HomeMy WebLinkAboutMiscellaneous - 71 ROCK ROAD 4/30/20180
Location
No.
Date
NpRTM TOWN OF NORTHANDOVER
p
F p Certificate.of Occupancy $
Building/Frame Permit Fee
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CHusE< Foundation Permit. Fee $
Other Permit Fee $
f.
Sewer' Connection Fee
Water Connection Fee $ 92
TOTAL $ ...
Building Inspector c
Div. Public Works
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DEPARTNENT OF PUBLIC SAFETY
CONSTRUCTION SUPERVISOR LICENSE^i
.+.
Number: Expires: Birthdate:'.
;'.
CS 658342 69/191999 69/191962
Restricted To: 66
9
DENNIS N BURKE
0"4151 ROCK RD
N ANDOVER, NA 61845
1:
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WU1114M J. SCOTT
Director
Town of North Andover
OFFICE OF
COMMUNITY DEVELOPMENT AND SERVICES
146 Main Street
North Andover, Massachusetts 01845
r
In accordance with the provisions of MGL c 40 S 54, a condition of Building Permit
Number is that the debris resulting from this work shall be disposed of in a
properly licensed solid waste disposal facility as defined by NiGL c 11 1, S 150A.
The debris will be disposed of in:
(Location of Facility)
Signature of Permit Applicant
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for this
project through the Office of the Building Inspector.
./
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
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MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTIN G
(Print or Type)
%U o A7 A 14 /U d O v Mass. Date- 4' G o f 19
Building 7% Or
Location C' Permit # ���i
r
Owner's
Name
New ❑ Renovation ❑ Replacement V Plans Submitted: Yes ❑ No ❑
Installing Company Name dc>,r- Fly A /,) OL h C L.Ler
Address 5 `1 ` R R l L- PrP R U
Oc)Vj;FP rl�ASs GEc�/y
Business Telephone 3 `�
Name of Licensed Plumber
Check one: Certificate
❑ Corp.
C4 a tnership
❑ Firm/Co.
INSURANCE COVERAGE: Check One
I have a current liability insurance policy or its substantial equivalent. Yes 6-f No ❑
If you have checked yes, please ' dicate 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.
Signature of Owner or Owner's Agent
Check One:
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 the permit issued for this application will be in compliance with all
pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
By
Title
City/Town
APPROVED (OFFICE USE ONLY)
Type of License: )a,9_49 -,�/ li�&r•
dumber Signature ofLiLi'censed Plumber
y❑ GGasfitter License Number v '3
"aster
❑ Journeyman
OCT 2 5 1C01
mim
Installing Company Name dc>,r- Fly A /,) OL h C L.Ler
Address 5 `1 ` R R l L- PrP R U
Oc)Vj;FP rl�ASs GEc�/y
Business Telephone 3 `�
Name of Licensed Plumber
Check one: Certificate
❑ Corp.
C4 a tnership
❑ Firm/Co.
INSURANCE COVERAGE: Check One
I have a current liability insurance policy or its substantial equivalent. Yes 6-f No ❑
If you have checked yes, please ' dicate 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.
Signature of Owner or Owner's Agent
Check One:
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 the permit issued for this application will be in compliance with all
pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
By
Title
City/Town
APPROVED (OFFICE USE ONLY)
Type of License: )a,9_49 -,�/ li�&r•
dumber Signature ofLiLi'censed Plumber
y❑ GGasfitter License Number v '3
"aster
❑ Journeyman
OCT 2 5 1C01
Date.. . '..... .
TOWN OF NO ANDOVER,
PERMIT FOR GAt INSTALLATION
l�
This certifies that .. � �.:.'. ......... el-
..........,.... .r:........ .
. �1
has permission for gas installation ........ .
in the buildings of ...........
at �..,� ,� ! ! . r.. !............... North Andover, Mass.
Fee..!- ..`. Lic. No....r:.... ..........................
• i ! GAS INSPECTOR
WHITE: Applicant CANARY: Building Ddpt. PINK: Treasurer GOLD: File