HomeMy WebLinkAboutMiscellaneous - Suite 68MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
Building Location
/ ` Owners Name
Date
Permit #
/ ✓ � �y
Type of Occupancy Z�1y iexc,Amount X",�
New RenovationEl
Replacement Plans Submitted Yes No
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or type) '��"�'
Installing Company Name—if
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Check one: Certificate
Address Iq Kpgbley,,be ❑ Partner.
Ale nC
„ Business Telephone �� Firm/Co.
Name of Licensed Plumber:
Insurance Coverage: Indicate the type urance coverage checking the appropriate box:
Liability insurance policy Other type of indemnity ❑ Bond
Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Owner ❑ Agent ❑
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' stallations peed under Permit Issued for this application will be in
compliance with all pertinent provisions of the M usetts to I ode and Chapter 142 of the General Laws.
By:SignaLure o is a um er
Title
Ty e of Plu zing License
City/Town 1kens um er MasterJourneyman11 ❑
APPROVED (OFFICE USE ONLY
198 Massachusetts Avenue
North Andover, MA 01845
(978)794-0010
GARY C. DEMETRIOU, D.M.D.
March 11, 2008
Town of North Andover
Health Department
1600 Osgood Street
North Andover, MA 01845
MAR 14 2008
TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
This is a letter of commitment regarding the office space located at:
451 Andover Street
North Andover Office Park
North Andover, MA
An amalgam separator and backflow preventer are in the plans to be put in
the above mentioned office.
Please contact me if there is anything further.
Thank you,
G C. De etriou, D.
Location
No.
Date
40RT" TOWN OF NORTH ANDOVER
Ota«•' •,4'C
p Certificate of Occupancy $40
r J
* ; + 'Building/Frame Permit Fee $
eundation Permit Fee $
� s�cHus t
O vG Or Permit Fee $
9 <� SeW4 Connection Fee $
ate r' nnection Fee $
TOTAL�2�A
Building Inspector'
Div. Public Works
Location'/'>-/.
No. i/�', Date /6,, :'r - 7
,'°"T" TOWN -OF NORTH ANDOVER
Certifidate of'Qccupancy
$
Buildinerame Pe`r`mit Fee
$
Q 0 r`
�ssncHusEt Foundation f=ee',
Permit
$
e r--Other'Permit Free
$
Sewer Connection Fee
Water Connection Fee
$
$
TOTAL
� .7
Building Inspector /
Div. Public Works
PER1iIT ANO.
N
APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS.
PAGE 1
MAP ado.
LOT NO.
I
2 RECORD OF OWNERSHIP IDATE
BOOK ;PAGE —
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SUB DIV. LOT NO.
LOCATIOPURPOSE
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OWNER' NAME ,q le- S�
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NO. OF STORIES [/ SIZE
OWN v
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BASEMENT OR SLAB
ARC ECT'S NAME
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SIZE OF FLOOR TIMBERS IST 2ND
3RD
BUILDER'S NAME
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SPAN —
DISTANCE TO NEAREST EUILDING
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DIMENSIONS OF SILLS
DISTANCE FROM STREET
POSTS
DISTANCE FROM LOT LINES – SIDES REAR
•' GIRDERS
AREA OF LOT FRONTAGE
HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW AI,N
SIZE OF FOOTING X
IS BUILDING ADDITION AAytz)
MATERIAL OF CHIMNEY
IS BUILDING ALTERATION ye5 Z /er/� N ���
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IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS CODE
�65
IS BUILDING CONNECTED TO TOWN WATER es
BOARD OF APPEALS ACTION. IF ANY
IS BUILDING CONNECTED TO TOWN SEWER es
IS BUILDING CONNECTED TO NATURAL GAS LINE e5
INSTRUCTIONS
SEE BOTH SIDES
PAGE 1 FILL OUT SECTIONS 1 - 3
PAGE 2 FILL OUT SECTIONS 1 12
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE /1F�I•LE1D AND APPROVED BY BUILDING INSPECTOR
DATE FILED f --2 w I M i
61�111 ILI 'rte `�
SIGNATURIYOF OWNER OR AUTHORIZED AGENT
,4 OWNER TEL. #�
FEE l� 0 t9 CONTR. TEL. #.�-03
CONTR. LIC. # 0'/L d�
PERMIT GRANTED
19
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3 PROPERTY INFORMATION
LAND COST ,1
EST. BLDG. COST -r &W0 /P/
EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
BOARD OF HEALTH
PLANNING BOARD
BOARD OF SELECTMEN
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North Andover Office
Park, North Andover,
MA
—Ciin =%g. V X 4V &a. wid
7 x V. if V
—ww *4" between► Aoee
-.,AN partiW" are Hoot b GOING vrlth
heading / & wndttlWN vwtta and
WlMW Itphthp outlet In waoh room
—Electro on all wage and on long
walla every 8 feet
—AAINmum of two 2 x 4 iourwo" tipFking
panels in "on office and the open area
Is 10 be wag I
�Ak Wm are to be controM by ewi&m
in eaoh room and open pr"
—New owpoonp wtlh peOW9 throughout
—AN vet painted
--trletagahon Ota jur4fim box and oonduR
—bumudon ofduplex wol Outlet at the
ptww wptwn WOW O.e. InsWe clo-
—kwjAetbn o1 a 1' x 1' plywood board
on the wNl for the Wwl&MUOn of the
Ph" gym*n
—kwaaadon of one(1) dedloated eie*dcml
CkVA from the eteatrlcat panel to the
Wcs wn of the phone eyWenr.
--Oheotorti ofte(locked)
Y"z
/ 5--60 s,
Mike
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North Andover Office
Park, North Andover,
MA
p..
—Glaaa In wderlar w*, b' x 4'&Q . and
7 x V, In doors at y
—Soled w&m bemoon dfloee
•,All pWtl " are floor ro polling with
NOV / & oondlltoning Val" and
i AMW Ilphtlnp oudew In eam Town
•Elecxrio on vl Wsk and on long
WWII eery a feet
..M1 IUM of two 2 x 4 fburDSCOM WWng
panels in each at** ars the oprn area
I. to be well it
All It" we to be oontroW by awiW"
In aaoh room and opar► prat
oarpeono wash p&OOWV tttroWpftout
—All walie pawned
..kwUWsL.Onof �,Y MSM'boxeW Wnduft
to Ute top of wallboard for woh We-
pWw •
_kunm don of AC duplex w@J outlet sit Ow
phone wpiwn lcoatlwt 0.e. IMMAM W-
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[ WA"don of 4L1' x 1' prywood board
on the wall fol the v ataMUon of the
—Nwamdon of one(1) dedareed deatrlael
x"Ud IMM the Whtr" pwrl to the
Wambon of the ptwne eyete+o.
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North Andover Office
Park, North Andover,
MA
—OWn U ext U' V x 4' aQ . and
7 x V. In doom to
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Is to ba *1911 a
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In aaan ruom and open ores
..t wp„Cn0 v Mh Palk N thrwohout
—AN WAM p.wnad
—k>rtaYation of a Jun dw box and oondult
to ttw top of WMAW rd fw "ah %We-
ptwrw bouton.
—kMtakdon of AG duplex welt "Id Rt the
aww Mwn WvWon O.e. IMIIAW c19-
- of a 1' x 1, plywood board
on the "I fw the kwWatlon of Me
—kwanadon �() dedN�Pe al
WGmjW of the phone tea•
—Oksomm QOwVOQQkG4
North Andover Office
Park, North Andover,
MA
N e "D
—mus In edarlo, V x 4' aa . and
r x V. In doors at V
—601W walla atw+an offt"
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h"*V / alr oondOning vwtta and
awltofwd bound oudeW In wM room
-EWwW on vl wak and on long
WWII @,my 8 bat
..Mlr fM n of two 2 x 4 SWOSO ra ung
p&rmw in "on aMm and the opim uaa
Is to be wdl It
—AK IOU are to be oorYt OW by aM&M
In won room and opon Orae►
—New owp"q warh podON UNWOrwut
—AN w&M pmUW
—kwrtaYation of a Jur�tlon box and oondult
to Vw top of wamoowd for wAh WG-
prww Wasson.
—Ina &&won of AC duplex w@J "W at the
phwna Mien Woatlwt Om. In*IW ole
—Mwtmkldon of a 1' x 1' plywood board
on to wall for Um IrWWAUon of the
—ktatalatbn of ona(1) dedaraed daWOW
ck"A from the el KMC d panel to the
l GOWn of the phone trysWTM
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Of
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
,SSACNUS�
<. it
This certifies that .. .. .
has permission to perform,- Y..
u� t
plumbing in the buildings of ..'J......G.: ...... ... ........
i
at. - u ..... ...... , North Andover, Mass.
Fee` ..r� .. Lic. No- 4?,/..... / - � ✓l,'�r.......... .
/ PLUMBING INSPECTOR
Check # �,�"� V /
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
MASSACHUSETTS UNIFORM APPLICATIONXIOR PERMIT TO DO PLUMBING
(Type print)
NORTH
ANDOVER, MASSACHUSETTS �A�Date
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n � ./ deC7G
Building Location ��r !U � )L'i'Q S � Owners Name /'�/, AA.; %�,ut R CFGC'c Permit # �
Amount
S0 i / � — Type of Occupancy Cr, M M r 2 G 1 %�t
New Co Renovation r-1 Replacement 0 Plans Submitted Yes No
FTXTTIRES
(Print or type)
Installing Company Name
Address V t [/ L.>0 x
1t) G cC If
Business Telephone
Check one: Certificate
❑ Corp.
11 Partner.
I1 Firm/Co.
Name of Licensed Plumber-
Insurance
lumberInsurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy Q Other type of indemnity ❑ Bond ❑
Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Owner El Agent F1
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 Issued for this application will be in
compliance with all pertinent provisions of the MassaclVzetp State Plumbingode and Chapter 142 of the General Laws.
By:i a o kens um er
Type of Plumbing License
Title .�,3 fo 31
City/Town icense Num5er Master ❑
APPROVED (OFFICE USE ONLY
Journeyman E
,i ••• MMMMMMMMMMMMMMMMMMMMMMMmm
...st@ • MMMMMMMMMMMMMMMMMMMMMMMMmI
(Print or type)
Installing Company Name
Address V t [/ L.>0 x
1t) G cC If
Business Telephone
Check one: Certificate
❑ Corp.
11 Partner.
I1 Firm/Co.
Name of Licensed Plumber-
Insurance
lumberInsurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy Q Other type of indemnity ❑ Bond ❑
Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Owner El Agent F1
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 Issued for this application will be in
compliance with all pertinent provisions of the MassaclVzetp State Plumbingode and Chapter 142 of the General Laws.
By:i a o kens um er
Type of Plumbing License
Title .�,3 fo 31
City/Town icense Num5er Master ❑
APPROVED (OFFICE USE ONLY
Journeyman E
v
� f
CERTIFICATE OF USE & OCCUPANCY
TOWN OF NORTH ANDOVER
Building Permit Number 512 Qnlo81 Date: Sotember 9.2008
THIS CERTIFIES THAT
THE BUILDING LOCATED ON 451 Andover St - Z�� (5�' eP
MAY BE OCCUPIED AS Commercial Space- Dentist Office
IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE
BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY.
Certificate Issued to: rna DMIl ou
451 Andover Street
North Andover MA 01845
Building hupeMr
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JDLaGrasse & Associates, Inc.
Architects, Engineers & Land Planners
ARCHITECTS CERTIFICATION OF SUBSTANTIAL COMPLETION
September 3, 2008
PROJECT NAME: Gary C. Demetriou, DMD Office Development
PROJECT LOCATION: 451 Andover Street Unit G8
NAME OF BUILDINGS: North Andover Office Park
ARCHITECTS PROJECT NO: 2161 G
NATURE OF PROJECT: Interior Development for Dentist
Architects
Joseph D. LaGrasse, AIA
Thomas F. Galvin, AIA
Julianna E. Hoch, RA
IN ACCORDANCE WITH SECTION 116 OF THE MASSACHUSETTS STATE BUILDING
CODE, 780 CMR -6TH EDITION
I, JOSEPH D. LAGRASSE, AIA REGISTRATION NO. 4153
BEING A REGISTERED PROFESSIONAL ARCHITECT HEREBY CERTIFY THAT I HAVE
PROVIDED CONSTRUCTION OBSERVATION SERVICES ON BEHALF OF THE OWNER, THAT I
WAS PRESENT AT THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS AND
THAT TO THE BEST OF MY KNOWLEDGE, INFORMATION, AND BELIEF, THE WORK OF THE
PROJECT HAS BEEN EXECUTED IN CONFORMITY WITH THE DOCUMENTS APPROVED FOR
THE BUILDING PERMIT.
TO THE BEST OF MY KNOWLEDGE, INFORMATION, AND BELIEF, THE WORK OF;
❑ INTERIOR SUITE BUILD OUT FOR UNIT G8 ONLY HAS BEEN SATISFACTORILY
COMPLETED IN ACCORDNACE WITH THE CONSTRUCTION DOCUMENTS.
D. LAGRASSE, A1?-/
D. LAGRASSE & ASSOCIAT
File: misc/idlai/architectsceniticaion99
Offices
One Elm Square
Andover, MA 01810
1420 Celebration Blvd.
Celebration, FL 34747
AA26001333
NM 4153
ANDOVER.
NAA
T 978.470.3675
F 978.470.3670
www.lagrassearchitects.com
CERTIFICATE OF USE & OCCUPANCY
TOWN OF NORTH ANDOVER
Building Permit Number 512 3/7/081 Date: September 9. 2008
THIS CERTIFIES THAT
THE BUILDING LOCATED ON 451 Andover St - 24, G= f
MAY BE OCCUPIED AS Commercial Since- Dentist Office
IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE
BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY.
f A �
Certificate Issued to Demetriou
451 Andover Street
North Andover MA 01845
Building inspector
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"p-1nsarnj �"' .m sawimd Permit Number.
BOARD OF FIRE PREVENTION -REGULATIONS Occupancy aFee
/wu w03UC 70 SE IIDUORMED MTH THE MASSAQWsr Td IILLCMCAL CODE 537 CWIt 12..M n
PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: • l ""z I% oy
City or Town of: , ANDOVER
To the Inspector of
By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Wires:
Location: (Street & Numberr))' �j/ C.l�1C' e,-
Owner or Tenant: 1V• ,4A44)Ut/f - 6l`jele—r
Owners Address:
Is this permit In conjunction with a Building
Permit? Yes No
Or"' oCheck
Appropriate ppropriate Box)
Purpose of Building:
Utility Authorization it
r
-
Existing Service: Amps /
Volts Overhead Q
Underground. ❑
a
# of Meters
New Service: Amps—/
Votts Overhead ❑
Underground.D # of Meters:
Number of Feeders and Ampaclty
Location and Nature Of. Proposed Electrical
Work. ��<ST�I �/��7 /,J
dl 7724c1c------------------------
-No.
No. of Recessed Fbaures
No. of Cetl; Susp. (Paddle) Fans
No. Of Lighting Outlets
No. of Transformers Total KVA
No. of Hot Tuba
Generators
No. of Lighting Fbduns
r
Swimming Pool: Above ground 0
KVA
In Ground 0 # of Emergency Lighting Battery units
No, of Receptacle Outlets
No. Of 011 Burners
Fire Alarms 0ofzones
i
EE
No. of Gas Burners
* of Detection & InMAWV Devices
M of Sounding Devices:
FNNo.s
* of Sen Contained
No. of Air Conditioners TOTAL TONS: Detedbn/Sounding Devi
No., of waste Disposals
Heat Pump Touts:
Local o Municipal Connection 0 Other o
Number. TONS:
Security Systems:
W.No, of Devices or Equivalent
No. of Dishwashers
Space /Area HuUnp:
Kyy
No. of
Data ung N0 of Devices or Equivalent
Heating Appliances
KW Telecommunications wiring: No of Devices
or
Equivalent
No. of Water Heaters KW
No. of Signs* of Batlasta.
p of Hydro Massage Tubs
_#
No. of Motore Total HP
OTHER;
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance
including 'completed operation' coverage or Its substantial equlvalI The undersigned corn" that such coverage Is In force, and has exhibited
issuing office. CHECK ONE: INSURANCE O- BOND O pn� of same to the permh
. OTHER o Please specify:
Estimated Value of Electrical Work s
(When required by municipal policy)
Work to Start:
I art/fy, under the Ins and inspections to be requested In accordance with MEC Rule 10, and upon completion"
P+ pena/tles of perJurY, that the Inform t/o
this appll tion Is We and complete.
Firm Name: U,L j v
Licensee: z`/Z/ L�/ �G/ �✓ u LIC. * , g Z
S�7#nwr
ture:
(Napplleabp In the LIC. a�'Z
������ OGw bar IlneJ
Adores:: tc�/
Bus. Tel. + 2� /�7
All. Tel. ar �•
OWNER'S INSURANCE WAIVER: I swan that the Llt:ensN does not have the Uabtlhy Insurance coverage normally required by law. By my signaturo bei I �
waive this requirement I am the (checkck one) Owner 0 OR Agent 0
Signature of Owner/Agent:
Telephone
N2 4404
1 0.0
Datex�-7 .......
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that .......
has permission to perform
................
plumbing in the buildings of_. .
.
at ....... (F .......-� ................
.. North Andover, Mass.
4
Fee�� ...... Lic. ............
PLUMBiN6"CNSPECTOR
Check #
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
f P�/Date ���`� v
Building Location L-15) A Ndo Uf C- S40wners Name NoR-- P ue/C o ACrci Permit X41 �
a
G
ount �<
of Occupancy Co nl M -eQI e
New M Renovation M Replacement ® 1 Plans miffed Yes 11 No 11
(Print or type) Check one:
Installing Company Name Sp / 09!24 l•) / L t//! 1 �i/1/��_ Corp.
Address yc e�` �# d / Partner.
Certificate
Business Telephone 77 8' 1- 3 . Firm/Co.
Name of Licensed Plumber. si}. d.4 �C cl—,yeAc 64CJ
J surance Coverage: Indicate the type of insurance coverage by checking the appropriate box: ❑
Liability insurance policy M Other type of indemnity ❑ Bond
Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
ignature Owner Agent
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 Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
By: Signa oof'�dpl
? ofPlumbing License
Title a3
City/Town icense um er Master ❑ Journeyman
APPROVED (OFFICE USE ONLY
Joseph D. LaG
One Elm Square, Andover, MA 01810
tel. 978.470.3675 fax: 978.470.3670
Associates, Inc.
www.lagrassearchitects.com
ARCHITECTS CERTIFICATION OF ROUGH FRAMMING COMPLETION
PROJECT NA Suite G8 -North Andover Office Park Tenant Improvements
PROJECT LOCATION: 451�n�over Street, No. Andover, MA 7
NAME OF BUILDINGS: 451 Andover St., North Andover, MA
ARCHITECTS PROJECT NO: 2172
NATURE OF PROJECT: Interior Reconstruction
IN ACCORDANCE WITH SECTION 116 OF THE MASSACHUSETTS STATE
BUILDING CODE, 780 CMR - 6T" EDITION
I, JOSEPH D. LAGRASSE, REGISTRATION NO. 4153
BEING A REGISTERED PROFESSIONAL ARCHITECT, I HEREBY CERTIFY THAT I
HAVE PROVIDED CONSTRUCTION OBSERVATION SERVICES ON BEHALF OF THE
OWNER, THAT I WAS PRESENT ON THE CONSTRUCTION SITE ON A REGULAR &
PERIODIC BASIS AND TO THE BEST OF MY KNOWLEDGE, INFORMATION, AND
BELIEF, THE WORK OF THE PROJECT TO DATE HAS BEEN EXECUTED IN
CONFORMITY WITH DOCUMENTS APPROVED FOR THE BUILDING PERMIT, AND
AMENDMENTS TO DATE.
TO THE BEST OF MY KNOWLEDGE, INFORMATION, AND BELIEF, THE WORK OF;
❑ ROUGH FRAMING, PARTY WALLS, AND CONCRETE FLOOR
CONSTRUCTION HAS BEEN SATISFACTORILY COMPLETED IN
ACCORDANCE WITH THE CONSTRUCTION DOCUMENTS, AND CAN
CONTINUE TO GYPSUM AND INTERIOR FINISH.
❑ EXCEPTIONS:
jdlai@aol.com
MECHANICAL AND ELECTRICAL SYSTEMS ARE NOT PART OF THE
REVIEW.
A, ��RED AIQC
J S . H LAGRASSE _ IA
JONdPH D. LAGRASSE ASSOCIATES, o
No. 4163
ANDOVER,
MA
Principals
Joseph D. LaGrasse AIA Philippe R. Thibault AIA
Member of the American Institute of Architects & Boston Society of Architects
,h TOWN OF
-• o
PERMIT
Date . � `� . �' . .
N RTH NDOVI
FOR R LUMBING
�SACMUS�-
This certifies that N .. �? .............
has permission to perform ...-.- ............. ..!.. .
plumbing in the -buildings of:..............-"�............. .
at. ....................' ....//. , North Andover, Mass.
Feed./ .5�. Lic. No/17?'G"/.
PLUMBINGP PECTOR
Check .H 2n'6
!V8!