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Miscellaneous - 40 PHILLIPS COURT 4/30/2018 (2)
�f0 ��7 0��L /fid S - ' C�DGI/'j� � - -- ----- --- -- Date TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that . . . . ✓!�-1 . -_ �G. . �? L --- C� • t has permission to perform . �J�. . .�.�. . ... . . . . . . . . . . . � ,QrCk wiring in the building of . . . . . . . . . . . . . . . . . . . . . . at . `2. . !. !G S. . . .Cv ACTRICAL rth Andover, Ma s. Fee 1'l.0 0 c. Lic. No. . 7 . b 3 . . . . . . . . . . . . . . . EL INSPECTOR Check# 37,9/ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance-with the provisions of M.G.L.c.143,§3L,the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166,§32,an electrical permit shall be issued to the person, firm or corporar n stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.145,§3L:,' Permits shall-be limited as to the time ofongoing construction activity,and may be.deemed-by the.Inspector_of_Wires abandoned.and.invalidif_he._ - or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity,stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008 and extending"through August 15,2012. ule 8—Permit/Date Closed: m /L ***Note:Reapply for new perm 0 Permit Extension Act—Permit/Date Closed: Official Use Only Permit No. a�►apa.��E� - BOARD OF FIRE PREVENTION REGULATIONS Occupancy and fee ed ( :am lam) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be pafmm d m accordance with do M s uat Co&Wz sn, �12-00 j (MEASEPRiNTMMK OR MRAU DWORMATI0iV Date: If. IF11 City or Town aft. _�r G Jv�,c TO the Infector of Wires. By this application the undersign6d gives notice of his or her intention to perfiorm the electrical worts described below. Location(Street&Number) Y(a 1114,6C//S CT' Owner or Tenant IAIW 4'4� I—V , A4e Telephone No. Owner's Address Is this permit to soajno Ilion with a building permit'? Yes ❑ No ❑ (Check Appropriate Box) Purpose of BuIIdur9 Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps I Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: lehma rhe a!! raMe way be t,wivrd by the Lns pwfor o iPirer. No.of Recessed Luminaires Na of COIL-Sbsp(Paddle)Fans o.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of LuminairesAbove f Emergency ugliting Swimming Pool ❑ ❑ °'o wnqLamtBa Units No.of Receptacle Oaths of OB Bursas ALARMS No.of Zones No.Of switches No.of Gas Burners ofBetection and lufflaftE Devices Tom No.of Ranges of Air Cond. Tons o•o(Ahxtssg Devim Hadt Pm lued No.of Waste Disposers Totals: °� Devices No.of Dimers SpacdArea Heating KW ❑ a$ectlea 0 Other No.of Dryers - Heating Appliances Kw., Nv.of or FAWivalent o.o ester I o.of o. _ Data�r ileate� s $ � Na ofDevices orFquivalent Wirin No.Hydromassage Bathtubs No of Motors Total HP °urea ons No.of Device or=Tent OTHER: Afladi adaWimtd def ff fdexhr4 orar required by the respecter of fres. Estimated Value of Electrical Work: (When required by numicipa[policy-) work to start: Inspections,to be requested in accordance with MBC Rule 10,and upon completion. INSURANCE COVERAGE: Unhess waived by the owttet',no permit for the pie of e[ec ricai work may issue unless the P P=f of liabr'iity a QWcoverage or its substantial equivalent. The undersigned certifies tient such cwemge is in fonxti and has edaUted proof of sama to the permit issuing offiice, CHECK ONE: INSURANCE 5h BOND ❑ OfPliM ❑ (Specify:) I oefify,wader the pails and pies ofpffjmy,that Ire wformw9osx avf this frac and complel� FIRM NAME: V"i P t'i._4,Tev GAL Cc"-r *C f CLU 1AC.NO: Licensee: ✓ca ifA,&& art_ Signature LIC—No.: a lb 3 (Ilapplicrrbl�crater 'in rbete uuaiberluu;) Bus.Tel.NO Address: f1'7 a2 �'Nrf ST A*. AS Ait.Tei.No. �6 3 7 3-�"73 *Per hLG.L c.147,s 57-61,security work regmres lit of Public Safety"S"Int= Lic.No. OIVNER'S INSURANCE WAlVEL- I sen aware that the Licensee does nW have the debility mnance coverage nomratty required by lave. By my signakm behrw,I hereby waive this rwpmemmL I am die(clock one)❑owner ❑ownees a •at Owner/Agent Signature Telephone No. PERMIT FEE:8 0982 Date . 6./.� . . �6 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that . . . . . . . . . . . . . . . . has permission to perform . . . e . .. . . . . . . . . plumbing in the buildings of. . . . . . . : . . . ... : . . . . . . . . . . . . . . . . . at . . . . /;f : . . . . .1 . . .C. . . . . . . . . , North Ander, ass. Fee . Lic. No/'? y �.�iC ! Andover, . PLUMBING INSPECTOR Check MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITYTI MA DATE PERMIT# JOBSITE ADDRESS _ OWNER'S NAME off _ jr OWNER ADDRESS i TEL FAX TYPE TYPE OR OCCUPANCY TYPE COMMERCIAL Eli EDUCATIONAL Qi. RESIDENTIAL-] PRINT CLEARLY NEW: t' RENOVATION: REPLACEMENT:Q PLANS SUBMITTED: YES® NO FIXTURES l FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB _ _6 _ __._6 ____.__l [. . f ? ______i ► __.._._..__ _! _._--___I __.f w _E i CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GASIOIL/SAND SYSTEM _ ? .IL .._i DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM _I ......____( __.__...I -_..__._i DEDICATED WATER RECYCLE SYSTEM .:-._.__J DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) ! ! . ... KITCHEN SINK LAVATORY ROOF DRAIN __..._._...1 1-11L.--.1 SHOWER STALL SERVICE/MOP SINK TOILETi .___( __. _...( ____—_! URINAL WASHING MACHINE CONNECTION kNATER HEATER ALL TYPES \AtT ER PIPINGCER INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YESNO �] OF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY Q BOND E] ®WNER'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. g CHECK ONE ONLY: OWNER 0 AGENT SIGNATURE OF OWNER OR AGENT B 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 com nce with apPertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME SIGNATURE mp-Nr- JP 0 CORPORATION E1#=PARTNERSHIP E_]# LLC # COMPANY NAME v« y� S' � `1,ADDRESS CITYec - STATE �► �J ZIP TEL -. . . ._. _E CELL FAX �� -7_._7.1/ U/. MAIL - ---- _.G9 .0-_. L©.' . ... . ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ i FEE: $ PERMIT# f PLAN REVIEW NOTES r r The Commonwealth of Massachusetts Department of IndustrialAccidents Office of In 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organizationgndividual): 2A V Address: ' �t�Q -S City/State/Zip: ,l le-ft L-C Phone#: !2 Are you an employer?Check the appropriate box: Type of project(required): 1.� employer I am a em to er with 4. El 6.I am a general contractor and I ❑ TT 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. ? [_1 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. El 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 I L j) 'Tlumbing repairs or additions myself. [No workers' comp. c.152,§1(4),and we have no 12.❑Roof repairs insurance required.]r employees.[No workers' 13.[J Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. i 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 is providing workers'compensation insurance for my employees Below is the policy and job site information. All Insurance Company Name: :y'�e Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder 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. Ido hereby certify under the airs and penalties of perjury that the information provided above is true and correct. Sinature: Date: Phone#: q 7P— kZ, 7 y 2_1 5f 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#: 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 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 ofpublic 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-contractors)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 Investigations 600 washingtou Street Boston,MA,02111 Tel,#617-727-4900 ext 406 or 1-877:MASSAFE Revised 5-26-05 Fax##617-727•-7749 Www.Mass,govfdia :COMMONWEALTH OF MASSACHUSETTS PLUMBERS AND GASFITTERS 'LICENSED AS A.MASTER PLUMBER , 'ISSUES THE ABOVE-LICENSE TO # BRUCE: A_ STEELE, 86 P(jND .ST B'ILLERICA MA 018:21 1226 `� 12348 05/01/14 172423 _'�: f. �K, 1 Date .t// g TOWN OF NORTH ANDOVER ' PERMIT FOR GAS INSTALLATION This certifies that . . . . . .j� f has permission for gas installation . . , y , in the buildin s of. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ,North Ando er, Mass. at .� Fee . .�:5. . . . Lic. No/-�/--/g. . . GAS INSPECTOR Check# Q 8656 I i i •` �, MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY /I//J �r1/ e �2 � MA DATE A PERMIT# JOBSITE ADDRESS OWNER'S NAME - GOWNER ADDRESS TEL��� �FAx TYPE OR OCCUPANCY TYPE COMMERCIAL El EDUCATIONAL E] RESIDENTIAL PRINT CLEARLY NEW:[ RENOVATION: REPLACEMENTS PLANS SUBMITTED: YES F_I NO Q APPLIANCES 7 FLOORS— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER . .__ COOK STOVE ELI =1__.. ..__ JJ. DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE r-- INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT -s . l I _ I _I OVEN POOL HEATER �V :_ J ROOM I SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER ] UNVENTED ROOM HEATER I I I I I WATER HEATER OTHER .... — - - -- -- - --� — I = I �� INSURANCE COVERAGE have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES I NO r 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 E] 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 application will be in complianc with UP inent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. 9� _-- PLUMBER-GASFITTER NAME LICENSE#1SIGNATURE �� . MPtN1 MGF F_1 JP [:jl JGF[ LPGI E] CORPORATION Q# PARTNERSHIP 0#=LLC # �✓? i COMPANY NAMETBAUC-4-5. ��� ' 5 ADDRESS CITY C S jj(L -_.___� STATE _ -; ZIP TEL FAX -- !1 CELLEMAIL. _.. - ' �� ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# 444� ��^� PLAN REVIEW NOTES 3 i - 1 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Invesfigations 600 Washington Street Boston,MA 02111 UT www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeLyibly Name(Business/Organization/Individual): F Address: ze _A,-,�,vej 5 City/State/Zip: `�l2��yam ,64— Phone Are you an employer?Check the appropriate box: Type of project(required): I JNTarn a employer with_� 4. El am a general contractor and I � have Hired the sub-contractors 6. E]New construction employees(full and/or part-time). 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7• ❑Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. g, ❑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 NTlumbing repairs or additions myself. [No workers'comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]i employees.[No workers' ' comp.insurance required.] 13.❑Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Al Homeowners who submit this affidavit indicating they ate 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. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. L/ Insurance Company Name:. TZAII-W t _ dlG�yt Policy#or Self-ins.Lie.#: / Expiration Date: / 3 Job Site Address: ��j,�� C �` /�/ 6/J� City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder 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. Ido hereby certify u r the par and penalties of perjury that the information provided a Overs rue and correct. Signature: Date: j Phone#: 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#: Information and InstrnctiMs 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 shallnot 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-contractors)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 Cor .onwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston.,MA 02111 Tel.#617-727-4900 ext 406 or 1-877rMASS.A.FB Revised 5-26-05 Fax#617-727-7749 wWW mass,gov/dia a 4. ✓' COMMONWEALTH OF MASSACHU.SM. S ' PLUMBERS AND GASFITTERS LICE'NSED AS A MASTER PLUMBER 3 ISES THE ABOVE-LICENSE TO SU BRUCE` A STEELE �. ..86POP. .ST B`ILLE'R`ICA MA 018:21 1226 12348 05/01/14 . 172423 t f Date. .����Z. . . ... .. . HpRTM 0F4���o ,°1ti° _ y �? TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION �9SSAC MUSES This certifies that . . . . . . . . . . . . . . . . . . has permission for gas inLstalla pon in the buildings of :f'I� . . . . . . . . . . . . . . . . . . . . . . . . . Y`� � - . . . North Ando er Mass. Fee. . . . .0 Lic. No. .4 . GAS INSPECTOR Check# —17110 f 8278 Date. .1. 1 . . 95 ,19 '4oRTM TOWN OF NORTH ANDOVER o . PERMIT FOR PLUMBING i CHUS This certifies that . . .a//r^/4j?. . . . . . . . . . . . . . . . . . has permission to perform . . . . .�! �". . c• �-s . . . . . . plumbing in the buildings of . . . �" ;?,,r C . . . . . . . . . . . . . . . . at . . . . Yom. .Al/ /jF�'�' . .ezr KorthAnpver, Mass. Fee��?.�''. .Lic. No..ls?f2. PLUMBING INSPECTOR Check ." MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK l CITY NORTH ANDOVER MA DATE .07/30/12 PERMIT# JOBS ITE ADDRESS 40 PHILLIPS URT OWNER'S NAME BRODERICK POWNER ADDRESSTEL � FAX TYPE OR OCCUPANCY TYPE COMMERCIAL El EDUCATIONAL RESIDENTIAL Ej PRINT CLEARLY NEW:El RENOVATION:El REPLACEMENT: PLANS SUBMITTED: YES[] NO FIXTURES 1 FLOOR- BSM 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM _ __....._. ..._. _,' DEDICATED GASIOIUSAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM _ ,_,__ DISHWASHER I DRINKING FOUNTAIN _ 771 _. I .. FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY _ 3 ROOF DRAIN I SHOWER STALL SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES ,__, _ _ _ WATER PIPING i OTHER ,BACKFLOW FOR BOILER 2 ..... ............_. _ ....3 t 3 4 i. 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[a OTHER TYPE OF INDEMNITY BONDE] 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 0 AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are nd accurate to the best of my knowledge and that all plumbing work and installations perfonned under the permit issued for this application will be in co a with 'Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME JEFF HUTNICK LICENSE# 15212 SIGNATURE MPEj JPO CORPORATIOR[D#1 284Q PARTNERMPQ# LLC[D# -_ `. COMPANY NAME CALLAHAN AC&HTG ADDRESS 91 BELMONT ST CITY NORTH ANDOVER STATE= ZIP01845 TEL 978-689-9233 FAX CELLEMAIL PLUMBING CALLAHANAC.COM i MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY NORTH ANDOVER MA DATE 07/30/12 PERMIT# HER , JOBSITE ADDRESS 40 PHILLIPS COURT OWNER'S NAMEBRODERICK OWNERADDRESS _.. ... TE .. FAX : TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL E RESIDENTIAL PRINT CLEARLY NEW:0 RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES E] NOE] APPLIANCES Z FLOORS- BSM 1 2 3 4 5 1 6 7 8 9 10 1 11 12 13 14 _. M..... .�..... BOILER 2r ...... BOOSTER CONVERSION BURNER COOK STOVE r DIRECT VENT HEATER DRYER ., . FIREPLACE 1F" FRYOLATOR 1 r s FURNACE _. GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT , F I r.. OVEN POOL HEATER L _. .. .._ ROOM/SPACE HEATER ...:. _n!...._. .. .._ .. I ._..w . ,r.... .. . ROOF TOP UNIT TEST I UNIT HEATER UNVENTED ROOM HEATER E-7,... _ _ �C_ ..... ., �® ... ,_____-. WATER HEATER � l . _ ~~~� ! ...... OTHE IL IL INSURANCE COVERAGE I have a current liabili insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES NO 1 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY F, 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 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 compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME JEFF HUTNICK LICENSE# 15212 SIGNATURE MP 0 MCF[I JP Ej JGF LPGI Ej CORPORATION ! # 284'PARTNERSHIP LLC #� �. . COMPANY NAME: C HAN AC&HTG ADDRESS 91 BELMONT ST } CITY rNORTHANDOVER STATE MAS ZIP 01845 TEL 978 689 9233 _ _.. FAX =, CELL EMAIL PLUMBING@CALLAHANAC.COMy the �.OII'Inionwealth of lassachzxs errs -0c'partnzent oflrztltrstrialccicicyrits ^'1 I-� Ofjtce Of-Investigatio)IS �'. �6t0''�Qlsif irzgtorz Street ,,• 4Boston,MA 02-11.1 `-�'Uz-l�ez.s, -, r•e'wr��.fzztzss.go>-/ria �-•oxul�cxxsafiaxl 1'3 lcalrt lrifozxz_ ti x1 �xasxtr��;ace �Ydavil: Y �ilte rs/Co ui:" t ler,/ l lte tx�x:x�rx,/1 tuaLcrso I3usine,;siUr",ulizatio,t/lndivi�lual): '� , ----. 1n Via Sc 1't•iu_t l.,t;t�ifrdy (' Cil •/Stait:.;.Ci �: / –' ------------.. Art —1 /I--= /twat f") 1'� y ,'�1 w, c'yuu au rintplu •ur'. — -1--r----- t']'IOI1r✓ �: J ' ! Check til, appropriate bon: ---! r /:._✓= _ with , 4. ❑ I am a general contractor and 1 eulployees (mull and/or part-tinne).* have hired the sub-contractors 1 J PL o1'pr ujc cl. (,ey ta„cti): 1 6. ani a sole p p ❑ NCA' cotl,;lrui:t100 ro rietor or partner- listed on the attached sheet. 7. ❑ ktiylodelifll, ship and have no employc�es ��,orl in ' These sub-contractors have for ul any capacity employees and have workers' �' ❑ Dcmolitiun l�'c �,'orhers' COmp. insurance comp. insurance.# 9. ❑ Building additiu!.l re.qui r ed.] 5- ❑ We are a corporation and its 10.❑ Liectrical repaiJs in adclitiurrs ❑ 1 am a homeowner doiilg all work officers have exercised thein myself, L:v O workers' comp. 11. right of exemption per IVJGL .Plumbing repai s ur additiun L'sw'atice required. t ] c. 152, §1(4)� and we have no 12. j Roof 1-i;pair, employees. (No workers' 13.0 011ier °. ::t Chef comp. insurance required.] __ -- -------- Y t1 Checks box 1 must also fill out the'section below showing their workers'compensation pulley iniormalion. T 110'`'"'" 1'IS��ho submit this affidavit indicatu,g they are doing all work and then hire outside contractors I`u oui11j iha check this box must attached an additional sheet showing the name of the sub-contractors s In state e=^ployecs. if Lie sub-;. uiusl submit a new alYlilavir inrJiarting such. onrractors have employees,the whether or not those crllitics f,avu —�— y niusi provide their workers'com alri an em p iq p.policy number. }er that is providing ►vorkers'conrperrsat'ion insurance for my errrployees. Below is t/iepolit-y acid jub sire il1Jurrnariuez lnsur�rlce Company Name: Folic� =f or Self-IfLic• #: Expiration Date:—<j Jou Sitr,�cldress: 7— Attach r, copy of'tile H'orlcers' ro Ciiy/State/Lip:— Failure.to secln-e coverage rzzpeasatio,n policy declaration page(showiu the olic ----- `Lie u to as required under Section 25A of MGL c. 152 c g p J number axed eapiratiuu cl;tle). l� 1,500.00 and/or one-year impz'isonzueni, as Well as civil penalties ill the tform of he a STpp orimi.na.l pertalries of'a )fup toy 250.00 a day against the violator, Be advised that a copy of this statement nvcsrig�tions of the D 1 OR1<O1::DE1�aria a iitac lA for insurance coverage verification. may be forwarded to the 011ice of rl�F1ereb}'certify under the pains and penalties o er'trr that the i�zforneatior fp y rpro viiled above is.true urzd correct. t_ne �f1 Date: /'– �,-�• 7_<�c'// UJ1i4, 1 use onl}. Do not write in Xliis area, to be eoxriplezed by city or town o :ffietat City or`1'o�t•lt; i lssuiu� kuthori Pcxn►it/lLit�ense 1• Board of Heallh 2 Buuone): ---- o. OrLer 13ildinb]fie>partrixent 3. City,/Town Clerk 4.Electrical.?inspector 5. d'1ur,xbil,e.➢„spectu, Co:lt:lct 1'2rSot1: Phone#: Date.J ��°. . . . . . . "��':1�c TOWN OF NORTH ANDOVER p c R PERMIT F,ORJRLUMBING • • + - +� SAC MUS ,. This certifies that . . . .13G'. .�-� 4-"'. . . . . . . . . . . . . . . . . . . . . . . has permission to perform . . . . . plumbing in the buildings of . . .? . . . . . . . . . . . . . . . . . . . . at . . .L/U. . . t� �. r. :,/'.'. . : . . . . . . . . . ., North'Andover, Mass: .; Fee. . .. . . . . .Lic. No../,?",.'-? . . . . . . . . . y. . . . PLUMBING INSPEC OR R Check H Z L- t: E . 7669 �d MASSACHUSETTS UNIFORM APPLICATION.FOR PERMIT TO DO PLUMBING Cit /Town:_ IA MA. Date: '` Permit# 1 _ Building Location: h' Owners Name: Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential New: ❑ Alteration: ❑ Renovation: ❑ Replacement: ©''– Plans Submitted: Yes ❑ No ❑ FIXTURES z z U) O (n U z N N N Z y W U) Z Y Q y J U W W QQ Z d' co Z Q Q W Z M O m y tY a a W U) F- WFZ Q N Z W (7 U a x J = Q W Q Q z d' Lu W y Z LL a Y = � O 0 i z Q a Y Q x w w W W a a y ° Q o Q> >QQ 0 °x o . Q 2 a Q m m O 0 LL 0 x Y .7 J fn N 1- O SUB BSMT. y BASEMENT $ 1 FLOOR 2 FLOOR Vu FLOOR 4'H FLOOR 5 THFLOOR 6 THFLOOR 7 . FLOOR 8TH FLOOR Check One Only Certificate# Installing Company Name: A ' - ❑ -- 111<- — �-- Corporation Address: j� S __ City/Town: �' .State:JV - ❑ Partnership r, Business Tel: L —_ _64?e)7 Fax: / _ ---------- ❑Firm/Company _____—___ Name of Licensed Plumber: INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YesIn No❑ If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy �'� 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 Only -------------- ------------- Owner ❑ Agent ❑ Signature of Owner or Owner's 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 compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By---- ----------- Type of License: `��'%'� t` % .tet• ----------------------- Title 0�lumber ggnature of Licensed-Plumber [aster City/Town_______ _ �urneyman License Number:_-13— APPROVED OFFICE USE ONLY FINAL INSPECTION BELOW FOR OFFICE USE ONLY PROGRESS INSPECTION(S) FEE: $ PERMIT# s APPLICATION FOR PERMIT TO DO PLUMBING NAME&TYPE OF BUILDING LOCATION OF BUILDING SKETCH PLUMBER LICENSE NUMBER: PERMIT GRANTED❑ DATE: PLUMBING INSPECTIOR. Date. �. �/:ek.... . f i NORTH 1P Of TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION SSACHUSE _ G . This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . . ".S .`. . . . . . . . . . . . . . in the buildings/of . . . . .17 `� �"{`. . . . . . . . . . . . . . . . . . . . . at . . . . . t:.: . r�. . . . . . . . . . . , North Andover, Mass. Fee. 2..)"-. . . Lic. NoJ.y�. . . . GAS INSPECTOR �Q eck# a t, 6312 t MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING p (Type or print) Date NORTH ANDOVER, MASSACHUSETTS olt Building Locations __ Z //7//rl�s LPermit# 40,7/ L' _/ D Amount$ Owner's Name �► „eT ,d New D Renovation Replacement D Plans Submitted D z ix a C7 w v' w O z z F C) O z z 9 c > w a z ¢ x a a w a w z d w d a F E" �n m Z O z p a x 'o x a 3 a ° a > o ° F o SUB-BA SEM ENT a BASEM ENT 11 ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4 T H . F L O O R 5TH . FLOOR 6 T H . F L O O R 7 T H . F L O O R 8 T H . F L O O R (Print or type) 1 Check one: Certificate Installing Company Name nlyWlrA-w� UNl,i1�ut� �,-LVtie Corp. Address lD PtUd NE S4 -6hofOOLd i'I'I A Partner. Business Telephone _ z "7 Firm/Co. Name of Licensed Plumber or Gas Fitter 12kk4ll " &k)44*fA) INSURANCE COVERAGE Check one:.. I have a current liability Insurance policy or it's substantial equivalent. Yes [a No If you have checked yes,please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity D Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent . Owner 13 Agent ❑ I hereby certify that all of the details and information I have submitted(dr entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachuse to Ga CodeA.,nd pter 142 of the General Laws. B Signature of Licensed Plumber Or G Fitter By: [� rn /3 q edSLo Title Plumber City/Town ❑ Gas Fitter License Number-- 13--master um e0%Master APPROVED(OFFICE USE ONLY) n,-4ourneyman ,I i Date. ./. . ? .g `•t .� ti "ORT" TOWN OF NORTH AWDO R PERMIT FOR PLUM ING �,SSAC IN 31 This certifies that . . . .�. � . .�. .,Y. . . . . . . . . . • . . s has permission to perform . . . .P . . .. . ><�u plumbing in the buildings of . . .P/i . . . . . . . . . . . . . . . . . . at . . . . . . . . . . . . . . . . . . . . . . . . . North 'Andover, Mass. r Fee . . .,. .Lie. No. 3.(f 5 . . �.. . . . . . . .. ., PLUMBING INSPECTOR Check * _ 7644 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town: Aloz 7 -/`fl/10,11GK MA. Date:_ / d Permit# Building Location: `f A Alf/!l „s 64 Owners Name: Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential New: ❑ Alteration: ❑ Renovation: aReplacement: ❑ Plans Submitted: Yes ❑ No FIXTURES z z O Y U }a — U W � � ma a QzZ �: WWaz ~ wZ < m MO _ o x < w 0 ucn n ZJa X Q Wo < a z W 0 W z W J v WaLL LL � a. Y WWW as ° io >z O Z ° 00Z aQ U. 0 0 n I- LL= � � � � 0 SUB BSMT. BASEMENT 1 1 FLOOR R 1 2 Nu FLOOR 3 FLOOR 47-FLOOR 5 1 HFLOOR 6 FLOOR —f'FLOOR ———4-4 _P'—FLOOR !� n ('� Check One Only Certificate# Installing Company Name: Row�4A) i"IU�l�i�1 y VP.�L1/tCF� //++ L ---- El Corporation Address: a (4Oa.Ni Sr City/Town: 3lYt�/n�f6-� State: ❑ Partnership Business Tel: 97P T?T'"&Z07 Fax: El Firm/Company Name of Licensed Plumber: `L�(�}//� w vtt Pf A.) INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yeslo❑ If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: 1 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 Owner's 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 compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By Type of License: Title Sig ure of Licensed Plumber Plumber City/Town ( ter APPROVED OFFICE USE ONLY ourneyman License Number: Locatiod—4,, No. ,, 7P. Date Z/ 5;s of Noor TOWN OF NORTH ANDOVEFF, Certificate of Occupancy $ Building/Frame Permit Fee $ ��s°'^^°•"��. Foundation Permit Fee SACNUSE �- Other Permit Fee $ Sewer Connection Fee' $ Water Connection Fee $ r TOTAL $ f S 1 ' n BuiId1ng'lns c or I.N10 Div. Public Works 'Location " : r , r/"- + it No. Date t "OR TN TOWN OF NORTH ANDOVER Certificate of Occupancy $ - ; t Building/Frame Permit Fee $ / `-•~-!2 19. 'SS�cMusf`� Foundation Permit Fee $ _ Other Permit Fee $ Sewer Connection Fee $ Water Connectior�Fee $ y TOTAL Building Inspector? Win• . Div. Public Works PERMIT NO. � / S APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 MAP K4O. I LOT NO. 2 RECORD OF OWNERSHIP DATE BOOK :PAGE - ZO SUB DIV. LOT NO. �I /� I ui LOCATION Q ��1 f URPOSE Of--BC7C131HG NER'S NAME NO. OF STORIES tom• SIZE J W NER'S ADDRESS. _J i 11.L^ /J. 0-„-�T BASEMENT OR SLAB ARCHITECT'S NAME � ! SIZE OF FLOOR TIMBERS IST 2ND 3RD �,I�BUILDER'S NAME Z SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR © GIRDERS AREA OF LOT �r ®a FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW (J� .. SIZE OF FOOTING X IS BUILDING ADDITION-- MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND LL BUILDING CONFORM TO REQUIREMENTS OF CODE �� (� E]S: UILDING CONNECTED TO TOWN WATER .] BOARD OF APPEALS ACTION. IF ANY UILDING CONNECTED TO TOWN SEWER UILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST ry SEE BOTH SIDES EST. BLDG. COST > PAGE 1 FIItL OUT SECTIONS t - 3 EST. BLDG. COST PE SQ. 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 �PLA S MUST BE FILED AND APPROVED BY BUILDING INSPECTOR 9DATE �OWNE FIQ--- riU1LDiN0 INiPRCTOR IGNATUR R OR AUTHORIZED AGENT FEE sem, OWNER TEL.# PERMIT GRANTED CONTR.TEL.# 19 .;r CONTR.LIC.# j H.I.C.# -- BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY _ STORIES 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 8 INTERIOR FINISH CONCRETE 3 t 2 13 CONCRETE BL'K. PINE __ BRICK OR STONE HAASTE PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT AREA FULL IN. B M'T' AREA 1/' 1/2 1/ FIN. ATTIC AREA NO BMT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCFETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARDW-D ASBESTOS SIDING _ COMMCN VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY �— STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 8 FLOOR I_ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ i SUPERIOR I� POOR ADEQUATE I NONE 5 ROOF 10 PLUMBING GABLEHIP BATH 13 FIX.) GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES _ y TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. 8 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 G—AS OIL B'M'T 2nd _ ELECTRIC Ist 13rd I NO HEATING S+ R NORTH F 01" .0 4 over. Q No. 178 r io ort dover, Mass., " 19 f-15 LAKE COCHiCHLwtCK 1' ADRATED E BOARD OF HEALTH Food/Kitchen �. �MIT T Septic System H ,i� 'E y �• s E� BUILDING INSPECTOR,.!! ' THIS CERTIFIES THAT.........................^� .. Foundation has permission to erect........�?"o ............ buildings on ......... .....?�''LLl..�C..............��4.�.................. Rough ;;�� �1 R �kl�,to�bB000U led 88........................................................Oa'�......�ro�' ...tr•��.t..... Chimney pp rovided.that,the person accepting this permit shall in eve respect conform to the terms of theapplication, on file In p �, ,. P P g P r1► PFinal s � �4,lthis^'oNice and,tovthe' rovisions'of the Codes and B Laws relating to the Inspection, Alteration and Construction,of � ¢ �� P. 11- g P } 1' ; ��` 8ulldidgs In the,Town of Nd&-Andover. ` $ PLUNtBING>INSPECTURUK r S3`fN,,i by+, 7� 'lhf i` of i 'e Ea 'iii ol; ' i '� ;z4 "x � ,VIOLATIONof the Zoning or°Building Regulations Voids this Permit. Rough r si ;:' '}� rk� ,� ;1• `�r - Final � 4' ,xi• t PERMIT EXPIRES IN 6 MONTHS T # �r �. ELECTRICAL INSPECTOR 'I r UNLESS CONSTRUCTIO TS Rough g I ,� + # a. !t y •............•..•..•........•.....•.....•••..• • •. • •.. Service k/aft t t BUILDING PECTOR• ` Final ,•fi f �3 rty�r j ��dt �ig$ Occupancy Permit Required to Occupy Building ;GAS INSPECTOR_; k`;� ; pi t Rough t Dis la in a Conspicuous Place on the Premises — Do Not Remove 4 ' bliplay P Final No Lathing or, Dry Wall To Be Done S C ,, ,dr, a , - x ,� � { •�,t, FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. � � f Nj 3 �utX t r r f3 YI PLANNING FINAL CONSERVATION FINAL Sheet O ,. u, y �¢ w; Smoke Det SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT ++., Office Use Only.' 01 4Z �IImnWnutM1t4 o �asn�Eits Permit No. Epatrtmatt of 111WIc *afetq Occupancy&Fee Checked V 3190 (leave blank) BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 ° 0 r - - APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Qui or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & ZO'er) Owner or Tenant 4P2FV14 .1 �11d z_<IeiC Owner's Address cs' !'L1�=- Is this permit in conjunction with a building permit: Yes ❑ No L� (Check App riate Box) is Puroose of Building Utility Authorization No. �� s Existing Service ldd Amps 18/ 2 0 Volts Overhead LLQUndgrnd ❑ No. of Meters New Service -We Amps 121J/ �t-:LVolts Overhead Elm/Undgrnd ❑ No. of Meters Number of Feeders and Ampacity / `.P- Location -Location and Nature of Proposed Electrical Work ��L%��/9 /,>`77/l��s- �.�/ '1t �C1Gf��7�e�r/ cis✓ / �_ /✓4S– Noof Lighting Outlets i No. of Hot Tubs No. of Transformers Total No, of Lighting Fixtures Swimming Pool Above'j In grnd. - grnd I Generators KVA No. of Emergency Lighting No. of Receptacle Outlets I No. of Oil Burners I Battery Units No. of Switch Outlets I No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges I No. of Air Cond. Total No. of Detection and tons Initiating Devices No. of Disposals No.of Heat Total Total Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers Soace/Area Heating KW Detection/Sounding Devices No. of Dryers I Heating Devices KW Local ElConneMunicicptioaln ❑Other No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage Tubs I No. of Motors Total HP OTHER: f INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES _ NO = I have submitted valid proof of same to the Office. YES = NO Z. If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE �_ BOND C OTHER = (Please Specify) I (Expiration Datel Estimated Value of E!ectrical Work S Work to Start Insoection Date Requested: Rough Final Signed under the Penalties of penury: FIRM NAME LIC. NO. ry Licensee -Signature LIC. NO. ¢ Bus. Tel. No. 4 � Address /0,6 Alt. Tel. No. s ,0 OWNER'S INSURANCE WAIVER: I am aware that the Licek-.-,. does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General and hat s ature on this permit application waives this requirement. Owner /A/{gent rt (Plea a the o � q7 7 /" ') 4 TelephonERMIT FEE 5 v (Signature of Owner or Agent) Cl� x5565 �.w+`-iwr^`+�'+%y' q�fry+'"_�.+'"- `,G'vim,'s"Vtd�:'L..L,••ysF'��:i�,-,_�,�,,;y'..;c.a,--,1. '4++'�.s.,ew�.:RY��"�F+�"�+i4'4^ t� Date..... G ! 2 AORT#1 _ ° " fs `° TOWN OF NORTH ANDOVER F p PERMIT FOR WIRING S US This certifies that ....... ... ......:4.q..e.e.k..................................... has permission to perform ....... (�.(...q amt �. F wiring in the building of..........A?, 4.T.A..-C ................................... at.....� ...............:... .North Andover,Mass. Fee.. [.t..;� Lic:No.. : .. (�' .........:..... ELECTRICAL INSPECTOR CC4 11/27/9513-.12 70,0 PAID WRITE: Applicant CRNA t. K:TreasurerLD: File