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HomeMy WebLinkAboutBuilding Permit #145 - 35 SAWYER ROAD 8/22/2007 %40RTH BUILDING PERMIT o���•' 16;'ao 6 oL TOWN OF NORTH ANDOVER 0 L +� APPLICATION FOR PLAN EXAMINATION Permit NO:1 70 Date Received a9 g6RATo'Pa`y(9 9SSACHU`��� Date Issued: - 2 7 IMPORTANT: Applicant must complete all items on this page � ✓ �. � Olt ,. TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑ Addition ❑ Two or more family ❑ Industrial ❑ Alteration No. of units: ❑ Commercial TFRepair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition 0 Other mer/Seer, £ r i DESCRIPTION WORK TO BE PREFORMED: i. c1 o sA-c i ck) r?j (-J,4 IC GSC-S ° Identification Please Type or Print Clearly) OWNER: Name: PC- Tc�« I Phone: Address: S �� y� P 'fir ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ `� ,(D(�`� o� FEE: $ c � Check No.: `7- Receipt No.: S'-Z e NOTE: Persons contractin. ith unregistered contractors do not have accesso th guaranty fund Signature of Agent/Owner Signature of contractor `"-- Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans lans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF- U FORM PLANNING & DEVELOPMENT ElDATE REJECTED DATE APPROVED ❑ COMMENTS CONSERVATION ElDATE REJECTED DATE APPROVED ❑ COMMENTS HEALTH ElDATE REJECTED DATE APPROVED COMMENTS ❑ r. TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/MassageBod Art y fFood ools ❑ Well ❑ Tobacco Sales ng/SalesPrivate(septic tank,etc. ❑ Permanent Dumpster on Site i I Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/si nature& Date Located at 384 Osgood Street Drivewa Permit FIRLaP4RT �N LoCatc at� 24MaIn�Sft � � K F � 1�t rt FIrD :3at11Crt1tq #' 11u - OR .L'rlY,ixMES :` ,d ,:_ a :, `z Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 section 21A—F and G min.s100-s1000 fine NOTES and DATA— For department use I i 1 I I ❑ Notified for pickup - Date i i i r Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products Addition Or. Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENTMITORM07 Revised 2.2007 2! No. Date a� 7 �oRTM TOWN OF NORTH ANDOVER �? OL ' Certificate of Occupancy $ �.�S',•.°'E<�' Building/Frame Permit Fee $ s�CHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 205z" Ll `Building Inspector renewal BYANDERSEN'wi.d.-rcp*,r,or'_. Customer Service 800-573-7606 104 Otis St.-Northborough,MA 01532•Main:(508)919.0900•Fax:(508)919.0903 J&L Windows,Inc.dba Renewal by Andersen•Contractor License#149601•Expiration Date 0912312008 /- n/ f WINDOW AGREEMENT 6 SOLD TO: leT4�d r it /CrT� TB///`S!` DATE: O o��L 0 ADDRESS: 2.s- SA G/we/ PHONE-Home: CITY: N ALPIO f/ STATE: PHONE-Work: (_) JOB SITE.ADDRESS(if different): SRAAIC- -E-mail: Approximate Start Date: 7-`Alk S Approximate Completion Date: LALKS SPECIFICATIONS Renewal by Andersen approved materials will be furnished and installed to these specifications: 1. Install total of: / windows. 2. Quantity of windows: _Double Hung(DB) ❑Equal sash ❑Cottage sash(1/3 top,2/3 bottom) ❑Oriel sash(2/3 top,1/3 bottom) _Casement(CW) O Hinge right ❑Hinge left(as viewed from exterior):❑Standard handle OMetro handle _Double Casement(CDW) OStandard handle OMetro handle _Casement/Picture/Casement(CPW) ❑1:1:1 or ❑1:2:1❑Standard handle Metro handle _2 Lite Gliding Window(GW) _Glider./Picture/Glider(GPW) ❑1:1:1 or ❑1:2:1 I` Awning Window(AW) � �`r'SFT,0 Picture Window(PW) 1 f Vt I Bay or Bow Window: Y , 1 V� [CAJe, ve 3. Ga's'es ❑No #Windows to Ke CustofA Fit eplaoement�_ 4. ❑Yes ❑No #of sills to be replaced: 5. ❑Yes ❑No #Windows to be New Construction Full frame(includes new interior&exterior casings): Exterior casings: ❑Pine ❑Maintenance-free material ❑Factory applied 908 Fibrex brickmold 6. Glazing to be: 24gh Performance ❑Other If other,please specify: 7. Exterior color to be: IB'White ❑Sand ❑Canvas ❑Terratone 8. Interior color to be: &❑Mite ❑Sand 13 Canvas ❑Terratone ❑Wood Note:Interior color can only be white,wood or same color as exterior. Wood interiors need to be finished by cust. 9. Hardware: MUhite ❑Stone ❑Canvas❑Brass Double Hung: Install lifts? ❑Yes ❑No 10. ❑Yes 2"N o Removal of metal frames or grilles #of Units: 11. ❑Yes ErNo Install new paint-ready or stain-ready casings. Inside or outside stops#of openings:_ Interior casing#of openings: Exterior casings#of openings: 13 Pine ❑Maintenance free material 12.Customers a 'are that RbA does not do any painting. �Cust.initials 13. ❑Yes Lel No Wrap exterior casings with aluminum coil stock: color. Note:Required with storm window ra�P val.Removal of storm windows will leave screw holes in casing. 14. New windows to have: 13 Half or 13"Full screens Screens to be: 19 riberglass ❑Aluminum 15.Windows to have grilles: ❑Yes Ifflo If Yes: ❑Grille Between Glass(GBG) ❑Removable Interior Wood(INTW) ❑Full Divided Light(FDL) Grille patterns: #:_ #:_ #:_ #:_ E' 11 E DH DH DH DH CW/Picture Glider CPW or GPW .use ad 'tional sheet If needed Customer approved(initials):_ 16. K�es ❑No insulate,caulk and seal windows with three-point system to prevent water and air infiltration. 17. FYT..S ❑No Remove and dispose of existing windows and storm 18. 13No Clean Up. All job related debris removed.Vacuum nightly. 19. 13No Insurance. All workers compensation and liability insurance maintained. 20. 's ❑No Warranty.Given to customer upon completion and receipt of full payment. 21.Additional information: it-© /k gk::_ 22. Regular Retail Price:$ 23.Total Project Amount:$ j6 D Sl-] All available discounts have been applied:91Yes ❑No 24.Is Project to be paid in($'Cash ❑Financed ❑Combination of Cash and Finance 25.Cash Deposit(1/3):$ /?SO= 1/3 of balance due at start of job and final 1/3 due at completion of job. 1(remaining 2. apaymentis fnade by credit card,an additional fee of 3%will be added to cover fee charged by Credit Card 26. ❑Yes ITNo Financed. If Yes,Amount Financed: (Account#: ) 27. Wi s 13 No Customer agrees to be present on the final day of installation for final inspection and to deliver final payment. 28.Rs O No Homeowner gives RBA approval to place a yard sign on their lawn at the time of measure.. 29. ❑Yes ❑No Building Permit-As a convenience the company will secure the building permit.The fee for the permit is not included in the agreement price and a separate check is required at the time of sale for this fee. 'RENEWAL BY ANDERSEN'IS NOT RESPONSIBLE FOR ANY EXISTING SECURITY SYSTEMS OR CONDITIONS THAT COULD NOT HAVE BEEN SEEN PRIOR TO OPENING THE WALLS.PLEASE REMOVE ALL SHADES,VERTICALS,BLINDS,CURTAINS,DRAPES OR WINDOW MOUNTED AIR CONDITIONERS,AND ANY FURNITURE AT LEAST SIX FEET AWAY FROM WINDOWS AND DOORS PRIOR TO THE INSTALLATION OF YOUR NEW WINDOWS.INSTALLERS ARE NOT RESPONSIBLE FOR THE REMOVAL OR INSTALLATION OF THESE TYPES OF ITEMS.'SALESMAN HAS NO AUTHORIZATION TO CHANGE ANY ITEMS OR MAKE ANY REPRESENTATIONS OTHER THAN CONTAINED IN THIS AGREEMENT AND'OWNER'REPRESENTS THAT NONE HAVE BEEN MADE TO,OR RELIED UPON BY-OWNER.-YOU ARE ENTITLED TO A COMPLETELY FILLED IN DUPLICATE OF THIS AGREEMENT.'CONTRACT SUBJECT TO FINAL INSPECTION BY RENEWAL BY ANDERSEN CONSTRUCTION DEPARTMENT.*TERMS AND CONDITIONS THAT GOVERN THIS CONTRACT ARE PRINTED ON THE REVERSE SIDE.This contract is a legal document.Your Renewal by Andersen products will be especially made-to-order for you.012913 NO IR a iee.TAN WILL REVISIONS OR CANCELLATION BE POSSIBLE BEYOND THE THIRD B Ih cc DAY AFT a THE Otv a T 1 A a Ftv SIChFD AND DEPOSIT PAID.BY SIGNING BELOW,YOU APE Acutinvn onrwr.Twnr ruc ABOVE ceo^;p;-:Ti4S FOR THE FAA^ ORDERING ARE C)RRECT. ` _ ` RbA Rep.Signature: ,. c,oLh.� Date: Customer Signature: T _Customer Signature: YYh e-Renewal by Andersen Yellow-Installa9on Pink.Homeowner 02-02-07 The, Coor!1Oeadth ssachusetls . D.epartmeitf of Industrial Accidents Oyu:of Investigations: . 600 K'`aahington"Street Boston, M9:OZ111 t . www.mdssgov/div orktfts' Co�PensatiQn.Instirance A[fida.vii .Builders/Contra..dors/Electricians/Plutoabers. Alcase Print Le ibl licant Iofo�matiob • • - 'zatio»lltidividilalj: • - . . • . . - ..: , . 1 dame. (8usuness/OtBan► Address: ; Pbone :rt you an employer? Check�.lbc appropriate boy[: :• Typ'e. . project(tctluit.. 91-11,am a �tr>ploye=r With. �: D 1 am a gcnoral ca.Dti'acto.[ and T 6, Q'Ne : cotistructioti s Davc b.ircd tlic sub-cpntrctors ct pYoyccs;(fLL11 atid/or,p.art-Umc"). cc. t 7. .�odcling , `lis[cd-oathcatr.2�bcdsh t �.I'am a,solcproptictor or.partncr- 'I'licsc sub-cantractors ave 8. Q Dczpolitio>i . ship'-and bivc no'.cMployccs y„orke•rs' coiup.insanci~ woTkinig fbi me iia any'capacity.. 9: ..Q'Buildmg addition. (J1p Wotktrs' co#[ip: i�stuancc S, Q.VI!c.asc?ctiTpotatio�aad ltt 10 Q BlectricII Tcp;irs-oT additioas rtq tired,)::: officers bays cxerei;td their, ri t o czc tion a MGL. iI.❑ Plu!hb'ing rcpgus or additions I 'atis abomdow� mei.doing all wrork � p •.mys elf. (No Workcis'•comv., c. .. 2, §1(4),;aid we h aYc,i�o 12,{] Roo.f repairs, 1DS�IZIDGG'•LCq\11IOd.J Cjt[plOyGCS.(Nbvvorkcts' 13,0 %Othtr CO1Tlp.1DSurancz[OgUlttd.:�' ; y�p hc"i thatch' cC"box*1 must-Alio.fill outthe section beleM 1o"hni thein�ioskars'eompinY.ponpo}ioyinCo.itnidor�' nieowners r+�o.wlisnit this a(t5&a jt indicaont trey arc doing ill«.ork`and theta bir:oujcidc'aohtmuft ri mitst submit i tsew: divil a►Cieatis�such ibactors thmT,chcck this box, st.attiohed an.additidhal shot ahoh�ing the name of fha sub contr+ctoti.a�d.t?iev rorlie's'.eiwtp..'poliry intoTT*satiot�. a an irnpJoytr that is proyiding.workerr'compensaiian insucartcefor yhy imployFcs, Bcloi"�s.thi policy and ob site �rancc•Cotup atay lel i ino cy"#or Sclf ins. L' ic: = l�p �✓� C- ��� � •Bxp�ation Date: �- Site Address; (qty/StitdZip:; .• 4,V f_ / ' ►cb a co oft r ers' eom .eosaiiou olit declaration' -sgc'(sbo.wio the ohty.�,umbcr and expir�at>ioo.dtate): . • . PY w , k p P Y p g', p.. uc,to scctiz; tovcragc as required�ladc[Section 2SA of MGL c•152.cai1 lcid co.'1Dc impositipn of�rutunal pcaalC9 of r up•to Si;S00- at�d/oi one ycarir p -sonmt?nt, as wcll.as civ?ptna)dcs in th i login Qf a STOP VOAK QR DE �d a had . �tv S2.50.00 a day_againstthe violator. Bz adyiscd that a:copy,ofthis ttatcmctitlnaybc forwatrdadto the Office of stigatioms ditbc DIA for irlsuramcc coverage verification:. . Ktreby ce u e the ai s'vQd e>;Odes 9fparjµry ih-at jh4-iriformatiortproytded above is trto qnd corrg�, aturc_' � - .' '. Date:• •• �. �_ . n �ciQl I'$cor�ty. Do ►tot ivrde'i•i Xhr's arca;ao h.-- coma-fed'by city or rower offtcidL.' .' Information andristructions Mass achusCrts'GeWal Laws cbaptcr 152 roquires all.crrtployers'to provide-WoAascomp.cnsation for their emp'loyres. puisuant to ibis statute, an•employee is dcfmtd as.`' .:every- ferso'n in-the saYice-of another undcrany contract ofhue: oxp�riS,Or Iicd oral or written," ,n imployer is defined as "an mi dividWl,partncnbip, asso.ciation, corporation di other legal entity, or atly ttivo.or rwre. of the foregoing engaged in,a joint, ttrprise,and including the legal ieprescnt 6Ycs-of.a deceased cttployez or the receiver or trustee.of aii•.individual;partndisbip;association or otherlega)entity,.cmploying employers.;However.-the. oyvner of a dW�lling hpusc,havingnotmorc chap t]1r66 apartmcms-and.wbo nsides•.tbemm, or the occupantofthc. . dwdling,housc of another wbo'crnvloys persow`tn do'tnaihtenancc, construction or.rtpait.WOTkon such dwelling bou$c or on the grounds.orbuildingappurtinant thereto_s)ia7l.n'.tbccausc ofsueb cmployrnimtbe deemed tobe as crnploy.er_'.' MGL cbaptcr 152, §25C(6).also*'fates that"every state:ot.local lieensi agency shall'*thhold the issuance of". -re.newal ofa lic4ni.e or ptrmit.to operite.a business or to,coustruct bWdioY;ln'tbt commowe�1th for.-any .'applican't:wbb bas 6,ot producia-icerptable evidence of compliance:witb the•iesurance coverage reg4ired." Additiorialty; MGL cbapt�r7S2; §2SC(1).sbtcs"Ncithcrtbc commotiwr;alt];nor�ny'of-itspoli6cal•subdrvisfo�s shall cntci'into:any coAtract for,the per nnancc ofpUbli. work until ieccpta.ble cvidcube of compliance wifb the,msuranco" requiiemcnts df Chit chapter.bave beenpresentiid to.the contracting auth-ority,`' Appltc,an is ; Please fill oft tbc..worl<trs" coTrrpensation affid2ivit.complctelyr by chccYiAg tDc boxes that apply to your situatxo>d and,'if nccessa-ry, supply sub-cootra*T(s)namo(s),% ddresi.(es) and'pbo>lcnuiribcr(s) along ith,tlieirceitifieatei(s)of insttia'Cc,,Linnited;Liability Companies(1LLC)otLi�nited Lil�ilify Paimcrsbips (LLP)with'Jo ciaployeei ott�ex thaa•the merfibeii'orpartnGrs, art notiequitod to earryykorYcrs' eorrrpensatiOn insurance If an LLC otLI;P.docs have ctnployccs;,apolicyis required. Bc advised thattLis affidavitmay:bcsubniiiTcd-to' Lz cat.of;Inclustxia2 AGcidct}ts.foi confirn7ation ofinSuranoc cQvcragc, Also.bee iurt'.to sign and date the:aMdavit:.•'Tbc a$tdayit should ` be iemmned to the city QT* town thartht applicatioib foe-6-o p&mt'oT l]CGnSC)s b'r'ing=rcqucstcd, bot theDcpattrricnt.of todustrial ACcidLnti,;Sho.u]d.you>yavcan}rquestions regarding fl�cIaivnr...ifyov arelc9uircd to obta�iri atiyoTlrccs' , coropelAation polity;please call the DepattMent.atihe tiumber Ji ted bcloW,• Self-insuled coti�ania-should enter cit . self-.insutaacc license nuinbct ou the appropriate jint; Clty.oeTo�-'OITi,dals •. • - � � �,- . .' - I . : .. .• Nease be sure their the affidavit is complcEc and priuttd.legiibly. TLcDcpartmctr-.'h's providc44 sp;cc st tl&bot%* = .of the affidavit for.you Lo t51J'out in the cvenftbe 6ffice,OfItiYcstigations-has to contact you reguding the applicant Blease bc.sure to fill'! C.Pearsit/liccase'nuiribeawwo-9yi1lbe-used as i reference,numbcr, In addition, an'appl'c ' •.�atTnustsubsnit multiplepernut/license applications:ia'ariygivcnycat,tot onlysubmit one a'ffidayitIDdieatin�curicnt P°l'cY %q formation•(if necessary)and under''�ob-Site.Address"the applicant•'sbould Or' to "all 7o6a tions in _(city or tOWD)•"'A.copyoftbcaFCidaYittbatbasbccn'officiall s y tatnpcd orm�rkcdbytlic city or'toy�n-may beptovided to due.• aPPlicapt a9.pioof,that a alid•affid��t`t is:on file:for fiiti}Tepcmnits orliccases. A ttcy✓affidavit must be filled oil acb Ycu- 'Where a.pome oyvner oT cituen.is obtaining!license oTperid Oatrelatcd ta;anybuiiness of cvmrriercial YCOturC 'i. C. •do ltcensoor e ' g .p rrrutjo burp ka' etc.)said.person is NQTlogWed.to eovTlctc this affidavit 3e.Omcc ofinycsdgations'wouldlikc to th.an.k ouin advariccfor your coo. naion aad:'shoud you have anuestions leasedonotbesltateib:giYt US.9.call: re.DcPartmc�t..:address, tcicp�onc and faxnurnbcr: The COnimonwealth.'ofMassachusetts Deparbment'of Industrial Accidents Office of 6.00-Washineon.Street Boston. 'ITZ toomrrwauuea o°_. aa<Ju L7b Board of Building Regulations and Standards Construction.Supervisor License a Licenses CS 74251 Birthdate 3/9/1963 Eipiration, _3..[9%2009 Tr# 11065 Restriction 00 JOHN K ESLER 104 OTIS ST /�--�— --5e NORTHBORO,MA 01532 Commissioner �� �rnvr�wnauecz��i. + ���craaa:�Zecaerttd Board of Building Regulation's a°,nd Standards HOME IMPROVEMENT CONTRACTOR Registratiow. 149601 Ex:piTa_tion , /24/2008 • ' Type Supplement Card RENEWAL BY A ALVAH MACDOrIA�:�_=1��-=r 104 OTIS STREET NORTHBOROUGH,Ma'6i532 Administrator Ja'n .02 - 2007 15s 26 JPAM•cKeone#1.ns 734 6'62` 8101` 2 P AC Dm. .CERTIFICA.TE OF LIABILITY INSURANCE 0.911212006 ^1O0�OI THIS CERTIFICATE IS ISSUED AS A•MATTER OF INFORMATION Joseph McKeon. ONLY AND' CONFERS .NO RIGHTS UPON THE CERTIFICATE n JP McKeoInsurance A enc , Inc, HOLDER. THIS CERTIFICATE DOES .NOT AMEND, EXTEND OR g Y ALTER THE COVERAGE AFFORDED BY THE POUCIES BELOW. P.O. Box 333 Ann Arbor, MI 48106-0333 INSURERS AFFORDING COVERAGE "C A RenewMbyAndemon 04URERA: 'Hil, I nCoinpany AL Windows, Inc, INCURER e: '104 Otis St' INSURER Q. N.aft6rough, MA, 01532 IIduRER o: rims E: COVERAG THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE,INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOUIREMENT, R".TERM OCONDITION OF ANY CONTRACT OR OTHERWITH DOCUMENT RESPECT TO MCH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,.THE INSURANCE AFFORDEO BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO All THE TERMS, EXCLUSIONS AND CONOM. NS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAW,OUR " l fwOIIC�MIM R POEICYEitECTNF POLICY EXPIRATION JiL UMTO 8 0°"RALLmurly HE118858850 9/7106 9/7107EACH 00cuRKNCE'... t 1,000,000 COMNER I °II AL OENERAL lAITY DPRE ES as t 1 0 "MIS MADE Q.00cUR MEDE7cP onr ee t 10000. PER SONAL 4 ADY INJURY 1 1,00,060 GENERAL AGGREGATE 1 ' 2 OEN LAOGREGATE UWT APPLES PER. PRODUCTS-CbNPAPAGC t 2.000.000 POLICY PROJECTtoC A 't"'0M0 1&"A01u^/ 35 MCC XD 6388' 10/1/05" 10/1/07 couewet)s IOLEUMMT 1. 1,000,000 ANY AUTO . (EA.eelelnq AL%.0 MIEOAUTOS. 9001LYM1lURY ; SCHEDULE0AUTOS. R'° P°—) . H+RED AUTOS - BODILY INJORT;" NON-O (PrAcWomQ i tM�J®AUT06 . PROPERTY CAMAOE ► >; . . (INtr.edO.nQ • OAPlADElWIL1TY AUTO OMLY-EAACCIOENT1 ANY AUTO EAACL f OTHER TMAr AUTO ONLY; AGO "f QEM[t1AUWK�TX EACH OCCURRENCE t DocuR CLAWS MADE ACGIREGAtE i OEOUCTeE E t RETENTION 1 A rYmmu 6omkmmTM MO 35 W8GNC8.861 1/1107 . 1/1108 A u- ° - RMPLOVIIOW U01UTY — ch AW PROPRIETOR0PARTNE XgcU pA E.L.EACH ACGDENT f500.000 OfnCIERINEIIOER EXCILOEOTbe wWw E.L d6EaS1; EA EMPLOYEE f ° /ROVeIONs eww CENER E.L.DISEASE-POLCYLWIT . OEJCRIPTION OF ORNLTONS I LOCAT10Ns I VEHIClE11 EACLVeIONS ADDED OY EN00k.&MENTI/PECiAL►ROYI>IIONS" CERTIFICATE HOLDER CANCELLATION tNO1"AMI OP M A°o11t oElcmo POUCIEs k CAMCELm Word TKEXPIRATION .INSURED COPY Q/1E T NEW.M WSUM0 WURtR WILL EWMAVOR TO MQL IO DAYS'WRMVN Ig110E To-THE CERTIIICAn tiow"wmm TO TH4 LEFT,OUT FAILURE TO DO e0 MALL INP O OYUOIITDN.OR UANUTY OF ANY KM UPON TM 11AI 'ITS AGENT$OR fewTNM- ORS REPIIE3 TNF . _ 6�.ACORD f��l?RATION"1988 . NORTH Town of Andover 0 SRN.pWsi-'.�. ti`.�1�' �. No. qS* WW - 0 dover, Mass C% fzl—'a ]z 0 LA C0C..0 HE WICK 0RA T E D BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........Pr-- 0............................................................................................. .............................. Foundation has permission to erect........................................ buildings ons— ... err... .............................. Rough to be occupied as.......... Chimney lee,ew-f-7 ........................................................................... provided that the person accepting 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 Final PERMIT EXPIRES N 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI0 STARTS 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 Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det.