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Miscellaneous - 40 MEADOW LANE 4/30/2018
--777777' LANE V . �/,D 210/045.F-0035-0000.0 1 Date.........., .��.�..�. ................ i OF NORTI.,� TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION gB,CHUg� 'f' This certifies that � ..................................................................V11 ... l\J U .. ... .......... ........... has permission for gas installation ... ......"q ....V:.L :5' in the buildin sof.............. `c ...R.. .............................................. at..:�Q........ .. rc). ?.....}-.'J......................... North Andover,Mass. Fee( �P...... Lic. No.g 3 G GAS INSPECTOR Check# L, L1 r� i r MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY I North Andover MA DATE —, k9L p 411512014 PERMIT# 7 -] 0- , JOBSITE ADDRESS 40 Meadow Lane OWNER'S NAME rs NC) GOWNER ADDRESS Same TE FAX TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL® RESIDENTIALE] PRINT CLEARLY NEW:❑ RENOVATION:Ej REPLACEMENT:® PLANS SUBMITTED: YES[] NO❑ APPLIANCES 7 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 _ INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT TEST KNIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHER Replace 1 Gas Meter ETA and Pipinq as Needed INSURANCE COVERAGE I have a current liability-insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES Q NO 1 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 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 in pliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASATTER NAME I Joseph Marino I LICENSE# 8736 SIMATURE MP❑ MGF❑ JP❑ JGF❑ LPGI❑ CORPORATION EJ# 3285C PAR SHIP❑# LLC❑# COMPANY NAME:j RH White Construction Co ADDRESS 141 Central St CITY I Auburn STATE MA ZIP 01501 TEL 1(508)832-3295 FAX 508-926-4347 1 CELL 508-832-4614 JEMAILI JMarino@RHWhite.com ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES 2 4qli Y GO 1IluiC1`IV�VIEALTH OF MASSA UIC�ISERS AND GASF T7.• "��•� S _- -_=�LI.�C�i��•E[J AS"A.'lUgaki7IR F',�E1M���R=-=•"-�� -� - - ;'f SUE5TR -ABOVE-' VGRNSET- MA-R.INO ARRI'NGTON ST 055/01/14 -` ~' Gl®iti111110NWE,4LTH OF MASS/ACt#tS: 1 `-:LU]1JI$ERS AMID GASFII'TERS NSi7 .4S A J4U.RNIrYMAN `�"l:ll't4�i' := - ===ISSUES THEABOVtLIOENSE ` ARRI=NGTON ST• `LUTD1 'E ER MA it 16th W_ •I b'9=` ' ; i U4/UJ/2014 14:04 bUU8J2b 1b1 KH WHl I L UUNS I KUG I HAUL= 112/02 ''C CERTIFICATE OF LIA,BILITI( INS,'INSURANCE DATE(MM/DONYYYL [7CHE'RSTIFICATF VINCE Page 1 of 1 08/29/2013 CERTIFICATE IS ISSUED ASA MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.TyIS 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 REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the polioy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not conferrights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAMFI 9villiq pf Massachusetts, Inc. PHONE c/o 29 cotturyy Hive. NO_FW. 877-945•-7378 'Ax O-No)- 888-46J-2378 R. 0. Box 305191E-MAIL Ntsehville, TN 37230-5191 DDRFS Cextificatea(�williB.com INSURER(0)AFFORD ING COVERAGE NAIL 0 IN9URERA!The Charter Oak rico xneuranoo Company 25615-001 INSURED R. X. White Conatraotion Company, Inc. INSURERS.Travol,ar9 Property Casualty C4a�paay of Am 25674-003 41 0. Box Street INSURERC:Nati0nA.1 Union Piro Ineuranco Company oe 7.9445-001 P. 0. Box 257 Auburn, MA 01501 INSURERD;TravelerB Indemnity Company 25658-Dal INSURER F; INSURF,R F; COVERAGES CERTIFICATE NUMBER:202e7680 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.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, EXCI,USIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ;NSR TYpE0p1N$URANCE DD' SUB POLICY NUMB@R POLICYEPP POLICYEXP vuvn LIMITS A GENERAL LIABILITY VTC2000 977A9948-13 9/1/2013 •9/1/2014 EEAAICMOCCURRENCE $ 2,aa0,p00 X COMMERCIAL GENERAL LIABII.ITY PRE $(p�oeeu an�.1 .$ 300 CLAIMS-MADE OCCUR MEDEXP(Anyone arson $ 10�000 PER80NAL&ADVINJURY S 2 OOt),000 GENERAL AGGREGATE $ 4,Q00 000 GEN'LAGGREGATFLIMITAPPLIESPER; PRODUCTS-COMPIOPAGO Is J000OOO POLICY LOG s AUTOMOBILELTABILITY VT.TC,AE 977K95SA-13 9/1/2013 9/1/201.4 OMgI EDSINGLF-LIMIT acc�dent $ 2-,000,000 AQIX ANYOWNEAUTO BODILY INJURY(Perpereon) `R AUTOS NED AUT08SCHEDULED BODILY INJURY(Peraccident) $ X HIRED AUTOS X NON-OWNED AUT08 eraccident $ X Co Dee X Co11 Deg C UMBRELLALIAB X OCCUR 538766140 H /1/2014 EACH OCCURRENCE $ S,000,000 : FXCE58 LIAa El CLAIMS-MADE AGOREGATE $ S,000,000 DED $ RETENTIONS 0001 S IJ WORKERS COMPENSATION VTRICUB 8205A185-13 /1/2074 X U AND EMPLOYERa'LIABILITY y N TAf.ZY.L1, D ANY PROPRIETORIPARTNFRIFXECUTIVE(N NIA VTC2XUB A203.A71A-13 /1/2014 E.L.EACHACCIDENT s 1,000 000 OFFICER/MEMSEREXCLUDED7 LL'JJ jganodeo(dIIbaUn)nr E.L.DISEASE-EA EMPLOYEE A 1,000,000 U�gliKlll 1 IUN OF U!'HRATIONS below El,DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOOATIONS I VEHICLES(Atlech Acord 101,Addltonel Remerke Schodula,It more 9plea Is n qulrad) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Evidence of Inmu>:&ace AUTHORIZEDREPRESENTATNE CoII34197604 Tpl:1694012 Cert::20287680 ©1988-2010ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD Liber tyMutualInsurance Liberty Mutual® New England Region Central Property Unit INSURANCE 75 sylvan street Danvers,MA 01923 Tel: (800)566-0323 July 15,2014 Town of North Andover Attn: Building Inspector 120 Main Street North Andover,MA 01845 I Re: Property Address: 40 Meadow Ln,North Andover,Ma 01845 Policy Number: H3221824453912 Underwriting Company: Liberty Mutual Fire Insurance Company Claim Number: 029934205-0001 Date of Loss: 6/3/2014 Attn: Town/City Official Pursuant to M.G.L. c. 139, § 3B, please be aware that a homeowners insurance claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or causes the condition of a building or other structure to render Mass. General Laws, Ch. 143, § 6 applicable. You are required to notify Liberty Mutual by certified mail in accordance with Mass. General Laws Ch. 175, X99, if you intend to initiate proceedings designed to perfect alien pursuant to Mass. General Laws, Ch. 139, § 3A & B, or Mass. General Laws, Ch. 143, 5 9, or Mass. General Laws,Ch. 111, 5 127B. This letter should not be construed as a waiver or estoppel of any of the terms, conditions or defenses afforded by the policy or applicable law. Please direct your notice to the attention of the undersigned and include a reference to the above captioned property address,policy number, claim number, and date of loss. Sincerely, Liberty Mutual Support Liberty Mutual Insurance New England Region Central Property Unit 1-800-566-0323 Date TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION • yn rr�_ " This certifies that J . . . . .. . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . has permission for gas .nstallation D r!P!1 in the bui ings oftl(�!� t'!` ' 1C, . . . . . . . . . . . . . . . . . . . . . . . at . . . . �o. . .W..G � � North An er Mass. Fee . . . . . . Lic. No. . . .? GASINSPECT Check# 31 ,� 8469 } ` MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY Ja r Y _ iVA,Gv�I_ 1 MA DATE // PERMIT# 8"Wt JOBSITE ADDRESS L ati. — OWNER'S NAME �w�Cn GOWNER ADDRESS eta. uW �N� TE �Oc7 -rf7y( FAX TYPE OR OCCUPANCY TYPE COMMERCIAL _I EDUCATIONAL PRINT RESIDENTIAL CLEARLY NEW:[j RENOVATION:Q REPLACEMENT: PLANS SUBMITTED: YES 0 NOQ APPLIANCES 7 FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 1 11 12 13 14 BOILER ! ( _ I _ _ _I - m I_ 1 BOOSTER __ . I .. = _ _ �J _Tl _-I CONVERSION BURNER --- COOK STOVE I DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR sJ[L— _ FURNACE a_r 1...__,J ._ - _ :_.EJ GENERATOR 1 -I F--_j GRILLE — .�= INFRARED HEATER -- LABORATORY COCKS I- . I - -�1J I._. T I i ,.� I J _ J L_.�_l _mm, I L —:_=J I. —. ---I MAKEUP AIR UNIT OVEN POOL HEATER -1 —__J 1 -� - .._ - r-f ..._I ROOM/SPACE HEATER ROOF TOP UNIT TEST ........1 UNIT HEATER UNVENTED ROOM HEATER _►I__- - ! (- _ i .,,r I __ I___ I_ _s . T__ (- 1 WATER HEATER OTHER INSURANCE COVERAGE have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES. NO [�_I 1 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICYE3 OTHER TYPE 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 ONLY: OWNER - AGENT El 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 te best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in comp nce with all Pe nent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUM BER-GASFITTER NAME[,,T , Lf¢J%lC/-f LICENSE# �a72�f__ IGNATURE MPMGF .-__I JP n JGF LPGI ( CORPORATION # — PARTNERSHIPS(#� _ LLC[ # COMPANY NAME:_._../�/� n�_7�------_-__-._- ADDRESS CITYa,i. P� . 03�!o STATE[j_@ ZIP 0 3�G �� TEL �0 3. 3 K?- FAX CELL EMAIL \)-KFC t- G 'AIN ' ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ , A/ V n FEE: $ PERMIT# `/ PLAN REVIEW NOTES N a.� f The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 UV. www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): pe,2161-r A/_/T/ Address: e11 i C ZZp2 d City/State/Zip: pl`4 /S 7 al-,J P14 C M&J'Phone#: G 0 3 -3 P �lC y Z Are you an employer?Check the appropriate box: Type of project(required): L❑ I am a employer with 4. ❑ I am a general contractor and I ployees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2XI am a sole proprietor or partner- listed on the attached sheet. 1 7. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.F1Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.]t employees. [No workers' comp.insurance required.] 13.❑ Other Any applicant that checks box#I 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. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. t am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site Information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: lob Site Address: City/State/Zip: attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). ailure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ine 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 if up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of nvestigations of the DIA for insurance coverage verification. do hereby certify nder the p ' s andpenalties ofperjury that the information provided above is true and correct. i nature: 2n2� Date: l/ 2 /Z 'hone#: 6a3 S/cS/z Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# 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#: C f J Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax#617-727-7749 www.mass.gov/dia R I , JI i I R COMMONWEALTH OF MASSACHUSETTS PLUMBER:", gND�C �:• .• LICENSED A:, A MASERIPL MBE . ISSUES THE ABOVE LICENSE TO: R j JAMES K FLA1 f1ERS v'. 7 NICHOLAS Rli (� / PLAISTOW NH 03865-2222 10724 05/L1/14 �� 171191 Date TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that . . . . 4K ... . . . . . . . . . . . . ..1.. . . . .� has permission to perform . . .<,Il S. . . �J�t!-c.fes./ . . . . . . . . . . . . . wiring in the building of . . �!(� .yV/ . c�i� � . . . . . . . . . . . . . . . at 4-v . . . . . . . . . . . . . . North Andover, Mass. Fee Lie. No. . .I. ELECTRICAL INSPECTOR Check# 11256 I I Commonwealth of Massachusetts Onidal (`.e 0111% � r'u heti!![No.. _L1 15-0 Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.9%051 (1ca�e blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK A]I%%ork to be perlonned in accordance%Kith the IMassachusetts Idectrical Code(MEC).5211'MR 12.00 WLL'.-I.SE PRINT IN LVK OR TYPE 1_L INPORALATION) Date: City or Town of: /'U! hyr16e_41_ To the Itztilte Int n Ii'ire�.e: By this application the undersigned gives notice of his or er intentSon to perform the electrical work described below. Location (Street & Number) //^ Owner or Tenant c.(I Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No P1, (Check Appropriate Box) Purpose of Building [ (/sC /�i Utility Authorization No. Existing Service "0 A ps Volts Overhead [ tindgrd❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: --0 C om rlelion of thefollowing tahle inti•he tiraired hi-the Inspector of It', No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA o.o No.of Luminaires Swimming Pool rnd.Above ❑ In-rnd. ❑ Batter •mergency .tgtng Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.o Detection and No.of Switches No.of Gas Burners 1 Initiating Devices No.of Rangestal No.of Air Cond. 7 oIonnss No.of Alerting Devices Heat Pump • Number on ' of " Forts KNt'o. el - 'ontaine No.of Waste Disposers Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ 1lunicipal ❑ Other Connection No.of Dryers Heating Appliances KNNSecurity SN,stems:" tio.of Devices or Equivalent No.o aterK". No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of tl7otors Total HP Telecommunications�Yiring: No.of Devices or E uivalent O'h11 ER: :math additional tlewil i%desire(!.or cu.c reynired hr the hrspe•c•tor of l f' Estimated Value of Ele•trical \Fork: � �� (When required by municipal policy.) \\"ork to Start: Inspections to be requested in accordance with iMEC Rule 10,and upon completion. INSVRANCE CV RAGE: Unless waived by the owner,no permit for the performance of electrical work may issue un] the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. Th undersigned certifies that such coverage is in force.and has exhibited proof of same to the permit issuing office. CI1ECK ONE: INSURANCE © BOND ❑ OTHER ❑ (Specit`,:) I c•ertifv,under the pains and penalties ojperjurv, that the information on this application is trite and complete. FIRM NAi1•IE: TricLIG NO.: 172313A Licensee: Richard J. Arel Signature LIC. NO.: 27514E r!/aphlicuh/e. e'nte'r "rrrn�pt"in lheliccm.crruanhrr linr.r Bus.Tel. No.:978-372- V1 Address: : .Alt.Tel. No.:q7R--in?— 151 "Security System Contractor License required for this work; if applicable.enter the license number here: OWNER'S INSURANCE.WAIVER: I am aware that the Licensee does not have the liability insurance coverage normall required by law. By my si"nature below. I hereby %vaive this requirement. I am the(check one)❑owner ❑owner's ag On nt PERMIT FEE: S Siggnaturetura "Telephone No. c� s Date.....:. ..........r�........ 4 HORTI� " TOWN OF NORTH ANDOVER p PERMIT FOR WIRING t s4CMus This certifies that '` .. . � has permission to perform ...::: ..i ! �'.. � ........................................... wiring in the building of........:- .�" ............................................................ at.. ... �=^ ... -- ,North Andover,Mass. ................................2.*..:....... Fee ............... Lic.No /.��'� ........ .�...... .. .. ... . .. . . . . . . . ...... .. .. . .. ... ELECTRICAL INS CTO Check # 9153 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (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 PRINTININK OR TYPE ALL INFORMATION) Date: j'2--I-or, 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) 4,0 Mc-4 Owner or Tenant YVI,E}�.1t �� Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No © (Check Appropriate Boz) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Und rd g ❑ No.of Meters New Service Amps / Volts Overhead❑ Und rd g ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: tit' Completion of the followin table may be waived b the Ins ector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total . Transformers KVA No.of Luminaire Outlets 1 No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- o.o mergency ig g d. rnd. 0 Batte Units ---, No.of Receptacle Outlets 2, No.of oil Burners FRE 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 No.of Waste Disposers Heat Pump[!!n=:: No.of Self-Contained Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Water No.of No.of Devices or E uivalent Heaters ' No.of Data Wiring: Signs Ballasts No.of Devices or E uivalent - No.Hydromassage Bathtubs No.of Motors Total Hp Telecommunications Wiring: OTHER: No.of Devices or Equivalent �ZTO` Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start-12-7-t7 CInspections 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 4 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 th ains andpenalties ofperjury,that the information on this application is true and complete. FIRM NAME �n<- �L�e e�y( � � LIC.NO.: 1E;h29 Licensee: .���,,i Signature LIC.NO.: ;--F2 9 (If applicable, enter"exempt"ity the lids number line.) Address: ��e r�_e l Z J e S,�}� t(,)�} 03.�.� Bus.Tel.No.: (6e3-2-33- 1 *Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.L cl No. ���-�� - s low 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.$-3-6��� r _ t • l r .. The Commonwealth of MassachusettsLh Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Ledbly Name (Business/Organization/Individual): Address: .7 City/State/Zip: �wl �J O �� Phone#: 3 3- 7 q S Are you an employer? Check the appropriate bog: Type of project(required): 1. I am a employer with 2— 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.t 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for in any capacity. workers' comp. insurance. 9. ❑Building addition [No workers' comp. insurance 5• ❑ We are a corporation and its required.] officers have exercised their 10. Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.El Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4), and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.0 Other comp. insurance required.] *:;.y applicant,that checks boxfl 1 n:;:;.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 their workers'comp.policy information. I am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy andjob site information. Insurance Company Name: Policy#or Self ins. Lic.#: _ l�GL fl (P S Expiration Date: 31 j 2 p l , Job Site Address: 4a mc-Ar �.J (�-L City/State/Zip: IV- 4 � M,/+- 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 c under the pains and penalties of perjury that the information provided above is true and correct Signafore: Date: 1 2-7 —o Phone#: (,cl C - 25 3 - 2 `i S_ F icial use only. Do not write in this area,to be completed by city or town official y or Town: Permit/License# 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as"an individual,partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary, supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability.Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents: Office of Invest,iptlions 640 Washington Street &aston,MA 02111 Tel. 4 617-7274900 ext 406 or 1-9.77MASSABE Revised 5-26-05 Fax 4 617-727-7749 v�mrw.mass.gov/dia � Date.... 3:;•_ �`" "�o� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ,SSACMUSE� i v /41(wr This certifies that rJ/^� .t� / has permission to performS �!>2 r 7`y 5 ,' '1......... ... wiring in the building of..........11-!m VI G.. .Um..................................... ....................... .North Andover,Mass. F � DO y Lic.No. . ^o.r ......... :.... Fee.... .. . . ..... . SS .06 2/pu ELECTRICAL INSPECTO Check # / 7813 \ Commonwealth of Wassachusetts Official Use Only - Permit No. � � t Department of Fire Ser�rices 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 IN INK OR TYPE ALL INFORMATION) Date: b - /Z -6 Z City orow of: a a H ar To the Inspector ofWires: By this application ndersigned gives notice of his or her intention to perform the electrical work described below. Location (Street& Number) 4p {'�'J,e�,�d� w ,�I/lym • d��✓� Y2✓, Ira, o/pI/J Owner or Tenant Ck, 6y l,�,X Telephone No. Owner's Address Qmead&gdoyv6 ma 0 1 Vs- Is this permit in conjunction with a building permit? Yes ❑ No x BLDG PERMIT # Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity = Location and Nature of Proposed Electrical Work: Install low voltage security system at above location Completion of the following table may be waived by the Inspector of Wires. No. of No. of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Trans Total Trsformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires SwimmingPool Above ❑ In- ❑ o. o Emergency Lighting rnd. rnd. Batter Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. In Detection and nitiatin Devices Ranges No. of Air Cond. Total No.of Alerting Devices No. of Ran g Tons No. of Waste Disposers Heat Pum Number Tons KW No.of Self-Contained p Totals Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local❑ Municipal Other No. of Dryers Heating Appliances KW AM—ritNo.of Devices or E uivalent 1 No. of WaterNo.of No. of . in : Heaters KW Signs Ballasts No.o evivalent No. Hydromassage Bathtubs No. of Motors Tota! HP TelecommunicationsNo.of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: 476•6 b (When required by municipal policy.) Work to Start: 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:) certify,under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Brinks Home Security LIC. NO.: 7005C Licensee: John Tanner Signature Y LIC. NO.: 3005D (If applicable, enter "exempt"in the license number line.) rr Bus.Tel. No.: 978-657-0443 Address: 155 West Street Wilmington, MA 01887 Alt. Tel. No.: *Per M.G.L. c.147, s. 57-61, security work requires Department of Public Safety"S"License LIC. NO.:SSCC002184 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By mylsignature below, I hereby waive this requirement. I am the(check one)❑ owner ® owner's agent. Owner/AgentPERMIT FEE: $ /0.0 6 Signature Telephone No. 978-657-0443 z No r r, 4 Date...... /20 f NORTH 1 °.t�•`°.;•_.."°° TOWN OF NORTH ANDOVER o PERMIT FOR WIRING ,SSACMUS� This certifies that . f kk I .........................r ' has permission to perform ......... :.(c... /('�•' f / wiring in the building of..... ................................................ at....... f�...... .1.C.s .��. .... -. ...... ,...,...,... North Andover,Mai. a — / Fee.. :t)v.... Lic.No. ;.��. 1I ........//...... nom...... !....:......... ....... 1 ELECTRICALINSPECTOR < � 'u 7( / WHITE: Applicant CANARY: Building Dept. PINK:Treasurer 7n+COADIO WE4L77lOFA'�ASS4©HUi �`S' Office Use ognly DEPARTM VT0FPUBLICS4= Permit No. BOARD OFFMPREYEVI70NRDGUL4T10AS-WOR12.00 Occupancy&Fees Checked APPLICATION FOR PERMITTO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the G electrical work described below. Location(Street&Number) 0 �l2�GJ 41'4) — Owner or Tenant 9(-[( 7 c Owner's Address U P*<4-Jam ^' Is this permit in conjunction with a building permit: Yes[Z] No (Check Appropriate Box) Purpose of Building SI•M F� �� Utility Authorization No. Existing Service �� Amps ���/ zY� Volts Overhead r 7- Underground M No.of Meters j New Service Amps Volts Overhead Underground No.of Meters N*umber of Feeders and Ampacity Location and Nature of Proposed Electrical Work V77-77 777 F91 c! 77,t= lNo.of Lighting OutletsNo.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures /f Swimming Pool Above Below Generators KVA 7ground ground No.of Receptacle Outlets { No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained f Detection/Sounding Devices No.of Dryers Heating Devices KW Local a Municipala Other v Connections .No.of Water Heaters KW No.of No.of Si Bailasis QNo.Hydro Massage Tubs No.of Motors Total HP OTHER lnsL=xeCaAmgt RnuattDthem4manatsdNbsmd,,smCo= iLaws ltmeaturatLmbtldyh>,stm=PbbLymduckgCar>pide • CovwdWcrtsskswrt cgrAutt YES © NO Iha%eahnimdvdMproofofsaretothe0ffim YES F NO M lf}ouhasetfnialYES,pleasectdiaiethetypecfeomWbyd=lcFtgthe NaRANCE0 BOND o OTHER o ftase ) Esth mkd Values Ekctncal Wodc S WakiDStatZ" Zf7pa-ayyo FMW SigraiundeMPaukksof FIRM NAME , 1 d t tc t-C C�f Lioa>seNa K-3 3 12/-I Lioasae �' SignAlte BtsQtessTd.Na E)2S1 1 YS I Aft Tel Na3 7 5—(0 77 Celt OWNER'S INSURANCE WAIVER,Ianawate#AlheLi =dbmyJ thecstrtatoeamWordssib arm e*rAdatasmgtmedbylvfasadrt&MCanal Laws andthatmysigrmwarthispwnitapphcmmwai.esdmm menem (Please check one) Owner a Agent Telephone No. PERMIT FEE 1 .� \ Location d I&W-Dj Olf ZAJ — No. Date MORTh TOWN OF NORTH ANDOVER �y Oft.ao a1�' r - Certificate of Occupancy $ 4L Building/fie Permit Fee $ . Foundation Permit Fee $ s�►cMus Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ /5' C Building Inspector t _ 7285 Div. Public Works PEnes irr":3? APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. (,/AGE 1 MAP iqO. I LOT NO. 2 RECORD OF OWNERSHIP IDATE (BOOK :PAGE — ZONE SUB DIV. LOT NO. �— LOCATION PURPOSE QFm0=SllllFIl94W OWNER'S NAME fY NO. OF STORIES SIZE ,,6 OWNER'S ADDRESS /� BASEMENT OR SLAB -- ARCHITECT'S NAME Com' SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME �_ _ � .J� �_�/��/� SPAN -- DISTANCE TO NEAREST BUILDING 1 DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES� REAR " GIRDERS AREA OF LOT .•.•77 FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY -c IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE ,J IS BUILDING CONNECTED TO TOWN WATER oe BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST - SEE BOTH SIDES EST. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER Q. FT. PAGE 2 FILL OUT SECTIONS i - 12 EST. BLDG. COST PER ROOM_ SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED Z APPROVED BY BUILDING INSPECTOR DATE FILED 0" BOARD OF HEALTH SIGNATURE OF OWNER OR A�U'THOR ZED AGENT F E E Jf,��.J �J QWNER TEL. �� .L.�. PLANNING BOARD PERMIT GRA TED CONTR.TEL.# CONTR.LIC.# is BOARD OF SELECTMEN BUILDING INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY s;CRIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION —I 8 INTERIOR FINISH CONCRETE B 1 2 13 CONCRETE 81.K. PINE BRICK OR STONE HARDW D — PIERS — PLASTER — — DRY VJAII UNFIN. 3 BASEMENT AREA FULL FIN, B M AREA _ 7, '/r 3/4 FIN. ATTIC AREA _ NO BMT FIRE PLACES _ .. HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 _2_f 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH _ ASPHALT SIDING HARD^✓D _ ASBESTOS SIDING _ COMMCN VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR 1-1 POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE HIP BATH (3 FIX.) GAMBRELMANSARD TOILET RM. (2 FIX.) _ FLAT I SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES_I_ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. ° TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd NO HEATING '1 O R T i-r own of �� �oft--hk6Anover No.19 6 -�. O - C A'Zor h. dower, Mass., 19 COC MIC MF WICK A�A0n`ATED B-U BOARD OF HEALTH PERMIT TO Food/Kitchen I LD Septic System THIS CERTIFIES THAT........W..14.4...lom........A.A.M.0.40r.&AC........................ BUILDING INSPECTOR Foundation has permission to erect...pa...r.K..... buildings on .....V.*... O#Vj040. A.#A.0 Rough g to be occupied as....Act..rA.4m.tir.....mir&A.C. ....ZA.... ............................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes 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 Final ELECTRICAL INSPECTOR UNLESS STAR-l"S � Rough ...............1W Im"Mr.-Mor................ ...4 Service BUILDING INSPECTOR Final OCCU1)CC11Cy 1"ennit .�?!'C�'u*rcd to QCCI.II)y 1 uild- inn GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT Location /-/c � � L A ti --t- No. �3 Datell.b600 NORT1y TOWN OF NORTH ANDOVER Of t.•o :•,.S.O • ; : Certificate of Occupancy $ sACNUSEt� Building/Frame Permit Fee $ ` Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # r Building Inspector PERMIT NO. ��� AI'1'LICATION FOR PERMIT TO BUILD********NORTI] ANDOVER, MA NI U'NO. 101'.NO, c. 2. HECOHU OF OWNuRSIIIP DATE BOOK PAGE 100E SUB MV. Lo N(1. I of A I ION v, 1 PURPOSE(V BIJII DING eCL tq C OWNER'S NA-ME " q (+ G NO.Of:STORIES SIZE (WNER'SADDRESS 'vD / a BASEMENT OR SLAB AR('1IITECI'S NAME ` c` SIZF OF FLOORTIMBERS OT 2 ND 3 RD Bt III DER'S NAME SPAN a DIS I-ANCE 10 NEAREST BUILDING DIMENSIONS OF SILI.S DIS LANCE I-ROM STREET DIMENSIONS OF 1'(JSl S DISTANCE FROM LOT LINES-SIDES REAR DIMENSIONS OF GIRDERS AREA OF LOT FRONTAGE IIEIGITT OF FOUNDATION THICKNESS IS BUILDING NEW SIZEOF F00TING X IS U(J11DING ADDITION MATERIAL OF CIBMNEY 15 BI JI I.DIN(;ALTERATION IS BUILDING ON SOLI D OR FILLED LAND lkll.l.BUILDING CONFORM TO REQUIREMENTS OF COI-)E IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION,IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTII('TIONS 3. PROPERTY INFORMATION LAND COST It EST.BLDG.COST is,8 P.A('tl: I FIII.CIITfSECTIONS 1-3 EST.81T)G.COST PER SQ.FT. EST.BLDG.COST PER ROOM EI ECTR>'C METERS MUST BE ON(AITSIDE OF BUILDING SEPTIC PERMIT NO. � I AI'IACI-IEDGARAGESMUST CONFORM.TOSTATE FIRE REGULATIONS 4. APPROVED 81': y- PLANS MIDST BE FILED AND APPROVE=D BY BUILDING INSPECTOR BUILDING INSPECTOR _ DA 11:1:11 ED Iw OWNERS TEL# 696 -1-'117 Ar..Af—.4 1 /��7 CONI'R.TELII CONTR.I.1(N sg q� S 111 L()I:OWNER(Nt All N21I:D AGENT � / II.I.C. 3 V3 I•I HNII GRAN ll=1) ^� 1 /•DO� The Commonwealth of Massachusetts F ` Department of Industrial Accidents office ofi11ee 021ians Washingt� 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit 77— ..1_ease'v .Iii :; °eat location: Z� .17`EGcJ i city /yA 9 N d19 U J n !/f/taphone# 92 C] I am a homeowner performing all work myself. !am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. e9mpanv name• address city: phone# insuranceco 'T•• .cuss ver -'c w policy# I am a sole proprietor, general contractor,or homeowner(circle one)and have hired the contractors listed below who have the following workers' compensation polices: company name•. address city: phone'# insurance co. oh .�rzr.+•»n 'gip'y a .tea"' -y fsr. :: .. / 0 company name: address: city phone# insurance co no # Attach ad"dit�grcal�heew�iE,gnecessary� �, � �F� „� TP� S Failure to securecoverage as required under Section 25A of VIGL 152 can lead to the imposition of criminal penalties of a fine 00.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fne of 5100.0day against mrstand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the ins and penalties of perjury that the information provided above is true and correct. Z7_,4fA Signature k,5 / �/ n Date j ' 31�c-44'4 Print name K•EN,.J E I h r� . i�C E "�' _ .- Phone# .y official use only do not write in this area to be completed by city or town official cityor town: p pL Building ein D Department ermit/license# check if immediate response is required oSelectmen's Office C]Health Department �ggcontact person: phone#; -Other (revised 3/95 PIA) HUUM:%Q): a 12 24 36 48 60 72 84 96 10$ 120 132 144 156 16$ 180 , 6 36 i I _ 4 , Xz I i lq 6072 84 toe la 1 1120 132 321 1 44 — — --- 144 .., ci .� � i C .� ;_ i. .,�, i •^_ � .;..�.. •�} _..�.,�• ., ---' -- ..1156 56 63 I > ! ....._....., I _,...�-.—1 _.... �-.r�� no-'x�rm ^K.:=s•.. �. .. _ _ .v�+��, ,,. .__ .. — --1 16V 180 . 2 192 ,.,:�...--- •.,..._t. . .... ���.,. ,,.� � ;. � �':� � .........,. 204 19 1, � �.�....yw rw.1.,w...l.,. ,twwv.^e,�.:.r�r .r.n�w•....... .r � ��J/�q}�I /�' t "^, � ; I ��r�. ^'r•^ �—{---' � ' I zee, , tk i - r t I 62 t .N — i — I1 v ;;'fir. �rt;�n;., •; '•. .ti.�,� 5'w .FAN �j j �S ti I ------------------------------ -27-00 THU 04 :37 FM L 1 l fC3 r ENTERF'R 1 SE 3EE 15084533869I 1 Lou Al 1 �I 4 1 NORTH Town of Andover Viso _ _ Lo dover, Mass., O7n oO COC MICHEMCK ADRATED PPa��(C S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System 1 �' 08( A `� BUILDING INSPECTOR THIS CERTIFIES THAT.. lb � .���.. !..w. .....,,M►1................ ............. ............................ ��`� ��w Foundation has permission to erect........ ........ ..................... buildings on .......... g ...... ............................... 1.y..�!...... Rou h to be occupied as........it.�it ...............�...R........... �Al.........v S M� psi Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes 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 45 IP PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCT ELECTRICAL INSPECTOR )�)N S T Rough Ida -Alk jW coop ........................................ ......a Service fareBUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal 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. PER)tIT NO. ` v/ APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 MAP X10. qff- LOT NO. �� 2 RECORD OF OWNERSHIP DATE (BOOK :PAGE ZONE I-j`U-B DIV. LOT NO. � I LOCATION PURPOSE OF BUILDING OWNER'S NAME NO. OF STORIES SIZE OWNER'S ADDRESSBASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME .,y SPAN -y/dl" DISTANCE TO NEA T BUILDING DIMENSIONS OF SILLS -_ POSTS DISTANCE FROM STREET DISTANCE FROM LOT LINES—SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW _- - SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND -yeosWILL BUILDING CONFORM TO RE UIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE 3 PROPERTY INFORMATION INSTRUCTIONS LAND COST SEE BOTH SIDES I EST. BLDG. COST / -470 0-6 EST. BLDG. COST PER . FT. PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS I - 12 PEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR a'7 DATE FILED _�� lNILDINO IMBPLGT'OR SIGNATURE OF NE1l OR AUTHO DA Q , L a-� -QWNERTEL/_ ( U FEE �{ �i - - _ ! 14MMIT GRAMT[D �. IWNTRTEL11Tj� _ any s— y.F,. 4. __ .....c. :_ _ - - - c10RT Town of over No. 3 - - m A 0 9�,G OCHICHEWICK iy,► dover, Mass., �l �G BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT............................ .1..... ................................................................... Foundation has permission to epett,........0?.4.M-.-.............. buildings on ........Q ......N<t&i-4.. .1-.;q..,,4 .......................... Rough to be occupied as.......'Is' R.... ....�w' l NCS-...O..V.t'lz.......�." 14y4z.......................................................... Chimney provided that the person acceptinb this permit shall in every respect conform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Final 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 ELECTRICAL INSPECTOR UNLESS CONSTRUCTION AR S Rough ....................... ................. ..................................................... . ... . .. Service...... BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous .Place, on the Premises- — Do Not Remove Rough No Lathing or Dry Wall To Be Done Final Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. Smoke Det. }�, .ia`•'��'.rf�Y+�N.tarvW�t'ew' reY.�'"tdlp �r .. , . Page of d A&B Siding and Roofing Co. L C, 30 Wiley Court • North Andover,Mass. 01845 / C )(> S Telephone (508) 683-8885 Aug1997 PROPOSAL SUBMITTED TO PHONE DATE William B a 5 t36-1 417 STREET JOB NAME O-Med CITY,STATE and ZIP CODE JOB LOCATION . .No Amover Ma- T , ARCHITECT DATE OF PLANS JOB PHONE We hereby submit estimates for: To�Install_Birti• Seal—Kind -2.5 roc ":6rn.C o4-hf;_.CU$9r .v1�._- ;. +frig roof oln r�,ain bouge - erid garage roof also. To use alivainum drip edge on travels and pa..tru, i For sum of. $1 ,890.00 � i i f •' I i r.. r rr' ip" hereby to furnish material and labor—complete in accordance with above specifications,for the sum of: dollars($ 1 ,890.00 Payment to be made as follows: ' i $945.00 Down „ and $945.00 Upon ccmplca.tion. All material Is guaranteed to be as specified.All work to be completed In a ---_x/ " workmanlike manner according to standard practices. Any alteration or Authorized deviation from above specifications Involving extra costs will be executed Signatur@ only upon written orders,and will become an extra charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. NOTE:This proposal may be j Our workers are fully covered by Workmen's Compensation Insurance. withdrawn by us if not accepted within days. Aan0e Of PrOP" — The above prices, specifics Ions and conditions are satisfactory and are herebyr accepted.You are authorized to do the work as specified. Payment Signaturby tl (,. will be made as outlined above. Date of Acceptance: Signature 4 rMASSACHUSETTS UNIFORM APPLICATION FOR. PERMIT TO DO GASFITTINC (Print or Type) A7 NORTH ANDOVER Mass. Date Oa l4uilding Location ?� � � Permit # II3�S � Owners Name New '—t Renovation Replacement Plans Submitted =] FIXTL. P=5 N x 2 Cf _ N LU W OW O 7W O O Ctx Oi H 1- W W Q 1 >- W 4 W W O W x d = a W W 't 0 CCWu f' us us h X O F- Z -j }- 2 1. YW- N m O 16- W O N = tsj Z d W G M .r Q ,u > C W O Z Q r; 4 Q O O W O W F- t= z o c9 x U. to O ..t c� > Q a 1- O SUR—MMT. BASEMENT ISTFLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR TTM FLOOR STHFLOOR (Print or Type) .� Check one: Certificate Installing Company Name `� Q Corp. Address - _ Partner. Firm/Co.� Business Telephone: Name of Licensed Plumber or Gas Fitter Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 0 Other type of indemnity Q 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 coverages. Signature of owner/agent of property Owner ❑ Agent F7 I hereby certify that all of the details and information 1 have submitted (or entered)in above application are true and accurate to the best of my knowledge and that all plumbing Work and InstaUatioas performed under Permit iueed fo: this application wilt be in compliance With all pertinent provisions of the Massachusetts State Cas Code and Chapter 142 of the General Laws. L' By TYPE LICENSE: Plumber Title asfitter Sign Lure of Licensed City/Town: Master Plumber_E Gasfitter Journeyman APPROVED (OFFICE USE ONLY) License Number Date... ......... ......... NoaTM TOWN OF NORTH ANDOVER ti F?Oe 4„`D e, O p L9 PERMIT FOR GAS INSTALLATION s a ,SSACHUSEt , This certifies that . ..'� !. . . . . . ;� !:.:: . .: . . . �. .`�. . . . . . . . . . . . . . has permission for gas installatiom*U.4 �. '. . . . .. .. . . . . . . . . . . . . in the buildings of . . at . .r ... . . . . . . . .. North Andover, Mass. Fee. Lic. No. .. . :.: . . . . . . . . . . . . I GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD:File MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTIN' G e (Print or Type) NORTH ANDOVER Mass. Date kuildin Location ccJ // 9 .Ca/ Permit # 4-1 Ow ers Name1,4c k5To c,,V 57o. New 71 Renovation D Replacement Plans Submitted Y T FIXTURES m m Q p .v m = t a m o a to a W 6 x W O to W W O W Z_ Q .'•. fL' W Q W t.• W F x Y! Q O i- Z �j f' z �.. O T U. t- 2 d W -e n ... tai O Z O N S <t ,to > a W z 4 s a Q x o 0 x t,. a 0 _4 v � > in a t`-'-- o SUR-13SWIT. BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR TTK FLOOR STH FLOOR (Print or Type) Check one: Certificate Installing Company Name p �f-N [� Corp. Address -r - Partner. F-1 Firm/Co. Business Telephone: Name of Licensed Plumber or Gas Fitter p4 hL- Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Q Other type of indemnity Q Bond 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 coverages. Signature of owner/agent of property Owner E] Agent El I hcteby 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 performed ands'Permit isseed for this application will-be in eompliartoa with all pertinent provisions of the MassachuseUs State Gas Code and Chapter 14:of am cental Laws. .. By rGasfitter CENSE: Title Signature of Licensed City/Town: Plumber or Gasfitter man APPROVED (OFFICE USE ONLY) -- License Number -. N° 3 J '; i, Date.//. /.................. F ORTp °`t"`°;•'"° TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSACMUS� This certifies that ...... has permission to perform ..... ' wiring in the building of......ATv!ml,. A .............................................. . . ..................................n,............... ... at......... ... ,North Andover �'s. Fee...................... Lic.NoA.�............ ...:�....� ............... ELECTRICAL INSPECTOR Check # / WHITE:Applicant CANARY: Building Dept. PINK:Treasurer 711,6. ;'f i � ,r ::r>. .,i.s :r�eyF' .� :}v'1 �,'._ .sem^ •.cys.>�,q�s '`..v-S4 a.'fz' "Y.7.�.r,�d >f���.�f IF. :�� �•�+:7, t ..4t_.h%F.�_ �+F ^r � `Sn'. .cif r rjLtl 'F.;.f �ti•'» '13'.1 r+t 1 1 �.} fIV1Cf� t i•+ 1 GN avis }a y �y�fi f �r ,t-.�i ,+ v.. �.. a tL•-;.7.a—^"- -.• - .�`�`J'�"1'� �T--: rf �: ! _, nOccupancy and Fc l-Checked =r' -BOARD.OF FIRE=PREVN,TIO,N REGULATIONSc' Rev:..1-1/99y, (Ic2veb10nlj':1`lx.`w. rf r 1 j APPLICATION FO-R�PERM.IT;TO •PERFORKELECT.RIC441 WORK;. All wurk.to he perfornlctl ilr�ccordancc with theMassachusetts GlcdriEaCoJc(1ICC ,527 CMR'12.06: (PLE.ISE PRINT IN INK OR 7'YP ':ILL /�Yf O ti1.1. LION) Date: City o Fown of: ,, � e �a IFz-t&E o the ltlspectol•of P71--es: By this application the undersigned eaves notice of his or her ince tion to perform the electrical work described below. Location(Street & Number) 40 Owner or Tenant Telephone No. ' C Owner's Address Sri-1l11\� l- t-LC Cf Is this permit in conjunction with a building permit? Yes ❑ No ® (Check M)propriate Box) Purpose of.Buildinh r, ,� Utility Authorization No. Existing Service Amps / Valls Overhead F1Undgrd ED No.of Meters .. New Scrvicc Amps / Fulls Overhead ❑ Undgrd ❑. No.-of Meters i t Number of Feeders and Ampacily Location and Nature of ProposedElectricalWork: l 41 4 r6&W.441 Can lesion ufdre lulluivure table maybe waived by ilrc/rrs cctor of Vires. No.of Recessed Fixtures No.of Ccil:Susp.(Paddle)Falls T o !ot at fransformcrs KVA No,of Lighting Omlcls No.of Ilot Tubs Generators KVA Above In- o.o Emergency Lighting No.of LIgIIIIIIg Fixtures Sn•inuuing Poul rod. Elrad. E] Batten•Units No.of Receptacle Outlets No.of Oil Burners FIRE ALAMVIS No. of Zones ' No.of Switches No.of Gas Burners n o If If testion and 2fingo Devices q No.of Ranges No.of Air Cond. Tonsl No.of Alerting Devices Heat Pump um er -r ons K o.oSelf-Contained No.of Waste Disposers 'totals: Detectionl/Alertina,Devices No.of Dishwashers Space/Area Heating KW Local ❑ d ❑ Other Connectinecti on No.of Dr rets Heating Appliances KW ecurity systems: No.of Devices or Equivalent No.of Water o.o I o.o Data Wiring: Heaters KW Signs Ballasts No.of Devices or E uivalent No.H;•dromassane Bathtubs No.of Motors Total LIP Telecommunications Wiring: b No.ofDecices or E uivalent OTHER: Attach additional detail if desired•or as required by the Inspector of{Vires. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability itsurance.including."completed operation"coverage or its substantial equivalent. 111e undersigned certifies that such coverage is in force,and has exhibited proof of sane to the permit issuing office. CHECK ONE: INSURANCE Q BOND ❑ OTHER ❑ (Specify:) (Expiration Date) L•stinnated 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. ccrti y,wader the pains acrd peitalties of perjuq•,Iltat the information 'it this application;is.trite and complete. FIIL\I NAlllli• N.H. Electric = _ - LIC.NO.: 7394A�- Licensee:_S.A. 'Decker, Signature LIC.NO.: (if applicable.enter "exempt•'in the licence ma~ber lit..• ro- 000, this.Tel.Nog? Address: 99 Main S W -.Rtfmrd_,MA 01886 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 lily signature below, I hereby waive this requirement. I am the(check one)❑owner ❑o%vncr's a gent. Owner/Agent Signature Telephone No. FPERMITFEE: S a rm Inspection Request New Hampshire Electric is requesting a Rough / Dina )nspection to be performed. at Name: r�. '�1 0 Address: qU bL (, Phone: I "rte L `qL&9 SR#: Date: I& AZ Thank you, JAN 18 2002 New Hampshire Electric Phone- 978-589-9611 99 Main Street Fax- 978-692-9344 BUILDING DEPT. Westford, MA 01886 C 143 Sec 3L Board of Fire Prevention Regulations; Rules Relative to Electrical Wiring and Fixtures: Any person installing for hire any electrical wiring or fixture subject to this section shall notify the Inspector of Wires in writing upon completion of the work. The inspector of wires shall within five days of such notification give written notice of his approval or disapproval of said work. A notice of disapproval shall contain specifications of the part of the work disapproved, together with a reference to the rule or regulation of the board of fire prevention regulations which has been violated. Date... .. .. . .��.!.�.... HORTM TOWN OF NORTH ANDOVER Of PERMIT FOR GAS INSTALLATION X r S°S+AC�MUSEt 5 � _ •moi This certifies that . . . . ./. . . . . . . . . . .`.'. . . . . . . . . :. . . . . . . . . . . . . . has permission for gas installation .' . .. . . . .. . . . . . .I. . . . . . in the buildings of . . . . . .r .' . /. . f�,. '.�'..� . . . .::. . . . . . . . . . .. at .I : . . ...... . . . . . . . . . . . . . . . . . . . . . . .. North Andover, Massa Fee. .'. Lic. No.: . .-i. . . . . . . . . . . . . . . . . . . . . . . . . . . . . GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File