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Building Permit #469 - 65 CAMPION ROAD 1/6/2010
TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: �l' C% Date Received Date Issued: J/ 1, 'IMPORTANT: Applicant must com Tete all items on this page LOCATIONCT ( _� PROPERTY OWNER - pdnnt MAP NO: PARCEL Pnnt ZONING -DISTRICT: _ Historic District _.yes Machine Shop Village yes TYPE OF IMPROVEMENT I PROPOSED USE New BuildingvvOne famil Non- Residential Addition Two or more family Y Industrial No. of units: Commercial lace Assessory Bldg Demolition Other Others: pSepfic_ VI/ell Floodplain.. - Wetlands - VVater/Sewer.; - 1Naters`hed .Distri DESCR FW R E PE FORMED: ME --' Phone: Address: Reg. No. FEE SCHEDULE. BULDINC PERMIT. $12.01i0 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $_ t I ]—+— FEE: $ Check No.:Q p,- Receipt No.: NOTE: Persons contracting with unregistered contractors do not have acces t th gu n fund Signature of Agent/Owner FB Signature of contr Location � �- Date. No. TOWN OF NORTH ANDOVER 9 $ • _ ; ; Certificate of Occupancy Building/Frame Permit Fee $ ��ss�cMusts�� Foundation Permit Fee $ Other Permit Fee TOTAL $ Check # 2272.9 Building inspector; �� THE FOLLOWING SECTIONSFOR N OFF - OFFICE U FORM E ONLY INTERDEPARTMENTAL SIG 1 DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION COMMENTS HEALTH COMMENTS Reviewed on Si nature Reviewed on Si nature Zoning 'Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Drivewa Water & Sewer Connection/Si nature & Date Permit DPW Town Engineer: Signature: Located 384 Osgood Street -yes no -_ 'FIRE DEPARTMENT 7-emp"Dumpster onside _ Located at 124`Main Street .Fire Dep artinentsignature/date A.DOMONAL Ft-pFOR�L�NCE RATINGS �cu>k—tort sLa.ta.c�x'� ce c�+c�xto . 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Linda IN 9 "rrbofsnt E?IEt6T St laro mrocu 6,61 m� b1 ata. �I� a a K x�r grttolQoc Board of Building Rcgulations and Standards .! "+ HOME IMPROVEMENT CONTRACTOR - i Registration:, 126893 Ezpi�ation: _8�Jl2010 .Type: _Supplement Card Gg The Home Depot':At Home'Sery ce 1 I r _The Commonwealth of�rlassachzapetis Department .6f Industrial Accidents Office of Investigations (_ 600 Washington Street Boston, MA 02111 t �1 4ovldia ` ww>a,,t�lass,� ri#, .vr3ir�n�+rani;:�r51�:�#rt#rician:�I�k'111�.�i;r; Yorkers' OrIlp�i�Sa#i0i7Ins�zranci _ . Tease Print L gibl-v Ap licant Inform atlon Ni aMC (Business/Organizationlindividual): r" 'il r� �L 1�. Address: s y City/State/Zip Phone #: Are you an ployer? Check the appropriate box: ❑ 'a4' ❑ I am a general contractor and I Type of project (required): P. New construction 1. employer with employees (full and/or part-time)- . have hired the sub -contractors listed on the attached sheet. 7. ❑ Remodeling 2. ❑ 1 am a sole proprietor or partner- These, sub -contractus have g. ❑. Demolition ship and have no employees working for me in any capacity. employees and have workers insurance. 9 ❑Building addition [No workers' comp. insurance - comp. 5We are a corporation and its . E]required.] 10.E]Electrical repairs or additions officers have exercised their 11.❑ Plumbing repairs or additions 3. ❑ I am -a homeowner doing all work. right of exemption per MGL 12.repairs . myself. o workers' comp. y � p' insurance required.] t c. 152, § 1(4), and we have no ,S+ ' 13 Other 1 01 employees. [No workers' comp. insurance required.] *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 3Contnctors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees_ If the sub -contractors have employees, they rqust provide their workers' comp. policy number. lam an employer that is providing worlrets' compensation insurancefor my employees. Below is the policy and job site inforrtzation. 1 Insurance Company Name; �- Expiration Date: Policy # or Self -ins. Lic. #: ' 1 1 @�.J� Sob Site Address: City/State/Zip: Attach a copy of the workers' compensation policy d laration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL C. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. ny6nd penalties of perjury that the information provided abovif is true and correct. I do hereby certify der h ai _ /.. n Official use only. Do not write in this area, to be completed by city or town ojj-iciai City or Town: Permit/License # Issuing Authority (circle one): 1, Board of Health 2. Building Department 3. City/Towu Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Phone #: Contact Person: ACORD,. CERTIFICATE OF LIABILITY INSURANCE DATE (MM/00/YYYY) 02/20/09 PRODUCER 1-404-995-3000 Marsh USA, Inc. homedepot.certrequest@marsh.com THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSR 347 5Piedmont Rd NE, Suite 1200 Atlanta, GA 30305 Fax (212) 948-0902 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A:Steadfast Ins Co 26387 THD At -Home Services, Inc. INSURERB:Zurich American Ins Co 16535 INSURER C: NATIONAL UNION FIRE INS CO OF PITTS 19445 2690 Cumberland Parkway Suite 300 Atlanta GA 30339 INSURERD:New Hampshire Ins Co 23841 INSURER E: Illinois Natl Ins Co 23817 v THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDI - POLICYEFFECTIVE POLICY EXPIRATION LIMITS TR NSRD TYPE OF INSURANCE POLICY NUMBER DATE MM DD DATE MM OD A GENERAL LIABILITY IPR 3757 608-02 03/01/09 03/01/10 EACHOCCURRENCE $4,000,000 DAMAGE TORENTED— 1,000,000 PREMISES Eaoccurence $ X COMMERCIAL GENERAL LIABILITY LIMITS OF POLICY ARE EXC SS MEO EXP (Any one person) $EXCLUDED CLAIMS MADE OCCUR "OF SIR: $1,000,000 PER CC" PERSONAL& ADV INJURY $4,000,000 GENERAL AGGREGATE $ 4,000,000 GENI AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OPAGG $4,000,000 X1 POLICY PE LOC B AUTOMOBILE LIABILITY BAP 2938863-06 03/01/09 03/01/10 COMBINED SINGLE LIMIT $1,000,000 X (Ea accident) ANYAUTO ALLOWNEDAUTOS BODILYINJURY $ (Per person) SCHEDULED AUTOS HIRED AUTOS BODILYINJURY $ (Per accident) NON -OWNED AUTOS X SELF INSURED AUTO PROPERTY DAMAGE $ (Per accident) PHYSICAL DAMAGE GARAGE LIABILITY AUTO ONLY - EAACCIOENT $ OTHERTHAN EAACC $ ANYAUTO AUTO ONLY: AGG $ A EXCESS/UMBRELLA LIABILITY IPR 3757 608-02 03/01/09 03/01/10 EACH OCCURRENCE $ 5,000,000 AGGREGATE $5,000,000 X OCCUR CLAIMS MADE $ $ DEDUCTIBLE $ RETENTION $ C WORKERSCOMPENSATIONAND 3566916 (CA) 03/01/09 03/01/10 X WC STATU- OTH- TORY LIMIT R E.L. EACH ACCIDENT $1,000,000 D EMPLOYERS'LIABILITY 3566915 (AOS) 03/01/09 03/01/10 E.L. DISEASE - EA EMPLOYEE $1,000,000 E ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? 3566917 (FL) 03/01/09 03/01/10 E.L. DISEASE -POLICY LIMIT $1,000,000 If yes, describe under SPECIAL PROVISIONS below D OTHER Workers Compensation 3566918 (KY, MO, NY, WI, 03/01/09 03/01/10 F TX Employers Excess TNSC45694422 (TX) r) 03/01/09 03/01/10 ccurrence/SIR 25M/2M C Workers Compensation 4801323(QSI) 03/01/09 03/01/10 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES/ EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS RE: EVIDENCE OF INSURANCE l.tK t 1NUA I t MUL.UtK SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION THD AT-HOME SERVICES, INC. DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 2690 CUMBERLAND PARKWAY SUITE 300 REPRESENTATIVES. ATLANTA, GA 30339 AUTHORIZED REPRESENTATIVE USA ACORD 25 (2001108) ckomraus_hd © ACORD CORPORATION 1988 11172180 2009-12-31 13:27 3480PR 6038940417 6038940417 >> Home Depot AHS P 1/6 HOME BaROYFMENT CONTRACT PLEASE READ THIS Sold, Furnished and Installed by: Branch Naim: Boston Date: �s�/� f�� THD At -Horne Services; Inc. diWa The Hume Depot At -Home Services 345A Greenwaxi Street, Unit 2, Worcester, MA 01607 Branch Number: 31 'Poll Free (800) 657-5182; Fax (508) 756-8823 Fedt W M # 75-2695460; ME Lie a C 02439; RI Cont. Lie# 16427 Cl' Lica 565522; MA Home Improvement Contractor Reg. a 126593. Installation Additt m City State Zip ) Pw>thaiier(s)' Wait Phone Hr►mo Phony" Celt Pbum f J Home Addrew (if different from Installation Address) LILY State Zip E-mail Address (to receive project commonicaiiom and Horne Depot updates): ❑ I DO NOT wish to receive any marketing etmils from The Home Depot Pro'eet Porters UrMk�igned {"Custowrer'�, the owners of the proporrty located at the rilx►ve installation adds ss, agrees to buy, artd THD At-Ho:�d erviees, Inc. ("T6e Home Repot") agrees to furnish, deliver and strange fur the insWlation ("lnstallation'� of all materials deson the haloesongany applicable State Sapplcmertt and Payment Summary attached hereto and any Change Ordets (culler tiveiy, Contras"): Joh 0: ur►m+t:&—.0 Cusmrner a9ml; that, immediately upon completion of the work for each Product, Customer will execute a Completion Certificate (one for each Posited as defined by an individual 51111 Sheet) and pay any balance due. As applicable, each Customer under this Contract. agrees to be jointly and severally obligated and liable hereunder. The Home Depot reserves the right to issue a Change Order or terminate this Contract or any individual Product(s) included herein, at its discretion, if The Home Depot or its autho&W service provider dtxcrnines that it eammn perform its obligations due to a structural problem with the horse, environmental hazards such as mold, asbestos or lead paint, other safety concerns, pricing emus or because work required to complete the job was not included in the Contract. Pevment % m arr The Payment Summary #_ � � � , included as part of this 0)ntract, sets forth the Lola) Contract amorunt and payor mut required for the deposlts and final payments by Product (as applicable). NOTICE TO CUSTOMER You are entitled to a completely filled-in copy of the Contract at the time you sign. IA► not sign a Completion Certificate (notc: there is one Completion Certificate for each listed Product as defined by individual Spec Sheets) before work an that Product is complete. In the event of termination of this Contract' Customer agrees to pay The Home Deport the costs of materials, labor, expenses and servicer provided by The Home Depot or Authorized Service Provider through the date of termination, plots any other amounts set forth in toils Agreement or allowed under applicable law. THE HOME DEPOT MAY WITHHOLD AMOUNT[ OWED TO THE ROMP DEPOT FROM THE DF..1'OM PAYMENT OR OTHER PAYMENTS MADE, WITHOUT LIMITING THE HOME DEPOT'S OTHER REMEDIES FOR RECOVERY OF SUCH AMOUNTS. A_ et nce and Authorization: Cminmer agrees and understands that this Agreement is the entire agreement between Customer and The Home Depot with regard to the Products and Installation services and supersedes all prior discussions and agreements, either oral or written, relating to said Products and Installation. This Agreement canna be assigned or amended except by a writing signed by Customer and The Home Ek:pot. Customer acknowledges and agrees that Customer has read, understands, voluntarily accepts the terms of and has received a copy of this Agreement. Atxepted by.... f:...::x Custutncr's Signature nate X_. Customer's Signature Date CANCELLATION: CUSTOMER MAY CAN(,'EL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO THE HOME DEPOT BY MIDNIGHT ON THE THIRD BUSlNM DAY AFTER SIGNING: THIS AGRIrPA TENT. THE STATE SUPPLEMENT ATTACHED HERETO CONTAINS A IiORM TO USE IF ONE Lq SPECIFICALLY PRES(,MED BY LAW IN C'USTOMER'S STATE. SuLbiol3w Sales nsultant's Signature Date Telephone No. CJj '-n",> -3 t Sales Consultant License No. (as applicable) NOTICE: AODMONAL TOM ANO (.'ON MOM ARE STATED ON THC REVERSE Stnte AND ARE PART OF TIM C(M7tAO-7 113009 C -SC White -Branch File Yellow-Custxw Pink - SalasConsutlard 0u) Siding mdows ❑ Iastdation ut �❑Roofing 043utters / Covers 136ntry Iktas 13— I !tooting ❑siding windows IrSnl2eitro � ❑Gullets / Covers ❑Getty Doors 171 Roofing ❑Siding wim.. lnattatioat $ ❑Gutless / Covers ❑Batry Doors f-1 Ratfittg Siding ❑ Rrmdaws ❑ Instdation ❑Gutters / Covers ❑Envy rxxn Q $ Mttdm-7S%DWX*-Of CoutradAmoiantdueuportmMitianofdig amhnrt MainePWdsisers may not depait nwre thmoa&d" a rthe CauraciAwaval. TotsllContract Amount $ l �� Cusmrner a9ml; that, immediately upon completion of the work for each Product, Customer will execute a Completion Certificate (one for each Posited as defined by an individual 51111 Sheet) and pay any balance due. As applicable, each Customer under this Contract. agrees to be jointly and severally obligated and liable hereunder. The Home Depot reserves the right to issue a Change Order or terminate this Contract or any individual Product(s) included herein, at its discretion, if The Home Depot or its autho&W service provider dtxcrnines that it eammn perform its obligations due to a structural problem with the horse, environmental hazards such as mold, asbestos or lead paint, other safety concerns, pricing emus or because work required to complete the job was not included in the Contract. Pevment % m arr The Payment Summary #_ � � � , included as part of this 0)ntract, sets forth the Lola) Contract amorunt and payor mut required for the deposlts and final payments by Product (as applicable). NOTICE TO CUSTOMER You are entitled to a completely filled-in copy of the Contract at the time you sign. IA► not sign a Completion Certificate (notc: there is one Completion Certificate for each listed Product as defined by individual Spec Sheets) before work an that Product is complete. In the event of termination of this Contract' Customer agrees to pay The Home Deport the costs of materials, labor, expenses and servicer provided by The Home Depot or Authorized Service Provider through the date of termination, plots any other amounts set forth in toils Agreement or allowed under applicable law. THE HOME DEPOT MAY WITHHOLD AMOUNT[ OWED TO THE ROMP DEPOT FROM THE DF..1'OM PAYMENT OR OTHER PAYMENTS MADE, WITHOUT LIMITING THE HOME DEPOT'S OTHER REMEDIES FOR RECOVERY OF SUCH AMOUNTS. A_ et nce and Authorization: Cminmer agrees and understands that this Agreement is the entire agreement between Customer and The Home Depot with regard to the Products and Installation services and supersedes all prior discussions and agreements, either oral or written, relating to said Products and Installation. This Agreement canna be assigned or amended except by a writing signed by Customer and The Home Ek:pot. Customer acknowledges and agrees that Customer has read, understands, voluntarily accepts the terms of and has received a copy of this Agreement. Atxepted by.... f:...::x Custutncr's Signature nate X_. Customer's Signature Date CANCELLATION: CUSTOMER MAY CAN(,'EL THIS AGREEMENT WITHOUT PENALTY OR OBLIGATION BY DELIVERING WRITTEN NOTICE TO THE HOME DEPOT BY MIDNIGHT ON THE THIRD BUSlNM DAY AFTER SIGNING: THIS AGRIrPA TENT. THE STATE SUPPLEMENT ATTACHED HERETO CONTAINS A IiORM TO USE IF ONE Lq SPECIFICALLY PRES(,MED BY LAW IN C'USTOMER'S STATE. SuLbiol3w Sales nsultant's Signature Date Telephone No. CJj '-n",> -3 t Sales Consultant License No. (as applicable) NOTICE: AODMONAL TOM ANO (.'ON MOM ARE STATED ON THC REVERSE Stnte AND ARE PART OF TIM C(M7tAO-7 113009 C -SC White -Branch File Yellow-Custxw Pink - SalasConsutlard 0u) Massachusetts - Department of Public Safety Board of Building Re-gulations and Standard; Construction Supervisor Specialty License License: CS SL 99124 Restricted to: WS JOHN AMERO 12 CARRIAGE CHACE LANE ATKINSON, NH 03811 Expiration: 7/16/2012 Comtnessi4pner Tr#: 99214 N m x m m X U) m v y C � CO) C7 CD Z y C -0. L r C d co) a� v o C7 CD CD CL. _ Q �dCD CD 0 CD C O CO) �■ CD av y o co CD � v H O -o Z CD O CD 3 0 CD O ozr I cn vl n O cn IV cn cn G1 M t_ wg-Ra. d s O Sir O Q N '71cn wCD G.O�m 6=mn 90H n s yea= m a n �' ` Z ?-= CO) --I ;n O O. = O1 Im N m N CD O O = O -0 ?m m O� 0� m ~' O O O yin: C �-m : y a c m CL cc O O m N m c C 1 d m CD N N d CO) p, d C o CC)CL � a N t0 it,.rt � R N co) 02 N M . C r CD CD CD 10 N P M c 0 0 :o CD N GO -0 O CD Cs: sm _ED a 3 CD o CD Q3 m O.'o C.2 O �s tom: o� C F: cn a cn tp -n qo G O '71cn wCD gJ G Oo Ct1 :570 w G pq to � w n �' ` qz G OG Oil C r It cn B n. ;n O O. = O M W W omi 0 0 c 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.$100-$1000 fine NOTES and DATA — (For department use ❑ Notified for pickup - Date Doc:.Building Permit Revised 2008 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 o 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 NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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 o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) o Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses o Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) o Copy of Contract --- - ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit 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: Doc.Building Permit Revised 2008 NORTH ANDOVER BUILDING DEPARTMENT .1600 Osgood Street North Andover Tel: 978-688-9545 Fax: 978-688-9542 DATE: I ADDRESS; .BUSINESSFORM FOR TOWNCLERK ZONINGDISTIIOT TYPE OF BUSINESS: C yAmp fra BUILDING LAYOUT PROVIDED: YES NO AVAiLA—BLF PARK1-NG SPACES: ZONING BYLAW USAGE: 'YES NO BUSINESS FORM FOP MWN CLERK 2.40 Home Occupation (1989/32) An accessory use conducted within a dwelling by a resident who resides in the dwelling as his principal address, which is clearly secondary to the use -of the -building for luring ptuposes. Home occupations shall 'include, "but not'limited to the following uses; personal services such as famished by an artist or instructor, but not occupation involved with motor vehicle repairs, beauty parlors, animal kennels, or the conduct of retail business, or the manufacturing o£goods, which impacts the residential nature of the neighborhood. 4. For use of a dwelling in any residential district or rnulti family district for a home occupation, the following conditions shall apply: a. Not more than a total of three (3) people may be employed in the home occupation, one of whom shall be the Milk of thd home occupation and residing in said dwelling; b. The use is carried on strictly within the principal building; c. There shall be no exterior alterations, accessory buildings, or display which are not customary with residential buildings; d. Not more than twenty- five (25) percent of the existing gross floor area of Ilie- dwelling Unit, so used, not to exceed one thousand (1000) square feet, is devoted to 'such use. In connection with such use, there is to be kept no stock in trade, commodities or products which occupy space beyond these limits; e. There will be. no display of goods or wares visible from the street; f. The building or premises occupied shall not be rendered objectionable or detrimental to the residential character of the neighborhood due to the exterior appearance, emission of odor, gas, smoke, dust, noise, disturbance, or in any other way become objectionable or detrimental to any residential use within the neighborhood; g. Any such building shall include no features of design not custommy in buildings for residential use. ignature Date --1 00 1 4 Date ..... 7.. - . / . / ...... ....... ... TOWN OF NORTH ANDOVER PERMIT FOR WIRING a This certifies that ................ has permission to perform .......... ...... ........... wiring in the building of ................. to(e)-u ..................................................... at ... 4v:F.. North Andover, Mass. Fee .... Lic. No.:5ZLITZE� ........... Check # /.32.1 Nv-t ti.14 CotnnMnwaa& o/ maddachWaffq Official Use Only cc�� cc77 �7 Permit No. leo r� .1JaParfmanE o�}nra Jarvkes Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev, 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFOR.ATATION} Date: kJ_ (,, +- ZCQi City or Town of: W C)g7t JA AN nCJ %R To the Inspe for of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) L S n (A -b Owner -or Tenant M(;L . W V Telephone No. _ ?_ Owner's Address IS,tq yYl - IL Is this.permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / volts Overhead ❑ Undgrd ❑ New Service .Amps / Volts Overhead ❑ Undgrd ❑ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work:. o, of Rer IND. E o, of Lr Gen D.ofI )_ n Ni No. No. Nc N of CeL;-Susp. (Paddle) Fans IND. E " Tubs Gen ❑t d. But FIR l Total No. IND. Tnn.c OT / r �1)) KW KW. --No. Ballasts Total H.P be No, of Meters No, of Meters KVA KVA ALARMS IND, of Zones Detection an of Alerting Devices al ❑mumctpai El other Connection rarity Systems: No. -of Devices or Equivalent :a Wiring: No, of Devices or Equivalent ecommunications Wiring: No. of Devices or Eauivalent NK. Attach additional detail if desired, or as required by the hispector ojii'ires, Estimated Value of Electricul y ut (When required b municipal policy) Y P P Y) Work to Start: �� �. A Inspe..._ _ in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by u,. —Zr,vneno permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent, The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office, CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information. on this application is true and complete. FIRM NAME: LIC. NO.: S Q5 Licensee: = M k -A&M ME Signature IC. NO.: (Ifapplicable, enter "mempl"urthe license number line.)us. Tel. No.f!p�2� Address: I I C) G �ROA4�i.11 Y - ��lGP- J-E.Z.LL /,�,Yr'`A 0t'€L�% t t. Tel. No.: *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No, OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE; $ w r tl � U w N � w w Cwn>rianw,419 o/ mamacLl& Official Use Only Permit No. ko 1Ja�arfmars� o�.fira �arvkea Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (hIEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: Pmkll Cn " ZQa City or Town oh�(��{ 1 W jE To the Inspe for of Wires; By this application the undersigned gives notice of his or her intention to perform the electrical work described below, Location (Street & Number)_ (� CAM p j N Owner•or Tenant R W U Telephone No, ?_ Owner's Address A yyl Is this.permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Boa) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service .Amps / Volts Overhead ❑ Undgrd ❑ No, of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work:. XT_5-r ZN =, '�y 9, N Ac -r--12 N b i=R ED �'n1��lAU.A.zzo1V oe- nl� - N��J ��Rrllper' . Com letian of thefollowinr table ing be waived by the Ins ector o Wires. No, of Recessed Luminaires No. of Cel-Susp. (Paddle) Fans o, of Total Transformers KVA No, of Luminaire Outlets No. of Hot Tubs Generators KVA No. of LuminairesSwimming Pool ove ❑ rnd. ❑ o. o mergency Lighting d. Bate Units No, of Receptacle Outlets No, of Oil Burners FIRE ALARMS No. of Zones No, of Switches No. of Gas Burners o. of Detection an Initiating Devices No, of Ranges No. of Air Cond, TonsTota No. of Alerting Devices No. of Waste Disposers Heat Pump I er I Tons Totals: i o, o elf -Contained '""`- Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑� Connection No, of Dryers Heating Appliances KW Security No. of Water No,KW No. of o. of Ballasts Devices or Equivalent Data Wiring: -Signs No. of Devices or Equivalent No: Hydromassage Bathtubs No. of Motors Total HP a ecommunications W iring: No. of Devices or E uivalent OTHER: NK. Attach additional detall if desired, or as required by the Inspector of F11ires. Estimated Value of Electrical Work (When required by municipal policy.) Work to Start: —— Inspections to be 'requested in accordance with MEC Rule 10, and upon completion. INSURANCE OVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent, The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify, tinder the pains and penalties ofperjury, that the information. on this application is trite and complete. FIRM NAME: LIC. NO.: 45' Licensee: -, —,I=m S.AYNNIZ Signature IC. NO.: (Ifapplicable, enter "exempt" in the license number line.) us. Tei. No.: �p Z Z I Address: I I Q (& BROAC-)IoeY - Wwa�lzf4iZLL Q1 "nt. Tel. No.: *Per M.G.L. c, 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No, OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE, $ f14,4 r � � d U � N a � a w L,eathe, Brian From: Wu, James Dames.wu@philips.com] Sent: Wednesday, May 09, 2012 11:55 AM To: Syed, Adeel; Leathe, Brian Cc: annika feenstra Subject: RE: Permits for 65 Campion Rd between 2008 and 2012 Hi Brian, I don't know why we didn't have the permit for the boiler replacement, but just FYI - Haffners installed the boiler last year, the fire marshal inspected and we were even told that we needed to install an additional hard wired smoke detector in our basement, which Haffners installed. Tks! James From: Syed, Adeel [mailto:Adeel.Syed@cartus.com] Sent: quarta-feira, 9 de maio de 2012 12:34 To: bleathe@townofnorthandover.com Cc: Wu, James; annika feenstra; Syed, Adeel Subject: FW: Permits for 65 Campion Rd between 2008 and 2012 Hi Brian, I spoke to Maura Deems in detail earlier today about 65 Campion Road and permits. She confirmed there are window permits on file from January 6th 2010. However there are no permits on file regarding a Boiler that was installed in April 2011. Can you advise if an inspection after the fact is necessary now? We at Cartus are ready to purchase his property and want to ensure this is not an issue with the Town. Please see communication from the homeowner Iw and they are copied on this email as well. Adeel Syed I Senior Client Services Consultant 40 Apple Ridge Rd, Danbury, CT 06810 USA Tel: +1 203 205 8623 1 Fax: +1 203 749 8903 1 Adeel.Sved@cartus.coml www.cartus.com Trusted guidance - for every move you make. Have an Whone? Download CartusMobile here! .4)/ Cartus �4 65 Campion Rd, North Andover, MA, 01845 The information contained in this message may be confidential and legally protected under applicable law. The message is intended solely for the addressee(s). If you are not the intended recipient, you are hereby notified that any use, forwarding, dissemination, or reproduction of this message is strictly prohibited and may be unlawful. If you are not the intended recipient, please contact the sender by return e-mail and destroy all copies of the original message. NOTICE: The information in this electronic mail message, including any attachments, is intended solely for the use of the individual(s) to whom it is addressed and may contain information that is privileged, confidential or otherwise exempt from disclosure. 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From: Wu, James [mailto:james.wu@philips.com] Sent: Wednesday, May 09, 2012 7:31 AM To: Syed, Adeel Subject: FW: Permits for 65 Campion Rd between 2008 and 2012 This message was received by Cartus using TLS encryption. Adeel, FYI — please make sure when you call that you call NORTH Andover;-) From: D'Agata, Patricia [ma iIto: pdagataO)andoverma.gov] Sent: quarta-feira, 9 de maio de 2012 08:30 To: Wu, James Subject: RE: Permits for 65 Campion Rd between 2008 and 2012 You sent this e-mail to Andover. Patti JDAgata Administrative Assistant Buifding Division Town ofAndover, W,4 Tef No. (978) 623-8301 Fax No. (978) 623-8320 Aplease consider the environment before printing this e-mail From: Wu, James [mailtoJames.wu(fthilips.com] Sent: Tuesday, May 08, 2012 9:49 PM To: D'Agata, Patricia Cc: Adeel.Syed(Q)cartus.com; annika feenstra(abhotmail.com Subject: Permits for 65 Campion Rd between 2008 and 2012 Dear sir/madam, We are selling our house and the buyers need to check the permits issued by the Town of North Andover between 2008 and 2012 for the installation of replacement windows (2x) and installation of a new boiler. Can you please confirm that these permits are on file? The buyer will contact you tomorrow to confirm. We did find the permit number from one of the projects and it is: Permit nr 469 dated: 1-6-10 (replacement windows) If you could provide this information to Adeel (in copy) it would be greatly appreciated. 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