HomeMy WebLinkAboutMiscellaneous - 44 MARIAN DRIVE 4/30/2018 (2) 44 MARIAN DRIVE `
2101107.C-0057-0000.0
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INSPECTIO11N PORT EXISTING FOUR �`EXISTINO`! \ N
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A COMPRESSNOERL BEDROOM 10245 \
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BENCHMARK:SPIKE IN:TREE
ELEV.100.00(ASSUMED DATUM)
220^02'
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589°39'20"W
ARMSTRONG N�
DAVIS
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Date.................................' r
tORTI�
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"°°� TOWN OF NORTH ANDOVER
PERMIT -FOR WIRING
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��This certifies that ......... 5.......,. �
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has permission to perform ........ �1. ........./��!L....4.................
wiring in the building of
at...� ../.'! . OAJ........D/.<. ............ .North Andover' ass.
Fee... -��.. Lic.No.. �� ........ .... ...... .l .
^� LECTRICAL INSPE It `'�
Check # �q/"5 1
10517
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 f
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
firm or corporation stated on the permit application. Such entity shall be responsible for the
electrical permit shall be issued to the person,
notification of completion of the work arrequired in M.G.L.c.143,§3L.
Permits shall-be limited as to toe time ot.ongoing construction activity,and may be.deemed.by the.Inspector-of_Wires abandoned-and.inualidaf-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 case.A p,_r&tit 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.
SQAule 8—Permit/Date Closed: f ***Note:Reapply for new permit
0 Permit Extension Act—Permit/Date Closed:
Commonwealth of Massachusetts Official Use Only
Permit No.
Department of Fire Services
--�—�" Occupancy and Fee Checked
�{ BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leaveblank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
jPLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: L e , ' , �2p/)
City or Town of: NORTH ANDOVER To the Inspector ofWires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number) y M 4%/,p ni r
Owner or Tenant 0u 0 4 Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box)
Purpose of Building gi 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
C� Location and Nature of Proposed Electrical Work: 3 S�cse+� �Or`Gk
Com letion of the ollowing table may be waived by the Inspector o Wires.
y No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
Above In- o.o Emergency Lighting
No.of Luminaires Swimming Pool rnd. E] rnd. ❑ Battery Units
No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No,of Detection and
Initiating Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
Tons
No.of Waste Disposers Heat Pump Number TonsKW 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:*
No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No.Hydromassagc.Bathtubs No.of Motors Total HP Telecommunications Wiring:
f No.of Devices or Equivalent
OTHER:
Attach additional detail if desired, or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the
licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned
certifies that such coverage is in forc as exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE t BOND ❑ OTHER ❑ (Specify:)
I certify,under the inss end enaylties of perjury,tltkt the information on t ' application is true and complete.
FIRM NAME: �C« ' / /yea- vs t c z LIC.NO.: V '9tb-si
Licensee: P,,"i IT Signatur � LIC.NO.: n
(If applicable, enter "exempt" n the license number line.) Bus.Tel.N0.• I—,fq`1`7 S 1'
Address: '-C?• PO4 t t 5 JV&. � AA-14 0181(5 Alt.Tel.No.:4 » asp
*Per M.G.L c. 47,s. 57-61,security work requires Department of Public Safety"S"License: Lic.No. ��
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required
by law. By my signature below,I hereby waive this requirement. I am the(check one) ❑owner ❑ owner's
Owner/Agent FPE"IT FEE. $
Signature Telephone No.
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The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
kip 600 Washington Street
Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information // Please Print Le ibl
Name (Business/Organization/Individual):
Address: Po. Sox ti S
City/State/Zip: &2 D, Am vuu- p4m Phone #: J
Are you an employer?Check the appropriate box: Type of project(required):
1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. E]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 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. ❑ Demolition
working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition
[No workers' comp. insurance 5. ❑ We are a corporation and its
required.] officers have exercised their 10.❑ Electrical repairs or additions
3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions
myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs
insurance required.]t employees. [No workers'
13.❑ 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 isproviding workers'compensation insurance for my employees. Below is thepolicy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.#: 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 required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby ce yd�elthe nsd pe al es of perjury that the information provided above is true and correct.
Si nature• Date: 61e C v
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#:
Date...6:.z.4,.z�
i ! NORT"
( N, o?;•� ``°- "�, ' TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
SSMUSf�
This certifies that ....... ��` ......f..."..'.vvnod I/.. ............................
�y ti�
has permission to perform .............Efi .�.........5.�C,i.F!Lt...............
wiring in'the building of................... . ..®btr/Q .......................................... .
A
at... ............................ ... .North Andover,Mass.
Fee.. 5. -Lic.No. ..3 2-1rr:..... .�'� !t :<:t1 -. ....
ELECTRICAL INSPEC�R
CPer ) �7
u•
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 'I
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 corporation 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.143,§3L.
Permits shall-be limited as to the time of ongoing construction activity,and may be.deemed.by the,Inspector_of-Wires abandoned_and.invalid,if_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. V `
❑ 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.
X-Rule 8—Permit/Date Closed: Z, z . / ( **Note:Reapply for new perrnat
0 Permit Extension Act—Permit/Date Closed:
l.U[[1111U/1VVWa1 .1/ U/
Department of Fire Services Permit No. �(
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leaveblank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:
City or Town of. NORTH ANDOVER To the Inspector of Wires:
By this application the undersigned gives notice of his or herX1,
'on to perform the el trical work described below.
Location(Street&Number) `` , ZZ (?(/SIJ
Owner or Tenant 491J& p�1C,h Telephone No. VIP to
Owner's Address
Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box)
Jj
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:
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No. of Luminaires' Swimming Pool Above ❑ In- ❑ o.o cy �g mg
rnd. rnd. Batter Units Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No.of Detection and
Initiating Devices
No. of Ranges No.of Air Cond. Total No.of Alerting Devices
g Tons
Heat Pump Number Tons KW........•. No.of Self-Contained
No. of Waste Disposers Totals: Detection/Alerting Devices
No.of Dishwashers S ace/Area Heating KW Local❑ Municipal ❑ Other
p g Connection
No.of Dryers Dr Heating Appliances KW Security Systems:*
y No.of Devices or Equivalent
No.of Water No.of No.of Data Wiring:
r` Heaters KW Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsNo.of Devices or Equivalent
OTHER: s
Attach additional detail if desired, or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by,municipal policy.)
Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: LIC.NO.:
Licensee: r O1.1 Of AO I SignatureLIC.NO.:
(If applicable, enter "exempt"in the license number line) Bus.Tel.No.: )3A 7075- Itf
Address: Alt.Tel.No.: ►
*Per M.G.L c. 147,s. 57-61,security work requires Department of Public Safety"S" icense: Lie.No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑ owner's
Owner/Agent PERMIT FEE: $
Signature Telephone No.
e
PERMIT NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1
1 MAP NO. LOT NO. 2 RECORD OF OWNERSHIP iDATE BOOK PAGE
ZONE I SUB DIV. LOT NO. I �-
LOCATIONr PURPOSE OF BUILDING t
OWNER'S NAME NO. OF STORIES S E / Lj�
OWNER'S ADDRESS //� /il.. 6^^ - BASEMENT OR SLAB /d. n (q �C�
ARCHITECT'S NAME `7 SIZE OF FLOOR TIMBERS V1LST(��y�C_ /® ND 3RD
BUILDER'S NAME SPAN /
DISTANCE TO NEAREST BUILDING _ f d /S�� DIMENSIONS OF SILLS
DISTANCE FROM STREET '" POSTS v�✓' 'V
DISTANCE FROM LOT LINES—SIDES O V REAR a. f GIRDERS
AREA OF LOT FRONTAGE HEIGHT OF FOUNDATIONr> ft THICKNESS G e /f
IS BUILDING NEW SIZE OF FOOTING •7C% �� X /i(/o •�y
IS BUILDING ADDITION t MATERIAL OF CHIMNEY Alt,
-L
IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND SG
i
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS 3 PROPERTY INFORMATION
LAND COST
SEE BOTH SIDES EST. BLDG. COST 22
JS
PAGE 1 FILL OUT SECTIONS 1 - 3
EST. BLDG. COST PER SQ. FT.
PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
DATE FILED J %�
BOARD OF HEALTH
SIGNATURE OF OWNER OR AUTHOR I D A ENT
FEE
PLANNING BOARD
PERMIT GRANTED
X19
BOARD OF SELECTMEN
BUILDING INSPECTOR
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY SroRIEs I 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 1 2 13
CONCRETE BL'K. PINE
BRICK OR STONE HARDW'D _
PIERS PLASTER _ __
DRY WALL _ __
UNFIN.
3 BASEMENT 11
AREA FULL FIN. B'M'T' AREA _
y, 1/7 1/1 FIN. ATTIC AREA _
NO B'M'T FIRE PLACES _
HEAD ROOM MODERN KITCHEN
4 WALLS I 9 FLOORS
CLAPBOARDS B 1 2 3
DROP SIDING CONCRETE �_
WOOD SHINGLES EARTH
ASPHALT SIDING _ 'D
ASBESTOS SIDING COMtA_ COMMCN
VERT. SIDING ASPH.TILE _
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY ATTIC STRS. & FLOOR _
BRICK ON FRAME
CONC. OR CINDER BLK.
STONE ON MASONRY WIRING
STONE ON FRAME _
SUPERIOR I I POOR
ADEQUATE NONE
rj ROOF 10 PLUMBING
GABLE HIP BATH (3 FIX.)
GAMBREL] MANSARD TOILET RM. (2 FIX.)
_
LAT SHED WATER CLOSET _
ASPHALT SHINGLES LAVATORY _
WOOD SHINGES KITCHEN SINK _
SLATE NO PLUMBING _
TAR & GRAVEL STALL SHOWER _
ROLL ROOFING MODERN FIXTURES _
TILE FLOOR
TILE DADO
6 FRAMING II 11 HEATING
WOOD JOIST PIPELESS FURNACE
_ FORCED HOT AIR FURN.
TIMBER BMS. &COLS. _ STEAM
STEEL BMS. & COLS. _ HOT'W'T'R OR VAPOR
WOOD RAFTERS _ AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS :
7 NO. OF ROOMS GAS
OIL'
B'M'T 2nd _ ELECTRIC
1st 13rd NO HEATING
Date............................... .
+
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that .AA4.... 7 ,
............................................................................
has permission to perform ......... Ar
............... A?/ ......................
wiring in the building of................... .......................................
at....... ...... ........................ .North Andover,Mass.
Fee..................... Lic.No.,.,?.
-�LECTRICAL INSPECTOR
Check #
68 *13
ME C0W0JVVF4L7710FU4SSACMSETIS Office Use only
DEPARTMENTOFPUBLIC.S4FE7Y Permit No.
BOARD OFFIREPREV&V70NRWa4TI0AS527(iVfR 12:00
Occupancy&Fees Checked r...
UVPPUCATTONFOR PERAffTO PEUORMaECTRICAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 7/do/o- _
Town of North Andover To the Inspector of Wire!
The undersigned applies for a permit to perform the electrical work described below.
Location(Street&Number) p F 6 8F,--G
Owner or Tenant �O U 1 LV t a_. 6
v
Owner's Address V
Is this permit in conjunction with a building permit: Yes M No (Check Appropriate Box) �{Q
Purpose of Building �.p Q�r Q p y �� Utility Authori`�'On No.3 3
t ExistingService `
Amps_ 1=Volts Overhead Underground Q No.of Meters
New Service d 0�. Amps&b/,, Volts Overhead Underground No.of Meters
Number of Feeders and Ampacity
e Location and Nature of Proposed Electrical Work V` (,,Ip 6p
No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total
KVA
No.of Lighting Fixtures Swimming Pool Above Below Generators KVA
and roved
No.of Receptacle Outlets No.of Oil Burners. r No.of Emergency Lighting Battery Units
No.of Switch Outlets It
No.of Gas Burners a
No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones
Tons
No.of Disposals No.of Heat Total Total No.of Detection and
Pumps Tons KW Initiating Devices
No.of Dishwashers Space Area Heating KW No.of Sounding Devices
No.of Self Contained
Detection/Sounding Devices
No.of Dryers Heating Devices KW Locala Connections Municipal Other'
No.of Water Heaters KW No.of No.of
Si s Bailasis
No. Hydro Massage Tubs No.of Motors Total HP
r
OTHER ,0VeA%e A SQ,( 16 G &me 1 d a G
Ttsur=Coi,ea Ptastta+Ybthetegt ements Gmnaal l aws
IhawanmentLiabtldyharanoePblrytnhudmgCar>plde Chmageorilsatr�amale4tivalait YES NO
Iha%esubrnibdvatidptxfafsanetothe0�YES NO r7 IfjmhatedniodYES,pimeck*thetAxcfoom Vbydcckffgthe
INSURANCE BOND OR IER (PgMSpM y)1 U e+ L
t ( Fx�atDlale
WcrkIDSlart 7 1� 1 1 C1 7 Estcr%edvaluedEmhzlWadc$
D* � Final
Sigr�dunda$iePt� -
FIRMNAME a
ce 1vt Liomserb O 9l
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Adc�s�.�!T�C �U d 6 A IOt/�� !' ►e �� T►JL"t 55- ! d�� AI<TUNn
OWNER'SINSL.'RANCENVAIVER;IanawatethattheCsedoesmtha�+etheirstaatrem4aage�dssaa(tva)m>tastet�ritedtryN( a> st stealla�s
aidintmysigrd ncntspasnAmpG amlvaimsthsm menat
(Please check one) Owner M Agent Q
Telephone No. PERMIT FEE E
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