HomeMy WebLinkAboutMiscellaneous - 51 BUCKINGHAM ROAD 4/30/2018/ 51 BUCKINGHAM ROAD
2101015.0-0017-0000.0 - - --
Lobation v
No. � -�� � Date
Y
at;;°"';�tio TOWN OF NORTH ANDOVER
3? ' ' o�
p Certificate of Occupancy $ `U• y Q
Building/Frame Permit Fee $
Foundation Permit Fee $
JACNUS ,0� %. ,q
~d Other Permit Fee $
S0 Connection Fee $ ............ -
0 � Water Connection Fee $
TOTAL"
? Building Inspector
Div. Public Works
Date ............,��..............
NORTII
S,°� TOWN OF NORTH ANDOVER
' PERMIT FOR WIRING
CHU
This certifies that .`4.:... - --.0 ............................................
has permission to perform,-` .............................................
wiring in the building Of... ..................................:..
at. /1........... - .� ' ,North Andover,Mass.
Fee ... ...... Lic.No-��...;�'�/ ........... ` —...
ELECTRICAL INSPE R� v
Check #
8591
/� &i huh Official Use Only
l.o,yi.,�ncvea ol a�dac e� O
cc�� c7Permit No. 69.5
'
eCJePartmzrat o�Jireervle26
6'ccupancy artd Fee CheckedS
`^ BOARD.OF FIRE PREVENTION REGULATIONSjRev:1,10711-1
(leave blank) i
APPLICATION. FOR PERMIT TO PERFOR -ELECTRICAL M1,O K
All work,to be in accordance with the Massachusetts Electncal Code(NEC),M CNa 2.00
(PLEASE PRINT IN IVK OR TYPE ALL INFORMATION) Date
1 To the Ins eetwr, � F
City or Town of: ' �r"Jt` '°3. t�[� 1�.. (s p ofWires:
By this application the undersigne gives notice oi-his or her intention to perfprm-the e.(ectriCal work described below.
Location(Street&Number)
Owner or Tenant P� u 11 tr'� `� Q� a 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 Serviced Amps /2 `? 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 df thefi6llowing table toy be waived by the Inspector of Wires.
No.of Recessed Luz ihmires NO.of Cei.l,-Sus i. addle Tans
No.of Total
l (1' ) '!'rfi�rnrcrs TjVf\ •
[""o. (if i,uziiiizs,iie0iiticts-- - - NO, oflJot'Jlibs (:rciici-ators .1
-----:- ---=-- ---------- -=----=--=---'A=l Jai_.--- );o.oz`1!;isi.ri-tciicy �jlin.;--------
)o c.
No, ofLuzniizaiies ;�`rviiii,uiz1g1'gn1gna. : — z,xitl.
° No.of Receptacle Outlets °'No.of Oil Burners. FIRE ALARMS No.of Zones
No.of Gas Burners
o.of Detection and
No.of Switches •Initiatin Devices
No.of Ranges No.of Air Cond.- Tons No.of Alerting Devices
No..of.Waste Disposers eat Pump Number ons No-of e - outame
P Totals:I"' Detection/Alerdng Devices
al
No.of Dishwashers Space/Area Heating KW Local[IConne cion E] other
Heating Appliances I{Rt Security ystems:
No.of Dryers No.of Devices or Equivalent
ro.of Water KW o,o o.of
Data Wiring:
Heaters Si s Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP a ecommunications wing:
No.of Devices or E uivalent
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 NEC 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 14 BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIIZNI NAME: Lo
LIC.NO.:3 Glc/ "CC.
Licensee: S`�A�-'e. Signature LIC.NO.:
(If applicable enter " empt"in the license numcer line.) Bus.Tel.No. ` w `�7
Address: D Alt.Tel.No.:� ��' 73�
*Per M.G.L.c. 147,s4 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 agent.
Owner/Agent
Signature Telephone No. rPERi�IIT FEE' "
1 Date.
'f
NORTh - N
f Of
of '` TOWN OF NORTH ANDOVER
r'
PERMIT FOR GAS INSTALLATION
s i
S
This certifies that . . . . . . . .i c!'.
y
has Permission for gas installation /-5; .
in the buildings of . . . . . . . . . . . . . . . . . . . . : .
at `. , North Andover, Mass.
FeO . . . . . . Lic. No..1.C?9.`.! �p,•�l
'GAS INSPECTOR
Check# p r
f
6694
MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FrrMG
(Type or print) r� 17
NORTH ANDOVER, MASSACHUSETTS : Date 2 —Zl_.o
Building Legations
Permit# 41
Amount$ L –G.
Owner's Name
S ✓V
New Renovation Replacement D Plans Submitted
w U a
w-j Mx x O = y x F
EW.. 0
W Z
x z F
w z U w r„ z CdF p a > W
C7 F Z (. x w OG w F F `..
z w > a z0 z o z w .a W
m o x LIZ:
0 0
U u a° >
SU B -BASER ENT
BASEMENT
IST. FLOOR
2ND FLOOR
3RD . FLOOR
4TH . FLOOR
{ 5TH . FLOOR
6TH . FLOOR
7TH . FLOOR
8TH . FLOOR
(Print or type) J
Name 7`0/�e— Check one: Certificate Installing Company
/ / �0 / 13 Corp.
Address 1✓L
Partner.
��= 0 0 3 Qy
business Telephone
Firm/Co.
Name of.Licensed Plumber or Gas Fitter Q
INSURANCE COVERAGE
I have a current liability Insurance,policy or it's substantial equivalent. Check one:
If you have checked Ys,pleEyielate the a cove Yes LJ No 13
typ rage by checking the
a
Liability insurance policy Other type of indemnity �-appropriate box. Bond
L.J ❑
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.
i
Signature of Owner or Owner's Agent Cheek one:
er
hereby certify that all of the details and information 1 have submitted(or entered)ed)in above application 13
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in the
compliance with all pertinent provisions of the Massachusetts State Ges
Code aud Ch ter 1 of the General Laws.
By: nature of Licensed Plumber Or Gas Fitter
Title Plumber 0
City/Town,
❑ Gas Fitter License Num er
1 aster
_ APPROVED(OFFICE USE ONLY) ❑ Journeyman
Location v 04 -
No. Date
NORTH TOWN OF NORTH ANDOVEF
Certificate of Occupancy $
a
°
Building/Frame Permit Fee $
1'7b�•••° '<� Foundation Permit Fee $
SSACMUSE D
ao
Other Permit Fee,5106-e $ —
Sewer Connection Fee $ —
_ Water Connection Fee $
TOTAL $ -S,
V Building Inspector
128 .85 Div. Public Works
Location
No. l f"I J Date
't
�oRT� TOWN OF NORTH ANDOVER;
0
:
1 oS Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $ f�
s�cNust
E Other Permit Fee f $
G
Sewer Connection Fee $
Water Connection Fee $
TOTAL $
Building Inspector
r $
Div. Public Works
i
11PAtMIT NO. [ APPLICA` I( " ICOR 1111,11 \11'1"1'O 11U11,1)********NOI T11 ANDOVE,1z" MA
AI\1•Nt). `—_- � L111.N(). ------ 2. iu( mmot (N\•NI It SIIII• OA] I• 1100K (':\(:V "
/t lh t. SIM hl\'. 1(11 mi.
' PI11tIY CSli l N Iilfii•HtfdP�: ' � __� -
111 1111)N v
t \NIKSNA ,L NO. N SiN1ES SIZE, —� -----
j triVN1:R�SADI)H�SS _ BASEML, ORSI.A13 -
AH( I III E("1•S NAME /) �D `6 5173:tx Il(XN2'IIMBEHS
1)1111 DI:K•S N.4hti: /��-��. �� `��� SPAN - --. —
DIS I ANNE I O NL-AHES I BUILDING _ � DIMENSIONS 01 Sit I.S
DIS I ANCL I ROM S I RI+V DIMFNSI(NJS(NPOS I S
DIS I ANCE I-HOt l 1.01 LINES-SIDES REAR Di,1FNSI()NS OF GIRDERS
All
AREA OF LOT 1H(NJIACAE IILI<ilI oF FOtINDAIION TIIICKNESS - —
IS BI111.DIN(i NEW SIL1.Cx I I XA IN(; X. ----
IS BUILDINOi Ai_T"E RATION IS UUII.1)INO;ON SCX.IDOR FII I ED LAND
\\'1(1.8l)iLDIN(i C(NJFO(IM TO Rli(1l IIREMFNI S(X COI)E IS Hl 111.011,10 C(NJNECFED IO 1 OWN WAI FH
Bc)ARD(N APPi=A1.SAC1lCNJ, IF ANY. ISHIM-DINGC(NdNEC1l:1)Il)I()wTlSI WUR
S fH ill.1)I NG,C(NJNECf ED 10 NA FURAL GAS I.IN(i
IN51ll("IIONS 3. 11ROPERII• INFORNIAI-ION LANUCOS F
ESI. 81.1)(;.COSI
vma: I FII I.(Ni(3EC-11(NJS 1-3 LS 1. U1.1 X;.COSI PLR SQ. 11. --------
ES1. Blix;.COSI PLRRlxx.1 _ --
EI F'CFKIC'MI:FERS MI IST BE ON 0(11 S I DE OF 13UI I I)lNG SEPI IC 1110,111 NU.
A -1 ACI IE1)(;AllMit:SMI)STC(NJF(mNi mSFATEIIRERE(ilILA IU)NS a. Al,I,ItOvED 81':
t...
i
PLANS MUST BE 111 ED AND APPROVIA)BY 131111.1)ING INSPFUMH UlMAO/INS111-1:1 OR
i
DA It. , :I) l ® OWNERS*1uI 7g4-070 }.
('()N I R.I I I N - -
&TAMApo
iNAll 01i( Fll1\' 1:10(41 At I I I I0IU/I:D AGO N I
IIV
1.1 I0M11 (MAN 111.>/� 19 --- -,-
T.7vvv %J I ti r ` 111%j rtILSL.,t-1 i v i y v rtt�v �r �— it
Permit
A building permit is required for the installation of any solid fuel burning appliance. The building permit and
installation inspection are limited to the stove installation and-not to the stove construction.
Stove
..: A. New ` `e Used
B. Type/radiant `P Circulating
C. Manufacturer QW1b, , M Lab. No.
Name/Model No. Collar size
Dimensions/Height `t ' Length `j,' Width
Chimney
A. New Existing
B. Size(flue area)
C. Other appliances attached to flue(Number and flue size)
0. Prefab(Manufacturer—name and type) "
E. Masonry/Lined Flue liner
typ•b manwacturorr f
Unlined
F. Height(refer to diagrams) cap
r
I
OVER, IC
3' tIN.
Mlty
8
n HEARTH
CHIMNEY HEIGHT
Hearth(non-combustible) Z_ x LVD"A. Materials
B. Sub-floor construction
C. Minimum dimensions(refer to diagram)
Clearances and Wail Protection isee stove inStallaticn c,earances chart)
A. Type of wall protection provided
B. Clearances(refer to diagrams)
l
i
FIREPLACE CORNER WALL;CENTER
13
34 f REGULATIONS
f
E
After obtaining the permit,there are three is in the stove installation process to
consider. First, the stove; second, the chimney; r he actual installation.
` First: All new woodburning stoves inst� assachusetts must be tested and
approved to U.L. 1482-and/or U.L. 737 as apprc. ed stoves may be approved by the
building department or the fire department. Eve I-burning room heater shall bear a
permanent and legible factory-applied label con east the following information:
1. Manufacturers name and trademark
2. Model and/or identification number or ince
3. Type of fuel(s) approved
4. Testing laboratory's name or tradema; ,tion
5. Date tested
' 6. Clearance to combustibles
}
a. Side
b. Rear
7. Test standard
8. Label serial number
Second: Existing chimneys should be. c 7r the presence of a flue liner and
general structural condition. A smoke test may t' determine if the draft is adequate, if
the flue is without obstruction and if there is at leakage. A visual inspection of the
y f chimney is needed to check for creosote deposi! cracks or breaks, and if the damper
is in good working order. The following two at :d to the chimney are important to
t inspect. The area where the chimney penetrat( the floor of ceiling joists should be
h checked to be sure that there is at least two incl -ice between combustible materials
and the chimney.
Third:Chimneys and chimney connector: istalled with the required clearances
i (see installation clearance table). The connects e sloped upwards toward the chim-
ney and the connections overlapped upwards t- --reosote leakage. A two inch clear-
ance shall be maintained where insulated pipe pi combustible wall, unless it is tested
and approved for lesser clearances.
A non-combustible hearth must be provid :oyes have legs and allow air to pass
below; if the legs are not present, an air space e non-combustible hearth must be
provided. Clearances vary with circulating and ves. In general, a non-combustible
shield should be installed with ventilation behind r clearances, no protection for large
clearances, and if the wall is a concrete foundati minimum distance may be allowed.
The following systems have been approve onstruction Material Safety Board:
Permaflue, Air Krete, Smi Exterior Insulation an stem, Supaflu, Thermo Crete, and
IsoKaern.The code requirement for two inch a exempted from this type of lining
because of its high insulating and refractory qt
5
i
Nov- 16-98 ,10: 54A Home and Hearth , Inc 603-926-2084 P . O1
i
w"t4M r..WILD ®sari� 0,&0 - ✓ KeMAW Tsvnuba
Otwtroar o2fa Cltahhewt
THOMAS C. WON% (f1Y)73T�9Z00 THAMAA R OVU
$41n art
LARRY P. GIORDANO
c.r.stsdOtMr SOLID FUEL. BURNING PELLET STOVE V1T
FOR PELLET STOVE.,SATMMNG 'NEGATIVE PRESSWX 7T fM(;
(REQUIRED IN ORDER TO OBTAIN A BUILDING PERMIT TO WSTAJL SUCH PELLET'STOVPS)
J
'fa the 511114 Boned of BRildiaj 1Rmgt►t111oea sed 5tandardr Date AuS. �,19,,Q 5
Tit.I GLOxcQ HQn11+an a tab unen
oetxeoifol HARMAN STOVE COMPANY
a winvowturer of sotid fuel burning pst*sioves/iteaterW&O Pita inacrta(eirc164P 1C utm}
r
t~eroly asjgJ r that the toNo Ang pellet he►dag 11pj4111nft%by exylteil Model ldeatilkallon:
atodege� Pette,t Pnv 11 (repoe* enc{osed)
Invinck6te Pe.Ete,t btove 640U rslre�idy �ec�
{ rrc`dJ
Invincibtet Cy
r+raved
lwve bran!",or t (etrele appropriate inforwatlon)per the ncSativo prtuuft tut tequirameeu
of ehhor ULC 3677100 standard @366.1,or via mothoddmquirsw ats of otmitar fis ional> 911tldarda�bad round to
tatisty the appIkebW aiteris of ULC 9627AZA Standard 9366.2 or other natlonelly reoo6ntsed st Wert*aldltknft tNrrreaet did not
Dona situr Atria:nonaal of abnormal"tugttive prassurt`itattog,
MA>WACCURSR HARMAN STOVE COMPANV _
RlafiHD 1
TYPED OR PRINT NAME ABO;H G t o n i a H a i m art
TrML- T A e a 6 Unen �—
On trim 22nd day of August 10-1§then paraonsily oppon d tt rm as,the
rt�cve GLORIA HARMAN
naaad
and me&oath that the abavc statements by h1wher,are Imus.
89701kit M Noteutal Sam
Kerwin.W Pubbo
y r28
NQTjJ 5UC
MY COMMISSION E)11'IM:. Astpgad; IGONow*$ sill
SItBI3s APPR YES v date 0 f NO aete4
1'335-t)8-21 15 r 25 PAGE
I
Nov- lb-98 ,1O: 54A Home and Hearth , Inc 603-926-2084 P.O2
Installing
Place the stove on a noncombustible floor pro- 13"
tector and away from combustible walls at least as
far as shown in figure 2 and 3. Note that the clear-
ances shown are minimum for safety but do not leave
much room for access when cleaning or servicing.
Please take this into account when placing the stove.
Place the Room Sensing Probe in the desired
location and run standard thermostat'wire back to
the terminals on the back of the stove and connect •
with the two terminals provided. Unlike a wall ther-
mostat the RS probe can be placed anywhere and go ,.
unnoticed. We recommend the room sensor be in-
stalled even if only cut short and connected to room
sensor remote ports.
Connect the power cord to a 120 volt recep-
ticle.
Prior to installing flue pipe, connect draft and
meter to stove. (The draft meter must have a mini-
mum range of 0-.5). Connect stove to 120V power
source. Set control board to test mode. Record draft Fig, 2
reading here (should read at least .S").
After connecting the flue system, follow the
above procedure. However,prior to taking the draft
reading be sure all doors and windows to the home
are closed. Record the draft reading if this
reading is more than.1" lower than the unconnected
1" 2„
reading check for possible restrictions or the need —�
for outside air(see page S).
Mobile Home Installation
When installing the Invincible RS in a mobile
o
home it is required that the stove be bolted to the
i
floor. This is usually done inside the pedistal base 12' I
where the bolt will not be visible and requires drill-
ing a hole where it is best suited.
Fig. 3
4
Nov- 10-98' 10:55A Home and 1=feao^t5h, Inc 603-926-2084 P.03
Venting
A combustion blower is used to extract the com-
bustion gases from the firebox.This causes a nega-
tive pressure in the firebox and a positive pressure in
the venting system as shown in fig. 4.The longer the
vent pipe and more elbows used in the system, the
greater the flow resistance. Because of these facts
we recommend using as few elbows as possible and
15 feet or less of vent pipe. if more than 15 feet of
pipe is needed,the diameter should be increased from
' 3" to 4" because a larger pipe causes less flow resis-
tante. Be sure to use approved pellet vent pipe and r
wall pass through fittings.
Vent Pipe
Pellet venting pipe(also known as PL vent) is
constructed of two layers with an airspace between
them.This air space acts as an insulator and reduces
the outside surface temperature to allow a clearance
GF tocombustibles of orly 3 inches.The sections of pipe
lock together to form an air tight seal in most cases
11 110111 t 11 however,in some cases a perfect seal is not achieved.
\ For this reason and the fact that the Invincible RS
operateswith a positive vent pressure wespecify that
the joints also be sealed with clear silicone.
Outside Air
O =Positive static pressure
B= Negative static pressure Outside air is optional except in mobile homes
and where building codes require. The benefit of
Fig, w outside air is mainly noticed in small very tight houses.
To install outside air use 2" sch 40 plastic pipe
inserted through the back of the stove. The pipe
should be run outside and terminate 3 feet or more to
the side or below the vent pipe outlet. Never termi-
nate the outside air above the vent pipe outlet. From
the stove and through the wall the PVC must be kept
3" from PL vent pipe.
HRV
When installing in a house with a Heat Reclaim-
ing Ventilation System (HRV)be sure the system is
balanced and is not creating a negative pressure in
the house.
5
The Harman
46 •
STOVE
COMPANY invmcl* bleSeries
Specifications:
INVINCIBLE RS INVINCIBLE INSERT
Weight 410 pounds 354 pounds
Blower size 134 cfm 134 cfm
Hopper capacity 65 pounds 40 pounds
BTU range 7,000 to 55,000 7,000 to 53,000
Heating capacity 1,800 sq. ft. 1,700 sq. ft.
Fuel Bio Mass Pellets Bio Mass Pellets
Flue size 3 inches 4 inches
Outside air size 2 inches N/A
Fuse rating 3 amp N/A
Clearances and Installation
INVINCIBLE RS O INVINCIBLE INSERT
Your Harman Dealer Is:
HA�aN -• � - . .
STOVE • "
COMPANY j ` � �.. - . -�, - •
Town of ORIAL
T Andover
L` L
0
* Z i dower, Mass., 19
z
LAKE - yy��
'9A_COC CHEW '
.9 �q r D Pay
S BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT........ ..... .. �r� ��,
�. ....... ....... � Foundation
.... ... .. ... .. ..
.... .. . . Av .. ... .
b 'Idin .................... .. .a .. ... Rough
has permission to erect. i
.... S ........ .......... gs on ............ ................
to be occupied as .. /�� ........ Chimney
....... ... .......... ................. .....................................................
provided that the person accepting this permit shall 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. Rough
/ Final
�G PERMIT EXPIRES IN 6 ON S ELECTRICAL INSPECTOR
g UNLESS CONSTRU S T (� Rough
.................... Service
UILDING INSPECTOR
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Display in a Conspicuous Place on the Premises — Do Not Remove Rough
P Y P Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. .
Burner
Street No.
Smoke Det.
MASSACHUSETTS UNIFORM APPLICATION R PERMIT TO DO GASFITTING
(Print or Type)'
A /
U'£' Mass. Date 11-30 19 Permit # _ .. ,k( _
Building Location c'S/ Qu CK/A160l Owner's Name YoA/
vu�ty Type of Occupancy
/ y
lbNew ❑ Renovation 5L Replacement ❑ Plans Submitted: Yes ❑ No U
rn wvi
(YjV Z cc dJ
W W tL O 8CC = H N
l O W it
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QQ Z
� fA C7 W W = fO O U) O Cc > .W
W W W W Z W Q l.- 0 1.- _
W J Q = W W (� Q W LL W V J rn W
QW > EW , ZQ >- Q ° Z8ZCr ° � �
tL = O 0 2 u- C7 J 0O M W o a. FW- O
SUB-BSMT.
BASEMENT
1ST FLOOR "
2ND"FLOOR
3RD.FLOOR
4TH FLOOR
4
5TH FLOOR I
6TH FLOOR , 1
7TH FLOOR i
8THFLOOR I
Installing Company Name ( #AISMVyfpolt) db Check one: Certificate #
Address 36) M W SSC L 4 /r- ❑ Corporation
LAA_M'1 j(_W,a) . Al 4- 4 ❑ Partnership
Business Telephone �I? 4s� OGS}? �k Firm/Co.
Name of Licensed Plumber or Gas Fitter �,5/+wtCS 1A)III iS
INSURANCE:COVERAGE:
have a current It ability insurance policy or its substantial equivalent.which meets the requirements of MGL Ch. 142.
Yes INo ❑
If you have checked Yes, pleaseindicatethe type coverage by checking the appropriate box.
A-liability insurance policy. l Other type of indemnity ❑ Bond ❑ •
OWNER'S INSURANCE WAIVER: I am aware that tl:e licensee does not have the insurance coverage required by
Chapter 142 sof 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 installation performed under the 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.
By r Type of License: /
1-1 Plumber
Title I 1 Gasfitter gnature of Licensed Plumber or Gas Fitter
City/Town f J Master License Number
APPROVED(OFFICE USE ONLY) 11 Journeyman
i
r
f v _.10
3321 Date. ./. �.-.3.:f':�. . . . . . .
°QTS TOWN OF NORTH ANDOVER
pf •�ao ,a 11% '
PERMIT FOR GAS INSTALLATION
O �
f P
,SSAC14USEt
This certifies that . . . .�'/!�. 5. f. • � '':S"�'`•`¢• '•"� • • • • • •
has permission for gas installation !: .`. .!:• • • • • •'
in the buildings of . . . ? '. S .5.:�. . . . '•`: •�? c�e• -
at . . . :��!. � �' •�•!`Q` . . . . . . .... North Andover, Mass.
Fee. . . �.:. . Lic. No.. . .. . . .. . . . . . . .t-.. ... . : . . . .
GAS INSPECTOR
WHITE:Applicant CANARY: Building Dept. PINK:Treasurer