home Improvement Contractor Not Applicable ❑
Company Name
e--CP ^ n G qA ���/ �,Q ��7J Registration Number ram
Addres
/f/L !�L L ,/
Expiration Date
Si ture Telephone
SECTION 4-WORKERS COMPENSATION(MLG.L C 152 § 25c(6) �
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 buildigg permit.
Signed affidavit Attached Yes.......V No.......❑
SECTION 5 Descrl tion of Proposed Work check all a Iicable
New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑
Accessory Bldg. ❑ Demolition ❑ Other pecify 5 l
A ' " 4 %� s r
Brief Description of Proposed Work: '
++' SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar)to be `t3FFIIi�L USErNL�' ''
Completed by permit applicant
1. Building �O �rKJ (a) Building Permit Fee
Multiplier
2 Electrical (b) Estimated Total Cost of
Construction
3 PlumbinE Building Permit fee(e)X (b)
4 Mechanical HVAC
5 Fire Protection L
6 Total 1+2+3+4+5 10,J), Check Number
SECTION 7a OWNER AUTHORIZAT ON TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
b
I, 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 of Owner Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
as Owner/Authorized Agent of subject
property
Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief
Print Name
Si nature of wner/A ent Date
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TUvIBERS I ST 2 ND 3
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS r
SIZE OF FOOTING X
MATERIAL OF CFENINEY
IS BUTLDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
.own . of Andover
No.
0o dover, Mass., 'a0�/
coc HIC HE WICK low
0RATED Cl
H BOARD OF HEALTH
Food/Kitchen
PERMI D Septic System
BUILDING INSPECTOR
THISCERTIFIES THAT............ ......•....... .N. ...................................................................................................... Foundation
..... ..... Rough
has permission to erec: .. ........ . . ........ buildings ajo?....
' a
tobe occupied as. -A A . ...................................................I.......................................................................... Chimney
provided that the 00 accepting t rmit shall in every respect conform to the terms of the application on file in Final
ersor 6�
r
9 is
this office, and to the provisions of odes and By-Laws relating to the Inspection, Alteration and Construction of
Buildings in the Town of North Andover. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
PERMIT EXPIRES IN 6 MONTHS Final
UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR
Rough
................................... M Service
11!1�PECTOR
Final
Occupancy Permit Required to Occupy Building — GAS INSPECTOR
Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
SEE. REVERSE SIDE Smoke Det.
MAY- 4-01 FRI 2:06 PM P. 2
`:+ :—t+L F.LD.No. `11-2320449 ME Lic.No.DDtaed
JOLT 4 5 3 1 b1) b 0-91110M NN Lie.No.
1LJ ��rnt MA Lk.No•120458
SALES- FUR ALL New Yet&Dept.of Consumer
New York' SERVICEIREPAIRS HomeCe�traf' Affairs Lk.No.0730db0
800.942411) Nae4*u Lie.No.f42704160000
Hoxton: PLEASE CALL The Service Side of Searst" Suffolk Lie.No.21194M
BOO SEARS-31 111.245.7294 Vanker:1397
Hartford Area: SIDING WastchesterWCo613•Ha7
BOO•SEARS"99CONTRACT Now Jeresy Us,No.LO11664
Connecticut Dept of Consumer
Provlden�c�u Area! Affairs Lie.No.OOS32774
689-SE=ARS-5t VT Lie.No. __
.,,c� Rhode Island Lk Nox707
SOLD TO�._,,,,_m�NE Nl)/�.a p/O I U'— _ ,r DATt: 9/�0�84, F
ADDRESS 3Z 1 00 PHONE(Home)(` S
CITY�/ . dl =E 2, S1'ATWZIP Ol PHONE(Work)
JOB SITE ADDRESS(If different) :50,
APPLIED VINYL & ALUMINUM SIDING T —
Sold.Fumlanad a Instated by BIERay Aluminum Siding corp.of Queens,tnc.
16 Lyyman St•,Suits M1 A 6odre Aulhorized Contractor
Weatbareugh,MA 01$61 40 Elment Rd. Elmont.NY 11003
Goneral Description of Work at Above Address: 3 C�
Dal::
�...w�...�
Type of House:Ie C! Approx.Start DatMasonry Approx.Completion Date: / ,
SPECIMATioNa
Soars,approved mplerials will be furnished end installed to tress aNdfkalbns:
YES ( PLEASE READ CAREFULLY:ONLY THE ITEMS CHEiCKEO NES"AnE INCLUDGD IN YOUR ORDER.
t• C7 SOLIDVINYLSIDING•txrverop�n�w larvas eslpnatsdkrskling In those areas oe nated alow.so
Colart`f(,C� ' rL nern�_packegO sdl--o Custom cornorposts color
�/ —
IA. SIDINGcoil epplled to lite►ogowinp utas Dory:
P��t Elevation (;q-Right Elevation 0 Entire Oalaik
111"Elevallon en Elevailon []
❑Other ❑OR 0nxna) --� --
2.17 a INSULATION-cover only flatwall areas dasionsted for aiding with 3 f t Inch InsutaUon.+� "
3.t-❑ U chars epprovsd GALVANIZED STEEL STARTER STRIP where contractor deems necass,ary.(Not tNaaabta with Nande j
4 O (ding to ba applied over exlsling foundation.
5. 17 Use Sears approved FERMA TAOS AND SINism STRIP whara conUaetor deems necessary,In same Color as siding.(Not availrbie with NaNte.)
6.Pt 0 WINDOW OPENINGS
❑Custom V400 with Sears approved vinyl clad aluminum t �� Color ca/u--
O JUmp Mt costings with siding and'J'channel i _Color
❑Channel existing window only(eg,Andersen Will or prevlOUSly wrapped)x Color
Oclalls _
T.K CAULK•in sills with rubberized color co-ordinated caulking q
e Fig Q DOORS•custom wrap with SEARS approved VINYL CLAOALUMINUM.#of COON I Color
9 FT-IJ GARAGE DOOR FRAMES-custom wra'withSEARSa roved VINYL
D Dp CLAD Color Ce
Single Cl Cootie With Mull 0 Double No Mull NC Ltr i!jP(A j•iS1 r
10.i1 f-rFW1A-CvslomwmpwilhSEARSapprovedVINYLCLADALVMINVM.Color
11. !1 S IT.(esvesroverhangs)cover01ISEARSapprovedSOLIDVIMSOFFITSYSTEM.Exceptareanotedeeiow.yVenlce.Color
12 r L4,'rIOr7ENWODD-Willantirbi line Rom 0 27 listed below.Any ricednipl;repairwIll be estimated drion
distovory and priced aecordngly.(polls not Ineiuds wood studs,or exierior sheolno).
13 r) Ltr Rcmove existing material an exterior of house.
O Vinyl 0 Aluminum ❑Wood Shlhgla (]Wood Siding ❑Other
Des"Ol Include any asbestos removal,
14 () M,-IOACHCOLINGS-t YKwith SEARS approved SOLID VINYL COLING MATERIAL inthe following areas
15. C'1 C AMSrCOLUMNa•wrapwtthSEARSsppraveeVINYLCULOALUMINUM(Notirevlarmlaundcotumns).Color
16.(_) 0y 1fERSREADER4-romowextaringandrepheewhhneweustomseamlessgurtenandreaeers.uvnita Brown
' t7 I I !�I!UTTERS provide and Install pair SEARS approved polystyrene shullors,Color ��—�
TB FY�TI M�tSTERMOUNTS provldamdlnalalllor // axteriprllpNnxlUreSon .Co10� �c r'C �� - —�—
t9Ll ( iASLE VENTS DIDMde end Install _. _ _viola.Color No eirea!a or triangle vents.
20,.49 CLEAN up property ri completion or work. .. .. �._
d 21. t i' ❑ fNSURANCE•all regUlttd WORKMANS COMP.end LIABILITY to M malntalned. Afl Oiseounfe Have bean AppOea.
22 r3',❑ w RARTY•ma01d euslorher alter compta0on and MI payment h receives.
23 1-1 AYMENTS-on NON FINANCED orders Insist*Is authorized to collect progressive payments, Deterred vayment,bNoresl Will Accrue
24.d; O ALI;ISCOUNTS APPLIED,
25,(-,) 171,4001TIONAL WORK•out specified abovs.
Ai
Ct' Cash/data Total S"L16y�Less deposit 3544 S L
2 Cash Balance S Other Payment(i(airy) M IyC
�1 W ASH C)FINANCED 9 does not include interest Balance on Substantial Completion
It financed,balance payable in^ __ monthly tnatelimanls of epproxlmeiply$ per month,payable by'Owner"10 Corihactor
gut If financed by Owner then Owner wig pay said amount to the lending Insulutton plus such Interest and Uedil somiovcharge of said lending Institution payable direcify
to ttU 14hAng institution loaning such monies(9'Owner'and will execute a Re1a0lnslallmen(obligation and any documcnts roouirod by such tending inslilutien In
Wnneetion with uoh loan.
26. 1'3 iOnK NOT Lobe done. 241! n C t —
z7. T ALT Repair or replace the following woods
Holies:It Rnanced.Ditty holder Of Ibis Consumer Cradll Contract Is sub. SALESMAN HAS NO AUTHORITY TO CHANCE ANY TERMS OR MARE
lett to all claims and defenses which Ina debtor could assert against ANY REPRESENTATIONS OTHER THAN CONTAINED IN TIII3 AGREE,
hs seller of goods of services obtained pursuard herato or with the MEN?AND"OWNER"REPRESENTS THAT NONE HAV)=9£EN MADE TO
seee03 hereol,Recovery by the debtor shall not ezeeed Amounts paid OR RELIED UPON BY"OWNER".YOU ARE ENTITLED TO A COMPLEIE-
Sy debtor hereunder. LY FILLED IN DUPLICATE ORIGINAL OF tHIS AAREEMEN r.
"OWNER REPRESENTS TO HAVE READ AND RECEIVED A DUPLI• "YOU,THE BUYER MAY CANCEL THIS TRANSACTION Ar ANY
CATE ORIGINAL OF THIS AGREEMENT AND TO BE THE AUTHO- TIME PRIOR TO II+tIDNiCHT OF THE THIRD BUSINESS DAY
RIZED AGENT OF ALL "OWNERS" OF THIS PROPERTY UPON AFTER THE DATE OF THIS TRANSACTION, SEE ATTACHED
NOTICE TO THE HE NOME THE
TOR(S)SUPPLIED.
LESSEE Sj, THIS R� OF HT.ON ALL ORTDERFORM S CANCELLED AFTER THE REG RECISION
CO-SIGNER(S). PERIOD, CUSTOMERS WILL BE RESPONSIBLE FOR A 20%
Conlraclor,if the expense at owner,shall procure all permits required ADMINISTRATIVE AND RESTOCKING FEE.
by law 32 folio". THE COMPANY WILL DEPOSIT ALL MONIES RECEIVED FROM
I. Owners who secure their own permits will be excluded from the
guaranty sand preri3lons of MSE Chapter 142A. 1N ANN ESCR0 - ACCOUNT At C ASE MANHATTAN—IANI 11d5.1-
2. Arty person who shall have co-slgned,guaranteed of signed any 062009 WITHIN F BUSjN_ES-S DAYS OF IY8 RECEIPT.
credit application or note slating to this agreement hereby accepts �0/
to be bound by Ibis epresment. DD not sl n this a Feemeoi Blore you read Not It 11 contains any blank
3. Owner(9)repssentl that the Contents On the beck of(his agreement space or it It does not contain everything agreed upon.
Is Di true part hereof and has been read and accepted by Dwr!er,
4.ALL INSTALLATION LABOR GUARANTEED 1(ONE)YEAR.
0
Print a
63193man's Nm
ae A'r a �SlOngnpa `' r�
$nlesmarn'e 01f/ (customer Sign Here)
LlcenaO No. Q signet
SEE REVERSE SIDE FOR ADDITIONAL TERMS AND CONDITIONS Rev,3/00
Iil HOME r~+:PROVE TENT CONTRACTORS REG E CTRA!TON
�F-eard o- 2uildins Regulat-ior= and Standards
Ona Ashburton Place - Room 1301
�ost�n , Massachusetts 02108
O �c Tj`.pR-Vci^ENT CONTRACTOR
R e g i S t ticn 12C Sc Expiration 01 /01 /02
E-L-R=,`( ALUM _ .`-.TDINC CORP
JOHN C 'NETL
4.0 EL;MCN 1 RD
EL MON I NY !L003
r
i
n•T <` ,• DATE IdP
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e.t•�:?-r6;cp . .ri�3i•A7v::$.wjyl:yn•+;.!;.,/....^.T.^.il`•�`� ,,.`vd-a.a� s�wa�i.�'� >Ye ^i7i.:'•."..�.vY--.•we>wI i 1Y1N5
rNGctn: x FrlX (51 6)596-Z 001 r..TN15 CERTIFICATE!S ISSUED ASA 141ATiER OF INFOPMATION
vans Int'er•rta> cnal
ONLY AND CONF'_RS NO RIGHTS UPON THE CERTIFICATE
^' KLDEF(,THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
10 P;2n i ns ul a Blvd. ALTER THE COVERAGE AFFORDED gY THE PO CIES BELOVI.
Lyrlhrook, NY :L1�63-?'IElt COMPANfESAFFOROINGCC'J' _—_
.................................i,,.,,..,,...,.... cRACc
.................................
CvMP?tJ`f aRl7 t'z rI15 CO
llrl:r. r<->ert Selde Est: 104 A
..............................................................................................................................................:.......
American Home . . .........................
PRG: The 8i 1-Ray Grcup, eral. COMPANY
.................................... .
EIM011C, N'. 11003 ;MPAr,Y
RLQ Ins
c
.....................................
D
.,�� .. M '1 ^(ie ttQ_•yid.—..ern.._
['In(aJ�:Y;�• e4dt-.3Yoetti; Irilygvo_;;Y".IW}'<�b�9i:i�j•� :,�iknwpy ftl+Lrr.Yatl iagM.u37.:".rmi,✓,...._or,. .1 _
•+ic -w �1M�•"�xa�7ij Y 4 aYu�R �_•J> :;'N'r•+�
• 1...-__•..�n rn::�t,.:....^.'....,•.'.",l' r.:r?tafNburl7c>�.:.r.bY>Sr,:.S?a.- —^— _ arc —
......_+. ev^tiNl�,��rn .r.11�r
. :.—
li IIS 6 TO CEI f r(Ili1lT 71iE=C L'C(cS OF INStircfWCE LISTED EELOW f LIVE_�N I..,SUED TO THE INSURED NAMED AaOVE FCR THE Pu(-IC(PE,?!C�:J
aGe c
vD:CA 1'kD,NO7:v11'HST NCtP1GlVdY rcE ti9REttENT,TE'�A OR C^,CITcN Cf ANY CCNTRACT OR OTHER Doc- ENT WITH RESPECT TO WHICH THLS
C f�71r1G 4TL:v1 Y SL-ISSUED OR A,(AY PERTA1�I,THE INSURANCE AFFCfRDED BY THE PCLIC:ES DESCRIBED HEREN LS SUBJFCT TO ALL THE'rE;f.L,
Ex LUSrC;JS AND CCNCf_lICNS CT SUCH P]L10Es.LWS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIh13.
......................................................
....................
TYPL"ilr:r�GU1t(N(E !PCLICYEFFECTIVE:POLICY EXPIRATION:
L;'p POLICY NUMBER
...._._.._ OATC(MMMOrM OAT7C(MLWCrM LJ6111'9
=XIIAL LLUllUTY -- 2
GZ4ERAL ACGHK;ArE !S oc
COMMERCIAL OQNCTAL LIAOILrTY i F ' "•'••'• '
;'.r•.. ;PR00k)CT6_Cr;tAP/OPACG 4 ,OQO,OG
1 :-'�, 'CL',ltrt5 MADE X CCV.R 'P�SCNAL.S ADV-INJURY..._..5..............t...........•.....
> : AOOAC08651 05/14/2000 05/14/Z001 1000,OC
CLVNCn 51 CCN71tACTCKS 7NOT'
`._AGI CCCURRENCl S
.................................. 1.000 OG
.` PiRE DAMAGE(.Any ono nro) 5 56 0 Cn
............
MFDECP(Any oniperl n( S ..-.. ..... ..
„A1JT AUU�LLGIL rrY —
AeN,%U7'0 :CCMBINn Z VGLE LIMrr S
Al L Cii h'r•It:3- AUT(:;
` :................I .......................;......................
Ef:11GDULED IIui CS BCC)ILYINJURY 'S
(Fr ncr-an)
I urr.0,auras "
................................ .. ...............--.
vcrlti:l;NEO Aurt =CCILY IUJURY
(Par xpn m,n
PRCPS;4TY DAMAGE I
AUrO C:JLY-:A AC-_;Ut:rir s
.... ..........--.._......_
:,NY.TTG .
O »E�7W-All.atft0 ONLY-
. ••.:;r,-,.. .-_ .:,
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a7;CLJ3 l;S L_ALII(a'T' _ AGGREGATE. S J
EACH C .0
URR::NC-c S S,oaa,.,oc(
utiletC Arca+ R;<L 0252717 : 05;'14/2000 : 05/74/2001 AGcRE�ArE 5,000,COCI
5 l
.......................... ............S....... .... ..............
- X_aT}Ica n'I,:N u�a3:�u�-�>J ,
'�JrJRltcr?O GR7,1(•'L-N�TICN iJ70 � � - — - -••-- —
HNPLDYEihLU2ILIT'f '..lURY-L'WT_o^ tlCG`5�0150 i RE,aCWAC11091,1 SOOf�JO(1�
III1i.l,;rtOFRI0CIw x...'N� y O$;��/GOOD E D5/14/_001 . ........... ... ...
NARINL'R E.T•:CUT1Y5 :ELDfSZL----POLICY UMrr `S JL'Q,Oil.ij
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DFFiCLNPw VtE' —_---. : —_ EL CIZGR5E-F-A_SIPLCYE=i i 500,QQ.I
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llr r it ContraC':�rs for1;Ofilc T171r-rrDVc,jeOLE
Coal,_ nD-, Ion: in
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?IiCVLD.:NY CF-HE AFCY;ff C C11_`_y r=L!-,a,:I__.
3'CFtgi•,TION DA.T=THERE•--y F,1 riB ,.FIN-C CC;if ANY'ATLL ENCEAVCR'C 1%•IL
Y+if ='.J NOTICc T L,c CcPTIFtCAT=:IOLDCR NAIJFo i 0
aFP;
The 3i 1-R_.Y ril'CL'o ollf AILJ`rr0ViJ'LUCNNC7JC:3_'LLLS(r 5=;1000tiJG.A7:v`N-RLI:'• :L.: I
-0 Elmc'n Road c-1VYXL�JJL WT�j /
A _ - - -
r;nK-Irl i., i-1' ii00� ,;u�(c'q-:-'�''D'
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MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
I ----� (dint or.Type)
(� '•l , - oti�•� Mass. DaleAPermit
_
Building Location c�-n !ro �
._.__ Owner's Nam
�T Type of Occupancy
New p Renovation L] Replacement wrz Pians Submitted: Yes(j No p
. N
N W 14
N N Y cc F' x
•• v� ¢ v; x 0 0 0 z r
W o 0 m F z m
x i p a ►" Q ¢ z ' 0 1' w
a a o 0
m rn F- W w O a C rf 4
N a W Z W x v, z a cc o in w
_ ►- r =
Z w
(� 1w z F X 1. ¢ W O O ? LL N U JH W
Y Q W .� 1 >. N (n z O — W O 1A x
a W �. ¢ w Z. < cc 4
M 'x o c� x u, a a d c�i oa y a a o
SUB—BSMT.
BASEMENT
IST r_LOOR
2ND FLOOR
3RD FLOOR
4TH FLOOR
STH FLOOR
6TH FLOOR
7TH FLOOR
f
STH FLOOR
'
Installing Company Name_ A N D VAR PLG 1 LF G C 0 I N C . Le
one: Certlficate #
F^,eidress ,7�; S o . l)n i o n `;T r P e t IB Corporation 1051
I a w r p n c e , Ma . ❑ Partnership
Uusiness Telephone 685-8383 ❑ Firm/Co.
Mame of Licensed Plumber or Gas Fitter J
I INSURANCE COV.RAGE:
I have a curre t bility Insurance policy or Its substantial equivalent which meets the requirements of MGL.-Ch.-.1.42. —
':'
Yes No ❑ .�
If you have checked es, lease dicate the t �c coverage U checking theappropriate bo U
Y_ P YFY 9I I --- - E
A liability insurance policy
Other type of Indemnity U Bond ❑x' '
- 4 1994
E�lot FEB
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance verage re wired b
Chapter 142 of the Mass, General laws, and that my signature on this permit application waive
Check on CUII ---•— � ` T ENT
U
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 and accurate to the best of my
bnowledge and that all plumbing work and installations performed under the permit issued or thi. ap;,;;caiion II in comp ante h all
pertinent provisions of the Nias;:^h��^efts ctalq Gas Code and Oiaoter 142 of! al ws.
L'y
T qr,of ll
censc:
^ _ Plumber Signature of LicensedPlumber or Gas Fitter;
Titie.` Gasfitter
Master License Number _ �3
City/Town Journeyman
!et't'I�C7i/C_U701 l IfS .O Y
Date........... .....
r
,NORTH TOWN OF NORTH ANDOVER
o? 0� PERMIT FOR GAS INSTALLATION
s i, � •
SSACMUSEtth
This certifies that . .!. . . . . . . . . . . . . .... . . . . . ... . . . . . . . . . . . . . . . . . . .
has permission for gas installation . . ,.: . .. . . . . . . . . . . . . . . . . .
in the buildings of !'t' . . . '. . . . . . . . .
at . . . . . . . . . . . . . . . . . . . . . . . . . . . . .! l�1",North Andover, Mass.
Fee. . . . . . . . 'Lic. No.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
GAS INSPECTOR
WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOI.r'