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HomeMy WebLinkAboutMiscellaneous - 88 DUNCAN DRIVE 4/30/2018,90 Date... ..................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ................................ 1...� ..... .....................v C + has permission to perform .... 1 .......................................... wiring in the building of...... L-�............................................ �, rJ ... Fee .... J . .......�........ Lic. No......... � Check # b-7 C _ t (fommonwea& o f Vamac4uaeib Official Use 90y cc��rr�� e1.leParimenl ol,}cc77 ire �ervice,j Permit No. I Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] 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: `7 3a I'i City or Town of: Ma(lpc To theI Spector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) $"f 'by afCA rf IL Owner or Tenant G/A!L( (,J Et kAAln> Telephone No. Owner's Address 8$ i),j tic -Ani �2. Aj oat14 Ajg-o v e y U 1 g`i 5: Is this permit in conjunction with a building permit? Yes [� No [J (Check Appropriate Box) Purpose of Building � - ticnf C.0 / 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: A ��-o rric, 4 Completion o the following table mav be waived bv the Ins ector of Wires. No. of Recessed Luminaires Z No. of Ceil: Susp. (Paddle) Fans i 1 No. of Total Transformers KVA No. of Luminaire Outlets 3 No. of Hot Tubs Generators KVA No. of Luminaires3 Swimming Pool Above ElIn- ❑ rnd. rnd. o. o Emergency Lighting Battery Units No. of Receptacle Outlets Z 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. TotalTons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Numher " -'- Tons I KW I No. o em -Contae Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal [:1 Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water KW Heaters o. o o. o 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 Electrical Work: 060, pro (When required by municipal policy.) Work to Start:/ Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE C VE E: 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 coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I terrify, under the pains and enalties of perjury, that the information on this application is true and complete FIRM NAME: LIC. NO.: Licensee: /IAA I c ,� , Rewc.G Signature LIC. NO.: Lf 3 76 -6 (If applicable, enter "exempt" in the license number line) lop, Bus. Tel. No.: Address: & o C/"L0- S L e—M 4 A tf 03rd 7 �_ Alt. Tel. No.: *Per M.G.L. c. 147, s. 57-61, security work requires Department 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 PERMIT FEE: $ Signature Telephone No. J 9 1iJ Qa4 o k— �-3-iv Ci At n v v I N ti �a,; •, 442 FARRWQQD DR - Z E, W = ` I 0183b -Ab F OD 84 07//1437 =6 64407 OP ID: OUJA r CERTIFICATE OF LIABILITY INSURANCE DATE(M07/001/1111 YYI) 4 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY 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 ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone: 978-688-6921 Macdonald & Pangione Insurance CONTACT NAME: P.O. Box 428 Fax: 978-688-5350 104 Main Street North Andover, MA 01845 Donald Schemack PHONE (FAI, A/C Ext' ac No E-MAIrLL ADDRESS: PRODUCER MELUC-1 CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: Preferred Mutual Ins Co 15024 INSURED Marc Melucci 442 Farrwood Drive INSURER B: Haverhill, MA 01835 INSURER C : 02/24/14 INSURER D: EACH OCCURRENCE $ 11000,000 INSURER E: MED EXP (Any one person) $ 10,000 INSURER F: nCVICIVIV IVUMtftK., THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. IN8RLT, DDL UBR LTR TYPE OF INSURANCE POLICY NUMBER MM/IDDY EFF MMND EXP LIMITS GENERAL LIABILITY A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR BOP 0100 70 5105 02/24/14 02/24/15 EACH OCCURRENCE $ 11000,000 DAMAGE TO RENTE[T_ PREMISES Ea occurrence $ MED EXP (Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: TX POLICY JFCT PRO LOC AIJTOMOBILE LIABILITY ANY AUTO(Ea PRODUCTS -COMP/OP AGG $ 2,000,000 $ COMBINED SINGLE LIMIT accident) $ BODILY INJURY (Per person) $ ALL OWNED AUTOS BODILY INJURY (Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE (Per accident) $ HIRED AUTOS NON -OWNED AUTOS $ $ UMBRELLA LIABOCCUR EXCESS LIAR HCLAIMS-MADE EACH OCCURRENCE $ AGGREGATE $ DEDUCTIBLE RETENTION WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETORJPARTNERIEXECUTNE OFFICERIMEMBEREXCLUDED? (Mar►dd cr in andNH) If describe under DE CRIPTION OF OPERATIONS below N/A $ WC STATU• OTH- TORYLIMITS I ER E.L. EACH ACCIDENT $ E.L. DISEASE - EA EMPLOYE $ E.L. DISEASE - POLICY LIMIT $ t DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) r11=RTIt=111ATC uni nco n SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE I O W N OF Q2N A T N-oov�' / MA- I THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE C2- &� L-____. v IUt$ts-ZUUy Ac:OHD CORPORATION. All rights reserved. ACORD 25 (2009/09) The ACORD name and logo are registered marks of ACORD Date ... ............. TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ..��— .�aJl A -f... - ). . ............................ has permission for gas installation ........ ........ in the buildings of...............ty-, A — 0 ...................................................................................... at .....b v ....... . .........North Andover, Mass. ..... ..... % Fee.b.() . . ...... Lic. No.q.3:�� ...... �, . ...................................................... (2-711-0- GAS INSPECTOR Check # G TYPE OR PRINT CLEARLY MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY (�(> p�J� MA DATE Lou JOBSITE ADDRESS --_ OWNER'S NAME OWNER ADDRESS yl (�TELA OCCUPANCY TYPE COMMERCIAL_ EDUCATIONAL _ NEW: RENOVATION: _ REPLACEMENT: 211 FLOORS BSM I 1 1 2 1 3 1 d I r I c I, BOOSTER CONVERSION BURNER COOK STOVE ` DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM / SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER PERMIT # iFAX RESIDENTIAL PLANS SUBMITTED: YES .7 NO 7 M®w I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES VNO '17 1 IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 71" OTHER TYPE INDEMNITY — BOND BOND OWNER'S INSURANCE WAIVER: I am aware that the licensee does nqt ,have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. SIGNATURE OF OWNER OR AGENT CHECK ONE ONLY: OWNER AGENT I hereby certify that all of the details and information 1 have submitted or entered regarding this application are a and accurate t a best of my knpwledge and that all plumbing work and installations performed under the permit issued for this application will be in m Iia wit IIP ' ent provision kn e Massachusetts State Plumbing Cod and Chapter 142 of the General Laws. RLUMBER-GASFITTER NAME' LICENSE # ATURE MP MGF_ 1 JP _ JGF _ LPGI _ CORPORATION V#s� PARTNERSHIP _# LLC `# I COMPANY NAME. ¢' G.ADDRESS CITY a STATEZIP TELVW FAX CELL, EMAII, /l M 5 on 1^ l8 /` iwn .� ., �..r- .:.-- p to The Commonwealth of Massachuseas Department ofbdustrkdAccidents Office of Investigations I Congress Stree4 Suite 100 4 Boston, MA 02114-2017 ' W%W m ss gov/diai- Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Apiplicant Information Please Print Legibly Name (Business/ownizeon/lndividual): G,e, Address: ve.A 4 La iatate/zi : Q.yn Phone #: — 13 '' � Are you an employer? Check the appropriate box: �4'.v I am a 1. ❑ I am a employer with ❑ general contractor and I Type of project (required): employees (full and/or part-time).* have hired the sub -contractors 6 New construction ❑ 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. -7, ❑ Remodeling ship and have no employees These sub -contractors have S. ❑ Demolition working for me in any capacity. [No workers' comp. insurance employees and have workers' Camp. insurance.-' 9• Building addition reqs] 5. Ye are a corporation and its 10.❑ Electrical repairs or additions 3. ❑ I am a homeowner doing all work officers have exercised their 11. ❑ Plumbing repairs or additions myself (No workers' comp. right of exemption per MGL 12. [J Roof repairs insurance required,] t c. 152, § 1(4), and we have no employees. (No workers' 13.0 Other comp. insurance reeuired.l *My appleantthat 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 state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. IM an employer that is providing workers' compensation insurance far 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. I do hereby o der thf pa s and f9aWn of per t the information provided abpve is L.4 6-7 u 1 O,p'kW use only. Do not write in this area, to be completed by city or town offie is City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Plumbing Inspector 6. Other Contact Person: Phone #: COMMONWEALTH OF MASSACHUSETTS PLUMBERS 9MLMFITTERS T ISSUES THE' FOLLOWING LICENSE LICENSED AS A MASTER PLUMBER ROBERT A SAMMATARO Cy 8 DUNRAVEN RD U WINDHAM NH 03087-1263 9333. 05/01/16 226084 v COMMONWEALTH OF MASSACHUSETTS PLUMBERS 9MLMFITTERS T ISSUES THE' FOLLOWING LICENSE LICENSED AS A MASTER PLUMBER ROBERT A SAMMATARO Cy 8 DUNRAVEN RD U WINDHAM NH 03087-1263 9333. 05/01/16 226084 North Andover MIMAP October 16, 2014 11048"201;. #81 104-B-0 6 .-"116 #97 ------ 104.B-0213 ­104B-0200 r:_ #102 ------ #96 ... ...... .... 1041"20S.'L..* #93 -o17-3 104.B-019 #103104.B-0214 IOUM199-. - 104.B-0215 #105 #102 7 -04.B -0199 #402. ... . #110 104 4411 041"133.... 04. 177 #166 104.B-01,72 #175 ----- -- 104JM180 #120 104.B-0134 104A"179 #154 10544)004 #163 7.:' .4 104.B-0135 104-B4HM N� #142 #167 104.E-0178 104-BIR-0128 #151:- 1, •• 4� 104_B-0182 #155 #162 #132 04.&00.23. 104A-01 #143 #143 104'B-0136 104.B-0127 #141 IMB-01 #131 s�l #136 104-B-0185 104.B-0126 104!B 0137#131 104-8-0174 #124 i #88 104.B10186 ---#119 104.B-0138 #1101 #114 104.B-0187 #89104.B-0188 104.E-0123 #70 104-B-0140 al, 104. 104J"141 #77 104.B-0139 6�e dih il. 104.E-00119"* 104.B-0142 #67 4 Al #50 4.B-0143 104.B-01. 0 #55 .qtr 1041"144 1.04: -0171 105.00041 nuc ...... 104'.81011 #43 #28 447.0 . ..... . -5, 0Q42 105_C 048 :.#530 105.C-0003 05.C-0040 105.C-0043 #38 05.C-0044 105.C-0005 #7 105.C-0037 #37 #10 105.C-0025 105.C-0045 10 -,-m7\ 'fos.C=00 0 _,�-�105-C-0009#501 #525 '.�.k #557 - Rail Line =« Wetlands Zoning Interstates Exempt Lands - I I Bu:inei I Busine : 1 Di:t 2 District Horizontal Datum: MIA Stateplane Coordinate System, Datum NAD83, SIR Roads Co Easements 13 Butnei : Busine a! N Genera Planne, Corrido a 3 District s 4 District Business District Commercial Dev Development Dist tholi Of "90 ". 6 Meters Data Sources: The data for this map was produced by Merrimack Valley Planning Commission (MVPC) using data provided by the Town of North Andover. Additional data provided by the Executive Office of Environmental Affairs/MassGIS. The information depicted on this map is 0 MVPC Boundary 0 Municipal Boundary Corrido E3 Corrido Development Dist Development Dist All W, Z for planning purposes only. It may not be adequate for legal boundary definition or regulatory interpretation. THE TOWN OF NORTH ANDOVER MAKES NO WARRANTIES, EXPRESSED OR IMPLIED, CONCERNING ndu In s3,2 I I D in t Zoning Overlay Adult Entertainment �n dust n Industri District . c� il 3 Diis nc 4L THE ACCURACY, COMPLETENESS, RELIABILITY, OR SUITABILITY OF THESE DATA. THE TOWN OF NORTH ANDOVER DOES NOT Downtown Overlay Distinct E3 Industri it S D strict clma 4- ASSUME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE OF Historic District Water Protection Reside Residence c ce I District 2 District THIS INFORMATION 0 Parcels R-ide ce 3 District A U Hydrographic Features 1" 295 ft de _'(�'d 4District ce 5 Dis 1ri t Streams de ce 6 Dis nct ge esidential District Date ...: - G .... ......................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that_ ' has permission to perform....Q'G ' ` L ...................................................... wiring in the building of . ��� %� ��✓ .................................................................................. at X 8 i�.�!'� �7�%� /,)/,o . North Andover, Mass. Fee ....:�!5 '.. Lic. No.. 5;71.'7 ! C`......... J/J} ' �.,'...T . .. ........ .. �.. ��7.. :.1....Ayr .... ELECTRICAL INSPECTOR/ Check # lU b 1 r .•,,,.,f,r,, �..uur,nws�l,trtry r�nrfnurnk r`� r �'ry _,7c;,;trrrs Perini INlet / QcilRIF�,E7O! FIRE,F'f2 V1"ivTiOt�tf2 C;tt1 t�Tlt�Nr" ( cuPAI'myan.inae(:h>>rt ,R4 ,> E? c v f 1 /9� j tc a vc D►an """"'...�,,,-•...�,,...>~ APPLICATION FOR Pr'WAIT TO PERFORM ELECTRICAL WORK r\tt 11•uttt IQ MC (fCriplfYM:) tri �Crntt•IG„t'f' •+,I� ,•,: \4.,sr,.,t�•I„urns {:t,,•^irrtat (.'P,lc iA1C1” ll'1.1,'rI S(' h'lt1rYT IN INK OR TY,I-11” •I 1. t t,vl r��t +ate: 1 5? r cntr� t a pa City ar Tolvi} of: Til rhe t,r. _" A.l ..-. %1 f1t'�_.. si c�rlor' �f it i, icy tlr,s dpyal+t:altuct the lin(iRrj1pt.+ tv ,1i �,i r of It t i,: t fnlesll,t�n Ill , �EI l�C� `, prriu� t the , i/c+tical vvOlk described below.. %.ptatiun (Siract .0 i�turinccrl - _...., ._ Owner or 1eflant ".•. TCir iJllQttR 1A. Ciwnrr'.c rltlt,tras� .,___.. f.-„__..,-.-_.__.,..�,-.._.,,_. �,.,...,..,...•.,,.,.,,•.�..,,,•..,. 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L.ara1 ( tyltitlieip.'� Ir 11Crfin�Apitil:t,rrrg ce Ar celiait i C�11lar ,�flr Af"11ft'r -- 1�\y CcurflV Yslarrw�m""""""°°'�"°'^R^�^ pf Devicts ar uJvnlalft +�o. Lfrrfrottta s �",�I,s..._,,_�__. O.. s^a��lrttrt)'s,.._.�..ryn^Af!1f;(Itl.4.._..._ ToJ1ij{)'� ...-. x,110 11�cxlccs s i� rlirnla}!t ER: � - ' NO �f [?t elltlAtl t' f}�' _. _..cl�icfs orl�Jr'ull�nt t if\St,1t kN('l;. ('t75 I! It.1 _ (00( If .111,11 4,,el r9 G' Urticss �aa,vcd by the a„Iter, itn pr nt: rCur titrinrl list lir'cn"C rnv �r r!s rA�rrir Pr/�y rhQ h,sporc,rar gjlVirrJ R u1.^S Proof of itabtltsy ,t,surznr.s” it,s►Irrl IC coni letrcl (,pc per(crrmarrce Of C}+tcrrical w Lind"I'signrd c,crilfics thsl such r over t p , cratrgrt' Cavarltyie cat ;rt ori; ntay istasto urtlese "FL in f�lrc, ; „d r..ic r cl„hrred rrr,cicf sar,tc ra tI,F arntii iusl�' Q��sc��lvl)lelit. 'Tito (.[�'�'/) G..K��Q tiI En. Inr Ra�Pf ("'C.iit r _ r,•QA�t^r'A� l / V IR Yf i �,•ih . MAI r� Csli�r,,tlr!r{ Valrre rf f:lrclr�cal 1WOlj; _. -- . _.. 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Aisem[:: �!�.q _ I 1 C. 1 alltfrcSS: r,...�� lf ! 1.Ir st t.tc c)»rvrt:R'S IN,5l+t; Cvcl^x,11 re,7vrrr a h q ,lte k.... ,..,1�f, +q�;^e/ i 1 11' PC Pill .iry�11,1+,IrG t?CtSly f l .l,l.•.5 .1�1l trn, e, rrla f,� Tt'i i1a QYI rrRi-ttig lli I I('I r!, t, ._.cervi• ,i,i, r , biirr) I I,fr arta •n»+n+^....w„ Sig ft t,t., k.n �� r cm er.i� tltaChslily ON' "• .r ",t Islip I'll i utr� i,Jn(y +PrJAr/nurni r`� `�'rr _,•Jc;+�,,'af Ttrt incl T g BOARD Or FIRE P RFV(=VTION C;tr!,�TIc,N�� PCcC,PAncyanr tillFell •tetC4 ` ll'1.t"r�sf' h'1flrvTl.V INK oil1r�Plpl�htCtlQInl.:r�t_n'yrt�l;..+.nfc,,•„%.�C,'�,� \,dj�,l 11/90) APPLICATION FOR PETWIT TO PERFORM (txan','oli T}�'a •t�rtrrcll,l:,nr_(t�.'n�sd�/c ,jk�Arl tCoI�"rl' r p51—y',1 G�' �(".1.Q., .�..,,,.,...,R111 Rtlrtt 10 heYP ,11 L r/)r't UCity or')'alyll t,f: Dyth,A dpsltc�llun tile undtrs�I� I }rcrOf ,r�t .,,,. lui1 l �s. 1-Ciepliuu (Slroet & VurrlI)Ct) Ac% Jrnf (he/ c'ccnlcal wntli descr,bcp9 G o%oi� o1VCIGr or l l'il!tllt , ...�,f��(L)? /��,._A G`/71l/� f v+r-_ O11'npt'.t Al I-Jraij _,,._..._,_ 'll............_••�r• .-,. _., K._l!. •C� III this permit itt eon)uncliurl !{ill :t ll lillll}1« llrr +, {' 1 fS �.,- - . _ _ ��_,4 t'{,p Jlrrse of tAuilrJirlK _ _ i_.� No � (ClIR,lC r� I,rr x~ ! 0�lrial0 �io,ry %�.�.Lt.C_�_.._.....----- •--.._.. 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A `NORTH 0 WA vomit w SACHUS Date.-: TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that has permission to perform ........ ......... r" .......... plumbing in the buildings of ........... : .................... at ............. I ............. ........ North Andover, Mass. Fee. Lic. No. .. ...................................... PLUMBING INSPECTOR Check # V`il X7 F MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (P,rriint/or Type) z%�j/�%� . Mass. Date Permit # Building Location 8 DUr) Car-) sOr Lie _Owner's Name / 78 — CO R 9 -3,5 %cP Type of Occupancy Residential New CI Renovation OReplacement QQ Plans Submitted: Yes O No O FIXTURES Installing Company Name Heritage Htg. &P.lg. Co. Inc. Check one: Address 3.5 p easant Street IX Corporation Stoneham, Ma 02180 ❑ Partnership Business Telephone—.781 — 4 3 8 —7Z 7 6 f-1 Firm/Co. Name of Ucensed Plumber Gordon Switzer Certlficane 714 INSURANCE COVERAGE: I have a current Ifaaitity Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes ® No ❑ If you have checked Vis. please indicate the type coverage by checking the appropriate box. A liability Insurance policy CK 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 O Agent ❑ I hereby certify that all of the details and information I have submitted for entered) in above application are truo and accurate to `he bost 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 provisions of the Massachusetts State Plumbing% Code and Chapter 142 off the General 1Laws- BY �/ / i 1/7 T./1) O/1 / na ure of Licmsed Plumber Title ' Clty/Town Type of license: Master [X Journeyman ❑ APP O O License Number 8 3 2 2 %z" Watts 9D bfp on water line to water boiler _. f Z Ne Q4 Y W W J N of O U Z;OLi ►<- 47 O N rt n Z Z 41 < Cr2 •Y j ( W n o S h U •; w N Y C a o W Cr O Cr a r ¢ r < W O J _ a C O '' N^ x Cr. ►w v i o = a w 3 z rn o cc w Z z w ►w o v N G < F t < < S w N 4 Q O < J .00 J < M Cr CC Q 0 < 49S- 3 Y, m p 3 s u< 3 a_ m 33 33 SUB—BSMT. �— BASEMENT IST FLOOR 2ND FLOOR `ORD.FLOOR 4TH FLOOR STN FLOOR 6TH FLOOR TTH FLOOR BTHFLOOR Installing Company Name Heritage Htg. &P.lg. Co. Inc. Check one: Address 3.5 p easant Street IX Corporation Stoneham, Ma 02180 ❑ Partnership Business Telephone—.781 — 4 3 8 —7Z 7 6 f-1 Firm/Co. Name of Ucensed Plumber Gordon Switzer Certlficane 714 INSURANCE COVERAGE: I have a current Ifaaitity Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes ® No ❑ If you have checked Vis. please indicate the type coverage by checking the appropriate box. A liability Insurance policy CK 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 O Agent ❑ I hereby certify that all of the details and information I have submitted for entered) in above application are truo and accurate to `he bost 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 provisions of the Massachusetts State Plumbing% Code and Chapter 142 off the General 1Laws- BY �/ / i 1/7 T./1) O/1 / na ure of Licmsed Plumber Title ' Clty/Town Type of license: Master [X Journeyman ❑ APP O O License Number 8 3 2 2 %z" Watts 9D bfp on water line to water boiler _. f T J z O W N O W U U. LL O a 0 3 O J W m N W x U N z O U W a N z_ J Q z LL m O r U W CL N z 1 LocationG•- a' No. 1- r Date �aRT� TOWN OF NORTH ANDOVER Certificate of Occupancy $ ` ♦ i i Building/Frame Permit Fee $ +.�s'^•°' E sACHUS Foundation Permit Fee $ Other Permit Feet-- - _ $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ / Building Inspecto .! ,08/06/98 10:13 25.00 pAID Div. Public Works Location No. Date HORTM TOWN OF NORTH ANDOVER F a Certificate of Occupancy $ ` Building/Frame Permit Fee $ Foundation Permit Fee $ SACH Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector Div. Public Works fn I JP z f-. L c a U w V) z z C - i- n 5 � c W N m U L cn VI W Ji z W v +n C w ¢ G w is , i t u Y z U i O d N Cn N F- X A z w w � z z �< 3 c k -K � < J 3 Cd C cCia J C 5 O r Q Z r C c ... Z = mx Q N � R �— w z< ? - c L. 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