HomeMy WebLinkAboutMiscellaneous - 722 GREAT POND ROAD 4/30/2018 (2)_N
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TOWN OF NORTH ANDOVER
0 silo p PERMIT FOR PLUMBING
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SACNUS�
This certifies that., .
has permission to perform .f. 1. , . ��.L� �IC� ..... )..... .
plumbing i he bu'ldiiinn%s of/ .�
at _ :�/. �V//..f . ,North Andover, Mass.
Fee. U. Lic. N4-��% . ............................. .
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PLUMBING INSPECTOR
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MASSACHUSETTS UNIFORM APPLICATION FO
(Print or Type
_.Mass. Dat
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Building
AA5 I-'
ERMIT TO DO PLUMBING
Permit # AV
kner's Name A&ent
Type of Occupancy '2t; ,51 D C- Ij T► ,A
New ❑ Renovation ❑ Rep! 'ce ent Plans Submitted: Yes ❑ No ❑
FI RES
Installing. Company Name "AOtr,Ee-r _Q 5j0tr m,4TA?t0 Check one: Certificate
Address �� �;? C /46 H M,4&) e:l-) ❑ Corporation
lY) E !l.4 U ie�7n1, ,r i A ,SIAL/ ❑ Partnership
Business Telephone (01 Z -5177 1
Name of Licensed Plumber & r� t ;e T i41 �I s►�ldi'Is� �Kl �
INSURANCE COVERAGE:
I have a current lability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes p' No ❑ '
If you have checkedrtes, 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:
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 nerformedunder the permit issued- for this application will be in compliance with all
pertinent provisions of the Massachusetts State Plum ng a and Tpter of the eral Laws.
63y 'w L
re of Licensed Plum er
T,fltle
Type of License: Master % Journeymalh ❑
City/Town , 1 ,
APPROVED OFFICE USE ONLY) License Number 13 j 5
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3727
Date.... ...........................ti
r.� � -.-, TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ... �9..Z' ...................................................................
has permission to perform- ..................................................
wiring in the building of . ......
. ... . . .... ...
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at ... Z;.�; .... . . ..... 1, .......... . North Andover, Mass.
Fee�.............. Lic. No.............. ...........................C..'.................
ELEcmeAL INSPECTOR
Check #
Commonwealth of Massachusetts
Department of Fire Services
BOARD OF FIRE PREVENTION REGULATIONS
Official Use Only
^
Permit No. �`
Occupancy and Fee Checked
[Rev. 11/99] leave blank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (ME ) III C R 12.00
(PLEASE PRINT IN INK OR TVP E IN AAL ORMATION) Date:
City or Town of: To the Inspector f Wires:
By this application the undersigne_,gives nbCt&J of his orhq ilttentign to ggrfgrm the electrical work described below.
Location (Street & N
Owner or Tenant
Owner's Address
Telephone No.
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 ❑
New Service Amps / Volts Overhead ❑ Undgrd ❑
Number of Feeders and Ampacity
No. of Meters
No. of Meters
Location and Nature of Proposed Electrical Work: Installation of Security system
Completion of the folloi,n table maybe waived by the Ins ector o Wires.
No. of Recessed Fixtures
No. of Ceil.-Susp. (Paddle) Fans
No. of Total
Transformers KVA
No. of Lighting Outlets
No. of Hot Tubs
Generators KVA
No. of,Lighting Fixtures
Swimming Pool rnd. Above ❑ In-
rnd. 0
o. o Emergency Lighting
Battery Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
I No. of Zones
No. of Switches .
No. of Gas Burners
o. of Detection and
Initiatin Devices
No. of Ranges
g
No. of Air Cond. Total
Tons
No. of Alerting Devices
No. of Waste Disposers
P
Heat Pump
Totals:
Number
Tons
KW
No: of Self -Contained
Detection/Alerting Devices
No. of Dishwashers
Space/Area Heating KW
Local ❑ Municipal ❑ Other
Connection
No. of Dryers
Heating Appliances KW
Security Systems:
No. of Devices or E uivalen
No. of Water KW
.0 No. of
Data Wiring:
Heaters
Signs Ballasts
No. of Devices or Equivalent
No. Hydromassage Bathtubs
No. of Motors Total HP
Telecommunications
o. of Devices or Equivalent
OTHER:
�3
Attach additional detail ifdesired, or as required by the Inspector of Wires.
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:)
(Expiration Date)
Estimated Value of tri 1 Work:Aye&(When required by municipal policy.)
Work to Start: Inspections 'to -be requested in accordance with MEC Rule 10, and upon completion.
I certify, under the pains and penalties of perjury, that the information on this application is true,and complete.
FIRM NAME: LIC. NO.:
Licensee: John S. Bassett Signature LIC. NO.: 1533C
(fapplicable, enter "exempt" in the license number line.) Bus. Tel. No. x+03 594 592$
Address: Alt. Tel. No.:
OWNER'S INSURANCE WAIVER: I am aware that the Lie, see 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: $
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING 1
(Print or Type) _
c NORTH ANDOVER Mass. Date
Building Location %�
Permit #
.� Owners Name rs116 1� 7V
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• New 77 Renovation Replacement 1,0 Plans Submitted 0
(Print or Type)
Installing Company
elephone: L'62i ?3t/— S—Y00
sensed Plumber or Gas Fitter
Check one:
Q Corp.
Certificate
Partner.
; Firm/Co.
Insurance Coverage: Indicate the type of insurance coverage by checking the
appropriate box:
Liability insurance policy F -;q Other type of indemnity = Bond
Insurance Waiver: I, the undersiened, have been made aware that the licensee of
this application does not have any one of the above three insurance coverages.
Signature of owner/agent of property Owner 17 Agent M
I hereby certify aut all of the details and information t have submitted (or entered) in stove application are true and accurate to the best o! my
knowtedge and ticat att plumbing wont and Installations petformed under Permit ::aced for this appticatioo will be in compliance with all pettin=t
provisions of rho Massachusetts State Cat Code and Ciapter 14-' of Lha Ccnca! Laws.
Ey TYPE LICENSE:
Plumber
16.sp-
Title l Gasfitter- Signature of Licensed
City/Town: Master Plumber or Gasfitter
Journeyman #7/9
APPROVED (OFFICE USE ONLY) License IJumber •
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(Print or Type)
Installing Company
elephone: L'62i ?3t/— S—Y00
sensed Plumber or Gas Fitter
Check one:
Q Corp.
Certificate
Partner.
; Firm/Co.
Insurance Coverage: Indicate the type of insurance coverage by checking the
appropriate box:
Liability insurance policy F -;q Other type of indemnity = Bond
Insurance Waiver: I, the undersiened, have been made aware that the licensee of
this application does not have any one of the above three insurance coverages.
Signature of owner/agent of property Owner 17 Agent M
I hereby certify aut all of the details and information t have submitted (or entered) in stove application are true and accurate to the best o! my
knowtedge and ticat att plumbing wont and Installations petformed under Permit ::aced for this appticatioo will be in compliance with all pettin=t
provisions of rho Massachusetts State Cat Code and Ciapter 14-' of Lha Ccnca! Laws.
Ey TYPE LICENSE:
Plumber
16.sp-
Title l Gasfitter- Signature of Licensed
City/Town: Master Plumber or Gasfitter
Journeyman #7/9
APPROVED (OFFICE USE ONLY) License IJumber •
S++K'jav-fin .,.7Tti'i"=+i.Ga�' :. t:r"+'i.w* . ,� ._ `. �.,m.•.:fYT+•.•t ., :: v.;,:
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1949
Date ..I
t
TOWN OF NORTH ANDOVER
NORTH ti,r
,eO
o p PERMIT FOR GAS INSTALLATION4 v.
�9SSACHUSE� -.
This certifies that... ..... ...
has permission for gas installation , . .....
in the buildings of y'
at . 01 North Andover, Mass
Fee S�.. Lic. NO.
/17.
GAS INSPECTOR
WHITE: App cafit- uildi ept P PINK: Treasurer GOLD: File
Installing
�••.•• ••�• •••••�. ,.� �,yrrvrlm Mf'r'3.ILrHi l�Jir f Vf7 i'CI1Mi i i � uV f'iwsvr�u.0
(Print or Type)
NORTH ANDOVER, Mass. Oate
Building 2 /,� Permit
Location
Owner's 011.
Name U—
New Renovation ❑ Replacement ❑ Plana Sub \ d: Yes ❑ No. p
FiXiUAEs
Address—, ""U O X %` � ��
Check one: Certificate
��� � � ,�v�� ❑Corp.
❑ Partnership
m/Co.
Business Telephone & X /O —,� �- 2 D
Name of Ucensed Plumber
INSURANCE COVERAGE:ec on
I have a current Ilabilty Insurance policy or Its substantial equhWenL Yes � No 13
If you have checked y", please indicate the type coverage by checking the appropriate box
A liability Insurance policy El"— Other type d 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:
Owner p Agent p
Signatuts o er a Owner's en
I = milty that all of the dotage and information I have submitted for antmedl In
knowledge and that a4 plumbing wak and Installations pedormod under the perr l J
pedinanl pro,&ions of the Massachusetts State Plumbing Code end Chapter 42 1
EY
Title
City/Town
APP Wf `ED (OFF)CE USE ONLY)
are true an &Wto to the best of my
k;ailon wig 'h ootrwRatacs with ag
License Number 4' /-) J
Type of Plumbing License: Master
Joutneyman 0
Date.. S� 7�+��•?
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3� apRTM 1 opL TOWN OF NORTH ANDOVER R
PERMIT FOR PLUMBING 8
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ro;�•i - LO
,SSACNUS�t
This. certifies that. . fj. /.,.... .
. ..Y f
Jr�'/�.........,�
44
has permission to perform .. .
F: plumbing in the buildings of .. .. .................... a'
a
at. .....!... North Andover, Massa;
Fee. .... Lic. No.sv-34. .
PLUMBING INSPECTOR
(1g
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
saKtiuxl0 Ittt
Milt dfill 0060atUse 0 office Use 061Y
Uepartnwnt of Public Safety Per+» a No.�-
V1, BOARD OF FIRE PREVENTION REGULATIONS $27 CMR 12:00 Uccupanty & Foo ehackad . .
3/90 (leave blanf0
PLICATION FOR PERMIT TO PERFORM CELECTMR RICAL WORD
AP All work, to bo performed in accordance with the Massashuwns Flu" i al Cvd ,
527
(PLEASE PRINT IN INK OR TYPE ALL INFORMA
To the Inspector of WIMO
City or Tuwn of
The underslgned, applies for a permit to perforin the eleCulcal work de6crl below.
Location (Street & Number). �-
Owner or Tenant _k. ]
Owners Address . !-
Is this permit in conjunction with it building prrrnie
N. L.S�I�" (Check Appropriate Box)
p C,^� .�aC_e . __ Utlliry Authorization Nu.
Purpose of Building l�..a[
. f j ' Amps ��" , -A—a 0 Volts avcrhcad Q Undgrd � No. of Mefem —
Existing'Service
New Service
Nurrdier of Feeders and Arniti,City
Location and Nature of Proposed Electrical Work _
No, of Lightin;
No. of Lightin
No. of Rewe t
No. of Switch
No. of
f RanSe
No. of f7i�Ix�1
No. of I)iihw
No. of Dryer!
No. of Water
No. Hydio Iv
OTHER:
Volts
Tubs
Overhead LJ Undgrd 1:1 No. of Meters
No, of C_as Burners
FIRE ALARMS No. of 7_ones--.---
a
No. of Detection and
No. of Alr Conditi0nets
Tons
Initiating Devices --��
eat Ola
ota
No. of Sounding Devices
No. of Pumas -Tans
KW
No. of Suff Contained
oete,�lionjsnunding Devices
SpacrJArea fleatln�-_____.,�
KW_
Municipal
LocalEl--�-�-�
• Connection ❑Other
Heatln Devices _ J
-�--- o ices
_ KW
ow 0 tigp
fro. P T N 0,
Signs Ballasts
1
Whin _
No. of MotorsTotal tip
—
InT t '
INSURANCE COVERAGE: Pursuant to the requirements of Massat:husttes Genoral Laws
I have a current Liability Insurance Policy Including Completed Operations Coverage ur icy substantial equivalent, YES C7 NO la I have subn,ltlsod valid proof
of came to this checked
YES please Indicate the type of coverage by checking the appropriate box.
O IJ
If you have checked YES, p _
INSURANCE BOND 0 OTHER (please Specify) —. --- (Expiration Date)
Estimated Value of Elimmical Work Zfinal
---
Work to Start �__ _ InspKIlon [late Requested: Rough
pe
_ --
Signed under the nalties of perjury:
�..�,..�...... tic. Na.
FIRM NA E � L, �?
Llc
ensee 518'n^atICN
�ure _ (` -- —
Bus. Tel, No.
AddressL�I .
Alt. Tel. No.
NER'S INSURANCE WAIVER: I am aware that the Licensee dosis not halve theaInsurdtice irement, owner or itAsg f ^ stanlia`Ploase cf eckent sone) (red; yMatsrcisueetts
aw signature on this permit appUcation waives this r q v
General Laws, and that my B ,b�
PERMIT FEE--
_ Telephone Nv._. -
(Signature of Owner or Agent)'
g 2631
NORTH
Date :... ... .....
.`F
TOWNt OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ...... .. . ... ............... :` ...... ..61......
10
has permission to perform ..: lr.j�........ .. ..:!
wiring in thebuilding of ....... .............
at ....... .. ,`..... .... .. ....... , North Andover, Mass.
A//
k--30 rELECTRICAL INSPECTOR
oclb 95 12:56 15.00 PAID`
WHITE: Applicant: CANARY: Bu lding.Dept, PINK: Treasurer GOLD: File ,
N2 2 JZ'-' 5 Date .....
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that .... 7��.A ....... i. .....
has permission to perform ........ 1/. 1.," ....... . ..............
wiring in the building of ...... ...................
at ........ 2.�IeCk .. *.... , North Andover, Mass.
Lic. No.11.0.27 ............................................................
ELECTRICAL INSPECTOR
09/04198 09:23 75.00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
2
N2 2025 Date ........ ... ...
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ......T.:�a.......................... // ............ ...........i.
has permission to perform ...... {'�I c �E..`P....... . ,..............
wiring in the building of �.. ! .. S
.. . ..... .. .....!..... .. ..................
at ........ v.....6'1P- ��<c.t... Pod.
.: .
1I111l .. , North Andover, Mass.
Lic. No..A.Iin .............. ..._ ..........
........
ELECTRICALINSPECTOR
/04/98 09:23 75.00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
Office Use Onit
The Commonwealth of Massachusetts Permit No.
fflcDepartment of Public Safety /90 ��� & k•ve bla k►
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 7
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 INrORHATION.) Date �
City or Town of %�3, �'J�nL,(-72 To the Inspecto of Wires:
The undersigned applies for a permit tonn perform the electrical work described below.
Location (Street & Number) 1160 (� 004T tb ws Rc/
Owner or Tenant /" it.,
Owner's Address
Is this permit in conjunction with a building permit: Yes ❑ No ~'(Check Appropriate Box)
o Purpose of Building !�'I %LJ 611-244M / & Utiliry Authorization NO.
Existing Service 46X"o Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters
Few Service Amps / Volts Overbead ❑ Undgrd ❑ No. of Mete.. -s
Nuaber of Feeders and Ampacity pp
Location and Nature of Proposed Electrical Work
0
No. of Lighting OutletsNo.
of Hot Subs
No. of Transformers Total
KVA
No. of Lighting Fixtures
Swimming Pool Above In-
grnd. ❑ grnd. ❑
Generators KVA
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. of Zones
No. of Detection and
Initiating Devices
No. of Sounding Devices
Pio. of Self Contained
Detection/Sounding Devices
Local ❑ Municipal ❑ Other
Connection
No. of Ranges
No. of Air Cond. Total
tons
No. of Disposals
No. of Heat local TotalPuonsTons KW
No. of Dishwashers
Space/Area Heating KW
No. of Dryers
Heating Devices KW
No. of Water Heaters KW
No, of No. of
Sigs Ballasts
n
ILow Voltage
Wirine
No. Hydro Massage Tubs
INo. of Motors Total HP
coverage or its sub-
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial
equivalent. YES F] NO ❑ I have submitted valid proof of same to this office. YES ❑ NO ❑
If you have checked YES, please indicate the type of coverage by checking the appropriate box.
INSURANCE BOND ❑ OTHER ❑ (Please Specify)
Expiration Dace)
Estimated Value of Electrical work S
Work to Start Inspection Dace Requested: Rough Final
Signed under the penalties of perjury:
FIRM NAPfE r _J 5;rt,, k6 1
L2 "41 C6,<J ,le
LZC. N''s-�
Licensee peJ ���u %S C! S
Signature c"
LIC. NO.
Address P'n r 1�G- ZOOS/
Bus.
Tel. No.
/L[)0_
Alt.
Tel. No.
OWNER'S INSURANCE WAIVER: I am aware
that the Licensee does not have
the
insurance
coverage or its sub-
stantial equivalent as required by Massachusetts General Laws, and
that. my
signature
on this permit
application waives this requirement.
Owner Agent (Please
Telephone No.
check one) ✓1
PERMIT FEE S /
Signature of Owner or Agent)