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Miscellaneous - 69 MAIN STREET 4/30/2018
�� _ _ _ __ _ _ _ _ _ _ _ _ __ _ __ _ _ 4 ___ , . J a � �. i i -`... Date .................... TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING sS� C CHU This certifies that .. ......................... ..................... ....... . .......... has permission to performlp..6.kl�........e............ It ....................................................... in the building of LA64 wiring j.4 ..................... pq 9 . .........................................k.................. at ....................................................... . North Andover,Mass. Feei...06�........Lic.No.,13A.. .............. ELECTRICAL INSPECTOR Check# 3 12A. 49 a �\ Goin non weatA o�1I1a1>lacftJtso Official Use Only MIMI cc�� c7 Permit No. oUeFarErnenE a�._tira�eraice! BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] 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 (PLEASEPRINTININK OR TYPE ALL INFORMATION) Date: City or Town of: P G' QkCA To the Inspector of Wires: By this application the undersigned gives notice of his r ber intention to perform the electrical work described below. Location(Street&Number) Owner or Tenant 1`���� I b Telephone No. 112 -/,/61 Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of temperature and fan controls on walk ins. Corn letion of the ollairin 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- Elo.o mergency ig ng rnd. rnd. Bottc 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 Total Initiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices 3 No.of Waste Disposers Heat Pump Num er onsw_ K No.of elf-Contain Totals: ` Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal [I 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 I siens Ballasts I No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wrr►agg• No.of Devices or E uiva cat OTHER: Attach additional detail if desirec4 ares required by the Inspector of Wires. �\ Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule I0,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 x BOND ❑ OTHER ❑ (Specify:) I certify,tinder the pains and penalties of perjury,that lite information on this application Is trite and complete- FIRM ompleteFIRM NAME: Natlenal Resmmm ManwrnaM,Ina LIC.NO.:imi" Licensee: RWA.Pw"Jr. Signature LIC.NO.: 1731" (Ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No.•781412e. Sn Eid 139 Address: Aga Nemmset SL,emn 2.Canon MA 02021 Alt.Tel.No. *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S„License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner _❑owner's agent. Owner/Agent PERMIT FEE:$ l a5`� Signature Telephone No. C,�t(II4 V--" b 1 uvv,;L lk f The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations I Congress Street,Suite 100 Boston,MA 02114-2017 www.massgov/dia Workers'Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(BusineWOrganizationnndividual): National Resource Management, Inc. Address:480 Neponset St.Bldg 2 City/State/Zip:Canton,MA 02021 Phone#:(781)828-8877 Are you an employer?Check the appropriate box: LM I am a employer with 70 4. ❑ I am a general contractor and I Type of project(required): employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9. ❑Building addition [No workers' comp. insurance comp.insurance.: required.] 5. ❑ We are a corporation and its 10.M Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their I l.❑Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12. Roof repairs insurance required.]t c. 152,§1(4),and we have no ❑ employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hive outside contractors must submit a new affidavit indicating such. tContractors 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. U the sub-contractors have employees,they must provide their workers'comp.policy number. [am an employer that Is providing workers'compensation Insurance for my employees Below Is the policy and job site Information. Insurance Company Name:CNA Insurance Policy#or Self-ins.Lic.#:NAWC825410 Expiration Date:10/1/2014 Job Site Address: All locations in City/StatelZip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Si a !` �e.J ���`.o« Date: Phone#: 78f8288877" Offlcia/use only. Do not write In this area,to be completed by city or town ofdial. 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#: 1 Client#:36573 NA71ORES ACORD. CERTIFICATE OF LIABILITY INSURANCE 10AW2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE HOLDER IMPORTANT:If the certificate holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed.If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement.A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER GT Kathy Osborn StariLWreather 8 ShepleyP .Elft 781320-9660 Not 781320-9901 Insurance Corp.of MA VIMAM Kosborndstarshe .corn PO BOX 549 AnamaINSURERM AFFORDING ODVERAGE HMO Providence,RI 02901-0549 INSURERA:CNA Insurance 03972 INSURED mum 6:Endurance American Specialty In 41718 National Resource Management,Inc. u sDRmc:Guard Insurance Group 480 Neponset Street,Bldg 02 INSURER D: Canton,MA 02021 INSURER E. INSURER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. SR TYPE OF INSURANCE MR MA POLICYNUMBERApsmLIMITS A GENERAL LIABILITY 5095758467 1010112013101011201 EACHoccuRRENcE s1000000 X COMMERCW.Gt?tERAluAenmD s300000 CL 1MS4=E ❑X OCCUR MED EXP WV ane $6,000 PERSONAL&ADV INJURY $1,000.000 GENERAL AGGREGATE s2.000.000 GENT.AGGREGATE UMLT APPLIES PER: PRODUCTS-COMPIOP AGO S Z000 000 PoucY FX M 7 Loc $ A Aummoeu LIABILITY 6096093603 1010112013 10/011201 0 S1,000,000 A X ANY Alrro 5095162646 1010112013 10/011201 BoaLY INJURY(Per Pws" $ ALLOW,AUTOS D X SCT OS BODILY INRIRY(peraoddwm $ X MIREDAUTOS X � PROPERTYQAMAGE s i B X ummmu A uAeOCCUR EXC10004255300 0101/2013 10/01/201 EACH oocuRRENcE s6,000,000 ESS LUUB CLAIMSMADE AGGREGATE s5 000 000 DED I X1 RETENTION:10000 $ C "10 COM noN NAWC425410 0/0112013 10/011201 X wC STATu OTM AAryNyDpE111PpLOOYEEERR�S'LIABILITY Q AMORE D(IX E��� N N 1 A E.L.EACH ACCIDENT $1,000,000 (MaMaoory In NN) E.L DISEASE-EA EMPLOYEE $1,000.000 DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I S1 000 000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES IAtleh ACORD 101,AddltlonW Remaft Schedule,B more specs b required) Evidence of Insurance CERTIFICATE HOLDER CANCELLATION For Permit Requirements Only SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROMIONS. AUTHORMED REPRESENTATIVE ®1988-201 O ACORD CORPORATION.All rights reserved. ACORD 26 ooh 9 of 1 The ACORD name and logo are registered marks of ACORD S _ r — ELICERS NSE_T MA =x80&10:`M!!Q -:HorrN-S3503,7972.;....... a:l a 1050 WNCOLNSHI as ,': ROUGH,MA OT/80 ........... I�t snon�ormnaryw-�i�oo ��� ! ,. ._ �' .�C:�-✓lam• COMMONWSALTHi OF MASSACHUSETTS • • • - • o - ��E.L�E TR`I I ANSA: .'ISSUES=THE =FOLLOWI.'NG `-11.`e SE=ASI=A - REG.GSTEREO MASTER ELECTR 1-c]-N N'AT�I�ONAL<<RE=SOfJRCE<�MANAGEMEsNTL'��r:.INC;<'�� �n" ..ROGER<'ALA:NT c O b14'�0�20�2• 1 { i Form 4 -- System Pumping Record Commonwealth of Mossachusetss : Massachusetts System Pumping Record Syshim"Owiie'r`' !tr vat Gr�+,a:n 1'r.'p System Location P. :.Uz EFVP J a 14 Sub Shap t :1 WAV ST F v ".'.i t :�TPEFT N-3R'Ri :h!.OY'te' HA 01645-2426 IiIURTH :,IXw-j`kk H, 01641) 47o 6' 144 t.j-6d�-31,1 1. Type: Emergency Routine Cesspool: No Yes v Septic tank: No Yes Date of Pumping: p Quantity Pumped: Gallons System Pumped By: Wind River Environmental, LLC Permit#: Contents transferred to: ►"Vel Contents Disposed at: CarVar, �{A q. Date: Pumper signature: , Condition of System/Other Comments Dep Approved from - 12/07/95 Form 4 -- System Pumping Record Commonwealth of Massachusetss : Massachusetts System Pumping Record System Owner System Location J E It �'ub 5tt)p LT r pT falb h01 69 thin Ft r^ ?12tH :;t Dlorth Ando-"r IIA. 01841, Voith Andovi,r. tt4 018Iw (1173) 114 x (97Ri HZ-3142 Type: Emergency Routine Cesspool: W Yes 9ilift inniee W =Yes Date of Pumping: ' Quantity Pumped: _Gallons System Pumped By: Wind River Environmental, LLC Permit#: Contents transferred to: Contents Disposed at: C r . Date: is D Z Pumper Signature: Condition of System/Other Comments Dep Approved from - 12/07/95 Date...... . -.r.2-O ... ,40RTH 0. TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING $,SS...AT'a ACHUS This certifies that .................... has Permission to perform ....... wiring in the building of................. ............S..kls ......... .... at........69.19' ...s'^..... North Andover,Mass. Fee.... Lic.No.............. .................... . �jo6 CJ AL INSPECTO EZiRl Check # tR, 3 7870 (..onrnwitwe th of Maddachu9alb Official Use Only ��pp -- Permit No. �U 21 spartmanl o1.015i"Sarvica9 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] 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: 1,) ,/6 - 07 City or Town of: Af. t4!�d6 tit' To the Inspector of Wires: r' By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) t/LZQ t Owner or Tenant j.t tM S u b Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service _ Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location apd Nature of Proposed Electrical Work: vg},�(� 0. try, o GC.ur t d r stir 14 LarPI S STem Completion of the ollowin table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans o.o Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA -! No.of Luminaires Swimming Pool Above ❑ n- ❑ o.o mergency Lighting rnd. rnd. Batte 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 ump um .er ons o.oSelf-Contained Totals: " " """" ....""""..... Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local Elunicipal ❑ Other Connection No.of Dryers Heating Appliances KW Security ystems:* No.of Devices or Equivalent No.o.o Water Heaters KW o. Data WirinSi ns Ballasts No.of Devices or E uivalent No. Hydromassage Bathtubs No.of Motors Total HP TelecommunicationsWiring: No.of Devices or Equivalent T Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: _ _ Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) I cert,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: P-T S2CUv-(: Sc r LIC.NO.: /533 e— Licensee: - ��� ,knAl Signature LIC.NO.: 9,80& (/f applicable,ente►+"exempt"in the license num a rne.) Bus.Tel.No.: 59� Address: l' X L/NT M je- go/1(S , uH 43049 Alt.Tel.No.: *Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No.. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally Z Y v required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's EDent. Owner/Agent Signature Telephone No. PERMIT FEE: S �f 7i • 3�6 � Zv 3(a0 � b IV:.ri.J1; REGISTERELECTRICIANS ED SYSTEM TECHNICIAN DOUGLAS BUCKERIDGE 14 LYONS STREET HAVERHILLY MA '-01832-4610 ' 2306 D 07/31/07- 952075 Ilk ✓�6Ea { jE�N1 SF/Pt18LIC�S License: SEC SYS CERT.CLEARANCE Number. SS CC 00.1594 Birthdate: 06/13/1c53 . Expires: 06/13/2007 Tr,no: 478.0 Restricted: 00 DOUGLAS BUCKERIDGE 14 LYONS ST HAVERHILL. MA 01832 Commissioner �]``— 91te -CoG� Department of Public Safety _ One Ashburton Place, Rm 1301 Boston, Ma 02108-1618 License: CERTIFICATE OF CLEARANCE Number: SS CC 001594 Expires: 06/13/2009 Restricted To: 00 DOUGLAS BUCKERIDGE 18 CLINTON DR HOLLIS, NH 03049 Tr.no: 894.0 Keep top for receipt and change of address notification. DPS-CA1 0 50M-07/07-PC8490 �ie -�o�Jvn�aru�Jealll o�✓/�aaaaC/:uaeka DEPARTMENT OF PUBLIC SAFETY CERTIFICATE OF CLEARANCE Number: SS CC 001594 Expires: 06/13/2009 Tr. no: 894.0 S-License: ADT DOUGLAS BUCKERIDGE 18 CLINTON DR HOLLIS, NH 03049 DIG SAFE CALL CENTER: (888)344-7233 Commissioner ,. . � t . Date........................... TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING S CHUS This certifies that ..........................yakti ............. . .............................. has permission to perform ........ ........................................... wiring in the building of........................... .. .............................. at..... S'T................................. North Andover,Mass. Fee Lic.No.16.1kY-./—.)........ . ..o ........... ELECTRICAL INSPE Check /I 91 61 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked [Rev. 1/071 (leave blank "F f 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 PRINTININKOR TYPE ALL INFORMATION) Date: - ,9-,,2,V09 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 j p lS Telephone No Owner's Address (nom. e (1�e �� D �(Check (�e 0 Is this permit in conjunction with a building permit? Yes ❑ No S { Nopriate Box) Purpose of Building .�U 17 - S ' p Utility Authorization No. Existin g Service Amps / Volts Overhead ❑ Und rd g ❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity " Location and Nature of Proposed Electrical Work: -t2 L 1,e a� © 0ie ' Com letion o t e following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total . Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires L g Pool Above ❑ In- o.o mergency ig g d rnd. ❑ F e Units -- No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas B;d. No.of Detection and InitiatingDevices No.of Ranges Tota No.of Air CTonsTotal No.of Alerting Devices No.of Waste Disposers Heat Pump TonsKW No.of Self-ContainedTotals: _..._..____..._......._. _. - Detection/Alerting Devices No.of Dishwashers Space/Area Heating KWLocal❑ Municipal Connection r7Other ENo.of Dryers Heatin A liances Securi S ste •* g PP KW ty y ms.of Water N No.of Devices or Equivalent Heaters ' °'°f No.of Data Wiring: ` Bathtubs No.Hydromassa Signs Ballasts . No.of Devicesr E u oivalent a g No.of Motors Total gp Telecommunications Wiring: OTHER: No. of Devices or E uivalent Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Stark -42 -d 2 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 ❑ BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties f perjury,that the information on this application is true and complete. FIRM NAME: pr/ , LIC.NO.: S/6 Licensee: Signature - LIC.NO.: (If applicable, a ter"ex pt" n the lic a num er line.) Address: us.Tel.No.: - 1i7y *Per M.G.L c. 147,s. 57-61,security work requires Department of Public Safety"SLi c.License: Alt.L l.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. $ �' '• ', � R ', � I � �Z � ��`� � `�L� j- ', The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA-02111 www-mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricans/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 2 (o q L l�U� Address: City/State/Zip: 00- ' - btu Phone#: Are you an employer? Chec k the appropriate bog: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. New construction employees(full and/or part-time).* have hired the sub-contractors 2.[ I am a sole proprietor or partner- listed on the attached sheet.t 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. . workers' comp. insurance. 9. B ilding addition [No workers' comp. insurance 5• ❑ We are a corporation and its required.] officers have exercised their 10. Electrical repairs or additions 3.0 I am a homeowner doing all work right of exemption per MGL 1 l.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §l(4), and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.❑ Other WHIP. insurance required.] *.::.y applicant that checks box 41 mu;also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. 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 Self4ris. Lic.#: 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 Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby cern under the pains nd p ahies of perjury that the information provided above is true and correct Signa----- Date: 0212 2 Phone#: Z- 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 s,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 ltocal 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. If 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 Deparunent 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 r 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 bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of fnvvesfigations 600 Washington Street Boston,MA 02111 Tel. # 617-7274900 ext 406: or 1-877-MASSAFE Revised 5-26-05 Fax 4 617-72.7-7749 v" 7.mass.gov/dia CERTIFICATE OF USE & OCCUPANCY voce[ ov Konh &ndew(wBuilding Permit Number 216 Date July 5 , 1991 THIS CERTIFIES THAT THE BUILDING LOCATED ON 69 Main St . , North Andover, Mass . MAY BE OCCUPIED AS J & M sub shop IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. � p10RTly s 3�OSSLED ib L 14. A CERTIFICATE ISSUED TO Mathew Xerrakis DBA (j&M Sub Shop) a°* ADDRESS 69 Main Street , Nor ,hAn over,Mass . x'17,9 SSACHQAC H U`� Building Inspector PLANNiNG_ FINAL CONS llW FFI FINALIT- S ®®®m® � /� K 6 �^fl ®wn o ��.. o 6 , 0� ndover _ �� 1990-oft h=K-Andover, Massop ..� CUC'.HIC Ht WICK 1 _ BOARD OF HEALTH P E R M:.,.ITI `� d THIS CERTIFIES THAT.............. , . :..:...... 7� � � �� 41 .:..... .............�...�... .... .. ..... BUILDING INSPECTOR has permission to eft ...............:..:...... buildings on ..:..... ... .. .......:........ .......... ugh Rough to be occupied as.. X pro. 1. �%..FbR...M.&.. ...... �-..�. t.r.ft. .... Fina Chimney 3 Ch Oe provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Rou ( _ Fna S o7 / Location C.� y �� � � 'rmAAit��. ;a � ` No. �� �� Date �� / .I Ivy C 1 1T H ELE RICAL INSPECTOR Rough "N1 Service f AOR'rh TOWN OF NORTH ANDOVER -� Fm o s•..o ,� .yo alo �- 3� ..... ................... 0 s Certificate of Occupancy $ BUILDING INSPECTOR GAS 1 SPECTOR ` Building/Frame Permit Fee $ Rou Occupy Building {{V // Foundation Permit Fee $ s�cMusE n ff-A/ .� e—. Fin 7 0�7(l' S Other Permit Fee $ 3 t y gESecu. Connection Fee $' e on .the Premises 5 ` I FIRE DEPT. Water Connection Fee $ Ve Burner /Jv/# Wo. An TOTAL $^ ected and Approved. by Smo�keEDetET�®� hover Caff -� � ���Ol Building Inspector or ! Div. Public Works � _ _ _ _ ,�� � - I � 4 _ _� Location I No. `z t : ' Date SKt-11� j NORTH TOWN OF NORTH ANDOVER " ' Of to ,•�h'O �� tom' c •- - p Certificate of Occupancy $ # - ece Building/Frame Permit Fee $ " �,SSACMUSES Foundation Permit Fee $ -- Other Permit Fee $ r M Sewer Connection Fee PAID BY M�ater'Connection Fee TOTAL $ n Building,Inspect_o.r— I � Div.Public Works J Location No. % ; Dateof NORTH TOWN OF NORTH ANDOVER A Certificate of Occupancy $ � Building/Frame Permit Fee $ CMUS<� Foundation Permit Fee $ Other Permit Fee $ 5 RC-81ve , Sewer Connection Fee $ Q , �nnection Fee $ �J f ,TOTAL _ $ A10. 10 vel, COI/ Building Inspector SOP Div. Public Works Al APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER MASS _ r . , VAP KJO.' LOT NO. 2 RECORD OF OWNERSHIP "DATE BOOK "PAGE }. ZONE I SUB DIV. LOT NO. — LOCATION PURPOSE OF BUILDING p ' OWNER'S.NAME NO. OF STORIES SIZE E.CIst7A)iz_ S'7b24F- OWNER'S ADDRESS ASEMENT OR SLAB • r `�1STj Nr+r v ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAMEI ��.1✓ SPAN DISTANCE TO NEAREST BUILDING ; DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES—SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW f_�xIyil SIZE OF FOOTING X IS BUILDING ADDITIONN© MATERIAL OF CHIMNEY IS BUILDING ALTERATION \ e; IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE L IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY V IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS ,0 3 PROPERTY INFORMATION O ,p C� . C.. LAND COST SEE BOTH SIDES WOOL Kxm ffo► EST. BLDG. COST s©IOOO PAGE 1 FILL OUT SECTIONS 1 - 3 /s�w�� ��_( N� EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 Sp�- EBT. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING [N /(G� -mmon4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REG�U//LATIONS -2 C PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE ;L�ED v BOARD OF HEALTH SI NATURE OF OWNER OR AUjHOftIZED AGENT 1 s A F E E �a PERMIT GRANTED PLANNING BOARD J; /�. 19 1 _ Y 1=-lV 1�'`►�.`�•{� BOARD OF SELECTMEN BUILDING INSPECTOR R BUILDING RECORD 1 OCCUPANCY 12 41 11 1 + - SINGLE FAMILY SiOBIES 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 .r t~. RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 :`.'INTERIOR FINISH y _ 4 ' CONCRETE _ _ B 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW'D n.IERS -=i PLASTER DRY W4LL:" UNFIN. 3 BAS EIMENT AREA FULL 'FIN. B'M'T' AREA - C V, r/ �(�.�' 'FIN. ATTIC AREA NO BMT FIRE,.PLACES ' y'. _ HEAD ROOM -MODERN KITCHEN ' 4 WALLS 19 FLOORS t i CLAPBOARDS B t 2 3 �. DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARD\rJ'D ' s�}.�»t!t :,t �r,artroatiaaApiaw ASBESTOS.SIDING _ COMMON __ } 'p'{ L'�7t VERT. SIDING ASPH. TILE _ it STUCCO ON MASONRY _ b toy STUCCO ON FRAME rT� i BRICK ON MASONRY ATTIC STRSI & FLOOR I_ `, Lo 1,;T .{ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR O ADEQUATE I� ONE I }, $ ROOF 10 PLUMBING ' _ I GABLE I HIP BATH (3 FIX.) _ GAMBREL MANSARD TOILET RM. (2 FIX.) _ 1 FLATIJ SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK - SLATE NO PLUMBING _ TAR & GRAVEL STALL`SHOWER! _ I ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING ` WOOD JOIST PIPELESS FURNACE _ FORCED HOT AIR FURN. 1 TIMBER BMS. &COLS. _ STEAM _ STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G" i UNIT HEATERS � ! GAS 7 NO. OF ROOMS OIL B'M'T 2nd _ ELECTRIC r r � 1st 13rd I NO HEATING ,2- _ _ H VG P Sag _ ®® F ' TOWn 0 ` 6 6 O N® n 0 t ...., , Y �, �NT�Sr� PERMIT ESM 1T . . W b _.K -n. er, Mass., �M� 1 0 COG MIG KE WICK Ge �q0R BOARD OF HEALTH THIS CERTIFIES THAT.............. .....� " .e!. BUILDING INSPECTOR has permission to e ... �............... buildings on ........ .d..... A.( b...'............ Rough ........ ............ to be occupied as.. J��'•..... AT1 p. ..Fb i$...�. .'=-=-" .. Final n Y Ch' e provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR Rough UNLESS CONS ( I - N ST SRT Service Final .•BUILDING IN SPOR GAS INSPECTOR Rough Occupancy Permit Required to Occupy Building Final Display in a Conspicuous Place on the Premises Do Not Remove Burner FIRE DEPT. No Lathing to Be Done Until Inspected and Approved by E Smoke SMo Det. Building Inspector JOB LOCATION �. . CONTRACTOR Reid Mechanical ENGINEER S U B M I T T A L GREENHECK - FAN - DELHI TAG QTY MODEL CFM SP VOLTS CYC PH FAN MTR TIP RPM RPM SPEED H.P. B.H.P:� 1. EF-1 1 CUBE 14-7 2600 .375 208 60 3 1590 1725 6088 3/4 .73 2. 3. RSF-1 1 DELHI-709 1300 .25 208 60 3 670 1725 1735 3/4 . 16 4. 5. 6. 7. 8. 9. .0. .1. 2. 3. 4. 5. 6. .7. I8. 19. 20. 21 . 22. ?3. 74 25. ?6. ?7. ?8. 29. 30. 31. 32. 33. 34. SUBMITTED BY: Sheet 1 of 3 Michael Kurtzer 3/22/90 w X09: A110- CONTRACTOR: DRWG. ENGINEER: SHEET 2 OF 3 ARCHITECT: DATE: MARK MODEL MOTOR INFORMATION FAN REO'D H.P. R.P.M. VOLTS CYC PH FRAME CFM SP RPM T S REMARKS EF-1 CUBE 14-7 1 3/4 1725 208 60 3 ODP 2600 .375 1590 6088 W/Curb, U.L.-762 MODEL CUBE OR CUBE-HP BELT DRIVE CENTRIFUGAL UPBLAST ROOF EXHAUSTER C DIMENSIONAL DATA ----------- ROOF ----- - MODEL A B C X DAMPER OPENING CUBE 10 22 233'. 23% 17% 12 14'1 CUBE 14 26 24% 27% 183 16 18'1 CUBE/CUBE-HP/8 30 28% 341/. 21 18 20'1 9 CUBE/CUBE-HP 21 30 28% 34'A 21 18 20'1 X CUBE/CUBE-HP 24 34 33'1 4035 25% 24 2811 CUBE/CUBE-HP 30 40 36 48 29% 30 321 CUBE/CUBE-HP 36 46 39'1 5815 29% 38 3811 -------------- CUBE 42 62 4435 03'A 1 35% 42 1 44'1 CUBE 48 58 48% 72'1 1 38 48 50% 21/2 Dimension A—Given is the inside dimension of the curb cap. —� The roof curb should be 1'1"less than the curb cap to allow for caulking and flashing. A Greenheck Fan Corporation owtirlM that One CUBE and CUDE44P rodent Fa—nx-a--7 shown im n are IlceneW to bow the AMCA SMI.The ratings shown we caeleao based on IMts made In scoordance with AMCA Standard 210 and AMCA awres Standard 900 and comply with the requirements of the AMCA Certified " p"'ngsPro°'er' &GREENHECK The sound ratings shown were Obtalrned M accordance with AMCA Standard 300.test sat up no.4.Loudness,values In sone at a distance of 5 feet wan calculated in accordance with AMCA Standud 301.The AMCA Certified P.O.WN IN ac orma.alaConanM weir rare.ns�erer�r Ratings Sound SMI aWlse to sons ratings only. DRAWING NO.12W10.83 For use with CUEICLAW-IC 4864V aeras I } 115E + .� <. ,,.�v�.r - r�� �� ��. S.R. •c :t ,y� � .Y1/ { •,a" �`'` DESIGNED FOR An ECONOMICAL solution for supplying Fresh Air HIGH-RISE APARTMENTS,SCHOOLS QUIETLY and EFFICIENTLY. COMMERCIAL-INDUSTRIAL APPLICATIONS A line of AIR SUPPLY UNITS available in five Sized with 9" (729 mm) — 10" (254 mm) popular sizes using Belt Drive Centrifuqal Blowers in a 12"(305 mm) — 15"(381 mm) — 18" (457 mm), Weatherproof Cabinet. Blowers. Iumcu MOTIfRO RII •• ' 1 i"zfs`x z: ' 33�` �' /.., TIIIC.i ... -.-. w�v,�"`�.ez �•'�z: �s� � .•sv�si. ,33y,3,�5'h , meq �. a��'ak D .pI•...c er�,,��� J Delhi Industries certifies that the 700 Series Fresh Air Unit <r shown hereon is licenced to bear the AMCA Seal. The ratings shown are based on tests made in accordance with AMCA Standard 210 and comply with the requirements of the AMCA Certified Ratings Program. ! Its A LOW SQUARE CONTOUR — EASILY INSTALLED TOP VIEW SHOWING GENEROUS INTAKE ON CURB. AND FILTER AREA FOR LOWER RESISTANCE. *Blower is equipped with Ball Bearings which have an operating temperature range of -650 to +250°F. B B {-540 to+1210 Cht � H *Blower is rubbe?mounted for quiet operation. •Cabinet and Drop Shield are galvanized construction A D with green enamel paint finish. t,��„132mm) J *Top insulated with '/z"(13 mm.) Fiberglass Flexible / Duct Liner. C 1 II FE--}-F G *Four standard sized permanent filters with each 1 1 model. I �+ A ' eSturdy 2" (51mm) recessed bottom for rigid, easy y D BOTTOM VIEW fastening to roof curb. A *Can be adapted for installation of heating and cooling 2•'(51mmi E�I A coils. *EASILY SERVICED: Top access cover allows easy 5/16"(8mm) HOLES FOR servicing to blower,motor and filters. FASTENING TO CURB A B C D E F G H J FILTERS 'INSIDE CABINET MODEL IN mm IN mm IN mm IN mm IN mm IN mm IN mm IN mm IN mm IN mm IN rnm 709 243b 619 323'9 822 2431/ 619 101/. 260 11"/,n 300 69/32 180 71/16 179 71/,s 179 101/. 260 4.10x20 4.25x51 24x24 610x610' 710 283'9 721 381/2 978 281:. 718 11h 289 131/9 333 75/9 194 81/2 216 81/2 218 121/4 311 4.12x24 4.305x610 28x28 711011 712 3234 822 425/9 1083 314% 797 131,9 341 154 397 8% 213 915/22 241 915/32 241 161/2 419 4.16x25 4-406x635 3202 813x813 715 32% 822 425/2 1083 3134 797 15'9 403 18s/9 473 62/9 175 614 159 10V. 280 161/2 419 4.16x25 4-406x635 32x32 813x813 718 36% 924 48?/,6 1227 37V4 946 18'9 479 211/9 556 7- 1 184 6 152 1V/2 292 203'4 527 4.20x28'/2 4508x724 36x36 914x914 •Curb size to be smaller than inside cabinet size to allow for flashing and roofing. Page 16 y 700 SERIES PERFORMANCE DATA ' IB"SP 1/4"SP 3/8"SP 1/2"SP 5/8"SP 3/4"SP 1"SP CAPACITY OUTLET VEL FREE AIR 31 Ps 62 Ps 93 Pt 125 Ps 156 Pi 187 Ps 2119 Ps CFM Vs FPM m/s RPM HP W RPM HP W RPM HP W RPM HP W RPM HP W RPM HP W RPM HP W RPM HP W • STD.DRIVE TIP SPEED RANGE MAX 3/4 HP,MODEL 709 580-792 RPM SHAFT 3/4" 19mm0 W 013 x RPM =m/s 500 236 595 3.02 227 .01 7 402 .02 15 558 .04 30 690 .06 45 792 .08 60 890 .11 82 954 .13 97 1088 .17 127 600 283 714 3.63 268 .01 7 412 .03 22 559 .05 37 692 .07 52 795 .10 75 899 .13 97 968 .15 112 1105 20 149 700 330 833 413 321 .02 .15 441 .04 30 572 .06 45 690 .08 60 790 .11 82 899 .15 112 974 .17 127 1119 .23 172 800 378 952 4.84 369 .04 30 469 .05 37 584 .07 52 698 .10 75 787 .12 90 897 .17 127 971 .19 142 1125 .26 194 1000 472 1190 6.05 459 .08 60 519 .09 67 621 .11 82 710 .15 112 810 .18 134 900 .20 149 965 .23 172 1117 .30 224 1200 566 11429 726 1 548 .11 82 595 .14 104 1 670 .16 119 750 20 149 836 .23 172 910 .28 209 989 .31 231 1117 .31 276 1400 661 1667 8.47 645 .20 149 680 .21 157 726 .23 172 800 28 209 876 .31 231 950 .36 269 1014 .39 291 1144 .49 366 1600 755 1905 9.68 720 29 216 750 .31 231 796 .33 246 860 .39 291 1 923 .41 306 998 .57 425 11048 .49 366 1168 .59 440 STD. DRIVE TIP SPEED RANGE MAX 3/4 HP,560 W 2.95 x RPM =FPM MODEL 710 505-690 RPM SHAFT 3/4" 19mm .015 x RPM=m/s 800 378 769 3.91 235 .02 15 375 .04 30 449 .06 45 600 .09 67 694 .12 90 790 .16 119 865 .19 142 1000 472 962 4.88 293 .05 37 403 .07 52 520 .09 67 605 .12 90 699 .15 112 780 .19 142 848 22 164 9% .30 224 1200 566 1154 5.86 365 .08 60 450 .10 75 546 .12 90 630 .17 127 713 .19 142 780 .22 164 855 26 194 979 .35 261 1400 661 1346 6.84 428 .11 132 498 .14 104 580 .17 127 651 20 149 734 25 187 803 .30 224 865 .33 246 987 .41 306 1600 755 1538 7.82 487 .11 127 547 .20 149 621 23 172 690 28 209 758 .31 231 828 .38 283 889 .41 306 997 .49 366 1800 850 1731 8.79 555 23 172 600 27 201 664 .30 224 728 .37 276 789 .39 291 850 .45 336 908 .49 366 1021 .60 448 2000 944 1923 9.77 601 .32 239 651 .36 269 708 .39 291 760 .45 336 824 .49 366 879 .53 395 934 .60 448 1040 .71 530 2200 1038 2115 10.75 669 .44 328 709 .47 351 755 .49 366 811 .53 395 864 .61 455 920 .69 515 965 .72 537 2400 1133 230811.72 1 720 .49 366 760 .53 395 805 .62 463 857 .71 530 908 .75 560 STD.DRIVE TIP SPEED RANGE MAX 3/4 HP,560 W 3.37 x RPM=FPM MODEL 712 447-611 RPM SHAFT 3/4" 19mm .017 x RPM=m/s 1600 755 10% 5.57 305 .06 46 400 .11 82 488 .16 119 567 20 149 642 25 187 715 .30 224 773 .36 269 899 .49 366 1800 850 1233 626 339 .10 75 429 .16 119 507 20 149 588 26 194 653 .30 224 722 .38 283 780 .41 306 892 .54. 403 J 2000 944 1370 6.96 371 .14 104 456 .20 149 529 25 182 600 .30 224 669 .36 269 745 .42 313 788 .48 358 898 .61 455 2200 1038 1507 7.65 416 20 149 491 26 194 554 .30 224 624 .38 283 685 .43 321 750 .50 373 799 .55 410 905 .69 515 2400 1133 1644 8.35 446 24 179 521 .31 231 580 .37 276 648 .44 328 702 .50 373 761 .57 425 815 .64 477 914 .78 582 2600 1227 1781 9.05 481 .32 239 551 .40 298 608 .44 328 660 .51 380 723 .59 440 773 .69 515 831 .74 552 2800 1321 1918 9.74 525 .41 306 590 .49 366 637 .53 395 697 .65 485 745 .68 507 3000 1416 2055 10.44 569 .46 343 624 .54 403 667 .63 470 720 .73 545 769 .79 589 3200 1510 2192 11.13 596 .61 455 1 651 .70 522 1 698 .74 552 750 .81 604 1 795 .91 679 STD.DRIVE TIP SPEED RANGE MAX 3 HP,2238 W 4.03 xRPM-FPM MODEL 715 401-548 RPM SHAFT 1"25mm .020 x RPM=m/s 3000 1416 1456 7.40 365 .35 261 410 .40 298 467 .47 351 515 .53 395 578 .66 492 !651 .79 589 706 .94 701 791 1.17 873 3200 1510 1553 7.89 398 .39 291 438 A5 336 485 .55 410 525 .68 507 584 .73 545 .81 604 708 1.01 753 805 129 %2 3400 1605 1650 8.38 421 .48 356 456 .53 395 504 .64 477 549 .74 552 594 .82 612 .98 731 707 1.09 813 813 1.41 1052 3600 1699 1748 8.88 450 .66 492 490 .73 545 524 .74 552 568 .81 604 607 .92 686 1.11 828 707 1.17 873 817 1.52 1134 3800 1793 1845 9.37 479 .74 552 509 .79 589 544 .85 634 590 1.01 753 622 1.04 776 125 933 710 127 947 818 1.61 1201 4000 1888 1942 9.86 483 .76 567 523 .83 619 564 .97 724 600 1.10 821 639 1.16 865 1.31 977 718 1.39 1037 816 1.71 1276 4200 1982 203910.36 504 .91 679 539 .98 731 582 1.09 813 611 1.19 888 657 1.30 970 691 1.43 1067 729 1.53 1141 817 1.83 1365 4400 2077 2136 10.85 528 1.00 746L 563 1.10 821 1 603 123 918 640 1.30 970 1 675 1.46 1089 1 715 1.57 1171 1 743 1.68 1253 1 821 1.97 1470 4600 2171 2233 11.34 575124 925 600 1.32 985 626 1.39 1037 665 1.53 1141 693 1.62 1209 730 1.81 1350 758 1.85 1380 829 2.13 1589 4800 2265 2330 11.84 608 1.44 1074 633 1.52 1134 651 1.57 1171 691 1.80 1343 712 1.80 1343 753 2.03 1514 775 2.04 1522 839 2.31 1723 5000 2360 2427 12.33 619 1.52 1134 644 1.60 1194 675 1.17 1320 700 1.91 1425 132 1.99 1485 161 2.10 1567 192 2.24 1671 852 2.51 1872 TIP SPEED MAX 3 HP,2238 W 4.80 x RPM =FPM MODEL 718 SHAFT 1".25mm .024 x RPM=m/s 3000 14161034 516 246 .18 134 311 25 187 377 .33 246 430 .41 306 491 .52 388 547 .68 507 583 .75 560 654 .94 701 3500 1652 1207 6.13 283 .29 216 343 .36 269 399 .44 328 451 .54 403 449 .65 485 550 .79 589 598 .91 679 675 1.16 865 4000 1888 1379 7.01 325 Al 306 375 .50 373 423 .59 440 474 .74 552 524 .83 619 560 .97 724 604 1.07 798 690 1.38 1029 4500 2124 1552 7.88 365 .65 485 410 .71 530 454 .77 574 500 .89 664 543 1.03 768 588 1.21 903 621 1.29 962 696 1.59 1186 5000 2360 1724 8.76 409 .77 574 449 .88 656 485 1.00 746 527 1.19 887 566 1.28 955 609 1.48 1104 646 1.58 1179 707 1.86 1388 5500 2596 1897 9.63 448 1.09 813 488 120 895 520 128 955 557 1.48 1104 590 1.56 1164 637 1.78 1328 665 1.89 1410 733 2.22 1656 6000 2832 2069 10.51 490 1.37 1022 $25 1.50 1119 553 1.60 1194 588 1.77 1320 619 1.91 1425 656 2.11 1574 688 2.26 1686 755 2.62 1955 6500 3068 2241 11.39 521 1.79 1335 556 1.91 1425 585 1.97 1470 624 2.19 1634 650 2.30 1716 679 2.57 1917 711 2.67 1992 774 3.05 2275 7000 3304 2414 1226 565 2.10 1567 600 2.30 1716 620 2.40 1790 653 2.79 2081 681 2.75 2052 713 3.00 2238 7500 3540 2586 13.14 610 2.74 2044 640 2.91 2171 657 2.91 2171 Performance shown Is for 700 Series with outlet duct Shaded data Is metric. HP and W do not Include belt drive losses. For SP over 1"(249 Pa)refer to Performance Curves or check factory. Page 17 r D D 0 b%7b% MODEL PFC PREFAB AD WOOD MAIM l l s/e NSUTATDN D.mv.1 c°"inu B O-PEA NOD1ND 1+UY 90"D ONLY VdM SKOFKAW REO+ESTED PFC JOB: +f_=+ ` CONTRACTOR: ORINB. NUMBER AD B OPE°NIING OF °A� ENGINEER: SHEET!--OF 3- 17-8 151/2 233/4 101/2 8 ARCHITECT: DATE 18-10 161h 243/4 121h 10 nuMrex xo<aIa nur M1eDu 19-8 171/2 253/. 101/2 8FAN YODEL MARK Kms. AD I 0 9illi ORMPEII Karo' ALMIL aar. 19-10 171/2 253/4 121/2 10 YES Ko in t1 AIL 20-12 181/2 263/4 141/2 12 CUBE EF-1 1 24% 32 18% 16x16 x 22-12 201/2 283/4 141/2 12DY=_R_S_F_—T___T16-', 1 4x14 X 22-14 201/2 283/4 161/2 14 23-15 211/2 293/4 17% None 24-14 221/2 XPA 161/2 14 26-16 241/2 323/4 181h 16 26-18 241/2 323/4 201/2 None 2614-16 25 331/4 181/2 16 30-18 281/2 363b 20% 18 30-20 28% 363/4 221/2 20. 31-22 29% 373/4 241/2 22 31-23 291/2 37% 2512 None CONSTRUCTION FEATURES 34-24 321h 403A 26% 24 36-24 341h 423/4 261/2 24 • Galvanized steel body.Aluminum 36-26 341h 423A 28% 26 available. 37-29 351h 433/4 311/2 None • Wooden nailing strips securely 40-30 381h 463/4 321/2 30 fastened. 44-30 42h 503/4 32/2 30 • Rigid fiberglass insulation to minimize 45-37 431/2 513/4 381/2 None condensation and reduce sound. 46.36 441h 523/4 381h 36 • Cant strips formed into curb body. 49-41 471h 553/4 421h None • Type available; 12 inch height With Model PFC prefabricated roof curbs are 52-36 501/2 583/4 381h 36or without damper tray. designed to speed installation and reduce 58-42 561/2 643/4 441/2 42 NOTE:PFC curbs must be roofed costs,without sacrificing quality.These sur- 58-48 56+h 643/4 501h 48 and flashed to the top of the wooden face mounted curbs are for decks that are 3 + t 62.54 601/2 68/4 56h None nailer e o assure weather tightness. not surface insulated. 64-48 621h 703/4 50+h 48 68-54 66'/2 743/4 561h 54 72-60 70% 783k 1 6212 1 60 MANUFACTURED BY BUCKLEY ASSOCIATES, INC., BRAINTREE, MA 02184 ENERGY SAVING HOOD MODEL KS-10ON STAINLESS STEEL CONSTRUCTION WALL AND ISLAND STYLES ' .� COMPLIES LATPST NE O ��.j BULLETIN - NO 9fi 0 0 O O s 9 H (DI 2 to I Li Li 5� r- W W J W 2W WALL STYLE ISLAND STYLE FEATURES. i 18 Ga. 304 stainless steel - 38 polish - continuously welded outer shell - welds ground and polished. 2 Fixed continuous outlet orifice. s Full length perforated distribution plate. a Fully insulated air plenum. s Hanger brackets in all corners. e Welded on supply collar with balancing and/or fire dampers as required. 7 100 watt U.L. vapor-proof lights pre-wired to junction box. a Welded on exhaust collar as required. 9 U.L. aluminum extractor filters standard. Stainless optional. id Removable stainless grease cup. AVAILABLE SIZES LENGTH WIDTH HEIGHT 4'-0" 42, 48, 54, or 60" 24 or 30" 5'-0" 42, 48, 54, or 60" 24 or 30" 6'-0" 42, 48, 54, or 60" 24 or 30" 8'-0" 42, 48, 54, or 60" 24 or 30" 10'-0" 42, 48, 54, or 60" 24 or 30" 12'-0" 42, 48, 54, or 60" 24 or 30" --Contact your Kees agent or the factory to learn about our fast delivery program. --All other sizes of energy saving hoods with other features available in a variety of additional hood models. Conventional exhaust only hoods of all styles also available. Contact your Kees agent or the factory. -- 65 Agents Coast To Coast -- Kees Inc. 4 Industrial Road Telephone: 414-876-3391 Elkhart Lake, WI 53020 Fax: 414-867-3065 04/88 KS10ON r - • '`� t Ail ¢ � 1 r w u k sJ �� f � c w rIN . ° a r a, `sA O How The System Works ❑Pressure stored in the Aqua-Blue cylinder propels the agent out of the nozzles and onto ❑ Fusible link heat detectors and agent the fire. discharge nozzles are located over cooking appliances and within the hood and duct. ❑The system automatically shuts off the appliances to remove the heat source. ❑When a fire melts a fusible link,a spring- loaded g loaded plunger opens the Aqua-Blue cylinder ❑No outside power source is necessary to valve. activate the Aqua-Blue system. _ e ~— 000, A,, e ~ `�� 00� 1 o r 0 0� For further information contact: MARKETING MANAGER PRE-ENGINEERED SYSTEMS REGIONAL OFFICES P O.Box 1147 Wake Forest,North Carolina 27587 919-556-6811 TELEX,802569 WALTKIDDE Signal Hill,California 90806 CANADIAN OFFICES Walter Kidde&Company of Canada,Ltd. Toronto,Ontario WALTER KIDDE a Division of Kidde,Inc. l Fire Systems Operations i I - BAY STATE FIRE PROTECTION CORP. Automatic Fire Suppression Systems P.O. Box 294 16"' O YEAR WOBURN, MA 01801 ' , 19go (617) 935.5536 i I-1084/84 BUILDING DEPARTMENT Printed In USA ;E 5L-rj S ({o(� 15� �(Aev\ }, arc, d(Acf Phd nPP)Jances - Will Su�piY POi46bl.e -ire Z�r��n u�stie�-s �'JS ReStuthecl ham/ T �/^e" ��p1l.�h.�evLT lJ it W /w x - x a Y2 co N e cn R1 C= j y C) 0-0CD C7 1 ie 1 cn Cn p � W �s o. t- M Suri �O�T4+ �Nt7ay E2,. FMA �8 I.NP _ .I 0- 115 v . ---- `Q ,N I cO ,D N r ALL WV-LVEt> �7NCT l8 x1'r3 x r GkAt "C IN C 2DA.NGE -PucT W A-Ll. �Tc-A1kL"1-(L(aT , q , S2t,�u L SS S'r� L W�t.1.. PANEL 1 i r 1 'I FORM U TOWN OF NORTH ANDOVER LOT RELEASE FORM - SUBDIVISION ASSESSORS MAP SUBDIVISION LOT(S) PERMANENT ADDRESS (ASSIGNED BY D.P.W. STREET AA ( j APPLICANT _ KQA PHONE DATE OF APPLICATION &'y Welo TOWN USE BELOW THIS LINE PLANNING BOARD DATE APPROVED TOWN PLANNER DATE REJECTED CONSERVATION COMMISSION DATE APPROVED CONSERVATION MIN. DATE REJECTED BOARD 0 EALTH DATE APPROVED H LTH SAffIT AN DATE REJECTED DEPARTMENT OF PUBLIC WORKS DRIVEWAY PERMIT A14- SEWER/WATER SEWER/WATER CONNECTIONS FIRE DEPT. �. �'jZ— In RECEIVED BY BUILDING INSPECTION DATE This form shall be signed by the agents of the Planning and Health Boards, the Conservation Commission prior to the issuance of any building permits for the subject lot. This form shall not releive the applicant from the compliance of any applicable Town requirement or Bylaw. Y p Date. N3806 "0°T:��o TOWN OF NORTH ANDOVER PERMIT EE FOR PLUMBING F A SSACMUS� This certifies that .. . . . . . . . . . . . . . . . . . . . . . ... . . . . . has permission to perform 49 . . . . . . . . ....-. . . . . . o dumbing in the buildings of . . . . . . . . . . . :` . /� at. . . . . . . . . . . . . . . . . . . . . . . . . . .. North Andover, Mass. 4_ `�t eec--5&. . . .. .Lic. No.l!:,. . .?. . $ PLUMBING INSPECTOR 9 a WHITE: Applicant CANARY: Building Dept. PINK:Treasurer a jo , MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING ype or print) _ _NORTH ANDOVER,MASSACHUSETTS Dateuilding Locations fp!Z jm gAl 4�� Permit # ® �0 to Amount �— Owner's Name �v L New Renovation ❑ ReplacementEll/ Plans Submitted n FIXTURES w a H a 4 d � H a SUB-ff C M Rfm M FLOOR ? 3RD FUM 4IH FL" 5IH FUM 6H1 FLOOR 7RiFID(R SIH FWM e (Print or typ ) �— � � Check one: Certificate Installing Company Name / J Corp. Address �/ ❑ Partner. L Business Telephone 3 - ❑ Firm/Co. Name of Licensed Plumber: y U N K-C1// 14CG5 Insurance Coveraee: Indicate the ftme of insurance coverage by checking the appropriate box: W26z=::- L,iii UMd=&iMWre Ime-h= "13=AW A- ariff-s zLi AN mew am-ow acdw AhAr Signature Owner ❑ Agent ❑ I hereby certify that all of the details and infonnation 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 coTpliance with all pertinent provisions of the Massachusto Pl bing C e and p General Laws. t a re o n Win— Type mType of lumbing License Title City/Townice Numuer Master Journeyman ❑ APPROVED(OFFICE USE ONLY 2931 Date. .. !:. -�.. . ........ ra ,NORT1, TOWN OF NORTH ANDOVER 3? PERMIT FOR GAS INSTALLATION p �^ y F 9 SSACNUSEtt`� J 17Z- a This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .g. . { LO 'has permission for gas installation An the buildings of G .'.'. . � .. at . .'�.- . . . . . . . . . . . . . . . . . . . . . . . . . .. North Andover, IVAss. � i Fee.&. :-.:'. . Lic. No.�- . . . . . . . . . . . . GAS INSPECTOR WHITE:Applicant CANARY:Building Dept. PINK:Treasurer Of Y MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS (G kType or print) Date 19 NORTH ANDOVER,MASSACHUSETTS Building Locations 1 0 / /G' /L .!/YI Permit# AN Amount$ Owner's Name New❑ Renovation ❑ Replacement Plans Submitted ❑ w z z O w E~ a `za O z w r�1 oa w w a a > d m x w z v w x w w F F x F z a Er x w w t� O > w F u a F w Qz w > a� w z a Z o 0 w O v, x > A a F O SU B-BASEM ENT B A S E M ENT IST. FLOOR 2ND. FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR (Print or type) j�4r r "pgf Check one: Certificate Installing Company Name 0 Corp. Address ❑ Partner. Business Telephone ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter Y! 1) jQ INSURANCE COVERAGE Check on I have a current liability Insurance policy or it's substantial equivalent. Yes No❑ If you have checked yes,please in ' ate the type coverage by checking the appropriate box. • Liability insurance policy1z 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 ❑ Agent ❑ I hereby certify that all of the details and information 1 have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts S e as Co and Chap r enera aws. 4 By: Signaof Licensed Plumber Or Gas Fitter Title Er Plumber g City/Town ❑ 9as Fitter -cense Purnoer Master APPROVED(OFFICE USE ONLY) ❑ Journeyman Location No. i 5' Date V °D TOWN OF NORTH ANDOVER „ Certificate of Occupancy $ + Building/Frame Permit Fee $ ,SSACMUSES Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ !-c'r'__-CF, 1VFD PAYQU Connection Fee $ TOTAL $ -e NOV 19 1991 Building Inspector No, Andover Collector Div. Public Works PERMIT N�mQ, 4:F2 APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP -NO. LOT NO. 2 RECORD OF OWNERSHIP JDATE BOOK ;PAGE ZONE I SUB DIV. LOT NO. LOCATION e 9' PURPOSE OF BUILDING OWNER'S NAME I A �uy_ NO. OF STORIES SIZE OWNER'S ADDRESS1 BASEMENT OR SLAB ARCHITECT'S NAME ,t p1 `I ` SIZE OF FLOOR TIMBERS IST /J 2ND 3RD BUILDER'S NAME � ..,.e'` E-� SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS �— DISTANCE FROM STREET '" '" POSTS DISTANCE FROM LOT LINES— SIDES REAR "' '" GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION x IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION, IF ANY t V 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 PAGE 1 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. LECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY 1TTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED -~ �r BOARD OF HEALTH SIGNATURE OF OWNE OR AUTHORIZED AGENT OWNER TEL. Lak 2- 1461 F E E /o 4— CONTR.TEL. CONTR.LIC.#d� lZ PLANNING BOARD PERMIT GRANTED qN off; /9. 19 BOARD OF SELECTMEN BUILDING INBPFI BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY I I STORIES 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 —I 8 INTERIOR FINISH CONCRETE _ 3 t 2 13 CONCRETE BL K. PINE _ BRICK OR STONE HARDWD PIERS PLASTER DRY WALL UNFIN. 3 BASEMENT AREA FULL IN. B'M'TAREA _ '/. '/s '/, FIN. ATTIC AREA _ N_O 8 M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDc B 1 2 3 DROP SIDING CONCRETE �_ ` WOOD 5 GLES EARTH _ ASPHALT DINGHARD%tJ'D _ ASBESTOS SIDING COMMON _ VERT. SIDING ASPH. TILE ---{I_ STUCCO ON MASONRY - STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR (_ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR POOR _ ADEQUATE I--i NONE 5 ROOF 10 PLUMBING GABLEHIP 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 II 11 HEATING I WOOD JOIST PIPELESS FURNACE . FORCED HOT AIR FURN. TIMBER BMS. & 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 ist 13rd I NO HEATING �a, -00NSF VA7K�N` FINAL PLANN�NG 'tAotl T FINAL SEWER/WATER FINAL Town of Anclover 6 OL No. 499 =5! __ D Y �J��f {b,q ��d�P� .� .• a•\ ® dG•�'�(s� �h, ��-�. � _ Jam` A er oR ?� PcRMI' T T LD fl BOARD OF HEALTH THIS CERTIFIES THAT............... .. ..... ......... ....................... � BUILDING INSPECTOR buildings on .. ..... a has permission to erect ..... .. g ........ Rough .� !, > � ® ,I . ® ... ... �. ' Chimney tobe occupied as .. .. .... .. ............ ,, • Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Rough Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR Rough UNLESS CONSTRU STAT Service Final ..... ... ................ . .... ..... . . . •BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Burner No Lathing to Be Done Until Inspected and roved b ' P �� y Smoke Det. Building Inspector