The URL can be used to link to this page

Home My WebLink AboutMiscellaneous - 57 GLENWOOD STREET 4/30/2018 / STREET 57 GLENWOOD 2101007 000.0 LczneBayStateGas A NiSource Company May 22, 2006 Elbeery Ramond Account Number: 6323520047 57 Glenwood St North Andover MA 01845 Dear Elbeery Ramond: This follow-up letter is to inform you that your gas H/H S/H located at 57 Glenwood St has been tagged due to a violation of state safety regulations. It is unsafe to use until the following condition has been corrected. Shut due to flood The Masachusetts code pertaining to the installation of gas appliances and gas piping, established under Chapter 737 Acts of 1960,requires that the condition be remedied. If you have questions or would like to discuss this issue, please call 978-687-1105 and ask for the Service supervisor. Please disregard this notice if the condition has been corrected. Sincerely, Service or Meter Department Bay State Gas Company CRR: CRR# C:\dsupdatedleg36ton Street P.O. Box 869 Lawrence, MA 01841-2312 978-687-1105 Fax: 978-688-1805/22/06 Date. . . . . '.(�� o' "��T:1tio TOWN OF ORTH ANDOVER PERMIT FOR PLUMBING ss�CHUsf� This certifies that/... . . . . . . . �y .�'�c.!��...��. .I. ��. .�. . . . . . . . . . has permission to perform plumbing in the buildings.of . . . . . . . . . . . . . . . . . . . . . . . . at .�. . .� : . . . . . . . . . . . . . . -� . . . .L�., North Andover, Mass. Fee/,1!41�. . . .Lic. No. . . . . . . . . . . . . . . . . G \PLUMBING�INSPECTOR Check # 7363 i MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date Building Location / rj L b✓Q Owners Name C Permit# Amount Type of Occupancy New 0 Renovation 1:1 Replacement jfp Plans Submitted Yes El No 1 FIXTURES F on rX a H F Fa: W SLRBM R4SRWW ISEKBM �D FIOQt 3RD ROIR 4M!=10C R SIH M 7M ff-- I gm (Print or type) i Check one: Certificate Installing Company Name 1.J� S��G� �\i�"6\1 -ty"1 ��^ ] Corp. Address E] Partner.' t.. S t n (31 Y Busidess Telephone CP-Firm/Co. ,a Name of Licensed Plumber. A YJ D"VI'(SSG Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box Liability insurance policy Other type of indemnity Bond ❑ Insurance Waiver I,thgAndersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner 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 ed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachus tate Ping Code and Chaff 142 othegral Laws. __ -• r By: tgna o icens umber Type of Plum Title g License City/Town37 License Numoer Master Journeyman APPROVED(OFFICE USE ONLY Date. ..c.X � rr NORT#1 TOWN OF NORTH ANDOVE • - PERMIT FOR GAS IMSTAtLATION h • �9SSACMUSEtt This certifies that�-... . i has permission for gas installation . ..+.! -. .;y . . . . . . . . in the buildings of . . . . .. .1 "`. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at `?7 . . . . .M . . . . .. North Andover, Mass. FeeAl.(°. . . . L'c. No./,'7 . . .�. . . ./. : . . . . . . . . . . J. i. GAS INSPECTOR v u Check# /L 5967 MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING (Type or print) Date NORTH ANDOVER, MASSACHUSETTS Building Locations 7 lam-�V1j �j 03 1 Permit# ca"14Owner,s Name Amount$ New D Renovation Replacement Plans Submitted D � a r� v� U oZwE � yy O z g z H u, x V w x z � e x a a w z d w E, F O > L H u w a x o x 3 a a ° > g F o SU B-BASEM ENT BASEMENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 9TH . FLOOR (Print or type) \ ��(� ) Ch k one: Certificate Installing Company Name_ ` �!JlC. l�j�y��1L1� IC � !jam 1�-- 1 � Corp. Address C 11`! 5 �'� �, ElPartner. usme s e ep one rm/Co. Name of Licensed dumber or Gas Fitter INSURANCE COVERAGE Check one: ' 1 have a current liability Insurance policy or it's substantial equivalent. Yes --? No If you have checked Yes,please indicate the type coverage by checking theappropriate box Liability insurance policy '' Other type of indemnity Bond 13 13 Owners Insurance Waiver: I am aware that the licensee does not havethe Insurance surance coverage required b Chapter Mass.General Laws,and that my signature on this permit application waives this requirement. q y Per 142 of the Check one: Signature of Owner or Owner's Agent Owner Agent t hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the ed 13 best of my knowledge and that all plumbing work and installations d under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts St fe G Co and Chapter 142 of the General Laws. By: Signature of L' sed Plumber Or Gas Fitter Title [3 Plumber i4�S-.7 City/Town [3 Gas Fitter License um er Master APPROVED(OFFICE USE ONLY) Journeyman Date... TOWN OF NORTH ANDOVER ` PERMIT FOR WIRING ,SSACMUSEt =L This certifies that ...�,E�2,t./�i,,�.r�, ....V��.t yo 6n j" Cc-"- has permission to perform .......... .. D . P ...... .. .... .. v wiring in the building of.................. addat.........5.2.......... ........... ................................... North Andover,Mass. ' Fee...Al..c...... Lic.No.../......... FILECTRicAL INSPECTOR f Check # 7339 �� Commonwealth of Massachusetts Official Use Only 7 Department of Fire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/071 (leave blank) 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: q c� `7 City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street& Number) Owner or Tenant W Telephone No.�►;J? Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No V1 (Check Appropriate Box) Purpose of Building Utilit thorization No. Existing Service Q0 Amps fes/ r01`fc)Volts Overhead Undgrd 11 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 Emergency Lighting rnd. ❑ rnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pum Number Tons KW No.of Self-Contained Totals .......... Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Munk'pal ❑ Other Connection No.of Dryers Heating Appliances KWSecurity 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. Hydromassage Bathtubs No.of Motors Total HP I Telecommunications Wiring: No.of Devices or E uivalent OTHER: r 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 covy6ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 1Z BOND ❑ OTHER ❑ (Specify:) I certify,under thepains and penalties o ury,that iejn�formjion on this applic n is true and complete. FIRM NAME: ! N LIC. NO.: Licensee: — ay�'�r� Signature LIC. NO.: (f applicable, enter `exem t"r�144licen'e number lin ) Bus.Tel. No.:977ckS Address: `� m o0l�< Alt. Tel. No.: *Per M.G.L c. 147, 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 agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ j i I 1 I s I ' ' A �,. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ' 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: 10 ��{�� < City/State/Zip: �' tt.1�^�t ` r Phone#: '761 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. ❑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. + 7• E] 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.E] Electrical repairs or additions 3.❑ I 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' 13.0 Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy infonnation. t 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 infonnation. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: MO-1dwc Policy#or Self-ins.Lic.#: Expiration Date: " Job Site Address: 0 q , � 4.di 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 overage verification. I do hereby certify un r t pa' and pe es of perjury that the on ormati inf provided above is true and correct Signature: Date: °aL3—0 Phone#: 9 7y 3LSz--&&00 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#: � . r-- C (,L S `Z � � � Z Date..7 �� Q..�r............. NORT►, TOWN OF NORTH ANDOVER O 9 PERMIT FOR WIRING SSA�NUS� This certifies that ... �. !�.�..... �. �. �. ............................................. has permission to perform ......r-�.AS... t!rt!!!.tt?? .. t3 f4./.(................... wiring in the building of... ............................... at.-5.q.... N..t�.dP..i4,..................................... .North Andover, ,�Mass. Fee..... ......... Lic.No LI 7'.l..p........................................... ....... / ELEcrRicAL INSPEC"MR cCheck `# 4 6 / 64 � Commonwealth of Massachusetts Official Use Only ' Permit No. 6 �T Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/05] leave blank) 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: '� • 0& City or Town of: pp,-rd Aytiaia&t' To the Inspe for of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street& Number) Owner or Tenant �p,ttGfPF 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 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 followin 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- 1:1 o.o Emergency Lighting rnd. 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 an Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pump Number Tons KW No.o elf-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances Kir Security Systems: No.of Devices or Equivalent No.o Water KW No.o No.o Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring. No.of Devices or E uivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of E ectr'cal Work: (When required by municipal policy.) Work to Start: j (p 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 , surance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cover ge 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: %C-V— Si"AAA ra-16, LIC. NO.: QJZ/ Licensee: PA-VP-t<--k<— p ��,��;,� -fir Signature e LIC. NO.: b�(,•f f� (If applicable, enter "exempt"in the license number line.) ^Bus.Tel. No.: ��a Address: G�t� (2 , >ooh.5: c p ,P� t,..,6e)Rut�' ��1A QHS/ , Alt.Tel.No.: *Security System Contractor License required for this work; if applicable,enter the license number here: 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. PERMIT FEE. $ L I ' I y 10 - 0 6 { 1 Date...J..� .. ... ....... Ile, AORT" TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING SAcmU This certifies that ...624-�- P'AJC5.... .......................... haspermissionto perform ... ......... Rwiringt4 in the building of...... ...... • at... -5 -7 6-t F/V Woob ............... ............................................................. North Andover,Mass. Fee..VA!::.�...... Lic.No..,57e:!�,:?-7.. ...... Check # 666 ,> a�rlucrmr�rx ur runaw:.w��rr �.�No. �/��e.BQARDO�FRREPREVFNII�AIVRDGULAT71A1kS3a7C RUIN IOCCUPOKY&Fees Checked .mmummmmmmo APPUCATTONFOR PERMIT TO PERFORMELEcnuCA.L WORK ALL WORK To BE PERFORMED Qr ACCORDANCE WITH THE MASSACHUSM EISCMICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL 11MRMA1I0N) 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 d:Number) 57 GLerJuva=� Owner or Tenant V m ELFx= Cz y Owner's Address < M�� Is this permit in conjunction with a building permit: Yes[3 No (Check Appropriate Box) Purpose of Building 'Re5i � Utility Authorization No. �. Existing Service C� Amps -2yArolts Overhead Underground No.of Metm New Service Amps I Volts Overhead UndergroundNo.of Me,tefs Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No.of Lighting Outlet No.of Hot Tube No.of Trutibrtoan TOW No.of Lighting R ma Switnndng Pool' Above Below KVA W KVA No.of Receptacle Outlets No.of Oil Butoeta No.of Emeryeocy Lighting Battery Univ No.of Switch Outlet No.of oas Banters :. No.of Ranges Na.of Air Cond. Total FIRE ALARMS No.of Zoaes TOW No.of Disposals Na Of Heat Total ToW No.of DeteW=etc! Po TOW KW Wtiadag Davina No.of Dishwashers Space Ata Heating KW t No,of SOuntlina Dodcas Na Of Self Castlabtd No.of Dryers Heating Devices KW Lad No. Manidpsl � Other No.of Water Heaton KW No.of No,of CwmectioW silme Bsibtis No.Hydra Mmap Tubs Na of Motors Total HP p�g,R• EiX1�CC Ci�CycT- �r�E� ��n cScoiJiJE� �A n-c �� G2C�� T� `Stec REcaNt�CrT�'� u1(=z�� c�C� 9AM A C, ttst�Co�a�t Pta�tbirerecfaesmrafli'Iasd>u�Gaa�lLaM Ihwact=sLAfthsa FbWmitdrVtCrnpktti orlssuhmnil r Ihvw&hrri kdveidpp afx=ioNeOf z YM hatetfi4ded YEKPksrei dc*lte heed 0 �XLYAW R GLRANCE W D rJ OM E�rn�dvalsofEMdd k$ WodttuSmR o6 inDrstRega�d 9/ZS6 q8WdU1krTrFkr2ftGrPW mill FEMNAME ticaeeNo u±o ss a � �� T s� �c� , rnq aao-7� Thi Na OW?�WSMRtANMWANIR,Ianawaethl tzU za At Td Na rdtMtrrp�sg�on�hbpamit �itealitaqui �a��`�0� 04��104"°dbl+l�s�cfisllsCetertllLaut� (Please check one) Owner C3 Agent ❑ Telephone No, per,FEE S �Ac 6 �� r Date........4.... .4.....Q.�� NORTH TOWN OF NORTH ANDOVER o ; p PERMIT FOR WIRING GNU This certifies that ........ t.42�!..- G/L................................ Goo 2 ' has permission to perform ................................................... wiring in the building of ..'........................................ S 7 f ec.v t r s�- at................................'................. ...................... ,North Andover,Mass. Fee.... �C..... Lic.No.eD.o2.8�........ i ...... ZAEI�iIC �� Check # 0 C4"v0� 675 Commonwealth of Massachusetts Owiranc\ Mid ITC Cht'�kQLI BOARD OF FIRE PREVENTION REGULATIONS Department Of Fire Services APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ICCO".1irc,�'A fill file 5 2 I'L L I.V Pv-%r t1A k 08 FYPE.I L L /�. FORI f I TWA',, Date 527(AIR I Ch or Town of: Xj C;Itioll the tilidersl", cd "]�Qs llk,licc of Ili,,or her intention to Iterti;rm Location(street & Number) JQL1ric;tI \ork de-,ci-llled Owner or Tenant Telephone No. Owners Address Is this permit in conjunction with a building permit? Yes E4"'l Vo ❑ (Check Appropriate Box) Purpose of Building—. 0-t--> W— Ltilitv Authorization No. Existing Service Amps i New_,Service .%mps Volts Overlivad n(I g rd❑ No. of deters Volts Overhead El Uridgird ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical \Nor C"m Y11(ji, lot: No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of 'Jai No.of Luminaire Outlets No.of Hot'Tubs Transformers K NA Generators KV,% iNo. of Liliminiii-es Swimmintj Pool a1110veFn 0 0 mergency ;"r" 7n ❑ llaitcry Units No.of Receptacle Outlets No.of Oil Burners No. of Switches FIRE ALARMS No. of Zones No. of Gas Burners No.of Detection and No.of RangesNo.of Air Cond. Total Initiating Devices roilis No.of,%lcrti"g Devices .No. Of Waste Disposers timber Fouls 1 K I Detection/Aderting Devices No. of Dishwashers Space/Area Heating KW flu I C I Local ElConnection0 Other Heating Appliances ',�,Y-S-ie,I-ins No. of DrNers No. of Water No.o KW No, Devices or Equivalent Heaters KW No.of Data WirinSi ns g: Ballasts NO.of Devices or lent Hydromassage 13athhifbs NO. of Motors rot.11 tlp Iclecommunications Wiring: OTHER: �'O-of Devices or Foluk Aent I-,tiinatcd V,iluc of FIcctl-ic,jI Ok lien f-c-quired IIN illurli6pal orkto ',t:ll-t: In:rcction.� to be \Sl-I-1.k N E COQ LR� in IC�:Uf*d;IIIcc 0th 'IEC Rule ji). Jild uponcompletion. !I() !,unlit tur tic 1-COGI-Illill'ILC'J 111:1t :i If t: fit. c !dress: Q>- F A at Ih., Ill ftt III bl.1, IlF %,i, r '� � � ��, o � �� . 1 f i Date.!- . �.(. . . . +o TOWN OF NORTH ANDOVER 10 ' PERMIT FOR PLUMBING a • �► +O++r�o'A�<5 b ,SSAC14USE� This certifies thatV has permission to perform . . . . . C.�` °" !`. . . . . . . . . . plumbing in the buildings of . .&kY A t.>1. . . . . . . . . . . . . . . . . . . . . at . . `j. . . . . . . . . . . . . . . . Nrorth Andover, Mass. C.FeOV `` Lic. No..? L .*'. . . . . . . . . << ,-1_�, . . . . . . v c L PLUMBING INSPE&bR~ Check # 020 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS BuildingLocation / Date 7— 6 v(p 7 Le/7 woo .� Owners Name YP.4ql 1vo Permit# Amount H,v �( ►Type of Occu anc New Renovation Replacement ® Plans Submitted Yes ❑ No FIXTURES /t'ice,SIS- o/v F z w w w z W N 3 z A a 3 Q A y �l� A d a M.FL" aru Rout -M]FOM 4MHJOM 51H HJDM 6M FL" 8II3 FIOQR (Print or type) Check one: Installing Company Name �� Certificate --� ❑ Corp. Address �� v l S �. Oy,►L Partner. Business Telephone Firm/Co. Name of Licensed Plumber: Q-V'\Q Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy ® Other type of indemnity E] Bond ❑ Insurance Waiver: I, the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner ❑ Agent ❑ 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 Massae se s [ate _Elumbi Code and Chapter I of the General Laws. By: 4, _. 31gllaLUM U1 Licenseuum er Title Type Of Plumbing License City/Town License ume� APPROVED(OFFICE USE ONLY Master ❑ Journeyman Date. . . .... . .. . N°RTM TOWN OF NORTH ANDOVER • - PERMIT FOR GAS INSTALLATION �,SSACHUSEtt This certifies that . . . .J).4. �. . . .�. .. ... . .. . . . . . . . . . . . . . . . . . has permission for gas installation . .P:cr-:.C. . . r?. {.<--- . . . . . . . in the buildings of . . t~.C .S ' .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . +a. . . . . . . . . . . . . . . . . North Andover, Mass. Fee. . 1:� v. . Lic. No.. J'f . . . . . . .j--. .� c . { GAS INSPECTOR Check# r 5547 MASSACHUSETTS UNIFORM APPLICATON FOR PERM TO DO GAS F MING (Type or print) Date '7— NORTH ANDOVER,MASSACHUSETTS / Building Locations _� 7 G l en w d oCi/ '10d/. Permit# �v fA 0 YU !; I 1 be-<, Owner's Name Amount$ New❑ Renovation ❑ Replacement ® Plans Submitted x w W a z Z x a O W W O a O W F � n H U � W FE W w F" U RS � � z � � o w � o w a > A a F• O SUB -BASEM ENT B A S E M ENT 1ST. FLO O R 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR F�- (Print or type) Check one: Certificate Installing Company Name S ��-��T\/ Corp. Address S/y J Ur7i J�r -5 1 Partner. Lo wQ_ll , a/?- Business Te ep one g _ S 4 9 _ -7--5Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes No❑ If you have checked}_es,please indicate the type coverage by checking the appropriate box. Liabilityinsurance ce olicY 13Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver: I m aware that the licensee does not have the Insurance coverage required by Chapter 142 of the M ss. neral ws, his permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ 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 Permit Issued for this application will be in compliance with all pertinent provisions of the Mass ch setts State Gas Code and Chapter 142 of eneral Laws. By: Signature of Licensed Plumber Or Gas Fitter Title ❑ Plumber oZD—3- q t y City/Town ❑ Gas Fitter 71cense um b er Master APPROVED(OFFICE USE ONLY) ® Journeyman 3559 Date... ...... .... ....... .... .... T#1 TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING -TS US This certifies that .'x:- has permission to perform ..,:. -.....r ........ ................ (% twiring in the building of............................. .................................................... at......5 ........................................... .................... ,North Andover,Mass. Ci Fee -.7.... Lic.No. ............... . ................................................ ELECTRICAL INSPECTOR Check # Official Use Only Permit No. Occupancy&Fee Checked C-113 BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00 (Please Print in ink or type all information) Date -,?-2— To the Inspector of Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number -57 U ��J 2�i .T Owner or Tenant R4 y Owner's Address S ll'i a-- Is this permit in conjunction with a building permit Yes ❑ Noj l (Check Appropriate Box) Purpose of Building &L-//L/�- V Utility Authorization No. E)isting Service Amps �Voits Overhead Undgmd ❑ No.of Meters New Service Amps Voits Overhead ❑ Undgm/d ❑ No.of Meters �) Number of Feeders and Ampacity /l�l�/�d�I� GilCT Fl��L �//C��. / l'�lT _�(� oO��an41'0 � <fA . Location and Nature of Proposed Electrical Work Total No.of Lighting Outlets No.of Hot fuse No.of Transformers KVA Above ❑ In ❑ No.of Lighting Fixtures Swimming Pool grnd ❑ grnd ❑ Generators KVA No.of Emergency Lighting No.of Receptacles Outlets No.of Oil Burners Battery Units No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone Total No.of Detection and No.of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No.of Di sal No. Pumps Tons KW No.of Sounding Devices No./of Self Contained I No.of Dishwashers Spa rea HeatiKW Detection/Sounding Devices ❑ Municipal ❑ Other No.of Dryers Heating Devices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Bailases Wiring No.Hydro Massage Tuds No.of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES= NO have submitted valid proof of same to the Office YES=�= If you have checked YES please indicate the type of cover by checking the appropriate box INSURANCE = BOND = OTHER = (Please Specify) (Expiration Date) Estimated Value of Electrical Work$ Work to Start--/ 2;L,O?-1 Inspection Date Resquested _ /!.'z 3—e�- Rough Fina Signed under the Penalties of perjury: FIRM NAME LIC.NO. —16E52 Lkensee � \ Signature <^r � � .� 2'`-1 LIC.NO. d7` A7 Address 3 3 5A4, AltTel'No. JtD9/— ��n�LS OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have:the insurance coverage or its substantial equivalent as required by Massachusetts Gen 7 O-La-),s.And that my signature on this permit application waives this requirement. Owner Agent �(Please Check one) Telephone No.7/J ZL-4 � 6 -105 PERMITTEE S� Signature of Owne Agent