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HomeMy WebLinkAboutMiscellaneous - 45 LIBERTY STREET 4/30/2018 (2) 45 LIBERTY STREET 210/105.D-0164-0000.0 THENORFOLK ®EDHAMGROLIN February 19, 2015 FORM OF NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B Building Commissioner, or Inspector of Buildings c/o City or Town Hall 1600 Osgood Street North Andover, MA 01845 Board of Health or Board of Selectmen c/o City or Town Hall 1600 Osgood Street North Andover, MA 01845 Fire Department or Arson Squad c/o City or Town Hall 1600 Osgood Street North Andover, MA 01845 RE: Our File No.: P1587149 Insured: ROBERT & LAURA ARLING Address: 45 LIBERTY ST., NORTH ANDOVER, MA Policy No.: D0464690 Loss Date: 02/14/2015 Loss Type: Building or Other Structure Damage A claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Ch. 143, Sec. 6 to be applicable. If any notice under Mass. Gen. Laws, Ch. 139, Sec. 3B is appropriate, please direct it to my attention and include a reference to the captioned insured, location, policy number, loss date and claim or file number. If no reply is received from your office within ten days, we will assume you have no liens of any type against this property, and the claim will be paid in our customary manner. Sincerely, �D �• `l/1�nCC,GC� Linda E. Babineau Property Claim Examiner 1-800-688-1825 x1253 NORFOLK&DEDHAM MUTUAL FIRE INSURANCE CO. 222 Ames Street,P.O.Box 9109,Dedham,MA 02027-9109 DORCHESTER MUTUAL INSURANCE CO. Telephone:(800)688-1825 FITCHBURG MUTUAL INSURANCE CO. Fax:(781)329-1818 Date. f./. �� C�. ....... Of NORT1y o= '' ° TOWN OF NORTH ANDOVER f � 9 • PERMIT FOR GAS INSTALLATION �L SSACNUSE 1 1 7 , This certifies that . . ... . . . . . . . . . . . . .� has permission for gas installation ./2.,f�.`" .S. `. . . . . . . . . . . . . . . . in the buildings of . .Iq.,A. !�:.r. . . . . . . . . . . . . . . :. . . . . . . . . . . . . r at . . . . . . . . . North Andover, Mass. Fee. 3 d. Lic. No.. !1.3.1. . . : . GAS INSPECTOR ' Check# ! �' 6749 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) r — NORTH ANDOVER ,Mass. Date 4/03 2009 Permit# 45 LIIBERTY ST LAURA ARLING Building Location Owner's Name Owner Tel# 508 783 0529-617 572 1692 Type of Occupancy RESIDENTIAL New 7 Renovation❑ Replacement Plan Submitted: Yes❑No[] FIXTURES x w U U) w a o ° M x x z J a ' a z z o F w a °m ' w a o o o w F w Z W ¢ x F. �, a c� > d $30-50 W z z x `� ° A U x > z a ¢ a o °o w °o w = o 0 = w o 3 ca 0 a U x > ca a ll 01W. 1 SUB-BSMT BASEMENT 1"FLOOR l } 2ND FLOOR ti 3RD FLOOR 4T"FLOOR 5T"FLOOR 6T"FLOOR 7TH FLOOR 8T"FLOOR Installing Company Name Eastern Propane & Oil, Inc Check one: Certificate Address 131 Water Street ZCorporation Danvers, MA 01923 Partnership Business Telephone# 800-322-6628 Firm/Co. Name of Licensed Plumber or Gas Fitter ROBERT TALBOT INSURANCE COVERAGE: I have a cures liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. Yes l ✓ I No 11If you have c ecked yes,please indicate the type coverage by checking the appropriate box. A liability insurance policy[71 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: Owner ❑ Agent ❑ Signature of Owner or Owner's 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 the permit i ed for is pplication will be in com nce with all ertinent provisions of the Massachusetts State Gas Code and Chapter 142 oft ener By Type of License: Plumber i oat re of sed Plumber or Gas Fitter Title *14-as fitter 1239 ••Master License Number City/Town •-Journeyman APPROVED(OFFICE USE ONLY) Office Use OIWO The Commonwealth of Massachusetts Penny No. Occupancy & pee Checked Department of Public safety 3/90 (leave blank 06 BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 1200 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL #K All uvrk to be performed In accordance with the Massachusetts Electrical Code. 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date j/Z`/ /F City or Town of !v c A1,1 ,(?(%(f f-1Z To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) / o Cu-ner or Tenant ,{I A R L. ��FS' r/oD� -12-9- Owner's Address S,4 til Is this permit in conjunction with a building permit: Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Slh`GLE l=A�-tll )e /,066 EUtility Authorization NO. 7a.3 7/ Existing Servic _Amps / Volts Overhead Undgrd❑ No. of Meters1 New Service Amps / Volts Overhead ❑ Undgrd❑ No. of Meters Number of Feeders and Ampacity, Location and Nature of Proposed Electrical Work t///2/N o Z�t A IN NO v No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimmin Above In- g Pool grnd. ❑ grnd. ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners Ba of Emergency Lighting atte Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones Total No. of Detection and No. of Ranges No. of Air Cond. tons Initiating Devices No. of Disposals No. of Heat Total Total No. of Sounding Devices p Pumps Tons KW No. of Dishwashers Space/Area Heating KW No. of Self Contained Detection/Sounding Devices No. of Dryers Heating Devices KW Local❑ Municipal ❑Other Connection No. of Water Heaters KW Not of No. o Low Voltage Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP 0Q I AY 1 3 J7 OTHER: 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 this office. YES Q" NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ® BOND ❑ OTHER ❑ (Please Specify) 9/16/9.17 Expiration Date Estimated Value of Electrical Work $ Work to Start Inspection Date Requested: Rough Final Signed under the penalties of perjury: FIRM NAME CONTINO ELECTRIC & CABLE INC. LIC. N'-I.A11983 Licensee LOUIS. CONT INO SignaturLIC. NO.E 2 6 7 8 8 Address 1 DONOVAN DR. WEST NEWBURY, U 19 8 5 . Tel. BusNo. 08 ) 3b'3 5T- Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) �F Telephone No. PERMIT FEE S n 60 Signature of Owner or Agent ' a Date..... .�..'...1.. ../..�..? 934 N°RTI{ °ft °:•�"° TOWN OF NORTH ANDOVER 3? 61 — °c PERMIT FOR WIRING This certifies that .... t 1 i..41.c a.....FJf6AA... ............................ has permission to perform .... . .,.. ........... wiring in the building of...... ..LKI.J./.................................................... at..... .....?. ............... North Andover Mass. Fee.......7.0.,r)g Lic.No//.72�..7............................................................... ELECTRICAL INSPECTOR ch � U5r15/97 I5:29 94.E PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Location r No. MZ Date f. V' i TOWN OF NORTH ANDOVER f pORTN O r a Certificate of Occupancy $ + • +_ • + Building/Frame Permit Fee $ �+s" Eta Foundation Permit Fee $ s�cMus Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ �� Building Inspector ! 10 7 ZI,607/97 11:29 520.00 PAID Div. Public Works PER111T NO. ( APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 3"AP d�0. O LOT NO. 2 RECORD OF OWNERSHIP (DATE BOOK ;PAGE ZONE / I SUB DIV. LOT'NO. LOCATION PURPOSE OF BUILDINGr, D OWNER'S NAME NO. OF STORIES /`• SI OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST ON � ^'3 RD BUILDER'S NAME /1. / SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET �' / POSTS DISTANCE FROM LOT LINES—SIDES/0-7 rL REAR '� GIRDERS 19 AREA OF LOT 871W s/►r� L l' FRONTAGE.7"1 qo I HEIGHT OF FOUNDATION CKNESS IS BUILDING NEW / 1SIZE OF FOOTING IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE i.�,/� IS BUILDING CONNECTED TO TOWN WATER O BOARD OF APPEALS ACTION. IF ANY I(� IS BUILDING CONNECTED TO TOWN SEWER 0 IS BUILDING CONNECTED TO NATURAL GAS LINE ,D INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEg BOTH SIDES EST. BLDG. COST 80 6-A:;, PAGE 1 FILL OUT SECTIONS i - 3 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS I - 12 SEPTIC PERMIT NO. ELECTRIC METEPS 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 YILDIN42 INSPECTOR SIGNAYURE OF OWN OR AUT IZE A F E E / OWNER TEL.# PERMIT GRANTED CONTR.TEL.# -7-70 9 / CONTR.LIC.# VO l7 ZT H.I.C.# AR A � BUILDING RECORD 1 OCCUPANCY 12 S--- '- INGLTFAMllY 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 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW-D _ PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. E'M'T' AREA _ '/ 1/2 3/ FIN. ATTIC AREA _ N_O B M'T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS 9 FLOORS CLAPBOARDS vB 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDVV D _ ASBESTOS SIDING COM/KAON VERT. SIDING ASPH. TIL _ STUCCO ON MASONRY L• _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 6 FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING h STONE ON FRAME _ SUPERIORI� POOR _ ADEQUATE NONE 5 Of 10 PLUMBING GABLE 1 IP BATH IX. 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 P TILE FLOOR TILE DADO 6 FRAMING A 11 HEATING WOOD JOIST V 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 i 2ndELECT IC Ist (fJ� 3rd11 NO HEATING _ F NORTy • Town of _ Andover �� rn o' s LAKE dover, Mass., 19 A 9�'cocHICHEwICK ��'1• '9 Aoq�T E D-,��-PA��,PEM%k ERMIIT- . T •(� - S � BOARD OF HEALTH Food/Kitchen Y......................D...7................... Septic System THIS CERTIFIES THAT.. ................ BUILDING INSPECTOR ...................................................S... ............ Foundation has permission to ere !9�0.[......{OxIS buildings on .......-JS . -.!_&E 7— Rough tobe occupied as....................................................... ....... f A..�.�./,/.,d.^�. .......................................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Final Buildia-igs in the Town of North Andover. VIOLATION of the Zoning or Building Regulations Voids this Permit. PLUMBING INSPECTORRough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR Rough ................................ ..... ... . ...... ................................................ Service LDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough No Lathing or Dry Wall To Be Done Final Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT [Burner reet No. Smoke Det. Y FORM U - VERIFICATION 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 section***************** APPLICANT: L#arA Phone LOCATION: Assessor' s Map Number Parcel Subdivision Lot(s) Street 6 St. Number — S_ ********************* *Official Use Only************************ RECOM E DAT NS OWN AGENTS: Date Approved �A f/ Conservation Administrator Date Refected CommentsWitt w 16' �iw e af, ��• ok Date Approved _ Town Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected Date Approved c3zjz/� Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections - driveway permit vG 1 Fire Department �e_. �r .r 6 d�CS,64 e� riJ l�C c�a-t'?c,c? .c.t n�.•.-t z Y a g 7 Received by Building Inspector Date r � /Af SO,{ vUUU vV 1 � � OII � II sol r '>I.N � iaJ3S -, Location QIP �r No. Date r N°RTS TOWN OF NORTH ANDOVER „ Certificate of Occupancy $ * Building/Frame Permit Fee $ • °,�< ,' • s " Foundation Permit Fee $ t sAc►+usE Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ F TOTAL $ F Building Inspector 09/07/95 12:39 15.00 PAID � '3 pry l 8 [ 01 Div. Public Works PER111T NO. APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 MAP 4-40. LOT NO. 2 RECORD OF OWNERSHIP DATE BOOK ;PAGE ZONE SUB DIV. LOT NO. OCATION L.I �.`- RPOSE OF BUILDING ` OWNER'S NAME Ct-fi LQ�.� In NO. OF STORIES SI NER'S ADDRESS Ty Lf_ 1C. �11 _ _� St7 BASEMENT OR SLAB ARCHITECT'S NAME �.C� J SIZE OF FLOOR TIMBERS IST 2ND 3RD ILDER'S NAME at- C"f- SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS aTANCE FROM STREET i 2O POSTS TANCE FROM LOT LINES - SIDES "1f 5+ 4et- REAR ZQ�' " GIRDERS AREA OF LOT �+ FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND 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 LAN COST SEE BOTH SIDES ST. BLDG. COST T©O PAGE 1 FILL OUT SECTIONS i - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 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 r /PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED Y� wuILDI NSPECTOR SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE -... OWNER TEL.# y� ZAS ^+ PERMIT GRANTSJ �j CONTR.TEL.# 19 y� CONTR.LIC.# H.I.C.# ��1 Gtkv-*-LctLq BUILDING RECORD i OCCUPANCY 12 SINGLE FAMILYS-ORIES 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 —I 8 INTERIOR FINISH CONCRETE d 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 AREA _ y, 1/7 '/ FIN. ATTIC AREA _ NO BMT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS 119 FLOORS CLAPBOARDS 8 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH ASPHALT SIDING HARD",'D ASBESTOS SIDING COMMON VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR I_ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I� POOR _ ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH (3 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 _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM ' STEEL BMS. 8 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 NORTH OW1. Of � �r 6Andover D No. ? Tor ndover, Mass., �0 19R coc HICnE_Icn 1 �A0RATED PP�\�'�� BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System q t BUILDING INSPECTOR THIS CERTIFIES THAT..�O.tagj�... .. QA......./. .J.................t-sL?.................................................................... Foundation has permission to erect..SH-0.6.................... buildings ...... ..g. ............ .......s�?T.......................... Rough to be occupied as...!0 . '" .....V 1. .i... .. . .....c6f- ............................................................................................ cl�i�t,ney provided that the person accepting this permit s II in every respect conform to the terms 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. Rouge, Final PERMIT EXP 6 MONTHS ' UNLESS CON TR T' ELECTRICAL INSPECTOR Rough ..... .... ... .. .. ... .. .. ... . ............. Service LD­ CTOR Final Occupancy Permit Required to Occupy Building Y GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT {/ INI Ai _ x= �eC oL�ATlON TEST-1 .« • � _ W_. aY. .� _ _ .. .. .. DEEP 7E.rr /m/T .. • .•• ••••••.. �.. v���rvr11Y1(Print a ^rru4,o%4 au �1 ruin rr-nm11 1 u uv r L.0uu ivrQ . 1YP41 , NORTH ANDOVER, Mass. Date `r 41 w „.10 BuIldlna Location . J Permit * 3 3 7 Owner's - ? Name / New O Renovation Replacement Q Plans Submitted: Yes p No p� FIXTURES J se } u° i s s s � s � s IL X s w o w < s ■ N < w s s s w w s a �e E Y • • a 66 ve ■ 1 s IL rr w >r /� � s O • t 1 s ■ O sus—ef11T. . fAftMaNT 1fT FLOOR IN0 FLOOR 810 FLOOR 4TH FLOOR ITN FLOOR eTN FL00R TTN FLOOR eTN FLOOR Check one: Certificate Installing Company Name <' �'±2 / f l / Address 1-7'Ir A/, .,�� ,.. ❑Partnership Firm/Co. Business Telephone "J Name of Ucensed Plumber INSURANCE COVERAGE: eC ode I have a current liability Insurance policy or Is substantial equivalent Yea t!-Y No ❑ If you have checked yam, please Indicate the type coverage by checking the appropriate box. A Ilabllly insurance polcy O , Other type of Indemnity p Bond 0 OWNER'S INSURANCE WAIVER: I am aware that the Iicenies does not have the Insurance coverage required by Chapter 142 of the Masa. General LAW$, and that my signature on this permit application waives this requirement. Check one: sionatufs o K Of owners en Owner ❑ Agent p I hereby corilty that al of the delals and Information I have submitted for entered)h above tion are true and&=crate to the best of my Mnowiedp e and that al plumbing work and Installailons performed under the p rmft Issued for a application wfl be In compflance with all pedinen wovislons of the Massachusetts State PfumbkV Code and Chapter 142 of Vw al Lowe. 11y • THIS e o a um r Cttyftown Ucanse Number O�v MPtMD(OFFICE USE ONLY) Type of Pkimbin0 License: Master t Journeyman ❑ - Date. .�r. .�. 3337 I r +o TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING SSACHUS� 4 i � This certifies that / . .� . . . . . . . . . . . . . . . . has permission to perform . . . . . plumbing in thebuildings of . at. . . .�a- . ," ��. North Andover, Mass. Fee. .�( . .Lic. No.{. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR 05/15/97 15:28 40.00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer