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HomeMy WebLinkAboutMiscellaneous - 40 SETTLERS RIDGE ROAD 4/30/2018 40 SETTLERS RIDGE ROAD / 210/061.0-0113-0000.0 y Date.......................2..... NORTI, °f�"`°:•�"° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING Al �,SSACMUS� This certifies that ...: .:..................................................................... has permission to perform wiring in the building of.... -..:. ......:......:...% ....................................... at. .................... ........%.....'........................L...... ,North Andover,Mass. Fee! . :�:........ Lic.No. .....................r......... ............................... ELECTRICAL INSPECTOR Check # 47 , 6 Commonwealth of Massachusetts Official Use Only Permit No. Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/991 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 M 1;.00 (PLEASE PRINT IN INK OR E AL�IXF-ZOATION) Date: City or Town of: To the Inspectol ofWires: By this application the undersigne gives noti of his,or.her intention to perform the electrical work described below. Location(Street&Num r) Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps i 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: Installation of Security system Completion of the followin table may be waived b the Inspector o Wires. ` No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA o. No.of Lighting Fixtures Swimming Pool Above ❑ In- o Emergency Lighting rnd. rnd. ❑ Battery Units No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No. of Switches No.of Gas Burners o.ot Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems: J Q No. o No.of Devices or Equivalent Water Kms, No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent 1`l0.Hydromassage Bathtubs No.of Motors Teta;HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. 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:) _ (Expiration Date) Estimated Value of lectri al Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify, under t e pain and penalties of perjury,that the information on this application is true and complete. FIRM NAME: casLIC.NO.: 1 r��(• Licensee: John S. Bassett Signature LIC.NO.: 1533C (If applicable, enter"exempt"in the license number line) Bus.Tel.No.: 603 594 5928 Address: Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Lid9hsee 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: $ , Date.Z.......1........I......... NORTH ``° '•�"° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ,SSACMUSE� This certifies that .... � r has permission to perform wiring in the building of x� . ................................................................................... at....`....... ........................................ :::................. North Andover,Mass. Fee.`Z:?..t........... Lic.No.�`5' ............................................................... . ELECTRICAL INSPECTOR Check # Y" 2 c/ i, b ; U Commonwealth of Massachusetts Official Use Only Permit No _ 07� Department of Fire Services 5� Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/99] eave blank APPLICATION FOR PERMIT TO PERFORM E CTRICAL WORK All work to be performed in accordance with the Massachusetts Electri CodeM40-03 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) D te: City or Town of. K)O(+4- ( -k)&Ute-& - o the Inspector of Wires: By this application the undersigned gives notice of his or her intention. dorm the electrical work described below. Location(Street&Number) 40 Se�Lr_cs ' t U Owner or Tenant b_uLV a AA lST Telephone No.q-M-93-0-Do2 Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) 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: Installation of Security system _P.eo,) 1eC-f- QtiU S l N5 Ctd.,Q., -9)_ p el p�3. Completion of the followin table may be waived b the Inspector* ns ec or of Wires. No. of Recessed Fixtures No.of Ceil:Susp.(Paddle)Fans No. of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Abo e ❑ rnd. ❑ No.Bato Emergency Lighting grnUnits- No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. of Zones No. of Switches No.of Gas Burners o.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heats ump Number Tons KW No. of Detection/Alerting Self-Contained ContnDevices r No. of Dishwashers Space/Area Heating KW Local Municiptal ElOther No. of Dryers Heating Appliances KW S stems o.o evtces or Equivalent No.of Watero.o o.o Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or E uivalent OTHER: Attach additional detail f desired,or as required by the Inspector of Wires. 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:) � (Expiration Date) Estimated Value of lect 'cal Work: , o (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties ofperjury, that the information on this application is true and complete. FIRM NAME: n SIC—NO:: 1 5'13_ Licensee: John S. Bassett Signature LIC.NO.: 1533C (Ifopplicable, enter"exempt"in the license number line) i % Bus.Tel.No.- 603 S94 5928 Address: Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the L nsee 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 PERMIT Signature Telephone No. FEE: $ S Office Use Only « Permit No- Occupancy aOccupancy&Fee Checked Vorto--e 4 P-#&S*# I BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 y APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK •` All work to be performed in accordance with the Massachusetts Electrical Code 5(2,7 CMR 12:00 (Please Print in ink or type all information) Date To the Inspector of Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number �c) -,l—L-L�^ S r- ` U E= (/ Owner or Tenant ( � L�l 6 't/�zv P'`t Owner's Address / S HC CIV-0-A-4 t_1 Is this permit in conjunction with a building permit Yes No ❑ (Check Appropriate Box) Purpose of Building /`-�S �� ^— �'L—_ ^�=Yr� �C- �V c`t✓ Utility Authorization No. O Existing ServiceAmps Volts Overhead ❑ Undgmd ❑ No.of Meters New Service f O 0 Amps /Zb oits, Overhead ❑ Undgmd ❑ No.of Meters Number of Feeders and Ampacity �-�--� Location and Nature of Proposed Electrical Total No.of Light8ng Outlets No.of Hot fuse No.of Transformers KVA Above ❑ in ❑ No.of Lighting Fixtures Swimming Pool gmd ❑ and ❑ Generators KVA No.of Emergency Lighting No.of Receptacles Outlets No.of Oil Burners Battery Units No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone Total No.of Detection and No.of Ranges No of Air Cond Tons Initiating Devices . Heat Total Total No.of Di sal No. Pumps Tons KW No.of Sounding Devices Nod of Self Contained No.of Dishwashers Space/Area Heating KW Detection/Sounding Devices ❑ Municipal ❑ Other No.of Dryers Heating Devices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Bailases Wiring No.Hydro Massage Tuds No.of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Compjat6operations Coverage or its substantial equivalent YES NO = have submitted va*proof of same to the Office YES NO = If you have checked YES please indicate the type of coverage by checking the appropriate box INSURANCE BOND = OTHER = (Please Specify) r7 (Expiration Date) Estimated Value o Electrical Work$ /100, � L. CLA— Workto Start _3— $r Inspection Date Resquested C44-� Rough Final Signed under1hp Penalties of perj ry: FIRM NAME CA r M A-r— LIC.NO. ✓"(R� ` Licensee itZ _4 Signature L-T LIC.NO. Z7 a�S _ Bus.Tel No. h 03 Z— Address �S L N` u y c�z5 i p w �`-G L Alt Tel.No. 7WNER'S INSURAN E WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts ieneral Laws.And 11hat my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE $ (Signature of Owner or Agent) N2 Date.��-.j..................... NORTH TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING SSAC)m4us This certifies that ....................................................................... has permission to perform ............ alt/ (�'� A wiring in the building of ej� .... ..................... ................................... at... ........ ....................... .......... ............ ,North Andover,MassX FeeO.................. Lic.Nd.. ., : ,:1—/-X................*iiLi;'��R-IC'A'*L-1'N-S*P'*E'CTO...................... *'T'O**R'...*"**........ts WHITE: Applicant CANARY: Building Dept. PINK:Treasurer Office Use Only Permit Na (Q f 7 - -t-,715 et�1CnL0�Z1!/�i'1 LFTs IY3�Xr4SSrQG�ri 5 '775 Occupancy&Fee Checked Det�P•�SQ6ay BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00�j c� (Please Print in ink or type all information) Date f l•© ^ / o To the Inspector of Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number�n Owner or Tenant Ownef s Address 6 / t Is this permit in conjunction with a building permit Yes (rte No O (Check Appropriate Boa) - ¢ Purpose of Building (l f h t `)�"� Utllity Authorization No. U o g k Z_ E)dsting Service Amps Voits Overhead ❑ Undgmd ❑ No.of Meters New Service Amps { 2 Overhead O Undgmd Z,- No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Total No.of L; ht8n Outlets No.of Hot fuse No.of Transformers KVA Above ❑ In ❑ 2 Na.of ugnting Fixtures Swimming Pool gmd ❑ and Generators KVA No.of Emergency Ligating No.of Receptacles Outlets Io 0 No.of Oil Burners Battery Units No.of Switch Outlets No of Gas Bumers Z� FIRE ALARMS No.of Zone Total No.of Detection and No.of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No.of Diposal No. Pumps Tons KW No.of Sounding Devices No.l of Self Contained No.of Dishwashers S ace/Area Heating KW DetectorvSounding Devices ❑ Municipal 13Other No.of Dryers Heatinq Devices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Bailases Wiring No.HyOro Massae Tuds No.of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liabili Insurance Policy including Compl�e Operations Coverage or its substantial equivalent YES NO = have submitted proof of same to the Office YES"0 = if you hive checked YES please indicate the type of coverage by checking the appropriate box INSURANCE BOND = OTHER = (Please Specify) (Expiration Date) EsUmated Value of Electrical Work$ "-c0b I "`C— Work to Start Inspection Date Resquested _Rough Final Signed under/to Penalties of perjury: FIRM NAME ��t LIC.NO./"1 >�'� -- M ��- f G S�' Licensee AA cc�L�L_C I /It !) Signature LIC.NO. Bus.Tel No. 3 3 z 9 Address Alt Tel.No. OWNER'S INSURANCE WAIVER: I am aware that the Llcenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE $�-- (Signature of Owner or Agent) Nk u Date..... 3? O� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �,SSACNUS�� This certifies that ................ has permission to perform .....1.V e.W....... .......... ..................................... wiring in the building of `?. Y ............r .......................................... at....�ld.....5 P. f l`?f.5.....I .......... ,North Andover,Mass. Fee-O.r- ..�. Lic.No. 7 U ....................... ................ ..ELECTRICAL INSPEC..T.O..R.. Ch � 06/10/98 10:55 2M.00 PAID WHITE: Applicant CANARY: Building Dept. PINK:Treasurer MR 32 IT NO 90 MAP I4 LOT NO. ! RECORD OF OWNERSHIP DATE BOOK PAGE y1 ZONE �Z_ SUB DIV. LOT NO. 61i OCATION PURPOSE OF BUILDING �m—_ ���t 1�s �I.�a cam- P.�Pr� OWNER'S NAM[ TA-P h L�jEj� V C NO. OF STORItS -z_ SIZE Z3 1 Z` owNER"s wDDREsc 1 _VI U, 0, }N \wD6 ■AS[MtNT OR tLA■ BASg,"#AJ7 i8'S f�I f,I�U'{� ARCHITECT'S NAME T�n d 0 ,j14j4 C46p y *lilt OF FLOOR TIMERS IST -C->< 1 !ND S' Sao BUILDER'S NAME i � 7� t✓�(� L /, c1f. ?` - SPAN DISTANCE TO NEAREST BUILDING /�3 i/ DIMENSIONS OF SILLS DISTANCE FROM STREET 30--'A POSTS ,3 I)k, be /c `- L- DISTANCE FROM LOT LINES - SIDES *7 i.GJ R J EAR i � - - ' GIRDERS L!) Z�J/© �s AREA OF LOT �'Z, &?-7 1= FRONTAGE. �� HEIGHT OF FOUNDATION 7 �" or THICKNESS /0/,/ IS BUILDING NEW SIZE OF FOOTING C-/ /0/-/ x IS BUILDING ADDITION MATER:AL OF CHIMNEY ` IS BUILDING ALTERATION �� IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IL ■UILOIN6 CONNECTED TO TOWN WATER YES BOARD OF APPEALS ACTION. IF ANY A IS BUILDING CONNECTED TO TOWN SEWER "�•✓ IS BUILDING CONNECTED TO NATURAL GAS LINE / ,f INSTRUCTIONS a PROPERTY INFORMATION LAND COST 1 ZIP i O� BEE MOTH SIDES tST. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 - a EST. BLDG. COST ►[R SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 CJ SEPTIC PERMIT NO. A t A ELECTRIC METEPS MUST ME ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS ►LAMS MUST ■[ FILED AND APPROVED BY BUILDING I CTOR Al DATE FILE ,/ SurfLDIPM INSPtGTOR ATUR[OF OWNER OR HORIZED AG[ s Owners Tel # ��`` E t Contrac� Tel# t'o a�Z63s WIT SRAJIT><D \ �_-_ 7 �, `. Contra. Lic # C->S _ HIC I*i j 67(67!? 0 _~ MIE.FRAME PERM �3 ; am- LUM I-' bEIVIIIIII t, rEm im LES— S� ET 116 LAR L ,qTS 9x 10 , S ► -i FLAN /74ALE D&TE : - } 167,- #166 67,-#166 #165 — N e 50' eUFFER - - -- - _ � i A' \ \\ %23$ \ 2 I T 10 N Q I LOT 1 1 �$: ? _ ` 1 Zz Io K�`231 \0 � — ._►_- -- I 2 �°.— Pti a J i�v�J � Irl j .:.: ► I - ��'.- I _ #163 �X12" RAP'. U RAIN Ti 5 i 6+00 •w .4 20' SEWER I , ._ . - / - • — . .� Tara Leigh Development Corp. - _ 185 Hickory Hill 'Rd. H. Andover MA 01845 1•1ORT Town of Andover No. m Zi dover, Mass., 19 w 0, -t _COC MICMEWICK`ice'\^ S 04 T E D `G BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.........................�-f. k.4........... .. ./... .�. ..........�.i�. V&....... -P,P............. Foundation has permission to erect.......................I................ buildings on .......' .V............ ..IT........���,.l..J.GCF— Rough tobe occupied as.................................................. /.. .Q.> ............ �F!'lf�� .............................................. Chimney provided that the person accepting this permit shall in every respect conform to the terfhs 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 PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION S T ELECTRICAL INSPECTORRough ........................ .......... ....................................... Service ... . ...... ...... B DING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke i)er. r FORM U - VERIFICATION FORM 4 • INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: Torq ���`i De Lely/ rJ/ Phone LOCATION: Assessor's Map /Number �o/ Parcel Subdivision Sefkf� Lot(s) 16 Street sn&a �1 St. Number �r' 6 ************************Official Use only************************ O'NDATIONS OF TOWN AGENTS: 91 Date Approved 1114 Conservation Administrator Date Rejected Comments S j ` Date Approved q�- Town Planner Date Rejected Comments Date Approved Food Inspector-Health ;D Date Rejected Jo Date Approved Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections "V Id lq7 - driveway permit / 7 Fire Detment aw� ia_fw� ceived b Bui ding I s ector'��'/ //�� Date j. CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number b 8 Date 9 THIS CERTIFIES THAT THE BUILDING LOCATED O MAY BE OCCUPIED AS IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE ILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. oq "' CERTIFICATE ISSUED TO 5L4.0 C:X/ p ADDRESS ''J,CHU' Building Inspector T40 R T� Town of 4 over10 R No. Z _ _ � dover, Mass., 19 �0 L _ AKE - 9A_COCHICHEWICK V 9-4 T E p BOARD OF,HEALTH P _ PERMIT T D Food/Kitchen ' Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ' :....:................................:....................:.....:................................................. Foundation has permission to erect.......................:................ buildings on ..............................:.........:.:..:......:....:,...:..:...........:.....1.......... ou tobe occupied as..............................................................:.........:................................. .............................................................. C y provided that the person accepting this permit shall in every respect conform to the terms of the application on file inFinal*, � - Com' j this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of $'19� Buildings in the Town of North Andover. PLUMBING SPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. PEFUM111' EXPIRES IN _-- �- _--- ELECTRICAL INSPECTOR LESS CONSI-RU -FI O � STARTS � � Rough' .... .................. .ServiceJ.<: BUIL ING INSPECTOR , g1"_ 11'7 Occupancy Permit Required to Occupy .wilding GAS INSPfCTDIf o G/ 1 Display in a Conspicuous Place on the Premises — Do NI Remove Rina h No Lathing or Dry Wall To Be Done TIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. �y Burner ;.s� Street No. O Smoke Det. Date.��-. � . . . . . ',*2 3732 NORTp �ra�•;��-•°;•.',�oo� TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING i SSACNUS i This certifies tha . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission to perform � .�C�! . . . �1. . . . . . . . . . . . . . . . plumbing in t�e buildings �of 4orth `-: "t. . . . . . . at. . � i . . . . . . . . Andover, Mass. Fee7a. . .Lic. No.) .d t�„ . . . . . . . . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR 06/22/98 10:14 180.00 RAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer f MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS / Date �7 Building Locations �d e'lTCe ie Q Je e - — Permit # Amount q; Owner's Name New Renovation Replacement Plans Submitted 1 1 FIXTURES cn wrAcot cr a S[SBRYX &Lg1VINf � ISE RDM am>l 3 3MRfm 41H FWOR 5M RfM 6IRRDM 71H FLOCIR 9fR FLOM Check one: Certificate (Print or type) L ,{�,�j/�cJ� Corp. Installing Company Name/oZ d j2 (/I�� �A ' ��' ` /s�Cd�ir/ � - Partner. « Address e Lt..;-1—.4 mac./ /K Firm/Co. Business Telephone c Name of Licensed Plumber: Insurance Coverage: Indicate the tWe of insurance coverage by checking the appropriate box:Bond ❑ Liability insurance policy Other type of indemnity Insurance Waiver: I,the undersigned,have been mdderaware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the r best of my knowledge and that all plumbing work and in tallations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Wire tts State Pl�inegrC�e hapter 42 of the General Laws. By; wen Type of Plum Ing License Title City/Town t—Men-9MMver Master E31",Journeyman ❑ APPROVED(OFFICE USE ONLY d ' MASSACHUSETTS UNIFORM APPLICATION FOR PERM(IIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS // Date ��j d S Building Locations Y6 5 f 7T Lf- Permit # 3l J I Amount "Z-- j rl li Owner's Name New Renovation ri Replacement 1 Plans Submitted FIXTURES z WCA a z 14 a Z x A c a a e x �a d a A F SlBI3 M Ba9SWM >Isr FLOOR rn FLOOR a 3RCk RSM gH FLOOR 5M RfM 6M FUM 7M FUM sIH FLOOR (Print or type) T , Check one: Certificate Installing Company Name 21� i )`�(� �` �'iicJq❑ Corp. Address o? �v"Cg�"y Partner. A/e t.0 r a"Au /LA d 3 d7s' Business Telephone - d a -3,Pa- ' Sag Firm/Co. Name of Licensed Plumber: Insurance Coveraee: Indicate the a of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity El 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 Signature Owner Agent I hereby 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 under Permit Issued for this application will be in compliance with all pertinent provisions of the chhuussseetts State Pjdffibing CO-4 and apter 142 of the General Laws. By: Sigriature Of icense um er , Type of Plumbing License Title 1//�--�� City/Town iL cense Number Master Journeyman ❑ APPROVED(OFFICE USE ONLY �F 9, j Date.�. . . .. . . . . . . . . . 3589 . A TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING n ,SSACHUS� This certifies that . J Fd has permission to perform . . . . . . ..: . . . . . . . . . _ . ao plumbing in t e buildings of �� • at. . u. . ". . . . . . . . . . . ., North Andover, Mass. Fee� �5 �Lic. No.//5.... (/. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR 1 WHITE: Applicant CANARY: Building Dept. PINK:Treasurer 1 Z M L O MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING Type or print) Date /�/°�2 1% p7 7 `l9 NORTH ANDOVER,MASSACHUSETTS F Iy� Building Locations �� e 17 le k 's Kt �C Permit# O° Amount$ Owner's Name --O 109 �2 e New Renovation ❑ Replacement ❑ Plans Submitted ❑ a z o w F zz 0 z W x W u W x w �a W F F w z E. w a ��" F F w O > r:. F w a F W �i W � 7 Z g ,c C 0 W x O W F w. O C7 x w A c7 u x > E a H O SUB-BASEM ENT B A S E M ENT 1ST. FLOOR % 2ND. FLOGR 3RD. FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR (Print or type)Z> ( Check one: Certificate Installing Company Name dJ {�jQ.Ljl �L��� k ��P�4�J�� Corp. Address9- Li AJ L6 C 'v ❑ Partner. /V e t c/-1--d Business Telephone �^ 3 —3 eaL7 y'o2,9 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter 4, K Jam?ill X, F,,t� KUL&. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑ If you have checked Les,please md' to the type coverage by checking the appropriate box. 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 Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ hereby 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 install tions performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massac s State G=Cdd LChter l42 fthe General Laws. ignature of Licensed Qlumber Or Gas Fitter By: Title Plumber •kt//Sao a City/Town ❑ Gas Fitter License Number r-4--M- aster APPROVED(OFFICE USE ONLY) E] Journeyman .) u J G Date. .Gv" �. K . . . .. .. ... . .. . .. A t N0RTM , TOWN OF NORTH ANDOVER g O �.t° ti0 0 ° pp PERMIT FOR GAS INSTALLATION s �I . SSACMUSE nJ M J p..ti This certifies that/ .. . . . . . . . . .. . . . . . . .`. . . . . . . . . . . .`. . has permission for gas installation �'. .t !. . . . . . • • • . • • • • • • S in the buildings of . . �:. . .'. . . . : �: . . . . . :. v. �. . . . . . . . at . . .. . . . . .. . . . . . .,.. . . . . .'. . . . . . >r., North Andover, Mass. FeeXv5,.. Lic. No.. : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GAS INSPECTOR WHITE:Applicant CANARY:Building Dept. PINK:Treasurer :. UA U Date.. ..... . .. . ..... c EE NORTH TOWN OF NORTH ANDOVER S pf thio ,^1ti0 F� pp PERMIT FOR GAS INSTALLATION ,SSACHu 't ~ O .n f! This certifies that-�,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation 'Y: . / . . . . . . . . . . . in the buildings.of j� ` . - ::`'`��!�'�'. .?`• • • • • • • • • • • • • • at . ..`' `. . . . . • • • •, North Andover, Mass. Fee., ?. . . . . . Lic. No.. . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer V 1 7 MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTING g kType or print) Date C / ? 19 / NORTH ANDOVER, MASSACHUSETTS Building Locations Y6 S eWt t- de, Permit# mount$ Owner's Name 7x w &elv` New Renovation ❑ Replacement ❑ Plans Submitted w v � � z p n F C C 1 C W v�G z n U w n z w W n `� �! x C :1 W U tCs7 `' Z J �- F n z C z �, C vFi 't ti =� C C W _ C C SUB-BASEM ENT BASEM ENT f 1ST. FLOOR 2ND. FLOOR 3RD . FLOOR 4T Ii . FLOOR 5TH . FLOOR 6T H . F L O O R 7T 11 . F L 0 0 R -8-T II . FLOOR (Print or ! p �o / Check one: Certificate Installing Company Name �Fyke[/,&'e �C rl (9 �'�7`�!R%/�9 ❑ Corp. Address �02 C-d 1 ❑ Partner. Business Telephone ( 6 3 3 a dr ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter /y C)1�°�`' xoy d Se —INS UIZANCE COVERAGE Check one: 1 have aprrent liability Insurance policy or it's substantial equivalent. Yes ? No❑ If you hake checked yes,please indi to the type coverage by checking the appropriate box. ❑ Liability insurance policy Other type of indemnity ❑ Bond Owner's Insurance Waiver: I am aware that the licensee does nbt 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: El of Owner or Owner's Agent Owner ❑ Agent I hereby 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 under Permit Issued for this application will be in compliance with all pertinent provisions of the Ma sett�StateGasfq, deand Chapte"ofeneral Laws. S' nature of License lumber Or Fitter By. Title Plumber Ciry/Town ❑ Gas Fitter License I um er [2—Master APPROVED(OFFICE USE ONLY) ❑ Journeyman