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Miscellaneous - 93 SUGARCANE LANE 4/30/2018
N RY Safety Insurance Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B.,, To: Building Commissioner or Board of Health or Inspector of Buildings Board of Selectman City Hall City Hall NORTH ANDOVER, MA 01845 - NORTH ANDOVER, MA 01845 RE: Insured: ALAN VEGA and SHEILA VEGA Property Address: 93 SUGAR CANE LANE, NORTH ANDOVER, MA Policy Number: HMA 0071321 Claim Number: BOS00043599 Date of Loss: 6/10/2014 Company: Safety Indemnity Insurance Company Claim has been made involving loss, damage or destruction of the above -captioned property, which may either exceed,$ 1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass. Gen. Laws, Chapter 139, Section 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim number. Allan Leavitt Claim Examiner 6/12/2014 Safety Insurance Company Homeowners Claims Unit P. O. Box 55098 Boston, MA 02205-5098 Phone: (617) 951-0600 EXT 3213 Fax: (617) 531-8891 Email: AllanLeavitt@Safetylnsurance.com x.41 G2.. to _ Lt+ n Locatio/ 4z. No ... ��� Date <Th, TOWN OF NORTH ANDOVER Certificate of Occupancy $ x ` + Building/Frame Permit Fee $ 4CMUSE<- Foundation Permit Fee $ Other Permit Fee $ 2 Sewer Connection Fee Water Connection Fee L .. TOTAL d Building Inspector /r?7/ 14:45 1,554.44 PAID k = 9447 Div. Public Works Location No.Date 4NORTh TOWN OF NORTH ANDOVER q. O�,t`ao ,a• ti0 4 Certificate of Occupancy $ Lb Building/Frame Permit Fee $ �ss�cMus�t� Foundation Permit Fee $ 1 DD U Other Permit Fee $ Sewer Connection Fee $ ?" Water Connection Fee $ TOTAL Building Inspect or 2122/95 10:56 150.00 PAID x3 - 9486 Div. Public Works e Sewer Connection Fee t�'Water Connection Fee $ /16S 77: 50 TOTAL $ T" B 'Idi g Ins ector 'c7f f Div lic Works k49 t"f Location ,2; No i�o'T Date z r y NORTH ;.TOWN OF NORTH ANDOVER A 'certificate of Occupancy $ Permit Fee Building/Frame $ sAr.US t� Foundation Permit Fee $ _ Other Permit Fee $ e Sewer Connection Fee t�'Water Connection Fee $ /16S 77: 50 TOTAL $ T" B 'Idi g Ins ector 'c7f f Div lic Works Q i X U) W a Q 3 t7 z G 0 z m Z W c m J Ic 0 J < I m _ Q' m W K 0 1 Q C 0 1 o o°° � o Z Q. O LL i 0 Z I d 0 W W Z W K Ip N < E p N d Z m m( o m C LU V N I Z 0 z Y � 0 j Q Z J Z � m A r N � W K Z f Z i O < Z< c y z 0 Z < I 0 2N N W C u W < m W F O < p Q Z u Z z u -1 N N e: 1 -j O 40 < m o I � ia �I 9 A v III z O r t 0 Z0 D Z O P LL 0o LL LL x 0 2 W W N x 111 m z W W 0 I m 4 r dW Z O uu u ~� f W C f W < 0 a < J m m m Z N 7 V) o < J W3 a K ; b Z 3 z J i o < ] i W tL' r L o u Z 01 t n ti W Z O c? W y oC? 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CdQyo Phone 6�'L-23Zy LOCATION: Assessor's Map Number 10'609 Parcel Subdivision 7 04IGS Lots) iK Street SUf rig c~x- 4,10wo- St. Number ************************Official Use Only************************ RECOMMENDATIONS OF WN AGENTS: Q Date Approved Conservation jAdministrator Date Rejected Comments +'e its eW5`Q1, 6,V \� Date Approved Town Planner Date Rejected Comments Food Inspector -Health Septic Inspector -Health Comments Date Approved Date Rejected Date Approved Date Rejected Public Works - sewer/water connections 12 - I'S -`5- - driveway permit-t-ci J L>- J� Uire Department Received by Building Inspector Date ¢' ,. .;t tv 2' S..'1��.Cir• .•s Fl+�" �,`�'�4 fY.t '# � £a. a ';. ., � ��t„, .fi � � � se +C�e: a iM *5v tit iEn.."�''..; 4 § - "T"�,. `rw i+a.� �, ;4.�+"�xz' •�,"dg C ma a r; ,,%"^�vw'$z'�` f s 4. 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SCALE:1 "= 50' DATE: 2/19/96 Scott L. Giles R.P.L.S. 50 Deer Meadow Road North Andover, Mass. W Z W Z Q U Q 0 Z) U) I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE THE OFFSETS OF THE BUILDING INSPECTOR ONLY y SHOWN COMPLY AND SUCH USE IS FOR THE WITH THE ZONING DETERMINATION OF ZONING LES 13>i�2 H BY LAWS OF��StE�►Eg CONFORMITY OR NON -CONFORMITY At LAM4 NORTH ANDOVER,MA WHEN CONSTRUCTED. WHEN BUILT 2/19/96 CERTIFICATE OF USE & OCCUPANCY Town of.North. /l Building Permit Number Date THIS CERTIFIES THAT THE BUILDING LOCATED ON MAY BE OCCUPIED AS S'/G �-2�f we l� IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. ". oT : �y CERTIFICATE ISSUED TO �n�(o w� .4 I V j 106F— ADDRESS -I'A mus�` Briding nspector ce B&A x1 W 144 q aG z, ' U 1a° U 4 C7 w `:Cb1 w a LE U) a o :c w° U w o w' u. w o G cn a�' PQ C/) o 0 V: O R O C : Q li = Occ rD tip y y .. E a L • �r.da O CL � s O V1 eCCL CD c.� y Cl) �o E CD m O O 0 m C s ( rymC Cf) �. Ca o o =a [ t3 uHo m 3 R.oZ �, o �c ac c Q i y O C = = m m o N tZ 11 _ m C O _ .N R CC V V •y. CDLij . C� m O Cc) . Q tZO = CC •O y O C ) F- t Q. Y m 0 COI— CD Z m Q O y D � W ca 0 co •ECo m m m ® �a CD Cc O� •� Z CD CDC s CL 0 �2� ---SSA�MUSETTS UNIFORM APPUCATION FOR PERMIT TO DO 11-L-4- vt� (Print or Type) NORTH ANDOVER, ,Mass. Date �'� Z _...toam 6ugdlnp PermitT Location . 3 S vG Ownees Name 1 "� Jr.( ti0( New 0---- Renovation ❑ Replacement ❑ Plans Submitted: Yes ❑ No. ❑ PIXTUAEs ......... Check one: Certificate Installing Company Name 'C7 torp. Address Ro. 6 D �0 170/ ❑ Partnership 1, ./cif '(/W 14 o [ F3 / ❑ Firm/Co. Business Telephone 2;-7 7 `'f 3 Name of Licensed Plumber T e ti L INSURANCE COVERAGE: Check one I have a current Ilablilty Insurance policy or No substantial equivalent. Yea ❑ No ❑ If you have checked In. please Indicate the type coverage by checking the appropriate box. A 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 Chapter 142 o1 the Mass. General Laws, and that my signature on We permit application waives this requirement. Check one: Owner ❑ Agent [ISigna urs of Owner or Owners Aqent I hereby certify that all of the detfts and Information I have submitted for entered" In above application are true and smurate to the best of my knowledge and that ail umbing work and Installatlona performed under the pem�ll Inued for thi�(7— tlon will in Rance with ail pertlnenl provisions of thi Massachusetts State Plumbing Code and Chapter 102 ol fit (3ener 8y /SignatursolUcensedPlum6ii Tna Ucense Number City/Town Type of Plumbing License: Master [y� AMIOVED (OFFICE USE ONLY) Journeyman ❑ r.41 Date. : / 'y *�2 2891 ° «•° • TOWN OF NORTH ANDOVER' . ca , ° PERMIT FOR PLUMBING 8 1S3.,CHUS� This certifies that has permission to perform ../ l..e.fi^ o plumbing in the buildings-of .. Rt.{. .� at. . `i`..3.. �c,�/a . t /? .. L ..... , North Andover, Mass Fee3.'9 Pf. . Lic. No.. IQ ✓' 4! ! ... . PLUMBING INSPECTOR WHITE: Applicant CANARY: Building Dept. -_PINK: Treasurer GOLD: File N2 2896 Dawe ....... ...... 0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .... .............................................................................. has permission to perform ..... .............. ...................................... wiring in the building of .... :4. .......................................... .......... ell at.Z ... :;Z- North Andover, Mass. -22C Fee:.. ) .............. Lic. No....::'`...... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ELECTRICAL INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS FOfficial Use Pcriinit Ovd FeeChecked .(lea,e blank) 4 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the hbssachusetts Electrical Co9-14-61 MECCMR 12.00 (PLEASE PRINT INWK OR TYPE ALLKIM FORMATION) Date: City or Town of: C , CAX- 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) Owner or Tenant a Telephone No.q31-to --Q 3 Is Owner's Address V Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Boa) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead I=I Undbrd ❑ 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 r A ArV-V1 Cont letiotr of the jollou,inz table maybe waived by ilie Inspector o(Wires No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No, of Hot TubsGenerators KVA No. of Lighting Fixtures Swimming Pool o bove ❑ In- ❑ rnd. ornd. o. o mergcncy tg ting Battcry Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners INo. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices e No. of Waste Disposers (Heat Pump Totals: Number Tons KW INo. of Self -Contained Detection/Alerting Devices - No. of DishwashersSpace/AreaHeating KW . `Local ❑ Municipal ❑Other Connection No. of Drvers Heatinz Appliances Kir Security )•stems: Na of Devices or Equivalent 01-T No. No. o Water 1W No. of No. o Stars Ballasts - Data Wiring: No. of Devices or Eouivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: Na of Devices or E uivalent OTHER Attach additional detail f desired, oras required by the Inspector of {fires. INSURANCE COVERAGE: Unless waived by the owner, no permit for the perfonnance 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 ❑ (Specif ,:) (Expiration Date) Estimated Value of Electrical Work- 43 ILI_ (When required by municipal policy.) Work to Start ' t Q ` U Inspections to be requested in accordance with NEC Rule 10, and upon completion. I cert fy, under the pains and penalties of perjury, that the information on this'application is true and complete. FIRM NAME: ADT Securitv Services 111 Morse Street, Non4oMA 02062 LIC. NO.: 1533C Licensee: John S. Bassett Signatur LIC. NO.: 1533C Of applicable, enter "czcntpt"in die license number line.) / Bus. Tel. No.: . - - 1 Address: Alt Tel. No.: 603-594-59 resi OW'NER'S INSURANCE WAIVER: I atn aware that the Li? ensee does nor have the liability insurance coverage normally ONLY required by law. By my signature below, I hercb}' waive this requirement. 1 am the (check one) ❑ owner ❑ owner's agent. Owner/A-ent Signature Telephone No. PERMIT FEE: S 60 Date :.. . 2..:C .� ..... . TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that .f! �!�r . ... % ? �. ` ............... has permission for gas installation .. R 6. l --r.1 ................. . in the buildings of ... t!. ? f� :............................. . at ....,,North Andover, Mass. Fee.2q::... Lic. No.. l f .... .: T �.:.... GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 4ASSAMUSETTS UII DORM APPL ICATON FOR PERMIT TO DC or print) Iwrc!'H ANDOVER, MASSACHUSETTS Building Locations q3 U Owner's Name yew Renovation ❑ Replacement ff - She11a Veq Plans Submitted Mjp*i!:" Prinl or rype) heck e;. CCrtifcate lnsmiling Company ame Andover Md. & Hta. Co. Inc.ocp �? ddress 20 Agean Dr. , Unit -10 ❑ Para�er. Methuen. Ma. 01844 Business Telephone (978) 685-8383 ❑ Fimi/Co .r 'game of Licensed Plumber or Gas Fitter reorae Lagose INSUP--kNCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes NoM ! r you have checked ves, please m cate the type coverage by checking the appropriate box. ;a', bilary 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 Chapter 142 of the Mass. General Laws, and that my'signature on this permit application waives this requirement. Check one. S _nature of Owner or Owner's Agent Owner ❑ Agent. ❑N —_—_ hereby certify that all of the details and information I have submitted (or entered) in above Dcsl of . my knowledge and that all plumbing work and installations performed under Permit -ompiiance with all pertinent provisions of the Massachusetts State Gas�2ode and Chapter I By: Tide C: ry;Tuwn .A.PPROVED I()FncF USF ONLY) ,�,�(gnature of 1 1 ✓1 Plumber . ❑ G Fitter Nlasier ❑ Journeyman ad accurate to the. ition will be in sed Plumber Or Gas Fittet: 9983 { License ( umoer ,,: t is y� r r z H G -e y a % Ottice use only T vire Tummunwelith of 55Z#115ett!i Permit No. e p 3zPzIitMr= of Lih11L—`7°;Ifrt-g Occupant/ &Fee Checked 1190 (leave blank) BOARD OF FIRE PREVENTION REGULATIONS '27 CM 12:fl0 APPLICATION FOR PERMIT TO PERFORM ELECTRICALWORK All work to be performed in accordance with the Massachusetts E:ectrical Code, 527 CM9 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date QM or Town of _jinn ry nlvrin(7FR To the Inspecto of Wires: The udersigned applies for a pe^mit to Location (Street & Number) the electrical work described below. Owner or Tenant ' Owner's Address " �°` " sr_` is this permit in conjunction with a building permit: Yes No _ (Check Appropriate Sox) Purocse of Building �r..gM Utility Authorization No � � Veils Overread EUncgrnd i Existing Service Amos l�r�_ Ne`.v Service Amos -J Vcits Overhead _ Uncgrna _ Numcer of Feeders ana Amcacity Location and Nature of Proposed Exec -,teat :^lerx No. of Meters No. of Nleters No. cf Transfarmers To tat No. of L!cn;Ing Outlets (� j( No. a: Hat -acs Kva I Abcver— :n- r— No. of Lighting Fixtures i Swimming ?rot grna _ erne. I Generators KVA No. of Emergency Lighting No. of ^ecectacie Outlets �� I No. of Oil Burners Barery Units No at Sw:tc`i Outtets No. cr Gas Surners Total No. at Ranges No- cf Air Canc. tens Heat Total 'alai No. of Oisoasals No.cf I Pu rps :ons K'.v No. of Cisnwasners ._ i ScaceiArea Heaang KW Na. of Orrers I Hearing Cev:ces !CSV OTHER: FIRE ALARMS No. of Banes No. of Detection and Initiating Oevtces No. of Sounding Devices Na. Sett Captained Oetac;:oniSounaing Oev:ces — Munic:oai Other Lccai Connect:cn No. %-t No. of I Law Voltage KEN I Signs Ballasts Wir.nc No. of Motors Total !-IP INSURANCE CCVERAGE: pursuant ;o the reeutrements at %jassacnu-sa-s general Laws ,r NO — I have a current Liaotiity Insurance Folic/ inctucing Ccrr:c!etee Ccerauens Coverage or as suestantial eaurvaient. YES X — have suamtrea valid proof at same to the Office. YES %;,0, NO — If you nave cnecxea YES. -tease nacate the tyre at coverage cy cnecxtng the appropriate cox. INSURANCE F SCNO = OTHER - (Pease Scec:!y) (Exctrauon Oatei Esttmatec Value of E!ec;ncal `Mork 5 Worx :a Start Signed unser ;he Penalties at perjur FIRM NAME Insoec;ton Oa;a Racuestec: Raugn Finai _ LIC. NO. _.cense - �. Bus. lel. No. s&AF -r�K AQcress �i��L ///////// G/'/IwN Alt. Tet. ^10.� OWNER'S INSURANCE WAIVER: I am aware that me L:censee ones at nave the insurance coverage or its suost. C- eeurvale� as au red by Massachusetts General Laws. dna :hat my signature an :n:s cermit application waives tots reawrement. Ow g (P!ease cnecx one) (/ eiecnane No. PE +M1T Fcc S %%Zaz (Signature of Owner ar Agentt 4.0 7 �10RT1� Of�,�ao ,•�ti0 F 9 �,SSACH Date......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ....... . �.�...t) .t!;....... ..........................:.... has permission to perform f.Vl.....1N.�.�2..i.�.4t wiring in the building of t at ....... ,North Andov , ..... �. ..... Fee.....`f�.r.��.. Lic. No.—AIA........... .......... ............ ..............�.. ELECTRICAL INS ECTOR C p �A/9� 15:59 44.0o PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer �j Office Use Only Gibe T111II11iIII wolf#. of Igsarf�mr f5 Permit No. lepartiaent of PUBLIC -6ttf tV Occupancy &Fee checked BOARD OF FIRE PREVENTION REGULATIONS 527 Cb1R 12:00 3190 peave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts E!ectricai Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date (XK or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) q3 Owner or Tenant n ( 0007?/%X% Owner's Address R e4A-� C A-)' Is this permit in conjunction with a building permit: Yes _ No 91 (Check Appropriate Box) Purpose of Building ��� �- y Utility Authorization No. Gvf f Existing Service Amos Volts Overhead - Undgrnd No. of Meters New Service Amps __/ Voits Overhead _ Uncigrnd r No. of Meters Numoer of Feeders and Ampacity`�/© Location and Nature of Preoosed Elec:ricai :"toric i . u No. of Transformers Total No. of Lighting Outlets No. o Hot -Lbs I KVA Abcve.— :n - No. of Lighting Fixtures i Swimming Pool g.r..na _ crnc. _ Generators KVA No. of Emergency Lighting No. of Recectacie Cutlets I No. of Oil Burners I Battery Units No. of Switch Outlets i No. of Gas Burners I FIRE ALARMS No. of Zones No. of [)election and Initiating Devices Sounding 9 No. of Devices No. of Seif Contained Detection/Sounding Devices II Local — Municipal — Other Connec::on No. of Ranges I No. of Air CorTotalc. ,ons No. of OisoosaisNo.of !lea; Tns K1VI Pumps :oen_ No. of Oishwasners Scace/Area Heat:ra KV! No. of Dryers Heating Devices KW No. of Water Heaters KW No. of No. at I Sic -is ?ailasts Low Voltage Wiring No. Hydro Massage Tubs No. of Motcrs Totai HF O T HER: INSURANCE COVERAGE: Pursuant :o the reewrements of `.tassacrusens general Laws I have a current Liapiiity Insurance Policy inclucing Comc:etec Oceratiens Coverage or its suostantial eguivaient. YES NO = I have supmitted valid orcof at same to the Office. YES 1 NO = It you have cheCKed YES. please indicate the type of coverage cy cttecxing the atoproeriate cox. INSURANCE ff BCND = OTHER = tP!ease Scec:'-+1 (Exotration Dam Estimated Value of E!ectrical WorK S 'IVerx :o Start Insoecaon Date ;;acL;es:ec: Rough Fnai Signed unser ;he P les of perjury: FIRM NAME p - 0/974-1, ��� LIC. NO. /t Signature NO. Licensee Q Rus. -el. No. 6�50- Alt. Address Tel. . to. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its suostantial ecuivalentt - gwred by Massachusetts General Laws. and :hat my signature on :his permit application waives this regwrement. O:�A�Agent (P!ease cnecx ones eiecnone No. PERMIT FEE S iSionature of Owner or Agent) x o5c� _ Date... .. R 575 HORTM TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ,SSACHUSE'� This certifies that .......................... . ..... ................ . ''. !!.. ... ,......... has permission to perform ... :.. ,.. .K .. wiring in he building of ..... ........... ...�;,�........................ at ......1...........'..rth. Andover, Mass. Fee.. X.-�J.qic. N/o �,�. ........................................... G ELECTRICAL INSPECTOR C-7AO/9610:01 15.40 PAID WHITE: Applicant CANARY: Building.Dept. PINK: Treasurer t- ul�e C�omIMonw>:# of .4jtt000r4U5rtt9 %pa taunt of PubliL _'IIfrtu BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Office Use Only Permit No. Occupancy & Fee Checked 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Q* or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a Location (Street & Number)) Owner or Tenant Owner's Address y , to perform the electrical work described below. S111W? (2%1%1f - Is this permit in conjunction with a building permit: Yes [Fil No ❑ (Check App Ox Purpose of Building i��A1h/L!K Utility Authorization No. Existing Service Amps' _J Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service 2M AmpsVolts Overhead ❑ Undgrnd ® No. of Meters Number of Feeders and Ampacity d x Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above In- grnd. ❑ grnd. ❑ I Generators KVA No. of Receptacle Outlets No. of Oil Burners I No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Sounding Devices No. of Self Contained Detection/Sounding Devices Municipal r Other Local ❑. Connection L No. of Ranges No. of Air Cond. Total tons No. of Disposals No.of Heat Total Total Pumps Tons KW No. of Dishwashers I Space/Area Heating KW No. of Dryers Heating Devices KW No. of Water Heaters KW No. of No. of I Signs Ballasts Low Voltage Wiring No. Hydro Massage Tubs I No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES !!K NO I have submitted valid proof of same to the Office. YES T,.,P NO __:: If you have checked YES. please indicate the type of coverage by checking the appropriate box. INSURANCE '� BOND 77 OTHER —� (Please Specify) (Expiration Date) Estimated Value of Electrical Work S Work to Start Signed under the Penalties of perjury: FIRM NAME Inspection Date Requested: Rough CA— Final LIC. NO. LIC F' NO. Licensee 44 V V__ W, II l Signature . `^J v Bus. Tel. No. e% Address ell y�L�� WP ���� - Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws. and that my signature on this permit application waives this requirement. Owner Agent (Please check one) X63 kv Telephone No. PERMIT FEE 5 k/d,2� (Signature of Owner or Agent) �ad`;/�,� `6 x•5565 Loeation ,No f c 01 t-,�AY?% Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ -Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ I? P Sewer Connection Fee $ Water Connection Fee $ TOTAL Building Inspector iq 9G95 Div. Public Works ~` Date ,.�� A °.441a TOWN OF NORTH ANDOVER PERMIT FOR WIRING SS'c USft r Q m This certifies.that;....... .f P. e.......:/....�...................... ..:.......................... has permissrc7,n to perform ....1.e........................................... . 1 �.!..`�........ 'fU.�wi riginthe buildingoC+ ........................ F .. North Andover Mass. � $ . Fe .. Lic. No.,-"%A77s........ :... .................................... ELECTRICAL INSPECTOR - V�4 077 WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File ,IImmIInWr# of �4fittgs#Ugettg 43ettartment of Puhik *afetg BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Office Use Onl Permit No. i Occupancy & Fee Checked 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date. * - a R -96 Q* or Town of NORTH To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number)7_- ` Owner or Tenant Owner's Address Is this permit in conjunction, with a building permit: Yes No ❑ (Check Appropriate Box) Purpose of Building � es t cll 4? Utility Authorization No. Existing Service Amps _J Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps __J Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity {� (� Location and Nature of Proposed Electrical Work isV V� No. of Lighting Outlets No. of Lighting Fixtures No. of Receptacle Outlets No. of Switch Outlets No. of Ranges No. of Disposals No. of Dishwashers 1 No. of Dryers No. of Water Heaters No. Hydra Massage Tubs OTHER: V _ , , 1,,, t No. of Hot Tubs Total No. of Transformers KVA Above In - Swimming Pool grnd. ❑ grnd. ❑ Generators KVA No. of Oil Burners I No. of Emergency Lighting Battery Units No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Sounding Devices o. of Self Contained etection/Sounding Devices Municipal❑Other cal ❑ Connection L�No. T Total No. of Air Cond. tons No.of Heat Total Total Pumps Tons KW i Space/Area Heating KW Heating Devices KW of No. of Ballasts w VoltageKWSigns iring O a No. of Motors Total HP INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES _ NO = I have submitted valid proof of same to the Office. YES = NO _ If you have checked YES, please indicate the type of coverage by checking the appr priate box. INSURANCE 't BOND __ OTH5F = (Please Specify) (Expiration Date) $P Estimated Value of Electrical Work S 000-0 . Work to Start — Z >_ { Inspection Date Requested: Rough Signed under the Penalties of perjury: FIRM NAME Stec l t7i—I Tl?retnn i�" 'L�.�� n /n Final LIC. NO.�Jr-1-- Licensee `�%PJJ /` xU /� y�� Signature r ✓"� LIC. NO. 2 2__ VZi \ I \ T Bus. Tel. No. Address,,? d �je� `� I V 2_AAJD � , ` 11 AW LP"� � Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE S (Signature of.Owner or Agent) x-5565 ��,x.'�+y';s'"''�if@F.4�+d3R`°tiwMd...-.v _ .� . .. -;., �►+'�,5�'3« "'X�ifwFS�"�'�i '.: `..v': 2�J Date:. Zz, NORTH TOWN :OF NORTH ANDOVER, 3=0ry t, t0 d,tOG r' o t PERMIT FOR INSTALLATION'° This certifies that 141, ...-: .. • lt..y'1 F�' i has permission for nstallationCU; ` in the buildings ffCi'IfL�G at ...9. 3.. 0!1 �� r. ov ass. ` Fee � .....- . Licc No.. ` , .:. 4 2-0 M INSPECTOR ..WHITE: Applicant CANARY: Building Dept. PINK: Treasurer, GOLD: File 7cv — MASSACHUSETTS UNIFORM APPLICATION FOR. PERMIT TO DO GASFITTING (Print or Type) NORTH ANDOVER Mass. Date `- >uilding Location 3 50��1(LCG�e Permit Owners NamA P- New 'Renovation Replacement Plans Submitted Ply C:cz (Print or Type)/')Check one: Certificate Installing Company Name % /'Z°G Corp. 06 Address (� L �5a -� - 7 U / Partner. A7 0('Zi73 F-1 Firm/Co. Business Telephone: Name of Licensed Plumber or Gas Fitter Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy En Other type of indemnity Q Bond Insurance Waiver: 1, the undersigned, 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 F] Agent El I heteby 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' Petmit issued for this application wW-bcAn compliance with all pertinent provisions of tho Massachusetts State Gas ;ode anul Otaptet 142 of tho Genual Laws. By T= LICENSE: Title FGa mber fitter- Signature of Liicensed City/Town: ter Plumber or G fitter rneyman APPROVED (OFFICE USE ONLY) Li ense Number 2H FLOOR MEMO MEMMEME mommmon so STH FLOOR MENEM 0 NEON MMERNMEMMINE � iiiiiii iiii�i�iiiiinivi (Print or Type)/')Check one: Certificate Installing Company Name % /'Z°G Corp. 06 Address (� L �5a -� - 7 U / Partner. A7 0('Zi73 F-1 Firm/Co. Business Telephone: Name of Licensed Plumber or Gas Fitter Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy En Other type of indemnity Q Bond Insurance Waiver: 1, the undersigned, 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 F] Agent El I heteby 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' Petmit issued for this application wW-bcAn compliance with all pertinent provisions of tho Massachusetts State Gas ;ode anul Otaptet 142 of tho Genual Laws. By T= LICENSE: Title FGa mber fitter- Signature of Liicensed City/Town: ter Plumber or G fitter rneyman APPROVED (OFFICE USE ONLY) Li ense Number 7 21 _Date.4't NORTH TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION ,SSACHUSEt - - This certifies that .-.�y.j:` .': �` !....t ... a+ has permission for gas installation .A:u: °r. � .. .. &.: -� in the buildings of ...!?!� Y t e at. .5A.!? !? . ?- , . , . , , , ,North Andover, Mass: '^ Fee. 74r Lic. No. �..0 3Y / , AS INSPECT •• ••. a' WHITE: Applicant CANARY: Building Dept. PINK: Treasueer GOLD File .