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1577 Date..2/1 .A
TOWN OF NORTH ANDOVER
p Pry
- FOR WIRING
This certifies that ..................
.. ..!...: j �� 4...N L .....................
has permission to perform. ��....... ...................................
:� A5
wiring in the building of ...... �.e.0.f.1�1...... �............................................
t at ...... VOIU... ��)Akt? .... 5L......................... ,. , North Ando err,,. ase
Fee . 3 vl] • Lic. No. .IJ �7 ....... .........R
! � .. L.....
ELECTICAL I OPECTOR
tt I�
4!05/9913:56 r
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
TIE COM1110NW ALTH0FM4S&4CHUSE77S Office Use only
DEPARTMWOFPUBLICS9FM Permit No. 77
BOARD OFMEPRUEMONRWUMTIOAS527CMR12:00 —
' Occupancy &Fees Checked
APPLICATIONFOR PERMIT TO PERFORM ELECTRICAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELEcrRICAL CODE, 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date g
Town of North Andover
The undersigned applies for a permit to
the electrical work described below.
Location (Street & Number) it j,� %-��;` S-7—
To the Inspector of Wires:
Owner or Tenant
Owner's Address S'D 7 17—
Is this permit in conjunction with a building permit: Yes %,J No (Check Appropriate Box)
Purpose of Building j�P�'? l /,( Utility Authorization No. %G'�
Existing Service Amps / Volts Overhead Underground No. of Meters
New Service &'0 Amps >�yOVolts Overhead Underground No. of Meters
Numer of Feeders and Ampacity �e A1,,
Location and Nature of Proposed Electrical Work
NolafLighting 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
O�
FIRE ALARMS
No. of Zones
No. of Ranges
No. of Air Cond. Total
Tons
No. of Detection and
No. of Disposals
No. of Heat Total Total
Pumps
Tons
KW
Initiating Devices
No. of Sounding Devices
No. of Dishwashers
Space Area Heating KW
No. of Self Contained
Detection/Sounding Devices
Local Municipal
Other
Ao. of Dryers
�e
Heating Devices KW
Connections
No. of Water Heaters KW
No. of No. of
Signs
Bailasis
No. Hydro Massage Tubs
No. of Motors
Total HP
OTHER
lnstra=Ca wage Ptawan 1otheta M=—atsdMwwhBd1sG=ialLaws
Iha%eaattLiabt'tdylrt ancePobcymdudigCar>p& Covw,WcritsskshTtialecgtivalait YES ,M NO
Iha%esuhmWdvabdproofofSWXIDtheOffm YES Lr" NO
a If}mhmd�adWYES,plem rdi*thet)WcfoomWbydteddigthe
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INSURANCE BOND OTHER a ()meSpe fy) C ,i�'�/�j `/ X / /-,3 .d X
EViratim Dat
Estimated VahiedDechn] Wait $
Wakbslatt hgecionD*RaVMd Rough FM
sig}tie mckrTiePp waescfpajtay .� ` -rte /j l✓`' i
FIRM NAME
U=190e /71 f/ a J U /�` f�'-� Signal= Lioa>seNo
Air O! �E /C ` f �-Pie%/1 ��'` �� o-, z ..� AltTelNa
OWNER'S INSURANCEWAIVER;Iamawarethatthel-ioff a ltrertt�raneoo orAss ilec}lvvata�tastec�medbyMassad>u GaraalLaws
aoddUmy*ahaeonftpan*appficmmwaitiesthlstewiranag 1
(Please check one) Owner Q Agent Q
Telephone No. PERMIT FEE $ �//
3991
Date.
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that. `^�!� !�'.C? t'....��. / ....
has permission to perform ... !..-f ........
plumbing in the buildings of ..13G .................... .
at ... .. ,North Andover, Mass.
Fee . 34? O, - . Lic. No. / D7 2 . ......
PLUMBING INSPECTOR
04/06/99 il:o3 3d0,00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer j
3 ov,
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO XDOUMBING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
-- r
'i'
Date
Building Location L ALJ ��' l� S / Owners Name a�' /G f 4- Permit #__,
Amount p o ,
Type of Occupancy 2
NewRenovation Replacement Plans Submitted Yes No El
I TYTTTRFC
I
(Print or type) //gy�mm i Check one: Certificate
Installing Company Name I-t�O@ 1 �1✓�,b td1 Cr Corp.
Address `'t% W � 2_20 Partner.
, yl q6'1 cp
Business Telephone e6s I -1C0 Z,Z(_CL_
Name of Licensed Plumber:
Insurance Coverage: Indicate the type of in ce coverage by checking the appropriate box: ❑
Liability insurance policyELI---
Other type of indemnity ❑ 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 infor
best of my knowledge and that all plumbing w
compliance with all pertinent provisions of the
By:
Title
City/Town
APPROVED (OFFICE USE ONLY
submitted (or entered) in above application are true and accurate to the
a pe rmed under Permit Issued for this application will be in
s` St Plumft Code and Chapter 142 of-the-Ggneral Laws.
Type of Plumbing License
oo
License a—
icense um er Master
Joumeyman 0
•
•
i
M
•
•
WIN 1t' ®��.0�..-�
...............
O.-M.------.--.�-..-.--..
11 M
(Print or type) //gy�mm i Check one: Certificate
Installing Company Name I-t�O@ 1 �1✓�,b td1 Cr Corp.
Address `'t% W � 2_20 Partner.
, yl q6'1 cp
Business Telephone e6s I -1C0 Z,Z(_CL_
Name of Licensed Plumber:
Insurance Coverage: Indicate the type of in ce coverage by checking the appropriate box: ❑
Liability insurance policyELI---
Other type of indemnity ❑ 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 infor
best of my knowledge and that all plumbing w
compliance with all pertinent provisions of the
By:
Title
City/Town
APPROVED (OFFICE USE ONLY
submitted (or entered) in above application are true and accurate to the
a pe rmed under Permit Issued for this application will be in
s` St Plumft Code and Chapter 142 of-the-Ggneral Laws.
Type of Plumbing License
oo
License a—
icense um er Master
Joumeyman 0
i
3 4 J Date . ...-............... .
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
J.-
s._....SE G
This certifies that —o! :!`.:'::.4!.r.....�...................
has permission for gas installation . �..�::.t .� ` .. ! �:. `.`.'. {...... .
in the buildings of .. .............
at ...1. r, 4 ... ::................ North Andover, Maii.
Fee.. :..... Lic. No... ..... ................:: .
GAS INSPECTOR
a
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
�0
/IASSA SETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTING
or print)
IN"n 1 H AlYDO
Building Locations
SACHUSETTS
)gin �,cz S
Owner's Name
New Renovation ❑ Replacement ❑
Date,j�� L a. 19 I
Permit # 3 1
Amount
Plans Submitted ❑
(Print orty �Check one: Certificate Installing Company
Name Y,6Ae, P tUm4 w' ❑ Corp.
Address 1 -D - —t�oli 1,12 ❑ Partner.
Teus/y56ow2 e m • c i r�p co
Business Telephone u276 1 5--F�irmlco-_--�
Name of Licensed Plumber or Gas Fitter RLCIL Oe—b
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or ' s substantial equivalent. Yes E3No❑
If you have checked yes, please Indic e type coverage by checking the appropriate box.
Liability insurance policy 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.
Signature of Owner or Owner's Agent
Check one:
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 Inst erftined under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachu its State Ga and Chapter 142 of the ene aws.
By:
Title
City/Town
APPROVED (OFFICE USE ONLY)
Si nature of Licensed Plumber Or Gas Fitter
ber a
Gas ' er (cense Number
aster
❑ Journeyman
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SUB-BASEM ENT
B AS E MEN T
IS"r. FLOGR
2N D. FLOG R
3RD. FLOOR
4T H. F L O G R
5'r H. FLO'O R
6T 11 FLOOR
7T 11 . F L O G R
8T FI FLOOR
(Print orty �Check one: Certificate Installing Company
Name Y,6Ae, P tUm4 w' ❑ Corp.
Address 1 -D - —t�oli 1,12 ❑ Partner.
Teus/y56ow2 e m • c i r�p co
Business Telephone u276 1 5--F�irmlco-_--�
Name of Licensed Plumber or Gas Fitter RLCIL Oe—b
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or ' s substantial equivalent. Yes E3No❑
If you have checked yes, please Indic e type coverage by checking the appropriate box.
Liability insurance policy 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.
Signature of Owner or Owner's Agent
Check one:
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 Inst erftined under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachu its State Ga and Chapter 142 of the ene aws.
By:
Title
City/Town
APPROVED (OFFICE USE ONLY)
Si nature of Licensed Plumber Or Gas Fitter
ber a
Gas ' er (cense Number
aster
❑ Journeyman
TOWN OF NORTH ANDOVER OCT 3 2001
SYSTEM PUMPING RECORD
DATE: S CiGj
SYSTEM OWNER & ADDRESS
NO 000
SYSTEM LOCATION
(example: left front of house)
11 �_'
//-- N/
DATE OF PUMPING: P_A5_6 % QUANTITY PUMPED /,�a� GALLONS
CESSPOOL: NO YES SEPTIC TANK: NO YES
NATURE OF SERVICE: ROUTINE EMERGENCY
OBSERVATIONS:
GOOD CONDITION
FULL TO COVER
HEAVY GREASE
BAFFLES IN PLACE
ROOTS
LEACHFIELD RUNBACK
EXCESSIVE SOLIDS
FLOODED
SOLIDS CARRYOVER
OTHER (EXPLAIN)
SYSTEM PUMPED BY: n 00 Ve(" SW -i c,
COMMENTS:
.CONTENTS TRANSFERRED TO: S�) • ry) t -
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