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HomeMy WebLinkAboutMiscellaneous - 595 CHICKERING ROAD 4/30/2018 (3) 595 CHICKERING ROAD(C) J 210/084.0-0028-0001.0 i Date..... .......... OF p►ORTIy,� TOWN OF NORTH ANDOVER PERMIT FOR WIRING BSACHU This certifies that .... f C> ....................................................................................................................... has permission to perform ..........................................N............................................ wiring in the building of..... 4 at .... ............................40 ...........North Andover,Mass. ...... ... .... Fee Li..No'.. ........... ** INSPECTOR C-T** ELECTRICALR Check# " r 1114- A-0 Commonwealth of Massachusetts Official Use Only Permit No. a Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C),527 CMR 12.00 (PLEASE PRINT IN)NK OR TYPE ALL INFORM TION) Date: ( 1 City or Town of: NORTH ANDOVER To the Ins ector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) C A&U t dna V Owner or Tenant C p`!C t he�lu �2, 4 Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Y rn 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: { S Q cle ` a %n+o pro c� 1 Completion of the following table maybe waived by the Inspecto of Wires. No.of Recessed Luminaires No.of Cell: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 mergency 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 and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: " "[' " "­­**­j***­*­­ * " Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security 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 IIP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of WYres. Estimated Value of ectric ].Work: (When required by municipal policy.) Work to Start: 111.25'114— Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO GE: 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 k. BOND ❑ OTHER ❑ (Specify:) X certify,under the ains and penalties ofperjury,that the information on this application is true and complete. r FIRM NAME: " ' 6 i LIC.NO.: Licensee: ,S C0 dyAP Signature ,— LIC.NO.: (Ifapplicable enter "ext"in h�license num er line.) t Bus.Tel.No.Ajk • me 1d 7y' � Address: r t Alt.Tel.No.: *Per M.G.L c. 147,s.57-61, ecurity 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 ignature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent PERMIT FEE.$ � Signature Telephone No. ❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance with the provisions of M.G.L.c.143,§3L,the rr permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166,§32,an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the i notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall be limited as to the time of ongoing construction activity,and may be deemed by the Inspector of Wires abandoned and invalid if he or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008 and extending-through August 15,2012. ❑ Rule 8—Permit/Date Closed: ***Note:Reapply for new permit ❑ ❑Permit Extension Act—Permit/Date Closed: Trench Inspection Pass M Failed 1fl Re-Inspection Required($.)❑ Inspectors Comments: Inspectors Signature: Date: SERVICE INSPECTION: Pass EN Failed Re-Inspection Required($.)❑ Inspectors Comments: Inspectors Signature: Date: PARTIAL ROUGH INSPECTION: Pass M Failed 0 Re-Inspection Required($.)❑ Inspectors Comments: Inspectors Signature: Date: ROUGH INSP CTION: Pass R1 Failed M Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: mut Date: FINAL INSPE ON: Pass Failed Re-Inspection Required($.) ❑ Inspectors Comments: r1 Inspectors Signature: Yw� Date: DEB WEINHOLD ... TOWN OF MERRIMAC,MA. .......dweinhold@townofinerrimac.com r J . The Commonwealth of Massachusetts Department of IndustrialAceldents --- d 1 Congress Street,Suite 100 Boston,MA 02114-2017 °t www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Le ibl Name(Business/Organization/Iudividual): els61e Liect Address: '2415- r ('V-n P\VC_ �'� +. City/State/Zip: C7 ,e h to I[�A R O�C)qP� Phone#: 6C)3 C:20 '02)S�J Are you an employer?Check the appropriate box: Type of project(required): 1.❑I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.KJ 1 am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 3.F1I am a homeowner doing all work myself[No workers'comp.insurance required.]t 9. El Demolition 4.F1I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 E]Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5. I am a general contractor and I have hired the sub-contractors listed on the attached sheet. ❑ t 13.❑Roof repairs • These sub-contractors have employees and have workers'comp.insLuance. 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no.employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submif 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 state whether or not those entities have employees. If the sub-contraciors have employees,'they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees.'Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lie.#: Expiration Date: Job Site Address: 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 MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a S'T'OP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un hepains and penalties ofperjufy that the information provided above is true and correct. r Si natur Date: 1 Phone#: G r) — 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall. enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. I£an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should'enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia • COMMONWEALTii OF-MA IUSETTS s o o - s • 6E ARD(3F I SSUES T! FOLL(M G !'I E;", - r : ? 's `s,1!)Ui ►r'EY4`�rPd. �L(.CTPEIG+ ) , ' �' U it a N�TM ��SbEO S��IOo r TOWN OF NORTH ANDOVER C NORTH ANDOVER, MASS SIGN PERMIT DATE: _June 3. 2008 PERMIT: 032-2008 THIS CERTIFIES THAT _Choice Fitness has permission to erect. 85 sg ft. Free Standing Ground Sign non illuminated on 595 Chickering Rd. provide 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 Sign Regulations in the Town of North Andover. Violation of the Zoning of Sign Regulations, Section#6, Voids this Permit. INTERNALLY ILLUMINATED SIGNS ARE PROHIBITED Inspector of Buildings Location f`c,4 No, Date Jcvp' NORTH TOWN OF NORTH ANDOVER O�t �ao ,a 1'y Certificate of Occupancy $ �ss��Nustt� Buildin ani Permit Fee $ y— Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 21 2 0 u Buildi g Inspector 1 TRUCK LETTERING ® WINDOW TINTING s SIGN PERMIT APPLICATION 1600 Osgood Street Building 20, Suite 2-36 TOWN OF NORTH ANDOVER Site Owner h0hnt, �et a t/tA Applicant /k/<e f S;`4.jt f Tel SiteAddress s9r r k c cit i--c n a Size of Proposed Sign 101 Man Parcel Illumination: a)Not illuminated b) n erna y i ummated How attached: a)Against the wall b) Roof _l c round 1 r,ee S'�v.,olt,�•e o ydvw� Materials: �/`Mti� v ��n 0 �7��� `c Rvc d) Other Proposed Colors: Background w . Lettering Au/,l► Q e.brl Cost of Sim ��C �. Border f i k ee- Tr i(M Note: No permanent/temporary sign shall be erected, or enlarged until an Reauired Attachments: application on the appropriate form furnished by the Sign Office has been Photographs of building filed with the Sign Officer containing such information including Material sample photographs,plans and scale drawings, as he may require, and a permit Color sample for such erection, alteration, or enlargement has been issued by him. Site or Plot Plan(Required for all free-standing signs) Such permit shall be issued only of the Sign Officer determines that the Drawings of proposed sign sign complies or will comply with all applicable provisions of the By- Other, specify, Law. Pt-f- 'EX%sk^5 hOh �o., 4rrht-J�j Si A. (ReA ice J / h Will sign overhang any public road or walkway Yes ( ) No If Yes, Name of Agency who will provide liability insurance: AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED: 6 Zo Zoe Receipt# ap Check# Ig q Revised 10.31.2006 Form Sign Permit Application SIGNATURE OF APPLICANT Date. -- .. ....... HORTM TOWN OF NORTH ANDOVER 'VFW ' PERMIT FOR WIRING 'S US J, This certifies that .._ has permission to perform ..................:............................................................ wiring in the building of .' ' ` .....`.. ' . ��EL .North Andover Mass. Fee.,'.-.4-5........... Lic.Nok4�....� ...... � ... ECTRICAL INS CTOR c Check # 41 Z V / ` 7967 5 ` Commonwealth of Massachusetts Official Use Only Wfinm Department of Fire Services Permit No. / 9(0 Z _ Occupancy and Fee Checked _ BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] ]eaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(M YC),517 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 111910e City or Town of: NORTH ANDOVER To the Insp ctor of Wires: By this application the undersigned gives notice of his or heTitenti on toperform the'�cal work described below. Location(Street&Number) ( U r2 V/) Owner or Tenant Cho k e Telephone No. Owner's Address 2 Is this permit in conjunction with a building�p/gr 't?� Yes ❑ No (Check Appropriate Box) Purpose of Building e wgse l� U 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: 4 h. Cil St �-Completion o the ollowin table maybe 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 mergency Lighting rnd. rnd. Battery Units No.of Receptacle Outlets No.of OR Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and TotInitiatin Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices t Heat Pump Nmer Tons KW No.of Self-Contained No.of Waste Disposers Totals: ........................."""..... ""'""W....""" No.of Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection # No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.of Heaters ' Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of E ctrical Work: (When required by municipal policy.) Work to Start: 1 1 Z3 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C RAGE: 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 cove ge is in force,and has exhibited proof o- e to tl a permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) `CUC s✓ J I certify,under the paJsgn penalties o erju�; that the{nform"a on this application is true and complete. s FIRM NAME: �,,(� t✓°G LIC.NO.: 4 Licensee: p 6-f Signature LIC.NO.: (If applicable, enter`exempt"i liceTe number line.) �3, Address: �$�1 i G —"6�1 kl Bus.Tel.No.: �� 3 Alt.Tel.No.: *Per M.G.L c. 147,s.57-61,security work requ' s 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: $ Jz`S V Location No. - —/ ,/ --�/ Date MORT1y TOWN OF NORTH ANDOVER Of�«ao •'�1. f 9 Certificate of Occupancy $ s�►aNus` Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ �� Check # � 206"t V Building Inspectdr/ 1 ' NORTH S4eD ,s �ti T � COc.ite lwKp 1` T AToo 9sSAG Ht15�� TOWNOF NORTH ANDOVER Sign Permit Date: September 21, 2007 Permit Number: 010-09 THIS CERTIFIES THAT, Dennis Metayer(Choice FitnessL Has permission to erect a 3'X8' (24sfWall Sign Externally.Illuminates On 595 Chickering Road MAP PARCEL provided that the person accepting this Permit shall in every respect conform to the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Sign Regulations in the Town of North Andover. Violation of the Zoning.of Sign Regulations, Section#6 Voids this Permit INTERNALLY ILLUMINATED SIGNS ARE PROHIBITED Inspector of Buildings 4ORTN0 06 '9 �`y n eyy T2A COCNit 8WKR y1 F�S RArso SACHU`+� TOWNOF NORTH ANDOVER Sign Permit Date: September 21, 2007 Permit Number: 010-08 THIS CERTIFIES THAT, Dennis Metayer(Choice Fitness) Has permission to erect a 3'X8' (24so Wall Sign On 595 Chickering Road MAP PARCEL provided that the person accepting this Permit shall in every respect conform to the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Sign Regulations in the Town of North Andover. Violation of the Zoning of Sign Regulations, Section#6 Voids this Permit INTERNALLY ILLUMINATED SIGNS ARE PROHIBITED Inspector of Buildings NORTH ' F q -1 E D 6 0 t � O coc.�xiNlwK■ V1 �SSAC H1J5�� TOWNOF NORTH ANDOVER Sign Permit Date: September 21, 2007 Permit Number: 011-08 THIS CERTIFIES THAT, Dennis Metayer(Choice Fitness Has permission to erect a 3'X8' (24sf)Wall Sign On 595 Chickering`Road MAP PARCEL provided that the person accepting this Permit shall in every respect conform to the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Sign Regulations in the Town of North Andover. Violation of the Zoning of Sign Regulations, Section#6 Voids this Permit INTERNALLY ILLUMINATED SIGNS ARE PROHIBITED 'Inspector of Buildings r1ORTli 4 '9 O �t�eo '0,6rt ~�O ? O 4 a49 � VL coeit ewItw �1 A rt o PPP` �SSACHUSE� TOWNOF NORTH ANDOVER Sign Permit Date: September 21, 2007 Permit Number: 012-08 THIS CERTIFIES THAT, Dennis Metayer Choice Fitness) Has permission to erect a 3'X8' (24so Wall Sign On 595 Chickering Road MAP PARCEL provided that the person accepting this Permit shall in every respect conform to the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Sign Regulations in the Town of North Andover. Violation of the Zoning of Sign Regulations, Section#6 Voids this Permit INTERNALLY ILLUMINATED SIGNS ARE PROHIBITED Inspector of Buildings t.1ORTF1 O tAt�!D ,yb 9 Y R T D co..i.C«iw.c" 1' DRArtD pPP�� �5 �SSAC HU`��� TOWNOF NORTH ANDOVER Sign Permit Date: September 21, 2007 Permit Number: 013-08 THIS CERTIFIES THAT, Dennis Metayer Choice Fitness Has permission to erect a 2'X5' (10s Wall Sign On 595 Chickering Road MAP PARCEL provided that the person accepting this Permit shall in every respect conform to the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Sign Regulations in the Town of North Andover. Violation of the Zoning of Sign Regulations, Section#6 Voids this Permit INTERNALLY ILLUMINATED SIGNS ARE PROHIBITED Inspector of Buildings X10 R TFC q 0 / �� ED 6 L o � � � R � O COCNICNI WKM V� SSAC HUSS TOWNOF NORTH ANDOVER . Sign Permit Date: September 21, 2007 Permit Number: 014-08 I THIS CERTIFIES THAT, Dennis MetaYer(Choice Fitness) Has permission to erect a 18"X 44" Wall Sign with Scroll Brackets On 595 Chickering Road MAP PARCEL___ provided that the person accepting this Permit shall in every respect conform to the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Sign Regulations in the Town of North Andover. Violation of the Zoning of Sign Regulations, Section#6 Voids this Permit INTERNALLY ILLUMINATED SIGNS ARE PROMITED Inspector of Buildings NORTt{ q O n► O cocaic"I y1 T ��A04"'AT90 0'PA` �y 9SSAC HUS�� TOWNOF NORTH ANDOVER Sign Permit Date: September 21, 2007 Permit Number: 015-08 THIS CERTIFIES THAT, Dennis Metayer(Choice Fitness) Has permission to erect a 4' X 5' EXTERNALLY ILLUMINATED WALL SIGN On 595 Chickering Road MAP PARCEL provided that the person accepting this Permit shall in every respect conform to the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Sign Regulations in the Town of North Andover. Violation of the Zoning of Sign Regulations, Section#6 Voids this Permit INTERNALLY ILLUMINATED SIGNS ARE PROHIBITED Inspector of Buildings SIGN PERMIT APPLICATION dl 1600 Osgood Street Building 20, Suite 2-36 TOWN OF NORTH ANDOVER Site Owner Pe A K C S A t- )t-e r' Applicant a l k--E 9 rO near k t i Tel Site Address S 75— (hick- -er 1 k!, K9.1d. Size of Proposed Sign � X �sq?C7'�• Map Parcel Illumination: a)Not illuminated b Internally illuminated How attached: aa) gainst the wall c) xternally illuminated "6) Roof c) Ground Materials: d) Other Proposed Colors: Background w�i -,�(0O 6� Lettering� (� c Cost of Sign Border G?/„e Note: No permanent/temporary sign shall be erected, or enlarged until an Required Attachments: application on the appropriate form furnished by the Sign Office has been Photographs of building filed with the Sign Officer containing such information including Material sample photographs,plans and scale drawings, as he may require, and a permit Color sample for such erection, alteration, or enlargement has been issued by him. Site or Plot Plan(Re uired for all free-standing signs) Such permit shall be issued only of the Sign Officer determines that the rawings of proposed sign sign complies or will comply with all applicable provisions of the By- Other, specity, Law. Will sign overhang any public road or walkway Yes ( ) ) If Yes, Name of Agency who will provide liability insurance: AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED n DATE FILED: ����6 ! �P. Receipt# r90w " Check# 5 o'I Revised 10.31.2006 Form Sign Permit Application SIGNATURE OF APPLICAN SIGN PERMIT APPLICATION ® 1600 Osgood Street Building 20, Suite 2-36 TOWN OF NORTH ANDOVER Site Owner /De a h es ALA ✓ec, Applicant i ke cW1`-1 Tel Site Address �� S �G�t`c l� �- �v-� Size of Proposed Sign May Parcel Illumination: a)Not illuminated b) Internally illuminated How attached: a) gainst the wall c) Externally illuminated Roof / c) Ground Materials: �ot P�9t,e�� U i i v/ It /�. d) Other Proposed Colors: Background GO oa Lettering �IvZ Cost of Sign Border -e Note: No permanent/temporary sign shall be erected, or enlarged until an Required Attachments: application on the appropriate form furnished by the Sign Office has been Photographs of building filed with the Sign Officer containing such information including Material sample photographs,plans and scale drawings, as he may require, and a permit Color sample for such erection, alteration, or enlargement has been issued by him. Site or Plot Plan�(R�eired for all free-standing signs) Such permit shall be issued only of the Sign Officer determines that the Drawings of pron sign complies or will comply with all applicable provisions of the By- Ot er, specify Law. Will sign overhang any public road or walkway Yes ( ) ) If Yes, Name of Agency who will provide liability insurance: AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED: O Receipt# Check ky 9 Z Revised 10.31.20 66 Form Sign Permit Application SIGNATURE OF APPLICANT � SIGN PERMIT APPLICATION 104 1600 Osgood Street Building 20, Suite 2-36 TOWN OF NORTH ANDOVER 0 Site Owner Pehpty A e, r% Applicant /RikP_ ?no Tel 9'7 Lf Site Address �9 S- C�l`�/��' �g �1. Size of Proposed Sign 3 X yap. May Parcel Illumination: a of illuminated Ci Internally illuminated How attached: a) Against the wall c) Externally illuminated b) Roof c) Ground Materials: y M i n �v►� tJ )n d) Other Proposed Colors: Background Tp h Lettering R/vf Cost of Sign 35-0 Border ( fid Note: No permanent/temporary sign shall be erected, or enlarged until an Required Attachments: application on the appropriate form furnished by the Sign Office has been Photographs of building filed with the Sign Officer containing such information including Material sample photographs,plans and scale drawings, as he may require, and a permit Color sample for such erection, alteration, or enlargement has been issued by him. lot red for all free-standing signs) Such permit shall be issued only of the Sign Officer determines that the Drawings of proposed sign sign complies or will comply with all applicable provisions of the By- Other, specs Law. Will sign overhang any public road or walkway Yes ( )oNo ) If Yes,Name of Agency who will provide liability insurance: AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED: L/o /o 7 Receipt#=4*/? Check# Revised 10.31.2006 t Form Sign Permit Application SIGNATURE OF APPLICANT SIGN PERMIT APPLICATION 1600 Osgood Street Building 20, Suite 2-36 TOWN OF NORTH ANDOVER Site Owner t�E'hNCS �eApplicant A)q r Tel / i Site Address .5-7,(— C FFG/ce r t nc, G��o{ , Size of Proposed Sign May Parcel Illumination: aot illuminated b) Internally illuminated How attached: a) gainst the wall c) Externally illuminated Roof /> C) Ground Materials: IuM �`n�rr� u I h �/� le,4 rS d) Other Proposed Colors: Background Ta h 0 Lettering 9lv2 Cost of Sian �� S Border 6nld Note: No permanent/temporary sign shall be erected, or enlarged until an Required Attachments: application on the appropriate form furnished by the Sign Office has been Photographs of building filed with the Sign Officer containing such information including Material sample photographs, plans and scale drawings, as he may require, and a permit Color sample for such erection, alteration, or enlargement has been issued by him. Site or Plot Plan Re�,,�Rr all free-standing signs) Such permit shall be issued only of the Sign Officer determines that the rawings of ropossign complies or will comply with all applicable provisions of the By- Ot er, specify Law. Will sign overhang any public road or walkway Yes ( )(No ) If Yes,Name of Agency who will provide liability insurance: AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED: / /aQ/D Receipt# �(,�9 Check# ©2c;2 s Revised 10.31.2006 1/ Form Sign Permit Application SIGNATURE OF APPLICANT SIGN PERMIT APPLICATION 1600 Osgood Street Building 20, Suite 2-36 TOWN OF NORTH ANDOVER Site Owner De h n t S" ASE l'4'/e i-' Applicant A/kms IS�o�r,g 6��' Tel 7% ya 3- Site Address S�S� C t`c�ur�`� �/ Size of Proposed Sign Map Parcel Illumination: a N b) Internally illuminated How attached: a) Against the wall 5 C r o 4ckG c) Externally illuminated b) Roof c) Ground Materials: I)le& I (3r4 cke d) Other �� �� ��aI7'�i� S!y/, • �t n�/� �P }��S Proposed Colors: Background TO p 1�' �- Lettering t?l v2 Cost of Sim Border 6 o)d Note: No permanent/temporary sign shall be erected, or enlarged until an Required Attachments: application on the appropriate form furnished by the Sign Office has been Photographs of building filed with the Sign Officer containing such information including Material sample photographs,plans and scale drawings, as he may require, and a permit Color sample for such erection, alteration, or enlargement has been issued by him. Site or Plot Plan e uired for all free-standing signs) Such permit shall be issued only of the Sign Officer determines that the nn sign complies or will comply with all applicable provisions of the By- Other, roposed sig ther, specify, Law. Will sign overhang any public road or walkwa es ) No ( ) If Yes, Name of Agency who will provide liability insurance: P0 hJ-- nSv✓a n rP 14 5e h AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED: �1/d­cvU Receipt# c:�b6! Check# c2j 92--" Revised 10.31.2006 Form Sign Permit Application SIGNATURE OF APPLICANT ,Q SIGN PERMIT APPLICATION 1600 Osgood Street Building 20, Suite 2-36 b TOWN OF NORTH ANDOVER Site Owner Dec, r.t`s /LIe ✓e �. Applicant Arec ac he',on Tel Site Address %� C Size of Proposed Sign /` May Parcel Illumination: a)Not illuminated Internally illuminated How attached: a) gainst the wall c) xternally illuminated ) Roof �/ / // c) Ground Materials: 6 eo,i n i pl�J ��`�' Zf-e* e o l e-411- d) Other (All zxW 1`L11`o'(yR Proposed Colors: Background6't 4 O 5 .� c .e Lettering Jul v6./a� .u.�i e Cost of Sign 3 S00 Border nv,.2 Note: No permanent/temporary sign shall be erected, or enlarged until an Required Attachments: application on the appropriate form furnished by the Sign Office has been Photographs of building filed with the Sign Officer containing such information including Material sample photographs, plans and scale drawings, as he may require, and a permit Color sample for such erection, alteration, or enlargement has been issued by him. Site or Plot Plan Required for all free-standing signs) Such permit shall be issued only of the Sign Officer determines that the rawings of proposed si sign complies or will comply with all applicable provisions of the By- Other, speci y Law. Will sign overhang any public road or walkway Yes ( No ) If Yes,Name of Agency who will provide liability insurance: AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED: % za0/07 Receipt# Check# a2 0 � Revised 10.31.2006 Form Sign Permit Application SIGNATURE OF APPLIKANT Dmirectory ■ .............................. ChotCeF',tne55 Swinging Sign 18"x44" (5.5 sq.ft.) 2'x5' Sign For Corner of Building 3'x8' For Side of Building �Fitll�'S5 Eh®iceFitnass Ehoic . EhoiceFitness . a® wo t. •49't � ' tness .iM� _��1., �- iHC UVL I'-CHUICB iTE REHABI I-UH fl LNE55 `1 ONE t 4 " 4 _ r� ` M x4.T J r Ad rtiona.Parkin i Rea A Will f '!9 R°;+U,r++f:. ♦ a�,' +, *_S' .1 L'� �� �� FIYe.t ti ;��LYc 4 1 H N a n _ 7 �'j'�" ' AA _ r ChipiceFiitnems Choice Logo 4 ' x15 ' Side Sign 3 ' x8 ' u m m 0 u E ,No SALON ELITE ORTHOPEDIC & SREHRTSEAB Side Sign 3 ' x8 ' NORTH q .t{..ED #61 MOO R , h X09 •wat A04ATED �Pai�y SSAC HUSH TOWN OF NORTH ANDOVER Sign Permit Date: November 5. 2007 Permit Number: 020-2008 THIS CERTIFIES THAT= Choice Fitness(Dennis Metayer) Has permission to erect a 4'x12'Front Awning Sign On 595 Chickering Road provided that the person accepting this Permit shall in every respect conform to the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Sign Regulations in the Town of North Andover. Violation of the Zoning.of Sign Regulations, Section#6 Voids this Permit Internally Illuminated Sips are Prohibited Inspector of Buildings <-7 �-- SIGN PERMIT APPLICATION 1600 Osgood Street Building 20, Suite 2-36 TOWN OF NORTH ANDOVER Site Owner Le (n n ISS Ae ci ye Applicant Ake r /�,lC{�`s hS� Tel ? > r W3 — 3/'>3 Site Address `C let 01 it vac, r Size of Proposed Sign y x ld� ' t9_1 AL►111y May Parcel Illumination: V Not illuminated b) Internally illuminated How attached: Against the wall c) Externally illuminated b) Roof (gGround Materials: Sfie. r`''aw, C to 4- , ►`c d) Other Proposed Colors: Background 131 � Lettering w h i Pe 6e Cost of Sign 0 (/my Border Note: No permanent/temporary sign shall be erected, or enlarged until an Required Attachments: application on the appropriate form furnished by the Sign Office has been Photographs of building *r filed with the Sign Officer containing such information including Material sample photographs,plans and scale drawings, as he may require, and a permit Color sample >?e for such erection,alteration, or enlargement has been issued by him. Site or Plot Plan (Required for all free-standing signs) Such permit shall be issued only of the Sign Officer determines that the Drawings of proposed sign sign complies or will comply with all applicable provisions of the By- Other, specify Law. Will sign overhang any public road or walkway Yes( ) C:.%` ) If Yes,Name of Agency who will provide liability insurance: AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED: /0L12 LO 2 Receipt# Check# Revised 10.31.2006 � Form Sign Permit Application GNATURE OF APPLICANT G 8 Y I i t,, t ��• Sp Awning Will Have A 16' Projection From The Building Front Will Be 4' Tall & 12' Wide With Lettering AWNING BACK TO COVER STAIRS 162 1201 AWNING 12' RAMP - 150 NOVA SALON AWNING moo` SIGN PERMIT APPLICATION 1600 Osgood Street Building 20, Suite 2-36 TOWN OF NORTH ANDOVER Site Owner �e h r r S A a 4 tia l­ Applicant A'L 1Ai Ise f S;r_wr � Tel c/7 i/ Site Address CA,,c 4 r /!n' �d/• Size of Proposed Sign May Parcel Illumination: aONot illuminated + b) Internally illuminated How attached: a(Kgainst the wall c) Externally illuminated b) Roof c) Ground Materials: S/c r, Fin, a r Cavcrj`� d) Other Proposed Colors: Background 15—A.e Lettering Cost of Sian lel 0 I ----- Border Note: No permanent/temporary sign shall be erected, or enlarged until an Required Attachments: application on the appropriate form furnished by the Sign Office has been Photographs of building 4 filed with the Sign Officer containing such information including Material sample photographs,plans and scale drawings, as he may require, and a permit Color sample g for such erection,alteration, or enlargement has been issued by him. Site or Plot Plan (Required for all free-standing signs) Such permit shall be issued only of the Sign Officer determines that the Drawings of proposed sign 7 sign complies or will comply with all applicable provisions of the By- Other, specify. Law. Will sign overhang any public road or walkway Yes ( ) No () If Yes,Name of Agency who will provide liability insurance: AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED:_0//2 �0 7 Receipt # Check# Revised 10.31.2006 Form Sign Permit Application SIGNATURE OF APPLICANT ® a � t r Ir `I11 N L, y� �qy pF r �''" —..� r '�`� �;gas' � `�' •. ,4..._,,,�„�,���,�, Awning Will Have A 3' Projection From The Building Front Will Be 4' Tall & 8' Wide With Lettering ® COVER STAG R S AW9MO ,N [fitQMPNOVASALOM � AWNUNG SIGN PERMIT APPLICATION 1600 Osgood Street Building 20, Suite 2-36 TOWN OF NORTH ANDOVER Site Owner 2 h 11'f e Applicant A *Ie �/j'li 1/9 S L�,hA Tel Site Address �� Ch�`G �e lam'/ Size of Proposed Sign ,-? t X J� May Parcel Illumination: (�ot illuminated b) Internally illuminated How attached: (0gainst the wall c) Externally illuminated Roof c) Ground Materials: d) Other C Proposed Colors: Background flea Lettering Cost of Sian Border Note: No permanent/temporary sign shall be erected, or enlarged until an Reguired Attachments: application on the appropriate form furnished by the Sign Office has been Photographs of building,- filed with the Sign Officer containing such information including Material sample photographs,plans and scale drawings, as he may require, and a permit Color sample r)( for such erection,alteration, or enlargement has been issued by him. Site or Plot Plan (Required for all free-standing signs) Such permit shall be issued only of the Sign Officer determines that the Drawings of proposed sign Ot- sign complies or will comply with all applicable provisions of the By- Other, specify. Law. Will sign overhang any public road or walkway Yes ( ) Noj If Yes,Name of Agency who will provide liability insurance: AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED: 10 //7 /O 7 Receipt# Check# Revised 10.31.2006 Form Sign Permit Application SIGNATURE OF APPLICANT i ry 4 f M, ! MEN d X Entrance Way Awning Will Have A 4' Projection From The Building And Will Be 9' Wide '& 4'9" Tall With Lettering '0 COVER s7AO R S a ®� i i i RAMP 0VrdA sA� AWNoMCM Side Sign 4'x8' Choice Logo 5'x19' Side Sign 4'x8' I Q e {UlV l 1 ®®ceF®rnes� &U�e r NUE E SALON SPA elite rehab ►----. - ChuiceFirness . e .............................. Date. / .�!�!��. L. .... .. MORTh TOWN OF NORTH ANDOVER ' O 9 • PERMIT FOR GAS INSTALLATION . 9 SACMUSEtA This certifies that . . . . °x'e'.�. . . .���. . . . . . . . . . . . . . . . . . . . has permission for gas installation . . . . . . . . . . . in the buildings of . . XY.M. 17.-r. . . . . . . . . . . . . . . at . . .V V.9-7. ��. . `.!c.��. t.�'. .!: . .. . . .��., North Andover, Mass. Fee./2. .;. ... Lic. No.�.Y.5/.7/. . . . . .��.�L c�,�. . . . . . GAS INSPECTOR Check# LJ k, 6-165 MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTING (Type or print) Date l ' 3' 67 NORTH ANDOVER,MASSACHUSETTS Building Locations Permit# �� Owner's Name Amount$ New Renovation 13/ Replacement Plans Submitted a rA w c a W a� z a� F a�a m ee w F W �i p O p Z F. v� a V U o. a W d C7 F Z d 2 OG C W y� A F. z d W d a F F Z O F+ W F W x o x E; 3 c a v0 a W A a F O SU B -BASEM ENT BASEM ENT 1ST. FLOOR 2ND . FLOOR 0 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR (Print or typ Name _ �Y�t-- ^�3► r q�i w� Check one: Certificate Installing Company ElCorp. Address c;- _ El Partner. usmess a ep one o _ 3 a I r a 603.any 9-f q Firm/Co. Name of Licensed Plumber or Gas Fitter ;z, a 2,�P� 2C� INSURANCE COVERAGE I Check on . I have a current liability Insurance,policy or it's substantial equivalent. Yes Noo If you have checked es please in *ate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity D Bond 0 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: Signature of Owner or Owner's Agent Owner 13 Agent 13 1 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 perform der Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas and C ter of the General Laws. By: Signatu of Licensed Plum r Gas Fitter Title Plumber —)4? 7G, City/Town 0 Gas Fitter License NUMDer 0Master APPROVED(OFFICE USE ONLY) Mlourneyman 10/31/2007 13:53 �Ax 810664288172 :US NUTRITION AFW-MA Ijr01i001 � I j regU�It�ln sarvlaes.ca I ! To 4r*PsIrs@newcoseFvIc9s,eom:, TO/3=007 01:37 PM oC %Mdr5haII@nbty.com>, <dJ5adln@newcoservlcas.com� i b(t ti f ublect REXALL-1030200713638PM-Servicer Location;Chcfce Pltness. Hlstnry: r This rnessage has bee forwomeo. ' I Request For SerVlce fzom REXALL Ca 11 6146.4101 I *** Seria;ll Number i5 not in datal4se: Serial Number[715b404) , Make[BEVAIA) , Model [MT45!] ' ! I Current LQIQation 7 Choice Fitnes Addre33, 595 Chickering Ro d city: North Andover State: MA Zip Code: I1 01845 Co: tact Na;n*: Eric or Dennis Contact Phone: 9786084021. Division: NONE , Coit Cent : NONE i Make; BEVIATR Moc3e1: MT45 Serial Nc: I 7150404 `II v Problem: unit is "new" old aLpck, Suapsct freon leaX occurred durin�3` ahi ,foz a new ?tore op6ning. Nature; Gar I Marshall Phone: 63005616 Ext: Emil: gmarshall@nbty.Cam Emai l2 I ; Your email. 'tracking number is 10317 00713638?? PLEASE DO NOT REPLY TO THIS rMAIL� i In case of %mergCncy Call 1-800 7' -0006 i , I � i li Td WdLS:TO LOOF T2 '.1=10 eO1,S-gLROST: 'ON XHd W0dj �� .�. ,� �� U 10/31/2007 13:53 11AX 818664288172 i US NUTRITION AFW-MA 1A001/001 —u � I i I � I II ill regUe0lt�nowcosaMt .� TO 1ropalrs@newcoservicoe,com> TO/3012007 01:37 PM j I r.Q. 140M6Mha11@nbty.comk, 4!0 JB8d1n( newcoserv1CA%_WM.W I Objoct REXALL-1030200713638PM-Service Location:Choice f Fitness. History; r,� This message hag be$�Iiorwsrded, i I ' I Request Fdr Serv.iCi� from JREXALL Ca11 0146JI01 f x** �se: sgri$1 Number[7150904) , Make[SEVAYIRJ , Seriall ftmber is not in datak� Model [MT45i) ij Current WQation - Choice Fitnes Address, 595 Chickering RO d city; I North Andover State: i MA zip Code: ; 01845 Contact NaTn%: Eric or Dennis Contact Phone: 9786889021 ( i DiVision: . NONE . Cost Cent0 : NONE Make; j BEVATR h1©de1: MT45 serial Nc: i X150404 I : Problem: Unit is "new" old sltpck. Recently delivered and is not cooling. Suspect fr6on Icak QccUrred durin nhipmen t. Please service ASAP as this is for a new ?tore opening. Name; Gari Marshall I Phone: 631tCOS616 kl Ext: Email: gmajshall@nbty.Com Emai,l2: I . is Your emall 'tracking number is 103�20071.36w8FM PLEASE DO NOT REPLY TO THIS £MATLii 2n Icase of jEm6rtjency Call 1-800 7?!i-Qd06 f , i , i Td WdLS:TO 2-00L TE -T00 0,0f;C,SSi`80ST: TIN XHd Woaj /Date./—&��`/*`��" ,';:0�T"�4,, TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACNUSE� �� d ala This certifies that . . . RR .. . . . . . . . . . . . 1 /7/ has permission to perform . . . . L/.1Y. . . . . . ./.—. . . . . . . . . . . . . . . . . . plumbing in the buildings of . .j at. . . .. 5.r North Andover, Mass. Fee. fir. . . .Lic. No l.`.'S. ?. . . . . . . . . .f.., . PLUMBING INSPECNR Check # y 7520 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date Ay ' 3 Building Location �� C�� � Owners Name Permit# ?S`Lo Amount Type of Occupancy New rj Renovation Replacement Plans Submitted Yes No El FIXTURES v7 rr CA On SLRHM H�41V)HM' M EOCR M FUM 3al KfM 4M BIM 5MBDM 6MKDM 7IH KBM M HffR (Print or type) �—� Check one: Certificate Installing Company Name `Y�� �� °� �- � ��� E—] Corp. Address �� �1� �'1 (s�v`-� '` � �3��5 Partner. >3s' gy 5<7 Business Telephone Fi m/Co. Name ofLicensed Plumber Insurance Coverage: Indicate the a of insurance coverage by checking the appropriate box Liability insurance policy - Other type of indemnity El 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 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 der Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts a and Chapter 142 of the General Laws. r By igna or LimasearturiDer Type ofPlumbin License Title ��i,2(- City/Town iCense um er Master El Journeyman APPROVED(OFFICE USE ONLY Date..... . Y f NORTH, TOWN OF NORTH ANDOVER PERMIT FOR WIRING CIN This certifies that ��..(.©/t has permission to perform .....r..!- G P ................................................................... wiring in the building of ��'�0 K t ' rvk S .............................. ................................. 3•� �t7 tC`c /2/1?v. I?.b...........North Andover,Mass. pb Fee.?91!, C. -. Lic.No..&75.22. !�:.... ....... . .F ELECTRICAL INSPECTOR Check # S73 36, ' 7311 E\ Commonwealth of Massachusetts Official Use Only a-MONTEMM Department of Fire Services Permit No. J BOARD OF FIRE PREVENTION REGULATIONS [Rev.1 07]y and Fee Checked i (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: t-{ 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 �\�p`L� F \���5 pe Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes 0 No ❑ (Check Appropriate Box) Purpose of Building y,^ Utility Authorization No. Existing Service GV Amps 'j-8V / L),G� Volts Overhead ✓❑ Undgrd❑ No.of Meters 1 New Service R Z% Amps lad / a Volts Overhead❑ Undgrd Q No.of Meters Q, Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion of the ollowin table may be waived by the Ins ector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans o.of ota Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators ;KVA No.of Luminaires Swimming Pool ove ❑ n- ❑ 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. g Total Tons I�� No.of Alerting Devices ` a No.of Waste Disposers eat umlp um er ons o.oSelf-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local[a un"pa ❑ Other Connection No.of Dryers Heating Appliances KW ecurity Systems: No.of Devices or Equivalent No.o Heaters KW ater o.o o.o Data Wiring: Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications wiring: OTHER: No.of Devices or Equivalent z Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: Zd,4CC` (When required by municipal policy.) Work to Start: 6t'� 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [3 BOND ❑ OTHER ❑ (Specify:) /certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME:' mph LIC. NO.: ),-1753A Licensee: �Ck- Signature (��1•-� LIC. (Ifapplicable,enter "exempt"in the license number line.) 1\1Jr —" Bus.Tel. No.:'T)F-3')pL-59'1'1 Address: k,!3S t�yQy rjp_ \Y\�-\ V-- �\c�v��\�, rr� o 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: 1 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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE. $ �-�cv (D1-7- F-� PAT/I- a -7 `'A-7 r Date It r �'<".O�TM TOWN OF NORTH ANDOVER 0 PERMIT FOR PLUMBING ,SSACHUS� 1 This certifies that . . .r"` ���! . .,. . '�. . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . plumbing in the buildings of .•. .. . . . at . :.... .< . . . . . . . . . . . . . . . . . . . . . . ., North Andover, Mass. Fee_'_570) . . .Lic. . . . . . . . . . . . . . . . PLUIMBING INSPECTOR Check # 41 ' 7296 i MASSACHUSETTS UNIFORM APPLICATION FOR PEKIGIIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Zla Date a Building Location C Lc — , LID Owners NamerZM6 Permit# C, Amount C '"C - T eofoccu any;C,� —�;��� New E] Renovation �/ Replacement 0 Plans Submitted Yes No ! FIXTURES Ln Ln H a SZB)E M B�41vII�a' ISC FIOQt 2 21V1 FIDQt �FIOOit � 4M FUM Q 5M FIUR 6M FLOCR 7IH FIQ R SIH FIDQt (Print or type) Check one: Certificate Installing Company Name \( \a.A L1 l5�,���� c ❑ Corp. Address Partner. Business Telephone — a V-7 Firm/Co. Name of Licensed Plumber. Insurance Coverage: Indicate the typSqf4zuurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond insurance Waiver. 1,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 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 Massachusetts State PI binge�td Chapter 142 of the General Laws. By: igna ure o 1�nsea riumoer �' Title Type of Plumbing License City/Town wense Numner Master ❑ Journeyman APPROVED(OFFICE USE ONLY t .00 D a�a a .� z s = t a w 0 0 O O .i C3 '1 tt1 1 0 0 pa a y ,r to k + ❑ LI Pol WATER CLOSETS 2i r d P KITCHEN IN f . Y �. S K h- v LAVATORIES Z R BATH TUNG SHOWER STALLS O DISHWASHERS a DISPOSERS n LAUNDRY TRAYS '17 it WASN..MACH. CONN. NOT WATER TANKS TANKLES! O S O SLOP SINKS "Z11 FLOOR DRAINS ❑ O OAS TRAPS . •p ja Ll ❑ URINALS � D DRINKING FOUNTAIN �. e AMU DRAIN I a D $ WATER PIPING O. 7� ROOF DRAINS g ❑ NACKPLOW PREY. 0, >D 'd OTHER FIXTURES1 C% v aSL o M Date.......'�?....2 d.-..a. raORTM °f t' `°;•�"° TOWN OF NORTH ANDOVER a maim PERMIT FOR WIRING . ; ,SSACHU This certifies that 1 E S�C'G2.T. ..... has permission to perform .......... ........ � r wiring in the building of....�'ggw.c_.C:.....!,.`...�.��( .. ...................... at...... 5.... ./. c":. .1. ��...ems?....hNorth Andover,Mass. oc' l L Fee.....�.5.....�Lic.No...... •.�!f !.� ;� ..... ELEcmicAL IMPECr01k Check # 75 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 7 4/75— Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev- 1/07] (1..blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( EC),V7 CMR 12.0 (PLEASE PRINT ININK OR TYPE ALL INFORMATION) Date: lQ q R. - City or Town of: NORTH ANDOVER To theInsp�of Wires: By this application the undersigned gives notice of his or her intention to perform the electn qwork described below. Location(Street&Number) 69 J Y I 1A V-0 cxxi Owner or Tenant fj Owner's Address Is this permit in conjunction with a building permit? Ye 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 Elecct/r�cal Work: , Completion of the following table maybe 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- El o.o Emergency ig ng rnd. rnd. Battely 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 Pu, Number Tons o.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Elunicipa1 ❑ Other C No.of Dryers Heating Appliances KW secdntms:• o.of Devices or Equivalent No.of Water KW No.of No,of Data Wiring Heaters Si s 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 Elqctri.cal Work: (When required by municipal policy.) Work to Start: (A- LU spections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO GE: 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 BOND ❑ OTHER ❑ (Specify:)Wlo( Vol�&"V Q (,1 b)I [ C�1 I certify,under the p and nallies.o perjury,that the info on on this applic ' n is true and complete. 1 FIRM N E: Ct, C LIC.NO.:��k+ C Licensee Q Signat J LIC.NO.: IC) (If applicable,enter"e �v 1 r e) `\ Bus.Tel.No. 214-Lal Address: 1 Alt.TeL No. — o - *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: $ y