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TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ....z2............. ~`........................................................
has permission to perform......- - ...... ..............................
wiringin the building of .......... .......... -3...... I ..................................................
.
at ................................... ........!'- ........... , North Andover, Mass.
..........
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1 Fee .................... Lic. Nod- �J1..._ v =...:..... ' .. ...
ELECTRICALINSPECTOR //
Check # U3 /V!
667
_J -
Commonwealth of Massachusetts
Department of Fire Services
Permit No.
Occuranc% and Fee Checked `9 J
BOARD OF FIRE PREVENTION REGULATIONS [Rcv. 9 051 ileavc hkink)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
SII '.pork to he pertormed in ;1"ordallce with the \(:usadlLISC is Hcctric,al Code t\11:0. 52" (AIR 12.00
PLEI,S'E PRI,%T LVINK OR TYPE. ILL INFORH I Tlo,V) Date: ����,��(�,
Cih, or Town of: �rJ A A�,6(ert,,et TO 111Ch7NIVL"1tu• u/ It"hT :
13y this ;application the undersigned gil,es notice of his or her intention to perform theelect ical work described below.
Location (Street & Number)_ PC1 /7 ,—(
(honer or Tenant /� I,G i/1 d, YICZ2h 7 Telephone No.
Owner's Address , z!j
Is this permit in conjunction with a building permit? Yes ❑ No [2' (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service AnIps / 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:
IA
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
kbove In- : o. o Emergency Lighting
Swimming Pool ;.. ❑ ❑
-Ind.Battery !'hits
No. of Receptacle Outlets
No. of Oil Burners 'FIRE ALARMS No. of Zones
No. of Switches
No. of Gas Burners No. of Detection and
InitiatingDevices
No. of Ranges
No. of Air Cond. Total
Tons i� N o• of Alerting Devices
No. of Waste Disposers
Heat Pump
Number
Tons
KW I No. of Self -Contained
Totals:
,DetectioniAlerting Devices
No. of Dishwashers
Space/Area Heating KW j Local ❑ Municlpal❑Other
Connection
No. of Dryers
Heating Appliances KW Security Systems:*
V o. of Devices or Equivalent
No. of Water
No. of No. of
Heaters KW
_Signs Ballasts
Data Wiring:
No. of Devices or Equivalent
No. Hydromassage Bathtubs
No. of Motors Total HP
I clecommunications Wiring:
No. of Devices or E ONalent
H I OTH ER:
Ilru:ir ;Jr./rrrr;nu; ,/rr,Oil r%,/rs,rr'rl. A',ra r'r /urrc l /%1 ,!1c I1 .1/, ,_I -J• I
s F.,:timated VJuc of Electrical Work: fz�0 (A hen required by mwith unicipal policy.)
k�ork to StarC �� In:,pcctiuns to be rciiueSted in accordnc
ae EIEC Rlllc 10, and upon completion.
IiNSLRANCE C'OV ER,\ :E: L.nicss lvaivcd by the owner. no permit for the performance Ofclectric.d work may i';sue unlc
the lic(AlSeL pri:%ides t,roofofliahility insurance including 11complctcd,rperation' covera.,e ur its "t11-slantial derat. i hr
n�lcr;i.nc.l cerritic: rhAt :uch c,l�urt ,c i:. in force. ;nld h;is hihited pr,wfcf:;arle to the permit i:.:uirr oI ice.
�.� i fl!I.R �� I hccily:,
Inder 11'r p/aJ�!!1t ll//1 /)<'t7lA/11[•.Y !f /)C'I'l///'t', ;rl r// r/AP aAfOl'�yr11 /rtl/ 17 .'111.1'
Licensee: �r�%j(/@ _51��1� C d/ _ ;i ll.atllre tCl., Aj
�>(® JL.. i 0_ p�
_ -n/,r :rrri,tl,�_,1 ni• �,rc., .- �� ,,��
Address, s .., ; 1_ s1� Alt. Tel. No
Security Sy -acro C,)nt•actor 1,iccn;e rcLluiRcd tirr this %`,Grk; fftipplic,ible, cntcr Lilt: license number hu•e:
0%NF_R'S INSURANCE �NAlVER: I ;irn mv;n•c thAt Ills I.i':cnrec ,/.- nr/ havc the li;.ibihty insurance c rn. rir,;111ti...
ic1.11.lircd by law. (3y nl\ si, nahuc bclol-v. I hereby this; rr�luircanurt. I ;1111 the (�.hcck one) ❑ c>wnur ❑ uw;ur':> .ae,,:nt.
Owner/Agent r/(
+;;al8tut'e a,, ., .. PFJ? WIT 9 VJI' '• & v
Date..! ....!...... ......
,,ORTN
Of.
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that..... '��: ... .................
has permission for gas installation ... ... ..............
in the buildings of ..............................
at ...... 2 . ............. North Andover, Mass.
Fee, ... �. Lic. No. ...........
GAS INSPECTOR
Check #
5347
1VIASSACHUSEI'I'S UNIFORNI APPUCATON FOR PERMIT TO DO GAS FTrrING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
Date
Building Locations ,� ` `fPermit # `y7
Amount $
Owner's Name_2�
Newj /,i Renovation Replacement Plans Submitted
(Print or type ��®® / C one: Certifi el�nnstalkyyg C pany
Name ��� L`Z1��G� /�� Lam.! orp. �C,.l. 0 C
Partner.
Firm/Co.
Name of Licensed Plumber or Gas Fitter �4,2f7l�
INSURANCE COVERAGE• Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes M11 No 11
If you have checked Yes, please indicate the type coverage by checking the appropriate box.
Liability insurance policy M— Other type of indemnity 13 Bond 0
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 0 Agent 0
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 Permit Issue for this application will be in
compliance with all pertinent provisions of the Massachuset s Co a�t�j4 the General Laws.
/ _A� ,
Title
City/Town
(OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
Plumber
Gas Fitter License Number
,§_
aster
Journeyman
4TH. FLOOR
(Print or type ��®® / C one: Certifi el�nnstalkyyg C pany
Name ��� L`Z1��G� /�� Lam.! orp. �C,.l. 0 C
Partner.
Firm/Co.
Name of Licensed Plumber or Gas Fitter �4,2f7l�
INSURANCE COVERAGE• Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes M11 No 11
If you have checked Yes, please indicate the type coverage by checking the appropriate box.
Liability insurance policy M— Other type of indemnity 13 Bond 0
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 0 Agent 0
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 Permit Issue for this application will be in
compliance with all pertinent provisions of the Massachuset s Co a�t�j4 the General Laws.
/ _A� ,
Title
City/Town
(OFFICE USE ONLY)
Signature of Licensed Plumber Or Gas Fitter
Plumber
Gas Fitter License Number
,§_
aster
Journeyman
4
6257
Date....
O"T"
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ...... 4.�fL ..4:7 r
................
L 0'r
has permission to perform ........ 7,7q .... f wl.k A .. ... 41 - r
wiring in the building of ........ ...................
... . .......
-.e at ........ p ......5 ............... . North Andover, Mass.
Fee..��.q.��. Lic. No..1.7;—VA ............. A.41-1 ... Aw� ..
Check # ELECTRICAL INSPECTORf 674-
-e�625--
;� _ t�crnrrn�cvea� a� f�ja:r9ar�zsr.�a!Cs { j7, ,isc �r:iv
Permit N-0.
�.C.!¢fartrtse:sl of Jere Jer•icsg i
r < i nCC -Fancy and Fre (_.hec4l ed
BOARD OF rlRE PREME TION RE s �i.AT!0;\jS � _
APPLICATION FOR PERMIT TO PERFORM EL
.1li �uECT �� WORK
work to tIc �:.r!'omzcu i:: accoti:tilre with t;:c tiassariiusctiS _ 4 �''
rctr:c:zi C-ztc I;rSL i }, X77 SSR 1-10
(PLEAS-' ,�i ;iy- ;;`i lr�/�� OR 7YP AL 1jVi '0JzWA7 0r'ii
City Or
own o:"he I�rspectoj j bY'r es:
By till$ 3p1?tlC3td0 I 'd -4e t122fCZ5igit£d givcs !I(�Qii--C or His or her intentIou iC �CI:?rrYt !l:e e1CCirtCai work S CSCr1Ee�i FJ t( 1V.
Location (Street & -Number)/ ! Gj �S�thtln� ��_
Owner or Tenant Lh)n1A �I6� i)Yn - q Q'�
Owner's Address SgY�li � e____
:S this permit ill coll'utictioll with a builtlitlg ptrrnif? Yes F !t No (C23ccf; Appropriate Box)
Purpose of Building �_ Ulilil-v Authorir:ttiou Nu.
Fxistitlr Service+ Z6 Volts r:crfzcad !X L•" -Blur,
:'ie SCrScrt iz<r: = rant( :s - d Volts Ovencc:wt � 'Jlldgrd Q
iYum4er yr Feeders atld Anspacity
No, of Miners.
No_ of t%Ieters.
— _ _� _
No. of R ccsscd Fixtures
--s ----- -: -._ , _�_
idC. OLCS2 .-SzlSl3. (I'a�diGj I �!tt`
_
.� ,<.•.r ve ,.uireu U urr 11 rerorol tr rrrs.
t.o. o Ott ---
FratlSfOCI1tt rs VIA .
No. of Lig.'.Itsng Outiets
�rl� —��
i o. of Lic; ti..- Fixtuscs
No- of Plot Tubs
�.be,.„e r --Ir- -�
S� 017<Iing Pool ' . ; `[�
Qf:tt .i:a
'Generators 1^*,° A
"_ O. o�er eliCV 36 Inn
g b g
Batterj- Units
`'lo. of Receptacle Outlets
IN , of fail Burners
FIRE ALARUNIS No. of Zones
No. of Swit£lie5 �!LNo.
of (las Bursters —
710-,-07'B e i e c t i c nd
Initiatins Devices
of Rnnges
_- -
3No. of Air Con�l.— �5''
beat 4'u OT Num' er 3kii�`V_
leo. ofAierting Devices
INO. o Self -Contained
'o. of �V gate Disposers
Ike”.Foals _
- __ . _..^�`
^t
Hetet fiot3lAletiin�+ De -,ices
r
4i o. of ibis:rwasliers
?
iSp=.'Area Heating a��4'
--- `--
!S .2213icip?
1 �fial Co33nCcitOla 0 Other
e
!.`io. of L)rvers
` _—
Heati:a4 Appliances 'i� #
_
-!�i!r.
ee urif vsoen .
Y �_
I No. of D-zvices or Equivnient !
IN u. of V:jter
iiiV
INC. of of jData
3Viriaz¢
fIe It ; s
—_
any lzadlasis
1""0, of Devices or Ec3uiy2;ent i
_—i
o ) i
tit 0. fiydrotllassage Batit.ubs
Y T_7I? !l
N o. of Motors Total . (
C e"zona unic ati— ons Wiring:
No. of Devin's or Egstiva.ent ____ .�
OTHER: 4
Y _
Afrac;lt additioval rderaid if desired• or as renis -ed by ifte lnspecter of :Vires.
I`+SURAN E COVERAGE.: [unless °.waived by the owner, no permit for the per:orman- ce of electrical wori: , may issue unless
tine ticansee provides proofof liability insurance including "co -;Meted operation" coverage or is sul=standal equivalent. The
undersigned ce.ti=les that such coverage is in forr_E, and has eximihited proof of sarre to "line permit issuing office_
-H-CK CtiF: itiSUR.1 NI C -'E Pq BONID D O"Fl-1ER ;Specify:)
(Espiriion Datei
t' Estillmated 1, 4,ue of Eicctrical Wolk: ZO(Xi. (When rc iuired by municipal poiicy.)
{ '�,4'ork is S!.art; 17-1'& 105 Inspections to be requested in accordance with MEC Rue .10, and wpon corlpletion.
Ir certify.. rarr,der• ih e'adds as?rrd peirrrdties q perjury, that the inkralation Cir this application is trite and eomptete.
FIRUNI NAINIE: Arel E1eQpriQ - Tnc - LAX. NO.:__l 72.381>< --
Licensee: Richard J. Arel _Signator LIC. I`+;'O.• 27514E
ffgppli-rCbie, rtrr 'er u(In :n :he!)cens ruu;rne, direr',}Bus. Tel. Noa_ 978-372-1601
Address- _Waohi agLp -31 Alf. Tel. No.: -0S -302- 187
OWN R'S INSURANCE NYAIVER. ; anm atitiarc t11ai f?:e Lirelssee do{•s nit llr•a•a ilme liability insurance coverage norrnal
required by la.-•, tit• a.;+ signature below. 1 hereby waive this requires tc::t, i ain the (check one) C owner [] oNvner's agent.
Olytler/A�:_.:t
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Print or TWQ JJ
NORTH ANDOVER, . Mast DalsG _10
sanding Perink
Location
/ Owner's
Name ash
New ❑ Renovation ❑ Replacement ❑ Plans Submttted: Yesl] No. ❑
FIXTURE$ ..._. _...
Installing Campa�y N
Address
Business Telephone .moo 641- 15 5 d
Name of Ucensed Plumber.
Check one: Cartyleate
❑ Corp.
❑ Partnership
['Firm/Co.
�GL %
INSURANCE COVERAGE: Che2k one
i have a current liability Insurance policy or its substaniW equWenL Yes ❑ No ❑
It you have checked yn, please Indicate the type coverage by checking the appropriate box.
A liability Insurance policy gh Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the Ilcenses does not have the Insurance coverage required by
Chapter 142 of the Mass. General Laws, and that my slgnatsse on this permit application waives this requirement.
Check one:
Signature of er a Q*net s Agent Owner ❑ Agent ❑
thereby certify that all of the details and information [hays mAxnitted fol entered) in &bow appfk0lon sue trw and accurate to the bast of my
kno rted a and that all plumbing work and instailaltons porfotmed under the pert" Issued application Will be In complancs with all
pertinent provisions of the Massachusetts State Plumbing Cade and (?rapier 142 of the. Laws.
By
Tule nature
at Ucansod-Plum
CttylTorm Ucense Number
Type of Plumbing lkense: Mas(et
AF'fIUYTD (OFF)CE USE ONLY) Journeyman 0
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1ST FLOOR
1MOFLOOR
$110 FLOOR
41rH FLOOR
STH FLOOR
STH FLOOR.
JTHFLOOR
STH FLOOR
Installing Campa�y N
Address
Business Telephone .moo 641- 15 5 d
Name of Ucensed Plumber.
Check one: Cartyleate
❑ Corp.
❑ Partnership
['Firm/Co.
�GL %
INSURANCE COVERAGE: Che2k one
i have a current liability Insurance policy or its substaniW equWenL Yes ❑ No ❑
It you have checked yn, please Indicate the type coverage by checking the appropriate box.
A liability Insurance policy gh Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the Ilcenses does not have the Insurance coverage required by
Chapter 142 of the Mass. General Laws, and that my slgnatsse on this permit application waives this requirement.
Check one:
Signature of er a Q*net s Agent Owner ❑ Agent ❑
thereby certify that all of the details and information [hays mAxnitted fol entered) in &bow appfk0lon sue trw and accurate to the bast of my
kno rted a and that all plumbing work and instailaltons porfotmed under the pert" Issued application Will be In complancs with all
pertinent provisions of the Massachusetts State Plumbing Cade and (?rapier 142 of the. Laws.
By
Tule nature
at Ucansod-Plum
CttylTorm Ucense Number
Type of Plumbing lkense: Mas(et
AF'fIUYTD (OFF)CE USE ONLY) Journeyman 0
N2 - 284®
Date.. :756
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
0
o
This certifies that ....L; v.+�
has permission to perform . . K� rvCti,
plumbing in the buildings of ..... .. ... . ...... .. a
at.............. .. , North Andover, Mass.
Fee ... ..... Lic. No..l. /. ... ............... ............. M
0
PLUMBING INSPECTOR
WHITE: Applicant CANARY: Building Dept.
PINK: Treasurer GOLD: File
MASSACHUSETTS UNIFORM APPILICATION FOR PERMIT
TO DO GASFITi1N1G
(Print or Type)
NORTH ANDOVER
Mass.
Date
I
_ tuilding Location gjl%p
Permit # U
�5
Owners Name
r'
New 77 Renovation II
Replacement Plans Submitted
n
(Print or Type) % Check one: Certificate
Installing Company Name )'YI�/�✓ / Q Corp.
Address oGf Partner.
�il/1 ! l^� //�h �0 ► ��j/��f Firm/Co.
Business Telephone:
Name of Licensed Plumber or Gas Fitter G't
Insurance Coverage: lndic::e ::-:e of insurance coverage by checking th
appropriate box:
Liability insurance policy e] Cther type of indemnity = Bond
Insurance Waiver: 1, the undersicned, have been made aware that the licensee of
this application does not have any one of the above three insurance coverages.
Signature of owner/agent of property Owner U Agent Q
I hereby ccrtify that all of the details and information I have submitted (or entered) in above application are true and aeeuzate to the best o! my
L"towrtcdse and that aft piumbin; work and instathatioes ;eszarascd unCC' Ptrr it iz=ed ro: this sppue►tioa will be is pIianoa with ad pe=ttn=t
provisions of the uaasaG4us4tJz State Cas Cade and Czaptez .14-",:.f t: a Gc.t--ai Lawn.
By TYPE LIC �tG'
L P uLub e r
Title t Gassitter Signature of Li sec
City/Town: raster P ewSir asfitter
Journeyman
APPROVED (OFFICE USE ONLY) —Tc'Pnsee Number
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(Print or Type) % Check one: Certificate
Installing Company Name )'YI�/�✓ / Q Corp.
Address oGf Partner.
�il/1 ! l^� //�h �0 ► ��j/��f Firm/Co.
Business Telephone:
Name of Licensed Plumber or Gas Fitter G't
Insurance Coverage: lndic::e ::-:e of insurance coverage by checking th
appropriate box:
Liability insurance policy e] Cther type of indemnity = Bond
Insurance Waiver: 1, the undersicned, have been made aware that the licensee of
this application does not have any one of the above three insurance coverages.
Signature of owner/agent of property Owner U Agent Q
I hereby ccrtify that all of the details and information I have submitted (or entered) in above application are true and aeeuzate to the best o! my
L"towrtcdse and that aft piumbin; work and instathatioes ;eszarascd unCC' Ptrr it iz=ed ro: this sppue►tioa will be is pIianoa with ad pe=ttn=t
provisions of the uaasaG4us4tJz State Cas Cade and Czaptez .14-",:.f t: a Gc.t--ai Lawn.
By TYPE LIC �tG'
L P uLub e r
Title t Gassitter Signature of Li sec
City/Town: raster P ewSir asfitter
Journeyman
APPROVED (OFFICE USE ONLY) —Tc'Pnsee Number
of ,AORTPI TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATIONCL
cu
Ui
This certifies that cn
has permission for gas installation
cn
in the buildings of .......... .................
at ................ North Andover, Mass.
Fee. S. ---_Lic. N ...........................
GASINSPECTOR
WHITE: Appirc-ant ANA. r'-5—wilding Dept. PINK: Treasurer GOLD: File
�.,^i37'i...,,,�,.�.r-..�..-'�---v.-'..'v7^iatw•-..+rK ��_- u� ,�i+'�-�-+ "�"er-'"""'�`' :: - «�*��"1�T1"'ri`�4,
Date/0/1-/j-
k
3833
TOWN OF3g NORTH ANDOVER a
� a
p PERMIT FOR PLUMBING ui$
I
This certifies that !!?.G...���. .....................
has permission to perform ...Ir ..... .!-/ ..................
1
plumbing in the buildings of .....................
Q
at ...% ................ . North Andover, Mass.
Fee.. 1 S., ,7. Lic. No...77.L-.). ...............................
PLUMBING INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
c i.JI, .�
i
Date 9.5� 1g Qj, Permit #t`/ 33
Building Location 1 /'i%/ IVa Owner's Name C--& '5- E�cti�J
Type of Occupancy
New ❑ Renovation ❑ Replacement ® Plans Submitted: Yes ❑ No O
FIXTURES q7e 6y/-333 .
Installing Company Name/4,AlC •Oa/y�nbin Check one:. Certificate
Address r�L Iv � V� • Corporation /.. 2� q
❑ Partnership
Business Telephone ,le / 7�-? 7. •- „'Z 9�� ❑ hmi/Co.
Name of Ucensed Plumber
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requireents of MGL Ch. 142:
Yes go No ❑ m
If you Have checked yes. please indicate the type coverage by checking the appropriate box.
liability Insurance policy ❑ Other type of Indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by
C4►apter 142 of the Mass. General Laws. and that my signature on this
permit application waives this requirement.
Check one:
S+gnature of Owner or Owner's agent Owner ❑ Agent ❑
I hereby certify that all of the details and information 1 have submitted (or entered) in above
knowledge and that all plumbing work and installations ed under the application are true and accurate to the best of my
pertinent provisions of the Massachusetts Stale Plum ng Cod and Chapter 4 of the GeneralLais ws.will be in compliance with all
FBy S+gnalu Licensed Type of cense: Master (� Journeymanl) IOFFICE USE ONLY) License Number
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Installing Company Name/4,AlC •Oa/y�nbin Check one:. Certificate
Address r�L Iv � V� • Corporation /.. 2� q
❑ Partnership
Business Telephone ,le / 7�-? 7. •- „'Z 9�� ❑ hmi/Co.
Name of Ucensed Plumber
INSURANCE COVERAGE:
I have a current liability insurance policy or its substantial equivalent which meets the requireents of MGL Ch. 142:
Yes go No ❑ m
If you Have checked yes. please indicate the type coverage by checking the appropriate box.
liability Insurance policy ❑ Other type of Indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by
C4►apter 142 of the Mass. General Laws. and that my signature on this
permit application waives this requirement.
Check one:
S+gnature of Owner or Owner's agent Owner ❑ Agent ❑
I hereby certify that all of the details and information 1 have submitted (or entered) in above
knowledge and that all plumbing work and installations ed under the application are true and accurate to the best of my
pertinent provisions of the Massachusetts Stale Plum ng Cod and Chapter 4 of the GeneralLais ws.will be in compliance with all
FBy S+gnalu Licensed Type of cense: Master (� Journeymanl) IOFFICE USE ONLY) License Number
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MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(Print or Type)
NO . ANDOVER , MA , Mass.. Date o :.19 permit # -
Building Location MILLPOND Owner°s Name
_ s �e
NO . ANDOVER , MA Type of Occupancy RES
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New ® Renovation ❑ Replacement Q . Plans Submitted: Yes❑ ' No ❑
Installing Company Name CALLAHAN AIR CONDITIONING
Address 91 BELMONT STREET
NO.ANDOVER,MA. 01845
Check one:
Ia Corporation
❑ Partnership
Business Telephone 508-689-9233 ❑ Firm/Co.
Name of Licensed Plumber or Gas Fitter JOSEPH KEVIN CALLAHAN
Certificate *71
INSURANCE COVERAGE:
1 have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes KJ No ® '
If you have checked yes, please Indicate the type coverage by checking the appropriate box.
A liability Insurance policy J) Other type of Indemnity 0 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 C1
I hereby certify that all of the details and information I have submitted (or entered) In 4bove application are true and accurate to the best of my
knowledge and that all plumbing work and Installations performed under the permit Idsued for this appilca0 will b In pllance with all
pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the neral LawV �/ %% 7
BY
Type of Ucense: . G�/��'
Plumbergnalur o c nse um a or Gas Ater
Title asfilter
Master License Number M-3440
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Installing Company Name CALLAHAN AIR CONDITIONING
Address 91 BELMONT STREET
NO.ANDOVER,MA. 01845
Check one:
Ia Corporation
❑ Partnership
Business Telephone 508-689-9233 ❑ Firm/Co.
Name of Licensed Plumber or Gas Fitter JOSEPH KEVIN CALLAHAN
Certificate *71
INSURANCE COVERAGE:
1 have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes KJ No ® '
If you have checked yes, please Indicate the type coverage by checking the appropriate box.
A liability Insurance policy J) Other type of Indemnity 0 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 C1
I hereby certify that all of the details and information I have submitted (or entered) In 4bove application are true and accurate to the best of my
knowledge and that all plumbing work and Installations performed under the permit Idsued for this appilca0 will b In pllance with all
pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the neral LawV �/ %% 7
BY
Type of Ucense: . G�/��'
Plumbergnalur o c nse um a or Gas Ater
Title asfilter
Master License Number M-3440
ArY Journeyman
O .
:,� '..fir �r�•��.r� *-�.:=.2r3,.
f . Q
,•n Date.. ./. �. ..� .
x 2174
NORTry
TOWN OF NORTH. ANDOVER
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PERMIT FOR GAS INSTALLATION
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This certifies that ....
has permission for gas iustallation
in the buildings of ...
..
at .... .... .... , North. Andover, Mass.
Fee . L{�-- Lic. �/No. 14L/ `....... 4-2 GAS INSPECTOR
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WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File
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C114t (ffommDnwtalt4 of Aussar4usetts Office Use Only
Department of Public Safety Permit No.
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 e
Occupancy &Fee Checked
3/90 (leave blank) `
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK V
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE/ALL INFORMATION) o Date
City or Town of n(,/����� +L/�` To the Inspector of Wires>
The undersigned, applies for a permit to perform the electrical work Oescrib"loyv.
Location (Street & Number) L
Owner or Tenant
Owner's Address
Is this permit in conjunction with a t
Purpose of Building --I�
Existing Service
New Service
Yes L.J No .
16LO Amps aCSL Volts
Amps
Volts
I (Check Appropriate Box)
Aility Authorization No.
Overhead 0 Undgrd ❑ No. of Meters
Overhead ❑ Undgrd ❑ No. of Meters
Number of Feeders and Ampacity ��(I/
Location and Nature of Proposed Electrical Work TOTAL�_ �J
OTHER:
INSURANCE COVERAGE: Pursuant to the requirements of Massachusties General Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES ❑ NO ❑ 1 have submitted valid proof
of same to this office. YES ❑ NO LJ
If you have checked S, please indicate the type of coverage by checking the appropriate box.
INSURANCE BOND ❑ OTHER❑ (Please Specify)
(Expiration Date)
Estimated Value of Electrical Work $
Work to Start
Si ned under the penalties of periury:
Inspection Date Requested: Rough
Final
8
LIC. NO.
FIRM NA
Licensee -f. -1 an ignatur
No. of Lighting Outlets
No. of Hot Tubs
No. of Transformers KVA
No. of Lighting Fixtures
A ve In -
SwimmingPool rnd. F1 rnd. ❑
Generators KVA
General Laws, and that my signature on this permit application waives this requirement. Owner Agent
(Please check one)
No. of Emergency Lighting
No. of Receptacle Outlets
No. of Oil Burners
Battery Units
No. of Switch Outlets
No. of Gas Burners
FIRE ALARMS No. of Zones
No. of Detection and
Total
No. of Ranges
No. of Air Conditioners Tons
Initiating Devices
of Sounding Devices.
No. of Self Contained
Detection/Sounding Devices
Municipal
Local❑ Connection ❑Other
No. of Disposals
Heat Total TotalNo.
No. of Pumps Tons KW
No. of Dishwashers
Space/Area Heating KW
No. of Dryers
Heating Devices KW
No. of No. of
Low Voltage
No. of Water Heaters KW
Signs Ballasts
Wiring
No. Hydro Massage Tubs____
No. of Motors Total HP
OTHER:
INSURANCE COVERAGE: Pursuant to the requirements of Massachusties General Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES ❑ NO ❑ 1 have submitted valid proof
of same to this office. YES ❑ NO LJ
If you have checked S, please indicate the type of coverage by checking the appropriate box.
INSURANCE BOND ❑ OTHER❑ (Please Specify)
(Expiration Date)
Estimated Value of Electrical Work $
Work to Start
Si ned under the penalties of periury:
Inspection Date Requested: Rough
Final
8
LIC. NO.
FIRM NA
Licensee -f. -1 an ignatur
LIC. NO.
Address
Bus. Tel. Nr
630
All. Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as required by Massachusetts
General Laws, and that my signature on this permit application waives this requirement. Owner Agent
(Please check one)
Telephone No.
PERMIT FEES
(Signature of Owner or Agent)
Datea . .....
TO
r - NOR7N -
°�< TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
c
This certifies that ...... { � J t ` (I
..... d................................................ .................
has permission to perform ....7.4t.R of 4C.f........ j4s.......
wiring in the building of ......SI~ k-e.ti. Q-...........:......:.........:....: ................
p
at ..... L7.....
..: `... �t .C?. �'!..........1 �.................... .. North Andover, Mass.
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Fee..I:S.O.4.... Lic. No. �n.k f 73
ELECTRICAL INSPECTOR
q
C'�l dC
103/ 1'c:14 is.00 PAID
WHITE: Applicant. CANARY: Building Dept. PINK: Treasurer GOLD: File