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Home My WebLink AboutMiscellaneous - 12-14 Water Street x Date.. . 3. . ... .. L HORTM Of"0. 6 6TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION • o �a �1SSCMUSEt This certifies that . . '. . . . . . . . . . . . . . . . . . . has permission for gas installation_ .,: :'. in the buildings-of . . .- � f' ,.:" �. . . ... .. . . . . . . . . . . . . . . . . . . . at . . . . . . . North Andover, Mass. `Fee '. . . . . Lic. No.. . '� r . . . . . . . . . . . . . . . �i GAS INSPECTOR Check# J / 4331 t i I MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS HUNG (Type or print) Date �74-- -Q 3 NORTH ANDOVER,MASSACHUSETTS Building Locations Aa kM -ZeA 5r Permit# 1Amount$ ZU v I /V Ic*j C 4 0 4eluyml Owner's Name New❑ RenovationElReplacement ® Plans Submitted ❑ w � a o U w a � N H �. z c a r � � w � � � ° o c a � r w x U w z q z d x w C O H a a z o a° � g a H o [3R B-BASEM ENT SEM ENT T. FLOOR D. FLOOR D. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH . FLOOR STH . FLOOR (Printf or type) T 1114L L �� M h�k on . Certificate Installing Company SName ❑ Corp. Address d- 13 O X S 7 oZ ❑ Partner e-4w4 e.-v« aid' SQL Business Telephone -971 6$'!5-' 9 5-0 y ❑ Firm/CO. Name of Licensed Plumber or Gas Fitter Tyyn AS 414/jO leq^1 INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ® No❑ Ifyou have checked,M,please indicate the type coverage by checking the appropriate box. Liability insurance policy ® Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver: I am aware that the licensee 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: Signature of Owner or Owner's Agent 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 Gas Code,.and Chapter 142 of the General Laws. �-j- By: Signature of Licensed Plumber Or Gas Fitter Title ® Plumber �t V t 3.3 City/Town ❑ Gas Fitter License Number ❑ Master APPROVED(OFFICE USE ONLY) ® Journeyman r Date.'/f. `;P 0- 3 ".SRT:�+ TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACNUSE� 1 This certifies that . . . . . . . . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . s plumbing in the buildings of . . . .>` at . . . . . . . .` . . . . .. .. . .. . :. ' . . . . . . .. North Andover, Mass. Fee.� r?.`. . .Lic. No. pv z . ` !. S-�.: . . . . . . . . . . . . . PLUMEIN INSPECTOR Check # / 2 2- 5560 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date y' Building Location IQ 16". 7e"4 51— Owners Name M;C14#C I alewAlOAl Permit# Amount 30 Type of Occupancy New Renovation13 Replacement Plans Submitted Yes ❑ No MI FIXTURES AOa cc a ca a SW-1m BASE"M M H-0011 MHjOOR MMOOR 4M FLOOR slH>r>t� 6MIUM y j 7t 7��7�1H�'1IM��l 9 l 1'LOCIR e (Print or type) Check one: Certificate Installing Company Name 7-1W4110 R A-/`1 /X// Corp. Address lsQK .57a. partner. L y to nam- 0/5 IM, Business Telephone 77 73 _7y—Icy E] Frrn/Co. Name of Licensed Plumber: W4,M4 S � ��,r��✓ Insurance Coverage: Indicate the type of insurance coverage by 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 IV signature Owner ❑ Agent El i 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 Massa usetts Pl ing Code and Chapter 142 of the General Laws. By: Signature or Licenseaum er Title Type of Plumbing License e1Y,73 City/Townicense 1Num5er Master ❑ Journeyman APPROVED(OFFICE USE ONLY ED Location 2 No. tel`` Date NORT1y TOWN OF NORTH ANDOVER O • OA 44L I Certificate of Occupancy $ li�s'••°•E Building/Frame Permit Fee $ JACH s Foundation Permit Fee $ Other Permit Fee $ TOTAL $ •Check # /V 15 + i� 8 Building Inspecttor' c TON" OF-NOWT ANDOVER B11AI DN G DEPAI� TMEN�' &PLICATION TO CONSTRUCUREPAM RENOVATE, OR,DEMOLISH A:ONE,OR TWO FAMILY,DWELLING itnoING PERMIT RuwEk. / DATE:ISSUED: Z- IGNAtJRE: ' Building Commissioner r ofBilildings Date ECTION 1-SITE INFORMATION I.J. Property Address: 1.2 Assessors Map and Parcel Number.Al O b� .y r � Map Nun om' Parcel Number 1.3 Zoning Information: 1.4 Dimensj ons:' 4 .. 4 ning Distad .:.. Use 6 BURLDING SETBACKS ft Front Yard' Si :. Rear Y lt' Provide Provided Yard ,,. z:.. ,. . . .._ ... .._. . Provided ,. "q weerUPl GLC'.4o. s41 ls. r�ooazonalafomyt�on l: S� D;aposatsysiero clic ❑ Private .. ❑ Zoea Outside Flood Zcoiw ❑ Munkipar ❑ r. " On Site S CTION 2 PROPERTY... . T __ .. OWNI+RSIII'/AUTHOttYZED A ITI f Owner of Record tilt e t7 mt:.(Pint) Address for Service nature Telephone: i.. 1 Owner of Record: _ ame Print Address for Service: 0 z tature Tel oiie ' m ✓TION 3-CONSTRUCTION SERVICES 90 Licensed Construction Supervisor. Not Applicable 0 nsed Construction Supervisor. License Num7 ber mn re5s 7 ature Expiratim.Date Telephone �. . tegistered Home mprovement Contractor Not Applicable 0 puny Name b Registration `Number(r es 8 L S 3 -3 Expiration Date b� Z i re Tele hone G SLCTION 4-WOMRS COMPENSATION(1V) L C 152' § ZSc y,. Workers Compensation Insurance.affidavit must.be cohipleted'and submitted With this application Failure to provide this affidavit will result V in the denial of the Issuance of the building rmit Signed affidavit Attached Yes.......❑ No SECTIONS Descri tion ofPrn `sed{Work checkalta licabhe New Construction 0 Existing Buildingepau(s) Alterahons(sj [7 nddition ❑ Accessory Bldg, ❑ Demolition t� -Other ❑ ' Specify rs �,:� °•, \1 ItN Brief Description of Proposed Work: ,, 41 f I'SECTION 6 ESTIMATED CONSTRUCTION COSTS: tem Estimated Cost(Dollar)to be J Comple,ted.b t.a licant; EElectrnical ('a) Building-Permit Fee Multi'iter a' (.b) §4unated'Total Cost.of Constru etion 3 Plumbin Building Permit fee(�)x(e> 4 Mechanical AC �r w, .5 Filo Protection / x 6 Total 1+2+3+4+5 ..aCheck Number ' a SECTT(SN 7a`OWNER AUTHORIZATION"TO BE COI�IpLETPO' N ' ONMERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT to IL . ,as Owner/Authoriied Agent of subjecf property by authorize =Behalf,in all matters relative to work authorized by thiibuilding permit application to act on S e of Owner Date j SE ON 7b NER/AUTHORIZED AGENT DECLARATION l' as Own Authorized Agent f subject property Hereby declare that the statements and information on the foregoing application are true and belief and accurate,to the best of my knowledge Print ---�-- i A Si mature of Owner/Agent ent Date 'NO .OF STORIES ' SIZE OR SLAB SIZE OF FLOOR TIMBERS i 2Nu3 SPAN ,DRvMNSIONS OF SILLS DIMENSIONS OF POSTS 77 Dl1vvIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHI1v Y IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE F NOK fF'1 Town of d 0 oLA o dover, Mass., / COCMICMEWICK AERATED S BOARD OF HEALTH PERMIT T D Food/Kitchen ! Septic System BUILDING INSPECTOR THIS CERTIFIES THAT......... ,...... Foundation has permission to erect........................................ buildings on �Z "� 7....... r-�G�'� ... ..... Rough to be occupied a .............................................. Chimney provided that the person acc Ing this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION T S ELECTRICAL INSPECTOR o da-� Rough ....................................................................................................:::.......... Service " BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough ` Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. IF SEE REVERSE SIDE Smoke Det. ✓fie �o�rvnzareulea aefivael�{ Beard 6f:Building Regtilauons,:afld Strittlard� G�¢en�e aryregistrataon vend for irdividul u5:s ci Ilyt,` HOME IAAPROVE TIENT CONTRACTC1 br`Tore theseapii anon date. If Counil return ta: -Board of 1uilling Regulations and St,ndards Registration 104569 h { 114/02 0 Ashbi-rtan Place .BostonAll 0;. TVez. PRIVATE CORFORA i iON 1 CHVID CAST,,c' ICONE ROOF RG i i 7 Fhllsi& ad.66 f6rd -0,921 �adn�cn.9trxcor + N �.vu�d w•i+hnu6igrik re