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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 1 Lb' L / 'i t W117XlRMMMMMMMMM mmmmmmmim��wi� J 1 .. ' mm ----.------------------E .,1 . • • MMMMMMMMMMMMMMMMMMMMMWM M1 IM MMMMOMMONEWEN or type) '��"�' Installing Company Name—if f 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 — ZONE SUB DIV. LOT NO. LOCATIOPURPOSE �l �llDuG� ra Ca>DAKe /eW J OWNER' NAME ,q le- S� (/10['10 NO. OF STORIES [/ SIZE OWN v S ADDRESS s/ vC` A 1/11 m BASEMENT OR SLAB ARC ECT'S NAME / SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME �n //� L _.� _ _ 1 T UTh GYN • �j/J� SPAN — DISTANCE TO NEAREST EUILDING rLi�ilZ�. 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 ��� •f/?OF 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 S=.P 2 7 ���. 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 'NV1d lO1d S30V ld3t1 SIHl 'O350dWRl3df1S '013 'S39VU -V9 'S3HO2lOd H11M 'SONIa1If18 d0 SNOISN3WIa 17VX3 aNV S31N11 101 WONA 30NV1S1a aNV lO1dOSNOISN3W1a 1OVX3 MOHSISIIW N01103S SIHl El I AONVdf1000 L ONOD31 JNIa11n9 ONIIV3H ON —I PIE P°L1W.9 D1M17313 110 SWOON i0 'ON L SV0 S631V3H 11Nn EXAM 1NVIOVM ONINO1110NOD MIV MOdVA NO 6,1.M NOH WV315 'NMni MIV NOH O3ONOi 3JVNMn3 SS313dl'd _ SM31iVM OOOM �SIOD 2 'SW9 1331S 'S107 8 'SW8 M3EWIl ` 1SI0f OOOM ONlIV3H it I DNIWVHi 9 Oa VO 3111 d0O1d 3111 _ S3dn1X13 NSIGOW- ON13008 11021 _ M3MOHS 11V1S 13AVNO '8 MVI ON19Wnld ON NNIS N3HD11N 31V1S 330NIHS DOOM AMOIVAVI S310NIHS 11VHdSV 13SOID 431VM M--dIH 03HS 1Vli 1'X13 ZI 'WM 131101OMVSNVW I 137i9WV9 I 319VO �9 'XI3 C H1V9 9Njownld OL 100N 31755337 MOOd 1-1 3 MOl 3d S ONINIM 3WVM3 NO 3NOI5 AMNOSVW NO 3NO1S �N19 M30NIJ NO ':)NOD _I NOOK 4 'SKIS 7I11V 3WVMi NO NJIM9 AMNOSVW NO NDIM9 —� E l 9 3111 'HdSV NOVIWOD 3WV83 NO AMNOSVW NO omnis ONIOIS '1M3A ONIOIS SOIS39SV O, M08VH ONIOIS LIVHdSV S910NIHS DOOM O1:) HINV3 313dDN0D SOMV09dNIGIS SNOOK 6 I S11VM b W008 OV3H 1.W 9 ON N3HD11N NM300W S3JVld 3MI3 V3MV JI11V 'Nld V3MV .1.W.9 NIA % °% '/i lln3 V3MV — — _ L HSINIi t N13Nn llVfA AMa 831SVld am(JMVH 3NId E 10I1131N1 S II X� LN3W3SV9 £ •_ — SM3ld 3NO1S NO Nn1M9 I— N.19 3138DNOD 313tDN05 NOIlVONnoj Z N0u:)n Ll1SN07 S1N3WINVdV - S3JI330 AIIWVq 'I11nW _— S31M015 All!NVi 3lJNIS El I AONVdf1000 L ONOD31 JNIa11n9 cn (A -1 Q1 TI � -1 (A -1 : 0 70 3 m 5 o cu o o � o o x c� to w c T d c 3 c fm m r-�v m N C W v? n ^ O m a r D �o n z v n c� O T TIV Z Z Z � tA M d n ell O -� i 0 �o Z •O cn 1 ' 2 cn rn 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 .SSS- 44/7 A 9 l%!N ,Nk, .JA 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- oo [ 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. -4)kOowr4 OTWO(laOW4 North Andover Office Park, North Andover, MA —OWn U ext U' V x 4' aQ . and 7 x V. In doom to —SoIW walla GatwNn aOWN p ltlorn are furor to OWN %1111 harlinp / alr oondlrioning "W" and awt00f1od jMWV OW" k1 @aW MM —EWWW on all %WWW and on long %a11a W" 8 f" —A,Wyrrwm of two 2 x 4 tourwoord fang pirg" In "on olthw and the OW arw Is to ba *1911 a .,m Y" wo 10 be =%row by BMW" 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" .AN pwWo o we 1" b ouliha with 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 -4Olremm UMMOGOW 4 1c d O 0 m 91 n'1 mn O �s m ^� O a a 1 s Ma 2 0 M< r - i.� a- --Date. N2 4. 5 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 � 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 R`7 LL m m VI m m C= y CA Cl) CD C `C � d 'v O n Z y CCD O 'v C' r- c m � c CZ _' y -�v o O v CD CD o CLQ % CD CD CD CD UPCO a C O Co) a, v y _• o CO C=D S- CA O 'v Z CD O CD CD 0 C O to ?5-EZO o C Z d y � m y y moo, o 2� ca m C' CD 4. = m nim =_ m 0l o CO y O --40 9mm = � Z ;.; %NCD O Z �• Co9 :.w O m 1 H o CD CD O N "c,-• V�1 nC.) : . :. 5 o: _ o ~" = m C/' p �. /n i a��G Cil R' V' p °' ac O C or �^ O. 11 d o GO �} �C" xtz (Da- O -� -ol� e a z O 0 y 09 O C 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 e�• Eli m W 5- R d --4 z O aW < Q N O COD Ci O to n am CD Z N � 2 h 2. OCDso .w ~ _ ..► O N T O -4 CD m N C y O O Gm a >_ > CD tC O ?` % OZyC! :• c aym iG O O O N OQm CD n0•r N ���,•: C. CL Q C c H m C= co ca N N O 1 •„ D CD O N SrCD 4. o' �, a -4 H C5 m ^1, 3,^ `'• 0 V- .� N CD pQ Wcob �► s� C, o IW m : C M: G �; ` C � o O C d y Cl) � m CD CLO r m =� c CZ y m -o CD CDCL O O ////� Vcr m CD y o CCD CD m c CDCD y� CL a y O CD I CD e�• Eli m W 5- R d --4 z O aW < Q N O COD Ci O to n am CD Z N � 2 h 2. OCDso .w ~ _ ..► O N T O -4 CD m N C y O O Gm a >_ > CD tC O ?` % OZyC! :• c aym iG O O O N OQm CD n0•r N ���,•: C. CL Q C c H m C= co ca N N O 1 •„ D CD O N SrCD 4. o' �, a -4 H C5 m ^1, 3,^ `'• 0 V- .� N CD pQ Wcob �► C, o IW m : C M: G �; ` o O C � m It O pQ Wcob w S TW4 N QG = OAC rD A. o A 0 CD LO C14 of Z. w 0 ZI 0 Q � 0 Z LL L 0 z W 3 C. 0 d dl l6 F- ie Y Z FL C G nwea o` ii/ad�utdsU! For Office rel 2 i �� (Rev. 11199) "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!