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HomeMy WebLinkAboutMiscellaneous - 75 DUNCAN DRIVE 4/30/2018f Date.s�• �• o This certifies that ... �� �: �:`''!o............................ has permission to perform .... A ..f ........................... plumbing in the buildings of ... ��,'?.��'.'. r.�.................... at ....� . ! `......... , North Andover, Mass. r Fee..�.....Lu. No. .'ll .:... ......: ...!- ..-.. y:-1,,...... PLUMBING INSPECTOR Check # it ? r y I,, - t1 U •) TOWN OF NORTH"ANDOVER p PERMIT FCQWPLUMBING 'SSAI. IS� o This certifies that ... �� �: �:`''!o............................ has permission to perform .... A ..f ........................... plumbing in the buildings of ... ��,'?.��'.'. r.�.................... at ....� . ! `......... , North Andover, Mass. r Fee..�.....Lu. No. .'ll .:... ......: ...!- ..-.. y:-1,,...... PLUMBING INSPECTOR Check # it ? r y I,, - t1 U •) r MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING (Type or print) Date NORTH ANDOVER, MASSACHUSETTS Building Locations Axne A13 I Y_�— Owner's Name New 2300010 Renovation 01 Replacement 11 Plans Submitted Permit # Amount $ , ©� LA is: IST. FLOOR :6TH. FLOOR (Print or type) ,.�// Name / /I/,o 19 9 Address 3s / 19111z,1 ness Name of Licensed Plumber or Gas Fitter ;I C k one: Certificate Installing Company Corp. Partner. Firm/Co. INSURANCE COVERAGE Check ne• I have a current liability Insurance policy or it's substantial equivalent. Yes No13 If you have checked /Les, please indicate the type coverage by checking the appropriate box. Liability insurance policy 1:3 Other type of indemnity ED Bond C3 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 E3 Agent 13 I hereby certify that all of the details and information 1 have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work apd installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Ga:fI nsode and fhapteV 42 the General Laws. (Title OVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber S� Gas Fitter License Nu er Master Journeyman p'tt.ao O Date ....�. J .............. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .........�.,r�. .................................................. has permission to perform . . ..� =' wiring in the building of ........:....-. ... .: ` IC ........................................................... North Andover Mass. Fee �J. ,.... Lic. No,�.�..l..". ............ �.:..`.-...... ........... ............. ELECTRICAL INSPECTOR / ��„ Check # r� y Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. �7J 71 Occupancy and Fee Checked [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (ME Y), 5;7 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: NORTH ANDOVER To the Insp ctor of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) Owner or Tenant 1"P. Owner's Address Telephone No. Is this permit in conjune ion with a building permit? Yes Er 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 and Nature of Proposed Electrical Work: S /v No. of Meters No. of Meters Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- ❑ rnd. rnd. o. o Emergency Lighting Battery Units No. of Receptacle Outlets ! No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers eat Pump Totals: Number I I Tons I 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 Equivalent No. of Water KW _ Heaters `— No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs — No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of lect ical Work: 29W (When required by municipal policy.) Work to Start:—,.51—Me % Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COV RAGE: 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 cove ge is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: �' r0�'ti / C'L G /UC' LIC. NO.: 7 0(5:�q Licensee:l'11� u//� M j. ; �(%�iLyj Signature LIC. NO.: (lfapplicable, enter " xenzpt" i. th cense�jzzunber line.) Bus. Tel. No.:& Address: CtX (/G/ �� fI- Alt. Tel. No..97,� *Per M.G.L c. 147, s. 57-61, security work requires De artment of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee 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. $ FAIL INSTALLATIM Cog LIST Wt LOT # ( ON 1AIL eascnss - As t3v�GT 3 � SCG' I3c'I'o� 1. Distance Tot ? �%"� 4 ' �' 1,9 a. Wetlands b. Drains C. Well 2. Water Line Location 3• No PVG Pipe it. Septic Tank a. _Tees --Length & To Clean Oat Covers. b. Cement Pipe to Tank On Both Sides of Tank 5. Distribution Box C,c,.,,CA— a. Covers & Box - No Cracks'' b. All Lines Flowing Equal Amounts T ' C. No Back Flow 6. Leach Field or Trench a. Dimensions b. Stone Depth c. Capped Ends d. Clean Double Washed Stone 7. Leach Pits a. Dimsnsio b. Stone th c. Spla Pads d. T e. m mint Pipe to Pit - Both Sides f. Clean Double Washed Stone 8. No Garbage Disposal 9. y nal Grading Inspection 10. Barricading Covered System As Built Submitted a. Lot Location `/t✓ ��S b. Dimensions of System To c. Location with Regard -to Pere Test d. Elevations e: Water Table TO: NORTH ANDOVER, MASS APRIL / 9 19 192 BOARD OF HEALTH FROM: DESIGN ENGINEER Re: Soil Absorption Sewage System Inspection This is to certify that I have inspected the construction of the said disposal system at L r / ,A/0AA/ .2)R 1 VF North Andover, Mass. SITE LOCATION The grades and construction are as specified in mvq plans and specifications dated Au C— I 19 6y ,q SS"c,C /I 7'L= 5 CO .0 %deg. r f� Fneer Ranitarian cro 9GALLo RCL6 r.s _5[4c_- NVQ TSL /SSM Q_W QTR 4 _sus �rrH �iP�tH aF 4fAp C 10SEPkpyGN� � BAfiC.4 �p +Nll ¢ No, Coo 12 F O.� /STER• SSjoNAL SFN\� i ElEv�*ioK Z'VVArR7 \ ��WE>�.ObITLe�T ric•Ss _ R av LO i 0/ 900 S•F BED •� a `s i /3 o x /A/ 13 S• o G _�oK 0_ct7' 1�.4•�?-/�yl-9o-t�w•9a—�a4.4a � `E ANO of L%rvE r�a•cS-�,� �1 H'i7 '�,�4•GS r;Y Is-- i�H G8 NO r No 43'M - 6H A'4 o9.,/ — Q,%a. •�a ? 1 11 S• "..c N Ql fu CL LL 4- O v Im n v L IL 44L `I O � O I .tw � +O+ E160A . y+ O O E C Qa.o mcj coa c c � t w a < z cCc U O D G , fo Q) V) C: O U I O C C a I m Q, �LN Commonwealth .of Massachusetts REC City/Town of kviSystem Pumping Record OCT 2 4 2006 \ Form 4 TOWN OF NORTH ANDOVER HEALTH DEPARTMENT DEP has provided this form for use by local Boards of Health. The System Pumping Record must be submitted to the local Board of Health or other approving authority. . A. Facility Information Important: When filling out 1. System Location forms on the computer, use (� a i only the tab key Address to move your cursor - do not use theretum City/Town key. 2. System Owner: Name Address (if different from location) City/Town State Zip Code State ip —ode Telephone Number U. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped. - Gallons 3. Type of system: ❑ Cesspool(s) eptic Tank- ❑ Tight.Tank ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes L,qo If yes, was it cleaned? El Yes ❑ No 5. Condition of System: 6. System Name Company %. LOCat10 Sig turd hftp://www.mass.gov/dep/Wz Here'r contents were posed: of iAauler htm#inspect Date License Number t5form4.doc• W03 System Pumping Record • Page 1 of 1 F WELL DATABASE ADDRESS: AGE OF WELL: N WELL-DRILLER: WELL PERMIT: z WELL LOC TION: l ;� I,�►l �- WELL PERMIT DATE: 7 DEPTH OF WELL; TYPE OF WELL: a.. DRILLED b. DUG c. UNKNOWN TYPE OF WATER BEARING ROCK: WATER ANALYSIS DATE: HIGH MANGANESE: Y N HIGH IRON: Y N OTHER CONTAINENANTS: Y N lk :SINV-K 7h llgoo =0 N IA :NNE HDIH :asarrVoj,,7VIN HDIH :alga 913.71.'IVl tV uai"", :XDMI DK19vaa xafvl1 l Jo ad -LL N' tMoDfla '9 :'I jHjA 30 adja IIals1 HLdaa :ZLVC Zll�uaa zza& :xOLLVDO'1'1,ia& :r ii xaa TTar� �)r :ssaxaav '' asVa7viya IMAL P, -d of H� th 117 .-1-2 Dlt,-OFAT, f CN C.' 'K LI.3r 1. OT 0 UO D,,Ag &-'+k t W iID saL:XTE-- Pro ,;Uad: Roas: Title YAJ1 OIC Reg 2.5 The submitt:d plan r-soat show as a a) the lot to be -,-iv-i�-d-arza lot # a battsra T a 6 bmi location, rnd log 6:.��p ob;;, b. -=Lion to tins Jb)' e 101 c c C location vnd results peivolation testv-distrn-ace to tios design calculations & calculations shcrAmg required luaching aroa e) 1� ti� location and dimensions of system -including reserve area f 8 stil f) existing and proposed contours 1 ti g) location my ;tet areas vithim loot of sevage disposal system. or ,- - disclaimer-eback -watlends rm,--pping t, -'(h) surface and oub-surfaco drairs v, -I -U -0.n 1001 of diuposal r.ys'v,.m or &.jc3-z!-=r (J) location _MY , ats A -n 100 of _apo; system or rba-rd filt.,s bcovna eo)nzas of -,-.ter jLq7ply wilcbln 2001 of x -7-7za e,.Ii;poml iyz&�x or 61-sclaimzr locr.11on of ly p�,;possd to serve lot -10,01 Arum leaching facility (1) locatiz-a of wtttr 3-:'Unas on p,cperty-101 Aoz It faz-ility (0 location of b;-aohmark �n), dri ".. aye o� garbage disposals P no PVC to be u3o-d in ctnuta--action (q) p i-ofila of of b.-se-ment., pLvt-,-,b.. pipe., v-.Ptic tz..Mk., distribution box inl3ts end watlAs,, eiot-iLa 'Uon field piping and Ot sr elevations �=m & -- --age dIrposal system (r) Led- ground .ator alevation in r-rca say, —(s) plan gist be by a or othzr p.%-of!:BL&on-,-I r-utLDAztad by 7,,-v to p{ impar -Lz:h plans Rug 6 Lptic Trinks (a) 6--j50% of flov, -,ztr Uble, tces, depth of tues, accw;s.. prw ?Ing (b) cl t.-;,aiout C) 101 from calar -, -Al or ing=uad avim-ing pool ---(d) 25, from cub barzr..-o ez_3-.ns Reg 10.2I Dist; Eor�,is I I(a) slope 0.08 Reg 10.4 b) vanp 4/v 7;!!57 -7 !r^ A,",--- Commonwealth of Massachusetts RSC City/Town of System Pumping Record NOV 10 2009 Form 4 " TOWN OF NORTH nNnn DEP has provided this form for use by local Boards of Health. Other forms T information must be, substantially the same as that provided here. Before using this form, check with your local Board of Health tQ determine the form they use. The System Pumping Record must be submitted to the local Board of Health or-othter approving authority. A. Facility Information 1. System Locatkgkleft side of house, Right side of house, Left front of house, Right front of house, rear of might rear of house. Left rear of building. Right rear of building. Address City/Town 2. System Owner: Name Address (if different from location) City/Town B. Pumping Record 1. Date of Pumping 3. Type of system: ❑ ❑ Other (describe): State rVJ Zip Code State Telephone Number Date e�?2. Quantity Pumped Cesspool(s) Septic Tank Gallons ❑ Tight Tank 4. Effluent Tee Filter present? ❑ Yes to / If yes, was it cleaned? ❑ Yes ❑ No 5. Condition of System: 6. System Pumped By: Neil Bateson Name Bateson Enterprises Inc Company 7. Location where contents were disposed: . L. S. D Lowell Waste Water Signature of Hauler F5821 Vehicle License Number Date t5form4.doc• 06/03 System Pumping Recons • Page 1 of 1 Commonwealth of Massachusetts ugCity/Town of System Pumping Record Form 4 DEP has provided this form for use by local Boards of Health. Other forms may be used, but the information must be substantially the same as that provided here. Before using.this form, check with your local Board of Health to determine the form they use. The System Pumping Record must be submitted to the local Board of Health or other approving authority. A. Facility Information 1. System Location: Left / Right front of hous ,Ping, Rig rear o u s e Left / right side of house, Left / Right side of building, Left / Right front of bul Left / Right rear of building, Under deck Address � - �— City/Town 2. System Owner. Name Wn Nc44Aj, State Zip Code Address (if different from location):: ---�j City/Town! State i de Nov, 19X013 Iii �����.�Co 4 Telephone Number k TOWN OF NORTH ANDOVER ` HEALTH ME4fLI B. Pumping Record 1. Date of Pumping Date 2. Quantity Pumped: Gallons 3. Type of system: ❑ Cesspool(s) eptic Tank ❑ Tight Tank ❑ Other (describe): 4. Effluent Tee Filter present? ❑ Yes No If yes, was it cleaned? ❑ Yes ❑ No. 5. Condition of System: 1 � Q �-v' 6. System Pumped By: Neil Bateson F5821 Name Vehicle License Number Bateson Enterprises Inc Company 7. Locafi"ere contents were disposed: Waste Water Date A/` --& r(3 t5form4.doc• 06/03 System Pumping Record • Page 1 of 1