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Home My WebLink AboutMiscellaneous - 342 HILLSIDE ROAD 4/30/20189392 Date. :/ F/ z' TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ... G . r C has permission to perform..A�'/l?!L''�/`!/'......!�,��/�I l� plumbin�g/ in the buildings of ..../j.G�!5'!.1.�'/................... . at..��// C�'........ �, Norlh Andover;. Mass. Fee. aU. Lic. No..'T .. � .... '... . PLUMBING INSP CTOR Check # 147 TYPE OR PRINT CLEARLY MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBIf4G WORK CITY 1 ►� �� e of z S MA. DATE -3 " ? 1 2-- PERMIT # I JOBSITE ADDRESS 3 y �� 113OWNER'S NAME OWNER ADDRESS TEL FAX OCCUPANCY TYPE: COMMERCIAL ❑ EDUCATIONAL ❑ RESIDENTIAL'J� NEW: ElRENOVATION: ElREPLACEMENT: r�CQ PLANS SUBMITTED: YES [INO ❑ FIXTURES -1 FLOOR— BSMT 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE. DEDICATED SPECIAL WASTE SYS DEDICATED GAS/01USAND SYS DEDICATED GREASE SYS DEDICATD GRAY WATER SYS DEDICATED WATER RECYCLE SYS DRINKING FOUNTAIN' DISHWASHER FOOD DISPOSER FLOOR /AREA DRAIN INTERCEPTOR (INTERIOR) KITCHEN SINK _ r LAVATORY ROOF DRAIN SHOWER STALL SERVICE / MOP SINK TOILET URINAL WASHING MACHINE CONNECTION 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 E�No ❑ IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW. LIABILITY INSURANCE POLICYtA OTHER TYPE OF INDEMNITY ❑ BOND ❑ I 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 I 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 an Ch pter 142 of t0iP.General Laws. PLUMBER NAME SIGNATURE LIC # 15- q I MP & JP ❑ CORPORATION [1# 1 t: . PARTNERSHIP ❑ # LLC ❑ # COMPANY NAME .5vf C�5 "1 1��S t�Vr� ADDRESS; CITY C' 100'a. t'`'L 1 STATE Pn /4 ZIP G%1 3 EMAIL TEL e-1 3:3 -5.3 -7 3 CELL FAX Date ....3%9/1. Z- ........ TOWN OF NORTH ANDOVER -,z PERMIT FOR GAS INSTALLATION This certifies that ....!.�. e .. �? rew'�.......... . . . has permission for gas installation in the buildings of . ...�? at ... � Z. l.. �-�.. ! .. North filover,�IVlass. Fee. 6, vo Lic. No..«u%.... GAS INSPECTOR Check # Z 8'127 y jZ�* TYPE OR PRINT CLEARLY MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY: o �.� e- MA. DATE: c2 3 1 PERMIT # _ JOBSITE ADDRESS: 3 04. OWNER'S NAME: ! i �� () A •5 � OWNER ADDRESS: TEL: FAX: OCCUPANCY TYPE: COMMERCIAL ❑ EDUCATIONAL ❑ RESIDENTIAL NEW: F-1RENOVATION: ❑ REPLACEMENT: PLANS SUBMITTED: YES ❑ NO ❑ APPLIANCES? FLOOR-+ Bsmt 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER _ BOOSTER 1 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 ROOFTOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER INSURANCE COVERAGE I have a current liabilityinsurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES c NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box below. LIABILITY INSURANCE POLICY lLq 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 to the best of my Knowledge and that all plumbing work and installations performed -under the permit issued for this appill be in co pjance with all Pertinent l' anon provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. j z PLUMBER/GASFITTER NAME ✓,, .L_ P r 0 c•,,i /2 LICENSE #) I. SIGNATURE COMPANY NAME: W � % S nn FIS- VAC ADDRESS: 35 LO ✓A7 /4 e199 /t - CITY : Pe= ,%le." e- I ! STATE: IWA ZIP: G 6 3 TEL: 413 3 -- S 3-7 3 CELL: EMAIL: MASTER [f: JOURNEYMAN ❑ LV INSTALLER ❑ CORPORATION [I# 10 3 PARTNERSHIP El# LLC ❑ # -�/ro/ e- — C�- r" i 310 CMR 10.99 Form.8 Commonwealth -ii of Massachusetts From DEP File No 242_249 (lo be orpvtoed by DEP) C,iv 1(,wr North Andover ADVICanXichael DiBitetto L_.o-r "I H f C,)_ s) DE 12D, +?ART'AL Certificate of Compliance Massachusetts Wetlands Protection Act, G.L. c. 131, §40 NORTH ANDOVER CONSERVATION COt•1MISSION IA It It To Michael DiBitetto (Name) Date of Issuance 5Sunig u for y 259 Essex St., Lawrence, MA 01840 (Address) ,AUG051- '7, 1991 This Certificate is issued for work regulated by an Order of Conditions issued to M IC µACL -D) arTE.7rO dated fa ) ��`� and issued by the NACC 1. It is hereby certified that the work regulated by the above -referenced Order of Conditions has been satisfactorily completed. 2. It is hereby certified that only the following portions of the work regulated by the above -refer- enced Order of Conditions have been satisfactorily completed: (If the Certificate of -Compliance does not include the entire project, specify what portions are included.) I -Or -ld- 3. 0_ It is hereby certified that the work regulated by the above -referenced Order of Conditions was never commenced. The Order of Conditions has lapsed and is therefore no longer valid. No future work subject to regulation under the Act may be commenced without tiling a nev: t.otice of Intent and receiving a new Order of Conditions. .................................................................................................................................................... ......... (Leave Soace Blank)