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HomeMy WebLinkAboutMiscellaneous - 85 HOLLY RIDGE ROAD 4/30/2018 (2)Date ... ...... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that has 'permission for gas installation in the buildin S/ I 1,10f Me,'Iww�z at B./l/M.WRY ......... FeeJ) 'a lirNo.. 0. Check4 7; ,4608 ............. N rth Andover, Mass, GASINSPECTOR MASSACHUSETTS UNIFORM APPLICATION (Print or Type) . G Mass. Building New ❑ Renovation ❑ ;PERMIT TO DO GASFITTING Permit # a0 Owner's Nam / .;2 4 Z&C,41 Type of Occupancy--j3-ES! -I-)CN T i P Plans Submitted: Yes❑ No ❑ Installing Company Name :2cige jZ T A .:� Am MAT A �0 Check one: Certificate Address 3(--) 06A C H iv►1qry z -K1. ❑ Corporation M E 7 H U E fJ t11 rl D ❑ Partnership Business Telephone 1� -92 —17 (7-7 f 9--Firm/Co. Name of Licensed Plumber or Gas Fitter -'R O A F- f` T A • 5 R M m d i A )?o INSURANCE COVERAGE: Ahave a current i' bility 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 coverage by checking the appropriate box. A liability insurance policy 0 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 ❑ Signature of Owner or Owner's 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 pe i ed for this application ' be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of ner Laws. By T of License: C� Plumber n ure of cen u or Gas fitter Title Iter er License Number City/Town Journeyman ATIFCVM (OFFICE NL I am Installing Company Name :2cige jZ T A .:� Am MAT A �0 Check one: Certificate Address 3(--) 06A C H iv►1qry z -K1. ❑ Corporation M E 7 H U E fJ t11 rl D ❑ Partnership Business Telephone 1� -92 —17 (7-7 f 9--Firm/Co. Name of Licensed Plumber or Gas Fitter -'R O A F- f` T A • 5 R M m d i A )?o INSURANCE COVERAGE: Ahave a current i' bility 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 coverage by checking the appropriate box. A liability insurance policy 0 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 ❑ Signature of Owner or Owner's 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 pe i ed for this application ' be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of ner Laws. By T of License: C� Plumber n ure of cen u or Gas fitter Title Iter er License Number City/Town Journeyman ATIFCVM (OFFICE NL z N , W d O a O Q Z I V W F;, w er: N - � Q N = . O O p - W O W N � � W U. • ¢ Q d W Z Z F O O ¢ a o F W W W D m J W a - G O mU. O F ma O O V J ~ O W 14m O a a - W Z J tu 2 J W NI W . S U HI W Y N Z O U W N Z J - a z - LL . r' ILA A0QACNUSE11S UNIFORM APPLICATION FOR PERMIT TO DO PLIUMBiNt3 (Print or Type) NORTH ANDOVER, , Mass. Date Building Permit # _ �( O? Owner's , 0 Name New 121, Renovation O Replacement ® Plans Submitted: Yes[] No p �iXTUAEs Installing Company Name (_r cab `C Address 1/O� Business Telephone V y5 719'6 Name of Licensed Plumber Check one: p corp. O Partnership p Firm/Co. INSURANCE COVERAGE: Check one 1 have a current Ilablity Insurance policy or Its substantial equivalent. Yes 11 No O II you have checked yg, please Indicate the type coverage by checking the appropriate box A liability Insurance policy Other type of Indemnity O Bond 0 Certificate OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage requlred by Chapter 142 of the Masa. General Laws, and that my signature on this permit application waives this requirement., Check one: Owner p Agent p Signature o Owner a owner's en I hereby eerily that all of the details and Information I have submitted tot enbred) In above application are true and accurate to the best of my knowledge and that a1 plumbing work and Installations performed under the permit Issrsed for s applkatlon vAl be In comptlance with all pertinent provisions of the Massachusetts State Pkimbing Code and Chapter 112 of the al laws. uta License Number %67 J-0 2 city/Town AF'1IUVED (OFFICE USE ONLY) Type of Pkxnbinp License: Master K Journeyman p i d � � . . ��■���MEN■■1111■11111 Installing Company Name (_r cab `C Address 1/O� Business Telephone V y5 719'6 Name of Licensed Plumber Check one: p corp. O Partnership p Firm/Co. INSURANCE COVERAGE: Check one 1 have a current Ilablity Insurance policy or Its substantial equivalent. Yes 11 No O II you have checked yg, please Indicate the type coverage by checking the appropriate box A liability Insurance policy Other type of Indemnity O Bond 0 Certificate OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage requlred by Chapter 142 of the Masa. General Laws, and that my signature on this permit application waives this requirement., Check one: Owner p Agent p Signature o Owner a owner's en I hereby eerily that all of the details and Information I have submitted tot enbred) In above application are true and accurate to the best of my knowledge and that a1 plumbing work and Installations performed under the permit Issrsed for s applkatlon vAl be In comptlance with all pertinent provisions of the Massachusetts State Pkimbing Code and Chapter 112 of the al laws. uta License Number %67 J-0 2 city/Town AF'1IUVED (OFFICE USE ONLY) Type of Pkxnbinp License: Master K Journeyman p i , t 1 r Date...!..�.i TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ........ -! �.. ��.... t r....... . has permission to perform .. . . t! ........... . plumbing in the buildings of . .. .!. A . ..... . at. . 4. :1.....�.� �. ! •.,Worth Andover, Mass. Fee/,.-. :-�. Lic. No.,/,J',—f° .... .....:.�%.f.1. .......f .. . PLUMBING INSPECTORf 11/19/93 11:122 62,50 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File ion No. 3qi _ � `9�} Date "ORTq TOWN OF NORTH ANDOVER - ; Certificate of Occupancy $ If- All Building/Frame Permit Fee $ % �2 s�H� Foundation Permit Fee $� /,00 f, Other Permit Fee Sewer Connection Fee MT14ater Connection Fee C�EGE�v�� P P TOTAL $�"` �N Building Inspector V10. Nnd°VeT �ollectn Div.. Public Works _�� Location`!r� No. �� P� ! Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee ACNUSE Other Permit Fee 1'67 j %S_ewer Connection Fee (VwaterNo� "c ion Fee IT ' Pilo, C r. Builii' g Inspector j Div. Public Works O 2 IN ©mm z ° � N� a37 f 0 Z 8 LL 6 W a I.- t 0 IL U U U f a au c� W p a a a U m m m U l+) < W y 0 11 y W I tl1 z 0 F. 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Y a0 Z O Q ; z 0 p C� Q LL f N< QaZ z �n QE Q O oc (� Z w Z >- LL F u w 2 N (7 fig ¢aw O ww0 v� m ^�O i �Zz QpNFO°OOZOZ�ZZ - ZzZiLLv� xZ 0¢0 c�0 O u ��� mm J LL v 0000 J 1I N N V U ZUw Y Vf lq w m p ¢ a m a QOpamce]] i w U u Y Y V UZOO u Z Z N w m aO�Qa 1- 2 p0 F- o m J n H Z7d �Ifa uuuuma a=°z�= uo3aa>��mm��� ���a3N�� Qu fG 0 3 :E � 0 3 f « m= w •r t• , � II FORDS U TOWN OF NORTH ANDOVER LOT RELEASE FOIA SUBDIVISIONC�C� ASSESSORS MAP m7 c�, SUBDIVISION LOT(S) � o. — PERMANENT ADDRESS (ASSIGNED BY D.P.-W.)_ STREET APPLICANT ��sc.�nit,- �nra�r.rc-fyhJ l.vc, Ir"��riQ�J PHONE DATE OF APPLICATION TOWN USE BELOW THIS LINE PLANNZNG,BOARD �i'�® TOWN PLANNER DATE APPROVED DATE REJECTED C NSERVATION COMMISSION DATE APPROVED ONSERVATION ADr N.jt.Z DATE REJECTED -4k , DATE APPROVED DATE REJECTED DEPARTMENT OF PUBLIC WORKS DRIVEWAY PERMIT B� C SEWER/WATER CONNECTIONS P-0 A4 / 5 �ti S Z R FIRE DEPT.`– r RECEIVED BY BUILDING INSPECTION DATE SFP 1 7 imi This form shall be signed by the agents of the Planning and health Boards, the Conservation Commission prior to the issuance of any building permits for the subject lot. This form shall not releive the applica t-. fr'oii the compliance of any applicable Town requirement or Bylaw. O z L LLI IL F— W LU c� - g OV O .Q o O Q Ob V � �� Z 29 O O it � C a 96 _v .� U CLi O C ~ C � Z� O � a=r z z W Wul 0 O 5�W) } C Q �— C 96 y � z 4) V z t z C u c ? °` Q Ov v m o OW O CL C �ZD... C > LL I O e� �, 3 d z o M 7 X iL V mm J•, Wm 3A L i O Olz0C OC `1C ` O z 0 U lL ao Q LL Q fn U. - : �: Q IL O •� m U) (a - g .Q o O n C O V � �� Z O O it � C a •� _v .� U CLi C CL. C � O � a=r C r �cl Wul (� cc IL } C Q �— C y � z 4) V i O t y C y c CL r" Lu C6 �z v C o OW O CL C �ZD... 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BUcV�t►.1� ZuSF'EGTbQ li S ki a �,t1 41 C.oMPI.y O ►.11.�y A � D �v vc�F-1 USE. t S �o iZ� k! cr THE.ZAt.1� �rC.TE CZr�lt� ATlo1.J F'>y L_Ak c S e� Cro �1 F o tL !rl tT Y oTz ►`1 a r, 1 Go w i FoQ�'t- lll 0 0 0 C 0 DD N II C— oT C- "o - to (24-f4c Location A % 7 660 Ll AP E_ ,rte f No. 3 Ff - C Date �'- 7! 2- 14O "7" TOWN OF NORTH ANDOVER of t.•= . �a° .. ° °c p Certificate of Occupancy $ Building/Frame Permit- Fee $ A 1 SEt., Foundation Permit Fee $ / Other Permit Fee $S, r n Sew Connection Fee $ MO �a� , ,99? Water Connection Fee $ r,o!10,r, ,,' C., TOTAL Div. Public Works Town of, Ia\I.ti `.s;�::�' 1i���i`��•l�J1 ��NI�U�' f.'�nll►..►i�l �� ..,-• . 11011.1)[WJt.11� I►IVL<I►►NIW (I; 17)lcl(['�•1; Pi.ANNIN(', 1'1.y\,NNlNG Fc ('OAl1%lUNl't'1" Ul;�'Lst.Ot'IIIt N'l' - I:.•\I;Ia.► I LI'. NI:I.ti( )N. C111AINL:Y APPLICA11014 ANO I'EK;AII K- DATE 7 I ERN I'l, # 3 ff= C ,.LOCATION of OWNER'S NAME: .:BUILDER'S NAME: 4ASON'S NAME: 4ASON'S ADDRESS: 4ASON'S TELEPHONE: )ATERIAL OF CHIMNEY: .WERIOR CHIMNEY: EXILIZIOIZ CHIhI1JLS�:_� (UMBER ANO SIZE OF FLUES: -HICKNESS OF HEARTH: lift eflunitey un- 6iAepCaee con(anul to Mlle. v() the curie and have "tucc.b alld .egutati.alvs been rceeet.ved: � �-------`---- 'ATE:-�i JGNATURE OF MASON: 'ERMIT GRANTED OBERT NICETTA UILDING INSPE NSPECTEU: EMARKS 0 SOLID BLOCK IZG(lUIHEI sie-0 THIS PERMIT MUSF GL: OISPLAVLO 014 ME i'RLAII SLS r` LU am g Cl Z� W1 N � Z W • Z � W 1i C Z y �- -\ J t u d Q � m_ V C Iwo L V W �Z O V 7 V.cm t ' O C� O m C Q v)lL O O Q ` ¢ 7' E m U) �% fA LU am s Z g 2 0 Z 0 �Z O 'Z G_ OW LL ` .c 0 LL - 0 w 2 LU W 1-•'"' r— U �� > w c O �,x d CG r— d w �o z c O o Z DO C m W C N r ,cc O W LAJ Q- s Z 0AE O W cc W 0 O r4 U tY (zt cY J Q � Q M Q 3 I F y Z w � J w W 3 A a � � a Q � a uoQ0 u w �y ztJ �mr o w C/) o rA W O z U a E� rk a U � � � a o ti