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HomeMy WebLinkAboutMiscellaneous - 86 MILLPOND 4/30/2018Co IN 0 r • s t Date. .,/GtlS`/%� . TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING Thi, rertif p, that has permission to perform "V4e P? .�/4 plumbing in the buildings -ooff . Va . R � ).,p. ........... . . at.. 8,67)M*A?�../.c�4!/1 6j ..i'.. North A dovLer, Mass. Fee l U . Lic. No.. !Z8 C!7la `l.� . ...... . PLUMBING INSPECTOR Check # �u2%J J) . - MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town praC� la►r�tlOY2.`C' , MA. Date:\c4 Permit# Building Location �6S \•' I�1 ��oultlhoHS2. Owners NameD%%V9— t,\C1` ) @. Type of Occupancy: Commercial ❑ Educational ❑ industrial ❑ Institutional ❑ Residential FYI New: ❑ Alteration: ❑ , Renovation: ❑ Replacement: ® Plans Submitted: Yes ❑ No Cva'ICa,te �1,0�,�, �7� �oEcS 3°�S L1 FIXTURES INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes IC No ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy :9� Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: 1 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 Agent 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. By Type of License: 7, Title Plumber Signature of Licensed Plumber cit /Town Master Qt �G City/Town License Number: ` D APPROVED (OFFICE USE ONLY DEDICATED z SYSTEMS O Ce z Ln 0 w z V1 La V1 Y{N/� Q F- Vf Y Z %' a H W H J Z l.1 Q W NO y (7 Q:fY LLJ a O Q ^N+ Z Q VI rY d' W F- OJ u> V1 G. W -R!h O M M Q `W 0 }7Q W Li -3W — !O O. 1 Z Z 4�'.... 0 � T W W U o: Q H = a a V, Ln c o o �,,,, 0 l=.) �- rd _ ; g s o= o Z Q oc a 3 a 3 _ Q 3 0 'u Vf W a r� �d 1~!1 a Q m m LL x �+ I- SUB BSMT. BASEMENT 1 T FLOOR 2"D FLOOR 3"D FLOOR 4T" FLOOR ST" FLOOR 6T" FLOOR 7T" FLOOR 8T" FLOOR c� � Installing CompanyName:CTF.b p `` Sery�c.e.s 1>nL Check One Only Certificate # `,�►MP1r�� 5Q Corporation Z%T)i Address ��1 t h ov, g.� \ n City/Town \hC 1 NState: 02.%%..5 ❑ Partnership Busi}iess Te. CA �03�\ \i51�{ ( Fax: ❑ Firm/Company Name of Licensed Plumber: �: r Q k 0- 10-' : \'Y) oX\" 0 VA INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes IC No ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy :9� Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: 1 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 Agent 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. By Type of License: 7, Title Plumber Signature of Licensed Plumber cit /Town Master Qt �G City/Town License Number: ` D APPROVED (OFFICE USE ONLY O O n 0 H� m m d, a n � o t'f r" r m C-7 m � ci C4 O ❑w< m ❑ c rz n I tz { � 1 ® .DATE (MM/DD/ ACCWfl CERTIFICATE OF LIABILITY INSURANCE DATE THIS CERTIFICATE IS ISSUED AS A•MATTER'OF INFORMATION`ONLY AND"CONFERS NO RIGHTS UPON THE',CERTIFICQTE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR 'N `AMEND,'EXTENd OR ALTER THE COVERAGE AFFORDED`'BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE.:A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,. AND THE CERTIFICATE HOLDER IMPORTANT: If the certificate holder;is an. ADQITIONAL'tNSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to .: p Y P .. Y 4 confer rights to the the terms and `oondltlons of the; ohc ; certain., ohcles.:. ma re utre an endorsement. A statement on this certificate does not. certificate holder in lieu ofsuch endorsement s). PRODUCER - - - CONTACT:.:,. ,... �:: ,.. ..... _ .. ,... -NAME...-- ..,D�k:...,.. i :..'•: T & H Brokers Inc. PHONE,, .. mac: No : -67 - 195 Farmington Ave Suite .300': - E-MAIL Farmington' CT 06032 ADDREss n INSURERS AFFORDING COVERAGE NAIC # .- INSURER A: :ri.ins.'..Co. 16535 - INSURED - _ _ INSURER B : - r e 7` t- iCo. o GEM Plumbing &. ;Heatir_g Services, Inc. IrisuRER'c:u N '82 GEM -Mechanical Services Inc: 1. INSURER D 1`Wellington Road's; : INSURER.E:.- . ".- Lincoln RI `02865 :FI"INSURERF: COVERAGES CERTIFICATE NUMBER: 2029567231' REVISION NUMBER: ?I THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE,LISTED BELOW :HAVE:BEEN ISSUED TO::THE+INSURED• NAIVIED :;ABOVE: FOR THE POLICY PERIOD INDICATED: NOTNlITHSTANDING' ANY REQUIREMENT, .TERM'OR.CONDITION OF ANY CONTRACT OR OTHER OOCUMENT,WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS S JB IECT TO ALL THE TERMS,. I EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRI: TYPE OF INSURANCE ADDLISUBR.' 'c ' I POUCYEFF POUCY.EXP LIMITS LTR -- -INSR WVD". POLICY NUMBER - MM/ODfYYYY1 MMIDO/YYYYI� ` GENERAL LIABILITY .0.6541592-01 - /1/2011 7/1/2012 EACH OCCURRENCE - ' $1,000,000 DAMAGE TO RENTED COf IN(ERCIALGENERALLIABILrr>f PREMISES' Ea occurrence): I $300,000 CLAIMS MADE'a OCCUR MED EXP (Arty one person) $10,000 PERSONAL`8'ADVINJURY .`$1,000,000 I _ ..... GENERAL AGGREGATE I$2,000,000 GEN'POLICYAGGREGATE UMT APPC(E LOC PROOUOTS cGMP/OPAGG 52;000,000 JEC X PRO . S _ 000 000AUTOMOBILE LIABILITY8/2011E�a 63e1591-01 Eaaccident) X A,NY AUTO - _ BODILY INJURY (Per persari) $ ALL OWNED SCHEDULED BODILY INJURY{Per accident). $ AUTOS AUTOS X HIRED AUTOS x; : NON -OWNED PeOPERTnDAMAGE AUTOS ; E X UMBRELLALIAB X ; OCCUR. SISCCCL01529211 /1/2011 /1/2012 EACH OCCURRENCE 155,000,000 EXCESS LIAB CLAIMS MADE AGGREGATE SS, 000, 000 DED - RETENTION SO . WORKERS COMPENSATION "' ` C5969600-01 ..::..:.. 0/.1/.2011 0/1/2012._.:... X f WUS -1n •07H= AND EMPLOYERS' LIABILITY'. _ ANY PROPRIETOR/PARTNER/EXECUTIVE YIN E.L. EACH ACCIDENT Si, 000,000 OFFICERIMEMBER EXCLUDED? N / %{ (Mandatory In NH) - EL. DISEASE'' 'SA EMPLOYE Sl, 000,'0'.00 If yes, describe under DESCRIPTION OF OPERATIONS below EL_ DISEASE POLICY LIMIT $1, 000 , 000 C Ins`allati' on Coverage, TM HE /,1/2011 /1/2012 P= Y One Site y. s 200,000 =resit 5 200 000 - Temp Storage S 200,ZOO _ ..,.. I DESCRIPTIONOF'OPERATIONS/LOCA LOCATIONS / VEHICl.ES'(Attach ACORD101; Additfanal Remarks Schedule if more spaceis required)'" :..4.- EVIDENCE OF INSURANCE '= SPZL�LE FOR INFORMATIONAL' PURPOSES ONLY.' L , i CERTIFICATE HOLDER CANCELLATION SHOULD'ANYAF.TFIE ABOVEDESCRIBED POLICIES BE:CANCELLED• .,.: BEFORE THE EXPIRATION DATE:: THEREOF NOTICE WILL MI= DELIVERED IN! ACCORDANCE RDANCE WITH THE POLICY PROVISIONS Sample RI 02865 AUTHORIZED: RERRESENTATIVE:. •`.:. ` I ©1988-2010 ACORD CORPORATION :All rights reserved. ACORD 25 (2010/05) ' The ACORD name and logo are registered marks of ACORD. r .�• t . 1�0 Date.... ... .. / -!�� -.... 6:7 ...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...... .................... ...... ..... ........... .4 ........... has permission to perform ..... 124 xq wiring in the building of ........... .............. ... &.................................... at ........................ .......................... . North Andover, Mass. .... Fee...- .5. .. Lic. No..:�I/-4�.;� ............. . .......... ............... ......... .. ... ........... ELECTRICAL INSPECMR Check # 7146 C\ 4 l' Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. � I `7 9 Occupancy and Fee Checked [Rev. 9/051 (leave blank) 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: 40 n '/io 00 iz 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) 86 rn t �i'PoE'► Owner or Tenant �� ��, ��p Telephone No. Owner's Address 'A e Is this permit in conjunction with a building permit? Yes [Al No ❑ (Check Appropriate Box) Purpose of Building �T F- I Utility Authorization No. Existing Service 1 Q Amps \9 Q Volts Overhead ❑ Undgrd Q No. of Meters (1C., rr. New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: JC h e.. RC ina g ` An _ 4 fix cruent, Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans o. of Total Transformers KVA No. of Luminaire Outlets c_ No. of Hot Tubs Generators KVA No. of Luminaires Above ❑ In- E3o. Swimming Pool rnd. rnd. o Emergency ig mg 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 Heat Pump Totals: I Number 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 Kms, 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 Telecom muni9tions 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: 000 (When required by municipal policy.) Work to Start: 1-7-6-7 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 cove age is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE (2 BOND ❑ OTHER ❑ (Specify:) 1 certify, under the pains anenalties of perjury, that the information on this application is true and complete. FIRM NAME: Rp he d 444,./ecA LIC. NO.: 37x/5.2 Licensee: Ro h'-, 21 6f ri llilveC Signature LIC. NO.: 9 % 9-7 2 (If applicable, enter "exempt" in the li ense number line.) -.-Bus. Tel. No.: 979 95'-;,R6,93 Address: to .2 � f/(9rf�/� 1/ &" 4J,61 " cg Alt. Tel. No.: 46 ° 3 7P; ,7,A9-7 *Security System Contractor License required for this work; if applicable, enter the license number here: 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. 1 am the (check one) ❑ owner ❑ owner's agent. Owner/Agent PERMIT FEE. $ Signature Telephone No. - f-,12-07 pl-A Date ..... ... ......... MONTH TOWN OF NORTH AOVER • nj� PERMIT FOR GkS I TALLATIOTION This certifies that ............ . ...... 1, . ....... has permission for gas installation ......... in the buildings of ............................. at 4� North - Andover, Mass. ............................. �5— - /�7 �/7 ,. � - Fee. Lic. No.. ....... .. ........ GAS I SP,66 N X� 6R' Check # MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING (Type or print) Date NORTH ANDOVER, MASSACHUSETTS Ur Building Locations 5J O , l Permit #(10 Amount Owner's Name New D Renovation 13/ Replacement 0 Plans Submitted 0 (Print or type) f C P Name /� Address6�Gt�� � ��"� n Ave Name of Licensed Plumber or Gas Fitter Ch eck e: Certificate Installing Company LiPartner. E]Firm/Co INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ NoO If you have checked }_es, please indicate the type coverage by checking the appropriate box. 13 Liability insurance policy 01 Other type of indemnity 13 Bond Owner's Insurance Waiver: 1 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 13 Agent D 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 and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter MPlumber D Gas Fitter Master DJourneyman v, a z w w CG O U m F v z o w F Q z z c z o F z z w d ow. a GF C7 `� z n > O F > F w x z N x x z 2 w d a �" �" > m z o z w x C) x w > w z x ¢ d O O w O w H z x O x w x 3 a t7 w v a > o a F O SUB-BASEM ENT BASEM ENT IST. F L O O R ! 2ND. FLOOR ! 3RD. FLOOR 4 T H. F L O O R 5 T H. F L O O R 6TH. FLOOR 7 T H F L O O R 8 T H. F L O O R (Print or type) f C P Name /� Address6�Gt�� � ��"� n Ave Name of Licensed Plumber or Gas Fitter Ch eck e: Certificate Installing Company LiPartner. E]Firm/Co INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ NoO If you have checked }_es, please indicate the type coverage by checking the appropriate box. 13 Liability insurance policy 01 Other type of indemnity 13 Bond Owner's Insurance Waiver: 1 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 13 Agent D 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 and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter MPlumber D Gas Fitter Master DJourneyman NA Date/-. e HOR7ly ., TOWNOFN TH ANDOVER p PER FOR PLUMBING �SACNU`�� l This certifies that ...c-`..'........ ....... � . ........ has permission to perform J¢`' -' �'" �'.................... plumbing in the buildings of ... . . -.l ....................... . at.. .. J �. .. /.....` .......... , North Andover, Mass. 4-0 G... Fee4,.. - .. Lic. No././.;.P7. v."" . . �Z�./_ ........... / PLUM BINGINSPECTOR Check 7236 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location S,6 Date M�6 Permit # 0 - - Amount Type of Occupancy -gej New C] Renovation Replacement 1:1 Plans Submitted Yes 0 No 0 FIXTURES (Print or type)/ C �/ J� Check one: Certificate Installing Company Name /� 1 Corp. Address � 7 W10 '1 we , J �� Partner. Business Telephone 29_ 22- 1Z24 Finn/Co. Name of Licensed Plumber t ay r e-nr—e Cw S Insurance Covera¢e: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity 11 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 IOwner 11 I hereby certify that all of the details and information I have submitted (or best of my knowledge and that all plumbing work and install 'ons perforr compliance with all pertinent provisions of the Massachus State Pluqi s By: igna or MEMO PM e of Plumbing ice Title 3/ City/Town cense um APPROVED (OFFICE USE ONLY Agent in above application are true and accurate to the Permit Issued for this application will be in and Chapter 142 of the General Laws. Master � Journeyman ❑ V Dat ....... �42 3925 01 "O R7 TOWN OF NORTH ANDOVER 0 PERMIT FOR PLUMBING SAC04US This certifies that.. .4 . . ....... ......... .. V. has permission to perfofo rm ............. . ................. ... plumbing in the buil4hings of ... .............. at. AA7...... North Andover, Mass. Fqp�J. Lic. NOW,? .. ... PLUMBING INSPECTOR 01/27/99 12:32 25. � PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer ASSACH.USETTS UNIFORM APPLICATION FOR. PERMIT TO D PLUMBING (Pnnt or Type) Mass. Date p rmit#/ tr _ Building Location 6-`��-`I-L :! Gl✓�� Owner's Name ��6N��'� 0 I �C Type of Occupancy New ❑ Renovation ❑ Replacement 111�` Plans Submitted: Yes '❑' No ❑ FIXTURES Installing Company Name go PPI -0 A) �T Check one:. Certificate Address ��� ��� ❑ Corporation �} Uf cab V 0 'W. Partnership Business Telephone ❑ 'Firm/Co. Name of Licensed Plumber s aoo do A2'/Lt g v INSURANCE COVERAGE: I have a current liability insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No O If you have chbcked JL, please indicate the type coverage by checking the appropriate box A liability insurance policy �( Other type of Indemnity O 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 OL Agent ❑ t ' Signature of Owner, or Owner`s Agent l 1 L..,.�1......, 4i1..4k. # o l of 4l.e A feil--A infnrrt;2llnn r hava vlhrnittPd rnr antetedl in above aDolication are true and accurate to the gest of rr knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance'with.all I pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By D - Signature f Licensed Plumber Title - Type of License: Master Journeyman ❑ City/Town3 APPROVED (OFFICE USE ONLY) License Number V < N Z O Y Z ~ y W O Z .Ch a f V Y C 3 X J= N' 2. iA = . ry N C 6 Q Qa Cr. 0. O O ¢ d N ¢ < W N ¢ J— D C G W ¢ W F< < S �= 6 Y a O h W F- < O a� % = H Na Q O < J j LL. < ¢ ¢ CG O ¢ <. c0 H G sue—BSMT. BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH. FLOOR 1E d STH FLOORJ_ I __j Installing Company Name go PPI -0 A) �T Check one:. Certificate Address ��� ��� ❑ Corporation �} Uf cab V 0 'W. Partnership Business Telephone ❑ 'Firm/Co. Name of Licensed Plumber s aoo do A2'/Lt g v INSURANCE COVERAGE: I have a current liability insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No O If you have chbcked JL, please indicate the type coverage by checking the appropriate box A liability insurance policy �( Other type of Indemnity O 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 OL Agent ❑ t ' Signature of Owner, or Owner`s Agent l 1 L..,.�1......, 4i1..4k. # o l of 4l.e A feil--A infnrrt;2llnn r hava vlhrnittPd rnr antetedl in above aDolication are true and accurate to the gest of rr knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance'with.all I pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By D - Signature f Licensed Plumber Title - Type of License: Master Journeyman ❑ City/Town3 APPROVED (OFFICE USE ONLY) License Number R 1�' MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print of Type) a G 20`, — NO . ANDOVER , MA, Mass. Date '' 0;IJ :.19 � Permit p7 0► Building Location 9f/ � MILLPOND Owner's Name NO . ANDOVER , MA Type of Occupancy RES New ® Renovation ❑ Replacement ❑ Plans Submitted: Yes❑ ' No ❑ Installing Company Name CALLAHAN AIR CONDITIONING Check one: Certtflcate r Address 91 BELMONT STR FT C3 Corporation NO . ANDOVER, MA . 01845 ❑ Partnership Business Telephone 508-689-9233 ❑ Firm/Co. Name of Ucensed Plumber or Gas Fitter JOSEPH KEVIN CALLAHAN INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes R] No 0 ' If you have checked yes, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy Z] Other type of Indemnity ❑ Bond O OWNER'S INSURANCE WAIVER: 1 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 C3 I hereby certify that all of the details and information I have submitted (or entered) in 4bove appticallon are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under the permit sued for this applicatim will b In pnance with all pertinent provisions of the Massachusetts Stale Gas Code and Chapter 142 of the neral law, 8Y Type of Ucense: umber gnatur o c Asa um a or Gas titer Title asritter Master Ucense Number M-3440 City/Town Jowneyman 0 . N � W N 1 N N Y V Q Vi N tt in W U.1N Wtu O a ¢ m N W F' < y W O N 6. C > W W P', W 2 V W .. = x N (Z Z W j tit C W V _¢ J T us v m ' V W y O a F- O SUB—aSMT. BASEMENT 7STFLOOR 2ND FLOOR V 3RD FLOOR 1 I I ATH FLOOR STH FLOOR aTHFLOOR 7TH FLOOR STH FLOOR Installing Company Name CALLAHAN AIR CONDITIONING Check one: Certtflcate r Address 91 BELMONT STR FT C3 Corporation NO . ANDOVER, MA . 01845 ❑ Partnership Business Telephone 508-689-9233 ❑ Firm/Co. Name of Ucensed Plumber or Gas Fitter JOSEPH KEVIN CALLAHAN INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes R] No 0 ' If you have checked yes, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy Z] Other type of Indemnity ❑ Bond O OWNER'S INSURANCE WAIVER: 1 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 C3 I hereby certify that all of the details and information I have submitted (or entered) in 4bove appticallon are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under the permit sued for this applicatim will b In pnance with all pertinent provisions of the Massachusetts Stale Gas Code and Chapter 142 of the neral law, 8Y Type of Ucense: umber gnatur o c Asa um a or Gas titer Title asritter Master Ucense Number M-3440 City/Town Jowneyman 0 . dr3✓R'v::4.'�-vcs.'�.i� � �r-r-� . � .v �. --::�-�. � �- ._;,yam -o, ...,-. ,.,.:;..--ti,�.�c- -�- ,. �--�c3D+` � r To 2679 Date.. x"....... F Shp ,40R TOWN OF NORTH ANDOVER 3r �� PERMIT FOR GAS INSTALLATION + 'ts •,..or ty �SSACMUSEt # w This certifies that . c14. t /j A 14. ......... has permission for gas installation .. /.. �`/? J................ in the buildings of ..A 1. ...........:..... at .. ...,%! ('.(:.......... , North Andover, MaV. Fee..a? ;). .. Lic. No..3. `� Y.° . . GAS INSPECTOR of WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File L, MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTIU' G (Print or Type) NORTH ANDOVER Mass. Date.., Building Location'0 Permit -es c S Owners Name�.h New Renovation II Replacement n Plans Submitted F: ! Y"! r o (Print or Type) % Check one:. Certificate Installing Company Name �iti'a �Oi Q Corp. Address Partner. ��✓, 1,... '. %. va %� /� Gf Firm./Co. Business Telephone: Name of Licensed Plumber or Cas Fitter Insurance Coverage: Indica-.e .r e t (Ce Of insurance coverage by checking the appropriate box: Liability insurance policy k1 tvice of indemnity Q Bond Q Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have ar.v one of the above three insurance coverages. Signature of owner/agent of property Owner Q Agent Q ! hc:cby certify that all of the details and information i. have submitte7 (cr entered) in above avpiieation are Uwe and accurate to the best of my )clowtedse and ttcat sit ptutnbin; wort and InsratSatiotts -=fQr=9;d under P-.ssrit i=cd.ro: this appilcttson wilt be in eompiisnoe with ail aeztlaeat provisions of tho Stassachuactts State Cas t✓3dc std Caaptc :4Z cf Ise Cc=zI Laws. .. By TYP= LIC'NS' l PIu.Tber� - Title l Gasfitter Signature of censed City/Town- ��lMaster p.�er or. Gasfitter journeyman APPROVED (OFFICE USE OML.YI License Number rA m to c m W tu 0LLA to .0 to = H Z III N F' W w Q O a W tu 4 u! G t- to y ay usul 0 a,cr > sua—asm—,. BASEME:tT !! -H 'IS FLOOR ZRO FLOOR ! I! I ! I f f I 1 I I I I I I I I I I{ 1 I I j 3RD FLOOR fI 47K FLOOR 5TH FLOOR STH FLOOR TTH FLOOR 8TH FLOOR I I ! I I I M I I I (Print or Type) % Check one:. Certificate Installing Company Name �iti'a �Oi Q Corp. Address Partner. ��✓, 1,... '. %. va %� /� Gf Firm./Co. Business Telephone: Name of Licensed Plumber or Cas Fitter Insurance Coverage: Indica-.e .r e t (Ce Of insurance coverage by checking the appropriate box: Liability insurance policy k1 tvice of indemnity Q Bond Q Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have ar.v one of the above three insurance coverages. Signature of owner/agent of property Owner Q Agent Q ! hc:cby certify that all of the details and information i. have submitte7 (cr entered) in above avpiieation are Uwe and accurate to the best of my )clowtedse and ttcat sit ptutnbin; wort and InsratSatiotts -=fQr=9;d under P-.ssrit i=cd.ro: this appilcttson wilt be in eompiisnoe with ail aeztlaeat provisions of tho Stassachuactts State Cas t✓3dc std Caaptc :4Z cf Ise Cc=zI Laws. .. By TYP= LIC'NS' l PIu.Tber� - Title l Gasfitter Signature of censed City/Town- ��lMaster p.�er or. Gasfitter journeyman APPROVED (OFFICE USE OML.YI License Number lUttttt milt (to 111011 R11��fhli$RYX� offrtt use only DepartntRnt of Public Sr(fely Peanit No. V1 BOARD OF EIRE PREVENTION REGULATIONS 527 CMR 12:00 ()ccupancy a Foo Chackod :------__ 3r90 (leave blanW APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work tobe performed toaccordance with the A9■s ac C Date (171 EASE PRINT W INK OR IYf'E ALL INFORMATION) r� }-( � L__1;_'______ .r.-..__ ------To the Inspector of W1res> City or Town ur _..__.._.....5/__.1.x."-��-_�/� The undersigned• aPpfles for a pefntlt to perforin the electrical workdesscribed below. Location (Street &Number) _ ._-_ ����"•`"-�'`------•—'—..y._.__._.._._..._....r.�-- --._--___.—____---- Owner or Tenant Owner's Address is this perriO in rnnjunCrion with a hrrllding ,permit' Yes L...J No Purpose of Durlrlurg _-- - Existing Servlce A Amps _���--�� Volts New Service Volts Number of Feeders and ArnlWiity ..------ - - t Location and. Nature of proposed Electrical Wore No of Lighting Outlets No. of Li htin Fi ! No. of Rcwe tacle t?u1' No. of SwHch Outlets No of Ranges No. of Uissx)sals No. of Dishwashers No. of Dryers of OTHER: Vit. of 11 T ubs 5„%Yimmin Pull No. of Oil 0urne No. of Cats Burnt No. of Air Condi He;( No. of Pum s Seace/Ar� _ e_a Heall Heatl_nit Devices FIo oT- 51$.n5�_,._..—N No. of Motors (Check Appropriate @ox) Jtility Authorization No. -� overhead 1'j1 Undgrd �j No. of Meters —.�-- Overhead LJ Undgrd I - J NO. of Meters KW o. FIRE ALARMS No. of Zones.---r-�- No, of Detection and initiating Drvlces� No. of Sounding Devices No. of Self Contained - oeteaion/Snunding Devices Municipal Locela, Connection ❑Other INSURANCE COVERAGE: f ursuani to the requirements o! �hassachusnes General Laws 6ub I have a current Liability Insurance policy Including Completed Operations Coveragr or its substantial equivalent. YES Ci NO (a 1 have mltlad valid pmol of same to this office. YES (_1 NO LJ of coverage b checking the appropriate box It you have checked Ws, , please Indicate the type B Y INSURANCE L!d BOh)p OTHERO (Please Specify) -- -" (Expiration Pate) Estimated Value of Elec:ttical Work 1i -- --- Final - - Work to Stara Inspection (late Requested: Rough Signed under the penalties of perjury. 11 G `It _ E1C. IJO. FIRns NA E _ � Licensee_. Signature LIC. NO. eG_ Bus. Tel, No. /... Address�— Alt, Tel. No. __ ....- » «.� OWNER'S INSURANCE WAIVER: I am aware that the licensee doe n not have sap the ,�eruiienl�Ownergc or it�sgceurestaniia`please ct ecksone) try MassachUaalts General Laws, and that my signature on this permit APPllcation waives Telephone Nu__— - PERMIT FEE S�-- I (Signature of Owner or Agent) Date ..... T" ® 2661 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ........!x.5........1. .......................... has permission to perform ....... ......... r- ...e...... wiring in the building of ............ Cot ........................... .................. at ..... ;k..(Q......1.'. ..*.V ... btl ..... .............. . North Andover, Mass. Fee3k.0.4 ... Lic.NoAhkr3 .......................................................... ELECTRICAL INSPECTOR c'k& Al 141195 10:05 30.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File T© 2066 Date ..... !' . TOWN OF NORTH ANDOVER PERMIT FOR. GAS INSTALLATION his certifies that ...: ..... lis permission for gas install ion/.....,� in the buildings of ...... J. I(. ......................... at .... , North Andover, Mass. Fee. -r . Lic. No.. ........ GAS INSPECTOR 4' WHITE: Applica CANARY: Building Dept. PINK: Treasurer GOLD: File, .