Loading...
HomeMy WebLinkAboutMiscellaneous - 75 Harold Streeto N • ❑ CT M N C �o a 0 cN,'� O Y E O O .1 2! E O7 U ` Z N� rim C C O C Q / N C Q2 N F O OC p E N 1 O p ZF LL _ n C O L O r 2 O Q .T o Z WF= ^ IL N J J_ �; ch m o p H C Q L > N s N -0 O E Z z w Y Q C o U' E U z ~ E � ca o Q o w w a •, b, ° C - 7 Z3 Q CO J N ti p L a) cn L N fl- CM c Q 2 O N z ^' `tl — F • 1 I— cA I� V c J No 4U'52 16 Date ./... . TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ... .':."... /.)A.. f/ ......... has permission to perform ...,.'. m ./. .1 ........................ /.......................... . plumbing in the buildings of . -/2 1..7 ....................... at .....5.. S'4 . ...... • ••.. North Andover, Mass. Fee. Lic. No.. ,P. ). � . .........�....� PLUMBING INSPECTOR Check #; e C J WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TONDO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date ' Building Location ��i�rU/7> C� Owners Name /'/'�5/ %7 �/ Permit # Amount / Type of Occupancy New 13 Renovation M m• Replacement FIXTURES T7 7= Plans Submitted Yes No j "1 (Print or type) / Check one: Certificate Installing Company Name -/-�� ' Corp: Address Partner. Business Telephone 4,�7- Fim>/Co. Name of Licensed Plumber. Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy P I Other type of indemnity D 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 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 i a 'ons performed under Permit Iss for this application will be in compliance with all pertinent provisions of the Massach efts State Plumb'„ ode an.e _ 4 e General Laws. �•p+•�•'"'.. vl ui wllJvu 11LULL UG1 4 -•••-.H.�•-' Type of Plumbing License Title City/ t nse um er Master Journeyman D APPROVED (OFFICE USE ONLY MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Types I� NORTH ANDOVER, . Masa. Date ? a BundtnPermit Location.? 3d!9 tl'. -1 tqj Nameet'a 11t 1/(2L J �t Nam New 0 Renovation ReplacemerA Plans Submitted: Yes 0 t o 0 FIXTURES � Check one: CertNlcate Installing Company Name /��9n / /D tiPl%1 / �d`y rel 0 Corp. v_ Address O Partnership _ 0 Firm/Co. Business Telephoned" 06 '?— Name of Ucensed Plumber L✓ ���� ��/� �-- INSURANCE COVERAGE: Check one I have a current liability Insurance policy or Re substantial equhratent. Yes 0 No p_ It you have checked jM. please indicate the type coverage by checking the appropriate box. A liability insurance p Alcy/10- Cther type of Indemnity 0 Bond 0 OWNER'S INSURANCE WAIVER: 1 am aware that the licenses does not have the Insurance coverage required by Chapter 142 a the Mass. General Laws, and that my slgnattase on this permit appilcation"watves_thla.regulrement. Check_ one: -_ Owner 0 Agent a._ Signature a Owner a Owners ent I hereby certify that all of the detafls and information i haw submitted lot entered) in above appikatlon are true and accurate to the best of my knowledge and that aA plumbing work and Installations performed under the permit Issued fol We appAaatlon will be in eompilance with LA pertinent provislons of the Massachusetts State h'fumbing Cade and Chapter 142 of the Laws. APPrICJVED lOfF10E USE ONLY) Lkansod ow Hansa Number Type of Plumbing Ucsnse: Master 0 Journeyman 2�=Is �j r J w A V I44 -- w o O s ur a t- r w t- u w < w x ': • s s a awe s0 t = sw s i ° .s s r►- as s O s r ur tw r M• .MaJt :7e 3P 11- s e s19 ►- sk IL ur ru r 1 i i o o j s �• e'�i 16 i a o s 1 on i Q sue—sarT. sAeassriNT IST FLOOR Into FLOOR 31110 FLOOR 4TH FLOOR ITM FLOON STH FLOOR, ITM FLOOR •THFLOOR - � Check one: CertNlcate Installing Company Name /��9n / /D tiPl%1 / �d`y rel 0 Corp. v_ Address O Partnership _ 0 Firm/Co. Business Telephoned" 06 '?— Name of Ucensed Plumber L✓ ���� ��/� �-- INSURANCE COVERAGE: Check one I have a current liability Insurance policy or Re substantial equhratent. Yes 0 No p_ It you have checked jM. please indicate the type coverage by checking the appropriate box. A liability insurance p Alcy/10- Cther type of Indemnity 0 Bond 0 OWNER'S INSURANCE WAIVER: 1 am aware that the licenses does not have the Insurance coverage required by Chapter 142 a the Mass. General Laws, and that my slgnattase on this permit appilcation"watves_thla.regulrement. Check_ one: -_ Owner 0 Agent a._ Signature a Owner a Owners ent I hereby certify that all of the detafls and information i haw submitted lot entered) in above appikatlon are true and accurate to the best of my knowledge and that aA plumbing work and Installations performed under the permit Issued fol We appAaatlon will be in eompilance with LA pertinent provislons of the Massachusetts State h'fumbing Cade and Chapter 142 of the Laws. APPrICJVED lOfF10E USE ONLY) Lkansod ow Hansa Number Type of Plumbing Ucsnse: Master 0 Journeyman ` Date../.U6. 95 N2 2682 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSA` 5f ' This certifies that .� . ....... ............ . ... .��l7 has permission to perform ... ... 01f. plumbing in t e buildings of ... V•. ................. . at .7.. /(, .... ,North Andover, Mass. Fee ....Lic. No?../ 6 0 ... .............................. L LL(3/ PLUMBING INSPECTOR �L. 1 14:18 35.00 RAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File Location No.V Date TOWN OF NORTH ANDOVER p Certificate of Occupancy $ Z' # Building/Frame Permit Fee $ _. Hus SA 14 Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ . TOTAL $ Building Inspector 10/16/95 14:58 141.00 PAID Div. Public Works PERMIT NO. - d� R 1 APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE I MAP KBO. I LOT NO. 2 RECORD OF OWNERSHIP IDATE (BOOK ;PAGE ZONE SUB DIV. LOT NO. - LOCATION/ / 17�4_kt5l J PURPOSE OF BUILDING If7-r- OWNER'S NAME t NO. OF STORIES SIZE OWNER'S ADDRESS /GIC-/ �,c,. / J [ J`Y _ �L ✓ BASEMENT OR SLAB 66,CC�,'ll- J ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD FFU1LDER'S NAME SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS POSTS DISTANCE FROM STREET 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 -� t BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER Ir IS BUILDING CONNECTED TO NATURAL GAS LINE �J 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 AUTHORIZE 7NT FEE ,L PERMIT GRANTED !—>D C' v 19Ir 9^� 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST / 7 -t:�o EST. BLDG. COST PER Sq. PT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY OWNER TEL. # CONTR. TEL. N 6860 CONTR. LIC. # © S_n H.I.C. # T BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY I S�OkIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. krO,o,e A1 erm&vr a !�xishi,7 w�ol� `r �L fU2°� �� ��' 1 APARTMENTS — CONSTRUCTION 2 FOUNDATION CONCRETE 8 INTERIOR FINISH B I 2 13 PINE HARDW-D PLASTER CONCRETE Bl. K. BRICK OR STONE PIERS DRY VJALL UNFIN. 3 BASEMENT AREA FULL FIN. B M AREA _ v, % 1/ FIN. ATTIC AREA N_O B M T 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 VERT. SIDING HARD"J'D COMMON ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY BRICK ON FRAME ATTIC STRS. 8 FLOOR _ CONC. OR CINDER BILK. WIRING STONE ON MASONRY STONE ON FRAME C SUPERIOR I- I POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE HIP BATH 13 FIX.) _ GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & 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 OIL B'M'T 2nd 10 13rd _ ELECTRIC NO HEATING krO,o,e A1 erm&vr a !�xishi,7 w�ol� `r �L fU2°� �� ��' 1 GN 1 u x a w x w O Q d CSA u w o u w z z Q ci U i% 0 W z z rl a w z d U w 04 V) cocov w w �, U zPw ►. w x w Q w' cin cu cn wl". c�-- P. O m c � � �y CD ` 1 c CA O % O V i R R = O v J :m :c 0 VAI' m N R m m CL O a N N L N r.r _ CO f � COQ CD o O o as : = o cm Cl) p m r V N Z G c i G c' F•�1 CL c Q : y O c O CS W c 'o RE.rL...�= �• o -M N O.L R c z � o'r E ca o N O LUcm CD O O c FQ" = R L ` H O F- L S CO 40 ?' Ez Q fl i J a O z E � F— G Z C O CO) co cm w W C O •� Q G� w y •E m m z OO CO 0 = U DC 0 O m Q N l� C O = C O J v •Q J 'O z p O Z z CO V O O C C Ca = cr: w C3 •y � z � Z � W m Cf) fl TOWN of NORTH ANDOVER AFFIDAVIT c• 1 r r - ate• . ■ w • cr. w • a • a w • .•:1 II••.• 1 r. w • •• :wY • II• • 011.1 011• •011• w •Iwo •• 111111416inre •' I .041 w • r• • - �� w • • •�• •I �• • 1 • •• .1 1 • • I • I1�" • • • 1 1 • I• ■ r I • .I .• .r6 r• • O..Y •0. •: 1 •1 1- • • • O.L `� 0• •• 1■►: 010 w / r •0. Y.1 Oi•r3•'w • . • • / r • r 0. .• 1 011' Type of Work: ( (' 140 r- Est. Cost /�00 Address of Work Owner Name: U (V 16 i ►, r Z Date of Permit Application: 16 116 I hereby certify that: Registration is not required for the following reason(s): Fat office Lige Qily Work excluded by law Rmdtrb. Job under $1,000 Date XBuilding not owner -occupied _Owner pulling own permit Other (specify) Notice is hereby given that: OWNERS PUUJNG THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS. FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRA- TION PROGRAM OR GUARANTY FUND UNDER MGL c. 142A. Signed uxler penalties of perjury: I hereby apply for a permit as the agent of the owner: lobOS j3r-tj�i 5A'� C6h,46Cb�'�i Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Date Owner Name COMMON IN OF MASSACHUSETTS EXPIRATION DATE RESTRICTIONS DEPARTMENT OF 1010 COIwmO PUIC SAFETY Z� BOSTQN� MA PUBLIC 0221 AVE. CAUTION FOR PROTECTION THEAGAINTHEFT, PUT RIGHT THUMB PRINT IN APPROPRIATE BOX ON LICENSE. BLASTING MUST INCLUD E PHOTO. THE CCMM,SSCUeR THIS DOCUMENT M CARRIEDONT, UST BE OTHERS RIGHT THUMB PRINT THE HOLDER EPERSONOF IIEN GAGEDINTHISOccu EN. PATION.. S) SIGN NAME, FULL -OVE S,' EFFEPTIVE DATE LIC NO. 7'. PHOTO (a NG OPR ONLY)FEE: Z7 HEtOF NOT VALID UNTIL POGHT. DOB:SAl"PED SIGNED ay � OR - SIGNA 7UPE LICENSEE AND OF"'CLALLY CAUTION FOR PROTECTION THEAGAINTHEFT, PUT RIGHT THUMB PRINT IN APPROPRIATE BOX ON LICENSE. BLASTING MUST INCLUD E PHOTO. THE CCMM,SSCUeR THIS DOCUMENT M CARRIEDONT, UST BE OTHERS RIGHT THUMB PRINT THE HOLDER EPERSONOF IIEN GAGEDINTHISOccu EN. PATION.. S) SIGN NAME, FULL -OVE S,' N k j - _ J � Z Z a �z L _ V O O - ca W s ^ C/) i O Z LL O o w -< - W = o � _z �R a CD Z � ~ A � ct W a C -- U j - _ L4 C�' CN O J O IMM4 f 4 4 H w � w :n v) O J O IMM4 f 4 4 H C=, CD I� n `z/ co L Cc Cc J ` F�1 /e CD CC Lu j CL 10 h jr- _� p Vi >- '� CD c cmO o w c COLJ Cl) CD CD CO C-) o !^� CL m d C.2 O i C ? . ✓ -- •� , CD p .� m -- fj Ci p i CZ O Q CL C: Q yCD p CD m Q o 72 CD cl) '1 Kar: Z V Q CD Z -' z vH z !'6 `o —' .� Cl) -'t:a=O = m O ` N C LU O Cc _ w v> ea to Cl) C-0 co o p z 2 cyv c M G` J w 4 0 k N n J_ I ~ z � 01 W IK s V! W < _ w W 2 0 0 o; z 0 2 t� �0 ZIK Z � 0 WW i � ` W r Z 0 u M IL L t 0 0 C < 0 V ►- 0 I Z O W `x M r A I a p N a Z J_ I ~ z W p r 0 W IK s V! W < _ w W 2 0 0 Z I z C 0 J 0 0 2 t� �0 K P- 0 r O < W Z i Z 0 � W J t Z 0 J 0 O N J Z 0 u M IL L t 0 0 C < 0 V ►- i i � Z O W `x M It < N Ili A I a b i 4 I_ w W u z 0 r u z W p r 0 W IK Y z < r_ V! W < _ w W 2 0 0 W j N f W r Y u I z C 0 J 0 p J m r j 0 1- u < N p f F M 1 c r u < F Y 0 I W z 0 J i a r u < ►- _N 0< K P- 0 r O < W W 0< a J O 0 N 0 F O Z 0 J 0 r N Z 0 � W J t Z 0 J 0 O N 0 I 0 V z Q j r J J 3 Z 0 u M IL L t 0 0 C < 0 ►- i In � b i N ^ � O1 M 1 0 I 0 0 I i LL �C u W W � r r F n p 0 0 i r J J x Ir i 0 x N W W j 0 v is I M L L U 0 I a W N d ~ N W ►- u i 0 < 3:g r Itf 0 t 0 M J u u z W p r 0 W IK Y z < r_ V! W < _ w W 2 0 ! N r O < !� W zr 0< W j N f W r Y u I z C 0 J 0 p J m r j 0 1- u < N p f F M 1 c r u < F Y 0 I W z 0 J i a r u < ►- _N 0< K P- 0 r O < W W 0< a J O 0 N 0 F O Z 0 J 0 r N Z 0 � W J t Z 0 J 0 O N 0 I 0 V z Q j r J J 3 Z 0 u M IL L t 0 0 C < 0 u 0 u Ix ►- i In z i N ^ � O1 M 1 0 0 I i u u W W � r r F I (~ I p 0 0 i r J J x Ir i 0 H N W W W v is I M L L (Please print) DATE Fla a �7 JOB LOCATION "HOMEOWNER" umber ame PRESENT MAILING ADDRESS Town of North Andover BUILDING DEPARTMENT Homeowner License Exemption treet Address Home Phone Section of town Work Phone w City Town State Zip code The current exemption for "homE-owners" was extended to include owner -occupied dwellings of.six units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. (State Building Code, Section 109.1.1) DEFINITION OF HOMEOWNER: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one to six family dwell- ing, attached or detached sL'ruc.tures accessory,to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a ci6iaeowner. Such "homeowner'' shall submit to the Building Official, on a fo'r'm acceptable to the Bulding Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply �-.ith said procedures and requirements. HOMEOWNER'S SIGNATUR .i'ROVAL OF BUILDING OFFICIAL Note: Three family dwellings 35,000 cubic feet, or larger, will be ;-equired to comply with State Building Code Section 127.0, Construction .-'.on trol. TONIN of NORTH ANDOVKR JTrUJMMt Cat=tx law .o array a. •• 'nrfa .■ o■ - a z t c- 142 A rapres d3at • - r.• s• • .• •a •:ea •• a ♦•a• •• a•:e n••iuewr�•r• •• .:.www rrr. • arra ian• •aar• o • or .e �.• • • . an .•« • •• •• .t . r. .n • a ••. n a• • r • •• r• • .r least • • c ■• u• • • a ■. . e• .• ••■ - e • are .• ..a to a.• • err- • - • • /C/o ♦ rCo L► �� Address of Wbrk___ 6A, owner ..n - Date of Permit Application: 7 I hereby ,certify that: Registration is not required for tine following reasou(s): Work excluded by law Job under $1,000 Building not owner -occupied , Owner pulling owu pezrnzt Other (specify) Far office Use Chly emit No. Date Notice is hereby given.that: O4NEZS-PULJJ2C U= OWN Pyr OR DFALEIC W= UNREGISMUM {lWTMCIDRS- CDR APPLICABLE HOME D4TMTa04T WORK DO NOT HAYS ACCESS TO 'IHE ARBTIRA- TION PROGRAM OR GUARANTY FUND uND R HM c. 142A_ Silty' �,-- pa -alt es of 'Jury: I hereby apply For a permit as the agent of the owner: DE Wl � Ie � Dat Contractor Name OR: 6S��Fa1�31 Registration No. Notwithstanding the above notice, I hereby apply -for a permit as the owner of the above property: J_ 7 Date' w-ner me D O b 0 G J x cy'- o O U m c O c v a 0 U W o � a o `� W C w N u vo V) a or. G w o a: v E c U o G w a o a; G w a W w c w o c� G w w w a a] zO cn cn 4 v 0 z t IO QM C V� ME O h O O 'ECDCD m m CL ~ �3 0 O O d CL cn< caCD ccc Q .O. O CD C CD 0 0. V y O C C C Q. CO) ca cy'- o m c c v o � O_ H C d� 5 CL •: y c T l�� o r m \; mo �. ca /ti o n 'E c CO2 0 t;c m c E y, m 3 m cm h ' v H O C O J. m o 0 cm h m W> CC •�. t OM � * O CLQ � C m :N V O GGi •� Z O Q CL �`mc c .o = o o a 0 N F - y la t �.. OLo rt... .y 0 F W 'E CLIcc 8 'o� z o m w m V� d m� O� 5 = W 0 H •� C �Z 6m� IO QM C V� ME O h O O 'ECDCD m m CL ~ �3 0 O O d CL cn< caCD ccc Q .O. O CD C CD 0 0. V y O C C C Q. CO) ca • S O Z M K a � . N V � Y Y 1 Ql I r W W U It •; z N W J � M N • u U n �II II 8� Z u 2 < IL 0 In �IK = 0 0 W 0 `g xW W �r i 0 N a Z • S O Z K N� V � Y 1 I r W U It •; z N W J Y • u U n �II II f .I ' 41 Z N x = �r 4 N W O 0 u IL 0 M z W f W C J 0 K 0 I- 0 0 W Z 0 u u z 0 J ■ J J 3 N Z 0 u H Z ww I z z 0 O I 2 2. u U W W r • p 0 0 N J J J _J 0 N ■ yyII W W b V I W. < < M l l 5 Z N� V � I 1 N < U It •; � W J • u n �II II r .I ' 41 Z N �r 4 J � ■ � W z 2 0 • W K f J 0 Z F K O l, V W Z r Y ; 0 !� y ; 0 F W ►- K a■ r r QW 7 t- U z r_ 0 Y r u z M_ 0 J r U Z M_ 0 0 J 4 0 a W _ i_ O J O N O _z 0 J ■ r J z O J O N W O 0 u IL 0 M z W f W C J 0 K 0 I- 0 0 W Z 0 u u z 0 J ■ J J 3 N Z 0 u H Z ww I z z 0 O I 2 2. u U W W r • p 0 0 N J J J _J 0 N ■ yyII W W b V I W. < < M l l 5 Z 0 V � 1 < U It •; � � J • 0 UC �II II .I ' 41 - 3 V �r 4 ix OC < FM u pp K < 3 r< u J 0 0 C O F l 0 0 S z W O 0 u IL 0 M z W f W C J 0 K 0 I- 0 0 W Z 0 u u z 0 J ■ J J 3 N Z 0 u H Z ww I z z 0 O I 2 2. u U W W r • p 0 0 N J J J _J 0 N ■ yyII W W b V I W. < < M l l 5 V � 1 It •; � �II II .I ' 41 - 3 V IY 1'6 P+ Z I N a � N Z � O 0 [ w OI O P- 0 0 J i. 0 W V1' ) W z I V Z Z U FL 0 IL J r 0 [ W W N I. M Z I W N Z � O � 0. J s � Z Q N p t� `moo N; M Z 0 N L V' z j 0 u U _ r W I W 3 r Z W = [<= ` 2 r Z z 0 O Z, L Z « i i W z [ U 0 4 N 8 Z � o • N W i' C � J r N W [ _ O _ I O 0 a V N s 0 rr i WM Q LI o i 1- W i• [ gg y 0 ' W « z < L z zz W I O \4 OI O P- 0 0 J i. 0 W V1' ) W z I V Z Z U FL 0 IL J r 0 [ W W N I. M Z 0 � 0. J s � Z Q p t� `moo N; Z 0 W ►! z j 0 u U _ r W I m M < W 3 r Z W = [<= ` 2 r Z z 0 O Z, L Z « i i W z [ U 0 4 N Z aI OI O P- 0 0 J i. 0 W V1' ) W z I V Z Z U FL 0 IL J r 0 [ W W N I. M ul Z 0 u in n w w ► z z 1 _O O I u u W W � r r H f � 0 0 0 r JJ J _J x W V 0 W. < < r L L Y Z 0 � 0. J � p W ►! _ j 0 u U 3 r r r• 2 0 0 « 0 r~1 Z ul Z 0 u in n w w ► z z 1 _O O I u u W W � r r H f � 0 0 0 r JJ J _J x W V 0 W. < < r L L Y MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO 00 GASFITTING (Print or Type) - NORTH ANDOVER Mass. Date /; tuilding Location Owners Name V10 A /.% d f • Y New 77 Renovation Q Replacement VM Plans Submitted I] FIXTUP=c (Print or Type) � / ,. Check one: Certificate Installing Company Name—/ " � �� %��G 2 `'''����/�� Q Corp. Address ISO -s`T Q� Partner. Ab0vtc1?- ZI;14 Q Firm/Co. Business Telephone: %9 y- Y3 y 9 Name of Licensed Plumber or Gas Fitter c. Insurancp Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy F,V7] Other type of indemnity Q Bond Q 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. ignature of owner/agent of property Owner Q Agent Q I hereby certify that ail of the details and information I have submitted (or entered) in above application are true and accurate to the b"t of my knowledge and that all plumbing work and hnstaUations petformed under Permit iuued fo: this application will be in compliance with all Pertincnt orovisions of the Massachusetts State Car Code and Ciapter 142 of the General Laws. By Title City/Town: APPROVED (OMCE USE ONLY) TYPE LICENSE: er Plumbb Plumer Signature of Licensed GzisMaster P umber or Gasfitter Journeyman �J g License Number N X W N Z cc as U3 cc N CCO ' .0 = k�- W a cc O U W r F = y -- a W a O'O y ts: W m W a Q W W y 0. cL W 4 Cr N W O z V us -- 01 - t0 .t Q q t•" G W z W t. W z 1= d z w W r cc a Q a W z o~ W v W o ro N= Cr = Q, d to > G W ct: z Q yW. c to d Gi < 2 O W O W Q W t- et z o U u. t l O rs U > Q a F- O SUS—$S..1T. t BASEMEMT I ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR (Print or Type) � / ,. Check one: Certificate Installing Company Name—/ " � �� %��G 2 `'''����/�� Q Corp. Address ISO -s`T Q� Partner. Ab0vtc1?- ZI;14 Q Firm/Co. Business Telephone: %9 y- Y3 y 9 Name of Licensed Plumber or Gas Fitter c. Insurancp Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy F,V7] Other type of indemnity Q Bond Q 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. ignature of owner/agent of property Owner Q Agent Q I hereby certify that ail of the details and information I have submitted (or entered) in above application are true and accurate to the b"t of my knowledge and that all plumbing work and hnstaUations petformed under Permit iuued fo: this application will be in compliance with all Pertincnt orovisions of the Massachusetts State Car Code and Ciapter 142 of the General Laws. By Title City/Town: APPROVED (OMCE USE ONLY) TYPE LICENSE: er Plumbb Plumer Signature of Licensed GzisMaster P umber or Gasfitter Journeyman �J g License Number Office Use Onty 01 4C (nmmvnwml# of �sar4usttts Permit No. •t arpurtaltrut of Public *afetg Occupancy & Fee Checked(01)0 BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3190 peave 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 //— T& or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a per�rTformelectrical work described below. Location (Street & Number) /� Owner or Tenant /v � z Owner's Address �- Is this permit in conjunction with a building permit: Yes No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Op Amps —J Volts Overhead Undgrnd ❑ No. of Meters New Service Amps _J Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work(/t���e No. of Lighting Outlets / I► / No. of Lighting Fixtures Imo/ No. of Receptacle Outlets No. of Switch Outlets No. of Ranges No. of Disposals �v No. of Dishwashers ,/1/7Vo. of Dryers / �a v X I No. of Hot Tubs Swimming Pool Above In- grnd. L_ grnd. ❑ No. of Oil Burners No. of Gas Burners I No. of Air Cond. Total tons No. of Water Heaters KW No.of Heat Total Total Pumos Tons KW Soace/Area Heating KW Heating Devices KW No. of No. of Signs Ballasts No. Hyaro Massage Tubs j No. of Motors Total HP OTHER: Total No. of Transformers KVA Generators KVA No. of Emergency Lighting Battery Units FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Sounding Devices No. of Self Contained Detection/Sounding Devices LocalMunicipal r Other �. Connection L_ Low Voltage Wiring INSURANCE COVERAGE: Pursuant to the reauirements of Massachusetts general Laws I have a current Liability Insurance Policy including Comoieted Operations Coverage or its substantial equivalent. YES = NO = 1 have submitted valid proof of same to the 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 Date) Estimated Value of Electrical Work S / ,t_ Work to Start Insoectton Date Requested: Rough Final Signed under the Penalties of perjury: FIRM NAME LIC. NO. Licensee . c� Signature C. NO. Y Address 5 !�-�J / J % r14n:V45'u -^ / "//'/ i %J `�' Alt. 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) (Signature of Owner or Agent) Telephone No. PERMIT FEE S X-6565 Date ..................... F NORT" ,TOWN OF NORTH ANDOVER p`4ao •e,"y p PERMIT FOR GAS INSTALLATION This certifies that .... t ......... �.....:...:.................. . has permission for gas installation ...' f...�..•.s:.................. ' in the buildings of .. :....!` ........................ at ..........:. .... , North Andover, Mass. Fee.Lic. No.. 't. .... J; Ivi/ 1t3:2? GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File TP Date........��.. aZ 2671 t NORTH � 0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING AC US This certifies that ............ . GAl. d has permission to perform....... �/j„....... � wiring in the build of .......,�� C/ ............................. at ..... North Andover, Mass. 0 � r Fee Lic. % .. j• �/0 c �'............. 1 ELECTRICAL INSPECTOR i kowc n 10:12 120.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File