Loading...
HomeMy WebLinkAboutMiscellaneous - 67 SANDRA LANE 4/30/2018 / 67 SANDRA LANE 210/097.0-0075-0000.0 ` CLAIM DEPARTMENT NL l 101 HIGH STREET, P. O. BOX 40, NORWICH, CT 06360 FOUNDED 1840 INSURANCE COMPANIES (860)887-3553-C7-1-800-962-0800-MA-RI 1-800-243-4080-FAX(860)866-8270-www.nlclnsurance.com 11/14/2011 Inspector of Buildings 1600 Osgood Street North Andover, MA 01845 RE: Insured: CHRISTOPHER M. WATERMAN AND LIESA M. WATERMAN Property Address: 67 SANDRA LANE {FORTH ANDOVER, MA 01845 Company Policy Number: H5053026 Date of Loss: 10/29/2011 Claim Number: C17234 Claim has been made involving loss, damage, or destruction of the above captioned property, which may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, Section 6, to be applicable. If any notice under Massachusetts General Laws, Chapter 139, Sec 3B is appropriate, please direct it to the attention of the writer and include reference to the captioned insured, location, policy number, date of loss, and claim number. On this date, copies of this notice have been sent by first class mail to the municipal officials named above at the address shown. Sincerely, NLC Insurance Companies TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: IMPORTANT:Applicant must complete all items on this page LOCATION 67 -�) ,u A, e ,,fi�rr Pint PROPERTY OWNER 4-e,l$ Unit# Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes no Machine Shop Village yes no 100 year-old structure yes 'no TYPE OF IMPROVEMENT PROPOSED USE 11 Residential Non-Residential ❑ New Building ❑One family ❑Addition 0 Two or more family ❑ Industrial ❑Alteration No. of units: ❑Commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other . ® Se � � ��""��� ,;.1 ®►Rlo�o,dp m`� ��w �. � - : p Wa er �" - ,,. ®Water/Sewe __ DESCRIPTION OF WORK TO BE PERFORMED: (Identification Please Type or Print Clearly) OWNER: Name: G✓a Al- Phone Address: -7 �,•,�rr.� �.✓e /L,�Nc Pv,cam /✓,a 1 CONTRACTOR Name: Phone: Address: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ ©, v oy FEE: $ (r Check No.: ,r1--Au,1 � ,,%t Receipt No.: `t NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund •unci RIM s='-. Signatui-e I4 7 101 HIGH STREET, PO BOX 40, NORWICH, CT 06360 FOUNDED 1840 7 INSURANCE COMPANIES (860)887-3553 — TOLL FREE 1-800-962-0800/1-800-243-4080 — FAX(860)886-8270/(860)887-2898 www,nlcinsurance.com November 8, 2011 North Andover Building Inspector Building Department 1600 Osgood Street North Andover, MA 01845 RE: Insured: Christopher M & Liesa M Waterman Property Address: 67 Sandra Lane North Andover, MA 01845 Company Policy Number: H5053026 Date of Loss: 10/29/11 Claim Number: C17234 Claim"has been made involving loss, damage, or destruction of the above captioned property, which may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, Section 6, to be applicable. If any notice under Massachusetts General Laws, Chapter 139, Sec 3B is appropriate, please direct it to the attention of the writer and include reference to the captioned insured, location, policy number, date of loss, and claim number. On this date, copies of this notice have been sent by first class mail to the municipal officials named above at the address shown. Sincerely, Linda Fahey U Date..... Opt?....... NORT1{ "O TOWN OF NORTH ANDOVER 3r .r ..._• OL p PERMIT FOR WIRING ,SSACMUS� i This certifies that �...• ��'' y ................................................. :`.'........... has permission to perform ........ 1...........................:.....................r..................... —wiring in the building of...... ........(2P z -, ................................ 7 �....! � � � ............. .North Andover,Mass. nFeC:�O Lic.No%�.;/y 9� ................................................... ................... / ELECTRICAL INSPECTOR Check # 4675 I Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 41� 715 R 19 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/991 (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: 8/11/03 City or Town of: No.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) 67 Sandra Lane Owner or Tenant Chris Waterman Telephone No. Owner's Address same Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building existing 1-family dwelling Utility Authorization No. n/a Existing Service 200 Amps 120/240 Volts Overhead❑ Undgrd❑ No.of Meters 1 New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: wire new oil boiler Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Fixtures No.of Ceil:Susp.(Paddle)Fans o.of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA ove - o.o mergency Lighting No.of Lighting Fixtures Swimming Pool 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 an Initiating Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers eat p umber ons o.o Self-Contained Totals: --------_---------- _______________________ Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal Connection l Other No.of Dryers Heating Appliances KW SecuritySystems: No.of Devices or Equivalent No.of Water KW o.o o.of Data Wiring: Heaters Signs Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications firing: No of Devices or Equivalent OTHER: Attach additional detail if desired or as required by the Inspector of Wires. 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 ❑ BOND ❑ OTHER ❑ (Specify:) 3/04 (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) i Work to Start: 8/11/03 Inspections to be requested in accordance with NEC Rule 10,and upon completion. I certify,under the pains andpenaldes ofperjury,that the information on this application is true and complete FIRM NAME: Andrew F. Sheehan Electrical Service LIC.NO.: A11498 Licensee:Andrew F. Sheehan Signature LIC.NO.: Al 1498 (If applicable,enter "exempt"in the license number line.) Bus.Tel.No.: 978.622.5852 Address: 249 Pine Hill Road*Chehnsford,Ma.01824-1965 Alt.TeL No.: 978.256.8740 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(checkone)❑ owner ❑owner's a ent. Owner/Agent XT„ PI ERMIT FEE.S .� � Date i . . . . . N° 4 319 TOWN OF NORTH ANDOVER O� , �4, O �.� PERMIT FOR PLUMBING �,SSACMUS� This certifies that . . . . . . . . . . . . has permission to perform r-�.'. ��r .. . . . . . . . . . . . . . . . . . plumbing in the buildings of . .' . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . .. .�. .� , North Andover, Mass. Fee r�29. . . . . .Lic. No. . . . C//J PLUMBING�tNSPECTOR v .. WHITE: Applicant CANARY: Building Dept. PINK:Treasurer ;� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) K)0 2 Jif-APJW(1 Q4e , Mass. Date a 2�Permit # I Building Location � S5 n/A2,/A C fJ Owner's Named/ eA pe J (.(/A E ,aIA') ,2 Z�� v�/A ✓��� Type of Occu ncy 5+ E�% tl New ❑ Renovation ❑ Replacement t�' ans Submitted: Yes ❑ No ❑ FIXTURES z a, z N Z Y a H O Z > N W Y J N < . � N D Q ¢ O Z N a ¢ ¢ = y = O Z N o- 16- O W 1•- W N � 0 ¢ Y < N U. Z Z f. J H y a) S ¢ W N _ a a 3 X V Z O O Ic N W ¢ yyj a a 0 Z .¢ a ¢ 0 W CC MCC (a N ¢ J p p W = < S 3 0 Z = 3 C Y d F- < Y a W k Y W f- V � M- O = a n sn F. Z O O N Z = W f- O V S 3 Y j m 01010 j 3 z SUB—BSMT. BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR/� Installing Company Name f'�O r3Ee"r N - ,SP(1n m A'T A e-0 Check one: Certificate Addr,.ss 7.)r": C0 RC ti/) f4f') p ' ❑ Corporation /r E%l_4 t ' c-) yo r4 0 ❑ Partnership Busir!4!ss Telephone -h7�Z-i97 I 9-Ar /Co. Name of Licensed Plumber �4 f r<3 r=;�?T fry ,5,4 M j4 rrq o0cC,' INSURANCE COVERAGE: 1 have a current f billy insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you have checkedrtes, please /indicate the type coverage by checking the appropriate box. A liability insurance policy ld 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. Check one: Signature of Owner or Owner's Agent Owner [I 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 ormed under the permit issu for this application will be in compliance with all ' pertinent provisions of the Massachusetts State Plum g e andr?jof the eral taws. Title re of Licensed Plum r City/TownType of License: Master Joumeymab❑ APPROVED OFFICE USE ONLY) License Number._233 5 BELOW FOR OFFICE USE ONLY FINAL INSPECTIONS SKETCHES 1 PROGRESS INSPECTIONS FEE NO. APPLICATION FOR PERMIT TO DO PLUMBING NAME do TYPE OF BUILDING LOCATION OF BUILDING PLUMBER PERMIT GRANTED ` DATE 19 PLUMBING INSPECTOR Location NDate NORTH TOWN OF NORTH ANDOVER O: •' • 0 Certificate of Occupancy $ . � Building/Frame Permit Fee $ Foundation Permit Fee $ s�C14U Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector 3 I 1e47 25.00 PAID Div. Public Works • i PE&JtIT NO. 1416 APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. to/ PAGE 1 MAP ,1 0. 2 I LOT NO._�S 2 RECORD OF OWNERSHIP DATE BOOK ;PAGE - ZONE ` SUB DIV. LOT NO. LOCATIO I! CI / 1 PURPOSE OF BUILDING��(A ��� OWNER'S NA // / /1 >11 �y, I (� /� ' NO. OF STORIES `[SEIZE OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME I /�f7, / SPAN DISTANCE TO NEAREST BUILDING ^' DIMENSIONS OF SILLS DISTANCE FROM STREET �.,r_/� POSTS DISTANCE FROM LOT LINES-SIDES REAR .1G GIRDERS / AREA OF LOT ! FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW �'�'/T[//r/ SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODEI /� IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY /'7Y✓/!/IL� �`if' IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST Z72 tJ '✓ PAGE I FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AN APPRO E/D/ BY BUILDING INSPECTOR DATE FILED '[� 2w�� BUILDING INSP[CTOR SIGNATUR OF OW ER OR AUTHO FEE �� OWN �0 CC2 PERMIT GRANTED _ / �j�z�"� O Pr , CONTR.LIC.# CONTR.TEL.� �^ 19 ��� H.I.C.# /OG� BUILDING RECORD ` 1 OCCUPANCY 12 SINGLE FAMILY _ SioRIES, THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA. APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 3 1 2 13 CONCRETE BL K. PINE BRICK OR STONE HARDW-D PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN. B M AREA _ 1/1 1/1 1/1 FIN. ATTIC AREA _ N_O B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARDIN'D _ ASBESTOS SIDING _ COMMCN VERT. SIDING ASPH.TILE {I_ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. d FLOOR I_ BRICK ON FRAME CONC. OR CINDER K. STONE ON MASONRY WIRING ' STONE ON FRAME SUPERIOR I� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE HIP BATH (3 FIX.) _ GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. b COLS. STEAM ; STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT-HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd I NO HEATING G Z T ly �� 14 O Over own Tof No. 4 _ 1 T? 1 No An Mass., Z 19 BUIL F BOARD OF HEALTH PERMIT TO Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT (,.4-1-Z&.�G.�.. .................. 4. w.•�.`'.Y... .............................. Foundation ...... has permission to erect.......�7=.................... buildings on ................ ............. l.I� .. ............ Rough tobe occupied as...................... .. ............................... .......P—.0_6-P ............................. ............ .................. ..... ... chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR = VIOLATION of the Zoning or Building Regulations Voids this Permit. Rougli Final PE"\./ IT E ',.PIR:" htiT IviO, THS UNI,ES CO?�1ST�:L1i._.lN S _ TS EE.ECTRICAL INSPECTOR Roui' Servs.e DING INSPECTOR Fina', Occupancy Permit Requi rid t OCCI ti y Building GAS INSPECTOR s Place on the Premises — Do Not Remove Rough Display m a Conspicuou Final No Lathing or Dry Wall To Be Done �• FIRE DEPARTMENT =� "�•� Until Inspected and Approved by the Building Inspector. n: Burr r Stre, No. Smc 2 Det. r 5. i'fiv Mal awle 1810 010 srv..,AAjU f.odl�i NOR i4 r - vSCF MC a �3Fn,'n' VISC?,L=C 5S5 dat R a r w . � =y - ,gq8 01101 ,�pr � �• � , 03t'1�11 �zssticted� 1 ' a J � - I -�v . .� yp Y , r,rade ` t. �.s uiw' r ns '}"'N`+ H1ea Ys<,.r,x,n.yM+,.-++r-�.;ry„ 4 �a,x: v+'tr^: 4 ..,.•y,., ^,aa*;.tt.. ,stae�.,: alar• `2,'r; oA,-% �.,e,.Fr s;rI . --t'.;.�.r e..rw +=-„<a,.r.P, r.. E' t w ,�'r+" h` .14 ?-.� .# ♦ 22 ,�„�.a ��'..F'et'9.r^�-..-, 54 .a.:va"ns•., .., -. ,,, �».�. �._y-r°:�"^€Y'e�ca^!f*}*g.�rw ur�rl.,:�. x �,+�:R". .#3k�+,,cr. .' � s:" Office Use ON - u E L0MMgnWt# IIf �46950#Ugtft� Permit No. +4epartment of Public tufetg Occupancy& Fee Checked o, - BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 s/so (leave blank) 3, 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 (X* or Town of NORTH ANDOV '.R To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 4 ) , 1- Owner or Tenant aA,-7 r Owner's Address Is this permit in conjunction with a building permit: Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Servi Amps /_/ /C2:?C_Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps _J Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Total No. of Lighting Outlets No. of Hot Tubs No. of Transformers KVA Above In- No. of Lighting Fixtures I Swimming Pool grnd. ❑ grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners I Battery Units No. of Switch Outlets I No. of Gas Burners FIRE ALARMS No. of Zones Total No. of Detection and No. of Air Cond. No. of Ranges I tons Initiating Devices No.of Heat Total Total No. of Disposals Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices I Municipal ❑Other No. of Dryers Heating Devices KW Local ❑ Connection No. of No. of Low Voltage No. of Water Heaters KW I Signs Ballasts Wiring No. Hydro Massage Tubs I No. of Motors Total HP OTHER: ).p Z�2E-Zlee INSURANCE COVERA E: Pursuant to the requir ents of Massachuse s 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 = NO Z If you have checked YES, please indicate the type of coverage by checking the app opriate box. �r �,, INSURANCE BOND OTHER Z (Please Specify) (Expiration Date) Estimated Value of Electrical W rk S /cv Work to Start 77�— Inspection Date Requested: Rough Final Signed under the Penalties of perjury: f LIC. NO. _IL FIRM NAME ,��T �' r Signature LIC. NO. Licensee Bus. Tel. No. Alt. Tel. No. Address OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE S (Signature of Owner or Agent) x-6565 i d. ` �T, 2599 Date.. . . o T2 NORT/, TOWN OF NORTH ANDOVER ' oFt,�.o ,s,tio ,�`t.t ICAL 32 "� PERMIT FOR INSTALLATION t s o`SGS y9SSACHUSES ,S This certifies that ����'t. CA!,WMI �� has permission for nstall 'o in the buil i gs of . . �4. . . . . . . . . . . . . . . . . . . at J7. A. . . . . . ., North Andover, Mass. .'L Fee. Lei/ •�.V. 15.00. . PAID . . . . . . . . . . . . . . . . . C. tM INSPECTOR WHITE:Applicant CANAP Building Dept. PINK:Treasurer GOLD: File +^ Office Use Only v ): �uritmDrilU�ttlt If 4Jag6ar4U5ttt9U 2 Permit No. i9epaTtmEnt of Ilublic ihfEtq Occupancy& Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3190 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL ORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT 1N INK OR TYPE ALL INFORMATION) Date I%* or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) e s ��rQ ���J�—PA46 Owner or Tenant +� /?n Owner's Address Ly�'I�� Is this permit in conjunction with a building permit: Yes ❑ No (Check Appropriate Box) Purpose of Building Utili Authorization No. Existing Service Amps —J Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps ----/—Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Total No. of Lighting Outlets No. of Hot Tubs TNo. of Transformers KVA No. of Lighting Fixtures I Swimming Pool Above In- No. grnd. ❑ grnd. ❑ I Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners I Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Air Cond. Total No. of Detection and No. of Ranges tons Initiating Devices No. of Disposals Dis No.of Heat Total Total P Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers I Space/Area Heating KW Detection/Sounding Devices I I Municipal No. of Dryers Heating Devices KW Local ❑Other ❑ Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage Tubs I No. of Motors Total HP OTHER INSURANCE COVERAGE: Pursuant o the require ents of Massachuse s general Laws 1 have a current Liability Insurance Policy inctu g Completed Operations Coverage or its substantial equivalent. YES NO I have submitted valid proof of same to the Office. YES = NO _. If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE (Expiration Date) BOND OTHER = (Please Specify) Estimated Value of Electrical or s Work to Start Inspection Date Requested: Rough Final Signed under the Penalties of perjury: 2L_—_/ i LIC. NO. FIRM NAME �+ Licensee Signature LIC. NO. Bus. Tel. No. Address Alt. Te I. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMI FEE �J (Signature of Owner or Agent) (//(/ C� x•6505 i Y . r n r 1 ',G '.u. .w .... M• .,•c 00A7E ) PAOOUCI� 7E IS ISSUED AS A MATTER OFRMA BECHARD INSURANCE AGENCY or&Y AM Na momm UPON 7w �►li ALTER THHOLDOL ECC0VtRA EM NOT tQl�MOBIL 211 MAIN ST C0M mnm ii� NASHUA NH 03060 COMPAW A CONMERCIAL UNION INS CQ iA'IIl110R GOAIPANY S SCHARN ELECTRIC e LIBERTY MUTUAL COYPALIY . 2 XNDVSTltXAL WAY 04 c SALE! NH 03079 COMPANY a iN=&Tw, NaiwlimAwom ANY moua EIf m.TEm oA pox tF ANY CONTRACT OR OTWR OQ AMr WM MPW TO WNW TM CoFMF GA7S MAV BE>SM OA MAY PEriTAIK Ta MURM"AFFCROED BY THE POLCM WSCMED HEWN IS 9UBJC'f TO ALL 7K Wrals. 4LCLUM019S AND C*tWM0NS OF SUCH PaL1Clis8.Lv&M KNOWN MAY HAVE BEEN REDUMO BY PAD CLAD. l� _! TM OF POL7CT L� � �� Lam k GOM&UAMU" PUM2 075 5 2/17/96 2/1? 97 apim"AmommYE i Z,"502,000 X ooL<i aw a roL mmu P+MUllYss-oar AGO 819 0001000 MM ❑O=M PEM 10"A ADV OAM S1,000,000 a CZNTRACTO"PAUT EWN occu $1.000,000 MM WjLVE WW** # 50'000 Lmmwwvarwr -1 • 5,000 AumImu"Laeaer CMU95639 2/17/96 2/17/97 � L cc5001000 alesrsa ago= AMf Aura ALL&AM AUM r+[{Mit1f X mceuleb Antos Now AV= 1l001.Y AallNll► ; /100r.0WN90 AUTOS owenmp* �.... VPAP�TY OANA00 s mak- AMf AUrD OLHfiR Nr/M t!01�� .�:'• 3 . I s Lal�B Lill0f]nI �iAIE FN I A FORM ASOMMUi 01W THAN Uyea=A FOW 3 WOMMSCOWMMATIOLIAIW WC1311248675016 3/07/96 3/01/97 X L%.cYUr UA MM_ .lit W THE m am%-MFV om us Is � r 0M%VU ARE: MML 016MASE-BACH N< oellell sham aF Rt416 }- �1afY1 ALi�[Qr�'AOCV!D�I'�ls�p raLLCIBs LRt CAtlGatllJO L�711E whoa DAM 1'eFAi60s, VU a Wft O MRAW WILL#IICMAVOK To W& ;,Q „sAYs 1I11MI1!IDII Ilollc£7e 1Nd CWMAU WLDft Llf1=T*l=LAW, AUT Pt"RE M ASAL MAM NO=AM"2060 NO 60LIQATIDM 00 UAW" w ANY am wow im eorl%w aamm 6B LILIramlcrinLflre�. ALrtI10ll�o LIEMHS0JIIATIYE HENRY A. BECHARD JR. DK N it ,'F....rk.: ...�»vr."'.:.-�.r"t.3;r. -�'--„x”-...-r-�=...�. .�-tib.,��-.^'•`E..,r^..i c'.�"- • ;v 4 Date. . 26 36J C? hl�. } E NOQTN._q TOWN OFNORTHN_OyR.TH ANDOVER g F2p`t„to ,e tiQp tiLce i rz1C44. PERMIT FOR GM 1NSTALLATIONg 5 .�} L �9SSA CHUSEtt (f7 This certifies that . . . . . . . has permission for installation � .�.�. (J�t t f . .r. t`.-` in the buildings of . 4.-*.*.*.'.'.*.*,* at . . . .7 . . 4`� rth Andover, ass. Fee. f!/: Lic. No.. .. .. . . . . . . . . . . INSPECTOR ,WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File Date.'� <".O'OTM,1O TOWN OF NORTH ANDOVER ti PERMIT FOR PLUMBING ,SSACMUS� This certifies that AA!f'. . J. . . . .�.?.� �7� has permission to perform . . . . . . . .r . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . . . . . . . . . . . . 5 `�� L L. . . . . , North Andover, Mass. Fee. Lic. No.. . . . . . . . . . .. . . . . . P UMBING INSPECTOR Check # cJ 5612 OR 8 ° c d -1CAI {NATER CLOSETS KITCHEN SINKS C LAVATORIES Z ... • �'1 BATHTUB 'fl IIHOWER STALLS a i DISHWASHERS Ic 1 � d DISPOSERS LAUNDRY TRAYS !- y L WASH. MACH. CONN. r 3 HOT WATER TANKS TANKLESS g SLOP SINKS O � Z FLOOR DRAINS O �. ❑ ro GAS TRAPS o R� I:I URINALS DRINKING FOUNTAIN Z AREA DRAIN Vt• W ATER PIPING �• ROOF DRAINS ` N n -1 rl Ll R BACKFLOW O PREV. v J) OTHER FIXTURES: p �- BOILER MATE 1 GREASE TMP '< r SCULLERY SINK d u)E. g SHOWER VALVE -- o N W � o BELOW FOR OFFICE USE ONLY FINAL INSPECTIONS SKETCHES FEE PROGRESS INSPECTIONS NO. APPLICATION FOR PERMIT TO DO PLUMBING UNDERGROUND ROUGH COMPLETE ROUGH FINAL INSPECTION PERMIT GRANTED DATE PLUMBING INSPECTOR Date. . TOWN OF NORTH ANDOVER ° PERMIT FOR PLUMBING ,SSACMUSE� This certifies that . . . rte. .'. . '.f . • . . . . . . . Y has permission to perform . . _ f . . . .r . plumbing in the buildings of � . . . . . . . . . . . . . . . . . . . . . . at . . .. -� � '^-�". . . . . . . ., North Andover, Mass. Fee?,-'. . . . . .Lic. No.. . . . . . . . . /�-PLUMBING WeKe OR Check # ell 5693 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMB (Type or print) NORTH ANDOVER,MASSACHUSETTS C/ Date Building Location � / < QI J & P Owners Name CSS )R ` 11 Permit# X33 Amount �b Type of Occupancy Q�Pf New Renovation Replacement ® Plans Submitted Yes ❑ No FIXTURES z En H a0 C4 QF Ln Cn Gn w w p� W � A C4 A W StEB4VIC Cii &�g1VINh NE RDOR ZD ROM 3M FLOOR 4IH FLOOR 5M BJXR 6M R" 7IH FLOOR SIH FIOQ2 (Print,or type) � Check one: Certificate Installin Company Name 1 o `� Corp. g � C�1 rQYI 1�fT ❑ Address - ` a ❑.Partner. + Business Telephone qS Firm/C0 Name of Licensed Plumber: q`441 f Ct -71 rU n Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy �/ Other type of indemnity Bond i I Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the abc three insurance ignature 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 tt 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 Massa�cc State lumbing Code and Chapter 142 of the General Laws. By: Signature-of Mum er Type of Plumbing License Title / City/Town icense um er Master Er, , Journeyman ❑-. APPROVE (OFFICE OFFICE USE ONLY O'v