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HomeMy WebLinkAboutMiscellaneous - 34 EMPIRE DRIVE 4/30/2018a> UO O 1'. d a Q � cm� -W 'o L 6 d al cmi J a1 Z i .N W 9 N U A H E V V = RN z a4 A N° 9688 Date. .k,..? �` ?— TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ... ¢-:-.... Com. �,.1�`�'`�(L,/, ........ . has permission to perform ......, , , , , , , , , , plumbing in the buildings of ...Q14 KONX-Q...U-i- ,.( A 6 (e—_ at ... �j...Y!!l .� s K. I©�1 , North Andover, Mass. Fee.,/9 .. Lic. No..��t..... . PLUMBING INSPECTOR,' } Check # 756 � WHITE: Applicant CANARY: Building Dept. PINK: Treasurer kl�r 4 'i� MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY ha 'D V -CI- MA. DATE # ^^PERR�MIT JOBSITE ADDRESS G1�'Q� ee (✓ru.� OWNER'S NAME bA4 POWNER ADDRESS TEL FAX TYPE OR OCCUPANCY TYPE: COMMERCIAL ❑ EDUCATIONAL ❑ RESIDENTIAL PRINT CLEARLY NEW: &-' RENOVATION.- ❑ REPLACEMENT: ❑ PLANS SUBMITTED: YES ❑ NO El FIXTURES Z FLOOR- 13SMT 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYS DEDICATED GAS/OIL/SAND SYS DEDICATED GREASE SYS DEDICATD GRAY WATER SYS DEDICATED WATER RECYCLE SYS DRINKING FOUNTAIN DISHWASHER FOOD DISPOSER FLOOR / AREA DRAIN INTERCEPTOR (INTERIOR) KITCHEN SINK 1 LAVATORY ROOF DRAIN SHOWER STALL SERVICE / MOP SINK TOILET ( L URINAL , WASHING MACHINE CONNECTION I WATER HEATER ALL TYPES WATER PIPING OTHER INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which, meets the requirements of MGL Ch. 142. Yes ['No ❑ IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Z 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE BOX ONLY: OWNER ❑ AGENT ❑ Signature of Owner or Owner's Agent 1 hereby certify that all of the details and information 1 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 in compliance with all Pertinent provision of the Massachusetts State Plumbing Code andCha ter 142 of the Gener I Laws. PLUMBER NAME 5TEP►+EIJ C G ALJlJSKV SIGNATURE LIC # 1034 i8 MP 0' JP ❑ CORPORATION X# .31916 PARTNERSHIP ❑ # LLC ❑ # COMPANYNAME &AL1fJSKY PL0M0i&1b it- AVATIP(a ADDRESS: P.D. Goo 1701 CITY i4AVERRIL_L STATE I'W,A- ZIP 01B31EMAIL Www. nnr plyrwbet'WI cowl TEL 71{ 3 CELL 505-50-510'4 FAX C17$- 021- L413i 'i� O C r C z 0 z 0 r -„ -� m = cn cfl D r r� z < o m x .� D x cn =i = o m o C ❑ m N o z ❑o z v r z b r y O z z 0 y CrJ Date TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that .... has permission for gas installation ... 14 as 1--4— in the buildings of.... at ... 0'4�.... North Andover, Mass. GASINSPECT4 Check # 756-7 8467 kT -6. hereby certify that all of the details and information 1 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 II be in compl' nce with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUM BER/GAS FITTER NAME: STEPHEN C GALINSKY LICENSE# 103g16 SIGNATU COMPANYNAME: QA1.li ' Kq PLWANOG + 14-rtfilr-J& ADDRESS: P.o. 0ox 17ol CITY: GAVE-P_HiL� MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK GOWNER TYPE OR PRINT CLEARLY CITY: 1140 <Vt\ MA. DATE: f 1'x4` (Z_ PERMIT # " JOBSITE ADDRESS: G V✓�Q�;.�. ��tl_ OWNER'S NAME: I�IL� (�'IA-iD Wlit ✓1,&m ADDRESS: TEL FAX: OCCUPANCY TYPE: COMMERCIAL ❑ EDUCATIONAL ❑ RESIDENTIAL [� NEW: El" RENOVATION.- ❑ REPLACEMENT: ❑ PLANS SUBMITTED: YES ❑ NO ❑ APPLIANCESZ FLOOR—+ Bsmt 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 INFRARED HEATER LABORATORY COCK MAKEUP AIR UNIT OVEN POOL HEATER ROOM / SPACE HEATER , ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER INSURANCE COVERAGE I have a current liabili insurance policy or its substantial equivalent which meets the requirements of MGL. Ch.142 YES M NO ❑ If you have 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. SIGNATURE OF OWNER OR AGENT CHECK ONE ONLY: OWNER ❑ AGENT E] hereby certify that all of the details and information 1 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 II be in compl' nce with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUM BER/GAS FITTER NAME: STEPHEN C GALINSKY LICENSE# 103g16 SIGNATU COMPANYNAME: QA1.li ' Kq PLWANOG + 14-rtfilr-J& ADDRESS: P.o. 0ox 17ol CITY: GAVE-P_HiL� STATE: rn-A. ZIP: 01831 FAX: q79- 5aj1-4131 TEL: 978-37y- 17y3 CELL: 5,0, - SOA- 5gOH EMAIL: WVV"VV• mrpIU MbNfC�o�,(.om MASTER C✓I JOURNEYMAN ❑ LP INSTALLER ❑ CORPORATION /#____1319G PARTNERSHIP ❑ # LLC ❑ # M � � r � 7y O C x c� b r� H 0 z z 0 m = m � H x C) ., 0 h r Ln m z o m Ch v N C m > z m (f) Ln m z o m z cn El CD o z ❑o r rA b H O z z - o H TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...`. ..`'`t a ..�./ .................. has permission to perform ... ... . wiring in the building of ..... r," /-.1........ Z. •r-.�-..% ,, North Andover, ass. >�.y 9... ee 3 z: f.,(,Lic. No. �1 ELECTRICAL INSPECTOR Check # %3 i s �U 11325 Official Use Only � Commonwealth of Massachusetts O� �� 2 -<Department of Fire Services Permit No. 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 ININK OR TYPE ALL INFORMATION) Date: /z City or Town of: NORTH ANDOVER 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) xd 7` -�r X A- � C— 42x Owner or Tenant Owner's Address No. Is this permit in conjunction with a building pery6it? Yes L -1 ---To LJ (Check Appropriate Box) ' Purpose of Building Utility Authorization No. %Y47 g 7 Existing Service ps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Z arJ Amps /� IzY d Volts Overhead ❑ Undgrd �No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: r /'.,.vn, Y.H— .,frhn fnllnwina tnhln may hp waived bV the lnSDecror o7 Yrtres. No. of Recessed Luminaires No. of Ce% Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVO' No. of Luminaires Above In- Swimming Pool rnd. rnd. o. o Emergency Lighting BatteKy Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Detection and No. of Switches No. of Gas Burners Devices No. of Ranges TotaInitiatin No. of Air Cond. Tons l No. of Alerting Devices Heat Pump Number Tons KW .._.•.• No. of Self -Contained Disposers No. of Waste Dis P Totals: - - .•.... Detection/Alertiniz Devices No. of Dishwashers Space/Area Heating KW Munici al Local ❑ ConneAion F1 Other No. of Dryers Heating Appliances KW SecNo. ourityf Deviices or Equivalent No. of WaterKW Heaters No. of No. of signs Ballasts Data Wiring: No. of Devices or E uivalent Telecommunications Wiring: No. Hydromassage Bathtubs No. of Motors Total HP No. of Devices or E uivalent OTHER: Estimated Value of Electrical Work: Attach aaamonat aerau J aesirea, or as requireu uy tae uwyecw. vJ (When required by municipal policy.) Work to Start: /L Inspections to be requested in accordance with MEC Rule 10, and upon completion. 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 ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: /%:/-" S�� /-/- n ,Zu /) LIC. NO.: 3� Licensee•, <6- . A / Signature LIC. NO.: (If applicable, ent "exempt" in the license number line) Bus. Tel. No.- Address: o.-Address: Alt. Tel. No.• *Per M.G.L c. 147, s. 57-61, security work requires Departtnentsf Public Safety "S" License: Lie. 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)E] owner ❑ owner's agent. Owner/Agent Telephone No. rPERMIT �=.-....+.•,.o i� ELECTRICAL PERMIT NO. INSPECTION REPORT: ELECTRICAL INSPECTOR - DOUG SMALL 1. ROUGH INSPECTION: Passed — Failed — [ ] Re -inspection required ($50.00) - [ j Inspectors' c mments: (Inspectors' igna re - no initials) Date 2. FINAL INECTION: Passed—\Y-41Failed — [ j Re -inspection required ($50.00) - [ ] Inspectors' co ents: (Inspectors' Sign ture - no nitials) Date 3. UNDER GROUND INSPECTION: Passed — [ j Failed — [ j Re -inspection required ($50.00) - [ ) Inspectors' comments: r (Inspectors' Signature - no initials) Date 4. INSPECTION — SERVICE: DATE CAL4ED NATIONAL GRID: NAME: Passed — Failed — [ ] Re -inspection required ($50.00) - [ ] Inspectors' c mments: 2- (Inspectors' Si ature - no initials) Date , 5. INSPECTION - OTHER: Passed — [ j Failed — [ ] Re -inspection required ($50.00) - [ ] Inspectors' comments: (Inspectors' Signature - no initials) Date DOOR TAGS ARE TO BE FILLED OUT AND LEFT ON SITE IF THE AREA TO BE INSPECTED IS NOT ACCESSIBLE AND A RE -INSPECTION OF $50.00 IS TO BE CHARGED. r lI—;!a- "j / 8 Date .....i .. , ........ ,,ORT#q TOWN OF NORTH ANDOVER OF , '� `D PERMIT FOR MECHANICAL INSTALLATION i � This certifies that . ................ . has permission for mechanicalinstallation.I)U i'-.i.�: .`r.� in the buildings of .. �. ..... . at ... '` . �?' �.!�. �......... , North Andover, Mass. Fee. a .h. r . Lic. No.7M... ..................:.. . GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. IPINK: Treasurer P.I Commonwealth of Massachusetts _—� Sheet Metal Permit - Date: I )1Y ?ermtt � Estirnated job Cest. S A% J 2 Per-nlc Fee: S 70,116 Pians 5ubrnitted: YES jNo Plans Rcvieti-cc: 1'Ei No Business Licensc�.c-:icant License = Business/iinfo�r/mation:/�.�r,e; Joo Lccati� r. IZtcrrnation: 21 Name-. ev— S ire- ,: -3 Cit, Town. Teicohcre:��� ?% J7 . 9�� 7` Tcl.n�.cre: <7 7F Zf 3/ 7J-5-,3 Photo :.D, required r' Cosy oEPho-c LE . at7,azhv-4: YE7-N'a Smit :mtisnl J-Yl�-i- �nrc:srri� cd 1' J -Z IC-Z-es;rie:ca to cweiiirgs 3 -Stokes or .css a:,d ZO mer_,. ! uP CO 1 10,00 i Sc-. =Sz c s or Residential: f Y2^.:iiy (/ V(uiti is,;,ii; cc" do : ":-cwnhouses 0,he- Coir.mer�:a!: CRcaii Square ur.de, 1 O,:1CO ft. ore- IMOG sC. a. !` urr:her Stories: S".cet mesa! work; -c be completed: ,1, u'Jrci'r:: :or: ?7�?.� lfeta! Waters ed Rzaf:r,a - K:; ;�er� �.•:last ��;te:. !Acral Chi--:ne., % Vents Air 3aia-ci-s -;cvidc detailed descr .cn o :�o... co ce dcr.c. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations f 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):'R- 9� �)1_?/j / it l/ Tar Address: 17 � y/ >>Cz r 22 oLs Are I. IV 2. El an employer? Phone #: 1-7X - X13 the appropriate box: I am a employer with 4. I am a general contractor and I employees (full and/or part-time).* I am a sole proprietor or partner- ship and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] t have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.+ 5. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, §1(4), and we have no employees. [No workers' comp. insurance Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions I LF❑ Plumbing repairs or additions 12.7 Roof repairs 13.❑ Other •Any applicant that checks box #1 must also fill 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 state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: % e ' `Expiration Policy # or Self -ins. Lic. #: ,�/ 41 � qG 0/�,- � Date: ` Job Site Address: -3 City/State/Zip:�%GGr�� 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 certify order the paJq and penaties of perjury that the information provided above is t�ue and correct Phone #: Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # M Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: a ACQRO CERTIFICATE. QF' LIABILITY INSURANCE . 4% , DATE D) �� 12/28/2012 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO'RIGHTS UPON THE CERTIFICATEHOLDER. THIS CERTIFICATE. DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND' OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS` CERTIFICATE. OF INSURANCE. DOES NOT CONSTITUTE A CONTRACT BETWEEN THE; ISSUING INSURER(S), AUTHORIZED REPRESENTA•TIVEO.R-PRODUCER,.AND-TH'ECERTIFICATE:HOL-DER: IMPORTANT,Af the- certificate, h -older Is:arr ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the termsand conditions of the policy, certain pollcles may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER. NANE: NORTH' ANDOVER INSURANCE- AGENCY, INC. K.X.:-EOSTZRY INSUIIANCE:_SERVICES PARK No, Ertl: (978) 686-2266 A!O ( Na)[ (975) 656-6410 Eooaess: c£ernandez@nafins.cotD I ... u t.R o sR.A . Mechanical., Inc. 16:3: MAIN S'EREE_T_;I _ - - INSURER(S) AFFORDING COVERAGE NAIC i NORTH ANDOVER MA 01845-250.8 INSURED INSURER A MERCHANTS INSURANCE CO A.A . Mechanical, Inc. INSURER a :GUAFM I1TSURANCE 16 LOmar Park INSURER C Suite 1 INSURER D / ! Pepperell MA 01463- 14LIICFn F IINSURER P , COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERMOR 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 OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. NSR LTR TYPE OF INSURANCE INSR 1WD POLICY NUMBER POLICY EFF (rawUMYYYY) POLICY EXP (NMMDNYYY) LIMBS A 0e 1-16 uwes.rrr Y tlPY1534,y4 1/01/2010 1/03/2014 EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY / / / ! AGE TO RENTtLi PREMISES Ea occurrence $ 100,000 CLAIMS40ADE Fx-1 OCCUR / / / / MED EXP (Any one person) $' 15,000 a ADV IN JnY it 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER' / / / / PRODUCTS - COMP/OP AGG $ 2,000,000 X POLICY PRO- LOC XT F / / / / EBLIA $ A AUTOMOBILE LIAeurr - CA000000S 1/0112013 1/01/2014 COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) BODILY INJURY (Per person) $ ANY AUTO - - ALL OWNED AUTOS BODILY INJURY (Per accident) $ S SCHEDULED AUTOS PROPERTY DAMAGE X HIRED AUTOS / / / / (Peracadent) X NON-OVMEDAUTOS / / / / $ A X UhERELLA LU1e X OCCUR UP9145439 1/01/2013 1/0112014 EACH OCCURRENCE $ 1,000,000 AGGREGATE $ 1,000,000 EXCESS LIAR CLAIMS -MADE ! / / / nmi ICTIRIF / / / / $ $ RETENTION $ / / / / B WORKERS COMPENSATION AWC46604E 1/01/2013 1/01/2014 - X VIC STATU- OTH- T T - AND EMPLOYERS• LIABILITY YIN E L EACH ACCIDENT $ 500,000 ANYPROPRIETORIPARTNER/EXECU nVE / / / / OFFICr. M, GMBGG GXOLuorO1 ❑ N / A / ! ! / (Mandatory In NH) E.L. DISEASE - EA EMPLOYEE $ 500,000 If yes, describe under / / / / DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS ! VEHICLES- (Attach ACORD 101, Additional Remarks ScheMa. C more space is required) CERTIFICATE HOLDER CANCELLATION ACORD 25 (2009/09) © 1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200909) The ACORD name and logo are registered marks of ACORD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. R.A. MECHANCIAL, INC. 16 1;ObMR PARK AVMOrJ=D RGlR9119NTATN! SUITE 1 —\J PEPPERELL MA 01463- ACORD 25 (2009/09) © 1988-2009 ACORD CORPORATION. All rights reserved. INS025 (200909) The ACORD name and logo are registered marks of ACORD 0 NCE COVERAGE: _current 1(abillty insurance policy or its equivalent which meets the requirements of M.G.L. Ch. 112 Yes No If you have chedced Yes, indicate the type of coverage by cheddng the appropriate box below: Q Liability Insurance Poli ❑ Other type of indemnity ❑ Bond OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 112 of the Massachusetts General s and that my signature on this permit application waives this requirement Signatu of Owner or Owner's Agent Owner ❑ Agent By cheddng this box I hereby certify that ail 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 sheet metal work and installation performed under this permit issued for this application will be in compliance with all pertinent provision of the Massachusetts Building Code and Chapter 112 of the General Laws. Duct inspection required prior to insulation installation: Yes No Progress Inspections - Date Comments Final Inspection Date Comments Type of License By: — Title: Permit;t. Fee S: Inspector Signature of Permit Approval Master ❑ Master -Restricted ❑ Journeyperson ❑ Joume erson -restricted Signature of Licensee License #: SHEET METAL PERMIT 0219.11 Sheet 1 Jab #- Performed for. eSS c RA MECHANICAL INC 16 LOMAR PARK PEr-PE E1 ' . MA 01.162 Phone: 9784; 28671 Fax 978432,4c-00 rame�tanicstQaot.cm S=te: 1 : 74 Psge 1 Rignttiwtefl Univer_ai 7.1.17 RSU11`07 ZD 14 -CC -14 11'=1:08 '.Ca=,rnenim and Scfdnq='LAL-NW.. c Qy \ j l wt +L - • - $ I � 1 �` ..777] zz �. i _ .. �. �.•. � ` A �! ice. rXi w •i _ �. get 1,X6 1 It 1 I I r'a-�r• _ � �\'-'�l/•1 fr „�(!:� :I�-."'_.W[C•'�'�1114�^.^.! I� : :�i r< �•-�R ^•3�iGl(�uCi. r'7 enL :ra .l{�'.7-it{�t.`r' � .. .: 1.Vai.�:�S�.C..- }1�r. ./ter.•}'%'.. •s���1j�•L �'I,�y,.A '•I�'.' f>l!1 •i 1.:Ciiv i.I: �:•F�AWW A14� -MA SrACHUSETTS DRIVER'S LICENSE r �n ro w�sz , ZH OF: 0.4 - .. y y. -9a 9N} dd NUMBER .. S&1859357: f ' 5 ••. - is ser•M yam,. o E �TTE a 657 MAMMOTH RD a11�3b'1sf(.°a . DRACUT, MA 01826.4349 d' 5 DD 09.07.2010 Rev 07.1SZ009 - COMMONWEALTH OF MASSACHUSETTS SMEET METAL ;A & X-VASTiER-UN RESTRICTED ISSUES THE ABCVE LICENSE TO: _ V0NALDz;jt',3UELLETTE X57 PIAMMOTH RC - DR.ACUT KA 018i�6"4349 4688 U�,./..�8`;+1_ri 223139