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HomeMy WebLinkAboutMiscellaneous - 86 MEADOWOOD ROAD 4/30/20185 n M.PMw b• c4m ...„ cm r: cit, �,• a> O O U a CJ •.= � O O � N .' O 'O O y N GL `�' � °�' •ice, � '� a •p ,��y 5• c� .fl •C7 U U b041 }�yi ci'i P" •O. �0 ti y 'w.H O fcI 040+7 'o coy o •d �m o�� o N y LL •O c*i p N � 0 C N i 020 o.ov p q 40t N O t .c rg °' o•�a4i ami C 3 a� '� U y-+ N R1 •N 00 lu -15 10 U b �•� •i0 N O ° 4a O d � � W o � a � 'b � o -• 4040 �v �..e15 w Cd U 0al O N cl y l CD ti 5 0` y a N P. C. C P, o m 0 00 `0015 Date..... . K.77" ...... .1 TOWN OF NORTH ANDOVER PERMIT FOR WIRING Thiscertifies that ............................................................................................. has permission to perform .... /?Wqn( ............ wiring in the/building of .................. ......................................... at ..... .... eb ................. . North Andover, Mass. Fee ... � Lic. No. . .....41 ................. i�(IICAL INSPECn Check # Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. Occupancy and Fee Checked rev. 1/07] (1Pavn hl.,&) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of. NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) Da VAI ciZ� Owner or Tenant p VU e( Telephone No. Owner's Address 9VA Is this permit in conjunction with a building permit? Yes [] No ,ja"- (Check Appropriate Box) Purpose of Buildingaklef£ � � taE 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: \NJ t ?-E Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: .3t" (When required by municipal policy.) Work to Start: — (— Inspections to be requested in accordance with MEC Rule 10, and upon completion. 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 cover e is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCEOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: LIC. NO.:.3 Licensee: �EW LJ ignature LIC. NO.: (Ifapplicable, enter "exempt" in the license number line) Bus. Tel. No.: 978 Address: Al Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Depa ent of Public Safe "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: $ om zof t e n o tabe m 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- ❑ o. o mergency lg ting rnd. rnd. Batte Units No. of Receptacle Outlets No. of Oil Burners FIRE �Det:ec�tionan�� No. of Switches No. of Gas Burners No. of d Initiatin Devices No. of Ranges No. of Air Cond. To Tonsl No. of Alerting Devices No. of Waste Disposers Heat Pump Number...Tons KW........ No. of Self -Contained Totals: Detection/Alertin Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices E No. of WHeaters KW ater No. or uivalent Data Wiring: ` as Si Ballasts Signs Balts No. of Devices or E uivalent 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 Electrical Work: .3t" (When required by municipal policy.) Work to Start: — (— Inspections to be requested in accordance with MEC Rule 10, and upon completion. 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 cover e is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCEOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: LIC. NO.:.3 Licensee: �EW LJ ignature LIC. NO.: (Ifapplicable, enter "exempt" in the license number line) Bus. Tel. No.: 978 Address: Al Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Depa ent of Public Safe "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: $ The Commonwealth of Massachusetts f Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LesEibly Name (Business/Organization/Individual): Address: of,6caI-L- City/State/Zip: ��. �5� t� Phone #:�9 S� Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 4. ❑ I am a general contractor and I (full and/or part-time).* have hired the sub -contractors Jloyees I am a sole proprietor or partner- listed on the attached sheget. t ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10. ❑ Electrical repairs or additions 11. ❑ Plumbing repairs or additions 12. ❑ Roof repairs 13.❑ Other -Any appncant tnat checks box # 1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. :Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify rkderthepai and pe lties of perjury that the information provided//above is true and correct. Sign re: // Date: Phone #: �� ,?— 310 0 – Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #• 7 6 :3 Date.' 1.�. . TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION c..ty This certifies that .. 15....1. M4 6j has permission for gas installation ..... r? . � i .......... in the buildings of ... .... ...- ........` .......... . at .6(. i�� o.W,O : % .... , North AndoveriMass. Fee. :�... Lic. NoJ5:1 �-Q.._ ......P.Zze .. GAS INSPECTOR Check #f CN— MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING 3 City/Town: !v0 0�� , MA. Date: Permit# v6 7 vGh poz ` er-) Building Location: Owners Name: W Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential New: ❑ Alteration: ❑ Renovation: ❑ Replacement: ❑ Plans Submitted: Yes ❑ No ❑ FIXTURES 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 V 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 ❑ By checking this box ❑; I hereby certifv that all of the details and information 1 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 ❑ Plumber Title Gas Fitter Signature of Licensed umber/Gas Fitter Master City/Town Journeyman License Number: `J 1 APPROVED OFFICE USE ONLY) ❑ LP Installer -"3t fn v6 IIIZ W Y ZCn Q O W WO U N ~ 2CA O =~do N cc o Wm= z O QW De WOEWW WQm W d H WW QFZ W X I W zfn >W W z m O rvW Q � W o O w N =tu > z U W z J H I— W} X fn Q Q O z to W J C9 O z o ca t W E- W W O� tr M Q X W W Q> O Q O w z z W Q H v O D u_ 0 a x x-1 O a M W I— >>> O SUB BSMT. BASEMENT 1 FLOOR 2 FLOOR 3 FLOOR 4 FLOOR 5 FLOOR 6 FLOOR -i'FLOOR 8 FLOOR �"�"' &r 0y Check One Only Certificate # Installing Company Name: )n(n �Us • Address:3-3�S� M�5+-C,M \h State: E] Corporation E]Partnership Business Tel-d.��ami 1 -s`) 1 S : �„ l% Fax: irm/Company Name of Licensed Plumber/Gas Fitter:9 m4LV, S v'' 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 V 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 ❑ By checking this box ❑; I hereby certifv that all of the details and information 1 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 ❑ Plumber Title Gas Fitter Signature of Licensed umber/Gas Fitter Master City/Town Journeyman License Number: `J 1 APPROVED OFFICE USE ONLY) ❑ LP Installer -"3t ,G oTf3 Q "Location No. Date ' MORT1y T TOWN OF NORTH ANDOVER „ Certificate of Occupancy $ 1 i Building/Frame Permit Fee $ 41"1"'60 ''�b"•�° <� Foundation Permit Fee $ ss�ciiu8e Other Permit Fee $ --•-- Sewer Connection Fee $ �� IWer Connection Fee TOTAL $ Building Inspector a.YC 604 Div. Public Works . �cr�?�4P- Location— No. X Location 13 P r /' No. Date MaRT" TOWN OF NORTH ANDOVER p Certificate of Occupancy $Oy C7 • * ' _ Building/Frame Permit Fee $ cHFoundation Permit Fee $ d, v v 3 Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ 4 , 4 r Building Inspector - TO - 6046 Div. Public Works J -0n % ' a Location J& A2 &a , No. Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ utner Nermlt ree ewer connection Fee Water Connection Fee 'Y- TOTAL c�? L 6398 $ $, Bund ng ,cIns e; for am' iv. Public Oorks FORM U - LOT RRL EASE- FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section******************* APPLICANT: 2eAJ�V CVL2 Phone / 1,5 - / 26 LOCATION: Assessor'sMap Number Parcel Subdivision M(cj(1 Du ?OGYI Lot(s) /,3 Street I IP Q A Z.I St. Number ************************Official Use Only************************ RECOMMENDAT ONS OF TOWN AGENTS: Conservation Administrator Comments Date Approved Date Rejected Date Approved b Town Planner Date Rejected Comments A 2.2�� Zo Health Agent Comments Date Approved. Date Rejected Public Works.- sewer/water connections i OJ 5 %D Y� j!4 - driveway permit Fire Department 1_ ux/.e-/1 Received by Building Inspector r s t�-7 3 0 n n Date U r �'vab�s'.E� • �Y- /ASS l�ovrE /2S, ,- is -z3 ' 6,¢szs� = O. /48 A c. L!/NL-47-10V ZaeaT/O.C/ �S"ver-DRAG DEPARTMffNT �y �r eexrl, s ro r,e riree 1,vse1",f, wo /PL o T RL 4.v /-10 T.y6 B.4.Ve r1141- ;"Ve- G0Z-441AW la e0, -.47L-,0 O.c/ r1le Gor qS J-11W10VIV ANO TN.VT?OAFS GO.{/FGic'i7/ /N !Y/Tf/ 7"Ot✓.✓' OFNO. AW400- `At ZON/116 ,f64"A91,Va JE A,441o'S F�'O�1 STPEGrT,f fOT Uw/ES.'' NO . �iNOOv6.2� //VI . s F!/.�TiYC.� LE.!'T/FY Tif�ilT TN/,S OA✓ELL/N6 /.S' NOT GOG4TE0 /N T�YE FEGiE.PAG ,SCAoO /d•42A.�p A.PEA, O.P.�%!�i(/ %CQiP �SydrvN OJG/ �E Mt/N/Ty P.f�tlG� �NOFk4gss ?SVO98 00i0d /�E.�Dauiaap iE'F-.vtry e4eco oA 611 SA3 _ R.4.S. oA E �FEsst�`'� Tib'//S PlA E Pv.�PdSES - �/4T FO.e Baavo,Py /oto Bo�.vO.vc'Y /NFOR�f- �E�•P/iff.9Gt' E,vGit/EE.P/,(�6 SE.PY/lES ,4riovWeC..y F�o� Exrsrii/c .eeroeos. 66 f'q•P,� .ST.rEET A.VOOYE� WXX4440/ X. 77. O/8/O p i� ui 1F--1 d �- ad .m c z cli s 0, c 0 iC* L . ao cy o c Cv V 2 'CL .. z CL c�> k7 R .43 m ♦:D CL y of Ij co c CL= E mm a 1221 m y Cf y C C R O m act .: m La m L O Cf yr +-'� C CM p C m o J-- m cc-,)mZ`c .. C=O oc o _ H m H C C 'c = CD c N a m_ s W cp 'OC .. c H .N_ c.t`a5 Z oc •E w •y o C3 cn y O' = c M'S o H == cm :w � x o w° cn a C/) O z °c wo 04 U cz w O U W C2 co w O w W Po J) w O � a v w w m' cn cn ui 1F--1 d �- ad .m c z cli s 0, c 0 iC* L . ao cy o c Cv V 2 'CL .. z CL c�> k7 R .43 m ♦:D CL y of Ij co c CL= E mm a 1221 m y Cf y C C R O m act .: m La m L O Cf yr +-'� C CM p C m o J-- m cc-,)mZ`c .. C=O oc o _ H m H C C 'c = CD c N a m_ s W cp 'OC .. c H .N_ c.t`a5 Z oc •E w •y o C3 cn y O' = c M'S o H == cm :w � v a O W UJ LA.' O v co C. CO) c o� Oz �O — co c z 0 Q � U ik. cn o a� o0 C* y co C O co V m CL y O v .CL COD C O O C _cc Q CA r�mftl r cc LU cc z u✓ Q LL cc Ay 0 u N 0 Z U U J z LL O v co C. CO) c — co c z 0 Q o� C mm W C/) z o a� o0 ,.•_�yf ao r N. r cc LU cc z u✓ Q LL cc Ay 0 u N 0 Z U U V z Q a v® v O.a � ots� W ow Cl) LM LL z O® W c Qo Cl) LL H W C.) P-� m ..9 0 C IPEXXITT Nfi. L APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. �� PAGE 1 MAP K -4O. LOT NO. .� ZONEI SUB DIV. LOT NO. e LOCATION AvLo cfh 2 RECORD OF OWNERSHIP IDATE PURPOSE OF BUILDING BOOK "PAGE J ).2%61t� OWNER'S NAME mendQ Q NO. OF STORIES ) SIZE /" Z i OWNER'S ADDRESS 133 lur 17 '�e �n �I /I !U BASEMENT OR SLAB ARCHITECT'S NAME / Lw 7z7- 17/ r� _hiC�c_c uIYY� Us SIZE OF FLOOR TIMBERS IST2X /1 2ND [J Zj V �h 3RD Gi /� (/ BUILDER'S NAME n , , �.%n , Q /yM ` �/a SPAN DISTANCE TO NEAREST BUILDING l/.l DIMENSIONS OF SILLS --- DISTANCE FROM STREET "j n / POSTS #(,� DISTANCE FROM LOT LINES - SIDES REAR / " GIRDERS Sx /2 AREA OF LOT /�An L�"12_ FRONTAGE VFT / HEIGHT OF FOUNDATION ®/ THICKNESS IS BUILDING NEW SIZE OF FOOTING D // 2_2i X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATIONIS BUILDING O OLID R FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE /J C IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY A� '. V IS BUILDING CONNECTED TO TOWN SEWER - IS BUILDING CONNECTED TO NATURAL GAS L14E INSTRUCTIONS SEE BOTH SIDES PAGE I FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS I - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING %re-T-d?,4:0 0= ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR 5-17-7,3 DATE FILED � SIGNATURE OF OWN FEE 9Vat o o PERMIT GRANTED G 19 �- FLNF. AGENT OWNER TEL. # cl75/ V26 CONTR. TEL. # CONTR. LIC. 't 17 fir 3 PROPERTY INFORMATION LAND COST ALJ' , 1600 EST. BLDG. COST EST. BLDG. COST PER SQEST. BLDG. COST PER FT. ¢Al 1 EST. BLDG. COST PER ROOM I / i LZLI) SEPTIC PERMIT PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN ■YILOINQ INSPECTOR OCCUPANCY SINGLE FAMILY 1'_& STORIES MULTI. FAMILY- 't0iF:F I C E S APARTMENTS CONSTRUCTION 2 FOUNDATION CONCRETE3 I 8 INTERIOR FINISH 1 2 3 PINE CONCRETE BL K. BRICK OR STONE HARDW D PIERS PLASTER' -DRY WALL UNFIN 7,—. 3 BASEMENT AREA FULL FIN. B'M T' AREA 1/1 1/7 3/, FIN. ATTIC AREA,-, tlO B M T FIRE PLACES -IN HEAD ROOM MODERN KITCHEN 4 WALLS FLOORS CLAPBOARDS V;n%j DROP SIDING B x - 1 2 3 'TONCkETE WOOD SHINGLES 4EARTH ASPHALT SIDING— ASBESTOS SIDING VERT. SIDING STUCCO ON MASONRYV . HARD\A/ D COMMCN -ASPH TILE STUCCO ON FRAME BRICK ON MASONRY) k BRICK ON FRAME )ATTIC STRS. 8 FLOOR I_ CONC. OR CINDER BILK. WIRING STONE ON *MAS.ON Ly STONE ON FRAME' SUPERIOR13� Pgg2_ -ADEQIJATE NONE 1 5 ROOF 71 GABLEBATH GAMBREL E L -] MANSARD 1� HIP FLAT SHED lo PLUMBING 13 FIX.) TOILET RM. (2 FIX.) 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 I -11 HEATING WOOD JOIST PIPE LESS 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 IGAS JOIL B*M'T 2nd I st 2 1 -id ELECTRIC NO HEATING ;BUILDING RECORD 12 .,- THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF1311­111­bINGS: WITH POR61ES, GA- RAGES. ETC. SUPERIMPOSED. THIS RE -PLACES PLOT PLAN. 131 Tom A w, -1% N. t2 ,cry MUJ z �ydj "Z y C �.7 O = . 00 O C � � O . vv •CL Z �R O `� _ m o�WF y ID Sm 2.CA yCD C.22 ... OR N W m � i O C3�p N m Q� >.5 J C C � m � =c N A C y :mom y m �CM o c � Na w y O C � O ca 0 d Q 2 y _m C = m m +-. p O . O.OI- co r.+ m _ - m W CON .0-W=L yr C ~ •O.Z O C LU �E c2 .o E •y � m oWE= y d m.5 O.- f- r +o.. o. � cc m H O U M 10 r1 CD J z �i E co �� O u s' Q CA C z 0 v� w° 0kU w- a o W v a u: cn w ° oG C cry cn cn ,cry MUJ z �ydj "Z y C �.7 O = . 00 O C � � O . vv •CL Z �R O `� _ m o�WF y ID Sm 2.CA yCD C.22 ... OR N W m � i O C3�p N m Q� >.5 J C C � m � =c N A C y :mom y m �CM o c � Na w y O C � O ca 0 d Q 2 y _m C = m m +-. p O . O.OI- co r.+ m _ - m W CON .0-W=L yr C ~ •O.Z O C LU �E c2 .o E •y � m oWE= y d m.5 O.- f- r +o.. o. � cc m H O U M 10 r1 CD J z �i E co O �Z wa Q CA C � �c Z F- w ca 'C �� > Q • co mm L z W > CD �. o V i � m< o -W cc 0 -J 'D Q .9-- a 0.2 J LL CO) Z o. z_ rr �z C.3 COD 4 LLLL CL F- G V2 C'3 Z Z a u 'u a_ U S f " ,rt` 7a AA.L • t�� cam, z a o,u /C f �1 b c:Ck l.+h-s s crl:w A l G► �� 6, W W 1 YZ C �saMtid) 11r -►an 7C"G�C T-n� 14"S S!'fV�•.aN K i w. 4pt v, N Gut' S CA re V' -r e%-) ra. A r) L C t�rzc Or ID McGraw -Ha Facsimile ho t� l Company: _f j'i,v_'fJp �- Fax: From:,%` Date: No. of pages: Comments: i' Nov i��5 DIWIMcGraw-Hill 24 l lartwell Avenue Lexington, MA 02171 Tel: (6 17) Fax: (617) 860-6807 I( I D : jr 1, . - N01.) 14 '95 4 17 No Oci4 *P . � 2- 4. IV 'A fA I I& ram NovA -N fv% T-- i� Wi zovo r -F V1,111,14 cn. A 416' P MORTGAor iNsprCTION PLAN 1 4 �'j LOU= IN W ) 10*1AW lu blINAW fiLUUMEWIN't trft i Mjtl I WAn L1RkW;V#C4*lLD\oj (Or I P�, 14 A, t -1 r 'd A f\jLoq.g�g, NTOU0,70i OR Aft OKWY MOM MATIM ?FM twuniT Ar: l+" WAW 0 WUA 40& W01M 1, VM*" WHWYAR N111W, MAIUCHUSM IMM" IN 'My fSTAW191M nOW Mei;OOMMV14M PAAL NO,: 740 Prrn 0WANYIS NOT "0'&ijkjK GATE W DIC LATUT 0[ZD QF =1 WlbtM Mbim Aitf billyM Itim THMI ?#IF FMT fNtiw WE PIRGeMY Llh9 if is Ab%hsm W1. fig. hay PLM 01c- PAIA 611044, I "s -Val BRADFORD ENGINEERING CO. w %ILT4 A mc osol vjs) V4 --ms R,q4 MAY 19 95-23 . S •yEREBY CE.cT/FY To TyE TlT(,�c /.t/S!/.�.�,gt/O TD TNEBAN,rT.S',yT T,�EO�'El.L/,yp �, �«,ATEO O,t/ TiYEear ,lS s.�on►-,vA.vo T.�GOT�r-pa�s !Y/Tii/ T•i�ETOc✓.✓' OFNO. A.tIGCr64WGLLVFGiP�/ .4L�6. I.PO/.fib JET�II.PS F•�GM .STREGT 6 .c�E6vLAT,Ctvs 1 Fv.�H� OE.PT/fY TN.IT T.Y/„t G�Ar-�,r� N6 /S �vOT GOGgTEO /�/ TiYE FEGtE.PAG F[Ao0 /K4LO.�p A.PEA, �few,v piV i'E . �IL�N OF)A4 2527098 G�/p 6 o'° N_�� �-vavGAT/d.V �a�car�oc/ f'L O T 4v /�o . J�P,q%rN =ale ��oouo� �'e-.vcrsi �ae.Q Bovvo,Py Pve',�SES - wOT FO,P .IT/D.v,gm,W EX/ T �o`�,voveriti.�o,��s- /tf.P/,�l•4Gt' E.fiG.csiEE.Piv .rEz'a as. G6 f'-4,�'.E� .S'7.rEEJ' . 6 .s'E•Pi�/lES .i/OOYE.� �JAS,SgEyvSETTS O/8/O i2j47 Date .......... ..... ... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION ,�gg� '1- f This certifies ...... :` ... .... % ......'............ . has permission for gas installation.,J;.�.:................'...... in the buildings of ....1 = G IASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) f Ln rl�� ,Mass. Date 193— Permit# (, l Building Location�� LA -A {)_Owner's Namevn j.,.j Type of Occupancy, 41 If V— New ❑ Renovation ❑ Replacement ❑ Plans Submitted: Yes[] No ❑ Installing Company Name P.11 Check one: Certificate Address _ 2A f - U, z W Corporation I qe 6 _ i lkM tft A fM/rA ©Lt 2:)- ❑ Partnership Business Telephone_ ) 7 4 - I � C/ 3 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter �L ( M INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes �W No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability Insurance policy P : 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: Signature of Owner or Owner's Agent 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 the permit issued for this application YA-11 be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General s. City/Town APPRONEq OFFICE S O L Tym of License: umber Signa ure of Licensed Plumber or Gas itter Gasfitter aster License Number 3 �� Journeyman I� Y • ��������������■ t�MENEM s■ MR! NUNN WIdwed.. ■����«�������������r�■ Ron Installing Company Name P.11 Check one: Certificate Address _ 2A f - U, z W Corporation I qe 6 _ i lkM tft A fM/rA ©Lt 2:)- ❑ Partnership Business Telephone_ ) 7 4 - I � C/ 3 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter �L ( M INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes �W No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability Insurance policy P : 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: Signature of Owner or Owner's Agent 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 the permit issued for this application YA-11 be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General s. City/Town APPRONEq OFFICE S O L Tym of License: umber Signa ure of Licensed Plumber or Gas itter Gasfitter aster License Number 3 �� Journeyman I� z O_ H U w a N z N N W O IL LL r d z_ F- et F O iL N V d W 0. O O Q _z O F F- MN V o z a Q O W z O 1- Q t3 J CL a a w w W LL r r I r r i I i et I i O V W 0. O _z j MN V