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HomeMy WebLinkAboutMiscellaneous - 7 WEYLAND CIRCLE 4/30/2018N O v M gz N Z W C) Op n 00 Cr-) o r" 00 Date. .Q.. ?J....... o? ` TOWN OF NORTH ANDOVER • - PERMIT FOR GAS INSTALLATION s .' • '� y9SSwuuSEt This certifies that .. / H. .. /:—. 5. P� A `.. S ............... . has permission for gas installation .. Lk.. .................. in the buildings of . C' -q .2 ........................ at ......7... �!� "fir �!? ...C. //'I , North Andover, Mass. Fee.�� ..... Lic. No. f�%� �.. ..-c�✓''� ...... LINSPECTOR/ Check # . 5193 fi MA,SSACHUSErIS UNIFORM APPPUCATON FOR PERNIlT TO DO GAS FTTTING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Locations Date v U '% Permit # Amount $ c Ive) 19 Owner's Name New ® Renovation ® Replacement ❑ Plans Submitted ❑ o U a a z o z H a a x w z �zz, E" F W ao1 ww o U �] a o W C A a a H O o x C�7 UO A a. SUB-BASEM ENT B A S E M ENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TE.F L O OR 7TLOOR STH. FLOOR % c (`i Chec one: Certificate Installing Company (Print or type) � � / � J . �- 21�. v � � Corp. Name VV Address b � Partner. Business a ep one ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter '09-M INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes No ❑ If you have checked es, please indicate the type coverage by checking the appropriate box. 13Liability insurance policy j� Other type of indemnity 1:3 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'sAgent Owner 13—Agent ❑ _— _ .. AN : ..1... ..1:.... r..-- n n t— nnA rha I hereby certlty that all of the tletans a11u ,nivl,ua.,v„ i „a. o -,--a- �-.- -- i --- �� •-_____._ ___ __ __ ____- --- - - -- - best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with ail pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. r. tle (OFFICE USE ONLY) Signature of Licensed Plumber r G Fitter Plumber / ❑ Gas Fitter tcense Number Master Journeyman Location ' No. y41 ' Date Z G Z_ Check # 15880 TOWN OF NORTH ANDOVER Certificate of Occupancy $ eye Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Building Inspector/ TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: c6e,— Building Commissioner/In for of Buildings Date SECTION i- SITE INFORMATION 1.1 Property Address: 7��e &,ec 1.2 Assessors Map and Parcel Number: Map Number Parcel Nuiri6et 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Re red Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: Public ❑ Private 0 Zone Outside Flood Zone 0 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record U��./ &(Aee�' Ale., 4xjy44 are (Print) Xddress fo Service : /N/'� 4014018Y3/� R Signature Telephone ' 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Not Applicable 0 License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Telephone O z rn 90 O ic a. rn rM r z^ YI SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 & 2506) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition 0 Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of/Proposed Work: C" SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant �3FFICIL�USE U1�TLY d 1. Building • (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (e) X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNE AU ORIZATION TO RE COMPLETED WHEN OWNERS T_ TRACTORAPPLIES FORaUILDING PERMIT , I, acaner/ �thorized Agent of subject property Hereby authoriz to act on My behalf, in all matters relative to work authorized by this building permit application. �. Z 9—/,s Signature of Owner Date if SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, As Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name Si ature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS I ST 2 ° 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHEVINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE D. Robert Nicetta Building Commissioner (978) 688-9545 (978) 688-9542 Fax Town of North Andover Building Department 27 Charles Street North Andover, MA. 41845 HOMEOWNER UCENSE EXEMpTloN Please pnnt DATE SOB LOCATION Number Street Address/ •�e�= 10MEOWNER `_�►'✓G�/�+�/ ( . Name Home Fhon.e �� ESENT MAILING ADDRF,S 10OW4- .. State Map / Iot The current exemption'for "homeowners" was extended t>, include o�'O�uP1ed dwellings of two units or less and to allow such homeowners to engage an indM' d not possess a license,. provided that the owner acts as su ualforhke who does. pervisor. (State SuOding Code g,�on 1 oa 3: 5. ? ) DEFINITION OF HOMFyyOWIVER_ Person(s) who owns a parcel of land on which he/she resides or intends to reside there is, or is intended to be, a one or two on which cessory to such use and/or farm �� Felling. attached or reside, �- two year penort shalt not be'consider A person° rrxNe.thar►ghornein a horneo weer The undersigned "homeowner" assumes responsibility for co mpfianc Applicable codes, by--laweSulatiorrs, s, rules and r e w'th the State Suilding Code and other The undersigned "homeowner" certifies that he/she and Building Department minimum ins ection understands the Town of No. An P procedure and rea m?ts and � helshe will ' �►PN with said procedures and reauirear�er� � / 'PROVAL OF BUILDING OFFICIAL s.' •t5'8 I 0 i ^0 � C -N_ Lv O� • 2�j U '!o .S . � O . R 774 N i 22 S �ti6 G 6 • SAT ,ov 30' 1 S //EPE�Y CE.�T/FY TO Tye T/TLE 1A1SU•PO C ANO �L D T TD Tf/E BA.vr T.irAT T.yE OwE[G/,c4C /S LG+C'ATEO O.v T//E LaT.lS ---W,00rN AND T/L4T?OG7ES LO.(/FGK'A/ /N !Y rw Tii/E fv—, OF v0. A .rs�a vE a 20.vi vii �E6!/GAT.b.✓S .fd ,'"Crf FPOM ST-,PEETS 1 F!/.rT.YC.� <E.�TiFY T.V.IT T.l+/.s D.�✓EGL/.✓6 /S �vOT / LOG4TEp IAA T•YE FEOE,PAG ZAAO A14Z4etO tSfJOIvN O.X1 FEiN/f COMMt/N/Ty PUNGL /CaX 1vOQ �EAcry 250098 GLU7� O �'Oeo nOFk4,�ti HOIRAVANN ca '1jl�ll I � :. -c` VC �IIE.P,P/itlgGt' E—,vG,ct�EE.P/,v6 SE•P/�/lES 64 A.VOOi�E.� �/.4S.S.4G,f�l/SETTS o/8/O 11 r'll. % IF 1� z T"s 4 4 4t t I q -i i T 4 7 +: �4 14 f T sin "i S� w lci H- i i -r4 -.4 j s-1 4 tl� It T31 TT 77 j 1774 L4i 71i 4 -;'i -ij- 1 _'-77 17, .4 L4 J.1- `44—tl t7 ql 1.4 �4 7 T, ttl7i- T iA 44 4 J- 4' 4 4 i 44- j �-j Lt� sl ��4+ 44 � i.! - Iyy :�;' .14� TP -t 4 I 14 "i -i 4 t t -p: AL T; TT :7rid A ZTZ T-7 T 4 J�; j ItIn.- 4 t+ �4 "J, 1 i -i _P� 14 r - f: i -4-i t- T, 1 4- ttH 4q 1-i 14 +z j4l 1 4-i p A t it TA [' Ki"r-tr f 4 �i 4 il if 4 T' i H! 4- E! + Ti t ,4f IT M i 4- J it A11 Li ai f i4� 4 "T �t 4� 4_; -j4 + 4 777 Z j - it -i F 4 j-" 144 -[J Ll_i.14 I i r 4 1 T 44 4 4 J '.'41 J� Z '.7, 1LLL 41." ':v sA IJ 4 s'. 7' -4 O z I cz x w Az dv p u, -b u cn o w � z Q o ' C w° pp X U Cct wuG". w 04 7w �'.'� OD a a `n U U a p U a z d C7 to z w a d Q w a m o cn Q cn uj am o :a o � cc p a= c :moo a ` Co CD m rm t; a= 1 � Go m oN v� N :D, 3 •• C1m y c c m` ' N = = O Em m gs U m (n y m ; m C/) ?� a Ns W x CIO act c Cc o �:c x`o Q' a:oc Q m m = o = m m_.. 3 N F- 0 z w o 4; RD .. N dt C Z OC = "' m N O V m v m w� Fa -a Vi d m� o� J 2 eyp y'� C CL CIO OM Ot - CD O E z O C* O .E CD C O O w CL y O 2 .CL ti C O O .0 !D CL C#2 Co0 co O Q cmQ C !C O O O coZ Q N C 0 U) w Ir Lli LLJ CC LUW U) 3; Location19 .: No Date k� ppRTH TOWN OF NORTH ANDOVER 41 p Certificate of Occupancy $ _. Building/Frame Permit Fee $ �sQAC oundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $— t Building Inspector Ty 11/01/95-10:051.1,142.00 PAID t $$2 Div. Public Works .?.rte- ,'-w � -�� ;`.' r w- ;'--r`-' ' �vr r.�s--r.�- • -' � '�'-t j � f ell - Location el (rJ A g No Date %-- Building/Frame Permit; Fee 5 �,oRTh TOWN OF NORTH ANDOVER ` Certificate of Occupancy A $ Building/Frame Permit; Fee $ S Foundation Permit Fee Other Permit Fee Sewer Connection Fee $ frA - Water Connection Fee $ - /077,50 }¢, TOTAL $pr Z�il 10/1 95 14:3 t,077.50 % 8' 9 7 DivlPurblic Works e— k.. Location`:'`�t—�4t'-i�t NoDate 3 OR TOWN TOWN OF NORTH ANDOVER R Certificate of Occupancy $ .� Building/Frame Permit Fee $ Foundation Permit Fee $ c►+uSEt :Other Permit Fee $ Sewer Connection Fee. $ Water Connection Fee $ 2.'`` TOTAL 106/95uildin _ 14:44 Ins ector 9 P ' 150.00 PAID _ •` Div. Public Works /J PERMIT NO* APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. L m PAGE 1' MAP d40. LOT NO. CONTR. TEL. # 2 RECORD OF OWNERSHIP :DATE BOOK :PAGE ZONE I SUB DIV. LOT NO.�. i LOCATION/ . 2 V a iA d I r PURPOSE OF BUILDING OWNER'S NAME � D y ' i5 D v _ j /� W O� / �� L NO. OF STORIES SIZE S I OWNER'S ADDRESS • 2-_? 3 %-u r rl b� .�,P ST BASEMENT OR SLAB �& st7-tLVj J '2 &F- VJ r -AD ARCHITECT'S NAME i alp SIZE OF FLOOR TIMBERS ! IST v/D 2ND ?Kl- 3RD •i d I'l / BUILDER'S NAME /f C. Arp SPAN DISTANCE TO NEAREST BUILDING L/O DIMENSIONS OF SILLS v V '" POSTS I �i•/��//d,,, J DISTANCE FROM STREET DISTANCE FROM LOT LINES - SIDES 'y /i d REAR /0 1/0 GIRDERS GIRDERS y J/1 AREA OF LOT S 5" V J FRONTAGE HEIGHT OF FOUNDATION �,/��i,�-+ THICKNESS V IS BUILDING NEW •p C SIZE OF FOOTING Ie X ii IS BUILDING ADDITION A/ O MATERIAL OF CHIMNEY / IS BUILDING ALTERATION T} vV IS BUILDING ON SOLID OR FILLED LAND / WILL BUILDING CONFORM TO REQUIREMENTS OF CODE ` C•- IS BUILDING CONNECTED TO TOWN WATER V e S' J�� BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER r$ IS BUILDING CONNECTED TO NATURAL GAS LINE e INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 3 PERMIT FOR FOUNDATION ONLY REGULATED BY PARA. 114.8-S. B.C. PAGE 2 FILL OUT SECTIONS 1 - 12 DATE lblal`30 ^FEE PAID _1,00 ® ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED L 5-b. ov PERMIT FOR FRAMUBUILDING PERMIT GRANTED 19 EE PAID_ gm mm ME �^ [00- 8K, ao-• MME PERMIT s. PROPERTY INFORMATION LAND COST EST. BLDG. COST EST. BLDG. COST PE EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. Al C/A 4 'APPROVED APPROVED BY BUILDING OWNERTELJ I� V �— // O CONTR. TEL. # (D o / 1-2 CONTR. LIC. # % H.I.C. k I OCCUPANCY SINGLE FAMILY I STORIES MULTI. FAMILY F PlCtS APARTMENTS fCONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE PINE 3 1 2 13 CONCRETE BL K. BRICK OR STONE HARDW D PIERS PLASTER -FRI WALL UNFIN. 3 WEMEN . T\ AREA FULL FIN. B M'T' AREA, 1/1 1/2 1/1 _fIN. ATTIC AREA tLO 8 M T FIRE PLACES - , , HEAD ROOM MODERN KITCHEN 4 WALLS 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING r _CQNCRETE EARTH HARDVJ'D COMtACN _ASPH TILE VERT. SIDING STUCCO ON MASONRY-,' . STUCCO ON FRAME BRICK, ON MASON 7 11 ATTIC STIRS. & FLOOR BRICK ON FRAME IO CONC. OR CINDER'BLK. WIRING STONE- ON MASONRY. STONE ON *FRAME SUPERIOR I Xj POOR _ADEOUATE NONE 10 PLUMBING BATH 13 FIX.) TOILET RM. 12,FIX%1 WATER - CLOSET\\ LAVATORY / Ilk 5 ROOF GABLE HIP GAM11ELI MANSARD FLAT SHED ASPHALT GLES", WOOD SHINGES KITCHtW SINK L SLATE NO -PLUMBING' TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES TILE FLOOR `TILE DADO 6 FRAMING I 11 HEATING 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 H'T G -RADIANT UNIT HEATERS 7 NO. OF ROOMS I AS IL I'M'T 2nd 117.,J�Zfjl �ELRTRIC C I NO HEATING ' ' _17-771 3,d- I 611 BUILDING RECORD 12 THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT, DIMENSIONS OF- BU I LDINGS.. -WITH', POFiCHES. GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT.PLAN. .� � �M1i'.iJ.1.si'i.�liit?I�+� 51014 TI -R41.5 --T_ , T_ Ttm E -I Tf."19A MAW Wi Lo O� 01 © m O O O ¢ O w ✓ p w Z co y C C CM CD O coCO Em m co cm co o s A •� O i co OL CVC O d �-' •° 01 Q y W °�° o cc a o vCC J� a �° C y O co > m Z w G cn cn LU v 00d :U vc2 C:2. MCC w € z LA - co m EaaCD ci w c m V D C Vf C C m O m c - �D Q� E ,a m li U CO2Vf � CO J y C a M — cm CD CA Ca R o y W O U co 0-4 Amo :a �cacm �o �mor . C.3N p > Z �o: r I- C= o C LZ Q L y m C = m m rL.. 3 C7 C) N m sH m N R � m � w c :smss CL LLI E C., V O C� m CD � C _ CD V2 .0 L N H Z cm 2 Q W C!) z 0 U W- J Q z (r W W W cn m O E O O C) Z co y C C CM CD coCO Em m co cm co o s •� O i co OL CVC O d �-' a- 01 Q y C a o cc vCC J� O co Z w CD y U CJI CO) O � _ C Cv CL CO3 2 Q W C!) z 0 U W- J Q z (r W W W cn FORM U - IAT REIXASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills ou/t� this section***************** APPT.TCANT: f--fJX W0CJ"/I ( fel l`c�r;i, Dh.,,,o l, Q- % '/ t2-& LOCATION: Assessor's Map Number Parcel Subdivision Xw00 Lots) �� l S treet St. Nu -icer % Use Only*******************w**** i RECO IDA"S OF TOWN AGENTS: Date ADcroved Con=ter: ation Ad -nistrator Dare Rejected Cc= er. Town Planner Fcod lnsrecmc_- Health Se*-z_c lnscec ...r -:lea -t.. Date Approved -gh Daze Reiecte^ Date Approved Dare Re-iec-z=,4 Date Apprcve-d a Dare Rej ec zed ;Icr%:s - sewer/water connections - dr_vewav perm. Fire De-ar,:me.n't: x 6�� Reed by Building In :.ector_--- J (l CT 1 2 IR95 ; e Data i • INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills ou/t� this section***************** APPT.TCANT: f--fJX W0CJ"/I ( fel l`c�r;i, Dh.,,,o l, Q- % '/ t2-& LOCATION: Assessor's Map Number Parcel Subdivision Xw00 Lots) �� l S treet St. Nu -icer % Use Only*******************w**** i RECO IDA"S OF TOWN AGENTS: Date ADcroved Con=ter: ation Ad -nistrator Dare Rejected Cc= er. Town Planner Fcod lnsrecmc_- Health Se*-z_c lnscec ...r -:lea -t.. Date Approved -gh Daze Reiecte^ Date Approved Dare Re-iec-z=,4 Date Apprcve-d a Dare Rej ec zed ;Icr%:s - sewer/water connections - dr_vewav perm. Fire De-ar,:me.n't: x 6�� Reed by Building In :.ector_--- J (l CT 1 2 IR95 ; e Data j ' I O, O O o -� o0 o, R � 0 0� 71�1 i N_ 'Jp � 2.2 'v6 G 1 FO`�Q�Tiav 0 ba ' 3� � C'i�,C'9000, _ Ou'�y3 S W6f6gY CE.cT/FY TO TyE RL or TIJ T•�1E BA.V.r TWgT ?W,P—eZ4AAW /S LACATEO O.v ,-Ale LOT fS S/,CA✓N ANO T/G7T?OGEES CO,�/FGtPAJ //(/ O ' No. ANOOvf e ZpN/.vG �E6vCAT.t7.tiS ,4L�6vI.e0/.tR", SETBAL.t'S F�O�f1 ST.PEETS � LOT UN6S. '' iC�O, �,�,OD vE.e l��G'SS, LOG4TE0 /N ;&e H 04e,0 APE oT O.P�N�/V foie tSyOivN Oit/ FEMA' COM�a/t/N/Ty Pif�t/CL '� �QX !�✓��O �E.S' G �- 2so098 Oq'TC1� 6/2/93 �i � OF � �NE�P.P/�t1�4Gf' E.v6idEE.P/�l/6 SE.PI�/�'ES 66 �,4,fW ST.rEET 11.4.vOOYE.� AL4SS,4G//l/.SETTS O/8/O Location No. Date i ? TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit F<ee�.�" q $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $� Building Inspector 127/95 2 25.00 PAID =93-91Div. Public Works S - �d .... .` KAREN H.P. NELSON ' r azo Main Street.01M °i'""°'NORTH ANDOVER (soa) ssa-sa 83 d; BCILDING �==•ewe•►•, DriMION OF CONSERVATION HEALTH PLANNING PLANNING &. COINBIUNITY DEVELOPNMNT CHIMNEY APPLICATION AND PERMIT DATE ` LOCATION OWN'ER'S NAME (1ide- '' A00 or BUILDER'S NA MASON'S NAME MASON'S ADDR PERMIT # +^c— (Z M.ASONIS TELEPHONE MATERIAL OF CHIMNE'_ INTERIOR CHI:VEY i nuc EXTERIOR CHIMNEY /S1 2G NU 4B='^ 1D SiZE OF FTLT` c i THICi�7ESS OF HEARTH Wil_ chimney or fi aza con --fo _., to reauirerents of the code and have rules and reculatiC:-:s been received: SIGziATURE OF MASON CONTR. LIC. EST. CONSTRUCTION PRICE PERi•IIT GRANTEDZ ROBERT NiCETTA, BUILD;:G I, S^rr-CTED REMARKS =RICK REQUIRED THIS PER.uIT l -L -ST BE DISPLAYED ON THE PRE:SISES Ot32q (�4 V -,g 22,T- L4 CJ LU LPJ 0 r z v -- C.>- --4 �--4 m c -Z C LU : z•, o vCpy tai cc _F CY p�m��a A. 90= W � p cz Ily N !C m JCO Cj y Cc= WCc l C wcmCD Im o U 41 o x E. o .� W O L Q � m ; y o o = W m fl. p N {.i.. ~ m N m rp„~ m co u. v2 m a ego r4 N d� _ CM) CA3 cmco ) Lai cn a maoM -¢-� H = R p CD O E O O 0 y CD a� i C� O CD C.) ev M V! O O .y c O LD m R CLy G FO— CD L 0 O CD CL CL �Q C CC CQ O O zco Q CO) C F— z w Q W a J Q _z J V' Q LL ~ cr- LU z � Z � LU Q w CL cn N � J x w Z -- ► v U, �. z "_ w► s d Z 0 " \ U� Z w� -r o z D a, U) v) CJ LU LPJ 0 r z v -- C.>- --4 �--4 m c -Z C LU : z•, o vCpy tai cc _F CY p�m��a A. 90= W � p cz Ily N !C m JCO Cj y Cc= WCc l C wcmCD Im o U 41 o x E. o .� W O L Q � m ; y o o = W m fl. p N {.i.. ~ m N m rp„~ m co u. v2 m a ego r4 N d� _ CM) CA3 cmco ) Lai cn a maoM -¢-� H = R p CD O E O O 0 y CD a� i C� O CD C.) ev M V! O O .y c O LD m R CLy G FO— CD L 0 O CD CL CL �Q C CC CQ O O zco Q CO) C F— z w Q W a J Q _z J V' Q LL ~ cr- LU z � Z � LU Q w CL cn 41 e M cc c m 0 z E CD a cm m x H oa a d W¢ o wz 0 o a oa v aw A U O a W Ex-�O IN 0 0144 Tammunwealt4 of Am usPtts lepurttntnt of Public Oafiztq BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Office Use Only Permit No. Occupancy & Fee Checked 3190 (leave blank) 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 I/1�v -1 r (%* or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical) work described -low. Location (Street & Number) l�GT 4Vey �`�r^ <nj Owner or Tenant Owner's Address 7 3 -3 Tvn//Kr 57-, &� Is this permit in conjunctionwithabuilding permit: Yes `E' No ❑ (Check Appropriate Box) Purpose of Building �l A 1!r_1hL!L— Utility Authorization No. _50231-3 Existing Service Amps Volts Overhead 1:1Undgrnd ❑ No. of Meters ��,,`r 11 New Service � Amps 4IC—IJ2:�10Volts Overhead ❑ Undgrnd d No. of Meters Number of Feeders and Ampacity /� Location and Nature of Proposed Electrical Work Lew po,m:d OTHER: INSURANCE COVERAGE: Pursuant to the requirements of M acnusetts general Laws 1 have a current Liability Insurance Policy including Comoed 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 appte box. INSURANCE y laBOND = OTHER = (Please Specify) — (Expiration Date) Estimated Value of Electrical S Work to Stan _U �S Signed under that Penalties of erjur FIRM NAME L Inspection Date Requested: Rough r o- // Final LIC. NO. Licensee/ i� ✓ •lr'� 'C Signature �� C. NO. / us. Tel. No. Address T ��/f "P/ Alt. Tel. No. V 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)A�a d6Telephone No. PERMIT FEES V ( gnature of Owner or Agent) C/ `� 7/ x-6565 Total No. of Lighting Outlets No. of Hot Tubs No. of Transformers KVA No. of Lighting Fixtures I I— Swimming Pool Above.— In- grnd i � grnd. I_' I Generators KVA No. of Emergency Lighting No. of Recectacie Outlets I No. of Oil Burners I Battery Units No. of Switch Outlets I No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Total No. of Ranges No. of Air Cond. I tons Initiating Devices No. of Sounding Devices No. of Self Contained No. of Disposals I No.of Heat Total Total Pumps Tons KW No. of Dishwashers I SpaceiArea Heating KW Detection/Sounding Devices Local Municipal Other ❑ Connection ❑ No. of Dryers I Heating Devices KW No. of No. of Low Voltage No. of Water Heaters KW I Signs Ballasts Wiring u., •. &A—.— T,,hc I No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of M acnusetts general Laws 1 have a current Liability Insurance Policy including Comoed 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 appte box. INSURANCE y laBOND = OTHER = (Please Specify) — (Expiration Date) Estimated Value of Electrical S Work to Stan _U �S Signed under that Penalties of erjur FIRM NAME L Inspection Date Requested: Rough r o- // Final LIC. NO. Licensee/ i� ✓ •lr'� 'C Signature �� C. NO. / us. Tel. No. Address T ��/f "P/ Alt. Tel. No. V 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)A�a d6Telephone No. PERMIT FEES V ( gnature of Owner or Agent) C/ `� 7/ x-6565 �.�.-'+, :-mss.--^.w' �z+�i�v `' - y'cc�+mir`- ""-�"..c'-.- a � i^�--� s :-.p: -+a_.�.,,�y,,-, ,. -�.• , r.� �-._,,,��.,�r«tist Date ..../.�..gl.. . 2712 NOR71, TOWN OF NORTH ANDOVER * PERMIT FOR WIRING A �,SSACMUSEt O This certifies that ..... ......................................................... ' has permission to perform .............. .......... wiring in the building of v w d%cJ f. c��l ... . ..... . ....................... at ....� f..... ....... ...... ....... Yc N......... ,North Andover, Massa ....... 1 Fe ,..a. aK.k:UU Lic. No: .7O/1 ........ ................................................ ELECTRICALINSPECTOR c(�1�'/ WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File 4 Date.. . !V- 3...... �,ao ,eye O TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION 9 i This certifies that ... 1\!4 ti :Gr................... has permission for gas installation .. f5�.1�-. r ..4 <.............. " in the buildings of ..C' ? . % Aq......................... at... ..... . r Fee..3�?,.... Lic. No.. -)?.J)—.. Check # / � ) 1 4334 North Andover, Mass. GAS INSPECTOR Nl (A b5 u -f [)MC�- I ++ "S" MASSACHUSETTS UNIFORM APPLICATION L� FOR PERMIT TO DO GASFITTING P it # 37 Name Occupancy 51 Plans Submitted: Yesp No p 3 6t Installing Company Name YANKEE GAS Check one: Address 140 SOUTH MAIN STREET ® Corporation MIDDLETON, MA 01949 p Partnership Business Telephone 978-774-2760 0 Firm/Co. Name of Licensed Plumber or Gas Fitter WILLIAM R. HARRIS Certificate . 103C INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes )(3 No C1 If you have checked Yes, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy EX . Other type of Indemnity O Bond O OWNER'S INSURANCE WAIVER: 1 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: Owner0 Agent 0 Signature of Owner or Owner's Agent 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 the permit Issued for this appli tion will be In cpmpliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the ral Laws. // By T of License: Plumber Signature o um r or as titer Title Gastitter 3785 aster License Number City/Town Journeyman 1 ' ■tttttttttittt■ MENNEN tit ttttttt tilt ttttt�ttt tit t t - • • - tttttttttttttt�tttt-_tt tit • • • - tt tttttttttttt tttttt . .. ■ENEEMEMEMEttitttttMENNEN ... ■tttttttttttttttttttirtttt■ .. - ■ttittttttittttittitt■ tit' ' • • - ■®ttttttttttttttttttttit ■ .. - ■itittitttittitittttttttt■ .. - ■tttttttttttttttttttttttt■ Installing Company Name YANKEE GAS Check one: Address 140 SOUTH MAIN STREET ® Corporation MIDDLETON, MA 01949 p Partnership Business Telephone 978-774-2760 0 Firm/Co. Name of Licensed Plumber or Gas Fitter WILLIAM R. HARRIS Certificate . 103C INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes )(3 No C1 If you have checked Yes, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy EX . Other type of Indemnity O Bond O OWNER'S INSURANCE WAIVER: 1 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: Owner0 Agent 0 Signature of Owner or Owner's Agent 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 the permit Issued for this appli tion will be In cpmpliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the ral Laws. // By T of License: Plumber Signature o um r or as titer Title Gastitter 3785 aster License Number City/Town Journeyman