HomeMy WebLinkAboutMiscellaneous - 5 Foulds Terrace Date. . 9-
ORT fi
•D M 1�a TOWN OF NORTH ANDD VER
PERMIT FOR PLUMBING
,SSACMuSE�
....., �.
This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . .� . . . .
has permission to perform.. . .... . . . . . • . . .
plumbing in the buildings of . . . . . . . ...1-. . .!.-.- �. •
at
. . . . . Andover,, North Andover, Mass.
p 1 �
FeeQ) . .Lic. No. j �/;�
��~A MBIA INSPECTOR
VV
Check .N
818
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
'City/Town NO RTH A!0 d U UL MA. Date: Permit# C 10127
6
Building Location:�0 UbiOS /�/P/��L'E Owners Name:NG. aoue /TDUS/N9` *74
Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential [300"
New: ❑ Alteration: ❑ Renovation: ❑ Replacement: &J-/ Plans Submitted: Yes❑ No❑
FIXTURES
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SUB BSMT.
BASEMENT
1 FLOOR
2 FLOOR
3 FLOOR
4'r-FLOOR
5 FLOOR
6 TH FLOOR
Pr-FLOOR
8 1H FLOOR
Check One Only Certificate#
Installing Company Name: Rom'01410-P
r �Corporation
Address e��y s S�ity/Town:�Q1� E 9 L State:M8
Q p
El Partnership
Business Tel:7 Z&�� I&/ Fax: 97A 2 740 YS
❑Firm/Company
Name of Licensed PlumberAqui, 0 Hop, P
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 %j Other type of indemnity ❑ Bond l►
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 Owner's 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 compliance with all
Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
By Type of License:
Title Plumber ignatur of License P ber
City/Town [?Master License Number: 9 ��
APPROVED OFFICE USE ONLY ❑Journeyman
yol4D CERTIFICATE OF LIABILITY INSURANCE OP ID CE DATE(MM/DD/YYY9)
—r DAVID-3 08/11/09
8 11 09
PROD ER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Byam Bros-Mahoney Insurance HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
191 Pawtucket Blvd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Lowell MA 01854
Phone: 978-454-2926 Fax:978-937-0745 INSURERS AFFORDING COVERAGE NAIC#
INSURED INSURER A: Mountain valley Indemity Co.
INSURER B: Guard Insurance
David M. Murphy Plumbing INSURER C: Commerce Insurance Company
Heat & Gas Fitting Inc. P y
3 Chambing ers Street INSURER D:
Lowell, MA 01852
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING
ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
LTR NSR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY
L CY EXPIRATIO
DATE MMIFEC DATE MM/DD/YY LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1000000
A X COMMERCIAL GENERAL LIABILITY 320-0022545-06 05/15/09 05/15/10 PREMISELIAMAIJIS(E.occurence) $100000
•
CLAIMS MADE X OCCUR MED EXP(Any one person) $5000
-PERSONAL&ADV INJURY $1000000
GENERAL AGGREGATE $2000000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $2000000
POLICY PRO-
ECT LOC
J
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT $1000000
C ANY AUTO 08MMZX1488 09/12/08 09/12/09 (Ea accident)
ALL OWNED AUTOS BODILY INJURY
X SCHEDULED AUTOS (Per person) $
X HIRED AUTOS
BODILY INJURY $
X NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE $
(Per accident)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $
A X OCCUR EICLAIMSMADE X20-0028029-04 05/15/09 05/15/10 AGGREGATE $
HDEDUCTIBLE $
X RETENTION $10,000 $
WORKERS COMPENSATION AND TORY LIMITS I X I ER
EMPLOYERS'LIABILITY
B DAWC911326 10/17/08 10/17/09 E.L.EACH ACCIDENT $1000000
ANY PROPRIETOR/PARTNER/EXECUTIVE
OFFICER/MEMBEREXCLUDED? E.L.DISEASE-EA EMPLOYEE $1000000
If yes,describe under
SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $1000000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS
CERTIFICATE HOLDER CANCELLATION
TOWOFAN SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
Town of North Andover IMPOSE NO OBLIGATIOyy qq L OF Y I P T fy$ BE I7S QCLBNTS OR
120 Main Street )s m-XI �R � �<:ta� NL�..C.
North Andover MA 01845 REPRESENTATIVES.
AUTHORIZED REPRESENTATIVE
B am Bros
ACORD 25(2001108) m, � .k2",=�a ACQ .,MPTION 1988
.vs.LY:..iY
N° 2 E 5 9 Date/.—.
`N2
f NpRTM q
TOWN OF NORTH ANDOVER
a r
PERMIT FOR WIRING
SACMU
This certifies that .....t :�`��''�^. '
has permission to perform .....................
wiring in the building of./Y7 :. .!..... �-^ ° " ... ?_-_`
`J �!��-P ear ` — %
at....................................................... .... ,North Andover,Mass.
Fee
..CIE/
....... Lic.No............. . .;.yam'.........................................
J ELECTRICAL INSPECTOR
Check #
WHITE:Applicant CANARY: Building Dept. PINK:Treasurer
\ THECOMMON E4LTHOFMA5SAOHiSETJS OfficeUseonly
DEPARTMWOFPUBLICSAFM Permit No.
BOARD OFMEPREVEMONRWULATIOAND7CMR120 �� J
Occupancy&Fees Checked
APPLICATION
FOR PERMIT TO PERFORM ELECTRICAL 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
Town of North Andover To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location(Street&Number) 5 F-00 t-05 TeitRAC�
Owner or Tenant AV►oo'lle . liA60*t-1C0 A-,Tr1i0Rt'TX
Owner's Address
Is this permit in conjunction with a building permit: Yes[2rNo (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Overhead Underground No.of Meters
New Service Amps/� Volts Overhead Underground No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work ,15" P.-0401Z REA0%JA't10 JV 4 >E "41DIC.AP 43447-44
No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total
KVA
No.of Lighting Fixtures Swimming Pool Above Below Generators KVA
ground ground
No.of Receptacle Outlets ' No.of Oil Burners No.of Emergency Lighting Battery Units
No.of Switch Outlets
No.of Gas Burners
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 Local Municipal Other
Connections
No.of Water Heaters KW No.of No.of
Signs Bailasis
No.Hydro Massage Tubs No.of Motors Total HP
OTHER ��15TA�t t.J�Q t r16 F o(2 1.1A�D 1 cq P c D $A'T•K QE.P►AC.� e,Xt Stud 6
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IrstaartoeCo�aa�Ptd5lTc11YtD1het9C]1ID0T19tiSd319d��'1H13c11Laws
Ihaw aa>itatUbildylr>Fd=PoliYHim tgCar#* Cota'aW Its�>tiala0mleit YES NO
l homes bnftdwMptoofof btheOffie YES If}cuha\edwdWYES plemmdc*thetypeofoo�aagebydxckirgthe
WSURAI BOND 01NER M (PIeweSpe*)
E timAdvaluedUedncalwotk$
Work IDSW •0 1 , hq=tionD*-RgxsW Ra# Final
sigtted uttderTr Rndties of
FIRMNAME Ccd �,L�LTR 1 C LiMWNa 15 a S 3 A
Lioalsee �F,- S ACOA Sigrattae ---- ,._ LioerseNo 3 b 00�
BtsirmliidNo. 663 635 30iZ
Addres4— _Ze_"_ �tt� Pt�ty4rt i�1 K o3a7b AiTeL% to03 770 33%t
OWNER'SMURANCEWANFR;IamawaretlrattheLicarsedoesnut theatstra>wwveaWorilsRkSW aleqvalalt3Sm WbyMmmdlsettsCienaalLam
and tltat my sern the p�app6c�ian wanes this rec�mattrnt.
(Please check one) Owner Agent Q
Telephone No.
PERMIT FEE
Date%
N2 4611
-14,0 TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
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,SSACMUS�
1
This certifies that . .
. . . . . . . . . . . .
:.tea. . . . . . . . . . .
has permission to perform . . . . . . . . . . . . . . . . . • •
14 plumbing in the buildings o> •F-^ • •-� <� ! '�
� O
at North Andover, Mass.
Fee3P. . . . . .Lic. NoA/4',f- . .. . ✓ . . . . . . . . . . . . .
P�,Um v G INSPECTOR
Check #
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer
21�?, 6�
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING '
(Print or Type)
1,oa 0VWO- Mass. Date___LQ . ,� — ,L®00
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City, Town permit #_ G
a Building [:pe
ner ' s
AT: Location Gy4bs rwt 4e&- me_ ArW w
F
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AVS W ep 40"dsh* a ry
ofoccupancy: �o�� y.v�ry
New ❑ Renovation ® �Replacement CENT�rtt
p � ,
Plans
FIXTURES Submitted: Yes ❑ No
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SUB—BS MT.
BASEMENT
1ST FLOOR
2ND FLOOR
3RD FLOOR
4TH FLOOR
5TH FLOOR
6TH FLOOR
7TH FLOOR
8TH FLOOR
(Print or Type) Check One: Certificate
,Installing Company Name -ROBER-T W. `CRVI NE 5014S, 'IQC• E� Corp. 2014 Lo C,
Address St ALLEY S`t
❑ Partnership _
LY►a m MA 01 RO Z - 4 4 4 ( ❑ Firm/Company
Business Telephone -7151 - 5%1 - 04(04 Name of Licensed Plumber or Gasfitter
'TERRANU M .SMONh
I hereby certify that all of the details and information 1 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 Massachusetts State Gas Code and Chapter 142 of the General Laws.
I have informed the owner or his agent that I do not have liability insurance including completed operations coverage.
Signature Owner/
I have a current liability insurance
to e policy to include completed operations coverage. (�
By
Signature of Licensed Plumber
Title
City/Town Type of Plumbing License
�0Da [Z Master ❑ Journeyman
APPROVED (OFFICE USE ONLY) License Number
BELOW FOR OFFICE USE ONLY w
FINAL INSPECTIONS SKETCHES PROGRESS INSPECTIONS
FEE
NO.
APPLICATION FOR PERMIT TO DO PLUMBING
NAME &TYPE OF BUILDING
LOCATION OF BUILDING
PLUMBER
MOBERT W 'XRVINE F Sor.IS INX.
r PERMIT GRANTED
DATE 19
PLUMBING INSPECTOR