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HomeMy WebLinkAboutMiscellaneous - Main St - 390a �y I \� y 'A 1,10 .4 Y— 6 - IC? 7 Date....... ....................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ............. b'AwD .. <;.Opf & ...................................... ............. has permission to perform .......... k ....!T ............................................. wiring in the building of ........... ......... 01q0,12c // ................... ... at .......... �1!�? .... MkIIP.,V. .... 5dr ................... North Andover, Mass. - 4:�71ic. No..Y.0.7.Z 41.6 ........... 1� . .......... ......... ........ Fee..IL�5. ... ... .. .. . .... .... . ........ . ELEMRicAL I SPE R Check # 7 6 9 1* ,.ft Commonwealth of Massachusetts s Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. Occupancy and Fee Checked [Rev. 1/07] nPa„P 111—v� 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 W INK OR TYPE ALL INFORMATION) Date: - City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) �9n y,>' A/Zi C -1 - Owner p Owner or Tenant N'r Ply .AA, �� f� j e Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building d- I I , - a _ Utility Authorization No. Existing Service T.,dV Amps JOU / Volts Overhead Q--�Undgrd ❑ No. of Meters % New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical We17ork: 341 / - e- No. of Recessed Luminaires No. of Luminaire Outlets ------------Com letion o t ollowin No. of Ceil: Susp. (Paddle) Fans No. of Hot Tubs table may be waived by the Inspector of Wires. No. of Total Transformers KVA Generators KVA o. o mergency ig g A!q2g Units No. of Luminaires No. of Receptacle Outlets Swimmin Pool Above In- g rnd. El rnd. � No. of Oil Burners FIRE ALARMS No, of Zones No. of Switches No. of Ranges No. of Gas Burners No, of Air Cond. Total Tons No. of Detection and Initiatine Devices No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number...Tons..... "" "' KW No. of Se -Contained Detection/Alertinry Devices No. of Dishwashers No. of Dryers of Water Heaters KW No. Hydromassage Bathtubs Space/Area HeatingKW Heating Appliances KW No. of No. of Signs Ballasts . No. of Motors Total HP Local ❑ tion ❑ Otber EM�pal Security :*o. No. of or E uivalent Data Wiring: No. of Devices or E uivalent Telecommunications Wiring: No. of Devices or Equivalent Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE ICOVERAGE: 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 certify, under the p 'ns andpenalties ofperjury, that the information on this application is true and complete. FIRM NAME: LIC. NO.: �elzcLf Licensee: Signature LIC. NO.: Vd 7z�/ (If applicable, enter "exempt - in the icense number line.) Address: Bus. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Alt. L lc. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ }--A qW47� (,7 I-V -T �� �'d-7 /�Irl »-. FN I use �omtnunweulih of 6�u��n� $epartintat of public *afttg BOARD OF PRE PREVENTION REGULATIONS 527 CMR 12.00 0111" We Q* Permit No, Oot Pwwy A Fre CNciied 3M oft* tlutk) ' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL W All work o be performed in accordance with the Massachusetts Electrical Code, 527 OR� (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) CMR ��� qA or Town of NORTH ANDOVFR Oate _9� To the InspeMolr 01 Wlree: The udersiyned applies for a permit to perform the electric work described below. Location (Street 3 Number Owner or Tenant Owner's Address (� > Is this permit, in conjunctio ith a building permit: Yesr! No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead t Undgrnd 0 No. of bletere New Service Amps Overhead _ Unagrno C No. of Meters Number of Feeders and Ampaclty Q /J Location and Nature of Proposed Electrical 'Norlc "177 7117 7217 . N0. 01 Lighting Outlets I No. of Hot -_::S Total v0 = if you nave checked YES. Wnaae thecae IIN type d Covarags oy, "roortate Cox. INSSONO MMIGOValus = OTHER = (Pteaae St ec ��l No. of %nalorrne,ra of E! ctn of Work s . S�(i. ati0n Oalel KVA No. of Lighting Fixturesi Swimming P=ot Al)eve — :n• r. I Licensee Srro _ crno _ Generators KVA No. of Recootacis Outlets I No. of Oil corners I No. of Emergency Lighting waives thus r utr e��• finer AVON l Bane ry Units ,• No. of Swtlen Outlets I No. of Gas = rrers FIRE ALARMS N0. Of ZOMa NO, 01 RangesI No. Cl An C, r..c. oral No. of Detection and Cns . Initiating Oevtcaa No. of Oisoossls I No.ol Heal "wat 70tat Pur -ons Z:s KV4 No. of Sounding ObvlCSS No. at Oishwasners SoacerArea .+eaucq K:l No. of Sed Contained t OelechonfSounoing OevlCea NO. of Oryars I Healing Cov ces KWL-ocat — Muntciow +_ Connection Other... No. of Water Heaters KW No. of Nu ji Signs ?a lass Low Voltage; Wiring No. Hydro Massage Tuos I No, of tilotcrs 7otai HP OTHER. %ice 5MA%j rrursuant :o the reouwrements JI tlassacr.oses•s ;eneral Laws 1 have.a Current LtaOtlrty Insurance Policy rnctuatn siec Ccerauons Coverage or its have suofntheo vatld proof of dame to the Ontce YES — substantial.eouivalery. YES NO v0 = if you nave checked YES. Wnaae thecae IIN type d Covarags oy, "roortate Cox. INSSONO MMIGOValus = OTHER = (Pteaae St ec ��l of E! ctn of Work s . S�(i. ati0n Oalel Work to StanInsoec:ton Oat@ ;;ac6es:ec: Rough Signed wtoor the Pe a111as� f peau : Final FIRM NAME Licensee tic. NO. Address ��/ �/ - , J t, til S/ LIC NO 9ua. Til. N Cid tri AII. Tel. NO. OwNER•5 INSURANCE WAIVER: I am aware Ina, the t_:censee ^ees_ no, the insurance eOverege or its substantial 1 equivalent u r♦ aur.ed by Massscnusoils General Laws, ano that my signature on '"is =ermit aopttcatton (PIeaN Cnecrl Onel' G waives thus r utr e��• finer AVON l _ eieonone No. - (S.gnaiwe at owner Or Agents PERMIT FEE f " •I 1# ", I N2 1436 - 5:a Date..&,/A. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ........... G (±�&j'c- T "C - ....................... .................................. has permission to perform ........ 6 P.:e,m 6 j -t ( . ...................... wiring in the building of .... s't ...... ...... C r . .................... at ..... ....... t/.kA ....... 1.5i ....................... . North Andover, Mass. Fet� ........ Lic. No.yh.919 ............................................................... ELEcnicAL INSPECIPOR tk kT�' ( 02/12/98 12:09 25. 00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer -M—\ MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO t3ASFITTINt3 (Print or Type) NORTH ANDOVER Maas: Date UV BuAding Permit # Locatlon _1 ` 2 , `,U 7°" - Owner's Name S %`, Y GL U New O Renovatlon O Replacement )E� Plans Submitted:. Yea O No [] E j ava—eaMT. • I11A*XMENT 1sT FLOOR 21410. FLOOR ARD FLOOR 4TH FLOOR aTH FLOOR STH FLOOR FT FLOOR FLOOR Installing Company Name - Address Address Q�� ,� a T— Business Telephone L /,0 2 > 0 Name of Licensed Plumber or Gas Fitter Check one: QJ Corp. u Partnership 0-Firiffiko. INSURANCE COVERAGE: : Check on I have a current liability Insurance pollcy or its substantial equivalent. ' Yea No O If YOU have checked yes, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy Other type of Indemnity O ' Bond O i Certificate OWNER'S INSURANCE WAIVER: I am aware that the Ilcensee 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: %nature of or or Owner's Vgen Owner O Agent O I hereby certify that all of the details and Information 1 have submitted (or entered) In above a plication are true and accurate to the bell of my It and that all plumbing work and Install elions performed under the permit Ise pertinent provisions of the Massachusetts State Ges Gbd nd of apPllcat) n will be com lance with all CIty/Town APPI]OVED (OFFICE USE ONLY) e a Chapter Ke the T nse: umber na urs o nee um of or as or Gastitter l_� Joumeyman �e"Se IJumber 0 �, �v a W d o' a w a N w M ac e h s� >< 0 V 3 tl A u M N O� ~ 0 a s X 3 M d M 0 Installing Company Name - Address Address Q�� ,� a T— Business Telephone L /,0 2 > 0 Name of Licensed Plumber or Gas Fitter Check one: QJ Corp. u Partnership 0-Firiffiko. INSURANCE COVERAGE: : Check on I have a current liability Insurance pollcy or its substantial equivalent. ' Yea No O If YOU have checked yes, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy Other type of Indemnity O ' Bond O i Certificate OWNER'S INSURANCE WAIVER: I am aware that the Ilcensee 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: %nature of or or Owner's Vgen Owner O Agent O I hereby certify that all of the details and Information 1 have submitted (or entered) In above a plication are true and accurate to the bell of my It and that all plumbing work and Install elions performed under the permit Ise pertinent provisions of the Massachusetts State Ges Gbd nd of apPllcat) n will be com lance with all CIty/Town APPI]OVED (OFFICE USE ONLY) e a Chapter Ke the T nse: umber na urs o nee um of or as or Gastitter l_� Joumeyman �e"Se IJumber 0 �, n /STING MAIN YES [—] NO EXISTING SERVICE YES F] NO NEW MAIN REQUIRED F YES MNO Z NEW SERVICE REQ. DYES O 5�NO U NEW METER REQ. YES F-] NO W ' TOTAL CAPITAL COST: Z _ w MAIN $ SERVICE $ FIT $ w ACCEPTED YES F-] NO ROR REQUIRED YES NO z W ENGINEERING COMMENTS ,P ��� I EER NOMAD AUTHORIZATION FORM SIZE C�- CODE PRESSURE / �] PRESSURE SIZE CODE _ SIZE LENGTH SIZE LENGTH METER CODE SIZE Qa9 LOCATION 0I O LuU DATE ROR G a C DPU /- /o - 9�a_ DATE GRID NO. 13s, LENGTH PRESSURE CODE PRESSURE CODE REGULATOR r� CODE TOTAL $ LVM FORM REQUIRED YES ROR CHARGE % OTHER CHARGES CUSTOMER CONTRIBUTION AUTHORIZATION NO: SECT APPROVALS DATE MAIN FINANCE SERVICE CONTROLLER BUDGET []YES []NO RETIREMENT []YES F� NO ACTUAL COST FOOTAGE SIZE MAIN SERVICE - SUPPLEMENT ❑ YES NO METER FIT '- 4 REASON TOTAL E DAY l M CODE RATE YEAR INSTALL DWELLING GRID NO. C+I MONTHLY READ ❑YES ENO DATE SET COMPANY REJECTION rp ' �F DIS. NO: CUSTOMER NOTIFIED ISERVfCE INSTALLED "DATE ❑ Z METER FIT INSTALLED AMOUNT REBATED N` O U COMPANY APPROVES DYES aN0 $ CUSTOMER REJECTS ❑ z COMPANY DIVISION O DATE F- COMPANY APPROVES 04 c� 1.11 ..; ' N CUSTOMER ACCEPTS ❑. Z O CUSTOMER ACCOUNT NO. H STREET NO. STREET NAME BUSINESS TE�.!90(3 ZIP CODE LANRLORD NAME' 0 390 MAIC! ST686-6858 z a CONTRIBUTION RECEIVED NA 01845 U 000-000c w wp CUSTOMER AT THIS LOCATION CUSTOMER ACCT. NO. PT. CODE EX. REV. REQ. EOPT. CODE MEDIA RESPONSE BEST TIME TOC, ASELOAD (CCF/MO. NEW + EX) CCF USE P �U 2 0 2 ;' KNYT"M �w .77777 MASTER NOMAD NO. DPU /- /o - 9�a_ DATE GRID NO. 13s, LENGTH PRESSURE CODE PRESSURE CODE REGULATOR r� CODE TOTAL $ LVM FORM REQUIRED YES ROR CHARGE % OTHER CHARGES CUSTOMER CONTRIBUTION AUTHORIZATION NO: SECT APPROVALS DATE MAIN FINANCE SERVICE CONTROLLER BUDGET []YES []NO RETIREMENT []YES F� NO ACTUAL COST FOOTAGE SIZE MAIN SERVICE - SUPPLEMENT ❑ YES NO METER FIT '- 4 REASON TOTAL E DAY l M CODE RATE YEAR INSTALL DWELLING GRID NO. C+I MONTHLY READ ❑YES ENO DATE SET rp ' �F DIS. NO: AUTHORIZATION NO., ISERVfCE INSTALLED "DATE SERVICE FOOTAGE: SERVICE SIZE METER FIT INSTALLED AMOUNT REBATED N` DYES aN0 $ NOMAD NUMBER n PROSPECT TYPE COMPANY DIVISION TIME IN DATE Comm 01 04 c� 1.11 ..; ' 01/06/92 . 141682 Z O ~AME HOME TEL. NO. STREET NO. STREET NAME TOWN; S PAUL_'s CHURCH — STREET NO. STREET NAME BUSINESS TE�.!90(3 ZIP CODE LANRLORD NAME' 0 390 MAIC! ST686-6858 z TOWN ZIP CODE LOT NO. FLOOR/APT LANDLORD ADDRESS TELEPHONE,NO.-_ NA 01845 U 000-000c w CUSTOMER AT THIS LOCATION CUSTOMER ACCT. NO. PT. CODE EX. REV. REQ. EOPT. CODE MEDIA RESPONSE BEST TIME TOC, CLASS CODE ' CODE YES NO 40419715510 - S 7311 2 0 2 ;' KNYT"M SALESPERSOt(, ,,. EMP. NO. MASTER NOMAD NO. SALES CLERK Sf._llIONY 098 I�!° C . Location No. Date. TOWN OF NO"RTA - AIN DOVER Certificate of ddCuPtcy $ Building/Frame P4.rmit Fee $ Foundation Permii,Fee $ Other Permit Fee Sewer Connection Fee Water Connection Fee TOTAL ?/+IS 13:24 32.00 PAID Building Inspector DJY.. 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CONSIRUCTIOW Su"rERVISOR LICEa ' t Nuiber: Expires: Birthdate: ' CS 063168 02/12/1998 02/12!190 ARTHUR F DflljGN t DERRY, NH 03038'cl " (` \ ✓1. i�a�nrnanweal/i o�✓�iaa�ae uie�a HOME IMPROVEMENT CONTRACTOR Registration 118848 Type - DBA Expiration 04/21/99 A.F. WATSON GEN CONTRACTING ARTHUR F. WATSON 't6GEMONT ST ADMINISTRATOR DERRY NH 03038 .* % 0 9 R -v, H CD .p C � 'D O n Z y 06 n. � O CL y MR CD o p C. O Q CD CD CD C O CO) CL v y -• o C � v CO) O 1 Z CD � o � co 0 CD 0 W O �•N < Q N ro ?? m A m nto w O d Im N O a?a 0 Er CD m so H O �O p O IE ?m: 3 � m H m 0 7 7d O Zci O e.C2 C ? H �_ CL > —ft s. o ca g s ' O � H C O m CL co O H 01 N d C =� c• O a a CO) CCD m H yob o O O H .dam►• »a V Y cc mo 33 CO) CD Vim: =m 1 N CD Vim: dd Com: ate: c, 9 c O It Cl) m •�I T m CO) a Nil H 0 0 c O ro ?? :� nto w ro r C) w oho S a � CL n C7 d C 0-4 �. ro 7d Nil H 0 0 c i Date 0*� TOW-WOF NORTH ANDOVER --p 0 ERMIT FOR GAS INSTALLATION lVow, L) '7SACHU 11_7 - This certifies that ......... . ................................. has permission for gas in the buildings of ... a t . .. ....... North Andover, Mass. OU Fee. . —Lic. No.—. GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File AIJt ]3-9[3 12=24 FROM:DAl71S MALM D"AGOST7NE JD=6372273732 PAGE 1./2 FROM: Howard P. Speicher TO: William J. Sullivan, c/o Mary Ippolito DATE: August 13, 1998 TELECOPMR NUMBER: 978 588-9556 NUMBER OF PAGES (including cover sheet): 2 Message: Letter follows. fL I ,j AUG13 1998 � r L '' �! ` �.; If you do not receive all. pages or have any problems tivith. receiving, please call: (617) 367-2500 or and ask for Client/Matter: 7471-1 Phis .azcssagc is imended only for rhe u;� of she individual or entity to which it is addressed atad tray contain itsformation that is privileged, confidential and exempt from disclnsare under applicabre jaw. If= reader of this message is nos the intended rrziPicut or not tlx eatptoya or a; ent responsible for deiiverino the message to the intended recipient, you are hereby notified that any cltssetnsnarion, distribution or copying of ttd_ comaxzunication is stzictIy prohibited. If you have received this communication in error, please notify us immediately by telephone and return the original message to use at the above address via the U.S. Postal Service. 08/13/98 12:29 TX/RX N0.0985 P.001 32:2'S FROM:DAIIIS MALM D"AGDSTINE ID:S372273732 Sita 3. D'A =dne Alan L. SW ;:Ior '. Midnatl M�1ro Robert I. "Via V ligan P. Griffm k 1uAe,O. C-MUL- gal F- L---4on Canal R. eohro :obert C. Cw=d Wwmord P. Speicher >? - Q. Seri— Paul L. roj— An R I cmw Goy M FeIdc= g*" S mnrskD OcMe A. HcvKtc adith Ashtm Thomas S. Fitzpatiok obn T, Lynda Wj=d in NEW Ksnpshira only dmiud in Connoz;-, only DAVms, MALM & D' Aws SIE A Pltopswxwl Co� Oros HOMN PLAM BogTpiq, Nj4_nACWA=7:5 041108-"70 Ta"xatm (617) 367-2500 Tw=ormL (617) 5�-6215 Robot 1.0; iieh J. Oavhn coedsc 4 Ardrew D. myon Amy L. Frscyssini' PmndaB. Fkmi.e G. Rob M Sehvrandr Aon NL Sobedwrdti [rww C. sahroffner Harold R. Davis. oECounmi August 13, 1998 VIA FAX 978 688-9556 William J. Sullivan, Chairman c/o Ms. Mary Ippolito Board of Appeals North Andover Municipal Building 120 Main Street North Andover, MA 01845 PAGE Writes D'irea Dial. (677);P -AV pupa 7decopiec (6!7) SOS-�12Y ®,yF: �QmdlaW.aom Re: James J. Nassar. 1r A,&peai to Board af�+u� ►�gls of decision of Buildirr�CarrE�tissiQner dated Jgne 15, 199_8 Dear Mr. Sullivan: Thank you for your letter dated August 12,1998, which was faxed to my office this morning. I assume your letter refers to my request at the scheduled hearing'on August 11, 1998, that the Board issue, or order the Building Commissioner, to issue an interim stop work order to Mr. Lupoli pending further action by the Board of Appeals. The reason for this request, as I stated at the scheduled hearing, is that Mr. Lupoli requested the continuance of tate bearing that the Board granted to September 8, 1999- In view of Mr. Lupoli's request for a continuance, he should not be permitted to take advantage of the delay he requested to complete, and possibly occupy, the building he is constructing in violation of the variances granted by the Board of Appeals and the site pian approval garlted by the Planning Board. Pursuant to Section 8 of chapter 40A of the General Laws, the Board of Appeals has the authority to hear and act on appeals from enforcement decisions of the building commissioner. Along with the Board's authority to reverse the decision of the Building Commissioner not to enforce the Zoning By-law, the Board has the authority to order compliance with the Zoning By-law pending its final determination. The Board already has evidence before, submitted by -Mr: Nassar at the hearing, that establishes the violations. We look forward to the Board hilly addressing the issues raised by this appeal at the continued hearing to be held on September 8, 1998. cc: James J. Nassar, Jr. 1:-gPMC OUINASSn12=LLriAK.LTt Very truly yours, Howard F. Speicher 2./2 08/13/98 12:29 TX/RX N0.0985 P.002 N Z NORTIo TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD OF APPEALS u August 12, 1998 Davis, Malm & D'Agostino Howard P. Speicher, Esq. One Boston Place Boston, MA 02108-4470 Re: 490 Main Street/476 Chickering Rd. Dear Attorney Speicher, This letter is in reference to your request for a Stop Work Order to be issued by the Zoning Board of Appeals regarding the property located at 490 Main Street/476 Chickering Road. The Zoning Board of Appeals does not see its role as issuing such order in the absence of legal evidence by you that such action is allowed under applicable law. If you wish to continue with this request, please forward to our office evidence that the Zoning Board is empowered to issue a Stop Work Order. Sincerely, William J. ullivan Chairman, oning Board of Appeals ml/speicher Town of North Andover OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES 146 Main Street North Andover, Massachusetts 01845 WILLIAM J. SCOTT Director June 15, 1998 Davis, Malm & D'Agostine Howard P. Speicher, Esq One Boston Place Boston MA 02108-4470 Re: 490 Main Street /476 Chickering Rd Dear Mr. Speicher. I am responding to your letter of May 13, 1998 requesting that I issue a stop work order for the on going construction of a building at 490 Main Street/476 Chickering Road. You have made your request pursuant to G.L. 40A Sec. 7. For reasons described below, I am declining to issue a stop work order. Your letter describes certain alleged zoning violations based on your assumption that overhang eave (s) on the Main Street side and in the side of the building facing Mr. Nassar's property encroaches further into the required setback and violates the dimensional requirements of the Zoning By-law. In fact, Section 7.3 - yard setbacks states that minimum front, side, and rear setbacks shall be set forth in Table 2, except for awes and uncovered steps. As such, no variance was required for,eave (s) setback. You also allege that the extension of the foundation one the side of the building facing Mr. Nassar's building was not approved by the Board of Appeals in connection with the variance granted by the Board of Appeals decision on Petition: 006-97, Dated March 20, 1998 which addresses this and all other variances as shown one the site plan and granted by the Board of Appeals. Plans on file in the Planning Department reveal that the building under construction is the same as approved by the site plan review process. If you have any further questions, please call my office. Very truly yours, D. Robert Nicetta, Building Commissioner Enclosure cc: W.J. Scott, Director, C. D. & S , S BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 , ' MASSACHUSETTS U141FORM APPLICATION FOR PERMIT T0:D0'PLUM131 (Type or Print) , �.;.;. iry ' NORTH ANDOVER Mass •.�-4; 6 . Date:' ''� Building Location Permit Owners Name New '[] Renovation Replacement 0 Plans Sybmitted FIXTV F5 sun-,esMT. BASEMENT 1ST FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR (Print or Type) Installing Company Name Check one: Certificate �] Corp. Partner. -: Firm/Co. Business Telephone &c23 - %3% Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy ET Other type of indemnity Q Bond Li 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 Coverages. . Signature of ownerlagent of property Owner Aged% I bembr cellifp 11181 all of We detail: and Worms lion I leas submiticd lot enmcd) in alws.c applicaliaa lite flee z1ale to VK bol r IV ' �• - kllowkdge and 11181 all plumbing work and inslallalinnt lice(nrnscd undo rcr4141 issued for this applicalioa wid be io btlNydiallpa Mid 1111 �a1llNalll vision of lbs Matsaaltusellt Slate Plumbiat Codc and Cluplct 112 01`111C (:cnual Laws. 8y . Title• City/Town: Signature of'Licensed Plumber Ty a of Plumbing License sus n ra/ z Z x in Y a H O of O Z I• > W a W W Y_ W lc x Z CC 416 IC O ,,,1 q W fp la- O = F- U cc W OI 07 Y a 0 0 Z d• z = ~ , V Z ac O O a lr m Q W >- IC a 2 h a H W a p s 4 Z < tt a• < l6 O• J K {� W 7WC F I'. W 0 0 .� ,-,t o' a !a- a �C O W Q k. « I- a> h O x a. 7 sa f z = 0 a O a °1 X E W W o k o 0 v W Z < 3 I•- < a x a s _ a J a 3 o x a A O J a O cc W oG < O 'X < I- O I.- fi O 0 < O 0 6TH FLOOR 7TH FLOOR 8TH FLOOR (Print or Type) Installing Company Name Check one: Certificate �] Corp. Partner. -: Firm/Co. Business Telephone &c23 - %3% Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy ET Other type of indemnity Q Bond Li 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 Coverages. . Signature of ownerlagent of property Owner Aged% I bembr cellifp 11181 all of We detail: and Worms lion I leas submiticd lot enmcd) in alws.c applicaliaa lite flee z1ale to VK bol r IV ' �• - kllowkdge and 11181 all plumbing work and inslallalinnt lice(nrnscd undo rcr4141 issued for this applicalioa wid be io btlNydiallpa Mid 1111 �a1llNalll vision of lbs Matsaaltusellt Slate Plumbiat Codc and Cluplct 112 01`111C (:cnual Laws. 8y . Title• City/Town: Signature of'Licensed Plumber Ty a of Plumbing License sus n ra/ 4 3614 Date. d- ..... .. /�.' 5;�r TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that .................. ............................... has permission to perform'...1-4.-lu ....................... ..... plumbing in the buildings of ..................... ........... at North Andover, Mass. Foe .... Lic. Na ... .... ........................ PLUMBING INSPECTOR 02110/98 11:32 30. 00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer