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Home My WebLink AboutGLSD - Organics to Energy Project - Building Permit #21169 - 240 CHARLES STREET 8/22/2016 2/ 1 , t :August 22, 21,169 This i - erm it.To Isere more,scan this barcode or visit northand rma,viewpointGloud,comt#/r rds/2'1169 TOWN OF NORTH ANDOVER PERMIT FOR, GAS INSTALLATION RI This certifies that aul_J Dipope hpermission for gas installation Provide gas,piping,to I w t it heater and - 2 generatM in the, uildings of LAW,RENCECITY OF AIRPORT COMMIS t 240 CHARLES STREET w North Andover, Mass. ic. No.. 1 IThomasIKs From: 'Town of North Andover MA ! tPlyiilu . tw Sent: Monday, August 22, 2016 6: 9 A To: Thomas . K is Subject-, Payment made for undefined #21169 1d,1 Town of' North Andover, MA P i'd UUNUIV, j� i tl i:• y ThanksusinyoftmService Thomias Kosik 2 169 August 22 2016 Permit e $1010.00 Total $100.00 1 I i I Powered by the ViewPoint Cloud platform i 111 1 01 *Gas Permit# 11 -Vi wPoint Cloud 2116Z2 *Gas Permit—In conjunction with a Building Permit(Commercial or Residential) Permit Issued TIMELINE Su fission receive! Aug 19,2016 at 1 : r Permit Issuance Issued Aug 22,2016 at Gas Permit Review Completed Aug 22, 2016 at : m Permit Fee Paid Aug 22,2016 at 6: ar *Gas Permit#21169 in conjunction with a Building Permit(Commercial or Residential) identiai) #tp ,/In rthandov rma-viewpoint loud. oml#lr r s1 1 6 . ..................................................................................... . 114191 1 *Gas Permit## 11 9-Viewpoint Cloud Location Applicant 240 C ALES STREET(A),, NORTH A DOVE1 , MA Thomas Ko ik Owner LAWRENCE CITY OF AIRPORT COMMIS(View Owner Information) Attachments Uploaded by Thomas Kosik on Aug 19,2016 10:50 AID# Primary Contractor Search for your Gas Fitter License using the search bar below.Either the Firm's Name or ficensee#is required. Firm' (Business)Name Plumber- astitter Name(Li en ee)" License#* Type of Business License Type* License Expiration Cate* License Active License Status Paul J Dionne 11164 Master Plumber 04/30/2018 0 Active Failing Address" Preferred Telephone#;* Fax# Email Alternate Phone 2 JONSPIN RD.,WILM[ GT N MA 018871019 -3990 978-657-3997 T M@PJD1 N . M617-293-6908 l hereby certify that all of the details and information i have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing wort and installations performed under the permit issued for this application will be to compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.'" Project info tips//nort ndov rma.vi wpoint loud-corm#/r cords/ 11 l ........................................................................................................................................................................... . .... ....... ....................................................................... ... ..... ......................................................................... 111 1 01 ""Gas Permit#21169-ViewPoint Cloud Is this Permit in conjunction with a Building Permit(select yes or no) Yes Occupancy Type(DOTE:For any residential building larger than two family please select Commercial) Com r ial [ndu tri I iuc tion I Total#Units* Type of Work* Description of Work to be Performed"` Plans Submitted Are you installing a generator? 1 New Construction Provide gas piping to 1 water Neater and back-up gas to 2 generators 0V Yes Are you installing a propane tangy? Date Work is to Start(inspections to be requested in accordance tiwh MEC Rule 10,and upon completion) 11 Generator Application o Installation of Ground Disturbance before approval Generator KW" Use 1500 Commercial Describe where the proposed generator will be Iocated on the Property inside building Fixtures/Appliances Fill in all proposed fixtures/appliances,their location,and how many are to be installed.1f the item is not found It may be listed under"miscellaneous fixtures/appliances" below. If it is not in that section enter the item under"other'within this section. btt :llnorth ndo erma.viewpoint loud.co 1#/r ordsl 11 / ....................................................................................................................I.............................._._.._...._............................................. . . . ......................................................................................... . ............................................................ 1 1 1 1 *Gas Permit 9211 --ViewPoint Cloud Total Number of Fixtures/Appliances Please add up the total number of fixtures and enter it below Total#of Appliances/Fixtures Miscellaneous Fixtures/Appliances Please complete all that apply Gas Meter and Near M t r Piping Remodeling of Gas Piping-Commercial Remodeling of Gas Piping-Residential Swimming Poof Heater Temporary Heater L.P.Gas Installation Permit Q C-) ,#Of Residential New/Replacement of Water Heater(s) f Commercial New/Repfacement of Water Heater(s) #of Residential Furnace or Gas Boiler Replacement ement and Conversion Burner f Commercial Furnace or Gas Boiler Replacement cement and Conversion Burner Test Total Number ter of Roof Top Heaters 0 Total Number ber Roof Top Air Conditioners hftps://northandoverma.viewpointcloud.com/#/records/21169 416 1119/ 01 "'Gas Permit#21169-Vie Point Cloud Direct Vent Neater/Fireplac Insurance I have a current Habifity insurance policy or its substantial equivalent which meets the requirements of M t_.Ch.1 .If NO is selected a copy of the signed Owner' I nsurance Wa ive r rust be attached to this application. Yes If yes,indicate the type of coverage If'other',specify Liability Insurance Policy Worker's Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumber To be filed with th e permitting authority Are you an employer?Select the appropriate type.Any applicant that selects#1 must a[so fill out the section below showing their workers'compensation policy inf rm ti n, 1. I am an employer with employee (full and/or part-time) Type of Project Plumbing Repairs or Additions I am an employer that is providing workers' compensation insurance for arty employees. Below is the policy and Job site information. Failure to secure coverage as required under MG .152,25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,ent,as well as civil penalties In the form of a STOP WORK ORDER and a fine of up to 50.00 day against the violator;A copy f this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Insurance Company Marne(Attach a copy of workers'compensation policy declaration page showing the policy number and expiration date) Amgu rd Insurance hltps,/Inortharidoverma-viewpointcloud.com/#!records/21169 ! .................................... 111 1 01 *Gas Permit# 11 -View point Cloud Policy#or self-Ins.License Expiration Date PJWC556297 1 017 Workers' Compensation Affidavit Signature I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. 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