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HomeMy WebLinkAboutPlumbing and Gas Permit - Permits #10692 and 9476 - 38 TURNPIKE STREET 8/18/2014 TOWN VER FNORTH ANDO O 0 PERMIT FOR dot, �Qcwc-1 This cert�ifies,that..,.............. ........ ......... ....... has permission to perform.,. ...... plum'bing in,thebuildings of'... .a..Ma.a,.��.M.sea,�..M..M.a....a.a.,...a..a:.....a......aa North Andover,,Mass. .......... ....... eaa Ma7 .................. Lic. NO ...... PLUMBING INSPECTOR Check# .......... MASSACHUSETTS _ UNIFORM ICATION FOR A PERMIT TO PERFORM PLUMBING CITYT# r �w I' r. 4 iH.n.,.im.r-_�rvdfle � ernwu.,wnrr MM�YA1��^^T""°'"'npw'M �.� I I I b MA DATE em � t m- JOB .., wr,..Irw!�W+i..�w.r.S.n.i-+.vrwi.u..',X.ti�r+"X. .......Mw.."a.r+.-:.......yr..�.r.e.m..primmra sm x new w's....r....�.mto-V'ie......nUW.ws♦ .+..:...i��..�..wII OWNERS NAME SITE ES tl• >n PMXn Xn'1�r x+x.tTn{w'yll 'r w WAPMin'.MwY.r.Mn+A.wr(nut(sYwe OWNER ADDRESS TEL FAX: - x�n .� rvwnr�III '��a+�R4:,u w.i r...•wexi„u�.xxer ,. IMrv —r=1r=n--. I TYPE OR OCCUPANCY TYP E COMMERCIAL I�� EDUC NAL RESIDENTIAL PRINT10,000010 RENOVATION-.t -. REPLACEMENT: PLANS SUBMITTE ,:II YES E] NOD BATHTUBI CROS SiE� TII E� IE I I F. I�" :: :,Xa ----- DEDICATED TE SPECIAL WASTE SYSTEM � I � I _ I i f DE I TED GI IS II ISSN SYSTEM x "J DEDICATED GREASE SYSTEM I ......... ---------- DEDICATED GRAY WATER SYSTEM � I I � DEDICATED WATER,RECYCLE SYSTEM w I' I DIS VVAS E :. f J I I I II ING FOUNTAIN IF I FOOD DISPOSER I I - w ; _ T �I IIF .. _.v._ r,.... __�.. �.X_ _ _ �.� �J FLOOR AREA DRAIN , I I I IT I CE T R, INTER]0 I .ITI E SINK -............ LAVATORYI I I I I - 1 ROOF DRAIN �x SHOWER STALL I I SERVICE MOP SIIN I f I I TOILET I LI ,__v,_.,....._-...a.n�.., �.,-._..,,.._,r: ...,_....:. ,«m_..n.i;, r._,.-..,.-r...», r-. «•,n x..........n ...x.,�..�.,a�v.w. n.,..�.,..,. URINAL � e WASHING MACHINE CONNECTION I VVATER HEATER WA,TER PIPING a � r I OTHER a 9 I L w� r �A.,.___""—' __—"_"t__,"�'¢'_'..'_"'mm^__ ..__.,. .__..,.__,,...,_.�. ,. ,.�.. :.:,. .,:......vr..�..w�„wn�•crw'Xnw.n.w.wo,� r.:._.,.:.:,_..... ':. ,~�r.^,. r � � I I I p K r a i I I e I el 4 I Iq I � : a r •.:�e r mn r«.mr"x x'x r m•.nr i..u• n u mm:.-ux,ax n xm. —'S __... r p '.m_:r.'.�� "- ,.naw� "u'i u'a'..iv..._�.•._°i i aM's. '� _rn:x. mm-nr^w� �n. INSURANCE COVERAGE.P m r■ insurance ■ c Id YY � havecurrent- I liability ins r nc I'i � � r itssubstantial� i l equivalent which meets-the requirements, MIL Ch.1 , YES ' N, .. , w PF YOU CHECKED YES)PLEASE INDICATE THE TA F COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY I'IIIE POLICY OTHER TE IIIIEIJIIT _P BOND [.._I Zzi E ' WAIVER,-,-I aware that the II I theinsurance I r� required' r f the GeneralMassachusetts era t � `I � signature r ru~� I � IIi n "Iin � t1�� requirement. CHECK ONE 0 �' L � , AGENT 10--' SIGNATURE, E OWNER OR AGENT hereby certify that all of the details and infarm tion I have submitteldor entered regarding!this,applicatiorLAW, and' ate to the best of rny knowledge and that all plumbing work and instaliations performedunder the permft Issued for this l tan in It Rte 1 II Pertinent provision of the Massachusetts;state Plumbing Code and Chapter 142 of the General Laws.. o l` loo I�' I mm PLi PLUMBERS NAME � �LI RI SE� CA SI I IATURE MAI ,I a d 0 J,P El, CORPORATION[ji,,# ��PARTN E R IS H I,P E, �LLC 131V COMPANY NAMEI lot, YZA Lk �T I �T TE ZII TEL >/0 i'` FAX ^"�^ tl' CELL �^d K �f�� � EMAIL LI-W-2 I Illrrr��nnnrc ROUGH PLUMBING INSPECTION NOTES -BELLOW FOR OFFICE USE ONLY FINAL INSPECTION E4 Yes No s THIS APPLICATION SERVE'S AS THE PERMIT [:1 ❑ FEE. PERMIT 0 --- PL .1 REVIIEW NOTES I �~ The Commonwealth ofMassaOuse#s - Department of-hidustrialAceldiiks Office Of ffivesikafions 66 Washington Street Boston,MA 02111 ;vr ass,go v1dia Workeis' Compewation Insurance Afrada-vit:Buffders/ContractorsfFIectriciansf-Pliiinbers -cant formation 'lease Print Legffil Name(B-asin ssio` ax ation/& -rid-a .: k LL Address: ................ P City/State/Zip. Phono#X .re you an e io c ?check ffie appropriate box; Type of project(required.): _1.0 1 m a employer with mm -- 1 am a general contractor and 1 6. El New con.struction mploya 3 M and/or paw tea).* have J.ke d the mb-G outractor t .1 a a.s D pr pxjetor or P a a QK- sied on the aache�, t, ` ; oa�v�deg ship and1avo no.c . loyees Thane sub-contactors have 8. El DamoHflon oimng �0x e a.m capacity, . ]Buffdffig audition [No- er D-r 'COMP. surauco 5. Wo are a c orp exagon audits10. C eftleal lop aks or additions q ' d.] 0 COO have e- I 1)���umbing re airs or ons 01 ate. meo . or d - a - r0x right o c e p en per M � MYS elf.[No Wgrkals,cOM c.1 ,§1 ,and wo ha o no 12.0 Rooftepaks 13.E]other comp.t s ance re ed. �-�n applicautthat checks bo X mustalso fill outthe seotioa below sho i gtheir or ors"oompensationpAGy i o atio . 7 Homeowners who submit fhig a. tdavit ingoathzthey tiie dp'mg all-work and then hie o-atsido contraotois must su met a now affidavit indfoaffig Muth. � oitfraoters that chcok 19s box mxist aached Migdlflonal sheet s'hawt g tho name of tho sub-con actors and their workers'comp.policy information. I am an MY lover that i ro ing workers'coinpensafion iftsurancefor n,y employeay. Relo the-Tolley andjoh site inmanc e,C omp my Name: Policy or 801-f-ing.LIG. ." Exviratloa D ate: Job Site address: Icitylsteof i Attach a copy offlio workers"comp P. a on olley declaration page o ing Vie p oNey numb or and expliraVon date). ao to socure coexge as Taqy1"Tec1undQr Sodion25Aload . eso oc �a pae a fluo up to 1� o 0.0 and/or onao-Year imprlso ant,as well as civil ponalfles in the form of a.8TORWORK ORDER.and a fts o u o$250.00 a day against the-10 o Beadvised that a copy offs statementma be fozwarded to the Office of Juvastigations of tho DIA for ms an c` erag oxi [ca on. o 11e.e ,y file 8 at es o ' ep ffia the i ormidio rov ec abo lsftue c rro .ee w re: t7a� \L Da : _Jt, )I Tho e V.. R Official use ,y. . o not i e 1 area o eon �'etec city ar town offlelal. City or Town: Permit/License 0 Brig. ntlaity(circle 1.33oard of ealth 2.Building Departmeet 3.CityJTown Clerk 4.Electrical Inspector S.Numbing fuspector .Other Contact Per on: phone J Date� f ..............W..p..rvpw iiJ�.�x p.xF"i.ww mxn.awrvue...p on xk it T OWN OF NORTH ANDOVER S, INSTALLATION PERMIT FOR GA .. w T Hu This certifie th s a wi........ .ww..x.xi.wm.w.pi..w..ww.iw....;...i.... w.w..e w.w wa w.ww pww..x.x..ii�w.... has perrmission for gas i s .......x�.......w..i..ww ..��........p.w��.....xxi,.w...xwwisww.ww.w.w..,www.x.w buildings,-_�" tlf l4.w..v.. .w.rd xw w.w....wxwsiw.+wp..nsWwW••••••'•N•........ 1 � w�w Andover,i.......ww.. ?W i Fee �/� iia n e � „�it, " i ....� .x.,w.w �: ....., � .,. .,ww.w � i�.,...w...�s xi fa!w.rw, xiw..ww.,ww...wx ww www i.w w�w w ww.w,w,p,iiq�.wx.,.,wxe ii-w.sw ./w.�..w wx x.p....w.w iiwww w.war• GAS INSPECTOR } '✓Affl /,�..'�.v/.. i/ii„ .,�ii,,, ,nip /i/i,l ii //i,.ii. .✓ai/,i i�� I I APPLICATION IT TO PERFORM GAS FITTING WORK v CITY IVIA DATE FS OWNER DRESS T E L TYPE OR PRINT OCCUPANCY TYPE COMMERCIAL, EDUCATIONAL CLEARLV NEB': RENOVATION- REPLACEMENT: PLANS,SUBMITTED: YES N PPLIA CES 1 FL S--+ BSM 1 2 3 4 5 61 � 7 8 10 11 13 1 BILE BOOSTER� CONVERSION BURNER COOK STOVE DIRECT VENT T HEATERDRYER I FIREPLACE FRYOLATOR FURNACE GENERATOR I I GRILLE INFRARED HEATED LABORATORY COCKS KELI ' I' UNIT' E POOL HEATER ROOM SPACA E HE TER7T V, ROOFTOP UNIT TEST _ I UNIT HEATER " E TE D ROOM HEATER "ATE .SEATER, w THE m , u INSURANCE COVERAGE N have a current liaboily insurance policy or,Its substantial equivalent which meets the requirements of'MGL.Ch.142 YES aNO II IF YOU CHECKED YES,PLEASE INDICATE TYPE OF COVERAGE LIABILITY IT NCE POLICY INDEMNITY I OWNER'S INSURANCE WAIVER-I am aware that the licensee does not have the insurance 'der required, m Massachusetts r I Laws,and that my signatureI r It application wai'vesthis requirement. I AGENTCHECK ONE ONLY,- OWNER SIGNATURE OF OWNER AGENT A A I hereby certify that all ofthe detall 'and information I have submitted r entered regarding thisapplication are u to the hest of my knowledge, and that all plumbing workand installations,performed under the permit issued for this application mill h ' _ � µ� � rt nt provision ision f the Massachusetts StateJrIn C ter 1 LICENSE E SI TN EPL E -GASEITTER NAB or GE P l PARTNERSHIP LI I TI LLB COMPANY NAME-' AD RESS' CITY STATE TEL � WM ..,..�.._.: .. .,.. ._.:.. .. � wMwYAVH�ti9AM1➢MM. ,', ;... ;, I � � W� M" �I u FAX,(,, �` ELL EVIL` . L Jb m I I - i ,', _+1rF_ _ _ TV MB1_ HOF MA sJr+r` r•.;',..5r.•''.�-., _ .';_y•',tip;.. :... .. � '��_,.�µ�':. (('{{'''�� - . r r ' R+