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HomeMy WebLinkAboutMiscellaneous - 74 JEFFERSON STREET 4/30/2018b m Date.. .......... TOWN OF NORTH ANDOVER • 'PERMIT FOR GAS INSTALLATION This certifies that has permission for gas installation f?a,914zA � ra in the buildings of V!A4,........ .......... ........ ... . t at 7Y, -X6, M, 90,61. No / :rAt An2v�er Mass. Fee:4;!.�iPP. Lic. No. wv� ............ GAS INSPECTOR Check # Z2. 34-1 C's MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING b City/Town:N Ar`�N`e^MA. Date: 12� Ze't \N Permit# Building Location l,)q) `19 X10}SZ Owners NameMLV C%CA An 0i = Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential'j New: ❑ Alteration: ❑ Renovation: ❑ Replacement: Plans Submitted: Yes ❑ NoN FIXTI IRFS co 0i = Z CO � W U) 7 V O = N N O Z J } W Z 0 Z H W O IZ N W OILI m O Q a o O 0 FW— I— LU W U w Q J W W Z 9 fA = W O Z Lu Z W X WW > Z W> - W V) J Q Q m W J (D O Z LL O In F- H W I— W H W v o o u_ 0 c7 z z � O a W I— >>> O SUB BSMT. BASEMENT 1 1 FLOOR 2 No FLOOR 3 RuFLOOR -Z'FLOOR 5 FLOOR 6 FLOOR 7 FLOOR -i'FLOOR Installing Company Name: � �'ulCe,S Check One Only Certificate # Address City/Towne&N _n State: ❑ Corporation ❑ Partnership Business Tel:15?( Fax: Name of Licensed Plumber/Gas Fitter: _ �\Firm/Company �0h-c� INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes No ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Aaent By checking this box ❑; I hereby certify that all of the details and information I have submitted (or entered) regarding this 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 provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Type of License: By Q Plumber Title .r� /7 L El Fitter Sighajure of Licensed Plumber/Gas Fitter ❑ Master \ \ City/Town ❑Journeyman License Number: \ 1N APPROVED (OFFICE USE ONLY) ❑ LP Installer C The Commonwealth of Massachusetts `• Department of rndustrial Accidents Office ofinvestigations . 600 Washington Street -Boston, MA 02.711 Workers' Compensation Insurance Affidavit: massg Alit Information � ers/Contractors/El ppcanectricians/Plumbers Name (Business/Organizafion/Individual): \ L rlease Print Le ibi Address: mit GQ. .. • .. City/State/Zip: Qe�C1pj \ x� ©wwQ Phone #: —72.A�'• �{ �-��,� Are you an employer? Check the appropriate box: I • & I am a employer with 4. ❑ Type employees (full and/orpart-time).* 2- ❑ I am a sole haveam a hiredneral contractor and I the sub -contractors of project (required): 6- ❑ New construction proprietor or Partner- ship and have no employees listed on the attached sheet. # These sub -:contractors 7. ❑ Remodeling working for me in any capacity. [No workers' comp. insurance have workers' comp, insurance. 5. ❑ We are a corporation 8. ❑ Demolition 9- ❑ Building addition required.), 3 • I am a homeowner doing all work and its officers have exercised their right of exemption El Electrical repairs or additions 1 myself, [No workers' comp, insurance required.] t per MGL c. 152 1 4 employees.), and we have no ,0 ED Plumbing repairs or additions 12 12 -El [No workers repairs ;A --y applicant that chec_W bot i+1 must , comp. insurance required.] 13•❑ Other t Homeowners who submit this affidavit indicating u they a sectioa he?ai=,• shun r e Contractors that check this box must attached an additional sheet showing b W�u wU f e ,s y sat ou oi;� ey are doing all work and forsaficn, then outside contractors must submit anew affidavit indicating such. I am an employer that is providing workers' compensation the name of the sub -contractors and their workers' comp. Policy information. information, ansierance for my employees Below is the policy and job site Insurance Company Name: �10.:���=Q� 1�S�s�,��, . Policy # or Self -ins. Lic. #: O 8 b y I:L 1 i3 b� Expiration . q Job Site Address: --7q$ _Z 5 Date: 1City/State/Zip:Vi pkfawe,, Attach a copy of the workers' compensation policy declaration page (showing the policy number a Failure to secure coverage as required under Section 25A ofM.GL c. 152 can lead to the imposition o • and expiration date). fine up to $1,500.00 and/or one-year imprisonment, as well as civil e Of up to $250.00 a da a f criminal penalties of a y against the violator. Be advised that a co P nas § s in the form of a STOP WORK ORDER and a ;fine Investigations of the DIA. for insurance coverage verification PY of this statement may be forwarded to the Office of Ido herehv ruins and penalties of perjury that the information provide{I above is true and correct �� sz% I IJ- Official "­ __ 1.. n - wi:zre in this area, to be completed by city or town official City or Town: Issuing Authority (circIe one); permit/License # Z. Board of Health 2. Building Department 3. Ciiy/Town 6. Other Clerk 4. Electrical Inspector 5. Plumbing Inspector Contact Person: Phone .d#• 9244 Date . j j.3.h Z- ... TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING s This certifies that .70— �O.. 61QCk9!i ...//................ . has permission to perform . %C mpa�. 1*�r..1Z.4S:....... plumbing in the buildings of at . �;. %G .% ° rs�A. S�- . / . �, orth Andover, Mass. Fee. �J`r�` . Lic. No, //!a ?��.. �h�� � rnl....... . PLUMBING INSPECTOR Check # ZZ ?o MASSACHUSETTS UNIFORM APPLICATION .FOR PERMIT TO DO PL UMBIlVG (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location?y lb -1S ?0,32-, Jfi �S� 1 Date \ � � Permit # Owners �\1 Ckr(D-&) Amount New ® Renovation r] 01 65,6D V161 Replacement El FIXTURES Plans Submitted Yes11No (Print or type) Check one: Installing Company Name 1 _ &e, -•v t Cq,S Corp. Certificate ❑ Address p0 96A�, �J" 33 o 0 «lob ❑ Partner. Business Telephone _s?S l 31 b- 6 8 6b ❑ Fir vCo. Name or Licensed Plumber: QP v-) c1 YS) C1,C.,Y,`,,\ Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance pokicy L:NJ Other type of indemnity ❑ Bond Insurance Waiver: L 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�rith ali en vi ono 'the ssachusetts State Plumbing Code and Chapter I42 of the General Laws. .':��" :fes �r���-�__ D c� e G' Type of Plumbing License ense um *'r Master D (OFFICE USE ONLY Journeyman [_,! Date.... Nn 1764 _ NORTM q TOWN OF N ORTH ANDOVER PERMIT FOR WIRING oZ • '' p Four ta Post Office Box 8 SAGMV Tewksbury,MA 01871 � t !n ... .......... (508) 851-4900 ��� . ?....... ........•-............ ,; APPLICATION This certifies that ..... e_ P All work to be I permission to perform .......• a ........... a' (PLEASEPRINTIN INK:haS t �,•�••••• �"�` ' in the building of .......... �g Cit or Town of AI1dov rt vinnng North The undersigned applies�.. ........ .... ..n l /p( Location (Street & Numbe at •"�" I Owner or Tenant _ T / Lir6 Lic. No ELECI7tICALINSPECfOR / ✓ �.. Owner's Address l�FT Fee •••-••""""""' [[[111 ..a Is this permit in conjunctiol Cq 1( d U Purpose of Building 1 ` Q Existing Service Am[ CANARY: Building Dept. PINK: Treasurer 4 New Service Amp, WHITE: ApPliCant Number of Feeders and Ampat - Ir Location and Nature of Proposi,.__.,• or-vvorK [s%�Lnea- %Wq//`! �&r-,d l�162 D"/h, ��a <an.v✓ &..-, 7— 1 j' No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above In- grnd. ❑ grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and No. of Ranges No. of Air Cond. Total tons Initiating Devices No. of Sounding Devices No. of Self Contained No. of Disposals - No. of Heat Total Total Pumps Tons KW No. of Dishwashers Space/Area Heating KW DetectionlSounding Devices Local❑ Municipal ❑ Other Connection No. of Dryers Heating Devices KW No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy includ- ing Completed 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 byy checking the approppriate box. INSURANCE ❑ BOND ❑ OTHER ❑ (Please Specify) %/IHU.e'/vcu• 079 FiG�' (Expiration Date) Estimated Value of Electrical Work $f% �y- Work to Start Inspection Date Requested: Rough Final / X - Z(� Signed under the Penalti s -of Perjury: p FIRM NAME—y, "'O U� o L l LIC. NO612200' Licensee cI O.SW ,01 /1 St ldlz K ✓✓� Siig^ nature LIC. NO. A16Z .Se Address 0 • X60 X Q / �LIJ�J �Uf1. V OC �Jr! Alt. el. No. 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) Telephone No. PERMIT FEE $ Is-, G) (Signature of Owner or Agent) Notify Inspector for rough and/or final inspection. Permit must be obtained before commencing any, and all work in compliance with G.L.C. 141 8 all applica- ble laws & ordinances is required and understood. X-6796 Lv ""A/j, ��� IT W 1 764 Date ....../..../// TOWN OF NORTH ANDOVER A PERMIT FOR WIRING 0 This certifies that ...... �.. v u:.o .........?...1 qR ......... c:........ �. c,� ............ has permission to perform t ,2 ......... (_ �`" .! wiring in the building of ....... .........`...1..' ........... R .....:.. :............................. l l P i?Sa .... North Andov r Fee ... ��^.`. UU Lic. No /�...>EE*�M .. ......... ` . .l.r!'.... Q .. . ...... . ICAL INSPEcroR C, oM -7( WHITE: Applicant CANARY: Building Dept. PINK: Treasurer r 0 W u n I LIGHT�N� i Office Use Only i Permit No. Occupancy &Fee Checked 3/90 (leave blank) Fast WYMEW x Tewksbury, MA 01876� ward II (508) 851.4900 Area i APPLICATION FO F RM ELECTRICAL WORK IAll work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date City or Town of //0 1'V1 ,240,z/2 To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number)6�F%-fF/f s,o/�/ cS % Floor Owner or Tenant f�L�l/ri a/- Gs7zf-I, Tel. No. Owner's Address xy Is this permit in conjunction with a building permit: Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building C'01Y06 Utility Authorization No. Existing Service Amps _J Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps _/ Volts- - Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work fi�2r-dwe'7k .44mila"'D 4WfJn4 hl,-A7— No. of Lighting Outlets No. of Hot Tubs 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 No. 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 Total Total Pumps Tons KW No. of Dishwashers Space/Area Heating KW No. of Dryers Heating Devices KW No. of Water Heaters KW No. of No. of Signs Ballasts Low Voltage Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy includ- ing Completed 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 b checking the appro riate box. INSURANCE ❑ BOND ❑ OTHER ❑ (Please Specify) %/I�y,�4p�d �Z -YL-P (Expiration Date) Estimated Value of Electrical Work $�y- Work to Start Inspection Date Requested: Rough Final Signed under the Penalti f Perjury: p FIRM NAME "OUB oe L • ! LIC. NO-4i22Q� Licensee z Signature o LIC. NO. A/G/ S"9 jF0• %,r t� �EccJasa_� ate./ 404 el e, B Address AIL. Tel. No. 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) Telephone No. PERMIT FEE $ (Signature of Owner or Agent) Notify Inspector for rough and/or final inspection. Permit must be obtained before commencing any, and all work in compliance with G.L.C. 141 & all applica- ble laws & ordinances is required and understood. X-6796 -/T, 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance-with the provisions of M.G.L. c. 143, § 3L, the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed on the prescribed form. Atter a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166, § 32, an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L. c. 143, § 3L. Permits shall-be limited as to the time of.ongoing construction activity, and maybe-deemed. by the 7nspector_of-Wires abandoned-and.invalidifhe—.. _ or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012. The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this puipose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effect or existence" during the qualifying period beginning on August 15, 2008 and extending-through August 15, 2012. ffl�ule 8 — Permit/Date Closed: * ** Not : Reapply for neve permit I `fie it Extension Act — Permit/Date Closed: Date .Z-.�E.,17 .. ............... .n TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...... -Z..<2rte.................. has permission to perform ..... 4�—Z wiring in the building of ...... .. .......... ?., . ...V. 4% .......... Ir / . r", at .......... 7,!�... . ... Andover, Mass. .............:�e� ....... ,North Lic. No/:7 4R ......................................... ........ i ...... ELECTRICAL INSPECT,16R Check NSA 7691 U �., \ The Commonwealth of Massachusetts Office Use Only l Permit No. Department of Public Safety Occupancy & Fee Checked r BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 (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 September 21, 2007 North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 74 Jefferson Street OwnerorTenant Property Managemnet of Andover Owner's Address P• 0. Box 488 Is this permit in conjunction with a building permit: Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Residential Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service � Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work _Light ing ---in boiler doom".1. OTHER: 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. I have submitted valid proof of same to this office. YES R NO ❑. If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ® BOND ❑ OTHER ❑ (Please Specify) Estimated Value of Electrical Work $ Work to Start Signed under the penalties of perjury: FIRM NAME CROWE & SON Inspection Date Required: Rough ELECTRICAL CORP. YES ® NO ❑ (Expiration Date) Final LIC. NO.1716 8A Licensee .TAMES B. CROWS Signature 'LOW�&LIC. No.1716 8A V Bus. Tel No. 9-7 8) 4 5 3 -6— Address 576 MIDDLESEX STREET, LOWELL, MA 01851 AIt.TeINo. 978 - OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner ❑ Agent ❑ (Please check one) (Signature of Owner or Agent) Telephone No, PERMIT FEE $ 5 5 On Total No. of Lighting Outlets No. of Hot Tubs No. of Transformers INA No. of Lighting Fixtures Swimming Pool Agrnd 1:1gmd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas burners FIRE ALARMS No. of Zones No. of Detection and Total No. of Ran Ranges 9 No. of Air Cond. tons Initiating Devices Heat Total Tota! No. of Disposals No. of Pumps Tons KW No. of Sounding Devices 9 No. of Self Contained Vo. of Dishwashers Space/Area Heating KW Detection/Sounding Devices Municipal Local ❑ Connection ❑ Other No. of Dryers Heating Devices KW No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: 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. I have submitted valid proof of same to this office. YES R NO ❑. If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ® BOND ❑ OTHER ❑ (Please Specify) Estimated Value of Electrical Work $ Work to Start Signed under the penalties of perjury: FIRM NAME CROWE & SON Inspection Date Required: Rough ELECTRICAL CORP. YES ® NO ❑ (Expiration Date) Final LIC. NO.1716 8A Licensee .TAMES B. CROWS Signature 'LOW�&LIC. No.1716 8A V Bus. Tel No. 9-7 8) 4 5 3 -6— Address 576 MIDDLESEX STREET, LOWELL, MA 01851 AIt.TeINo. 978 - OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner ❑ Agent ❑ (Please check one) (Signature of Owner or Agent) Telephone No, PERMIT FEE $ 5 5 On Location 2 No. Date — -3 „ORTh TOWN OF NORTH ANDOVER ,, p Certificate of Occupancy $ Building/Frame Permit Fee $ �S Foundation Permit Fee $ s�cMust Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ ------ TOTAL $ /,57 / e) - Building Building Inspector ��93 09:19 15.00 PAID $ - 6743 Div. Public Works PER'lfIT NO. S l!!� APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER MASS. AGE 1 L" L I MAP 4-40. LOT NO. I 2 RECORD OF OWNERSHIP (DATE BOOK iPAGE ZfaNE SUB DIV. LOT NO.I LO TION _jI e c2 -SJR S'l-- RPOSE OF BUILDING Ae-plac,nq Kekc4Ien6#'e-h NEWS NAME A A`%I'? slicx8 otn NO. OF STORIES SIZE WNER'S ADDRESS `J S� BASEMENT OR SLAB ARCHITECT'S NAME - SIZE OF FLOOR TIMBERS IST 2ND 3RD UILDER'S NAME t`�GI►" Sha�gn 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 OF CODE 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 PAGE I 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 DA FILED ltlQ v SIGNATURE'Ok OWNER OR AUTHORIZED AGENT FEE C) .a PERMIT GRANTED NER TEL, CONTR. TEL. # yl&�72 a2 19 CONTR. LIC. # 0 e, 0 a 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST /� Q EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF S/JELECTMEN BYI iNa INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES MULTI. FAMILY OFFICES APARTMENTS CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE B 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN. 8'M'TAREA _ '/. 1/2 1/1 FIN. ATTIC AREA N_O 8 M FIRE PLACES _ _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B _ 1 2 3 �_ _ _ DROP SIDING WOOD SHINGLES CONCRETE EARTH ASPHALT SIDING ASBESTOS SIDING HARD1r✓'D COMMCN VERT. SIDING ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY BRICK ON FRAME ATTIC STRS. & FLOOR I_ CONC. OR CINDER BILK. WIRING STONE ON MASONRY STONE ON FRAME _ SUPERIOR I I POOR ADEQUATE NONE 10 PLUMBING 5 ROOF GABLE I HIP BATH (3 FIX.) GAMBREL MANSARD TOILET RM. (2OILET RM. (2 FIX.) FLAT SHED 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 FRAMING 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 _ RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS B'M'T 2nd _ I.r 13rd I ELECTRIC 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. m C CC/ O CIJ C � ~ rte. ,"Cn Ma' m z -n w � z y y r O y D rte" 0 m w 'O oGa S "r7 7 0' C X Cn �^ n 'x1 0. x ('D d O�. x T y � n O CD Z y -n CD O �• CL t/) O O C � CD O CL cr E C, 00 CD0CD za M D m < O CD C. y. y 0 z o co CD CA O m O O • CD -n O Z D G CD C ccp -,,,= 0. m 2 O -• in o Q Cn �. o < m .a C� = = m 0 m C7 o cc m Z �� y o, ^' m yo' Fn - CD W o N p N 0 ?m D = o EC9H m n 0 to 0 . C o La. cm,. W is o. o Com• VJ CCD CO) CD r-� 7 cl) n n: 0 6 CS cn ►� R1 y CD,1J C ca �C cn CD � �. n y y 00: � CoA c. •a o `D CD cn ercnco y CD C7 ci 0 0; C o n cl) o 0 CD: cn d rR CC/ O CIJ C � ~ rte. ,"Cn Ma' ^rl °= ,i7 O -n w cp � < "t y y r O �y w %7 aoCc rte" 0 m w n Z oGa S "r7 7 0' C X Cn �^ n 'x1 0. x ('D d O�. x �J W y 0 9 O C } Date..'................... X414 NpQTM TOWN OF NORTH ANDOVER '6 PERMIT PERMIT FOR GAS INSTALLATION A F i • This certifies that ............................................. has permission for gas installation ........... in the buildings of ..,' f.. ��_..r...: r•:.......- .......... at .. r� ,, ... :. "�._.j 7 ..... North Andover, Mass. Fee;........ Lic. No/ . .7'!X � . r#}i`1�3L4=:' lil 12.50 PAID GAS INSPECTOR WHITE: Applicant —CAffARY: Building Dept. PINK: Treasurer GOLD: File 1 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO 00 GASFITTING (Print or Type) C NORTH ANDOVER Mass. Date building Location '2 Permit # Owners Name 71 A,/ • Y New "7 Renovation 1E Replacement p Plans Submitted D (Print. or Type) Check one: Certificate Installing Company Name��� ��9 �F1� Si -UPJ Q Corp. 13210 Address GAIL k4N01( _A - L] Partner. /l aoje: /-% j _,4-D yv\A Firm/Co. Business Telephone: 6'cjl — �0(_L1 —G80q Name of Licensed Plumber or Gas Fitter t �G,^-�✓ S ��'� Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy E:N 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 coverages. • • • • • Y Y • ���a����t��»moi»��ti��■ MllN mosom»etonams .. .. - mommmmtmomm IMES (Print. or Type) Check one: Certificate Installing Company Name��� ��9 �F1� Si -UPJ Q Corp. 13210 Address GAIL k4N01( _A - L] Partner. /l aoje: /-% j _,4-D yv\A Firm/Co. Business Telephone: 6'cjl — �0(_L1 —G80q Name of Licensed Plumber or Gas Fitter t �G,^-�✓ S ��'� Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy E:N 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 coverages. gnature of owner/agent of property Owner 11 Agent M I hereby certify that ail 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 aU plumbing work and Installations perforated under Permit iuucd fo: this application wW be in compliance with all pettlnent provisions of the Massachusetts State Cas Code and Chapter 142 of the General Ltws. By Title City/Town: APPROVED (OFFiC:E USE. ONLY) TYPE LICENSE. Plumber Gasfitter Master Journeyman Signature of Licensed Plumber or Gasfitter ICC) it 'T License Number Date . C ^r NONTh� TOWN OF NORTH ANDOVER ' u,�•i. PERiI ?r FAR GAS INSTALLATION t This certifies that .... .` .. . ......j...t .'..- ................. . has permission for gas installation . ............... in the buildings of ... ?' .'L . f : ... F�...� r ................. at r _.� .:.. ....'.'.......... , North Andover, Mass. Fee..`.`.... Lic. No/'ia`� ... .......................... '/— ` ¢., -, -- GAS INSPECTOR WHITE: Applicant CANARY: Building Ddpt. PINK: Treasurer GOLD: File MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING t (Print or Type) C NORTH ANDOVER Mass. Date 23 Building Location—'? L) �.}/ Ste- Permit # i,22� Owners Name Nle A m:e:> f,1.A-c)AW • New -7 Renovation D Replacement Plans Submitted D FIXTUP!::'z (Print or Type) Check one: Certificate Installing Company Name /46 ?"6cAo'b;ty 4 1if'mt�,S 5iA%,vcQ Corp. /3 Address 0Ae_ 14no(( -/+O!F— = Partner. Firm/Co. Business Telephone: / Name of Licensed Plumber or Gas Fitter 7,o✓�A5 Pu- v`-_0 Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity F__� Bond Ej 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 coverages. Signature of owner/agent of property Owner 0 Agent M 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 worst and instAdalions performed under' Permit issLed for this application will -be in compliance with ad pertinent provisions of tho Massachusetts Slate Gas Code and Chapter 142 of the General laws, By Title City/Town: APPROVED (OFFICE USE ONLY) TYPE LICENSE: Plumber Gas fitter Signature of Licensed Master Plumber or Gasfitter Journeyman License Number MEN MENEEMENEEMERNME no (Print or Type) Check one: Certificate Installing Company Name /46 ?"6cAo'b;ty 4 1if'mt�,S 5iA%,vcQ Corp. /3 Address 0Ae_ 14no(( -/+O!F— = Partner. Firm/Co. Business Telephone: / Name of Licensed Plumber or Gas Fitter 7,o✓�A5 Pu- v`-_0 Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity F__� Bond Ej 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 coverages. Signature of owner/agent of property Owner 0 Agent M 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 worst and instAdalions performed under' Permit issLed for this application will -be in compliance with ad pertinent provisions of tho Massachusetts Slate Gas Code and Chapter 142 of the General laws, By Title City/Town: APPROVED (OFFICE USE ONLY) TYPE LICENSE: Plumber Gas fitter Signature of Licensed Master Plumber or Gasfitter Journeyman License Number