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HomeMy WebLinkAboutMiscellaneous - 700 CHESTNUT STREET 4/30/2018d Fc 044-6 D �- nA 'enr�uQ ie� li�cQg )-owt-C'q I1a&1Iq a1►ei�� -7o 04�4 *� \ s 4 vT S7'.2EET r MOMr � rwrar,.a�r sa►r�.��,.ra�.or �aenra �r AW LIT qC! J M W AVP YXMt/rOAW 4%Wlor~ I1�/7~iV i�i� 1V-ZV 9W A&. ANQOVt,t Ari�lJGIfAM AOE7 we" /!IC{M O7.M�1';f � (i1T XA*" � 't / R derpip Y ~P Ti1K� iMrYL= Af AAW �NwK �jtl �e♦i�M -'4AWAO& wty MAMA • VSVO98 00,,:rG C • a.�ao 6/z/�3 N F M� • RL or f'L.4A1 V 7-- C CO.v ST.Qt/CY�O/t/ (pep O.Oae ' .wEtcuwce� E,�,s,,Krer,,�,� .�rrcEs kF, CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number A e 0 Date 7h THIS CERTIFIES THAT THE BUILDING LOCATED ON 74497449C flfS A) 07L S 7L - MAY I MAY BE OCCUPIED ASS le- �A ►ly a s��//y� IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. C". ° "' ; �� CERTIFICATE ISSUED TO - e ` r� �C� �!� N8 �(7C/ ADDRESS �� `� T aiwo►F°- Building Inspector c N! C � y n C3 Z CO) CL F r Q CDCL O cr d CD SOca w 0 C CD y� CD CL O y Y..f C I 0 0 O C y O O d S a�cmN S aCam m Cl) C y e7 C2 3 z CD = m „w a CD �O m m C y N � N O m m = > >CD O �a O' O =.-Z .+ O O N C2 ;L W,"� aj C 42 a.�r•i m O CD :� ® CD m N yam m� C y :� H O.=r: �Q m CD CD to -- �=r Cm CD :n n �Q IL -« .. �m 0 m = ap. a .( 0 c oCD a oil � 0 �1 Cf) aj p ro � GO I•� ISIr d Cu / N �N 10 E� E W y 0 a 0 c Location 7©o C,4ES�tiLf—1 ST' lot C No. Date NORTH TOWN OF NORTH ANDOVEFk 9 Certificate of Occupancy $ Building/Frame Permit Fee $ C co' Foundation Permit Fee $ � --ssACNUSE_ ro Other Permit Fee $ 7 Sewer Connection Fee $ 00 OD D. $,j¢ Water Connection Fee $ /d6,2�• Co TOTAL s�g J / f (' ,- 3Dc? D Buildin ?Inspe or c�iasJ�4 o�:sa 12 5 ? 6 works PERMIT ASO. (/ APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP 4-40. LOT NO. G`/ I 2 RE ORD OF OWNERSHIP IDATE BOOK PAGE ZONE SUB DIV. LOT NO. f -I LOCATION 7OD U T PU E OF BUILDING t•J OWNER'S NAME 1 r{—�— NO.'15F STORIES SIZE OWNER'S ADDRESS ••� //��� ��`1' /_ BASEMENT OR SLABARCHITE��r8��/•�—�--;' �••y� �/� CNAME ,.%w�d� OF FLOOR TIMBERS IST 3RD BUIL ERS N MEj/1i1 +2ND SPAN DIMENSIONS OF SILLS DISTANCE TO NEAREST BUILDING /moi✓/t/C DISTANCE FROM STREET % POSTS /+h/ (�• 1 DISTANCE FROM LOT LINES — SIDES / REAR GGCAC✓�jy GIRDERS lQ AREA OF LOT /t�FRONTAGE !J/iG�r CICS HEIGHT OF FOUNDATION' / THICKNESS /Q ae IS BUILDING NEW SIZE OF FOOTING ,� X IS BUILDING ADDITION MATERIAL OF CHIMNEY t IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE /G % y 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 SEE BOTH SIDES pj �� ydf�� -,a .. -.� L4 • � , f PAGE 1 FILL OUT SECTIONS 1 - 3 CID I I PAGE 2 FILL OUT SECTIONS 1 12 ! ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING I Ifs. tl d'^-. ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIO14S PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED _1__2z — 57 91 3��® SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE OA PERMIT GRANTED 1s s PROPER17V INFORMATION go 9'417, LAND COST y EST. BLDG. COT r EST. BLDG. C T PER SQ. FT. cj EST. BLDG. C ST PER ROOM SEPTIC PERMI NO. 4 APPROVED BY / BUILDING INSPBCTOR OWNERTEL.# 94�f-r?' CONTR. TEL. # ` S EM4 CONTR. LIC.# L// / I I � H.I.C. # BUILDING RECORD ` 1 OCCUPANCY 12 SINGLE FAMILY Si ORIES MULTI. FAMILY _OFFICES __ APARTMENTS CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH d 1 2 13 PINE CONCRETE CONCRETE BL K. BRICK OR STONE HARDW D PIERS PLASTER DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN, 8 M TAREA _ 114 '/I 'L FIN. ATTIC AREA NO B M'T FIRE PLACES _ L HEAD ROOM MODERN KITCHEN 4 WALLS I g FLOORS CLAPBOARDS DROP SIDING WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING VERT. SIDING CONCRETE EARTH HARDW D COMIACN ASPH. TILE 8 1 2 3 �_ _ _ _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY BRICK ON FRAME ATTIC STIRS. 6 FLOOR CONC. OR CINDER BLK. WIRING - STONE ON MASONRY STONE ON FRAME SUPERIOR I� POOR ADEQUATE NONE 10 PLUMBING BATH 13FIX.) 5 ROOF GABLE HIP GAMBREL MANSARD FLAT SHED TOILET RM. (2 FIX.) WATER CLOSET ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR 8 GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR _ TILE DADO 6 FRAMINO I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS, 6 COLS. STEAM STEEL BMS. S 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'T2nd I ELECTRIC _ 1st L% 13rd I NO HEATING THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. .r 4 PER�trr NO. APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE i MAP 4-40. '� `> LOT NO. I 2 RECORD OF OWNERSHIP IDATE BOOK ;PAGE ZONE SUB DIV. LOT NO. (� LOCATION PURPOSE OF BUILDING OWNER'S NAME _ NO. OF STORIES .? ' SIZE ` ! / OWNER'S ADDRESS - e BASEMENT OR SLAB /_ f ARCHITECT'S NAME r f SIZE OF FLOOR TIMBERS 1ST' r 2ND 3RD .. / Ile BUILDER'S NAME SPAN / DISTANCE TO NEAREST BUILDING /}/ DIMENSIONS OF SILLS �• j i DISTANCE FROM STREET -� / '" POSTS DISTANCE FROM LOT LINES — SIDES i REAR GIRDERS AREA OF LOT �,•,!7 .• HEIGHT OF FOUNDATION ! THICKNESS, !j `r /FRONTAGE•' j� IS BUILDING NEW ` r arm /J SIZE OF FOOTING /I X i/ r IS BUILDING ADDITION MATERIAL OF CHIMNEY tj IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND I WILL BUILDING CONFORM TO REQUIREMENTS OF CODE / i IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER i IS BUILDING CONNECTED TO NATURAL GAS LINE • f INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 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 SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE PERMIT GRANTED 19 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST EST. BLDG. COST PER SQ. FT. rhe EST. BLDG. COST PER ROOM a SEPTIC PERMIT NO. 4 APPROVED BY ISUILDING INSPECTOR - r OWNERTEL.# CONTR. TEL. # / l CONTR. LIC. # H.I.C. # I OCCUPANCY SINGLE FAMILY StORlES MULTI. FAMILY Of FICES APARTMENTS if CONSTRUCTION 2 FOUNDATIONI 8 INTERIOR FINISH CONCRETE X �I _ d K. ��11 2 t CONCRETE BL'PINF �I—I URT WALL 3 BASEMENT II I AREA FULLFIN. B -M T AREA _ Y.1/2 1/1 FIN. ATTIC AREA _ NO BMT FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 7 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARDW'0 _ ASBESTOS SIDING _ COMMGN.rl VERT. SIDING ASPH. TILE �11 STUCCO ON MASONRY_ STUCCO ON FRAME 5 ROOF ATTIC STRS. 8 FIOOR WIRING SUPERIOR POOR ADEQUATE NONE 10 PLUMBING SLATE (; ISI STOALL SHOWER I -I LUMBING TAR A RAVFI BUILDING RECORD 12 THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. a ,i 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS, 8 COLS. STEAM STEEL BMS. dCOLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING _ RADIANT H'T'G UNIT HEATERS 7 N0. OF ROOMS GAS OIL B'M'T 2nd _I 1=1�I 3rd I I ELECTRIC NO HEATING NO HEATING N 1387 APPLICATION FOR SEWER SERVICE CONNECTION North Andover, Mass ���� LL. 19 ( / Application by the undersigned is hereby made to connect with the town sewer main in v ` Street, subject to the rules and regulations of the Division of Public Works. 7 The premises are known as No. (co C4o��y c,� �rrPAr or subdivision lot no. 975— 575 �L TbttL 14 lz�� Owner Address Contractor Addr s Applicant'ZSignaure PERMIT TO CONNECT WITH SEWER MAIN r The Division of Public Works hereby grants. permission to G'c� ao 132- t I �j(�(J i to make a connection with the sewer main at subject to the rules and regulations of the Division of Public Works.. Inspected by Date Street Division of Public Works By See back for rules and regulations �9 A N2 85 -4 - AP PUCATJON tOR' 5.4APRLICATIONFOR WATER SERVICE CONNECTION'." North Andover, Mass.'19 Application by the undersigned is hereby made'to connect with the town water main in Street, subject to the._rules and regulatio_ ns of the Division of Public Works. The premises are known as No. K0 Street or subdivision lot no. —t Z S —S 7.5 Z Owner Address Contractor Add r s pplicant's Signature 5/ a g vte er 02.00 PERMIT TO CONNECT WITH WATER MAIN rn The Board of Public Works hereby grants permission to.. " `—u Q to make a connection with the water main at Vi.J� subject to the rules and regulations of the Division of Public Works. Inspected by Date W - Street B rd of Public Works By See back for rules and regulations r FORM U - VERIFICATION 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 out this section***************** APPLICANT: V(iA c4axh Phone 97, S% F Z LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) r Street jT,, f ,L, St. Number lltv ************************Official Use Only************************ RE DAT O OF TOWN AGENTS: Date Approved onse ation Administrator Date Rejected Comments �� f� no Date Approved C� Town PlannerDate Rejected olo Comments�_ Date Approved Food Ins to -Health Date Rejected --� Date Approved JZ7272 -'Se,ptic nspector-Health Date Rejected Comments Public Works - sewer/water connectionsy - driveway permit Fire Department �t� lv/Y (L/t,If- U4 9 Received by Building Inspector Date Growth Management Bylaw Exemption Statement Town of North Andover Building Department This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information as requested below. Name of Applica on Building Permit (below) Address of Property for Permit (below) Map and Parcel :9 ,Y f3 Purpose of Application (check below) Ph eN�mber of A plicant: Single Family Two Family 27 3 -S 7S-� I the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 of the North Andover Growth Management Bylaw. I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the Building Permit. Further I understand that my interpretation of the EXEMPTION status is subject to review by the Building Department and is only officially accepted when the Building Permit is, issued. Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building permit application and associated attachments, complies with one or more of the following sections as indicated by a check mark. This is an application for a building permit for the enlargement, restoration, or reconstruction of a dwelling in ekistence as of the effective date of this by-law, provided that no additional residential unit is created. The lot(s) were/was created prior to May 6, 1996 are exempt from the provisions of this Section 8.7 of the Zoning Bylaw. This application is for dwelling units for tow and/or moderate income families or individuals, where all of the conditions of 8.7.6.care met and/or represents Dwelling units for senior residents, where occupancy of the units is restricted to senior persons through a properly executed and recorded deed restriction running with the land. For purposes of this Section "senior" shall mean persons over the age of 55. This application is a part of a development project which voluntarily agreed to a minimum 40% permanent reduction in density, (buildable lots), below the density, (buildable lots), permitted under zoning and feasible given the environmental conditions of the tract, with the surplus land equal to at least ten buildable acres and permanently designated as open space and/or farmland. The land to be preserved shall be protected from development by an Agricultural Preservation Restriction, Conservation Restriction, dedication to the Town, or other similar mechanism approved by the Planning Board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for building permits,(i.e. all other permits from all other boards and commissions have been received and the project is in compliance with those permits), and the Development Schedule does not accommodate issuing a building permit in that Year, one building permit will be issued per Year per Development until such time as the Development Schedule accommodates issuing building permits. Applicant must supply approved form U with this EXEMPTION. Please provide any and all information that would assist the Building Department in making a determination' that your application is allowed one or more of the above EXEMPTIONS. By signing below I attest to the accuracy of the information provided and that the attached building permit is allowed an EXEMPTION as cited above. Further I understand that the submittal of misleading and or inaccurate information, or the checking off of an above item which does not comply, whether done to my knowledge or not, is grown,Osfior I by the Building Department to issue a Building Permit. ignaturOwner or Authorized Agent who signed the Attached Building Permit Date This form must be attached to the Building Permit upon application for such permit. TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 9( /_ 384 OSGOOD STREET, 01845 Telephone (508) 685-0950 DIRECTOR — Fax (508) 688-9573 DRIVEWAY PERMIT Date: ::�i o 0 a> -\,j 1 z (9 g LOCATION: rrocs BUILDER: phone: OWNER: MaO L �4e t�e ((� phone: r�Q ae f3c.; MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck Software Version 2.0 CITY: Lawrence STATE: Massachusetts HDD: 6235 CONSTRUCTION TYPE: 1 HEATING SYSTEM TYPE: DATE: 1-21-1999 DATE OF PLANS: or 2 family, detached Other (Non -Electric Resistance) TITLE: Chestnut Street COMPANY INFORMATION: Belford Construction COMPLIANCE: PASSES Required UA = 428 Your Home = 385 Permit # Checked by/Date Area or Insul Sheath Glazing/Door Perimeter R -Value R -Value U -Value UA ------------------------------------------------------------------------------- CEILINGS 988 30.0 0.0 35 WALLS: Wood Frame, 16" O.C. 2081 13.0 3.0 148 WALLS: Wood Frame, 16" O.C. 281 0.0 3.0 48 GLAZING: Windows or Doors 213 0.500 107 FLOORS: Over Unconditioned Space 988 19.0 47 HVAC EFFICIENCY: Furnace, 85.0 AFUE ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the design load as specified in sections 780CMR 1310 and J4.4. 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N x _v- M .yy �..� a� Oo �sss e b = x X13 �yy � m A N N N N N Q NA1 NN N xxxxx -n_. a aSa►�+. �o _v- M .yy �..� n o �sss op = x X13 �yy dl � O 3 �n 1* 4r Z Q O m v • .� N m��• Oo N rn � N % N U' x x N % N % N x NN x x s r N x �g3D m a `3 sa N x x tsz x x x x x x 6a x 6 q _4 r- NQ aa a �EE N :-x NN x x N x NN x x N x ._GmrR �a a N� Z N N N N N' N UN xx .N til- x •.. •N x l N N x N� x N N x N x s s ate., a 6 � m A N N N N N Q NA1 NN N xxxxx aSa►�+. �o 0 n �sss op = x X13 �yy dl � O 3 �n 1* 4r Z Q O m v • .� N m��• Oo N rn � r N �g3D m sa 5 5 9 Date ;hZI ..... e 0 TOWN OF NORTH ANDOVER ....7 0 PERMIT FOR WIRING '%cMuS This certifies that ........ Sk.q.t✓ ...... ' lP ' C) 'J J, has permission to perform ....... ........ ........................ wiring in the building of ....J. at..... .. ........................... ,North Andover, ass? . .... .. ... ....... A:�� Lic. No; ... Fe .5. - - 6��- - ELECTRICAL C— O3�i26 /408: 2400 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer TBFC0A111fO1VT E4L7H0FM SS4CHI1.$= Office Use only DII'ART114NlOFPUBLCSAF�7Y Permit No. �1 BOARD OFFREPREYF.NlIONRIMl Z 527 12--00 Occupancy & Fees Checked UV PPLICATTONFOR PERMIT TO PERFORM ELECTRICAL WOM ALL WORK TO BE PERFORMED INACCORDANCE WITH THE MASSACHUSSfS E.ECtRICAL CODE, 527 CMR 12:00 —a (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 'LPI f ?� 07 Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Owner or Tenant Owner's Address tIs this permit in conjunction with a building permit: Yes [7 No F-1 (Check Appropriate Box) Purpose of Building 14711MIL y Utility Authorization No. 9,dy-L- 4e Existing Service Amps / Volts Overhead a Underground M No. of Meters New Service �_ qCyolts Overhead ®Underground No. of Meters % Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work f �f�✓% No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total �o. KVA of Lighting Fixtures Swimming Pool Above Below Generators KVA ground eround M No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No ot' Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumos Tons KW htiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW _ 71Connections o. of Water Heaters KW No. of No. of _ Sicns Bailasis hydro Massage Tubs No. of Motors Total HP O AER ®r � a .:1• •: �jStg=ae��� / � f/ Y � (� Btr�� TeL Na �iJ''�� -8"7 Add=//�[� G" AIL Tel. Na t OWNER'S MURANCEWAIVER;Iarria," ethattheLcmseciommthmethemi stm=ooea a-iissttstattialet.;tmaletasro4zedbyMass±xsettsGarza!Laws aodthamysignaii.irecnthispeimi.appTrtirnwaaesthis Faprm a>s. (Please check one) Owner Agent Telephone No. PERMIT FEES 3134 K 79 ,1pRTM -1 SAC L D • �SSACNUSEttg Date. TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION J This certifies that .6�`l<,.1 ��:/.....'` ................ 0 hfil permission for gas installation�... ..... E.f .......... . inghe buildings of ... ............... . at ..7. �! U.. G.. .' r. ��y :. ?G .... .... , North Andover, Mass. Fee. 7 .. Lic. No fvoj:! f.. .. z :. `. C GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MN MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO'GAS FITTING or print) NORTH ANDOVER MASSACHUSETTS Date 3-12 19Q A C Building Locations o a n Ya ►tico az Permit # 3 / 3 Y Amount $ %O. — Owner's Name �� ` kep-Q C-��5�� New Renovation ❑ Replacement ❑ Plans Submitted ❑ (Print or type) eck one: Certificate Installing Company Names Galinsky Plumbing & Heating Inc. Corp. 1906 Address P.O.Box 1701 Haverhill, MA 01831 ❑ Partner. Business Telephone 978-374-1743 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter Stephen C Galinskv INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ® No If you have checked+}res, please indicate the type coverage by checking the appropriate box 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 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 pertormea unser rermn ISSUCU 1U1 u,LZ ar,r„. �.... •• ••• -- compliance with all pertinent provisions of the Massachusetts State as Code and Chapter I o the eneral Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter ® Plumber 10344 ❑ Gas Fitter License um er 0 Master ❑ Journeyman w � �F� SCC Q Gaal C i C W z WW W F Z r x V p > (. w W .�• GC t7 I a z z a °� C C w o w N 'KU B-BASEM ENT BASEM ENT IST. FLOOR 2ND. FLOOR 6RD. FLOOR 4TH. FLOOR 5TH. F L 0 0 R TT II. FLOOR 7TH. FLOOR RT 11. FLOG R (Print or type) eck one: Certificate Installing Company Names Galinsky Plumbing & Heating Inc. Corp. 1906 Address P.O.Box 1701 Haverhill, MA 01831 ❑ Partner. Business Telephone 978-374-1743 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter Stephen C Galinskv INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ® No If you have checked+}res, please indicate the type coverage by checking the appropriate box 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 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 pertormea unser rermn ISSUCU 1U1 u,LZ ar,r„. �.... •• ••• -- compliance with all pertinent provisions of the Massachusetts State as Code and Chapter I o the eneral Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter ® Plumber 10344 ❑ Gas Fitter License um er 0 Master ❑ Journeyman Date . 3, '. 3975 TOWN OF NORTH ANDOVER a O PERMIT FOR PLUMBING SSACMUS� This certifies that ............. has permission to perform ....%. u-.. ............... S' plumbing in—the buildings of ....I 3A L/Fw.s................... 1 M at. . . , .. ... , North Andover, Mass..; Fee Lie. No.. t p a �. LI? ........ PLUMBING INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PL ING �peorprint) NORTH ANDOVER building Locations MASSACHUSETTS Date '1-12-99 Permit #— 3 C' 7J� Amount Q -2 ' �? O C ►7CS'SVl-v ( :: Owner's Name } New (,' Renovation Replacement 1-3PlansSubmitted n FIXTURES (Print or type) Check one: Certificate Installing Company Name Galinsky Plumbing & Heating Inc. ® Corp. 1906 Address - P • 0. Box 1701 HavPrhi 11 . MA 01 R11 w ri Partner. Business Telephone 978-374-1743 Finn/Co. Name of Licensed Plumber: Stephen C Galinskv Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 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 ri Agent El 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 PermiWlsed for this application will bein compliance with all pertinent provisions of the Massachusett ate Plu ng Code Cr 142 of the General Laws. BY: Tignatufe Or is ns um er Type of Plumbing License Title " City/Town L144465er Master 12 Journeyman APPROVED (OFFICE USE ONLY • -.-.�...�....-.-.�-..--.- (Print or type) Check one: Certificate Installing Company Name Galinsky Plumbing & Heating Inc. ® Corp. 1906 Address - P • 0. Box 1701 HavPrhi 11 . MA 01 R11 w ri Partner. Business Telephone 978-374-1743 Finn/Co. Name of Licensed Plumber: Stephen C Galinskv Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 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 ri Agent El 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 PermiWlsed for this application will bein compliance with all pertinent provisions of the Massachusett ate Plu ng Code Cr 142 of the General Laws. BY: Tignatufe Or is ns um er Type of Plumbing License Title " City/Town L144465er Master 12 Journeyman APPROVED (OFFICE USE ONLY