Loading...
HomeMy WebLinkAboutMiscellaneous - 43 SCOTT CIRCLE 4/30/2018 43 SCOTT CIRCLE / 210/105.D-0070-0000.0 1 i I i .I 'Location No. Y Date 's ,&ORT1y TOWN OF NORTH ANDOVER t ,r 0. F p Certificate of Occupancy $ 4L 11Building/Frame Permit Fee $ rs Jt� Foundation Permit Fee $ s4CMu5E Other Permit Fee $ e Sewer Connection Fee $ Water Connection Fee $ + TOTAL {, $ Building inspector Div. Public Works ,Location No. ✓� Date 01 °RT„ TOWN OF NORTH ANDOVM I•,hOR p Certificate of Occupancy $ Building/Frame Permit Fee $ CU11 , Foundation Permit Fee $ s�cMuse � Other Permit Fee $ _ Sewer Connection Fee $ o Water Connection Fee $ TOTAL $ Building Inspector �a CY Div. Public Works 1"E'RMIT NO. -3 Jr ` APPLICATION FOR PERMIT "1'O BUIL1)**** 'NUI T11 ANDOVLR, MA Al(I'NO. 1, s'�S/`t p V., f Q LO r.N 1D O- 2. NE('ONI)1) t HSnlr DATE I300K PACE Z,f)NI. M VV �`JJ SVIV IM H . 1.0 1 N( 'O N 1. wq y fa4 py I.()l All()N If^S cI 1 = + -� f'I IHI((SI:(Y HI 111 DIN(; �� �r ( V06 ipL ¢ 1 C)Q (��L�� 4 / 7 P No .O(;SI(N(ILS }- SIZE 3a-0p 1)WNf:R'S ADDRESS 43 13ASEIIIENT OR SI All AR(1111 ECI'S NAME SIZE OF 11 O)R I InIHFRS 1ST 2 3 HIII.DER'SNAME CvY r SPAN DISI ANCF TO NEAREST HUII.DING DIAIE.NSI(NNS(N-SWI S DIS I ANCE I ROM STREET DIMENSIONS(>F IY IS I S DIS I ANCE FRMI I Of LINES-SIDES REAR DIMENSIONS OF GIRDERS AIIFAOF-I.Or 0"7UooF+ rR(NJIAGE IIEinIrOFF(A)NDAIION THICKNESS ISH1111-DIN(;NEW C 3rry1' r SI ZEOF 10(Yl ING x IS HIIII-DING ADDITI(NN MATERIA].OF CHIMNEY IS BUILDIN(;ALTERATION IS WILIAM;ON SO1.11)OR FII I.ED LAND N91 I.BUILDING CONFORM TO REQ]IIREMEN I S OF CODE /' IS BIIILDING C(NJNECI EI)10 TOWN WAFER BOARD OF APPEALS ACTION, IF ANY / IS BUILDING CONNECI ED 10 TOWN SIiWER IS BUILDING CONNEC'1 ED 10 NA I URAI,GAS LINE 114S 1 uc I iONs 3. PROPF11'1l"INFORMATION I.AND COST ESI. BI IX;. COSr 7' PACE I FILI.OIrr SECTIONS 1-3 EST. BLIX;. COST 1'ER SQ. FT. EST. BI IX;. C'OS r I'ER ROOM ELECrRtC nIErERS MUST BE ON OUTSIDE OF 81/11 DIN(; SEPI IC PERM]r NU. A n ACI IED GARAGES MUST C(NJFORM TO S TATE FIRE REGUI.ATI N S a 4PL1(()I E D BY: oe PIANS MUST BE FILED AND APPROVED BY HIIILDING INSPECTOR BUII.I)1 G INSPECTOR DA IE I'll El,V/ – � (1WNLRS.I1:1.9 Lt�5 a -1 _[ca 1 iJr✓�. (kf1R.lEl.a2TO615 tf,1_lffii� I �1l)• �ltd)i'Zf; SI�;NA r11H1�.(X OWNER lNi A1Q1�11 N)ItI Z1iD/�A((//.',''L\�FfT C(N�rrR.l.l('N AUG z O 199:7 rARnnr(-,RAFrrr_1) V�� 19 3 0/3 6/3 01 `/ FORM U - LOT RELEASE FORM 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 or requirements. **********************k******APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT�� �, �� PHONE or LOCATION: Assessor's Map,.Number 50 l 0S p PARCEL SUBDIVISION LOT (S) STREET SC©-4---1= Cl y-CIA ST. NUMBER *********************OFFICIAL USE ONLY*******''""'**** RECOM DATIONS OF TOWN AGENTS: - 4 - CONSERVATION ADMINI TOR DATE APPROVED 0 DATE-REJECTED COMMENTS D Q dtit, i do ` -P �JAk rs nb TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED tPTIC INSPEC -HEALTH DATE APPROVED DATE REJFCTED COMMENTSlJ`��( tarel Kckm CC Po 1 must be 20' from tank if inground, 10' from tank if above ground PUBLIC WORKS -SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE of SCOTT OR TGA Bu� T �� MGY Ul?V EY PLAN LOCATED /N �-� SCALE /"-- 8,�' _ DATE: 4 lLs Scott L. Gi/es R.L.S 50 Deer Mecdow Roca, North Andover, Moss. o� 0 0 ctf�T( -1NAT Silt: tIN S�j�"i4e m--naK JI►IS S�ST�t•t ANO TTNAT-WE C41S� Ft►.aA�, C RAr--A ,• W&S e�� J W fir' -- 1 UMOT AN D 1-".LT i Mb RILLS �' q� Sit Kt ' �4-n.oNS As-fur fills all 19-3 OJT �'ti' -3� � � IAl jDBo1c_125.OZ. Cov } 4VT D.AO)L IZ3.34 . llp� � o 1�4.•32 i aCO 0 0 TO ISA .,E. �" AND ITS:T17-LE/NSU1?ER THIS L OT IS IN A FL 0 O HAZ,4 RO ZONE Q, / CERT/FY THAT OFFSETS SHOWN ARE FOR THE USE THE OFFSETS OF THE BUIL DING INSPECTOR ONL Y SHOWN COMPLY AND SUCH USE /S FOR THE WITH THEZON/NG DETERMINATION OFZONING v '' i•�g H BYLAWS OF CONFORMITY OR NON-C01VF01?MI7-Y7` �-��jt�V D'NA �fC15TEKE0 WHEN CONSTRUCTED. '��WNos WHEN BUIL T Date.A'. 1"a3855 t ,aORTI{ 3?�<��•°„• �,o� TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING K Y cNusf� This certifies that � 614- . . . . . . . . . . .� . . . . . . .�. J ` has permission to perform r�� - . . . . . . . . plumbing in the buildings ofd.�.�� . . . . . . . . . . . . . . . . . . . . . . . at. . � `' : . .'R . C%-! ! _� . . . . .. North Andover, Mass. 4Fee�0. . . . . . .Lic. No-�Y� 9 PLUMBING INSPECTOR 10/27/98 12;25 15,00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION F R PERMIT TO DO PLUMBING �(Pri t r Type) /O,Q 4 �/l� Mass. Date o'� 19� Permit # " Building Location r JedC vS't�/� Owner's Name Type of Occupancy _ f Ne Renovation ❑ Replacement ❑ Plans Submitted: Yes❑ No FIXTURES Z Z Y J N O Z Z N W cn Z_ N a oC < ~ Z O z H a ¢ = Q y LL Z F- O N W N O S f' < W N Z C a Q < G �. 3 X U Z Q p7 N W } F N G < ffl Z CC a cc O LL W 2 ~ ~ W 3 0 C '� y C h Q Y. O G G U. cc W Y W ` h O Z a 0 W H Z O p N __ = W f O 0 Y < < O < J J < ¢ ¢ = < O < f" O 1 in 0 c a _j ? = t- H LL o a A < 3 C m o \ sue-BSMT, r BASEMENT IST FLOOR r 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR / Installing Company Name_ f'!v, �d'/I � I� Check one: Certificate Address ❑ .Corporation f `e A 0 9 ❑ Partnership Business Telephone ( I V9a 3 AiRm/C0. Name of Licensed Plumber INSURANCE COVERAGE: I have alcu n liability insourance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. If you hav�ked es please Y �. PI a indicate the type coverage by checking the appropriate box. A liability insurance poli Other type of Indemnity O 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: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information ybinge ed(or entered abov lication are a and accurate to the best of my knowledge and that all plumbing work and installatiou er the pe it fo thi plicatio will be in compliance with all pertinent provisions of the Massachusetts State Plu apt r 14 of th Gen ral ws. BY Signature f 04 Title nsed Plumber - City/Town Type of License: Master ❑ .Journeyman cf APPROVED(OFFICE USE ONLY) License Number Ya d ra r Location No. Date I!-l—?-3 OtNORTH TOWN OF NORTH ANDOVER tt�ao ,a 1h 3? �� aO0 p Certificate orOccupancy $ ,19 ie e : Building/Frame Permit Fee $ /41 CK�5 t� Foundation Permit Fee $ Other Permit Fee $ S��egqwgr Connection Fee $ V1P6ter Connection Fee $ �j)r5 -TOTAL $ 5, - Building Inspector ' 6591 Div. Public Works f Location. �.�,- No. S n Date �aRT„ y TOWN OF NORTH ANDOVER Certificate of Occupancy $ 'Building/Frame Permit Fee $ Foundation Permit Fee $ /D 0-dy Mus A. Other Permit Fee $ Sewe.lConnection Fee $ A F-",-ID SSP a Water Connection Fee $ TOTAL $ 'D 0 J Building Inspector 6577 Div. Public Works ERMIT Nol -46�n ' APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. S PAGE I M MAP i4O. l X05 fl LOT NO. 2 RECORD OF OWNERSHIP JDATE BOOK 'PAGE ZONE I SUB DIV. LOT NO. I i LOCATION ,G F d t�3 C�T r @}./l� / PURPOSE OF BUILDING N Qcs-3 Q� ?� ("JfiAlOWNER'S NAME I (� C C�y� ) NO. OF S S SIZEM CJ GLV OWNER'S ADDRES ` &4 j �/ �� SEMENT LABol ARCHITECT'S NAME SIZE OF FLOOR TIMBERS 1ST DV ll��.^ & 2ND 3RD BUILDER'S NAME ClQgjtMr SPAN i1 DISTANCE TO NEAREST BUIL//DIIN6`v� �vv i' �✓J /��-, DIMENSIONS OF SILLS 7 iL DISTANCE FROM STREET ,�y,(/ - POSTS T (!IJ DISTANCE FROM LOT LINES-SIDES I REAR ��'Q GIRDERS AREA OF LOT FRONTAGE -� HEIGHT OF FOUNDATION / THICKNESS lel-' IS BUILDING NEW SIZE OF FOOTING G X c IS BUILDING ADDITION O MATERIAL OF CHIMNEY j IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLEDLAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE �/ IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY A /Y IS BUILDING CONNECTED TO TOWN SEWER ,V Y IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION WX IV=IM SLZ LAND COST "� ����©Q SEE BOTH SIDES U EST. BLDG. COSTf&,,EST. BLDG. COST PER SQ. FT.- SS PAGE 1 FILL OUT SECTIONS 1 - 3 [@!BRAE PERMIT $ `i�m Lie EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 tri•��^�ruj►�7/ �"CJ�f►iil 7 a SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY .� ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS f PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED 9 O` BOARD OF HEALTH SIGNATU OF W ORpVRIIVNT FEE Q r C, f9 - PLANNING BOARD PERMIT GRANTED OWNER TEL.# (W d d 19 CONTR.TEL.# Q3 16 If CONTR.LIC.# ti BOARD OF SELECTMEN SEP 2 4 1993 BUILDINa INSPccroR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY S ORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY::::A_jOFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS I .ES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION INTERIOR FINISH CONCRETE _ a t 2 18 CONCRETE BL'K. PINE BRICK OR STONE HARDW D — PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT I, AREA FULL FIN. B M'TAREA _ Y. 1/7 '/, FIN. ATTIC AREA N_O B M-T FIRE PLACES _ HEAD ROOM MODERN KITCHEN i� 4 WALLS 11-9 FLOORS CLAPBOARDS 8 12 3 DROP SIDING CONCRETE J WOOD SHINGLES EARTH __2 ASPHALT SIDING HARDN!J'0 ASBESTOS SIDING _ COMMGN _ VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY STUCCO ON FRAME 'y BRICK ON MASONRY ATTIC STRS. 6 FLOOR n BRICK ON FRAME I CONC. OR CINDER BLK. STONE ON MASONRY WIRING [ 'r i „`# STONE ON FRAME SUPERIOR I_9 POOR _ ADEQUATE NONE 5 RQOF 10 PLUMBING GABLE IV I HIP BATH (3 FIX.) GAMBRELI I MANSARD TOILET RM. (2 FIX.) • FLAT SHED WATER CLOSET ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR 8 GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST v PIPELESS FURNACE t FORCED HOT AIR FURN. TIMBER BMS. 3 COLS. STEAM �•� 1+ STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR Y WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T )/ 2nd W' _ EL NO HEATING ECTRIC 1st c 13rd I 4 FORM U - LOT RELEASE FORM 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 #k _. section***************** Phone LOCATION: Assessor's Map Number Jr _ Parcel SubdivisionLots) Street L(��" /� (� St. Number ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: tS Date Approved Conservation Administrator Date Rejected • Comments Date Approved Town ner Date Rejected Comments Date Approved �a3 Health Agent Date Rejected Comments Public Works sewer/water connections - driveway permit Fire Department �— ® �C Received by Building Inspector Date SEP 2 4 1993 MORTGAGE SURVEY PLAN • LOCATED IN U<>y- -" ), y ASS. SCALE I"_ = DATE 4 J 2 3 (4 Scott L. Giles R.L.S 50 Deer Meadow Rood North Andover, Moss. ►2Z, g�o � I hoz- ZAA 0 0 4y O - y �Nv TO AND ITS TITLE INSURER Q, THIS LOTIS Uor-IN A FLOOD HAZAROZONE ' I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE eta or THE OFFSETS OF THE BUILDING INSPECTOR ONL Y SHOWN COMPLY AND SUCH USE IS FOR THE WITH THEZONING DETERMINATION OF ZONING LES H BYLAWS OF CONFORMITY OR NON-CONFOR114ITY14Lkm-r72 �fCl�ENEO �' 4-,,�v D, WHEN CONS TRUCTED. '°'��c LAND s WHEN BUILT. °I (23(93 a r • _ SRTrl W < w oNvn of Nor over I No. 430 ' ort dover, Mass. S�/prJ it 191.5 ti COC L MEwICK ADRA TE D PPS\ �� BOARD OF HEALTH f PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...... .�►y .:. /. d,XQ :............................................................................. Foundation has permission to erect Q##*9 .*.�jf. buildings on .yA.141COM/R 401L.0-Ar4 -A....... Rough it to be occupied as�.f'I. .�► IMlt �✓IF�,Li/!�! �.I��dl .Ba��� � Chimney `1 provided that the person accepting this permit s II in ever respect confo`rnfto the terms of the application on file in P P P 9 P Y P PP 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. rthivlii WR FOUNDATION ONLY g REGULATED BY PA114J.& &C. PLUMBING INSPECTOR RA. VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough ; PERMIT EXPIRES IN 6 MOI\�j &qb1 - EEE PAIDf •n Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STA RTS ' Rough .PERMIT FOR FRAME/BUILDING Service BUILD G INSPECTOR Final S DATE: �'� FEE PAID ° Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough P Y P Final 4 No Lathing or Dry Wall To Be Done FIRE DEPARTMENT S Until Inspected and Approved by the Building Inspector. Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT CERTIFICATE OF USE & OCCUPANCY Town of Forth Andover BuildingPermit Number 430 1993 Date APRIL 20 1994 � � ae , THIS CERTIFIES THAT THE BUILDING LOCATED ON 43 SCOTT CIRCLE (Lot #2) MAY BE OCCUPIED AS SINGLE FAMILY DWELLING W/2 CAR G RA IIN ACCORDANCE & DECK WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. tiJ;lTM CERTIFICATE ISSUED TO _. Cheryl Dickerson i .1 Scott Circle ADDRESS North Andover, MA -- N� ` Building Inspector 0 Fa.;�., � w . . o of �0' hf ,tti No. 430 too o ATort dower, Mass., A COCr1iwit K rED BUILD BOARD OF HEALTH ` PERMIT To Food/Kitchen A Septic System �r BUILDING INSPECTORS ~ THIS CERTIFIES THAT...... .............................................................................. .............................................................................. ; Foundation ' ! "." . -has Permission to erectbuildings on r .ARough it y,, to be occupied asd'hV.A�. j ,�. . ��i�j� �.�� .���,�r< .T ,.,,,,,,,,,, Chimney provided that the person accepting this permit slfall in ever respect conforrrfto the terms of the application on file in P 9 P Y p PP ,� this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Final O� Buildings in the Town of North Andover. f-Lh1V11i FUR FOUNDATION ONLY PLUMBING SPECTOR REGULATED BY PARA 114.8,E B.C. VIOLATION of the Zoning or Building Regulations Voids this Permit. � l 9 s�'�t9-- , PERMIT EXPIRES IN 6 � - FEE PAID •P ina /���� Y; _ UNLESS CONSTRUCTIU I STAr `�� ELECTRIC I PEClr6lk' -41 • �/ � ,� PERMIT FOR FRAME/BUILDINQ Rough ..... ... .. ... .AID ....... Final Service ... ............................ FEE P �` � BUILD G INSPECTOR DATE:I_ -�-- OeCUI)ancy N7711it lZeq uired to Occ-i Buildin • . _y � GAS I S�'ECTOR Rou Display in a Conspicuous Place on the Premises — Do Not Remove Finagh / No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT C Burner d / PLANNING► _6\0 _\ FIN � AL CONSERVATION 4//�� V& Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT - Date i= 3909 f HOR71y, TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACHUS� This certifies thatUfs'. ?.iu.�r�!.l. . . ���. . . . . . . . . . . . . . has permission to perform . . . //.v-.T.. . . . . . . . . . . . . . . . . . . . . . . . . h plumbing in the buildings of . . PUT v . . . . . . . . . . . . . . . . . . . . . . . . " at . 41.3. . 57c .77-. C!/2, , , , , . , , , , , . . , North Andover, Mass. Fee. . . . . .Lic. No..�/ l. . . . . . C.�.-a.. :. . PLUMBING INSPECTOR 01/12/99 14:47 25.00 PAID WHITE: Applicant CANARY: Building Dept. PINK:Treasurer I . as� MASSACHUSETTS UNIFORM APPLICATION FOR RMIT TO DO PLUMBING n-\ (Print o Type) ��? ass.. Date Permit # 3 O 9 Building Location StbI14 4: L Ownees Name Type of Occupan �'1 New ❑ Renovation ❑ Replacement Plans Submitted: Yes ❑ No ❑ FIXTURES Z N Pz Y O Z W Y J N Q a N ? W W N Z N < rL a ~ Z ~ W z a aO 0WF- W Q Z U W y WN — aaO —¢`N 3a Fx UZ — OYSO Z O J cc JO O j < Q a x LL.Y W Q < S - a r o a F- y S H N LL. t7 O d C G'1 O SUB—BSMT, BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR s 4TH FLOOR s 5TH FLOOR 6TH FLOOR 7THFLOOR 8TH FLOOR / Installing Company Name /n:, i 2'I �/�i 6?/)vX) Check one: Certificate Address �(�[_ , ❑ Corporation 21 a�7� �" E3Partnership Business Telephone_ 2-72-- -�161-— Fmt/Co. 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. Yes No ❑ If you have checked ves. please indicate the type coverage by checking the appropriate box A liability Insurance policy Other type of Indemnity ❑ Bon ❑ 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 walves this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ 1 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 perform under the permit is ed for this pertinent provisions of the Massachusetts State Plumbing Cod nd apter I General Lawapplication will be in compliance with all Title Sign re of censed City/Town Type of License: Master Journeyman APPROVED(OFFICE USE ONLY) License Number %W/ 1G.� BELOW FOR OFFICE USE ONLY FINAL INSPECTIONS SKETCHES FEE PRO NO. APPLICATION FOR PEMW TO 00 PLUMIWQ UNDERGROUND ROUGH COMPLETE ROUGH FINAL INSPECTION PERMIT AMNTEO DATE �• J PLUNGM INSPECTOR .- i O 0 Dat .. TO ?/ + 0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING c U This certifies that ..... ......C—.. �-e c ..................................... has permission to perform ....A-G-:......1:.<I: ............................................... wiring in the building of..........0. A-)-td CM at..............................................!.•l ......................... .North Andover,Mass. p" co Fee... Lic.NoA�5. ..3......................................................... :9 ELECTRICAL INSPECTOR J jjq(, 7 WHITE:Applicant CANARY: Building Dept. PINK:Treasurer �=•-� Office Use Onty 1�4permit Na. uI1E L>ZITIIlIIIII1IIPIII IIf fic�LII�E 3 Etpartmurt of 11uhur -'UfYtq Occupancy& Fee Checked C' BOARD OF FIRE PREVENTION REGULATIONS 521 CMA 12:90 3M (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Cade, 527 CMR 12:0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date � (XX or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned appties for a permit to per`orm a elect I al wo k described be(ow. Location (Street 3 Number) 33 I Owner or Tenant &eyi CD C.vr,er's Address 30 Is this permit in ccn(ur•ctfon with a b iIding mit: Yes _ No _ (OtieCk ripGfCOrate ?CX) P-goose C.' Sulidirc SI0 � Utility Automation No. Existing Samce Amos N/Cits Overreact '_ Uncgrnc L-, No. of Meters Nevv Service Amos `/Cits Cverr,eac _ Urcgrnc _ No. of Meters Numcer at =--eters arc ..rm=ac::v J� 3 �Jatura Cr 7.c.'.Csec A t1 ctwv NC. Duvets NO. a, w.S TO;ai _.�....•.y . ,,. .. I No. at K.A Abave In- — 1 Na. .., �.cnt:rg =xtures Sw m^Inc roai .o crnc. _ i Generators KVA g. No. of E:rtergency l.ignttrc NO. a =____:ac:e Cutters Na. at Cil curaers ; Barer., Units No. of Switcn Duvets No. ar=as =_rr.ers I =tP.E .ALARMS No. cf 'ones Tatar I No. at Cetec mn arc I No. ar Rarces Nc. ct Air -_arc. tons Initiating Cavices No.at sat Total Total No. --t �isccsals ?u-cs Tors K'.V I Na. at Sounc:ng Cevices r No. of Sail Containee No. ct =,snwasners - ScaceiArea r4eatir.c Oetec mnrSouncing cevices I I Na. at ::riers f!eat:he ^ev:ees KOV I _scat Muntc!cat _ Cannec-:cn _Other Nc. .r No. at I Lcw Vcitage No. at ',Vater -;eaters :•(`N Sic.^.s ?aiiasts Wirinc No. :-�vcra `.lassace was Na. ct MOIC.'s Total �*° OT• E=. INSUPANCS C'1E=AGc ?•_rsuant :a the recuirerr.ents t//massac-usans ;ererai '_aws I have a current L:acuity Insurance Pciict nc:":nq Cz.-- etec Cceraucns iwveraae or -is sucstantiai eeuivalent. YES - nave sucmirea vau -root of same to the Cttics. YES✓✓✓✓_ VO t�^.a ^ave Dcxe(c Y_s. -tease naicate :ne tve�ejof2cev rage _v Cnec'm :ne e.(,,,v, nate =ox. �r��2, X INSURANCc — 3CN0 = O ! ER = tP'ease S_ec:`yJ a dater Esurr;atec value of EEecmcai Worx S Werx :a Star. Inscec-:en Oats Aacuestec: Rcug. renal ~. S. nee anter :he P� es of a L /(� t, �� =i Pi�.i NAME j iSA~ W -�YIrC� uC. NO. 7/(/'��_ L cense-- -L U10ASignature NO. Sus. Tet. No. Aacress J t�✓� !4q< fU AAC�11�v i Alt. lei. No. OWNER'S INSUr7ANCc'NAtvE=+: I aware teat the L:CenS a aces rat nave one insurance coverage or its Suostantial a tvalent as re- cu,ree by .Massacriusetts Generai Laws. aria :nat my signature an n:s aermit aoeucanon waives mis requirement. Cw Ag�� (P'ease cnecx ortet eiecr.cne No. PE=MIT F_= S ` Sicrature ct 6«nen cr Aqentl --- ,< 0 O n .�