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HomeMy WebLinkAboutMiscellaneous - 42 Matthews Lane L-NI ...rc-s:,..,r 'P�''s•y.,-r•tF7.•�"^�+"H'':i.-t'.-..^^�7,y.+-*-r-+.vel.�s+-.-.•.-...-....^^,.�,.:...tk+-Z`r-.''�..s�'s.'�,,-�..�.s.. _"'i_. T/,rc��^-:-.rr_... Date.... <, .7 429 MORTM TOWN OF NORTH ANDOVER PERMIT FOR WIRING s °� •"a SSACHUSEt .' This certifies that ( ` A has permission to perform .......� ........ .��/.,�.! wiring in the building of / S ." V . at..........1................................................................... .North Andover,Mass.. Fee. `/ ELECTRICAL INSPECTOR S 35.00 s�aiD WHITE:Applicant CANARY: BUi ��pp j/ppppldtTi�%ept.t.`PINK:Treasurer la The Commonwealth Of Mass O fficeMassachusetts Department of Pubilc SafeS IBOARD OF FiRE PREVENTION REGULATIONS 527 CMR 12:00 Q•i♦-� ':` "3 APPLY`ATiON FOR PERNT TO PERFORM ELECTRICAL An work j*be perfom,.d In eeo�rdenCa with m.Meuaenusetts Er�w code.SV CMR i2M WORK (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Qate__ City or Town of .1 'The undersigned applies for a permit to perform the electrical work described below. To the Inspector of Wires: Location (Street $ Number) �}14'r1 �S_ i- L r .L 3� Owne or Tenant D TY- tQ c, �A'- ) Owner's Address �f�Q�� �( )�`L D iiJ Is this permit in conjunction with a building permit es no k y' � (Che-,k Appropriate Box) Purpose of Buildinyt1�fl�r �'�p/��e"I/� Utility Authorization No. Existing Service Amps_____/__,Volts Overhead ❑ Undgrd ❑ No. of Meters New Service --AMPS-------J--Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity rn1 Location and Nat-,e of Proposed Electrical Work )7 `J'•f No.of lighting Outlets No.;�fHbs TOTAL No. of Transformers �A No. of Li htin FIxtures Above InSwial rnd.❑ rnd❑ GeneratorsNo. of Receptacle Outlets No. of Emergency Lighting KVA No. rners 8attery Units No. of Switch Outlets No. of Gas Burners FiRE ALARMS No. of Zones No. of Ranges TOTAL No. of Detection and No. of Air Conditioners TONS Initiating Devices No,of Disposals HEAT TOTAL TOTAL No. of Sounding Devices No. of Pumps TONS KW No. of Seif Contained No. of Dishwashers Soace/Area HeatingKW Detection/Sounding Devices No. of Dryers HeatingDevic:9s KW Municipal,❑ Connection ❑Other No. of Water Heaters No. of No.of Low Voltage KW Si ns 8.allasts ow Witrin No. of H ro Massage Tubs No. of Motors Total HP OTHER: ZOO— INSU COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent.YES Q 1 heave submitted valid proof of same to this office. YES 0 NO Q It you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE BOND ❑ OTHER ❑ (Please ityt %srtmated Value of Electrical Work S (Expiration Date) Wcrk to Start Inspection J. Date Rt>quested: Rough Signed under the penalties of perjury: Inspection FIRM NAME,eg �_0�; Licensee ' r+ UC. NO. . O Signadur L1C. NO Address �s�•• yp�p v �/// r Bus. tel. No.�Q3 f�i���J'T.�' 15� iY H'• CF-4 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverageubst ntial equivalent as required by Massachusetts General Laws, and that my signature on this application waives this requirement. Owneror its Agent (Please check one) (Signature of Owner or Agent) _Telephone No. PERMIT FEE $. 3v`-' M 1 9 M7 k' i Location No. Date Com , 0 1+ ' "0 TOWN OF NORTH ANDOVER 10 , Certificate of Occupancy $ - 40 1° ; Building/Frame Permit Fee $ L1 Foundation Permit Fee $ g s�cuuse Ot eh r,Permit Fee $ a —� $ A Sewer Connection Fee $ /h Water Connection Fee $ © 2. a (I/ a TOTAL $ j , Div &c Works Location No. Date r NQR7" TOWN OF NORTH ANDOVER A Certificate of Occupancy $ SC) Building/Frame Permit Fee $ cHuSE� Foundation Permit Fee $ Other Permit Fee $ `f Sewer Connection Fee $ f Water Connection Fee $ TOTAL $ Building Inspector 4l97-11:37 15o.00 PAID e Div.Public Works y { LocIrk?. n 4. No. ,`. Date 0 ro. e pORTM , TOWN OF NORTH ANDOVER OL p Certificate of Occupancy $ Building/Frame Permit Fee $ Ac U E Foundation Permit Fee $ � MUS t Other Permit Fee $ Sewer Connection Fee $ g Water Connection Fee $ d TOTAL $ Building Inspector i1° 10649 Div. Public Works a PJEa'ltrr NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP 4-40. LOT NO. 7 2 RECORD OF OWNERSHIP (DATE BOOK PAGE ZONEpI SUB DIV. LOf NO.tD . Vp � LOCATION 0'a f w s / a»� 1 PURPOSE OF BUILDING 111 ff a R-es OWNER'S NAME tr NO. OF STORIES SIZE OWNER'S ADDRESS 7 Y N�j /C / �� BASEMENT OR SLAB J ARCHITECT'S NAMEQ SIZE OF FLOOR TIMBERS 1ST g //,o 2ND ryX/6) 3RD BUILDER'S NAME fCOY_ SPAN �✓C 41 DISTANCE TO NEAREST BUILDING /f0 F DIMENSIONS OF SILLS y i/ DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR /LV-IL- GIRDERS AREA OF LOTrl�� h ll ® FRONTAGE HEIGHT OF FOUNDATION rY THICKNESS + IS BUILDING NEW D` e s' SIZE OF FOOTING �A11 X Lu IS BUILDING ADDITION *e//i V v MATERIAL OF CHIMNEY �lJki� IS BUILDING ALTERATION / IS BUILDING ON SOLID OR FILLED LJAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE a S' IS BUILDING CONNECTED TO TOWN WATER S' BOARD OF APPEALS ACTION. IF ANY NIA /I IS BUILDING CONNECTED TO TOWN SEWER �S ,v fT IS BUILDING CONNECTED TO NATURAL GAS LINE �s INSTRUCTIONS 3 PROPERTY INFORMATION AND COST SEE BOTH SIDES 166EST. BLDG. COST Uy / ,PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. ..v EST. BLDG.COST PER ROOM _g SEPTIC PAGE 2 FILL OUT SECTIONS I - 12 / ,r+ r SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED �� 7 NUILDINO INSPECTOR SIGNATURE OF OWNER OR:CI IZE AGENT /, F E E OWNER TEL.# L41G � �� 7 PERMIT GRANTED app r� /1 CONTR.TEL.# G 6/Y- 36' / e-f G ZZ 19 Fin CONTR.LIC.It E� 9 iL6w� H.I.C.# JA 9 NIS � �r 4. ' BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS.OF LOT AND DISTANCE FROM MULTL' FAMILY... ' OFFICES LOT LINES AND EXACT DIMENSIONS OF- BUILDINGS: WITH PORCHES. GA- APARTMENTS i RAGES. ETC. SUPERIMPOSED. THIS-REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE d 1 2 3 CONCRETE BL'K. PINE BRICK OR STONE HARDW D PIERS PLASTER DRY WALL UNFIN. _ 3 BASEMENT'. AREA FULL FIN. B'M'TAREA '/, 1/2 l/, FIN. ATTIC AREA NO B M'T FIRE PLACES, HEAD ROOM _ MODERN KITCHEN ' 1 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH ASPHALT SIDING HARDVJ'D _ ASBESTOS SIDING COMMGN VERT. SIDING 1,S-PH.TILE STUCCO ON MASONRY _ STUCCO ON FRAME L BRICK ON MASONRY ATTIC STRS.6 FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON-FRAME SUPERIOR POOR _ y ADEQUATE I NONE 5 ROOF 10 PLUMBING GABLE I K HIP BATH (3 FIX.) GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK t' SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING ) WOOD,JOIST PIPELESS FURNACE `. FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. &COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 N0. Of ROOMS GASOIL B'M'T 2nd _ ELECTRIC 1st 13rd I (� NO HEATING /d O. 30 i 06 0 = O.SOQO AG. O \. z/ Q �P od p 9S N_T� JEFFREY S. 6, ,4/ .cia6E^ rNT 0c h;ANN e�5t E 4NN� P i.,jr. d A Tom' /1�E�C'�P/ryl.�JGt'E.vG�•dEE.?%�/6 SE.P/�/lES • 6G �q.P�.ST.PEET .� r v ANOOYE.� il'lAS.S,4G,S/l/SETTS v/8/0 B Growth Management Bylaw Exemption Statement 9 Y p Town of North Andover Building Department This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information 9 Y 9 P rY as requested below. Na a of Applicant on Building Permit(below) Address of Property for Permit(below) Map and Parcel : Purpose of Application (check below) J?a Nur r,oVpplicant: Single Family _Two Family I the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 of the North Andover Growth Management Bylaw. I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the Building Permit. Further I understand that my interpretation of the EXEMPTION status is subject to review by the Building Department and is only officially accepted when the Building Permit is issued. Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building permit application and associated attachments, complies with one or more of the following sections as indicated by a check mark. This is an application for a building permit for the enlargement,restoration,or reconstruction of a dwelling in existence as of the effective date of this by-law,provided that no additional residential unit is created. The lot(s)were/was created prior to May 6, 1996 are exempt from the provisions of this Section 8.7 of the Zoning BI . This application is for dwelling units for low and/or moderate income families or individuals,where all of the conditions of 8.7.6.c are met and/or represents Dwelling units for senior residents,where occupancy of the units is restricted to senior persons through a properly executed and recorded deed restriction running with the land. For purposes of this Section"senior"shall mean persons over the age of 55. This application is a part of a development project which voluntarily agreed to a minimum 40%permanent reduction in density, (buildable lots),below the density,(buildable lots),permitted under zoning and feasible given the environmental conditions of the tract,with the surplus land equal to at least ten buildable acres and permanently designated as open space and/or farmland.The land to be preserved shall be protected from development by an Agricultural Preservation Restriction,Conservation Restriction,dedication to the Town,or other similar mechanism approved by the Planning Board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for building permits,(i.e.all other permits from all other boards and commissions have been received and the project is in compliance with those permits),and the Development Schedule does not accommodate issuing a building permit in that Year,one building permit will be issued per Year per Development until such time as the Development Schedule accommodates issuing building permits. Applicant must supply approved form U with this EXEMPTION. Please provide any and all information that would assist the Building Department in making a determination that your application is allowed one or more of the above EXEMPTIONS. By signing below I attest to the accuracy of the information provided and that the attached building permit is allowed an EXEMPTION as cited above. Further I understand that the submittal of misleading and or inaccurate information, or the checking off of an above item which does not comply,whether done to my knowled a or not, is grounds for r fusal y the Building Department to issue a Building Permit. 7 111'h 1r) SrgrTbature of Owner or Authori ed Agent wh ned the Attached Building Permit Dale This form must be attached to the Building Permit upon application for such permit. J��! 15 011q� 0 ov er sr No. 029 i dWj 0 ,, lover; Mass., 1 V cocNlcHEWICK ti•' BOARD OF HEALTH PERMI� T T Food/Kitchen Septic System . THi CERTIFIES THAT �, 1 BUILDING INSPECTOR .�.. .�i.�....Ov.t�.................. ..................................................... Foundation 4 �[., has permission to erect........................................ buildings on....: 's ..:....,.. ".�l�ill 5....... .14. E Rough Chimney to be occupied as.......:.....................................�.��.1..��..........�f��!..... .. y . . . . . . . . . . .. .. . . . provided that the person accepting this permit shall in every respect conform to a terms of the'appiication 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 h6#h Andover. PLUMBING INSPECTt°r VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS. UNLESS CONSTRUCTION STA ELECTRICAL IivsPcTo Rough ....................... Service .......... ... .. .... ....... .. ING INSPECTOR Final Occupancy' Permit Required to Occupy Building GAS INSPECTOR t Final Display in a Conspicuous Place on the Premises —• Do Not Remove No- Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building. Inspector. DEPARTMENT Burner �. Street No. 'irnoke Det. j FORM U - VERIFICATION FORM INSTRUCTIONS: This form is used to verify that all necessary 1 ' approvals/permits from Boards and Departments having jurisdiction j have been obtained. This does not relieve the applicant an landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: Phone LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) _ Z Street _ "l���L2�S �1., St. Number = *********************** Official tise Only************************ RECOMMENDATI NST AGENTS: W Date Approved Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected _ TV— Comments r Date Approved Food Inspector-Health Date Rejected Date Approved Septic Inspector-Health Date Rejected Comments I Public Works - sewer/water connections � . f - driveway permit (� Fire D par tm G(�� �ol� AC 1 Recei ed by Buil ing Ins ector Date SAN 1 5 - - s ' CERTIFICATE OF USE & OCCUPANCY Town of North Andover Building Permit Number v� Date -.... ZQ,b-0 ZZ 7 THIS CERTIFIES THAT THE BUILDING LOCATED ON 4 a 4A �! N MAY BE OCCUPIED AS IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. 9 04,".ORT"'�o CERTIFICATE ISSUED TO P. ✓� e— Wc)cj 6P,16. J�. �J,CD• ADDRESS A Uy P CIA- c St- dU- ke c1+y asACHUS Building Inspector x w , � �1• .. .ti .�< .. ` ; \ _ over .. o s �, a d®ver, Mass., / 19 i. 9 'co:.IcHEwIcK -•Fr A- pA rP�v ' TED 06` BOARD OF HEALTH a Food/Kitchen --ERT T Septic System - - 1 BUILDING INSPECTOR TH{' CERTIFIES THAT ....... a,..... i..l..:.....:::.`..::. L ._s ................................ ............................,..,:...:...................................................... Foundation has permission to erect.......................7................. buildings on .......,:...�:-.......... F if.t ::. :::..._:........,.:..:.;.�� �.:.'..... - Rough - .......................... ............ th t f-the at file to be occupied as................... �:.. �. :...........(... ..!.... ..!..:::............:............................................ Chimney provided that the persona accepting this permit shall in every respect conform tothe e erms o e applic ion on in Final -this; office, and to the provisions of the Codes and By-Laws rotating to the Inspection, Alteration and Construction of .Bindings ire the Town of North Andover. PLUMBING INSPECTOR , 1 -ATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS ELE ICAL INSPECTOR N UNLESS CONSTRUCTIONSTARTS, _ "dough`. ............................................ Service ! O INSPECTOR - - UILDIN OccuXt t ` Ccupy Building " - GA9 INSPECTOR 1 f Rough Display in 'a Cont i�ioace _on ,, emises --- Do Not Remove G - 1� No t_ath' :Dry-�1 all 70, Be Done W FI DEPARTMENT until 1n�,P��ted and - w e� b -th Auildin Inspector. . .�. Y _ - 9 P Bumer. � - Street No. i J ,s z Smoke Det. _4;0 IC w. • 44 Charles J. Martin, P.E., P.C. Consulting Engineers Complete Structural Building Analysis c October 24, 1997 Attention: Mr. Sam DiSalvo Building Inspector Town of North Andover Town Hall Annex 146 Main Street North Andover, Massachusetts 01845 RE: Pinewood Estates — Lot #3 Matthew's Lane North Andover, Massachusetts Dear Mr. DiSalvo: This is to confirm site inspections that were conducted on January 16, 1997, January 22, 1997, January 27, 1997, January 31, 1997 and February 5, 1997, in reference to construction of foundation at Lot #3, Matthews Lane, North Andover. I hereby certify that the foundation was constructed as per plans and specifications. On October 23, 1997, 1 re-inspected the foundation at the above location in reference to two minor shrinkage cracks at the front wall. These cracks were noted on our February 5, 1997 inspection, and as of this date, there is no indication of any ongoing movement or settlement. In my professional opinion, all indications show that the foundation is stable as of this date. Very truly yours, F1 OF �qse ©� CHAND �'y XAR Chan *mW cc: Thomas Hurley Evergreen Management Corporation 10 Winship Drive, Wakefield, MA 01880 • (617) 245-6615 (617) 246-3040 10/21/1997 11:36 6172374171 PAGE 01 C"CEW—V" Foundation Welding Wat*--- ming October 21 , 1997 Mr. Sam DiSilvo --.,.No Andover Building Dept. No. Andover, Ma. M 508-688-9542 Dear Mr. DiSilvo, Tom Kurley of vergreen Management has asked me to write you regarding the cracks at Lot 0, kinewood &states in No. Andover, Ma. For this purpose i am enclosing a field report that was rec- ntly issued for a headworks facility project we completed in July of this year. 21ease feel free to call me with any questions at 1-800- 548-3379. Edayne Fortier ~ ' rresident � J lei P.O.Box 812-728,Wsllsslay,Mos"chumft 02161 4 Phom 800546.9978 Fuc 617-237.4171 10/21/1997 11:36 6172374171 PAGE 02 n C"Cgfx Founisdon WoWl"& Waterline Industries P.O. Box 339 Kingston, N.H. 03348 July 24, 1997 5UBJBCT; Field Report 'ROJECT;iasthampton Headworks Facility Completion; July 229 1997 Crack injection of the sluiceway wall cracks proceeded by first a shallow chamfering of the edges of the cracks on the outsides, tops, and insides(to the waterline). Upon flushing this V with water and compressed air, the cracks were identified as to size and ability to accept epoxy resin. injection port holes(1J211) were then drilled to accept Lily ports and the chase was then backfilled with quick set grout. No leakage of water(sewerage) was detected, however some moistened concrete was found in crack #1 . Injection of a low viscosity epoxy was then completed using up to 60i.S.I. and a vise-upof resin to A prox. - 0 00 OC Y t p� 3 4 .S. a the top of crack #1 which was quite large. Crack numbers 2 and 4 accepted material very stingily. Crack numbers 3 and 5 refused to accept material excepting at the very top. The crack adjacent to the maintenance building was completed in much the same manner with the exeption that a very high viscosity (paste) resin was .needed in order to keep the material in the crack contained rather than have it flow out the rear. Minimal pressure was required with close porting in order to complete an injection to Approx. 6-8" of depth. 36 Oz. of material was used. The spall patching was completed as per the SIKA handbook using :;ikaTop 123.9`1us two component. Demo and scabling as well as sawcutting was completed prior to brushcoating and finish patching. P.O.Sol 912-728,Welleeley,Yaeesehuseft 021914M Phan 80044844 Fox 017-MY4171 2493 Date.. 3f.� Q a NpHTM TOWN OF NORTH ANDOVER g . PERMIT FOR GAS INSTALLATION �9SSACHUSEt M s This certifies that . . .1� H # : . . . ' . . . . . . . . has permission for gas installation . . . . .. .m: in the buildings of . . .kt!!. . . . . . . at `-^. . . . . . .. North Andover, Mass. Fee. . . . . . Lic. No../.Q).ft. k . . . . . . . . . . . . . . . . . . . . . . .. . . ►�#_ 3 GAS INSPECTOR WHITE:Applicant 3Y:Building Dept. PINK:Treasurer GOLD: File 1. 1. r t• 1 ` f y,Mv Wrlitlll r ' MASSACIIUSETTS UNIFORM APPLICATION. FOR PERMIT TO UO GLi,mNG (Print or Type) ti t*�. ,, ` ✓ Mass. bate ' l "51 19 Permit N 2 y q—) Building Location Owner's Name --- Z •l,,�R4 • SINGLE CAM.ILY t 1. W.k. ujot)A Type of Occupancy New{,j Renovation 0 Replacement O Plans Submitted: Yes d No U FIXTURES Z in a In 0 � v e V � � Ru � >~ 2 ?oo O 1" w to Z S In w O O F ailiX D o v 0 09r 3 �j SUB-BSMT. ( BASEMENT Y V 1st FLOOR _ 2nd FLOOR 3rd FLOOR 4th FLOOR Sth FLOOR 6th FLOOR 7th FLOOR 8th FLOOR Installing Company Name GALINSKY PLUMBING & HEATING INC. Check one: Certifit:ale Address P a 0 A f3OX 1701 K) Corporation HAVERHILL, MA 01831 C) partnership Business Telephone 508-374-1743 CJ Firm/Co- Name of licensed Plumber or Gas Fitter STEPHEN C. GALINSKY INSURANCE COVERAGE: 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes)1t No U if jnU have checked yes, please Indicate the type coverage by checking the appropriate box. A liahilily insurance pollcy'r Other type of indemnity U Bond U OWNER'S INSURANCE WAIVER:1 am awarr dial the licensre does not have the insurance coverage required by Chapter 142 of the Mass. Grnrfal I Pews, and 11,,11 my signature on this permit applicatinn walves this requirement. Check one: -- ._. -- -- ------ - - -- Owner d Agent L" Cipnaturt' of Ownm tit Owtirt's Aprnt _ 1 It,0, trrNlt it,at all of flit dr la iia and Inhnmarinn 1 ha.-r ynh,niiied tnr enlrred tin flip al—e applic al inn are It tip anti+truratr In the brcl of my knnwtrdre antl tl,at all plumbinI Mo,4 A,0 „4131inm rrdo,n,rd un,l,•r flit mimif y,utd frn Chit apptir Aron-111 M In tnmrhanre with al!Pertinent pm,isiont of the MAssachusens State G+s Code and Ch+Mer 112 011110 General 1++• h1r fit II(rntr t!Miller S 1lnakne of Uc ted plumhrr fitGot;(inn - — r_Inn,nt,n,an 10-3118 t MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO 00 GASFITCING 1 (Print or Type) NORTH ANDOVER Mass. Date : / -- kuilding LocationIF-wl a0.,N Permit # 0 rtGE'.w 1.�j Owners Name New 'C,-Renovation D Replacement n Plans Submitted n FIX --Uo=C o) v !� a: • tll • N pf V C F y OC of .0 to S F o < CI N N < c 0 O O C 2 tai Q w e; F- Y7 tl s y 4 N � W Z V �++ es ty •t Q O Q � W ut 07 J Q G t7 CC W us (1 G W W O T V .4 r to d W G t' Y- o m = O Z O H = o V U. a 0 -4 V 0j y e a Fes- C SASEMEXT I f f I I l ! f ! IST FLOOR 2ND FLOOR I I I I I I I I 3RD FLOOR I I ( I 4 I I I 4TH FLOOR STH FLOOR 6TH FLOOR TTKFLOOR ( I ! 8TH FLOOR � I I (Print or Type) Check one: Certificate P Installing Company Name CE]� Corp. Address e,a )#y, ['70 y Partner. kjxbAe lyt 1 )41 ;0 ct% Firm/Co- Business Telephone: S-6�, (LiO'f,%— Name of Licensed Plumber or Gas t=itter ` ' Insurance Coverage: Indicate t!%e type of insurance coverage by checking the appropriate box: Liability insurance policy ��her type of indemnity 0 Bond Insurance Waiver: 1 , the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner 17 Agent Q I hucby certify that atl of the details and Wannatiom t hare submitted (or entered)in above application are true end acmate to the best of mY knowledge and tluat all ptumbi" work and lnstatutioos yeriormed undef'Permit iuu d fat this spptication will-be in compliance with alt pertinent provisions of the Hassachusetts State Cas Cade and C&aptes!;Z of tso General Law&. 13 _PE LICENSE: By Plumber Title G�psfitter Signature of Licensed ..aster P1���r�sfitter City/Town: Journeyman APPROVED (OFFtcE USE ONLY) License Number Date. ./. X. . �. 3272 04 40RT" TOWN OF NORTH ANDOVER 3? #" I. - .. oc PERMIT FOR PLUMBING 4L ,SSAtNUS� This certifies that .{ .!' .1.l."t.` . . �''. . . ?. . . . . . . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . plumbing in the buildings of . A !!�.' . .��. . . . . . . . . . . . . at. North Andover, Mass, FeeLic. No.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR 031'3/9713:27 250.00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer f _ ,...,s:.x tea..-a...a .e.•=:S.is.'� :6 ._.ate . x S!? O r MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING L (Print or Type) �4' Psm ip Mass. Date 19 Permit # Z 7 Building Location'12" Owner's Name_►► `✓1& 011/1oM Type of Occupancy SINGLE FAMILY New/ Renovation ❑ Replacement ❑ Plans Submitted: Yes ❑ No ❑ FIXTURES z z 0 a t � H z F" z (� rn u " ocm � s v � y `129K SZs ; se zc 3s s < V 0 i2 a at Ov > c zit�n � � ~ � 00 ZZ O s _ _ O � .r � c3 � o3e0ee� 0 m �, cS3s � � If If SUB•BSMT. BASEMENT tst FLOOR 24 IIJI , 1 2nd FLOOR 3rd FLOOR 4th FLOOR 5th FLOOR 6(h FLOOR 7th FLOOR 8th FLOOR Installing Company Name GALINSKY PLUMBING & HEATING INC. Check one: Certificate Address P.O.BOX 1701 ® Corporation 1906 _ IIAVERHILL, MA 01831 C1 Partnership Business Telephone 508-374-1743. Cl Name of Licensed Plumber STEPHEN C. GALINSKY INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. yes)? No❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy)3' Other type of indemnity ❑ Bond O OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Ivlatc. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner❑ Agent O, 1 herebv rertifv that all of the details and information I have submitted for entered)in the above 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 in compli ce with at .ninent provi;ions of th achu s Sta lumbing Code and Chapter 142 of the General Laws, By Signature of license Plu her Tide Type of License:Master Journeyman❑ Cltv/Town License Number—ID-148- APPROVED umber_,1D-148APPROVED OFFICE USE ONLVI -;,6 ( 0 Date.. �....... NORTH TOWN OF NORTH ANDOVER OF at,,a° ,a,b0 3� "+ + PERMIT FOR GAS INSTALLATION O 'o F 9 ft '77,9+O+,no•'��,�•(y w¢ SA This a This certifies that • • has permission for gas installation in the buildings of . ?1?0l .' o Uc,-l . • • • • • . . . . . . . . . . . . . . . . . . t i Mag' at .!.?'! ��•-.s�:. . . . . . . . . . . . . . . .. North Andover, Mases Fee.7Q ' . . Lic. No./ y L.. . . . . . . . . . . . . . . . . . . . . . . . . . GAS INSPECTOR WHITE:Applicant CANARY:Building Dept. PINK:Treasurer q�+ �*•• :, Date. -/ ate. -/ . .!' . . E 344 .0 TOWN' TOWN OF NORTH ANDOVER 3. PERMIT FOR PLUMBING .:. ,SS/ItNUSE� ! Q This certifies that g/qj/4.5 Al . . . . . . . . . . . . . . . . . . � has permission to perform . . . e. L.". . ./yo!7 C. . . . . . . . . . . . . . S plumbing in the buildings of . . .P.lw� u-.v!? at. . . . %ir.f:� . . . . . . . . . . . . . . . . . . . North Andover, Mass. Feer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . u� .. PLUMBING INSPECTOR ui _ a"n WHITE:Applicant CANARY: Building Dept. PINK:Treasurer g v ' AASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING 1 (Print or Type) nA 6V Mass. Date - I y 19 Permit # 3 L Building Location Owner's Name « �CU_JQC-L MAs(-Je,&4 Type of Occupancy L-41,J`0— IF New,/ Renovation O Replacement ❑ Plans Submitted: Yes O No O FIXTURES z Z Z � < to r u ~ Z V to k i OAZ MSZZZdx0 - � W ZK u3 ` g NN O 0 01 W QQ 0 4At Y. W W � u < � C7i � � ~ ZOO ZZI�a tau 3S � zoSS3i0 SUB•BSMT. BASEMENT 1 1st FLOOR 2nd FLOOR 1 3rd FLOOR 41h FLOOR LL Sth FLOOR 6th FLOOR 7th FLOOR Oth FLOOR ` IfN S Check'one: Certificate Installing Compan Name ���' Address > 13 t6,---- f 0) l�orporation f a j, M A-- d � �� � O Partnership Business Telephone ❑ Name of Licensed Plumber INSURANCE COVERAGE: 1 have a current Ity insurance policy or its substantial equivaler►t whae h t.r.�. the requirements of MGL Ch. 142. Yes 0 No O If you have checked yes, please i icate the type coverage by checktna rte AwnPrtaw 1toz. A liability insurance policy e Other type of indemnity 0 PAv+d I OWNER'S INSURANCE WAIVER:I am aware that the licensee does nol haw*ow m,wance coverage required by Chapter 141 t+the M04% General Laws, and that my signature on this permit application waive+ thn RW frrnerd. Check cxw- Owner 0 Apni Signature of Owner or'Owner's Agent t Kwohy c"uh Char all rrl dr drualr rand mlormattan 1 have%ubrmtted la entXim,*wne8­1ahr .~am nac ateto the be+t d my Yr. "Wdw and Ow aN r -*—* Qand-41181,0M OeAnmra'd order OwPerm-,nvutrd IOr thisJpplKatlon will b nce all tht AAariat}.tne111 Stare %umbrna Cob are 0%4 ' Br $i�nNure lK urnhr'r T Ivor of lice"".Maven L rme Numb" �F "Wo mlFKt US(ONLY) (� "� .. •�f, j � .' � of• �°,'� t �� 1, � �`V � / . .,}s J �� 11 � � ��1.• } 1 Cw tt t 1 � 1 { � z O � � to 1 777VVV t •. .. _ .. �r= � � � $ f Si 3 1 �1 IJ t•M�.ta 1' lty,-,y... ..w .. !. 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