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HomeMy WebLinkAboutMiscellaneous - 40 SALEM STREET 4/30/2018 40 SALEM STREET 210/096.0-0052-0000.0 J ' � MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITYLPOV. ueI6 MA DATEI PERMIT# JOBSITE ADDRESS I `I OS ct �vh_ S OWNER'S NAME POWNER ADDRESS _ ''t __ ------- TELI FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL �-I RESIDENTIAL PRINT CLEARLY NEW:0 RENOVATION:F-1 REPLACEMENT:[✓� PLANS SUBMITTED: YES® NOB FIXTURES Z FLOOR— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB —, CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM _ I ! I DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN I _ R __s, _! _ i 1 FOOD DISPOSER _ I FLOOR/AREA DRAIN INTERCEPTOR INTERIOR KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET —_I URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES ~: WATER PIPING OTHER _ P 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® 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 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 complianc ith all Perti en rovision of the. Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME n LICENSE# 2u l SIGNATURE MP® JP Er CORPORATION®# PARTNERSHIP®# LLC®# COMPANY NAME I/L P ADDRESS WO rin e- CITY < bo r, i STATE ZIP 6 TEL FAX CELL I qS-b -z 3 6 EMAIL. 1 it�%nbigRxn2'A2!!TZ]-•.X _,— E * C r�-..p.•naar�ova,na��DLldz�mYa; .-.... .----- --— - ------ - ------ -------- �� -------- ---- -----_ _ __..� _. - 20727 TIMELINE —� SYIErefiYaiancl;:eiwdl ��'q. YIIvirai�c�S.��a � ymTI 2.'IlSmE�Sra '�,\{,s—�Jy O�gsn as sR.anywpts a. aaa 0.Wtee 0 Plumbing Permit Review titre ,ems i ..' ��2',semmnvMP'•%PmaerA'2 .� ..-....V.'_-_� ! *',�5aatia 4O SALEM STREET,NORTH ANDOVER, MA . - FdS9♦ffAif.RAP.9H!@Y'C.PL -OTRiPAl001F Mon Jun 27 2016 12:11:.PDF -OTGGi31001FMonjun 27„2016-12:11:.POF I 01 x Monday,Jun 27,2016 08:12 AM �j}l�sadbnn rbmx azum----- naMhaxbtigrna - - - _: :: ._ ------ — ---- --,_-- --------------- ------ ------ — --"- --- --- awmr/r-xx• J s "" "-..... _...<...... ......... _'_ _.Y--- —<.—..�...._....,... .. ...._.. "zr—..:.:_<.,_:___.._ ,.._ .T.�,... ----- - cFmoos '„rA1wro.Rrn; _... .._.. _...._.�.».°--- 20727 %Ilh.ftrt R.rWIt- c>asgu��cmas7m e�Trtg&nmit2G�umms&0saw+ TIMELINE — sxdnn'r innveu?ivet2 .. /�"� 4.¢a9raca�'4'�e1a � . �?s 3fA5.�'1i'Afan� ,��i,�1p' �ffirt�syaa0.'.n�ea:at�e�®Bs-ca�R.�;��a6a�2� aarry;rae�Sa�csB' k1>w Plumbing Permit ReMew I 0 3"']laK"w-C'S 40 SALEM STREET,NORTH ANDOVER, MA P9S➢ffi7.R@RFHffI&7C.I - eT� ----------- -- -OTR1PA1001F Monjun 27 2016_12:11:.POF -0TGG331001F Monjun 27 2016_12:11:.POF -..._...:--..Y-_.�-.--`.^--y,:,, �I�hADr°,y�mvr,-.art1Ca©r?,�.T�L S3ar��b2fC�aac.6i✓9>�ffiY�imsiY6l�mrf¢�6ajE'AS _... . Monday,Jun 27,2016 08:12 AM 7765 Date. . . . .� NORTH Of TOWN OF NORTH ANDOVER • - PERMIT FOR GAS INSTALLATION ♦ p9 • . 9 SSACMUSEtt l This certifies that has permission for gas installation . . .13 .5. . . 1�.� � �f. .. . . . . . A in the buildings of . . . .0*X.-T!: !L. . . . . . . . . . . . . . . . . . . . . . at . Y(�. . . 54. 1a.. . . . . . . . . . . . AINSP A over, Mass. Fee r v. . . Lic. No..(( c-/Z. . . . . T R Check 4 C� 7 Z MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING a City/Town:N Apv MA. Date:_Vj� Per�miitt# Building Location: S� �L=1`j s� Owners Name: CA Type of Occupancy: Commercial❑ Educational ❑ Industrial ❑ Institutional ❑ Residential [-r New: ❑ Alteration: ❑ Renovation: ❑ Replacement: Plans Submitted: Yes❑ No❑ FIXTURES 0: ca ai Lu z w 0) W v = m = O w w v co O x w z z 9 z OIt � w W W O F- ❑ LLJ w w w z x CO 0 Lu f-w ~ ❑ Cn O a W a~ m W O z O ca > z F'x SUB BSMT. BASEMENT 1 FLOOR 2 FLOOR 3 FLOOR 4 1H FLOOR 5 FLOOR 6 FLOOR 7 IHFLOOR r 8 FLOOR Check One Only Certificate# f Installing Company Name: C14LLAIH,u L Address:-qZ8 I�&AI-1 City/Town: ,&-ANIW �rporation �- State: �� ❑ Partnership Business Tel: �"/��� j�j�-3 3 Fax: ❑ Firm/Company Name of Licensed Plumber/Gas Fitter: V 7-/t)/ 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 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 Si nature of Owner or Owner's Agent Owner 1:1 Agent ❑ By checking this box❑;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 d Ch ter 142 of the General Laws. 7ByfType of License: �� 171 Gas Fitter Sign ur f License Plumber/Gas Fitter 2-Master Cityrrown ❑Journeyman License Number: S APPROVED OFFICE USE ONLY ❑LP Installer Date. I.—..G. .... .. t r. „ORT Of TOWN OF NORTH ANDOVER F ° k ; ; PERMIT FOR GAS INSTALLATION r[G ,SSACHUSEt r This certifies that . . . . . .��?�r .fix? `y' .��6' ... . . . . . has permission for gas installation . . .✓°^A? ,T. :"°. . . . . . . . . . . . . in the buildings of ! �.?. �- . . . . . . . . . . . . . . . . . . . . . . . . . . at . . %e2. . .r1V e�� -. . .G't.. . . . . . . . . . , North Andover, Mass. Fee.,))'. . . Lic. . . . . . . ZAS INSPECTOF( Check# I' j- 5429 TMASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or e1 1 t _ Mass. Date Gl 20 j4- Permit Building LoSation 1 owners me Type of Occupancy New❑ Renovation❑ Replacement/ Plans Submitted: Yes❑ No 0 /W � � ���� trr'/��• ? L w u] u� _ W t7 � Z ¢ � � I � J ! == 01 u>J LL LL7 Z Q 0 ¢ 0 O L7 S O U o n0 p SUB-BSMT BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR !ns tailing Company Name Check one: Certificate 4ddress ❑ Corporation 3usiness Telephone _U ❑ Partnership dame of Licensed Plumber or Gas Fitter IMIX0• INSURANCE COVERAGE: 'I have a current II blllty Insurance policy or its substantial equivalent; which meets the requirements of MCL Ch, 142. Yes No ❑ If you have checked yes, please Indicate the type of coverage by checking the appropriate box. A liability Insurance policy 0/ Other type of Indemnity ❑ Bond OWNER'S INSURNACE WAIVER: I am aware that the licensee does not have the Insurance coverage re 142 of the Mass.General Laws, and that my signature on s per application Walves this requirement by Chapter S gna re o Owner or Owners Agin Check one: Owner 0 Agent ❑ iereby eerdfy that all of the details and Information I have submitted for ent eredli In above application are true and accurate to the best of y knowledge and that all plumbing work and Installations performed under the permit Is e r this application be fn compliance with I pertinent provisions of the Massachusetts S tate Cas Code and Chapter 142 of the Oe L Type of License: By ❑Plumber Title S rre of L censed Plu ber or Cas F tter City/Town ❑C as fitter APPROVED(OFFICE USE ONLY) DJMt er License Number ?�M 0 Journeyman x � BELOW FON OFFICE USE ONLY FINAL INSPECTIONS SKVTCHES PROGRESS INSPECTIONS FEE N0. , APPLICATION FOR PERMIT TO 00 PLUMBING HAW A TYP!OF BUILDING LOCATION OF BUILDING - PLUInEII PERMIT GRANTED DATE 19 P MBING INSPECTOII Date. t HOR7p ?�.<� •�,;._��,oL TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSAGMUS This certifies that .`,_. . . has permission to perform plumbing in the buildin f . . '� ���- . . . . . . . . . . . . . . . �� 't at .�/� t 'E:.�1 vl. . . . . . . . . . . . . .. North Andover, Mass. ti Fee/�fr . . .Lic. No/�/�Ih!/. . . . . . . . . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR Check # i 6237 lot9. g - - � $ c 8 o rn 1] i WATER CLOSETS KITCHEN SINKS - LAVATORIES 2 BATHTUB O R a SHOWER STALLS - DISHWASHERS a ( $r 3 DISPOSERS LAUNDRY TRAYS °. WASH. MACH. CONN. -� • HOT WATER TANKS ti TANKlE88 S 3 .7 SLOP SINKS Z 0O f0 FLOOR DRAINS 9. � , OAS TRAPS C1 �, � I-1 0 0 URINALS m if DRINKING FOUNTAIN Z AREA GRAIN WATER PIPING fl n- ROOF DRAINS C its BACKFLOW PREV. s OTHER FIXTURES: O Q g ; BOILER MATE "p GREASE TRAP `� f � C SCULLERY SINK : OW 8 SHOWER VALVE SEWERAGE EJECTOZ Z o X17 n U BELOW FOR OFFICE USE ONLY FINAL INSPECTIONS SKETCMEB FEE PROGRESS INSPECTIONS NO. APPLICATION FOR PERMIT TO 00 PLUMBING UNDERGROUND ROUGH COMPLETE ROUGH FINAL INSPECTION PERMIT GRANTED i DATE PLUMBING INSPECTOR 1 /4" ttDate.. . . .. .. ..... . .... .. .. .rti. OF NORTH 141 3 � TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION 9SSACHU$ . This certifies that . . . . . . . . . . . . . . . .. has permission for gas;installation f/!!.' C.f:: . .X1-4 in the buuildin s of C._.� . '. /. . . . . . . . . . . . . . . . . . . . . . . . . at . fit:!. .- :1:/.(� . , o' . . . . . , North Andover, Mass. Fee. - ' ' Lic. No.. ? GAS INSPECTOR Check#\ Q A 4922 MASSACHUSEM.UNIFORM APPLICATION RMT TO QO GASFrMNG. 01tint 1«Type).. Mass. Date S Permit � BuldingAzoatba- 2s Name GY - Type of . New p Renovation:-p R , Plans Submitted:. Yesp . No•p � a p. a to a Q-a' �.: _ WT. < ■ b 1� < e:. G O W 'e: W . _ V. W. to W <.. d W' ; Z i W ~ C C W W 9 O Y e: = SUB-8SMT. BASEMENT !ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR. STH FLOOR 0TH FLOOR 7TH FLOOR" 0TH FLOOR. Installing Company Name ,tee; Address - 5li4 Qe,4szF . O Corporation_ �•At�fLt? rn!� . n t I (7 Partnership Business Telephone - - A FlmyCo. Fume of Licensed Plumber or Gas.Few_ n INSURANCE:COVERAGE:. I have aYcjffwt liab8ity•ir o ce Voiicy or fts.0 :equivalent-which-meets. he requirements oil.,MGL_.Ch: 142.. '%you have:cheekedaffl&plea=*WicaWZm4ype ge-by checift theappmpidwbox A liability insurance-poky Otheraype undemuft[ Bond- ❑ OWNER'S INSURANCE.WAIVER:larwaww thatthCAcenseedoes-not-hwm-_the irmanwicecoveragerequired:.by: Chapter. 142 of the:Ma2L General_:Laws,..aalahat-.my signsh"-on•this-permit-application valves this requirement Check one: Signature ofOwnerO Agent.O _OwnerAr��Owr�ers Agent. 1 hereby certify that all of the details and information I have submitted(pr entered)inabove application am true and accurate.to.On bad-of my plumbing knowledge and that allumbing work and insWjab0ns-pwfomred under the peRnit issued for in complijifimwith all pertinent provisions of the Maswchusetts State Gas.Cods and Chapter 142 of the General T of License: Signature of L i u or attar Me Gas6tter M City/Town aster License Number 1310(0. Journeyman I ' BELOW FOR OFFICE USE ONLY I FINAL, INSPECTION SKETCHES PItOOf1E8S INSPECTION M FEE - NO. APPLICATION FOR PERMIT TO DO OASFITTINO NAME A TYPE OF BUILDING. . . `r LOCATION OF BUILDING PLUMBER OR OASFIIIER W.MIO. PEMMIT OKAwfiED II DATE:x_:__20 I� I OAS INSPECTOR