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HomeMy WebLinkAboutMiscellaneous - 7 FULLER MEADOW ROAD 4/30/2018 (2) / 7 FULLER MEADOW ROAD 210/104.D-0129-0000.0 Date.... ..�..-e.....-4-1 r10RTly TOWN OF NORTH ANDOVER PERMIT FOR WIRING 88ACMus� This certifies that ................ f`� CU(�C(„(/ft 1IJ ........................ ...... ...................................................... has permission to perform ........4 .......mpf� � S!............... .......... . wiring in the building of jj...............(..'ib!�1. �b�/ y......................................................... at .......�..... JLL c� ' ` �.....(.t..0..........,North Andover,Mass. .. .............................. v© Fee.....5 5........Lic.No. 9P.!./ ................... ,,. . . : ....... . LECTRICAL INSPECTOR` Check# ZZ- r� r, L 0 --�--"--JJ Official Use Only ealth of Massachusetts permit No• commonw Checked Occupancy d Fee Ch —�� Department of Fire Serv�c TIONS rev•11199]an Leave blank PREVENTION REG ELECTRICAL WORK 'low BOARD OF FIRE PERFORM lz.00 C 527 CMR APPLICATION FOR PERMIT TO — )7 —1 with the Massachusetts Electrical Code(MEc), performed in accordance TION) Date' Allworktober To the Inspector of Wires: T IN INK OR TYPE ALL IN�1nJ`RM� LEASE PRIN cE�h I cE intention to perform the elects i t`��OLk described below. (P of: a'1 d city or Town ed fives notice of his or her < �� 11� application the undersign g ✓ �� M 2= Telephone No. � By this app 7 Location(Street&Number) 7 c,2(q cc�I (Check Appropriate Box) Owner or Tenant ❑ No Owner's Address t� Yes Utility Authorization No. it in conjunction with a building Perm, No.of Meters Is this perm Undgrd❑ Volts Overhead❑ No.of MetersG �1 purpose of Building / Undgnl Amps �- overhead Existing ServiCe Volts .�:-�S r, Amps �! �� cit" -S 14 f �t^ Newer '� acity .a S �S e C. Number of Feeders and AMP ork: ector o Wires. of proposes Electri�l W be waived b the Ins Location and Nature ollowin table Total Co le on o the No,of KVA addle)Taus 3 Transformers KVA No. f CeiL-Susp.(p Generators ed fixtures mergency fig ing No.of Recess No.of Hot Tubs o.o ❑ Batte Units Lighting outlets iu pool rade ❑ rnd. RMS No.of Zones No.of Lig t SwiMm g FSE ALA o.of Lighting Fixtures tectio Nn and No.of Oil Burners °.of De �`ri"11 Iniatin ti No.of ReCeptacle Outlets of Alerting Devices No,of Gas Burners Total No. No.of Switches No.of Air Cond. Tons KW No,of Self-Cern°Devices Number Tons Detection/Al Other gest pump Municipal ❑ No.of Ranges Totals: Local ❑ Connection Disposers S stems: Space/Area Heating Sec o of vices or E uivalent No.of Waste ApplianceKW N No.of Dishwashers Beating APP Data Wiring: uivalent o.o No.of Devices or icing: No.of Dryers o.o Ballasts Telecommunications W uivalent o•o ater KW Si ns Total IIP No.of Devices or E Heaters No.of Motors Wires. e Bathtubs the Inspector of No.gydromassag issue unless Attach additional detail if desired,or c required wok may performance of electrical equivalent. The OTHER owner no permit for the p verage or its substantialc the own feted operation'co office. JNSURANCE COVERAGE: Unless waived by «romp roof of same to the permit issuing insurance including A v2 Provides proof of liability and has exhibited p e c G.p . the licensee p e is in force, g ecify.) (Expiration Date undersigned certifies that such ch cover BOND ❑ OTHER ❑ ( p CHECK ONE CE (When required by municipal policy.) and upon completion. accordance with MEC Rule lo, Tete. nested in licutlon is true and comp Estimated V aloe of Electrical Work' spections to be req oration on this OPP LIC.NO.:__-____�- enalties of perjury'that the inf c 3(l EE Work to Start: d p _ LIC.NO.: Y� 3 j,.77 I certify,under t:hea;i -� g��3 v FIRM NAME: Signature Bus.Tel.No.• 33�z,ii 3 �r'<LlC � " <i/1� c-4-9 t Alt.Telco co ra ee normally insurance coverage Licensee: t°'in the license number line t jfQ.2l `r ❑owner's a crit. (If applicable,enter ` �SPat F ,e/ 0 vim cheCk one)❑owner R; I am aware that the Licensee n I am the�e liability p�ER'S INSURANCE W p'�E 1 hereby waive this req PE jT FEE: $ required bylaw. By my signature below, Telephone No. Owner/Agent Signature - COMMOM,IVEALTH OF M: us � e e - o • BOARD OF EL ECTRrC��Ns ISSUES THE FGLLOWtNG LiCEP � W kS A REG JOURNEYMAN ELETRrI,C �J'' fltir i� ERt?t J SULLIVAN 9 EAST-Vl AVENUE kILLERICA: P1A 01821 1.10 40311 : 07/31,� .b.: 56 62 6 "� The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information PIease Print Legibly Name(Business/Organization/Individual): Fc21 C Sof 11 V',V') Address: 9 S i SJu(Pw yU E City/State/Zip: [?(i J eA1 C c, M5 0 �-a 1 Phone#: Are you an employer?Check the appropriate box: Type of project(required): 1. a 4 employer with . ❑ I am a general contractor and I ' � 6. F1 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. E]Remodeling ship and'haveno employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5• ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I L E]Plumbing repairs or additions myself. [No workers'comp. c. 152,§1(4),and we have no 12.❑Roofrepairs insurance required.] employees. [No workers' 13.❑Other comp.insurance required.] o *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. i-Homeowners who submit this affidavit indicating they a're doing all work and then.hire outside contractors must submit anew affidavit indicating such. 1 $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. lam an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. r // Insurance Company Name:. Lt G���r�f U✓(�7t s C Policy#or Self-ins.Lie.#: Expiration Date: CVA /LP CC'r2 C� Job Site Address: sdc, City/State/Zip: Ac.2 fk 440V-L Ms 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. G ` X do hereby cert under the paint and alties of perjury that the information provided above is tru and correct. Si ature: Date: oZ a Phone#: 3 7a 7 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-contractors)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 Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' j 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 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: r The CoauxlonwealthofMassachusetts Department of Industrial Accidents Office of Investigations 6.00 Washington.Street Boston,MA,02111 Tei.#617-727-4900 ext 406 or-1-877�,MASS.A.FE Revised 5-26-05 Fax#617-727-7749 www.mmass.gov/dia. 35 -1 US Date... r?. . .7- HOTM TOWN OF NORTH ANDOVER F?Oyet..ao ,e,ti0 F PERMIT FOR GAS INSTALLATION `a SAcHUSEt This certifies that . . . . . . . . . . . . . . . . . . • • has permission for gas installation in the buildings of . .'��`"`�` . . . . . . . . . . . . . . . . . . . . . . . . at 1.7. North Andover, Mass. Fee.4. . . . . . Lic. . . . . . . . . . . . GAS!NSPEFf6R riX / 21 WHITE:Applicant CANARY:Building Dept. PINK:Treasurer MASSACHUSETTS t1�'ORM APPLICATO ORP ITT TO DO GAS 'TIlYG Type or print) NORTH ANDOVER, MASSACHUSETTS Date Building Locations 7 r- J L�N�/�- r`�E� S e 1t Permit# W Owner's Name Amount S `:..1 New❑ -: ; Renovation ❑ Replacement Plans Submitted e- .4 - v 4 W 14 ~ Cn '� U _Z ni -i z z z n _z14 c_ _ y; SUBENI ENT If s E .h ENT .- isT. FLOOR _ — 2N1) . FLOUR 3RD . FLUOR 4T It . F L U O R 5'1• it . F L O U R 6T If Ft) 0 7T it . FLOOR 8T(1 . F1, 0UR (Print or type) Name p An/ �d�lj,•,,� Check one: Certificate Installing Company Address 0 X 57172— Corp. Z ElPartner. Business Telephone Name OfLicensed Plumber or Gas FiFlrrnlCo. tter I INSliRANCE COVERAGE I haze a current liability Insurance policy or it's substantial equivalent. Check one: ! If you have checked_yes,please indicate the Yes12 Liability insurance policy type coverage by checking the NO '.� 3 appropriate box. Other type of indemnity Owner's Insurance Waiver. I am aware Bond icensee es not have the ED Vass.General Laws,and that my signature on this Permit application wa��his requirement. surance rage required by Chapter 142 of the Signature of Owner or Owner's Agent Check one: hereby certify tvner hat all of the details and intortnation f have submitted(or entered) in above AgentCl best of' knowledge and that all Plumbingw application are true and accurate to the compliance with all pertinent provisions ofthe Massachusetts State Gas Code nd Chapter 1-1?ofthe e o and installations performed under Permit Issued for this application will be in General Laws. Bv: Title Signature of Licensed Plumber © Plumber Or Gas Fitter City/Town Gas Fitter License ivu oe� -PPRU VED(OH-1cl-,USc r�NL Y Master Journeyman Date. No 4- 516 NORT/y TOWN OF NORTH ANDOVER ' PERMIT FOR PLUMBING SACHUSE� This certifies that . . . . . ... . Y.. . . .`. . . `'-� t �� has permission to perform . . . `r. '. . ` .". —'l`'w . . . . . . . . . . . . . . . . plumbing in the buildings of . . -? . . . . . . . . . . . . . . . . . . . . . . at,.. . . . . . -u-. c.c... �'N.e-- tl,�-��.jG� orth Andover, Mass. I �'IN ti' PLUOR Check # 6 (/ WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Building Location 7 Fu jier2 rYl r s W !i'd. Date �7 117 to o- Owners Name Lo^�©�? St'� Permit#—AL�k— Type of Occu ancvAmount 0 Gc/f lli"t/b New Renovation El ReplacementPlans Submitted Yes No FIXTURES a ►• w F w x � � a dCL "" F ►� A A a F r4 SLRBSK BASliN1H1q ISE FLOOR MD FLOOR 3M FLOOR 4IH FLOQ2 5TH FLOOR 6TH Flf= 71H HDODOR SIH FIDQZ (Print or type) Installing Company Name 1141jal 4-1Check one: Certificate �o�t /Ifir�ay El Corp. Address Pe- Ag?r Z4Aute 4 Partner. 1•usiness Telephone 9,rQ c f Firm/Co. Name of Licensed Plumber. 7Qe'17 /1*1104,0-,i/ Insurance Coverage: Indicate the type of insurance Liability insurance policy coverage by checking the appropriate box 1J Other type of indemnity ❑ Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner ❑ ❑ Agent I hereby certify that all of the details and 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 Massach—usetts State l mbing Code and Chapter 142 of the General Laws. By: Signature Or icens um er Title Type of Plumbing License City/Town L19 ,3 APPROVED(OFFICE USE ONLY icense um er Master ElJourneyman PERJiiT NO-- APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 10AAP i40o� / LOT NO. 01,57,S— 2 RECORD OF OWNERSHIP (DATE BOOK ;PAGE ZONE 1 SUB DIV. LOT NO. F— LOCATION 7 Z`AA PURPOSE OF BUILDING OWNER'S NAME �i /'/ NO. OF STORIES L SIZ�EI OWNER'S ADDRESS �+Ar� BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME 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 IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OFC E IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION �� //C� � � �j�/� L4'� LAND COST SEE BOTH SIDES �jT9" �C CS EST. BLDG. COST Cg4?/-t'x 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. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR 7 DATE FILED ,?�- lQ? LDING IN SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE ��� OWNER TEL.k PERMIT GRANTED ! L � - -7 V .3 / CONTR.TEL.// 16 ---� (� CONTR.LIC.# � H.I.C.x l�7 KJ b Jo- TAORT F own of - over * dover, Mass., 19 0LAKE I� -C C ICNEWICX Y�• ;TED �G BOARD OF HEALTH PERMIT T Food/Kitchen Septic System THIS CERTIFIES THAT BUILDING INSPECTOR �... Foundation has permission to erect......... ............ ............. buildings on .......fir............ . .NID .�...� .. Rough h tobe occupied as...................................................... . . .... .. ..................................................................:...................... Chimney provided that the person accepting this permit shall in every r act 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. Rough PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST Rough ......................... Service .. .. ..... . . . ....................................... UILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. Smoke Det. N - MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING �,✓ (Print or Type) Mass. Date 19 Permit �Z Building Location �, �� ��> 1,1 3 Owner's Name Type of Occupancy �l3' New Renovation ❑ Replacement ❑ Plans Submitted: Yes❑ ' No ❑ N H Y W N N N U N N Q N R O = W • W W W y � O a a � H in N D V W S +_ i•- yr QW W > W'.amu }" H +� W J - F•' Ul W O o > u. F' J yN., W C >- H m O �4y 0: S O V W W O d J U C > Sue—aSMT. BASEMENT I 1STFLOOR 2ND FLOOR I I I I 3RD FLOOR 4TH FLOOR 5TH FLOOR I I I I I I 6TH FLOOR I -1i I 7TH FLOOR I I STH FLOOR Instaliing Company Name Check one: Certificate u Address � � /� C'3—Ccrperatlon ❑ Partnership Business Telephone ❑ irm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE: I have a current lta�y insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142 Yes (& No ❑ If you have checked Vis, please indicate the type coverage by checking the appropriate box. _ A liability Insurance policy Other type of indemnity❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner❑ Agent ❑ I hereby cortity that all of the details and informatlon l have submitted(or entered)in a ove application are true and accurate to the best of my knowledge and that all plumbing work and Installatlons performed under the permit i !v for this plicaU n will in c pll with all pertinent provisions of the Massachusatts Stale Gas Code and Chapter 142 of the neral laws. T_:7 7 e of Ucense: LB mber atu o nse um er or Gas filter fitter Townastef Ucense NumbernC7VF Journeyman 2559 J>J9 Date.Ct..! i . . . . ... . .. .. NoRTM TOWN OF NORTH ANDOVER g' Frpy ..ao ,e,ti op N .j PERMIT FOR GAS INSTALLATION w 9 i 9SSACN Kt' / T This certifies that .(f.-"�� .� .1. . !�?�-. . .!` . . . . . . . . . . . .. ' has permission for gas installation . .0 t'.r :L.� :. . . . . .�. in the buildings of . „/�',,�.S c.�'i. . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . , North Andover, Mass. Fee.�� ". . Lic. No..3`!Y.& . . . . . . . t . . . . . . . . t AS INSPEC 1 3 ll- WHITE: WHITE:Applicant CANARY:Building Dept. PINK:Treasurer GOLD:File MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING z �- (Print or Type) p AJ f71271+ i�f)rf��PMass. Date 19 / 1 Permit # Z Building Location / /`" it-(- 'VV gpow Owner's Name�,sL/Nc�A Ma EK A tVL,dQte M44 Type of Occupancy�ESi 7CN T1 0 i— New ❑ Renovation ❑ Replacement Plans Submitted: Yes[:] No p N , N W y Y = ¢ df N N V z o` r < _ O 4 ¢ O O F. Q m N r y W O d c W < I- W w 4 tll ¢ W 2 V W N W < ¢ H C r S Q GW7 hW- Z J r z f. IW- ,W. 0 m z O 2 W O #AA s Y < W < C ¢ < < O O W ¢ O W F- <¢ '= O d S U. 0 3 G d J V m > O SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR _ 4TH FLOOR STH FLOOR 6THFLOOR 7TH FLOOR STH FLOOR Installing Company Name mit e-ji;(Z T A • :*)M MA Tr)X20 Check one: Certificate Address2J t.� 00A C H/h A ry `�J. ❑ Corporation 01 r 7 N U e fJ 01 rl D l k ❑ Partnership Business Telephone —I S-7 f plum/Co. Name of Licensed Plumber or Gas Fitter_�!?r�A E P T A- 5 A m M II iAr> -- INSURANCE COVERAGE: I have a current f bility insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No p If you have checkedrtes, please Indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity p 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 a �- 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 underthe pe i be wed for this application in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of her Laws. BY T of License: C� Plumber n ure of Licensedu or Gas Fitter Title tter er License Number 9333 City/Town O IC N Journeyman i� BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE NO. APPLICATION FOR PERMIT TO DO GASFITTING C -- I NAME d TYPE OF BUILDING LOCATION OF BUILDING ' PLUMBER OR GASFITTER LIG NO. PERMIT GRANTED DATE 19 GAS INSPECTOR r > v u Date.: j...,?: ...... f � A s-. HORTM TOWN OF NORTH ANDOVER OF ..ao ,^.tti0 PERMIT FOR GAS INSTALLATION ~ 9 S^CNUSEI� M / C.J This certifies that r . . . . . . . . . . . . . . has permission for gas installation . . t.< . . . . . . . . . . . . . . . . . . . . cm in the buildings of . .1.2"Aff-6. . . . . . . . . . . . . . . . . . . . . . . . . . o at . .' . � .<<*�? . .,�h. r.!`?�1'• .4 . . t1��. No Andover, Mass. Fee. ;?A< Lic. . . . . . . S INSPECTOR WHITE:Applicant CANARY:Building Dept. PINK:Treasurer