Loading...
HomeMy WebLinkAboutMiscellaneous - 10 WOODRIDGE DRIVE 4/30/2018 (2)North Andover Board of Assessors Public Access k aORTH OE 4 n •��y0 9sSwCHUSEt Click Seal To Return Search for Parcels Search for Sales Summary Residence Detached Structure Condo Commercial Page 1 of 1 North ard;of sessor , roperty Record Card Parcel ID :210/023.0-0007-0000.0 FY:2013 Community: North Andover W 5511 1 1 I I None [fill 0 4 is M, Location: 10 WOODRIDGE DRIVE Owner Name: WOOD RIDGE HOMES, INC Owner Address: 10 WOODRIDGE DRIVE City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 34 4 Land Area: 31.05 acres Use Code: 112 ->8 -UNIT -APT Total Finished Area: 252919 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 13,191,600 11,262,100 Building Value: 9,858,900 7,929,400 Land Value: 3,332,700 3,332,700 Market Land Value: 3,332,700 Chapter Land Value: LATEST SALE Price: 1 Sale 09/30/1981 Date: s Length Sale B-NO-INTRACORP Grantor: Doc: Book: 01530 Page: 0049 http://csc-ma.us/PROPAPP/display.do?linkld=2250954&town=NandoverPubAcc 3/28/2013 Thursday, Mar 28, 2013 02:51 PM O V O L' O h WW i N W z`z W Q W , C C O z Z Z CL Z a W Q' u ui w Co LU U. 'Y 0 C 00 _ c Sto 0 c V p p p C y. Z N LLO' U O' li C' N iz 2' LL p co N N V O L' I Z �S.J��o 14 Andmore Court,.. -Am • : e�l � 711.7 !_ �. �..%%. - [//lyyA �_ - �Brialirwoo &Court e : 1 • �� ".� : L:a1Tti ' • zmrf m .. 1?Y!*lam At Ir I 11, : r nm m-erson'tourt®®®�r flialdstone, Court Of m • 1 e i t.? �f • 1� i VA ,�Gjbsonv-Court®� AMI®UN A#J PP. MMA �S.J��o VII, #I c c O O y.r 'Q .�� o• m Q O O N V E Q. � C o 0 E 7 `0w _ O O Mir in CL N .Cc IRL CL tAM c mea`: LUw civ C H C ea CA x .Q c 0 V C 0- Uj V !- O N Im . W CO O ,. La. •y da. to c O ' .� r ts Q W 06 M Q O LA co N > —._ !_— i C-) 0 a0.. V > I Ml E O � • 0 Z O N W N •//me�q /M�/� E W W CL = �o 0 d. CL cmQ O .v —J cv CL O CD C d O CL V cn i c :U_ = 0 O ` 0 W W OW. LL Z Z 4! 2 W d' - 0 z Q Y 2 W Im 0� m m y�r�,� N oWC D Y,. v m c ...I a .ra W \� LL tw v - - L LLO c C' V C' LL o OC to LL w U- v E V1 00 N to c c O O y.r 'Q .�� o• m Q O O N V E Q. � C o 0 E 7 `0w _ O O Mir in CL N .Cc IRL CL tAM c mea`: LUw civ C H C ea CA x .Q c 0 V C 0- Uj V !- O N Im . W CO O ,. La. •y da. to c O ' .� r ts Q W 06 M Q O LA co N > —._ !_— i C-) 0 a0.. V > I Ml E O � • 0 Z O N W N •//me�q /M�/� E W W CL = �o 0 d. CL cmQ O .v —J cv CL O CD C d O CL V cn i c :U_ tA 7A Ip 0L;;FXV1%.PL_,J L -W%.7 Li/A I r--. '!' Inspection 4,Le Address Name. V, Phone Permit# Office Note' r Inspection Request: ES,;t�/Fo ing Foundation Rough Final Other MMMMMMM� Inspection Date Address Name :'hone :Iermit# Offi6e.-Note nsrctib� Request: ESC/Footing Rough Final Other \ddress slame 'hone :Iermit# Office Note Foundation Frame Inspected By: .41, - D t of Inspection: Pass Fail Other rrection Note/Inspection commell.: Time in: me out: .5Ins ected'By- of Inspection:=- Pass Fall Other Cogection Note/Inspectioh comments: e in: Ti Fail Other We/Inspection comments: nspection -Request: ESC/Footing Foundation Frame Rough Final. Other Tirbe in: Time out: Inspection Date address �j Inspected By: -A dame. 4 Z2 Date of.Inspection- 'hone* Pass Fah ther/ Office Note 4��. . lermit# Correction Notefinspe ti, commen 91 rispection Request: ESC/Footing Foundation Frame -Rough Final Othe r Time in: Time out: Inspection. Date kddress /,`Inspected By: lame '2 '4 ) 4:� Date of Inspe6tion: t V/ 'hone Pass. Fail Other lermit# Office Note Correction Note/lrrgpection comments: ispection.Request: ESC/Footing Foundation Frame Rough Final Other Time in: Time-out: Signature FREEMAN LAW GROUP LLC Attorneys at Law Peter L. Free mait Kevin T. Smith, Of Counsel Renie. Hamman, Paralegal, CP, ACP pfivenm n(n,Frixt WfiM%r0UPxou1 kstnith(t_efrecmanIawgroup.ccxn rf� uu�ea in ;I'rzern uxt a ec�utr.rmn Tei. (508) 362-4700 dtmirire (M) 04--2130 'fel. (50$) 362-4700 (975) 3694)63 7 Tel. (501,R)163-47 0 Mobile (978) 549-3399 VIA HAND DELIVERY July 16,203 Albert P. Manzi, III, Esq., Chairman Zoning hoard of Appeals Town of North Andover 1600 Osgood Street Building 20 Suite 2-36 North Andover, MA 01845 Re; Wood Ridge Monies, Inc. 10 Wood Ridge Drive — Assessors Map 23, Lot 7 Comprehensive Permit NOTICE OF PROJECT CHANGE Bear Chairman Manzi and Other Board Members; This firm represents Wood Ridge Homes, Inc. (" Vlood Ridge"), the owner of the 230 cooperative dwelling units on an approximately 31 acre locus at the above= referenced location. (the "locus" or "Wood Ridge locus"). As youmay know, Wood Ridge was built in approimately 1978 pursuant to a comprehensive permit issued under M.G.L. c. 408, ss. 20-23 (the "statute") issued by the housing Appeals Committee in Docket No. 74-03 (the "Cornprehensive Perinita'). Wood Ridge hereby requests approval of small reduction to the size of the locus, based on the facts described below. We believe that this change is an insubstantial change under the Chapter 40B regulations, 760 CMR 56.05 (11,}, and request the Board to make a finding of insubstantial change, as further discussed below. In January, 2015, Wood Ridge prepared a survey that indicated two small areas where a Ewe fence encroached on the Wood Ridge locus: one area of approximately 19,000 sq. ft. on the northwest corner of the locus, and one area of apprnxi(hiatcly724 sq. f. on the northeast corner of the locus (collectively the 'Disputed Areas"). The abutting property is owned by Maureen Roche, as Trustee of The James T. Roche Trust (the "Trust") which owns the Roche Farnl. In order to resolve a disagreement over the ownership and control over the Disputed Areas, both I 96 Willow Street a Yarniouthport, MA 02675 sa Phone (50$) 362-4700 a Fax (508) 362-4701 Wood Ridge and the Trust agreed to an arrangement to adjust the common boundary areas between the Wood Ridge locus and Trust locus which generally follows an existing fence line. Under this agreement, Wood Ridge will convey to the Trust two (2) small Lots of the Wood Ridge locus, approximating the Disputed Areas (Lot B and Lot C described below), plus one (1) additional small Lot (Lot A2 described below). The areas to be conveyed are shown as Lot A2, Lot B and Lot C on a plan entitled "Plan of Land Located in North Andover, (Essex County), Mass. 10 Woodridge Drive" prepared by Easters Land Survey Associates, Inc. dated July 9, 2015 (the "Proposed Plan"). A copy of the Proposed Plan is submitted herewith. Lot A2 is 142 +/- sq. ft., Lot B is 19,319 +/- sq. ft. and Lot C is 724+/- sq. ft. Lot B has been drawn so that the side -yard setback between the new property line and the building closest to it will be sixteen (16') feet, which is one foot greater than the fifteen (15') foot side -yard setback requirement under the present Zoning Bylaw. Lot A2 is being conveyed to compensate for the fact that in order to provide this 16' setback, Lot B carves out a very small (142 +/- sq. ft.) portion of the Disputed Areas (the one on the northwest corner of the locus) which will not be conveyed to the Trust. As stated above, Lot A2 is 142 +/- sq. ft. The conveyance of these 3 small Lots will not impact any other setback or dimensional requirements. Wood Ridge therefore requests that you approve this change to the locus, as shown on the Proposed Plans, as an insubstantial change, given that the adjustment will not impact any of the existing homes or other improvements approved as a part of the Wood Ridge project. The Trust joins in this request. We also believe that the above-described adjustments are insubstantial because the reduction in the size of the locus is only 20,185 sq. ft. out of the existing approximately 1,350,360 sq. ft. As a percentage of the locus, this is only a reduction of approximately 1.494%. In addition, Lots A, B and C (to be conveyed to the Trust) are not utilized by the project for stormwater management, septic treatment, parking, recreation or in any other manner, and thus the conveyance would not have any impact on the operation of the project or on its residents. This notice is being provided pursuant to 760 CMR 56.05(11)(a). Pursuant to these regulations, the Board shall determine'within twenty (20) days whether these changes are substantial in accordance with 760 CMR 56.05(11)(c) and (d). If it is determined that they are insubstantial changes, or if notice is not provided to the applicant to the contrary within such twenty (20) day period, the Comprehensive Permit shall be deemed modified to incorporate the changes. The above process does not require a public hearing. A public hearing would be required if you determine that the changes are substantial changes, and if so, and pursuant to the aforesaid regulations, a public hearing is to be held within thirty (30) days. However, we understand that your next scheduled meeting date is August 11, 2015.Therefore, we ask that you place this matter on your Agenda for that date, and Wood Ridge hereby waives the aforesaid 20 day period and extends it through 2 Aupst 14, 2015 (which will give you a few days after August l l to notify us in witiug of your dete guation). Please feel free to eontact erne of you have any questions. Thank you. Very duly yours, Peter- L. Freeman PLF cc: John Smolak, Esq. Colin Coleman, Esq. Brian billy, Esq. 3 WL /r W 2 O a W U) z U) w H z J J J J z W H z M M m O O U () O_ U) 0 0 _ N 4ZOS 0 Lf) O � � M o V U � CU O � m � ca > aS U Q'U O W cn O .0 a) O O C y licn O z W v 4-- > — Q� O z -� 0� cn c = W cn E '– E-- �a�cE O n _a) LF -5a z =3c, aO o- U- z �E�N O L O _ 'a �*- tm O > z OU) Zp O(n �a)pC Q.0 O H X a) �'' Z cn poj a) E p C N ui (n= C O O O "� =— O (6 J O -O (D cn m ,- re 0 c E C 0 - 14 a)(n-00 CD Q i = O p (.- O N N N W ,� *** N a) o a) v N -C O"jER rr �! O ~ O O T ,•° .moi `rv► W jO N > _0 a) �w+ O _ < u �_ Q �M0.1 �►,� L WL /r W 2 O a W U) z U) w H z J J J J z W H z M M m O O U () O_ U) 0 0 _ N 4ZOS 0 Lf) O � � M o V U � Location ./� {/� � .F r Date r No. Check #� 30652 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ f Building Inspector z�. f `( a 7 I E 3 m N d OCL hi N L (U 4. N c � v N N w O v v 3 � o O= c� �n QQ geO C fn U EN;E �A 2 K I �l P O y V CALL E�+ zt 106. M .:! OI p y - C O li .V aoo 3N6Af/1 1 LGC'n C C=< 0 O N� W Z z O 6 C •fp a (U c R s v 0 CL O I a v Vf C NcuO t r0 C CL IA ■�� a � M N N II 0 C J N rn 0 X ate+ 'O N N O� O� p C Q. O a `v VI X O w to°J C'. 41 vpc c v 4 CL a 7 X N � A Z Oc E 3 m N d OCL hi N L (U 4. N c � v N N w O v v 3 � o 11699 Date. f/2.2... Fee ............. Lic. No. I %Y5.. :5 1 Check # I Mass. ................................................................................. PLUMBING INSPECTOR ie -1. w MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY MA DATE ( PERMIT # JOBSITE ADDRESS a' o CGu f , OWNER'S NAME G OWNER ADDRESS J of, TEL FAX P TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL ® RESIDENTIAL] PRINT PLANS SUBMITTED: YES] NOP - CLEARLY NEW: � RENOVATION: ® REPLACEMENT: Ell 10 111 1 12 1 13 1 14 FIXTURES 7. FLOOR- BSM BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OILISAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/ AREA DRAIN INTERCEPTOR (INTERIOR) KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SERVICE /MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATERaPIPING — INSURANCE I have a current liabilit insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES. 9—NO-0 IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY � OTHER TYPE OF INDEMNITY © BOND EH OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ®AGENT �[] SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and in I have submitted or enured regarding this application are true an c6 ate t est of my e and that all plumbing work and installations performed under the permit issued for this application will be in compli ath all t pr isio the Massachusetts State Plumbing ode and Chapter 142 of the General Laws. LICENSE# SIGNA RE PLUMBERS NAMELMR� MP ®---j--p-[3 CORPORATION MI#E=PARTNERSHIP # 4 LLC COMPANY NAME -J- f_ . _ i ADDRESS CITY hPst1)1 STATE� ZIP � TEL FAX ! CELL��I EMAIL �- ----- - o❑ z LU CL The Commonwealth of Massa.chusetts Department of IndustrialAccidents 1 Congress Street, Suite 100 Boston, MM 02114-2017 y www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Name (Business/Organization/Individual): Address: City/State/Zip: `f,P1 A Are you an5p er? Check the appropriate box: a employer with employees (full and/or part-time).* Phone #: 2.❑ I am a sole proprietor, or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3. Q I am a homeowner doing all work myself. [No workers' comp. -insurance required.] t 4. ❑ 1 am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole proprietors with no employees. 5. ❑ I am a general contractor and I have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance? 6.We are a corporation and its officers, have exercised their right of exemption per MGL c. 152, § 1(4), and we have no. employees. [No workers' comp. insurance required.] Type of project (required): 7. 0 New construction 8. E] Remodeling 9. ❑ Demolition 10 ❑ Building addition 11. ❑ Electrical repairs or additions 12: Fj Plumbing repairs or additions I .0 Roof iepairs 14.0 Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit anew affidavit indicating such. #Contractors 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-c'fib Eors have employees, ley' must provide their workers' comp. policy number. f am an employer that is piovidiiig workers' compensation i surance for my employees.' Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lie. Expiration Date: Job Site Address: 1 % -1- /3 47%_�O1A�Ly^4 Z C—,,j r �— City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coveraize verification. I do hereby certify information provided above is true and correct Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Phone Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall. enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Depattment of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should'enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 02-23-15 www.mass.gov/dia 11689 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that.................`S ................................................................... has permission to perform .a..t.......lnLc:�t .. ►` '..� plumbing in the buildings of. .0&....�.j.- °!--PJ' ................. at o 1 i.eu.12ih.��.....�.�.....�.................... North Andover, Mass. Fee. .... . Lic. No.......�........................................................................................... • ��� PLUMBING INSPECTOR Check # (r P TYPE OR PRINT CLEARLY FIXTURES'l MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY , d''A WLPATE JOBSITE ADDRESS c OWNER',' OWNER ADDRESS OCCUPANCY TYPE COMMERCIAL EDUCATIONAL El NEW: M RENOVATION: El REPLACEMENT: BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GASIOIUSAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR 1 AREA DRAIN INTERCEPTOR (INTERIOR) KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SLNVICE / MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING �zb ' OTHER [ -�� PERMIT # NAME TEL �FAX _ RESIDENTIAL fl PLANS SUBMITTED: YES Q NOQ- 10 1 11 ( 12 1 13 1 14 INSURANCE : I have a current liabilit insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES . 90 IF YOU CHECKED YES, PLEASE INDICATE THE TYPE.OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY —1 OTHER TYPE OF INDEMNITY EI BOND Q OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER L] AGENT IF -11 SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information I have submitted or entered regarding this application are true and c and that all plumbing work and installations performed under the permit issued for this application will be in complian Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME �Q IILICENSE # TURE Of MPRJP Q CORPORATION � 11 #=PARTNERSHIP S]# LLC .{ COMPANY NAME [+ ADDRESS CITY,(L4 I,1�1� - __---_i STATE ® ZIP �' j TEL FAX p CELL I ��EMAIL -- - d� W Iii W \v n J � ,.: The Commonwealth of Massa chusetts z . Department oflndustrialAccidents 1 Congress Street, Suite 100 d Boston M4 02114-2017 /dia www mass. ov - . , g Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. , Applicant Information •Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip: Phone #: Are you an employer? Check the appropriate box: Type Of project (required): 1. ❑ I am a employer with employees (full and/or part-time).* 7. ❑ New construction 2.❑ I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity. [No workers' comp. insurance required.] 0. ❑ Demolition 3. ❑ I am a homeowner doing all work myself. [No workers' comp.. insurance required.] t 10 Building addition ❑4. ❑ I am a homeowner and will be hiring contractors to conduct all work on my property. I will ensure that all contractors either have workers' compensation insurance or are sole 11. ❑ Electrical, repairs or additions proprietors with no employees. 12: Plumbing repairs or additions ❑ ors steon e attached she. 5.I am a general contractor and I hhired rethe sub -contractors lid the et ❑ 13. 0 Roof repairs These sub -contractors have einployees and have workers' comp. instuance.# 6. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 14. ❑Other 152, § 1(4), and we have no. 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 subunit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors 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 nave employees, they must provide their workers' comp. policy number. Iain an employer that is providiiig workers' compensation insurance for my employees.' Below is the policy and job site information. Insurance Company N Policy # or Self -ins. Lie. Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties ofperjury that the information provided above is true and correct. Signature: Date: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of lure, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership; association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall. enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-'contractor'(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees 'other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents foi confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should'enter their self-insurance license number on the appropriate line. City or Town Officials . Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permitilicense applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 02-23-15 www.mass.gov/dia A 16 Date .....4..2...—'...I1 ........ TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING j C, This certifies that �. ... ........................................................................................................ has permission to perform..... Cr_ V41r- - ....... . ............................................... ( ........................... plumbing in the buildings of. .. at ... 4 C IMS f 410 V-.� ....................................................... * .............................. North Andover, Mass. Fee... ;� .... Lic. No. ) .. .......................................................................... ........ PLUMBING INSPECTOR Check 0 � V-� I I H.N"-- to Q.. MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK POWNER TYPE OR PRINT CLEARLY h CITY QV MA DATE � � U � i PERMIT # j I I I'' JOBSCfE ADDRESS LA !E f'_ C"S Q ilc" OWNER'S NAME ADDRESS TEL FAX OCCUPANCY TYPE COMMERCIAL ❑ EDUCATIONAL ❑ RESIDENTIAL &�� NEW. ❑ RENOVATION: ❑ REPLACEMENT: PLANS SUBMITTED: YES ❑ NO ❑ FIXTURES 1 FLOOR— BSM 1 1 2 3 4 5 6 7 8 9 10 11 12 1 13 1 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKINGFOUNTAIN FOOD DISPOSER FLOOR / AREA DRAIN INTERCEPTOR(INTERIOR) KITgHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SERVICE/ MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTK$ER ,t INSURANCE COVERAGE: I have a current Rabic insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142 YES NO ❑ IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW . 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ❑ AGENT ❑ SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are tare nd accurate to the oy knowledge ,�I�n and that all plumbing work and installations performed under the permit issued for this application will be in pl' with all Pertine of the Massachusetts State Plumbing Code and Chapter 142 of the General laws. PLUMBER'S NAME, . - LICENSE #`®m -4-111 V4 S MP JP CORPORATION ❑ # PARTNERSHIP ❑ # LLC ❑ # COMPANY NAME 40i 0)e_S_ J4 ADDRESS (� 'jh- CIN. (Aa �� STATE MA-ZIP. TEL `P _ FAX EMAIL res . �`. ` ' � `` . ` ' ' ' ,| / ` ` ` . . ''�'�� `� �/ , ' '.', ./- . � ' ` r \ .� ' ^ ` .� � , . / - ' �� Date......�4 f� .. ..................... TOWN OF NORTH ANDOVER 'PERMIT FOR GAS INSTALLATION This certifies that o� ................................................................................................................... has permission for gas i\\nstalla(t�ion.................................. in the buildings of.. ..W.(0.?l..t.4�.....t.....:................ at ..........`C.. .. /......................................... North Andover, Mass. Fee ...{..�............. Lic. No.� ? ...... ..................................................................... GASINSPECTOR Check # 099353 S MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT To PERFORM GAS FITTING WORK CITY MA DATE PRMIT # _ JOBSITE ADDRESS_i- OWNER'S NAPE OWNER ADDRESS�-- TE TPRINT OCCUPANCY TYPE COMMERCIAL [ EDUCATIONAL ( RESiDENTiAL 1 CLEARLY NEW: RENOVATION: F.] REPLACEMENT: PLANS SUBMITTED: YES n NOD APPLIANCES I_ FLOORS---� BSM 1 2 3 4 1 5 8 7 8 9 10 11 12 13 14 BOILER _ _. l [J � .... � I~_...� �_ i _ _I ..I � I _ ( _. I { �- I _ f _ J (.�._._.1. _ —i C - __ - BOOSTER �I - I I -J CONVERSION BURNER- �_ -_ I [ . f ::I _ c0ox SroVE�1 _I (� �.J _ _. F= _I f ! DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR=_. FURNACE ..-__.;—t ! ,l rv-1 Ii .f I - -T-J- : __.I 1 l -1 -- GENERATOR I I J -- 11 '. ! z __.._i--•.--1— [� 1 �,.R _! ,, i . i _.._I b_� 1 = , I GRILLE INFRARED HEATER _ LABORATORY COCKS sJl MAKEUP AIR UNIT (WEN _ :..:.. ! �_iI E __l [.. � E__1 1 �_' POOL HEATER ROOM /SPACE HEATER.! 1 C__ l . 1(T' ._._ _ 1J . _J ROOF TOP UNIT_. TEST--I.. J ,1 _._ __i _: -�i UNIT HEATER UNVENTED ROOM HEATER- � i _ ! j- I (-. I j- _[� (^ fr. i�� ► __[� �_�� i�. i� ir�f(-_ Imo► � WATER HEATER, OTHER --, INSURANCE COVERAGE I have a current liab. lifty insurance policy or its substantial equivalent which meets the requirements of MGL. Ch.142 YES ,. 0 I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAG Y CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY . • OTHER TYPE INDEMNITY(j 13OND fA OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 942 of the Massachusetts General Laws, and that my signature on this application waives tills permit requirement. - CHECK ONE ONLY: OWNER [.]J AGENT i _FSIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information I have submitted or entered regarding this application ar true nd accurato to t best of my knovviedgQ and that all plumbing work and installations performed under the permit issued for this application wilt be in pita ce with all Pertie t pr vi lon of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. i PLUMBER-GASFlTTER NAME_ LICENSE # Si I A U yt� fviP EA-4 _ MGF �__, JP (JGF _; LPGs Q CORPORATION Q# PARTNERSHIP D#�„- LLC [.-_]J# . COMPANY NAME •L_--:�. j ADDRESS Com,._ � CITY 1 __-_..11 STATE .._ _ -IP1-TEL F 7_... _IL _.. FAX F CEL om, S V The Commonwealth of Massachusetts z Department of Industir'ialAccidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 www mass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE MED WITH THE PERMITTING AUTHORITY. Aimlicaut Information 9 4 4=4 1 Please Print Legib Name (Business/Organization/fridividual): rZ Address --__6 &PL_ C-1 City/State/Zip: 4-iA-er-_ �� `/oA t4 Phone #: i Are you an employer? Check the appropriate box: Type Of project (required): 1.0 I am a employer with employees (full and/or part-time).* %, 0 New construction 2, sole proprietor or partnership and have no employees working for me in $, Remodeling any capacity. [No workers' comp. insurance required.] s 3.lam a homeowner doing all work myself [No workers' comp. insurance required.] t 9. ❑ Demolition 0 4. ❑ I am a homeowner and will be hiring contractors to conduct all work on my properly. I will 10 [j Building addition ensure that all contractors either have workers' compensation insurance or are sole 11..0 Electrical repairs or additions proprietors with no employees. 11 lumbing repairs or additions 5.0 I am a general contractor and I have hired the sub -contractors listed on the attached sheet. . These sub -contractors "have employees and have workers' comp. insurance.# 1Roof repairs 6..0 We are a corporation and its officers:have exercised their right of exemption per MGL c. 14. Q Other 152, §1(4), and we have no, 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. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such $Contractors 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 employee's, they must provide their workers' comp. policy number. Iain an employer Mat is pioviding workers' compensation insurance for my employees. information. i � Insurance Company Name: &cit �/� Policy # or Self -ins, Lie..#: Below is thepolicy and job site Expiration Date: fob Site Address: City/State/Zip:. Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by 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. A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do herebycertify and dhe and penalties ofperjury that the information provided above ' true and correct. Official use only. Do not write in this area, to be completed by city or town official . City or Town: Permit/License # Issuing Authority (circle one): ; 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: ..... ..., ,. ._.. _. __., .. ,.. .... ti �0-w(•s moi. ww.+.. Fr., .�,.:c... .R` r..*.is �.�r+f .'4�,►. ��SkSK'�1. +f Date .......... °... i. ..:................ TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION r This certifies that .......!` T..!.....`....."' ........................................... �,.�w-� has permission for gas inst llation ............... a in the building ow...... �= `,.��: at ....� ... v„ ....,� :..`................................ , Forth Andover, Mass. Fee 13.5 ......... Lic. No. ).� 45....... ..................................................................... GASINSPECTOR Check # - - ), 0993 Date... .. ... . *1 ...................... 11089 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that // ... ..... ....... . . ............ . ... ............ has permission to perform ........ .... ............ I plumbing in the buildings of 1U6 e Ale, ...................................... 0 ..................................................... ....... ..... ..... (4 -,6�9 North Andover, Mass. .... 7 Fee.4�...-: .... Lic. No. ................................................................................. PLUMBING INSPECTOR Check # "WATER HEATER ALL TYPES WATER PIPING OTHER INSURANCE COVERAGE: 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES U -NO Eli IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY'~ OTHER TYPE OF INDEMNITY [:11 BOND Q OWNER'S. INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER Q AGENT 10 SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true d a ra to the best of m ge and that all plumbing work and installations performed under the permit issued for this application will be in comp' nc it 1 P ent ovof e Massachusetts State Plumbing Code and Chapter 12 of the General Laws. PLUMBER'S AME LICENSE # r SIGNAT RE MP JP D( CORPORATION 0# PARTNERSHIP0# LLC a COMPANY NAME ;J ADDRESSI� CITY _...__I STATE t/k _� ZIP TEL FAX ] CELLILEMAIL 11 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK POWNER TYPE OR PRINT CLEARLY ll CITY vL 6 --]1 MA DATE _ j PERMIT # JOBSITE ADDRESS Ile NER'S NAME i - ADDRESS (�J +-•` _ TEL FAX OCCUPANCY TYPE COMMERCIAL EDUCATIONAL ® RESIDENTIAL EI -- NEW: E0 RENOVATION: REPLACEMENT: PLANS SUBMITTED: YES Ell NO _. FIXTURES 7. FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM ( _ _.1 _ 1 _ I ._ f r _ I � .._.. 1' I DEDICATED GAS/OIL/SAND SYSTEM 6 __ I 11—A ____I _- __j 'I[ DEDICATED GREASE SYSTEM q _( I fJ'. I �� L' ' __ _ € ! DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM _- DISHWASHER [ __.� (� _- .__._ .__ _J I _ 1 ___---f -___J l _.___j DRINKING FOUNTAIN FOOD DISPOSER (___-.---.[ FLOOR I AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY _._-J _.__1 I I __j ROOF DRAIN. SHOWER STALL SERVICE / MOP SINK _.1 1 _._._-.(_ _P __j ._---- _i TOILET I 1== URINAL WASHING MACHINE CONNECTION "WATER HEATER ALL TYPES WATER PIPING OTHER INSURANCE COVERAGE: 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES U -NO Eli IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY'~ OTHER TYPE OF INDEMNITY [:11 BOND Q OWNER'S. INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER Q AGENT 10 SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true d a ra to the best of m ge and that all plumbing work and installations performed under the permit issued for this application will be in comp' nc it 1 P ent ovof e Massachusetts State Plumbing Code and Chapter 12 of the General Laws. PLUMBER'S AME LICENSE # r SIGNAT RE MP JP D( CORPORATION 0# PARTNERSHIP0# LLC a COMPANY NAME ;J ADDRESSI� CITY _...__I STATE t/k _� ZIP TEL FAX ] CELLILEMAIL vl W O z o H U a W w 4� o� z ! ❑ W LU O z W °' *kLU x 9 ¢ w O a W C > tx w w a O z w ►_ U J IL a N ui s w t- LL H zz O H H J U a z a a O a •`Q�-" F7-i MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK V A CITY MA DATE Gl PERMIT D JOBSITE ADDRESS ,�,� ,r,,, , _ �0 NE 'S NAME OWNER ADDRESS(, ; TE FAX 1 TYPE OR OCCUPANCY TYPE COMMERCIAL ® EDUCATIONAL RESIDENTIAL — PRINT CLEARLY NEW: RENOVATION: REPLACEMENT: Ea�-' PLANS SUBMITTED: YES 0 NOR-- APPLIANCES Z FLOORS-► BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER -.._. z ......_ ... _ .. _ f �.� _ _ _ _. _ . .._.. -. I== ... ..- BOOSTER BOOSTER �� �I - - - r� - -- -- r- — - CONVERSION BURNER l . . -. _ 1 _ _ (_ :__ -77i COOK STOVE L! DIRECT VENT HEATER DRYER .. _ FIREPLACE _—j ._ I _. F- .. ) J FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER_ LABORATORY COCKS MAKEUP AIR UNIT .._f OVEN L_�I POOL HEATER ROOM/ SPACE HEATER ROOFTOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHER ---- i- - - -- - - —JL—AL—Jjll INSURANCE COVERAGE have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch.142 YES g Q"o I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW J LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY © BOND OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER F I AGENT 0 SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information I have submitted or entered regarding this application are true and ac r to t Jest of my wled e and that all plumbing work and installations performed under the permit issued for this application will be in compliance ail P e pro si of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUM BER-GASFITTER NAME� LICENSE # 1 SIGNA R MP MGF EjI JP [D JGF D LPGI © CORPORATION ©# PARTNERSHIP®#E= LLC E3# COMPANY NAME:CY �--.---�1 ADDRESS CITY t , _ _I STATE &P TEL FAX CELL TQ �i� I EMAIL -- - -- - —� W H z H U W O _ � z� O d� o r W z Un Cf) � a � o w W w CO) a g a a a U _ J a � w = w r H O z z O H U W a rA C�7 The Commonwealth of Massachusetts Department of IndustriqlAccMiks Office of Investigations 600 Washington Street Boston, MA. 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Naive (Business/OrganizatiorAndividual): Address: City/State/Zip: Phone #: Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. ship and'have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, §1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12. ❑ Roof repairs 13.❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation policy information. 7 Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp, policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy anti job site information. Insurance Company N Policy # or Self -ins. Lie. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration 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. Ido hereby certify under the pains and penalties ofperjury that the information provided above is true and correct. Signature: Date: Offcclal use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other - - - Contact Person: Phone Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, _ express or implied, oral or. written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who.has not producedacceptable evidence of compliance with the insurance coverage required" Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), address(es) and phone number(s) along with their certificates) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate Be. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of, Industrial Accidents Office of Investigations 600 Washington Street Boston? MA 02111 TO, # 617-727-4900 ext 406 or 1-877�,MASSAFE Revised 5-26-05 Fax # 617-727-7749 w-Mass,govfdaa 4AVE, RA I LL. A 018:32- 01832-�'89.00- I U 4 RFLocation d � f _ No. 4576 T Date 10 s: MQRTIy TOWN OF NORTH ANDOVER Certificate of Occupancy $ F ,SSACMUSEt� Building/Frame Permit Fee $ Foundation Permit Fee $ k° Other Permit Fee $ TOTAL $ �~ F. e,. -s Check # S / 186,51 Building Inspector M az%- 1 lull 1- all r iP r VKMA 11VN t 1.1 Property Address: TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING y 'iX, l'.'.x✓` '`bF� BUILDING PERMIT NUMBER: � i"'•''�rn � i4t<tX - ? � ..?"°C"w&<.S,G. C2 C G DATE ISSUED: SIGNATURE: Building Commissioner/I r of Buildings Date az%- 1 lull 1- all r iP r VKMA 11VN t 1.1 Property Address: 1.2Assesses Map and Paroel C) Map Number Number: �o 7 Parcel Number 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Area Fronts ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided ReqWred .Provided —+ 1.7 Watar Supply M.G.L.C.40. 54) Public ❑ PrM ft ❑ 1.5. Flood Zone Infomietion: Zone Outside Flood Zone ❑ 1.8 Municipal Sewerage Disposal System: ❑ On Site Disposal System ❑ aP.GIIVPI Z - rXVrMHI Y VW1NKK5nW1AUl'H0KIGED AGENT 1 Historic District: Yes No 2.1 Owner of Record wo, C k Q(�q - k -Mt P-" Name (Print) „.,,/ Address for Service : F 8r�-771-(5- / U waL-4/2(�y b r(. k -e. 0i Telephone 2.2 Owner of Record: Name Print Address for Service: SECTION 3 - CONSTRUCTION SERVICES 3.1 Licen Construction dupWI e sor: Not Applicable ❑ "Dau �� V-t(a/0 Licensed Construction S rvisor. Q C)` / (I1� 0 0,WL �-- License Number Address _l� d� 0 Expiration Date Signature Telephone 3.2 Registpred Home Improvement Contractor cruAGJfevan Company Name Address Not Applicable ❑ Registration Number ll 71- Expiration Date 0 S O z M 90 0 ic rm Az V SECTION 4 - WORKERS COMPENSATION (MG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work check all a Iieable New Construction ❑ Existing Building ❑ Repair(s) [Y Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ , Specify Brief Description of Proposed Work: cab r SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item 1. Building Wu% Completed by Estimated Cost errult a(Dolar) tlicant o be� / 700 � ����0�II� (a) Building Permit Fee Multiplier {?NL'11,�� � �a 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbin ;L Building Permit fee (a) X (b) 1 6V 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 — Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, b a &J it 7rUV) as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name Signature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINMERS 1 2 ND3 RD SPAN DMIENSIONS OF SILLS DMIENSIONS OF POSTS DM ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHININEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Ai \ The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street it Boston, MA 02111 ov/dia t www.mass. g Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeAbl, Name (Business/Organization/IndividuNa al): t 6 1 Ce 7/t -wo Address: `(q I- P1 -,0&94o ---,5t City/State/Zip: /Y &�UVttp— MCO d f'� hone #: q� � Are you an employer? Check the appropriate box: 1. tam a employer with C 4. ❑ 1 am a general contractor and employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ 1 am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.0 Electrical repairs or additions 1 I .❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other *,Any applicant that checks box # I must also till out the section below showing their workers' compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. A Insurance Company Name: Policy # or Self -ins. Lic. #: W ( -5 3-3- ')L 7-7'I Expiration Date: Job Site Address: Lo W Cos K l,(D y'� Gi-f� l��I�'^' . rq�q C/ City/State/Zip: Attach a copy of the workers' compensation policy declaration 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 tine 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. I do hereby certify under tjj and penalties of perjury that the information provided aboveis true and correct. Phone #: Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct building's in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the perfonnance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit.. The affidavit should be returned to the city or town that the application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to till out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be tilled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Fax # 617-727-7749 Revised 5 -26 -OS www.mass.gov/dia NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL 11, S 150 A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section 1 OA. The debris will be disposed of in: �L$5 Sa(em Fire Department Sign off: Dumpster Permit (Location of Facility) Signature of Permit Applicant ascato v LE cin a w° w°' v U w �' o°G w a w d c% w O o°G —co w W z cn cn N 0 Nb LJJ d.z ' toil, z U C/) Loll ,TJ CD O G3 L Z d O y � C _ CD cm I O CD _ mm 0 G3 CD O� 3� as G3 L C* a Ca �� o c ec C Z O �..� h O c _ .® c c CL(A 0 LLIN W W 19 W U) c o c C, C y O C ac ev � t o 0 ` Ea cC± O y.. N 3 � _. V �0+ Q a � RE c E :yam �� co y Nr cm '20" N s �C •� N :.� to E.00 �a0L O m Qcm's _ r c C d,ct O m a.32 Z o` c C a E O C �c = 0 0-3 N H 0 0•. N4 ~ O COD W O .0„ '0r Z Z r 'rr= ra m N O LLI b- C-3 a m�cm �A g = W .0 ` ti � O f- r $ CL.- co � toil, z U C/) Loll ,TJ CD O G3 L Z d O y � C _ CD cm I O CD _ mm 0 G3 CD O� 3� as G3 L C* a Ca �� o c ec C Z O �..� h O c _ .® c c CL(A 0 LLIN W W 19 W U) Date. "oRTM TOWN OF NORTH ANDOVER ' PERMIT FOR PLU f BIN s s I c � �,SSACHUSi - r This certifies that G.`.".`. S............... . has permission to perform ....... ..... C.....`................ . ILA plumbing in the buildings of '... ... '.`.f `'.. `. i .r . .... . at ..%� .Lc o� �� l.�.` .. r..... . _ . ,North -Andover, Mass. Fee .3 .� Lic..No. 2 ..... . r C1 7- 8141 PLUMBING INSPECTOR G Check !i 8E41 w! 4 �L MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date%S Building Location a & ane Owners Name permit /y1 Amount L Type of Occupancy New Renovation Replacement 1-3 Plans Submitted Yes, No — — (Print or type) Check one: Certificate . Installing Company Name El Corp. Address t r Partner. `` usmess Telephone Name of Licensed Plumber: zG�Ca 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 Signature Owner 1:1 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 perfder Permitil for this application will be in compliance with all pertinent provisions of the Massachusetts St de 142 of the General Laws. By: Signature or Licenseuum er Title Type of Plumbing License 025 � ---� City/Town icense um er Master ❑ Journeyman APPROVED (OFFICE USE ONLY LJ • .r ------.-.---No MMlMMMMWMMWM MN - W-OMM-MM-�--�� MMIEMN MMMEN MMWWMWMMWNMMMMMWMMMMMMMMMM (Print or type) Check one: Certificate . Installing Company Name El Corp. Address t r Partner. `` usmess Telephone Name of Licensed Plumber: zG�Ca 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 Signature Owner 1:1 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 perfder Permitil for this application will be in compliance with all pertinent provisions of the Massachusetts St de 142 of the General Laws. By: Signature or Licenseuum er Title Type of Plumbing License 025 � ---� City/Town icense um er Master ❑ Journeyman APPROVED (OFFICE USE ONLY LJ The Commonwealth of Massachusetts Department of Industrial Accident Office of investigations 600 NTashington Street Boston, MA 02111 www nwssgov/dia . Workers' Compensation jpUcawitrance Affidavit: Builders/Coatraetors/Electricians/plumbers I!t T>f>formation Name (Business/organization/Individual): City/state/Zip: Phone you an employer? Check the appropriate box: [Am ❑Iuitn a employer with 4. ❑ I am a generalcontractor and I Type Pralect (regent.employees (foil and/or part-time).* I am .a.sole proprietor. or have i>tred the sub-cortt<acors6 listed ❑New construction.] partner. ship have on the attached sheet, t 7. ❑ Remodeling and no employees working for me m any capacity. These sul}contractors have workers' comp. insurance. g' Q Demolition [No workers.' comp. insurance 5. ❑ are a corporation and its 9. ❑ Building addition g 3. ❑required.] I am a homeowner doing .We officers have exercised their 1Q•Q Electrical repairs or additions all work v myself, [No workers' comp. right of exemption per h nr c. 152, § 1(4), and we have 11.❑ Plumbing repairs or additions insurance -required.] 't no .employees. [No workers' 12.[] Roof repairs, .. comp. insurmn=mquired.] 13•[]_Other ;Any applicant that checks box' # 1 must also fill out the section below showing their workers' compensation Homeowners who submit this affiii avit indikitting they are doing s(1 work and then hue outside - ICoahactohat must check this box con rs ttractors poiiey infomtation must`submtt s new Amen Affidavit indicating such Amended, sn edditiowi sheet showing, the nems of the soh-cottnsctors and their workers' com . poEic ittformetioa. 1 an an c-W10yer first is provrdtng:workers I conpdn inuracefor �3anioYeninformafon. Below is thepohy and job site Insurance Company Name: Policy # or Self -ins. Lic. #: Expiration Date. Job Site Address: City/State/Zip. Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration da*4 Failure to secure coverage as required under Section 25A of MGL e. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well Ms civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250.00 a day against the violator. Be advised that a copy of th Investigations of the DIA for insurance coverage verification. is statement may be forwarded to the Office of I do hereby certify under the pains and penalties of perjury that the infnr" WOR provided above is true and rorrect Phone #: Qf}`ickd use only. Do not write in this area, to be con plet�d by city or town official City or Town: PermWLicense # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector S. Piumbing Inspector 6.Otber Contact Person Phone #: Information a nd Instructions Massachusetts General Laws chapter 152 requires all emp; overs to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, - express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the'foregoing engaged in a joint enterprise, and includirig the legal representatives of a deceased employer, or the receiver or bust= -of an individual, partnership, association or other legal entity, employing employees. 'However the owner•of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenmree, construction or repair work an such dwelling house or on the grounds or building appurtenarut thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local Ficensing agency shall withhold the issuance or renewal of a license or permit to operate a business or *o construct buildings in the commonwealth for any applicant who has not produced acceptable evidence.of compliance with the insurance coverage required" Additionally, MGL chapter 152, §25C(7) states "Neither tate commonwealth nor any of its political subdivisions shall enter into any contract for the per%cmance of public work until acceptable evidence of eornpliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation• affidavit comple✓taly, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), address(es). mind phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited L Lability Partnerships (LLP) with no employees other than the members or partners, are not required°to cant' workers' compensation insurance. If an LLC or LLP does have . employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage., Also *lb,e sure to sign and -date the affidavit The affidavit should be returned to the city or town that the .application for.the permit or license is being requested, not -the Department of Industrial Accidents. Should you have any ,questions regarding the law or if you are requimd to obtain a workers' oompensation policy, please call the Department at the number.listed below. Self=m��+�d chanpani eciu�l.t Pr!+ t"e;r self insurance -license number on the*appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department hes provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which %vial be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating -current policy information (if necessary) and under "Job Site Address" the applicant should write: "all locations in (city or town)." A copy of -the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a flog license or permitto bum leaves etc.) said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number. The Commonwealth of Massachusetts Department of 1.ndust W Accidents Office of Investigations 600 Washington Strrret Boston, MA 02111 TeL # 617-727-4900 ext 406 or 1-977-MASSAFE Revised 5-26-05 Fax # 617-727-7749 Www.mass.gov/dia TJ Date................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ... ............................ has permission to perform .......................................................... wiring in the building of —2,1 "/"� .. ......................... .. .................... at,'...... ..... zo....... ...... ....... - Z North Andover; -.Mass. ........... ..... . .......... .North . Lic. No. ......ELECTRICAL Check # —A", �-.- 9 MAY -20-2009 02:17P FROM:TOWN OF NORFOLK BUIL 508 541 3300 TO:819782565804 13:1/2 �arasonwsa of l/%advachueslll Official Ilse Ont _:z"daunl of �lt+e sirvksl Permit No.. r U) x'' Occupancy and Fee Checked' BOARD OF FIRE PREVENTION REGULATIONS Rev. 1/071 Icave blank v. APPLICATION FOR PER,MIT'TO PERFORM ELECTRICAL WORK All work to bo parfonned In accordanctrwM the Mwsaohusetts Electrical Codo �5'�C). 527 CMR 12.00 (PLEASE PRINr IN INK OR rYPE 4 • INF041 yL! ION) Datta: Clty or Town or: To the Inspector of Wires: By this application the undersigns grves.ng4ce of his or her Intention to perform the electrical work described below. Location (Street & Number) ._ t UO( 6)6M A • e ►� Owaer'orTenant►'nl��Lle��; Crv, Telephone No. Owner's Address Is this permit In conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Busting Service AmpsYolts Overhead ❑ Undgrd ❑ No, of Meters N w Slake Amps ,_ 'volts. Overhead ❑. Undgrd ❑ No. of Meters Number of Feeders and Ampaelty Location and Nature of Proposed Electrical Work; (P 0,o i e C- wl c9 No. of Recessed Luminaires r. -V I..c LV/lVnln {uule No. of Cell.-Susp. (Paddle) Fans may a# walvea vy Irle /n.r ector Wirt$ Total KVA Transformers KVA Ko. of Luminalre Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimmittg Pool Above. C] n- . ❑NO.-OTmergeney rnd. rnd. g ng Battery Units No. of Receptacle Outlets No. of 011 Burners FIRE ALARMS No. of Zones No. ofSwitches No. of Gas Burners. °• ° e ect on an Initlatin Devlees No. of Ranges No. of Alr'Ccnd. ` Tons . No. of Alerting Devices No. of Waste Disposers Heat ump umber Totals: ons o, o e -onto ne Detection/AlertingDevices No, of Dishwashers S ace/Area Hearin KWMunicipal p g Local ❑ ❑ Other Connection No. or Dryers Heating AppliancesKpy ecur ty ystems:* No. o OtterNo. Heaters KW °' ° n• °' or S! Ballasts of Devices or Equivalent Data Wiring: ns No. or Devices or E ulvatent No. Hydromassage Bathtubs No. of Motors Total HP Ia ecommun cat onsringg: No. of Devices or E uivalent OTHER: attach addltlonal detall Vdesired, or as required by rhe lnrpecror of IvIred 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. E C INSURANCOVERAGE: Unless waived by the owner, to permit for the performance orelectrical work may issue unless the licensee provides proof of l' llity.Insurance including "completed operation" coverage or its substantial equivalent The undersigned certifies that such verago is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) eert(fy, under the prdni and enaUles of perjury, that the Information. on this application is true and complete. FIRM NAME: C I c_ I Y1 S4 LIC. NO.: q Licensee: e t 4- Slgnsture ,—� L1C. NO•: al�'(p (t/applicable-'enter "escntpt" In the lieenre number line.) Address: Bus. Tel. No.: 'Per M.G.L. e. 147, s. 57.6 1, security work requires Department of Public Safety " S" Uccnso: Alt, l.icl No. OWNER'S INSURANCE WAIVER:. I sun aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby walve this requirement. I anti the (chec[one ❑ ownerOwner/Agent❑ owner's agent SignatureTelephone No. PM1T FEE: S L4 S i v Date.................................. TOWN OF NORTH ANDOVER 0 I'* -vow PERMIT FOR WIRING This certifies that ..... 14t, ........................................................................................ has permission to perform ............::n .......................................... ..................... wiring in the building of ... 7� .... at ....................... It. �. ....... North Andover, Mass. .. .......... Fee I—IZ6 ....... ..... Lic. No L ��r7RIAL iNSPECI'Oi Check 8683 of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. ?OYJ Occupancy and Fee Checked [Rev. 1/07] (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical C de (MEC), 527 CMR 12.00 (PLEASE PRINT W INK OR TYPE ALL INFORMATION) Date: ' C v � ( Zoo - City or Town of: NORTH ANDOVER To the Inspector of ices: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) ® �� a ?—L4 �1r1J6T61j e OwnerorTenant 'Commonwealth ..._ Owner's Address Sr4, lR Telephone No. Is this permit in conjunction with a buildinit? fi .� El (Check Appropriate Boa) Purpose of Building . f=%Dac c� t Utility Authorization No. � Eidsting Service Amps /�y / ZROVolts Overhead ©�N ❑ Undgrd o. of Meters rd New Service Amps / Volts Overhead ❑ Und g ❑ No. of Meters Number f F d o ee ers and.Ampacity Location and Nature of Proposed Electrical Work: �)(ZJ �Xc';S� yY`CAt'FcL,4Dg permYes No �laS No. of Recessed Luminaires No. of Luminaire Outlets i No. of Luminaires No. of Receptacle Outlets f No. of Switches �t No, of Ranges i No. of Waste Disposers No. of Dishwashers No. of Dryers No. of Water KW Heaters No. Hydromassage Bathtubs 1�`�tel� eti� •- R Completion o the No. of Ceil: Susp. (Paddle) Fans No. of Hot Tubs Swimming Pool Above ❑ In- d gri No, of Oil Burners No. of Gas Burners No. of Air Cond. Total Tons ce-c y _ S ou'f -m table may be waived by the Ins ector o Wires. 0.0 . Total — Transformers KVA Generators KVA ❑ i -4o. or emergency Lighting Batter Units FIRE ALARMS I of Zones No, of Detection and Initiating Devices . No. of Alerting Devices otals: µ Detection Space/Area Heating KW Local ❑ Heating Appliances KW Security No. ofNo. of No. of Data Wir; Signs Ballasts. AT- _r of Motors Total HpI Telecommunicatil No. of Devices or ❑ Other Attach additional detail if desired, or as required by the Inspector of Wires. 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 COVERAGE: Unless w ' ed by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance ciuding "completed operation coverage or its substantial equivalent. The undersigned certifies that such cove ge is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify, under the ains andpenalties of perjury, that the information on this application is true and complete. FIRM NA1 Ve C�- t. L LIC. NO. -J±/ F 13.11 Licensee: r E -o t f[��'� Signature �LINI (If applicable, a er '�ezempt " in the license tuber lnee)� LIC. NO.: Address: e , [ z Bus. Tel. No.:1 A3 y�6, Alt. 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/Agent ❑owner ❑owner's agent. Signature Telephone No. PERMIT FEE. $j� 9112 4 I The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 c j www.nwss.gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Narne (Business/Organization/individual):___ftH 10 A Address: City/,State/Zip:, Phone #:_ 3-22-??( Are you ane pioyer? Check.the appropriate box: L ❑ Type of project (required): i employer with ployees (full and/or part-time).* 4..❑ I am a general contractor and 1 have hired the sub -contractors 6. [3 New construction 2-. I am.a.sole proprietor or partner- listed on the attached sheet. t 7. [Hriernodeling ship and have no employees These sub -contractors have 8. ❑ Demolition working for me .in any capacity, [No workers' comp, insurance workers' comp. insurance. 5. ❑ We are a corporation and its g, ❑ Building addition ' required,] officers have exercised their 10. Etlectrical repairs or additions 3. ❑ I am a homeowner doing all work right of exemption per MGL 11. [1 Plumbing repairs or additions myself. [No•workers' comp. c. 1.52, § 1(4), and we have no 12.❑ Roof repairs insurance required.] .t employees. [No workers' 13.❑ Other comp. insurance required..] rr•• -•••• ••�• wtw,., u�x must also nu out the section below showing their workers' 'compensation policy information. 1 Homeowners who submit this at�davit indicating they are doing all work and then hire outside con ;Contractors that check this box must atractors must submit a new affidavit indicating such. ttached an additional sheet showing the name of the sub -contractors and their +! erkws' c--mP- policy information. t ant an employer that is providing:warkers' compensation insurancefor or my employees, Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'. compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required. under Section 25A of MGL e. 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 again=ins olatoo'Be advised that a copy of this statement may be forwarded to the Office of investigations � e DIA fqce ov rage verification. I do hereby �erq y under that the information provided abgve)& tmg-and correct Si attire: v(� W. V (1 ��' Date: Phone #: 2 j Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other t Y f Contact Person: Phone #• Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not.more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or.to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance 'coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es).and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage.. A.iso be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested, notthe Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies shouild enter their self-insurance Iicense number on the'appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permittlicense number which vvill be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating -current policy information (.if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.) said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give as a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Depart ricrit of Industrial Accidents Office of Investigations , 600 Washington Street Boston, Iv1A 02111 Tel. # 617-727-4900 ext 406 or 1-8.77-MASSAFE Revised 5-26-115 Fax # 617-727-7749 www.mass.govidia J Date. 7/f1 % . . NOR'r" 3?�..� •�,;.��;aL TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ...... ....... has permission to perform ....A;,� !;..y..:..:... `. . plumbing in the buildings of ....... .... f s. <'! .... . ti • at ..:. J ..... vfr� .. , North Andover; Mass. Fee .-? .. ..... , � ....... . PLUMBING INSPECTOR Check #.r • f s �N 73GO MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date✓ � d Building Location 2 t -0 --Owners Name w 4(24 14 ca S- permit # Amount _ Type of Occupancy New Renovation Replacement FIXTURES Plans Submitted Yes [:] No (Print or type) �� Check one: Certificate Installing Company Name / e � G� �. �O� �� El Corp. Address � G, t r-6fx L ElPartner. Business Telephone 4 0 -LZ) 13—Firm/Co. Name of Licensed Plumber. Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy aM Other type of indemnity 11 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 Signature Owner 11 Agent 11 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 install 'on perfo under Permit Issued f this application will be in compliance with all pertinent provisions of the Massachus to Plu to Code anapter of the 1 Laws. By: Igna Orr]ens um er 411 T Title e of Plumbing License CI. APPROVED (OFFICE USE ONLY Pwn icense um er Master E1 ---Journeyman ❑ APPR MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date `� G Building Location / // r- CL ers Namee, Permit # Amount New Renovation Replacement Plans Submitted Yes ems- I�izs FIRTURES (Print or type)lell Check one: Certificate Installing Company Name M Corp. ElPartner. © Firm oC Name of Licensed Plumber. Insurance Coverage: Indicate the typy �e-ofinsurance coverage by checking the appropriate box: Liability insurance policy © Other type of indemnity 11 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 Signature Owner 11 I hereby certify that all of the details and information I have submitted (or entered) best of my knowledge and that all plumbing work and installations perforped compliance with all pertinent provisions of the Massachusetts State in By: igna ureloi Licenseci rRumer C Title Type of Plumbing License City/Town L►cense Nunmer Master APPROVED (OFFICE USE ONLY Agent ebove application are true and accurate to the sued for this applic n will be in d E4aPtePK2 o e,6eneral Laws. Journeyman r: 7 Date. . TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that .,4 ................. has permission for gas installation !,C. .................. in the buildings of .... t.A-. Q A /7 1 .................... at j. ........ North Andover, Mass. Fee. 2-. 7. Lic. No..? ).-.) .. .... ...... GAS INSPECTOR Check #. 7- 5907 MASSACHUSETTS UNIFORM APPLICATON FOR PERNIlT TO DO GAS Ff I' MGI (Type or print) Date New D F0 Replacement Plans Submitted E Permit # r7d 7 Amount $ rL12�— (Print or type) Name Address _..j Busmess a e, Name of Licensed Plumber or Gas Fitter Check one: Certificate Installing Company Corp. Partner. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes - - � If you have checked Yes, please indicate the overage by checking the appropriate box. Liability insurance policy Other type of indemnity 1:3 Bond Owner's Insurance Waiver: 1 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 nereoy certity tnat all of the oetails and intormation I have submitted (or entered) in above applica ' are true and accurate to best of my knowledge and that all plumbing work and installations performed underPe it Iss f this application wjR*fb j� compliance with all pertinent provisions of the Massachusetts State Gas Code and Ater 2 e G era Laws. Z �� By: Title City/Town PPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber DGas Fitter (cense -Number 0 Master Journeyman Z H a a F W W z U W C v1 W FO a' q C7 F z [�- Z x w [ar] U � W Ew- U w z d w d x F= F v, m z O z w .a O O z x o x w 3 a a z> c a F o SUB-BASEM ENT BASEM ENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6 T H. F L O O R 7TH. FLOOR 8TH. FLOOR (Print or type) Name Address _..j Busmess a e, Name of Licensed Plumber or Gas Fitter Check one: Certificate Installing Company Corp. Partner. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes - - � If you have checked Yes, please indicate the overage by checking the appropriate box. Liability insurance policy Other type of indemnity 1:3 Bond Owner's Insurance Waiver: 1 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 nereoy certity tnat all of the oetails and intormation I have submitted (or entered) in above applica ' are true and accurate to best of my knowledge and that all plumbing work and installations performed underPe it Iss f this application wjR*fb j� compliance with all pertinent provisions of the Massachusetts State Gas Code and Ater 2 e G era Laws. Z �� By: Title City/Town PPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber DGas Fitter (cense -Number 0 Master Journeyman Date. ....... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that . . .91� 1 .f.....1 . 1�.'4 has permission for gas installation .... .5 ................... in the buildings of ... 0. � .4?. J. (.q ...................... . at ... 9.3. P. CA ........ I North Andover, Mass. Fee..?...) .... Lic. No. 2. &S INSPECTOW_ Check # 5906 MASSACHUSETTS UNIFORM APPLICATON FOR PERMPT TO DO GASG (Type or print) Date l Q NORTH ANDOVER, MASSACHUSETTS J Building Locations Permit # 3 -104 Z;�Vndr^ik�& gl/tV Amount $ Owner's Name New D Renovation D Replacement Plans Submitted 1-3 (Print or type) Name Address ness Name of Licensed Plumber or Gas Fitter Check one: Certificate Installing Company 11 Corp. E] Partner. �7LCo. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes NoO If you have checked Les, please indicate overage by checking the appropriate box. Liability insurance policy Other type of indemnity D Bond 13 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 13 Agent 13 ml %;; y %,ulL ly L IdL au U< uic uctaus anu mtormatton I nave suomlttea (or enterea) i best of my knowledge and that all plumbing work and installations performe un r compliance with all pertinent provisions of the Massachusetts State Gas de 11d'1� By: Title City/Town APPROVED (OFFICE USE ONLY) application are tr d accurate to the awed fort ' p 'cation will be in Signature of Licensed Plumber Or Gas Fitter Plumber 1^ � 3 Gas Fitter License Numuer 0 Master d_ler[Tlie�yman Laws. � a z H tea,' w w � w z o w F- rx C a oo z H 0) z a o x > w C7 F z F z H F W V p > k, F W a cnG W z d w Q x > m z o a x o SUB-BASEM ENT B A S E M E N T 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7 T H. F L O O R 8TH. FLOOR (Print or type) Name Address ness Name of Licensed Plumber or Gas Fitter Check one: Certificate Installing Company 11 Corp. E] Partner. �7LCo. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes NoO If you have checked Les, please indicate overage by checking the appropriate box. Liability insurance policy Other type of indemnity D Bond 13 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 13 Agent 13 ml %;; y %,ulL ly L IdL au U< uic uctaus anu mtormatton I nave suomlttea (or enterea) i best of my knowledge and that all plumbing work and installations performe un r compliance with all pertinent provisions of the Massachusetts State Gas de 11d'1� By: Title City/Town APPROVED (OFFICE USE ONLY) application are tr d accurate to the awed fort ' p 'cation will be in Signature of Licensed Plumber Or Gas Fitter Plumber 1^ � 3 Gas Fitter License Numuer 0 Master d_ler[Tlie�yman Laws. is Date. . 1...... . NORTH TOWN OF NORTH ANDOVER 0 t. PERMIT FOR GAS INSTALLATION This certifies that .... 5. has permission for gas installation ... LA- . . . . . . . . . . . . . . . . . . in the buildings of ....LA . .5.. ................... . at .../:..). /�. p. jr4 s. j--. .......... North Andover, Mass. Fee.. 2. Lic. No..Z Ql� . . 1, 1 ...... /GAS INSPECTOR Check# 5.904 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date Building Location"I/Owners Name Permit �J/ �— Amount- FIXTURES mo t /,1 />rr ��°�✓ i �'�O 14iq a Tvoe of Occunancv s��., �, New 0 Renovation 0 Replacement Plans FIXTURES (Print or type) / Installing Company Name I po Yes 1:1 No Check one: Certificate 1-1 Corp. ElPartner. 1—Fw�. Name of Licensed Plumber. Insurance Coverage: Indicate the type nance coverage by checking the appropriate box: Liability insurance policyL:r 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 ►gnature Owner Agent I hereby certify that all of the details and information I have submitted (or ent ) ' , e application are true and accurate to the best of my knowledge and that all plumbing work and installations perform ed for thisli will be in compliance with all pertinent provisions of the Massachusetts State Pl t C Chap of e 1 Laws. By: Signature o teens um er Type of Plumbing License Title 2 (2 -57License icense um er Master Journeyman APPROVED (OFFICE USE ONLY Dat �16. .7 ...... Of .NORTH TOWN OF NORTH ANDOVER 0 -;. 0 PERMIT FOR GAS INSTALLATION This certifies that //k .................... has permission for gas installation ... ! :�--.I .................. in the buildings of ... .................... at ... ... C.... -,( ..... North Andover, Mass. ( Fee ... 2, i.... Lic. No. ......... .... ....LD... L-.... GAS INSPECTOR Check # 5900 MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTING (Type or print) Date C� NORTH ANDOVER, MASSACHUSETTS 11 Building Locations jQ— r✓I o r T Permit # V Amount $ Z i I2c.0 Owner's Name New D Renovation D Replacement -Submitted (Print or type) Address e fep/`C/I � C t r c I usmess Name of Licensed Plumber or Gas Fitter Check one: Certificate Installing Company ElCorp. ElPartner. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes �—Noo If you have checked Les, please indica e type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity D Bond 13 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 13 nereoy ccruly roar all of me aetaus ana Information I nave submitted (or entered) in above ppIication are true and accurate to the best of my knowledge and that all plumbing work and installations performed under P It sued for this appli will be in compliance with all pertinent provisions of the Massachusetts State Gas Code av 142 of the Germ La s. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Qr Gas Fitter 0 Plumberd�� Gas Fitter License Number oMas r-� ourneyman z H a W w a p 0 ;D x Q o W F F a z z p F w x 00 w z v w a W a o o F w F z F F cd z a E. y m z O Z w W O x w 3 A Cd7 a U a > SUB -BASEMENT BASEM ENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 16T H. F L O O R 7TH. FLOOR 18T H. F L O O R (Print or type) Address e fep/`C/I � C t r c I usmess Name of Licensed Plumber or Gas Fitter Check one: Certificate Installing Company ElCorp. ElPartner. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes �—Noo If you have checked Les, please indica e type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity D Bond 13 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 13 nereoy ccruly roar all of me aetaus ana Information I nave submitted (or entered) in above ppIication are true and accurate to the best of my knowledge and that all plumbing work and installations performed under P It sued for this appli will be in compliance with all pertinent provisions of the Massachusetts State Gas Code av 142 of the Germ La s. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Qr Gas Fitter 0 Plumberd�� Gas Fitter License Number oMas r-� ourneyman Date!... aTOWN OF NORTH ANDOVER s°L PERMIT FOR PLUMBING This certifies that 6. f.......P:' .bl ............. . . has permission to perform .... ... -;x plumbing in the buildings of ... .................. at, ��...� t"..L, ....6, .......... , North Andover, Mass. Fee. .) Lic. No. :2. f Z. ? . ? ........ I - a PLUMBING INSPEC O� R Check #` j 7`28 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location (/ VG✓vk CDU i - Owners of Date 1--2-LL Permit # 7 L M Amount New E] Renovation 0 Replacement ®� Plans Submitted Yes No FIXTURES (Print or type) Check one: Certificate Installing Company Name E] Corp. Address +� ElPartner. Business Telephone S 3 37 j2- Z 4 Co. Name of Licensed Plumber. , za4r u, _ Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy LJ 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 ignature Owner 11 Agent E] I hereby certify that all of the details and information I have submitted (or ent ) in above application a and accurate to the best of my knowledge and that all plumbing work and installations p o der Permit Issu application will be in compliance with all pertinent provisions of the Massachusetts Sta u g C ap of the General Laws. By: SignaTure kens um e T e of Plumbing License Title V3 APPROVED ►cense NumDer Master Journeyman APPROVED (OFFICE USE ONLY ! Date. . ... ...0 ... TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ... /V zA4- ................................... has permission sion to perform ....... V'. ........................ plumbing in the buildings of ............ at, C --y .. ............. North Andover, Mass. Fee. Lic. No. ...... PLUMBING INSPECTOR Check .7283 j. v MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date Couilding Location % (�Owners Name 11G� ' Permit # - - y-- l Amount ' New Renovation Replacement Plans Submitted Yes 0 No 11 FIXTURES (Print or type) Installing Company N Address Check one: Corp. Partner. &ftffiko. Name of Licensed Plumber. Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 0/' Other type of indemnity 11 Bond Certificate 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 Signature Owner El I hereby certify that all of the details and information I have submitted (or entered best of my knowledge and that all plumbing work and installations orm de compliance with all pertinent provisions of the Massachusetts S lu i By lgnaMre 01 L1CenSQQ-r1UMDer Title Type of Plumbing License City/Town Eicense NumDer3 Master APPROVED (,OFFICE USE ONLY Agent in above application are -true and accurate to the r�Egrmit Issu fo pplication will be in �d Qtia 2,efthe General Laws. Journeyman Dated/vG.?... 1 '4ORTH TOWN OF NORTH ANDOVER 0 I . % PERMIT FOR PLUMBING 41 This certifies that ... 4, 9 .................. has permis'sion to perform ....P ...... ...................... plumbing in the buildings of .. � v P. kh. .;. ............... at. I . t. ............... North Andover, Mass. Fee. b -7. Lic. No. 2. C. 1. 1 ? . 9 -PLUMBING INSPECTOR Check PY 23 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS n � /% Date /l Building Location % C /�/�V f Owners Names �( LL�Rermzt % ti- `1 Amo 7 Type of Occupancv New Renovation 0 Replacement 0--' Plans Submitted Yes FIXTURES (Print or type) Installing Company Name Address Check one: 11 Corp. Partner. 0 r mnlCo. No 11 Certificate Name of Licensed Plumber. /- /(_ /= Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity El Bond ❑ insurance Waiver. I, the undersigned, have been made aware that the licensee of this application does not have any one of the above threeinsurance Signature Owner 11 I hereby certify that all of the details and information I have submitted (or entered) best of my knowledge and that all plumbing work and installations perfo ed d compliance with all pertinent provisions of the Massachusetts State. b' C i By Igna ure 01 LlCenSeCler Type of Plumbing License Title .� City/Town License lNumuer Master APPROVED (OFFICE USE ONLY Agent n above application are true and accurate to the Permit Issued for this application will be in and Chapter 142 of the General Laws. Journeyman �j Date. 0., 4, TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that . W4� . . 1 &..-. . ,... I . . ............................. has permis'sion to perform ....13. 7..........' ................... -�I ', plumbing in the buildings of ...V .. .......I.. . k..' ............. .at.. .............. North Andover, Mass. Fee.k? ..... Lic. No.). .. ......... �.' PLUM . BING INSPECTOR Check 72W MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS ,c�uDate l Building Location / r %' i'Gf Y ✓ l" Gi/-/ wnets Name � � rs('� �` n�. ¢ t Permit # TL rP Amourd �;'r New 0 Renovation 0 Replacement Plans Su itted Yes No FIXTURES (Print or type) Installing Con Address _ Business Tele Check one: Certificate 11 Corp. riPartner. �irtfflC°• Name of Licensed Plumber. Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Ste`__ Other type of indemnity 11 Bond 0 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 ignature Owner 0 Agent 11 I hereby certify that all of the details and information I have submitted (or entered) in above applicafi n are true and accurate to the best of my knowledge and that all plumbing work and installations performed un ermit Iss r this application will be in compliance with all pertinent provisions of the Massachusetts State Plumb' a and 142 of the General Laws. By Signature o ensea riumDer- Type of Plumb2uing License Title 1�J City/Towndense um er Master Journeyman rj f APPROVED (OFFICE USE ONLY 1..�� 1 Date. .0. ?.�. . f 1 <� "ORTH. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING IP ,SSACHUS� This certifies that ...�7.Ei.�.'. ! ... ! �.� ..�.-7 . ................ . has permission to perform ....Sl:. r✓.ke.'_ L ...... .. ........... . plumbing in the buildings of .. ............ . ,p at.....z. 44... l /. S. f. h... .!........... , North Andover, Mass. nn Fee..Lic. No.....'..;..� ...... `�..�.:.... . / /PLUMBING INSP CTOR Check #` < L 7 4 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLU BIN (Type or print) NORTH ANDOVER, MASSACHUSETTS 1 116 Date Building Location .- gi SCJ Owners Name G�l/!/� . � Perm% --7" it Amount 1'j - Type of Occupancy /=--/Z—�' New ❑ Renovation 0 (Print or type) Installing Company Name Address <=t -- Replacement ❑ Replacement Plans Submitted Yes FIXTURES No Lam' J ' Check one: Certificate f ❑ Corp. G s ❑ tFimgCo. Name of Licensed Plumber. _ r Insurance Coverage: Indicate the msut c—e 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 Signature Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) inve application are true and accurate to the best of my knowledge and that all plumbing work and installations perfo it Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State in and Chapter 142 of the General Laws. By: SignatureoI Licenseaum er e of Plumbing License 16"2s Title City/Town License Number Master Journeyman APPROVED (OFFICE USE ONLY Date. ?........... . 4, TOWN OF NORTH ANDOVER s � _ p PERMIT FOR PLUMBING ,SSACHUSE� l7 This certifies that ..... ..... ................... has permission to perform .... 'e� .t <_. ........................ plumbing in the buildings of ....`v.(' .Z� H ..- ............. . .at .... . `.. `".............. . North Andover, Mass. 4 ' � � � f-- i� PLGMBING INSPECTOR Check 7290 MASSACHUSETTS UNIFORM APPLICATON FOR PERM( T TO DO GAS FITTING (Type or print) Date NORTH ANDOVER, MASSACHUSETTS Building Locations V Permit # y 1'1�' Amount $ C e ri r � Owner's Name New D Renovation D Replacement D Plans Submitted D (Print Name Addre ness Name of Licensed Plumber or Gas Fitter Check one: Certificate Installing Company "D Corp. DPartner. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 0 ---vivo[] If you have checked Les, please indicate the e -coverage by checking the appropriate box. Liability insurance policy Other type of indemnity D Bond D 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 D Agent D 1 IIGIGVy L.OILI 1.' Ln t. all VI LIM UGCa11S anu inrormanon i nave suomntea (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 Issue f this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Ch rr 14 f e General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fi 1 Plumber S DGas Fitter License Mrnber D Mast urneyman W c� W d a C4 0 J F H H >� z z a aa z d Ga U v w x z z o > w Z z W Cw7 0 > H w W ¢ a W Q H Iw„ 0 Z o x z ,wx 'oa° °a SU B -BA MENENT B A S E M E N T 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7 T H. F L O O R I 8TH. FLOOR (Print Name Addre ness Name of Licensed Plumber or Gas Fitter Check one: Certificate Installing Company "D Corp. DPartner. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 0 ---vivo[] If you have checked Les, please indicate the e -coverage by checking the appropriate box. Liability insurance policy Other type of indemnity D Bond D 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 D Agent D 1 IIGIGVy L.OILI 1.' Ln t. all VI LIM UGCa11S anu inrormanon i nave suomntea (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 Issue f this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Ch rr 14 f e General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fi 1 Plumber S DGas Fitter License Mrnber D Mast urneyman Date ...../ 7 ............................ TOWN OF NORTH ANDOVER PERMIT FOR WIRING Thiscertifies that ............................................................ .............................. has permission to perform wiring in the building of A�"4 ................................ 31 at .... 10 .... W.49 *A Z ........ L)./?. ................ . North Andover, Mass. Fee .... d .=ic. No. .......................... ELECTRICAL INSPECro Check # 7130 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. ! 50 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/99] 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 INFORMATION) Date: 12/15/2006 City or Town of: North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 10 Wood Ridge Drive Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 Owner's Address 10 Wood Ridge Drive, North Andover, MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residence 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: Installed court light fixture and pole at Briarwood Court Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ In- El rnd. rnd. o Emergency Eg mg Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS I No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons g No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number Tons J.KW ... ... .. .. .......... No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: (When required by municipal policy.) (Expiration Date) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the informatioty,on this app J{cation is true and complete. FIRM NAME: Landers Electrical Co., Inc. LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signaturf/ LIC. NO.: 9743 (If applicable, enter "exempt" in the license number line) Bus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE: $ 20.00 Date .......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING A This certifies that ............ Le.&.S .......... ....... t ...................... has permission to perform ....... P�tE-- L /.?,-/ 7-F-1 EF- .... ................................................................ wiring in the building of . uo�.Awe NZ.... .............. S ..... caot" ...... MAGl .................. ,North Andover, Mass. Fee..�O .......... Lic. No... .3............ . 7?11 CTRICAL INSPECTOR � rr Check # g 7131 N Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 1 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/991 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 INFORMATION) Date: 12/15/2006 City or Town of. North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 10 Wood Ridge Drive Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 Owner's Address 10 Wood Ridge Drive, North Andover, MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residence Existing Service New Service Amps / Volts Amps / Volts Number of Feeders and Ampacity Utility Authorization No. Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd ❑ No. of Meters No. of Meters Location and Nature of Proposed Electrical Work: Installed court light fixture and Pole at Emerson Court Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑In- Elo. rnd. rnd. o Emergency Lighting Batte Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number Tons KW ....................... No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: (When required by municipal policy.) (Expiration Date) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Landers Electrical Co., Inc. Z LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signature/ � LIC. NO.: 9743 (If applicable, enter "exempt" in the license number line) Bus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE. $ 20.00 yr -i Date........'..' Ll- 0 -7 ................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING L Thiscertifies that ............................................................ ................................ has permission to perform .................. ... .......... wiring in the building of ....... ................ at ................................................... ,North Andover, .Mass. z! .:�13 ............ J Fee ................ ..... Lic. No....?7 LE I A Check# 10 7132 -tl\- Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 2— BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/991 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 INFORMATION) Date: 12/15/2006 City or Town of. North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 10 Wood Ridge Drive Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 Owner's Address 10 Wood Ridge Drive, North Andover, MA 01845 Is this permit in conjunction with a building permit? Yes '❑ No X (Check Appropriate Box) Purpose of Building Residence Existing Service Amps / Volts New Service Amps / Volts Utility Authorization No. Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd ❑ No. of Meters No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installed lamps and ballasts for street lights. Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ In- ❑ rnd. grnd. o. of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number.... ................................... Tons... ............ KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: (When required by municipal policy.) (Expiration Date) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties ofperjury, that the information on this a1,* ation is true and complete. FIRM NAME: Landers Electrical Co., Inc. ,% n LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signature/ LIC. NO.: 9743 (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 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 PERMIT FEE. $ 2 0. 00 Signature Telephone No. pORTM e °�<��•°;•�tio FO - 9 a ti Date. �. ? �f TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ....;.ice ....... ................ .. . Yr has. permission to perform ..... . . ...................... . plumbing in the buildings of ....44-.G.(e a.? ................... .at ... •t: v c,� .......... , North Andover, Mass. Fee. ?:r.. Lic. No.. .. ......�� PLUMBING INSPECTOR Check #`! 7286 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS //, Date Building Location � & L,5© r Owners Name [ Permit # 11 %'t-dt Amount Type of Occupancv New Renovation Replacement Plans Submitted Yes No FIXTURES (Print or type) Check one: Certificate Installing Company Name 11Corp. Address �l rC I 11 Partner. U(7P Business Telephone 3 ' vj Name of Licensed Plumber. Insurance Coverage: Indicate the type o ' ce coverage by checking the appropriate bo)c Liability insurance policyLff�—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 ignature Owner 11 Agent I hereby certify that all of the details and information I have submitted (or entered) in aboveappli ion are true and accurate to the best of my knowledge and that all plumbing work and installations performed underPermit I for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbin and t 142 of the General Laws. By: Signature orri—ce—HEM rium5er Title e f luC License - City/Town License um er Master Journeyman APPROVED (OFFICE USE ONLY ass . a.9 Date�L G. 7... 3 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that .. <. ." .`...... ..!.................. . has permission to perform ............................ w plumbing in the buildings of ...t!L t? %? l c� j `' ............ 3 gat .... -r. ! ....... North Andover, Mass. Fee. ..... Lic. No.. 4 .l. ? . ? . f y PLUMBING INSPEC"TOR A Check #'~ 7 2.8 5 s MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) / NORTH ANDOVER, MASSACHUSETTS /% CGur/" Date's C✓C' Building Location C G� 7 Owners Names Permit #—Z Z 't d Amount t r'— Type of Occupancy New 1:1 Renovation 0 Replacement E]['-- Plans Submitted Yes No C] FIXTURES (Print o C�heck onCertificate InstallngComp y Name_Corp. Address �(�� Partner. !�rt Business Telephone ' �c Irm/Co. Name of Licensed Plumber / A ---- /2/ 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 Signature Owner 11 Agent 1 I hereby certify that all of the details and information I have submitWPlumbliod pplication are true and accurate to the best of my knowledge and that all plumbing work and installations sued for this application will be in compliance with all pertinent provisions of the Massachusetts State ter 142 of the General Laws. By tgna ure o tcens um er Type�of � um- b* - License Title �t�.5 City/Town License NumSFr' Master Journeyman APPROVED (OFFICE USE ONLY v Date;`. .4L . 3? TOWN OF NORTH ANDOVER ,z PERMIT FOR GAS INSTALLATION This certifies that ... ./. ! ............................... . has permission for gas installation .... ev.'." '/. :.............. in the buildings of ... ! . �. S'. ./l � f ....................... at ... �� . (.i � xf,.-:... 4-�.......... North Andover, Mass. Fee. I ? ..... Lic. No. 2A �- � *1NS'P*�Y.� GAS INSPECTOR Check # l ;:N MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS (Type or print) Date 76;- - NORTH ANDOVER, MASSACHUSETTS Building Locations Oso� (C' c If 7� Permit Owner's Name Amount $ New ❑ Renovation ❑ Replacement Plans Submitted ❑ (Print or type) Name Address Name' of Licensed Plumber or Gas Fitter Check one: Certificate Installing Company ❑ Corp. C, ❑ Partner. 1,� 1 Firm/C'n INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 0 ---Nan If you have checked yes, 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 applicationwaives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ nereoy cerury mar au or me aetans ana inrormation I nave submitted (or entered) in above applicatioEyaws. and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issyed for cation will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter of -t , Title City/Town PPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter ❑ Plumber ;26.;2 ❑ Gas Fitter License Number ❑ Master um—e—yman a � z H z oW F x a z c w F x z z o r✓ W z as n F w O O ;D a W d W d F v> O > C7 F Z F Z W C7 H U a W d w a Ex„ 'z FW- J a d d o °o w a o x a x O x ;T. O 3 a t5 a v x > o a H o SUB-BASEM ENT BASEM ENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7 T H. F L O O R 8TH. FLOOR (Print or type) Name Address Name' of Licensed Plumber or Gas Fitter Check one: Certificate Installing Company ❑ Corp. C, ❑ Partner. 1,� 1 Firm/C'n INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 0 ---Nan If you have checked yes, 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 applicationwaives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ nereoy cerury mar au or me aetans ana inrormation I nave submitted (or entered) in above applicatioEyaws. and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issyed for cation will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter of -t , Title City/Town PPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter ❑ Plumber ;26.;2 ❑ Gas Fitter License Number ❑ Master um—e—yman r Z�% c fG ,f Date .. ..... ... . •k. NORTH 3? ° TOWN OF NORTH ANDOVER �l O 9 • PERMIT FOR GAS INSTALLATION This certifies that ...r! .l �� .`:.... t? L . t-1 ............... has permission for gas installation .. LA. .17 " ................... in the buildings of ...l- .v.v . t-.` ................... at ... .. C.. ........ .. �' ` ....... No..th Andover, Mass. Fee... Lic. No.?, GAS INSPECTOR Check # 7 5909 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location G moi% ��✓f Owners i Type of Occu New 0 Renovation 0 Replacement FIXTURES Date 11,211a :.. Permit # 7 Ll is Amount Yes 11 No 11 (Print or type) / Check one: Certificate Installing Company Name Corp. Address ��'�- Partner. Business Telephone 'um/Co. Name of Licensed Plumber �t Q InsuranceCoverage: Indicate the type o 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 Signature Owner 11 Agent E] I hereby certify that all of the details and information I have submitted (or entered)' above app ,tication are true and accurate to the best of my knowledge and that all plumbing work and installations performed P t I ed for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbi e C pter 142 of the General Laws. By: Signature o Ic um er Tyke of Plumbing License Title /1 City/Town License NumDer Master Journeyman APPROVED (OFFICE USE ONLY 1� Date . 1� —�7--d6 .................. TOWN. OF NORTH ANDOVER - p PERMIT FOR WIRING ACMUS� , This certifies that ..............','''.1.. .......... .............................. has permission to perform f.....�.... ...LG. tc� wiring in the building of .....".... at........d..GtJmC3..a.f....�1.<.......... .. . North Andover, Mass. Fee. �� -- Lic. No.... F l 'tr P ELECTRI CAL INSPECTOR Check # >� 71� 7054 Commonwealth of Massachusetts Official Use Only Department of Fire` Services Permit No. 7" BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/991 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 INFORMATION) Date: 10/27/2006 City or Town of. North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 10 Wood Ridge Drive Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 Owner's Address 10 Wood Ridge Drive, North Andover, MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residence 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: Rewired Photocell No. of Meters No. of Meters Completion o the followin table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ In- rnd. rnd. ❑ o . o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number I Tons J.KWNo. .......... of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances Key Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: (When required by municipal policy.) (Expiration Date) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Landers Electrical Co., Inc. LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signature LIC. NO.: 9743 (If applicable, enter "exempt" in the license number line) Bus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 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 PERMIT FEE: $ 2 0. 00 Signature Telephone No. Date..../....` .................. TOWN OF NORTH ANDOVER p PERMIT FOR WIRING This certifies that .......E2G ............. ..................... ,...... ...................... has permission to perform..................... . e ..... ................. wiring in the building of ..................... at UtJoo �frx .................... . North Andover, Mass. Fee . .. ®""'. Lic. No fi.5 5!2 ...........pi��;�,�pu TOR f 4 Check #1 jJ 7030 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. '70 g e, BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/991 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), M CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 10/18/2006 City or Town of. North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 10 Wood Ridge Drive Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 Owner's Address 10 Wood Ridge Drive, North Andover, MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residence 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: Hooked Up A/C in Office No. of Meters No. of Meters Completion of the followin table mav be waived bv the Ins ector of Wires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures In Swimming Pool rnd. Above ❑ rnd. F-1 —No-. �g mg omergency BatteryUnits No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number Tons KWNo. ....................... of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or E uivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring. No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) (Expiration Date) 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. I certify, under the pains andpenalties ofperjury, that the information on this applicatto s true and complete. FIRM NAME: Landers Electrical Co., Inc. �' 7� LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signature -LIC. NO.: 9743 (Ifapplicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 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 PERMIT FEE. $ 20.00 Signature Telephone No. Date.... ,NORTH TOWN OF N RTH 1 DOVER PERMIT FOR GA STALLATjTION This certifies that .......... � /& ................ has permission for gas installation in the buildings of ................. I ......................... ZZA at /'?........ ... �-5z/ ........ I North` Andover, Mass. Fee .91?. * .... Lic. No.) ....... ��i�C'T'.......... IN tz�p Check # /9��P 5671 MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GASG (Type or print) Date NORTH ANDOVER, MASSACHUSETTS 77- Building Locations vLG I� ` /Gt/Od Building r. c— Permit # Amo nt $ err I �1'�, �� S Owner's Name New ❑ Renovation ❑ Replacement fitted (Print or type) Name Address 11c 1J Name of Licensed Plumber or Gas Fitter Check one: Certificate Installing Company Corp. �^ Partner. 04SURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes It you have checked Les, please indicate the type coverage by checking the appropriate box. Liability insurance policy er type of indemnity 13 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 13 Agent 13 I hereby certify that all of the details and information I have submitted (or entere ) in ab e pplication are. true an ccur to to the best of my knowledge and that all plumbing work and installations performed tder er ' ISSL for this a 1 tion I be in compliance with all pertinent provisions of the ;Massachusetts State Gas C a C nrer.t'd. thfr; � 1 �,x,� By: Title City/Town APPROVED ('OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber 2::� Gas Fitter a ense um er Master ® Journeyman x w �a o x e x oZ Z O z w P. F z F a w � w � A N x a z c ;14c F > z c z J o o a 3 a z > .4 U S U B -B A S E M E N T B A S E M ENT 1ST. FLOGR 2ND. FLOOR 3RD. F L O O R 4T II. FLOOR 5 T H. F L O O R 6 T H. F L O O R 7 T H. F L O OR 8 T H. F L O O R (Print or type) Name Address 11c 1J Name of Licensed Plumber or Gas Fitter Check one: Certificate Installing Company Corp. �^ Partner. 04SURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes It you have checked Les, please indicate the type coverage by checking the appropriate box. Liability insurance policy er type of indemnity 13 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 13 Agent 13 I hereby certify that all of the details and information I have submitted (or entere ) in ab e pplication are. true an ccur to to the best of my knowledge and that all plumbing work and installations performed tder er ' ISSL for this a 1 tion I be in compliance with all pertinent provisions of the ;Massachusetts State Gas C a C nrer.t'd. thfr; � 1 �,x,� By: Title City/Town APPROVED ('OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber 2::� Gas Fitter a ense um er Master ® Journeyman Of MORTN 1� 'fi ~ Date TOWN OF NORTH AND R PERMIT FOR PL ING This certifies that .. C. P . ................... has permission to perform ... 5... �� ` plumbing in the buildings of . 13.i. L.Y.':..P' '.`"...... at .. 1.0.. k,i- u_u �. h_ � ..0 .` ....... .... North Andover, Mass. Fee. 4 r. .. Lic. No.!i 20.) .'... ..... j .. G -* ' ......... . PLUMBING INSPECTOR Check � V `r '� 7034 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS � Q Date Building Location GtiG�D c�C , Owners Name , Permit #� Amount 14�- Type of Occunancv `'�" `�"� �� � crZS New Renovation Replacement 1:1 Plans Submitted Yes ❑ No ❑ VTV" TDUC � -�------------------- • .i ---' M-172-0,1101210MMMMMM-------------------I e.' MMM M------------------' W 1 f c.' ..------.�.---------.�-� .� ,..1 - lI ----..M------------------=111,111ro'llumm =MM� r -mm -m -- MMM M1 . RI.1-07 WMM mmmm - e -T' ------------ --1 -1 I ' 5----------- --1 (Print or type) �/ �4 Check one: Certificate Installing Company Name—4/. ❑Corp. Address Partner. BusinessTel-eptione o Name of Licensed Plumber: Insurance Coverage: Indicate the type of msuranc verage by checking the appropriate box: Liability insurance policy Other type of indemnity ® Bond F 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 Signature Owner ❑ I hereby certify that all of the details and information 1 have submitted (or entered) it best of my knowledge and that all plumbing work and installations performed der compliance with all pertinent provisions of the Massachusetts State Plu ' g Co By: Signature o icense i er T� of Plumbing License Title C � s� City/Town tcense um er Master APPROVED (OFFICE USE ONLY Agent ❑ 1 abo - Ipplication are true and ace to to the rmi ssued for this ap_p�li,ati w be in an ha r I ot;Ehc Sde -a ,aws. ❑ Journeyman E :_ ,i Date ..... `... .. � NORTM TOWN OF NORTH ANDOVER = p PERMIT FOR WIRING This certifies that 2 E ................................... has permission to perform ..........J'�fi� `!� .:. ..1'S ................................... wiring in the building of ... �l/ J .d Wil. �P . 4, 1. ........................ at ............v..........1JS,.tcl.c�`..!.............. .North Andover, Mass? Fee �.5.'............ Lic. No .............. ......... _ 4!., ........ ... LECI'RICAL INSP Check # 17 4954 0 U Z U OO w M. J c w T T m. o CQ@) .q coo 0000 M 13i i7; o ,m w 0 0 U Z U OO w M. J c w JAN-14-2004(�ED 01.31 RICE & ROH[BU KECTR,H, INC. (FAK)1MiflMl KM .t 11tpBtinitrtt cE Vub1lt: Etlp Occupancy b Fee Chocked BOARD OF FIRE PREVENTION RE UL . ONS 527 CMR 12.00 peeve blank) APPLICATION FOR PERMIT" TO PERFORM ELECTRICAL WWKt All work to be perlormed In accordanc Ith the Massachusetts Electrical Code. S27 CMR 12;00 (PLEASE PRINT IN INK Op TYPE ALL INFORMATION) pale Ri& or ibwn of To the Inspector of Wires-, The uderaigned applies for a permit Io per rm the electrical work described below. Location (Street d. Number) �PlC 7- .1 Owner or Tenant�,a/f,7. r Owner's Address 9 VnP / /R Is this permit In conjunction Ill se bulldingrpermit- Yes No ❑ (Check Appropriate Box) Purpose of Building �S Utlllty Authorltailvn No. Existing Service Amps ____jVolls Overhead El Undgrnd ❑ No. of Meters ew CusrvI0G �., Amps __/_Vnlla Overhead L.1 Undgrnd ❑ No. 01 Maters Number of Feeders and Ampocily 10 Idni Location and Neldte of Proposed Electrical Work fie- ae j Na. of Ughlkrg Outlets No. of Hat ilrbs ti No. of Llghling Flslures No. of Ascoulocle Oulletir No. of Switch Outiats No. of Ranges No. or Disposals No. of brshwashave No. of Dryers r� No. of Weler Hoalore No. Hydro Message (Lbs aTHEn; 15-Imming Pool Above In. amid. ❑ grnd. No. of Oil Burners No. of Gas Burners No. at Air Cond. Tblel tons No. of Tlansformers Total KVA Generators KVA No. of Emergency Lighting Battery units FIRE ALARMS No. of Zones No. of Detection and Initiating Davlese INSURANCE COVERAQE: Nurau■nt to the reQulremenls or Massscnusen: general Laws I have a current Liability Insurance Policy Including Completed Operations coverage or Ns lubelonlisl toulvitlent. have submlrisd valid proof of some b the Office. YES - NO C It yo ha Checked VE checking the apprawlato boll, 6. plsas4ndtcate the 1ESypo by of Covera • I / y INSURANCE X, SONO C OTI-lFp G (Phase SpeCify) –� Eslfmafed Value er EI. 1 Ical Wor i lExpk■lionn Data) Work to Blurt -- If/—, Inspection Das Requested: nou h // L "iY// Signed under Ih Illes of p g Final FIRM NAIVE tp LIC. No.L.�_� Address I--U–/f' a31C ��1Z. i/�ssl1 Bus. iet. No.. 7 -/ r All. lot. No. Quir*d by I assach CE General 1 all ewers Its*that tha Llcensss d00a not have rhe Invurarscs Coverage m es aubsianrtal equivalent es rr 1 qu Ple se MesseChuaslh General Laws. end Ih•t my signa1mg on mils rm N V (please Check one) 1>a h application .rekree this raauirsmsnt. Owner Agent Telephone No. PERMIT FEE ($ipnsture of Owner or 1bMi1 r-0'Jes Noor Heal Tblal Total pumps Tons KW No. of Bound" Devices epticafAree Heating KW No. of Sell Contained bstectlontSounding Devices Hosting Devices KW LocalMunicipal t-� [:]Other-�- 1-J Connection .— KW Z. of No, at Signs Ballasts Low Votlego Wiring Ne. of Motors Total NP INSURANCE COVERAQE: Nurau■nt to the reQulremenls or Massscnusen: general Laws I have a current Liability Insurance Policy Including Completed Operations coverage or Ns lubelonlisl toulvitlent. have submlrisd valid proof of some b the Office. YES - NO C It yo ha Checked VE checking the apprawlato boll, 6. plsas4ndtcate the 1ESypo by of Covera • I / y INSURANCE X, SONO C OTI-lFp G (Phase SpeCify) –� Eslfmafed Value er EI. 1 Ical Wor i lExpk■lionn Data) Work to Blurt -- If/—, Inspection Das Requested: nou h // L "iY// Signed under Ih Illes of p g Final FIRM NAIVE tp LIC. No.L.�_� Address I--U–/f' a31C ��1Z. i/�ssl1 Bus. iet. No.. 7 -/ r All. lot. No. Quir*d by I assach CE General 1 all ewers Its*that tha Llcensss d00a not have rhe Invurarscs Coverage m es aubsianrtal equivalent es rr 1 qu Ple se MesseChuaslh General Laws. end Ih•t my signa1mg on mils rm N V (please Check one) 1>a h application .rekree this raauirsmsnt. Owner Agent Telephone No. PERMIT FEE ($ipnsture of Owner or 1bMi1 r-0'Jes .7 Date. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that )../.5 ............. has permission to perform ... ............ plumbing in the buildings of LA,.o c, c -1.t? -k ...... at. !--,.,,North Andover, Mass. Fee. Lic. No/? �.7.7 .. ..... q,*'�.1-6—i--tlsy-.?- ......... PLUMBING INSPECTOR Check # -6951, i N MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location/� Ownerw&o dL '0 Q L A � lti'regdv►, rr tgpseS Date 7_ Y,` 1V/ Permit # c 9 Amount ('Z . New Renovation Replacement Plans Submitted Yes No FIXTURES .i .i . .� �� • .i .� .. .i, .i. �� •. .i (Print ortygpe) -ZK- f „ �� Check� Installing CompanyjNCorp. Address J Address ► T S Partner. Gti �w` l 3� 7S Business Te ep one p - / 1 Firm/Co. Certificate Name of Licensed Plumber: 'VA N d v N t/1J d l V Insurance Coverage: Indicate the type of ins rance coverage by checking the appropriate box: Liability insurance policy F1 Other type of indemnity D 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 igna ure Owner D Agent El I hereby certify that all of the details and information 1 have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations formed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts Sta ha t e General Laws. By: Signalge or Licenseuum er pe of Plu bing License Title 4 Z City/Town Ice z 1 um er Master Journeyman D APPROVED (OFFICE USE ONLY -'r Date. J....... IN TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ... J-111 . �� . �.... !�,!- .. �............... has permission for gas installation .. ..(:f ................... in the buildings of ....LA -U F?.t. .S. L..•.•••.••••.••••••. at ... ... . . . . . . . . . . . North Andover, Mass. Fee.j. ?...�.. Lic. No..L 4.1. .1.. . GAS INSPECT - R Check # 5903 MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS G (Type or print) Date NORTH ANDOVER, MASSACHUSETTS Building Locations `��� '�'�`� CU() Permit # 'C-1 d Amount $ L �� L�Owner's Name 1141 49 New ❑ Renovation ❑ Replacement 0____ Plans Submitted ❑ (Print Name Addre ness Name of Licensed Plumber or Gas Fitter Check one: Certificate Installing Company ❑ Corp. ❑ Partner. ❑ Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ��No❑ If you have checked yes, please indicate -Type coverage by checking the appropriate box. Liability insurance policy a 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 nereoy cernry mat au or the aetaus and intormation I nave submitted (or entered) in above pp11cation are true and accurate to the best of my knowledge and that all plumbing work and installations performed ynder Pssued for this applica ' ill be in compliance with all pertinent provisions of the Massachusetts State Gas Cye g/and ter,l4'1 eff the Ge eeral By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter ❑ Plumber a;� r 7 ❑ Gas Fitter Tr7cense Number ❑ Master J�eyman w N a a H z G x w x �, z a > w z F z x w w Cw7 p > w Ew- V a w zH a oz> x F �" �- m z o z w o m x SU B- B A SE M E N T B A S E M ENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6 T H. F L O O R 7TH. FLOOR 8TH. FLOOR (Print Name Addre ness Name of Licensed Plumber or Gas Fitter Check one: Certificate Installing Company ❑ Corp. ❑ Partner. ❑ Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ��No❑ If you have checked yes, please indicate -Type coverage by checking the appropriate box. Liability insurance policy a 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 nereoy cernry mat au or the aetaus and intormation I nave submitted (or entered) in above pp11cation are true and accurate to the best of my knowledge and that all plumbing work and installations performed ynder Pssued for this applica ' ill be in compliance with all pertinent provisions of the Massachusetts State Gas Cye g/and ter,l4'1 eff the Ge eeral By: Title City/Town APPROVED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter ❑ Plumber a;� r 7 ❑ Gas Fitter Tr7cense Number ❑ Master J�eyman R Date �../S _06........ TOWN OF NORTH ANDOVER PERMIT FOR WIRING SSACMUS� f This certifies that.........�':�"�............................................ has permission to perform G.js ? c�''-«'-f'............................................... wiring in the building of . KZ7........................ d at . /c1.... 2J t�- .................`=,, ........ , North Andover, Mass. .......F.::........ Lic. No..... / Fe ` . `......... ........ ELECTRICAL, INSP 4CsTOR Check � �%�d 6454 Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS r Official Use Only Permit No. Occupancy and Fee Checked [Rev. 11/99] 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 INFORMATION) Date: 02/02/2006 City or Town of North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 10 Wood Ridge Drive Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 Owner's Address 10 Wood Ridge Drive, No. Andover, MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residential 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: Repaired photoeye for flagpole Completion o the followiniz table mav be waived bv the Inspector of Wires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑In- ❑ rnd. rnd. o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number I Tons .......... J.KW........... of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) (Expiration Date) 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. I certify, under the pains and penalties of perjury, that the information on this plication is true and complete. FIRM NAME: Landers Electrical Co., Inc. f , A LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signatyri LIC. NO.: 9743 (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 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 PERMIT FEE. $ 20.00 Signature Telephone No. 6384 Date ..... / — a'6 '0.1, ......................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING S CHUS Thiscertifies that ............................................................ ................................ has permission to perform ....... 7.-0 ...... ......... wiring in the building of ..... ........... at ...... K.I ..... . North Andover, Mass. ............. Fee ...... �? ............. Lic. No..-'::5--�' p .7:.it .... ................. ......... . ELECTRICAL i SPECTOR Check # Q Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. l �L BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked '< [Rev. 11/991 (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 INFORMATION) Date: 01/24/2006 City or Town of. North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 10 Wood Ridge Drive Owner or Tenant Wood Ridge Homes Telephone No. 978423-7867 Owner's Address 10 Wood Ridge Drive, North Andover, MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residence 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: Replaced ballast and lamp for street light Completion of the following table may be waived by the Ins ector of Wires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Above In- Swimming Pool rnd. [:]rnd. ❑ o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number Tons KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) (Expiration Date) 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. I certify, under the pains and penalties of perjury, that the information on this plication is true and complete. FIRM NAME: Landers Electrical Co., Inc. LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signature LIC. NO.: 9743 (Ifapplicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 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. $ 5.00 LANDERS ELECTRICAL CO., INC. 1000 OSGOOD STREET— P.O. BOX 783 —NORTH ANDOVER, MA 01845 Phone 978-686-3828 — Fax 978-682-1646 Woodridge Homes ATTN: Gary Webster RECEIVED 10 Woodridge Road No. Andover, MA 01845 DEC 2 2 2004 INVOICE December 17, 2004 INVOICE # 040562 111/29/04 Street Light#6, Supplied and Installed 40OW Multi -tap Ballast . and 40OW Metal Halide Lamp Material & Labor: $ 214.13 TOTAL DUE THIS INVOICE: $ 214.13 TERMS- Net Due Upon Receipt of Invoice 2.0 % Per Month Finance Charge on Balances Over 30 Days THANK YOU 6385 Date......j . — ... 2 ...6..... - . 06 .. ... .. ....... TOWN OF NORTH ANDOVER PERMIT FOR WIRING F This certifies that ..................... 44..OF< ....... ............... .......... ............ has permission to perform ............. ...... T 0 wiring in the building of ........ 141 .. OZ.) ......... ibis ........... at............... !V&0.,,NPR .................................. . North Andover, Mass. Fee............. c. No. .......... E�E -I�AL INSPECTOR Cheek # 9 N Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked up [Rev. 11/991 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 INFORMATION) Date: 01/24/2006 City or Town of. North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) Ardmore Street Owner or Tenant Wood Ridge Homes Telephone No. 978423-7867 Q Owner's Address 10 Wood Ridge Drive, North Andover, MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residence 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 d'6l`T^ (� iIU t 12C% `/ Location and Nature of Proposed Electrical Work: Replaced smoke detector IQ ILI QCompletion of the followin table mav be waived hv the In ector nf Wires No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above [IIn-o rnd. grnd. ❑ o. Emergency Lighting Batte Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS I No. of Zones No. of Switches No. of Gas Burners No. o f Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number] I Tons I IKWNo. .........."...'.'..... of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of WaterKW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total. HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) (Expiration Date) 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. I certify, under the pains and penalties of perjury, that the informaon this plication is true and complete. tio FIRM NAME: Landers Electrical Co., Inc. LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signature LIC. NO.: 9743 (If applicable, enter "exempt" in the license number line.) Bus. TO. No.: 978-686-3828 ,,,,Address: 1000 Osgood Street, North Andover, MA 01845 Alt. TO. No.: 978-686-3829 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 a ent. Owner/Agent PERMIT FEE: $ 5.0017 Signature Telephone No. r. - LANDERS ELECTRICAL CO., INC. 1000 OSGOOD STREET —P.O. BOX 783 —NORTH ANDOVER, MA 01845 Phone 978-686-3828 — Fax 978-682-1646 Woodridge �ECE�v�Q ATTN: Gary Webster 10 Woodridge Road No. Andover, MA 01845 DEC 2 2 2004 BY - INVOICE December 17. 2004 INVOICE # 040462 09/09/04 Locate and Replace Faulty Smoke Detector at Admore Labor: $ 65.00 TOTAL DUE THIS INVOICE: $ 65.00 t. i TERMS: Net Due Upon Receipt of Invoice 2.0% Per Month Finance Charge on Balances Over 30 Days THANK YOU A,. 6370 Date ...... /. — a /' - "--) 6 ........................ TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .................. �—'Ov &'.. ...... 4 4e!7 -;.; - — ------- has permission to perform ..... .... LU 021-:e- n ............... . ......... wiring in the building of .... ... . ............ at ..... YV4-W-) ?��Q!vf 4� ............... . North Andover, Mass. Fee .... Lic. No. ....... id cTRICAL INSPECTOR Check # W D `x Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 70 1 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/99] 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 INFORMATION) Date: 01/24/2006 City or Town of. North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 10 Wood Ridge Drive Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 Owner's Address 10 Wood Ridge Drive, North Andover, MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residence 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: Checked street lights and court lights Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ In- rnd. rnd. ❑ o. omergencyigmg Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiatin Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: I Number . ........... Tons "'' " ' "' KW ........... No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail ifdesired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: (When required by municipal policy.) (Expiration Date) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Landers Electrical Co., Inc. X /� LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signature LIC. NO.: 9743 (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 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 a ent. Owner/Agent PERMIT FEE. $ 35.00 Signature Telephone No. It LANDERS ELECTRICAL CO., INC. 1000 OSGOOD STREET— P.O. BOX 783 —NORTH ANDOVER, MA 01845 Phone 978-686-3828 — Fax 978-682-1646 �+ RECEIVED Woodridge DEC 2 2 2004 ATTN: Gary Webster 10 Woodridge Road No. Andover, MA 01845 December 17, 2004 INVOICE # 040371 08/13 - 08/26/04 INVOICE Checked street lights and court lights Located short on street lights . checked timer, office lights (walkway) located short on court light, Gibson Court changed ballast on pole 10 installed lamp at pole 8 Material, Labor, Bucket Truck: TOTAL DUE THIS INVOICE: t, $ 1,113.75 $ 1,113.75 TERMS: Net Due Upon Receipt of Invoice 2.0% Per Month Finance Charge on Balances Over 30 Days THANK YOU _A 6367 Date ..... J. TOWN OF NORTH ANDOVER PERMIT FOR WIRING . . . . . . . . . . . . . .............. ............................. This certifies that .... ... has permission to perform ........ j.&'V ..... .Ta....................... ................ wiring in the building of ...... ...... .5...... at .... ........................................... . North Andover, Mass. Fee ...... Lic. No. '.01�lq ................... ELECTRICAL INSPECTOR Check # M A -C-\ Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. y 362 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/991 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 INFORMATION) Date: 01/24/2006 City or Town of. North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) Ardmore, 10 Wood Ridge Drive Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 Owner's Address 10 Wood Ridge Drive, North Andover, MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residence 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: Repaired street lights No. of Meters No. of Meters Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑In- El rnd. rnd. 0. o Emergency Lighting Batte Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges g No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: I I.Tons KW ....................... No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection of Dryers Heating Appliances KW SteNo. SecurityNo. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail ifdesired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: (When required by municipal policy.) (Expiration Date) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this a lication is true and complete. FIRM NAME: Landers Electrical Co., Inc. , � LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signaturg/ LIC. NO.: 9743 (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 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 PERMIT FEE. $ 5.00 Signature Telephone No. i' NDERS ELECTRICAL CO.,INC. Wood Ridge Homes ATTN: Gary 10 Wood Ridge Drive No. Andover, MA 01845 October 24, 2005 INVOICE # 050500 10/12/2005 y 1000 OSGOOD STREET oc - �. INVOICE RE: No streetlights on from foot of driveway to top of hill Checked circuits, tripped breaker at Ardmore. Replaced breaker and increased wire size from panel to contactor Material & Labor: $ 277.88 TOTAL DUE THIS INVOICE: $ 277.88 TERMS: Net Due Upon Receipt of Invoice 2.0% Per Month Finance Charge On Balances Over 30 Days THANK YOU PO BOX 783 NORTH ANDOVER, MA 01845 TEL (978) 686-3828 FAX (978) 682-1646 ..r—a=f.x}..Y..y.'. �'. ".?'-3-. ':•rs r'T�� .r .. ..t. i - :Yr � _.�.,-. � ;,�,'.�' �,.. 6399 Date... 1..... .........1........'.. TOWN OF NORTH ANDOVER PERMIT FOR WIRING :.:.% This certifies that .............. W ' G/' " L� has permission to perform wiring in the building of .......a"'i7 ..Rto.� ......... 1�.......... ....... at ...... -m13.--{.�1.......... k ............. . North Andover, Mass. Fee ..................... Lic. No........... ....................-/yam ELECTRICAL INSPECTOR Chemo # I� C y� S Commonwealth of Massachusetts Official Use Only q Department of Fire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/991 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 INFORMATION) Date: 01/24/2006 City or Town of. North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 10 Wood Ridge Drive Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 Owner's Address 10 Wood Ridge Drive, North Andover, MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residence 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: Respliced broken wire underground No. of Meters No. of Meters Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑In- ❑ rnd. grnd. o. of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners of Detection and No. Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number I Tons ................. KW .............. No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ElMunicipal El Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water Kms, Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) (Expiration Date) 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. I certify, under the pains and penalties of perjury, that the informatio on this pplic ion is true and complete. FIRM NAME: Landers Electrical Co., Inc. LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signature LIC. NO.: 9743 (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 w 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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE: $ 5.00 4NDERS ELECTRICAL CO.,INC. Wood Ridge Homes ATTN: Gary 10 Wood Ridge Drive No. Andover, MA 01845 INVOICE June 30, 2005 INVOICE # 050016 01/11/2005 Respliced broken wire underground with split bolts 1000 OSGOOD STREET Material & Labor: $ 97.50 TOTAL DUE THIS INVOICE: $ 97.50 TERMS: Net Due Upon Receipt of Invoice 2.0% Per Month Finance Charge On Balances Over 30 Days THANK YOU PO BOX 783 NORTH ANDOVER, MA 01845 TEL (978) 686-3828 FAX (978) 682-1646 IL' t443 Date ......1.." '....6 .-06 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ................................................ has permission to perform...... ........................... ............................... wiring in the building of ............................................ .. ............................... at ....... North Andover, Mass. �I 5— Fee ............. .......... —.. Lic. No ...... .......... ELECTRICAL INSPE60R Check # NORTH Date ......1.." '....6 .-06 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ................................................ has permission to perform...... ........................... ............................... wiring in the building of ............................................ .. ............................... at ....... North Andover, Mass. �I 5— Fee ............. .......... —.. Lic. No ...... .......... ELECTRICAL INSPE60R Check # r� Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/991 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 INFORMATION) Date: 01/24/2006 City or Town of. North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 10 Wood Ridge Drive Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 Owner's Address 10 Wood Ridee Drive. North Andover. MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residence Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Utility Authorization No. Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd ❑ Location and Nature of Proposed Electrical Work: Moved A/C Plug in Work Shop No. of Meters No. of Meters Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ In- rnd. rnd. ❑ o. omergencyiging Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiatin2 Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number Tons KWNo. ..........' ' ' of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HPTelecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) (Expiration Date) 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. I certify, under the pains and penalties ofperjury, that the information on this plication is true and complete. FIRM NAME: Landers Electrical Co., Inc. LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signature LIC. NO.: 9743 (If applicable, enter "exempt" in the license number line.) VBus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 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 age Owner/Agent Signature Telephone No. PERMIT FEE. $ 5.00 LANDERS ELECTRICAL CO.,INC. I Wood Ridge Homes ATTN: Gary 10 Wood Ridge Drive No. Andover, MA 01845 INVOICE June 30, 2005 INVOICE # 050157 04/20/05 Move A/C Plug in Work Shop Material & Labor: TOTAL DUE THIS INVOICE: $ 168.77 $ 168.77 TERMS: Net Due Upon Receipt of Invoice 2.0% Per Month Finance Charge On Balances Over 30 Days THANK YOU I 1000 OSGOOD STREET PO BOX 783 NORTH ANDOVER, MA 01845 TEL(978)686-3828 FAX (978) 682-1646 t _ W '6395 Date .... (.— . `?6—.0 0 . L' ..... .. .......... ... ... TOWN OF NORTH ANDOVER PERMIT FOR WIRING 'This certifies that! .1, ............................. has permission to perform ............. /.1.. �.. wiring in the building of ..... ............... I at ........... / ... C.). ....... ........... . North Andover, Mass. Fee ....... Lic. No. 51�1214 rz� ............. ....................... 4. q ELECTRICAL INSPECTOR Check # Official Use Only Commonwealth of Massachusetts Department of Fire Services Permit No. a %� BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/991 leave blank Y 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 INFORMATION) Date: 01/24/2006 City or Town of: North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. -.9 Location (Street & Number) 10 Wood Ridge Drive Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 Owner's Address 10 Wood Ridge Drive, North Andover, MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) N Purpose of Building Residence 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: Replaced 1 Pole Light Fixture i Completion of the_following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑In- El rnd. rnd. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number ...................................................... Tons KW No. of Self-Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water Kms, Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) (Expiration Date) 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. I certify, under thepains and penalties of perjury, that the information n this a plication is true and complete. !° FIRM NAME: Landers Electrical Co., Inc. LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signatur LIC. NO.: 9743 r (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 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. $ 5.00 11 ►ENDERS r, ELECTRICAL CO.,INC. l Wood Ridge Homes ATTN: Gary 10 Wood Ridge Drive No. Andover, MA 01845 INVOICE August 12, 2005 INVOICE # 050287 07/19/2005 RE: Replace 1 Pole Light w/Broken Lens per Gary Removed old fixture, supplied and installed new head Material & Labor: $ 342.38 TOTAL DUE THIS INVOICE: $ 342.38 TERMS: Net Due Upon Receipt of Invoice 2.0% Per Month Finance Charge On Balances Over 30 Days THANK YOU 1000 OSGOOD STREET PO BOX 783 NORTH ANDOVER, MA 01845 TEL (978) 686-3828 FAX (978) 682-1646 1 6397 -If Date ..... t7.24:7.�. 4 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .................. /''`e cc ............................ ....... t7............ ............ ........... has permission to perform .......... R ....... .... ............ wiring in the building of ........ at ..... 4kG.,.0 .... 6 ......... North Andover, Mass. FT ... 5�. C94V ...... Lic. No. ............... fLECTRICAL INSPECTOi( Check # e Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. G BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/99] 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 INFORMATION) Date: 01/24/2006 City or Town of. North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 10 Wood Ridge Drive Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 © Owner's Address 10 Wood Ridge Drive, North Andover, MA 01845 I Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) W Purpose of Building Residence 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: Troubleshoot broken electric line No. of Meters No. of Meters Completion o the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ In- rnd. rnd. ❑ No . o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number ...................................................... Tons KW No. of Self-Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water Heaters KW No. of No. of Signs Ballasts Data Wiring: No. of Devices or E uivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) (Expiration Date) 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. I certify, under the pains and penalties ofperjury, that the information o this ap lication is true and complete. FIRM NAME: Landers Electrical Co., Inc. LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signature LIC. NO.: 9743 (If applicable, enter "exempt" in the license number line) Bus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 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 a ent. Owner/Agent PERMIT FEE. $ 5.00 Signature Telephone No. ,iANDERS ELECTRICAL CO.,INC. i Wood Ridge Homes ATTN: Gary 10 Wood Ridge Drive No. Andover, MA 01845 01 k INVOICE June 30, 2005 INVOICE # 050005 01/03/05 Troubleshoot broken electric line that was dug up by construction. Troubleshoot problem w/existing light that wasn't working. Labor: $ 225.00 TOTAL DUE THIS INVOICE: $ 225.00 TERMS: Net Due Upon Receipt of Invoice 2.0% Per Month Finance Charge On Balances Over 30 Days THANK YOU r 1000 OSGOOD STREET PO BOX 783 NORTH ANDOVER, MA 01845 TEL (978) 686-3828 FAX (978) 682-1646 1 6392 Date ..... 1 ?4 —�6 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ........... Z.......P&WS 77 ....................... ............. has permission to perform ........ A.AV4-777.0.kvt.'�R.. ... wiring in the building of ...... IA,/P. 0. C).. _6.4-77E ...... I at ... . r.......... j t)14� ........ .......... . North Andover, Mass. Fee r.�.... Lic. No. /.Z'0..................... . ............... ELS RICAL INSPEC 'MR Check '# Commonwealth of Massachusetts Official fUse Only Department of Fire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/99] 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 INFORMATION) Date: 01/24/2006 City or Town of. North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 10 Wood Ridge Drive Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 Owner's Address 10 Wood Ridse Drive. North Andover. MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residence Utility Authorization No. i Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters ILI New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters ILZ� Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Troubleshoot emergency battery units, replace 1 battery unit Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Above In- Swimming Pool rnd. ❑ rnd. El o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number ­ . ......I Tons ................... KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring* No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: (When required by municipal policy.) (Expiration Date) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. y I certify, under the pains and penalties of perjury, that the in f ormatton this a lication is true and complete. FIRM NAME: Landers Electrical Co., Inc. ,� /� LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signature -' ffl&4 7 _%�aj2.— LIC. NO.: 9743 (If applicable, enter "exempt" in the license number line.) /?iVBus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE: $ 5.00 ANDERS EI-ECTRICAL CO.,INC. y Wood Ridge Homes ATTN: Gary 10 Wood Ridge Drive No. Andover, MA 01845 INVOICE June 30, 2005 INVOICE # 050017 01/12 — 01/20/05 Troubleshoot Emergency Battery Units, Supplied and Replaced 1 Emergi-Lite 6V Battery Unit Material & Labor: $ 518.75 TOTAL DUE THIS INVOICE: $ 518.75 TERMS: Net Due Upon Receipt of Invoice 2.0% Per Month Finance Charge On Balances Over 30 Days THANK YOU 1000 OSGOOD STREET PO BOX 783 NORTH ANDOVER, MA 01845 TEL (978) 686-3828 FAX (978) 682-1646 ~ 698 Date ....... ..— —d NORT" 0t,�``°;°1"° TOWN OF NORTH ANDOVER PERMIT FOR WIRING f �,SSACMUS� Thiscertifies that ............................................................ ....................... has permission to perform ...........1..` �................. r.......... L......... wiring in the building of .......... qU a ��� ...../.66/1 _... .... at-�'��� .... C� �. , North Andover, Mass. /O �� !� Fee..... 5 ............ Lic. Nod..d. e# ........................... t............. .............. /...... ELECTRICAL INSPECTOR y Check # __ _ `9 0% Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. L BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11 /991 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 INFORMATION) Date: 01/24/2006 City or Town of: North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 10 Wood Ridge Drive Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 Owner's Address 10 Wood Ridge Drive, North Andover, MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residence 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: Hooked up double -pole switch No. of Meters No. of Meters Completion o the following table may be waived bv the Inspector of Wires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ In- rnd. rnd. ❑ o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners of Detection and No. Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number .............................................. Tons KW No. of Self -Contained Detection/Alerting Devices . No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Eq uivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) (Expiration Date) 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. I certify, under the pains andpenalties ofperjury, that the information on this a lic tion is true and complete. FIRM NAME: Landers Electrical Co., Inc. LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signature LIC. NO.: 9743 (Ifapplicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE. $ 5.00 SANDERS ELECTRICAL CO.,INC. I -,Wood Ridge Homes ATTN: Gary 10 Wood Ridge Drive No. Andover, MA 01845 INVOICE June 30, 2005 INVOICE # 050012 01 /13/2005 Hooked Up Double Pole Switch Labor: TOTAL DUE THIS INVOICE: $ 65.00 $ 65.00 TERMS: Net Due Upon Receipt of Invoice 2.0% Per Month Finance Charge On Balances Over 30 Days THANK YOU 1000 OSGOOD STREET PO BOX 783 NORTH ANDOVER, MA 01845 TEL (978) 686.3828 FAX (978) 682-1646 y _ y, .0 11 6396 / - Date ............. ?-6-06..................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING I This certifies that ................... ... V-0. has pe rmission to perform ......... .......................... ........... Ivo wiring in the building of .......... .... . .......... at ........... .... 0 .... ...... O.K ....... . ;�qorth Andover, Mass. .IrFee... ... Lic. No...,.S.I.(.214 ................ .. ..... .. .. . . .... .. .. ........... ELA-r�R[&A�L �Ii;N�SP�ECTOR Check # N Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 9 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/99] 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 INFORMATION) Date: 01/24/2006 City or Town of. North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 10 Wood Ridge Drive Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 Owner's Address 10 Wood Ridge Drive, North Andover, MA 01845 a W Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residence 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: Installed new dishwasher O Completion o the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ In- rnd. rnd. ❑ o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number I Tons J.KW........... ........... of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) (Expiration Date) 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. I certify, under the pains and penalties of perjury, that the info rma io n this a plication is true and complete. FIRM NAME: Landers Electrical Co., Inc. LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signatur4�41LIC. NO.: 9743 (If applicable, enter "exempt" in the license number line) Bus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE: $ 5.00 f t ANDERS ELECTRICAL CO.,INC. Wood Ridge Homes ATTN: Gary 10 Wood Ridge Drive No. Andover, MA 01845 INVOICE June 30, 2005 INVOICE # 050009 01/12/05 Removed dishwasher, installed new dishwasher Material & Labor: $ 66.31 TOTAL DUE THIS INVOICE: $ 66.31 TERMS: Net Due Upon Receipt of Invoice 2.0% Per Month Finance Charge On Balances Over 30 Days THANK YOU 1000 OSGOOD STREET PO BOX 783 NORTH ANDOVER, MA 01845 TEL (978) 686-3828 FAX (978) 682-1646 6391 Date... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ................f,-.-., ? S -, F---/ Z.: 5 . .......... ........ has permission to perform .......... &.*7 . 1 r ........ wiring in the building of .......... Lvoo'6 ... % . ............................... e ... . ... . li .WC? —Y. � at ...... ................. e.....oe ............ North Andover, Mass. 0 Fee ..1 ............. Lic. No. ............... ELECTRICALINSPECTOR fi 1, Check # A Commonwealth of Massachusetts Offs ' 1 Use Only Department of Fire Services Permit No. f BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/99] 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 INFORMATION) Date: 01/24/2006 City or Town of. North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 10 Wood Ridge Drive Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 Owner's Address 10 Wood Ridge Drive, North Andover, MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residence Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installed GFCI outlet in the kitchen of the Community Room Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Above In- Swimming Pool rnd. ❑ rnd. E:1BatteUnits 0.0Emergency Lighting No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number I Tons J.KWNo. ........... of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equi alent No. of Water Heaters KW No. of No. of Si ns Ballasts Data Wi ring• No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: (When required by municipal policy.) (Expiration Date) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties ofperjury, that the information on t779 ation is true and complete. FIRM NAME: Landers Electrical Co., Inc. ,Z LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signature LIC. NO.: 9743 (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE. $ 5.00 NDERS ELECTRICAL CO.,INC. Wood Ridge Homes `�. ATTN: Gary 10 Wood Ridge Drive No. Andover, MA 01845 i I INVOICE June 30, 2005 INVOICE # 050023 01/19/2005 Added a GFCI outlet in the kitchen of the Community Room Material & Labor: $ 276.25 TOTAL DUE THIS INVOICE: $ 276.25 TERMS: Net Due Upon Receipt of Invoice 2.0% Per Month Finance Charge On Balances Over 30 Days THANK YOU 1000 OSGOOD STREET PO BOX 783 NORTH ANDOVER, MA 01845 TEL (978) 686-3828 FAX (978) 682-1646 6372 Date... .............................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .................. 4.?.v ..-2 ...... ';.; . . ........... has permission to perform........... 4�.F- ....... wiring in the building of ..... .......... at ..... ...... b.1Z ........ . North Andover, Mass. Tee.... .... ......... Lic. No:�.;�7'q .................. 4'e.. I ELEMICAL INSPECTIO Check # It,\ Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. c>3 % 2� BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/99] 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 INFORMATION) Date: 01/24/2006 City or Town of. North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 10 Wood Ridge Drive 1149 Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 Owner's Address 10 Wood Ridge Drive, North Andover, MA 01845 �j Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residence Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Utility Authorization No. Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd ❑ Wire Electric Doors in Office No. of Meters No. of Meters Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Above In- Swimming Pool rnd. ❑ rnd. El o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number I TonsW. No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: (When required by municipal policy.) (Expiration Date) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Landers Electrical Co.. Inc. LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signature/ / — / LIC. NO.: 9743 (If applicable, enter "exempt" in the license number line.) L7 Bus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 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 a ent. Owner/Agent Signature Telephone No.PERMIT FEE. $ 5.00 NDERS A -ilECTRICAL CO-INC. Wood Ridge Homes ATTN: Gary 10 Wood Ridge Drive No. Andover, MA 01845 INVOICE June 30, 2005 INVOICE # 050007 01/11, 01/12/05 Wire Electric Doors in Office Material & Labor: $ 225.38 TOTAL DUE THIS INVOICE: $ 225.38 TERMS: Net Due Upon Receipt of Invoice 2.0% Per Month Finance Charge On Balances Over 30 Days THANK YOU 1000 OSGOOD STREET PO BOX 783 NORTH ANDOVER, MA 01845 TEL (978) 686-3828 FAX (978) 682-1646 y .. .. 1 rh.4--,^ mss.. '„k .!✓....T �. Date...I....a ................ 1 HORTI, TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that!.. x— . <............................. ................... has permission to perform .............r. ................ !%... ,.......... wiring in the building of .....14....•x.. ?! :.'S ... .....A.1 . ! .. �,....... !� at .........:...................... ......... ... 52................... ,North Andover, Mass. Fee..'5-- s�r� , .................. Lic. No. ............. .............. ELECTRICAL INSPE rOR 7 Check # _ Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. f BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked :1 [Rev. 11/99] leave blank •u 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 INFORMATION) Date: 01/24/2006 f City or Town of: North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 10 Wood Ridge Drive Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 Owner's Address 10 Wood Ridge Drive, North Andover, MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residence 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: Installed receptacle in office for computer Completion ofthe following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Above In- Swimming Pool rnd. ❑ rnd. El o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS TNo. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number I Tons I I KW ....................... No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) (Expiration Date) 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. I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Landers Electrical Co., Inc. LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signature LIC. NO.: 9743 (Ifapplicab[e, enter "exempt" in the license number line) y IBus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE. $ 5.00 1 LANDERS ,ELECTRICAL CO.,INC. Z Wood Ridge Homes ATTN: Gary 10 Wood Ridge Drive No. Andover, MA 01845 INVOICE June 30, 2005 INVOICE # 050126 03/30/2005 Installed Receptacle in Office for Computer Material & Labor: TOTAL DUE THIS INVOICE: $ 202.55 $ 202.55 TERMS: Net Due Upon Receipt of Invoice 2.0% Per Month Finance Charge On Balances Over 30 Days THANK YOU 1000 OSGOOD STREET PO BOX 783 NORTH ANDOVER, MA 01845 TEL (978) 686-3828 FAX (978) 682-1646 Date..... !- -ZL -ez' ........................... NORTH 4, TOWN OF NORTH ANDOVER to PERMIT FOR WIRING This certifies that .............. ......... ....... has permission to perform ......... ...... ......... wiring in the building of �Jqcle....... ........ ........ .... ......... at ...... ......... ,North Andover, Mass. .. F' Lic. No. ..... . ......................... .. ; .. ........... . ................. ELECTRICAL INSPECTOR Check # c Z Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. (rte � %/ BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/991 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 INFORMATION) Date: 01/24/2006 City or Town of. North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 10 Wood Ridge Drive Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 Owner's Address 10 Wood Ridge Drive, North Andover, MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residence 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: Installed outlet for copier in office No. of Meters No. of Meters Completion of the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Above In- Swimming Pool rnd. ❑ rnd. ❑ o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number Tons ....................""."'............ JKW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) (Expiration Date) 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. I certify, under the pains andpenalties ofperjury, that the information on this a lication is true and complete. FIRM NAME: Landers Electrical Co., Inc. LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signatur LIC. NO.: 9743 (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE. $ 5.00 "J/A NDERS ELECTRICAL CO.,INC. `t. Wood Ridge Homes ATTN: Gary 10 Wood Ridge Drive No. Andover, MA 01845 INVOICE June 30, 2005 INVOICE # 040616 12/16/2004 Installed Outlet for Copier in Office Material & Labor: $ 325.91 TOTAL DUE THIS INVOICE: $ 325.91 TERMS: Net Due Upon Receipt of Invoice 2.0% Per Month Finance Charge On Balances Over 30 Days THANK YOU 1000 OSGOOD STREET PO BOX 783 NORTH ANDOVER, MA 01845 TEL (978) 686-3828 FAX (978) 682-1646 6349 Date .... ....................... .. TOWN OF NORTH ANDOVER PERMIT FOR WIRING P -,k5o -' -t I -:- -- ��'/ ............... /-f"�y -� t4e S r- Z"' This certifies that ............................ ..................................... has permission to perform ...... ............ wiring in the building of ...... [�vC1i e� At� ..... tJ 01: at ......... /0 ... ... North Andover, Mass. ..... ................ . . Fee ..!��. Lic. No. ........ I$H L Check # L . Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. h / BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked '( [Rev. 11/991 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 INFORMATION) Date: 01/24/2006 City or Town of: North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 10 Wood Ridge Drive `9 Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 Owner's Address 10 Wood Ridge Drive, North Andover, MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) M y� Q f Purpose of Building Residence 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: changed 2 ballasts in office No. of Meters No. of Meters Completion of the followine table may be waived by the Insnector ofWire.c No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ In- rnd. rnd. ❑ o . o Emergency Lighting, Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners of Detection and No. Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number Tons J.KW ..................... No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) (Expiration Date) 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. I certify, under the pains and penalties of perjury, that the information on this ap lic tion is true and complete. FIRM NAME: Landers Electrical Co., Inc. LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signatur LIC. NO.: 9743 (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978-686-3828 F Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 ` 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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE. $ 5.00 LANDERS ELECTRICAL CO.,INC. Wood Ridge Homes ATTN: Gary 10 Wood Ridge Drive No. Andover, MA 01845 June 30, 2005 INVOICE # 050298 07/06/05 1000 OSGOOD STREET J INVOICE Replaced 2 Customer Ballasts in Office Labor: TOTAL DUE THIS INVOICE: $ 85.00 $ 85.00 TERMS: Net Due Upon Receipt of Invoice 2.0% Per Month Finance Charge On Balances Over 30 Days THANK YOU PO BOX 783 NORTH ANDOVER, MA 01845 TEL (978) 686-3828 FAX (978) 462-1646 x_ 6338 Date. `.a................... NORTh 0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING �i ,sg^c MUSE This certifies that c ............... ...................................;......... ..... �.................... has permission to 6 ............. perform .... V. 4� cYc9/ .._._ G" f T . �0� .f1) wrong in the building of.............:.....................�............................................ 3 at. '�...................... . North Andover, Mass. �- Fee.�..""..... Lic.No...���.... .... :..,.-li'%'ZZt'''S.- ELECTRICAL INSPECTOR :� `i'' Check # _A I Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 39 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked kv [Rev. 11/991 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 INFORMATION) Date: 01/24/2006 City or Town of. North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 10 Wood Ridge Drive Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 Owner's Address 10 Wood Ridge Drive, North Andover, MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residence 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: Troubleshoot lights flickering Completion ofthe following table may be waived by the Insnector of Wires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tub's Generators KVA No. of Lighting Fixtures AboveIn- Swimming Pool rnd. ❑ rnd. ❑ o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS I No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number . *** Tons ............... KW "' No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or E uivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: (When required by municipal policy.) (Expiration Date) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Landers Electrical Co., Inc. LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signatur LIC. NO.: 9743 (If applicable, enter "exempt" in the license number line) Bus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 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 PERMIT FEE. $ 35.00 Signature Telephone No. i LANDERS ELECTRICAL CO., INC. 1000 OSGOOD STREET —P.O. BOX 783 —NORTH ANDOVER, MA 01845 Phone 978-686-3828 — Fax 978-682-1646 Woodridge Homes ATTN: Gary Webster RECEIVED 10 Woodridge Road No. Andover, MA 01845 DEC. 2 2 2004 BY INVOICE December 17, 2004 INVOICE # 040352 08/02 - 08/25/04 RE: Lights Flickering Traced underground conductors, recorded voltages, seal modular meter center, met w/Mass. Electric Material & Labor: $ 832.41 TOTAL DUE THIS INVOICE: $ 832.41 TERMS: Net Due Upon Receipt of Invoice 2.0 % Per Month Finance Charge on Balances Over 30 Days THANK YOU i�'^3��.s-,:.r?4ra?�.,�+.+Ft_t >.=.�.--:t�F.- .:,-?:,. r.-..�+�. ir.-a,ta �.,-.:s�, ....�,.. '.-c��-�:. .r-...� 3�..,. �..--a..m't,• �e-r« F G 633'7 Date .......... .... ...... ..... TOWN OF NORTH ANDOVER PERMIT FOR WIRING if This certifies that ...........4-4lc�.4 .5........ 4r........................... Ls�t ��dZ/C 5 has permission to perform r�.� �.�...�.......�.i'�,.�.......... fY........ wiring in the building of / . ? k?aap.... f ✓4 .....A... r, at ........ O e0j. ...................... . North Andover, Mass. t Li` 121? 1 Fee ....:................ c. No.......... ............, ,,.._ ELECTRICAL INSP&MR Check # x Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. a BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked u,p [Rev. 11/99] 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 INFORMATION) Date: 01/24/2006 City or Town of: North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 10 Wood Ridge Drive Owner or Tenant Wood Ridge Homes Telephone No. 978-423-7867 Owner's Address 10 Wood Ridge Drive, North Andover, MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residence 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: Supplied and installed 24 emergency batteries Completion of the following table may he waived by the Incnertnr nfWirov No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ In- rnd. rnd. ❑ o. omergencyLighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals:..........Detection/Alerting Number....Tons KW No. of Self -Contained Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring' No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: (When required by municipal policy.) (Expiration Date) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. 1 certify, under the pains and penalties ofperjury, that the inform771-2 s application is true and complete. FIRM NAME: Landers Electrical Co., Inc. /� LIC. NO.: A5912 Licensee: Terrence J. Landers, Vice -President Signatur;e LIC. NO.: 9743 (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.• 978-686-3828 Address: 1000 Osgood Street, North Andover, MA 01845 Alt. Tel. No.: 978-686-3829 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 a ent. Owner/Agent PERMIT FEE. $ 35.00 Signature Telephone No. LANDERS ELECTRICAL CO., INC. 1000 OSGOOD STREET— P.O. BOX 783 —NORTH ANDOVER, MA 01845 Phone 978-686-3828 — Fax 978-682-1646 Woodridge Homes ATTN: Gary Webster RECEIVE® 10 Woodridge Road No. Andover, MA 01845 DEC 2 2 2004 INVOICE December 17, 2004 INVOICE # 040423 09/01, 09/02/04 Supplied and Installed 24 Emergency Batteries Material & Labor as per quote: $ 850.00 TOTAL DUE THIS INVOICE: $ 850.00 TERMS: Net Due Upon Receipt of Invoice 2.0% Per Month Finance Charge on Balances Over 30 Days THANK YOU ,ORTIy 0. .o ' '. _. Date TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ... . r r...1 �...................... has permission to perform ...... ...... I ................. . plumbing in the buildings of ................ . at .. 1.62... JR. A l .*. c . .............. North Andover, Mass. Fee. Q "... Lic. No../ L ? .5 �F.. ....... / �• . "t'l %: �...... . PLUMBING INSPECTOR Check # . 6757 I,/ MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location/0 91, �-' Q— t" W ovd New 0 d01 ( -e ms, Tvne of � (�(ita 1 '\ t, c► Date 1 # DZY-0ame �jp ern Amount :?11. ancy Renovation 1:1 ReplacementPQ Plans Submitted Yes ❑ No ❑ FIXTURES J • .r r .J W1.13-.71110MMMMMMMMM..-M--®--.-� --- MM WkSlars-111M MMLlMMOMMMMMOM W WMMM MMMMMOMMM MMM M MMM MW 11-10M.' MMMMOMMMMM MMMMMWMM� 1 �MMMMMMMMMMMMMNMMMMMM------ :1 e!' mmmmmM----.M--.---------- (Print or type) j v/\�Installing Company Name 4 Check one: Certificate ❑ Corp. pAddress - =—� r ? l S T` Partner. Business Telephone l� p oZLnj`�L�� / Firm/Co. i Name of Licensed Plumber: � a\�- (490\7 Insurance Coverage: Indicate the type of insurance coverAge by checking the appropriate box: Liability insurance policy P 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 Signature I Owner I hereby certify that all of the details and information I have submi best of my knowledge and that all plumbing work and installations compliance with all pertinent provisions of the Massachusett By: 1-9 Signaf o icon Agent ❑ ted (or entered) in above application are true and accurate to the 4Vmirbjg tile�t Issued for this application will be in ode and homer -the -General Laws. Title pe of Plumbing License C�� City/Town icense um er Master Journeyman EDAPPROVED (OFFICE USE ONLY A. WOLF PLlJ1GIM6 d NEAT MG P. O. DOZE # 2289 SALEM, N.H. 03079 TEL: 608-$9$-6505 FAX:SA-ME CALL AHEAD INVOICE NUMBER: INVOICE DATE: RANDOLPH H 111OLF NA. MASTER PLUMBER # 12299 Ifffn 36 P -9 -SEP -O5 r OCT 3 1 2005 Invoice Date TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that .... at. �.�.�....•••.•••••...... has permission to perform ..A.C. - ................ . plumbing in the buildings of .: irl1. �. .la.G` 5............... at ../..G.. ........... , North Andover, Mass. Fee .YO? Lie. No... S ... `..-�J%.-,� ...... . fPLUMBING INSPECTOR Check # 678 r: MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location/69 J91\ - Owners 1,9 0U� Ai J(,t Type of �d iQi N ' l ]l'Vt�Q Date /C/) � J SPermit # 47)-21 Amount New Renovation Replacement I Plans Submitted Yes ❑ No FIYTTTi?FQ (Print or type) ti Installing Company Name Address -ej�" Name of Licensed Plumber: In C 04) ytuvv-6/� C) Check one: Certificate El Corp. Partner. P"'Firm/Co. surance overage. Indicate uie pe or insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity 11Bond ❑ 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 Signature IOwner 0 Agent ❑ I hereby certify that all of the details and information I have subm' ed (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installatio fo ed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massa husetts t ng o e an C er'C4 o -the General Laws. By: r re Or icense um er Title T� Z 1 bing License City/Town rcense um er APPROVED (OFFICE oo Master j/� Journeyman(OFFICE USE ONLY H. WOLF PtUfl-tN6 d HEA 1G P 0 BOX # 2229 Invoice EW010E NUNOER. IAYOICE DATE: SALEX N.M. 03079_-WOOLPH H WOLF TEL: 603-234-9231 MA. -MASTER PLUNDER # 12299 CUSTOMER: WOODRIDOE HOMES CO-OP TELEPHONE ADDRESS. 10 WOODRIDGE DI{ FAX: WRI36 1 -NO 11-05 c,v Nov o 8 2005 Cm; STA7X SIG rAL coDF-- NO. ANDOVER MA. 01,645 PO NUMBER: 10 BRIER CT 0.00 $0.00 0.00 ,0.00 TOTAL ACTIYFFY COST: ' ATOVE-WITCEFUY SINK i I I/2c COUP DISPOSAL, IIISHWASHER 1.00 COP TUBE 'Z" AND ST011E % S.S. SINGLE BOWL SINK PEHOYE WATER PIPIN6 AND 68.00 D-1/2 PYC.PaTRAP WICO DRAM PIPI1V6 - : F.OD ) 1-1/2PVCDANOYC/O ItEMSTALL ALL PIXTUAT S sy;5Q ) 1-I/2 Pvc 45 AND APPIJANCPs ) 1-1/2 PAC DESANCO REPIPE Wad TER AND DRAM 1.50 I R.0 AN6LE STOPS 1350 1/2c90 .3) 1=1/9PvcPIPE 4.25 I 1/2CTEE 11 1-1/2 Pl/c COUP TOTAL AC4TERMLS COST.` ET. 10 DAYS THANK YOU TOTAL BILLIN6. $x.91,65 Invoice 1 Date. ....... TOWN j,0F NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ..... /= :....%'./ . ................... has ,permission for gas installation .....P. AR in the buildings of ... k1 Q.A.5.,. ....... . at ..../ 0 �---......... North Andover, Mass. Fee. -11 � _ .... . GAS INSPECTOR Check # 5397 0 MASSACHUSP-TI5 UNN ORNI APFUCATON FOR PERNIlT TO DO GAS FITTING (Type or print) NORTH ANDOVER, MASSACHUSETTS B 'Id' L •ations f r ` � C +- IN ut tng oc Owner's Name New D Renovation 1:1 Replacement 11 Date lJ K-6 Permit # I Amount $ 3 L ' Plans Submitted 11 (Print or type)2 C one: Certificate Installing Company Name vV I Corp. Address l Partner. U7 usmess a ep oneZ Firm/Co. Name of Licensed Plumber or Gas Fitter Amt INSURANCE COVERAGE • Chep I have a current liability Insurance policy or it's substantial equivalent. Yes No13 If you have checked yes, pl a ndicate the type coverage by checking the appropriate bo 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 13 Agent 0 I hereby certify that all of the details and information I have suDnuttea (or enterea) in aDove appucanon are true ana accurate to the best of my knowledge and that all plumbing work and installations pe/formed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts, at a �e-a pter 142 of the General Laws. tie ty/Town VED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber % z Gas Fitter License Number Master Journeyman Doi, OWN= 2ND. FL R (Print or type)2 C one: Certificate Installing Company Name vV I Corp. Address l Partner. U7 usmess a ep oneZ Firm/Co. Name of Licensed Plumber or Gas Fitter Amt INSURANCE COVERAGE • Chep I have a current liability Insurance policy or it's substantial equivalent. Yes No13 If you have checked yes, pl a ndicate the type coverage by checking the appropriate bo 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 13 Agent 0 I hereby certify that all of the details and information I have suDnuttea (or enterea) in aDove appucanon are true ana accurate to the best of my knowledge and that all plumbing work and installations pe/formed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts, at a �e-a pter 142 of the General Laws. tie ty/Town VED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber % z Gas Fitter License Number Master Journeyman Date. <1. . . _ L 5 - ".0 �T TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ... ... ........... f . .................. has permission to perform C- Lc: c :�. C�iq plumbing in the buildings of .. u `=' " r .� 1. at ............. North Andover, Mass. v Fee. 3 ! '"..- . Lic. No../!. . T ........ ?-'-c�~° ,,, ...... PLUMBING INSPECTOR Check # 6779 14 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANI,)CIVFR MAccA(-inter-rre Ali -Ir nt or type) Check one: Certificate 1talling Company Name 40 E3 Corp. AddressOL� Partner. Busmess a hnne p Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate t e type of insurance coverage y checking the appropriate b 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 threeinsurance Signature Owner 1:1 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 perfo ed n r Permit Issued for this application will be in compliance with all pertinent provisions of the Massachetts State nd Ch pter 142 of the General Laws. By: rgna o cense u er Title e of Plumbing License City/Town rens um er APPROVED 01 Master Journeyman ❑ (OFFICE USE ONLY r R. H. WOLF PL11MBI.NO d HEATING INVOICE NUMBER: 19RI00 BY INVOICE DATE: 8 -DRC -04 P. O. BOX # 2229 SALEM, N.R. 03079 RANDOLD11 R WOLF TEL: 603-898-6505 MA. MASTER PLUMBER # 12299 FAX:SAME CALL AHEAD NET. 10 DAYS THANK YOU 'TO'N'AL BILLING: $9.3700 Invoice Date. X, .//-- elo 40RTH 0 0 TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION t 49 ACWJ�CHU5c K. This certifies that .... Clk. C-. t 4 . .................. has permission for gas installation ..... ............... in the buildings of ... ..................... at f . . . . . . . . . . . . . . . . . North Andover, Mass. Fee ... 3 Lic. No./ .. ........... . . I -INSPECTOR Check # 5407 1VIASSACHUSEIIS UNIFORM AFFUCA'PON FOR PERM TO DO GAS FTrnNG (Type or print) Date NORTH ANDOVER, MASSACHUSETTS a Building Locations e - v Permit # Amount $ Abo;d f � i �,P � � _Owner's Name New ❑ Renovation ❑ Replacement Plans Submitted ❑ (Print or type) Name Name of Licensed Plumber or Gas Fitter C one: Certificate Installing Company Corp. ❑ Partner. ❑Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes No❑ If you have checked yes, plplain ndicate the type coverage by checking the appropriate bopi Liability insurance policy Other type of indemnity ❑ Bond 13Owner's Insurance Waiver: 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 Ga c e ndCha r 142 of the General Laws. ,- tie (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber 2 Gas Fitter License Number Master Journeyman IST. FLOOR (Print or type) Name Name of Licensed Plumber or Gas Fitter C one: Certificate Installing Company Corp. ❑ Partner. ❑Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes No❑ If you have checked yes, plplain ndicate the type coverage by checking the appropriate bopi Liability insurance policy Other type of indemnity ❑ Bond 13Owner's Insurance Waiver: 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 Ga c e ndCha r 142 of the General Laws. ,- tie (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber 2 Gas Fitter License Number Master Journeyman ?. N WOLF PLUMBIN ar d HEA Tll 6 INVOICE NUMBER: WR106 INVOICE DAM 5 -MAR -05 P. 0. BOX # 2229 SALEM, N.H. 08079 RANDOLPH fl. MOLE* TEL: 608-898-6505 SIA. MASTER PLUMBER f 12299 PAX:SAME CALL AHEAD CUSTOMER: WOODRIDGE HOMES CO-OP TELEPHONE: ADDRESS: 10 WOODRIDGE DR. FAX: arf, STATE, POSTAL CODE: NO. ANDOVER, MA. 01845 PO NUMBER: 14 BRIER ORDER DATE GARY: ' DATE RANDY O(f x$0.00 `-M-05 160.00 RANDY 0.00 $0.00 o.00 $$0.00 TOTAL ACTIVftY COST:M�RIAIS 60 00 ' UNITi POKE . RRhIOVE.OIA RA19BE 0.00 INSTAL I. NEW 0.00 b RECEIVED 0.00 0.00 MAR = 8 2005 0.00 0.00 0.00 0.00 0.00 0.00 TOTAL MATERIALS COST: $0.00": NET. 10 DAYS THANK YOU TOTAL BILLING: $160.00 Invoice � pORT1� s Date. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ... f .................... has permission to perform ..... 5. . . plumbing in the buildings of ..`'U. 0.0.. �a.f. �.� �- ............. at ... l4�.'.............. North Andover, Mass. Fee.? 2. "'� . Lic. No.. .Z Z S. $ ..... f..` -�--spy.-..�..... . `PLUMBING INSPECTOR Check # 6769 .. 41' MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Loc G -- Owners N of Date ant Permi t# (p 7 C,9 Amount 13-0�3! New Renovation Replacement j{j Plans Submitted Yes ❑ No FIATURES W1 --------------- / 79 -------------------------. �1M -.--"-------------------- . 1 cP ------------------------- ,..1 s ' --m---------------------- W&II:80re-11MMMMMMMM-----MM---.------- W I 1 1 ' WMMMMMMWWWMWMMM MMW -� I ' ------------------------- M;ii;vgFo-#.,.-MmmmmmMMMMMMMMMMMMMMMMMMM- (Print or type) Check one: Certificate Installing Company Name ❑ Corp. Address Partner. Business a ep one �a ' o a Firm/Co. v Name of Licensed Plumber: Insurance Coverage: Indic e t e type of m,. ranee coverage by c ecking the appiopm a box: Liability insurance policyvi Other type of indemnity ❑ Bond D Insurance Waiver: I, the unersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner 0 Agent E] 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 perform nd r Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State P miapter 142 of the General Laws. By: igna ureIC se um er �� Type f Plumbing License Title City/TowniL'cense um a MasterJourneyman 1. APPROVED (OFFICE USE ONLY 0 R. fl. HfOLF PLUMBl1 G d HEA INVOICE NUMBER: R1 18 INVOICE DATE: 16-AU6-06 P. O. BOX # 2229 SALEM, N.U. 03079 RANDOLPH H. WOE' TEL: 603-896-6505 SIA. MASTER PLUNDER # 12299 FAX:SAME CALL AHEAD CUSTOMER:'YOODRID6E DOMES CO-OP TELEPHONE: ADDRESS. 10 WOODRIDGE DR. RAX: crrY, STATE, POSTAL com NO. ANDOVER, MA. 01$45 PO NUMBER: ORDER DATE. GARY: 10 BRIER END DATE DY 6'00 $9000 16 -AUG -O5 r s 0:00 0.00 $0.00 ` TOTAL ACTIYITY COST: _.._._. _.. _ .. $$40 C NET. 10 DAYS THANK YOU TOTAL BILLING: $592.72 Invoice �. 1) 2 PVC P -TRAP REPLACE SHOWER 1 ST FL. 0.00 1) 2X.1-1 /2 PVC TlWYE REPIPE DRAIN FOR SHOWER 0.00 1) 1-1/2 IVC ST 22 AND FOR INDIRECT WASTE 0.00 3) 1-1/2 PVC 45 REPIPE VENT FOR DRAIN 0.00 4) 2 PVC 90 612 IVC PIPE REPIPE WATER AND CENTER 0.00 4) 1/2C 90 SHOWER VALVE 0.00 2) 1/2C COUP 0.00 4E) 1/2C MIL HANGER 0.00 1) 1/2CE DROP 90 0.00 2) 2 NII COUP S.S. 0.00 10`) 1/2C TUBE "L" TOTAL MATERIALS COST: _ `' .. $5241Z NET. 10 DAYS THANK YOU TOTAL BILLING: $592.72 Invoice R. H. WOLF P.LU1 BNG d NEA77NG P. 0. BOX # 2229 SALEM, N.B. 03079 TEL: 603-$9$-6505 FAX:SAME CALL AHEAD INVOICE NUMBER: INVOICE DATE: RANDOLPH H WOLF NA. MASTER PLUMBER # 12299 wR i 1 o' 27-JUL-05 CUSTOMER: WOODRIDGE HOMES CO-OP TELEPHONE: ADDRESS: 10 WOODIRID6E DR. FAX: Cml, STATE, POSTAL CODE: NO. ANDOVER, MA. 01$45 PO NUMBER: 10 BRIER ORDER DATE GARY: START / END DATE R1�N13ir 1.50 $90.00 27=JUL-05 135.00 0.00 $0.00 I TOTAL ACTW" COST: $135:00 �. NONE STARTED WORK ON SHOWER 0.00 INSTALLATION 0.00 WORK STOPPED BECAUSE OF 0.00 MOLD 0.00 0.00 0.00 0.00 0.00 0.00 0.00 TOTAL MATERIALS COST: $b.00' NET. 10 DAYS THANK YOU TOTAL BILLING: $135:00 Invoice rP fl Date 41. z .......... TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION �9SS^CMUSESl This certifies that .... 1-.4. h. ................... has permission for gas installation R /v....: -:c.. • ... . in the buildings of .................. at 4/2 i. North Andover, Mass. Fee..34 ..... Lic. No../., -.t. 9. F.. ..... 1; ..... INSPECTOR Check 5399 MASSACHUSETIS UNHDRNI APFUCATON FOR PERNIIT TO DO GAS F rnNG (Type or print) NORTH ANDOVER, MASSACHUSETTS (� q Building Locations Owner's Name New El❑ Renovation Replacement Date G z Plans Submitted 0 Permit # ,S 3 `t 9 Amount .$ 32— Plans 2— (Print or Name— Name ame_ V1 Name of Licensed Plumber or Gas Fitter one: Certificate Installing Company Corp. Partner. Firm/Co INSURANCE COVERAGE Check ne I have a current liability Insurance policy or it's substantial equivalent. Yes No❑ If you have checked yes, plea e iicate the type coverage by checking the appropriate bo Liability insurance policy Other type of indemnity ❑ Bond 13Owner's Insurance Waiver: 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;12C�7dean Permit Issued for this application will be in compliance with all pertinent provisions of the Massachuset hapter 142 of the General Laws. ty/Town (OFFICE USE ONLY) Signature of Licensed Plumber Or G Fitter Plumber Gas Fitter r7conse Nurnrer Joumeyman .. R FLOOR (Print or Name— Name ame_ V1 Name of Licensed Plumber or Gas Fitter one: Certificate Installing Company Corp. Partner. Firm/Co INSURANCE COVERAGE Check ne I have a current liability Insurance policy or it's substantial equivalent. Yes No❑ If you have checked yes, plea e iicate the type coverage by checking the appropriate bo Liability insurance policy Other type of indemnity ❑ Bond 13Owner's Insurance Waiver: 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;12C�7dean Permit Issued for this application will be in compliance with all pertinent provisions of the Massachuset hapter 142 of the General Laws. ty/Town (OFFICE USE ONLY) Signature of Licensed Plumber Or G Fitter Plumber Gas Fitter r7conse Nurnrer Joumeyman i R. ff. WOLF EkMOM do HEA TMG INVOICE NUMBER: 'WR 134 INVOICE DATE: 27 -SEP -05 P. 0. BOX # 2229 SALEM, N.B. 03079 RAWOOLPH H. WOLF FrO TEL: 603-898-6505 AIA. MASTER PLUMBER # 122 PAX:SAME CALL AHEAD 3 2005 CUSTOMER: WOODRIDGE HOMES CO-OP TELEPII ADDRESS: 10 WOODRIDGE DR. FAX: crrY, STATE. POSTAL CODE: NO. ANDOVER, MA. 01845 PO NUMBER: I D BRIER ORDER DATE GARY: PLUMBER IIELPER START / 1 DATE AMOUNT ICY 0.00 $0.00 -TOTAL ACTIVITY COST - - 95.:00-- ,. 1) I /2KCL BLK HIP� REPLACE Cia4S STO-VE 1.50 a 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 TOTAL MATERIALS COST: $x:50.:. NET. 10 DAYS THANK YOU TOTAL BILLING: $96,50 Invoice Date././.f`l.�t. . -.A TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING This certifies that ..... .... /�.� . .................. has permission to perform .... ............. plumbing in the buildings of ............ . at ../. P ..W0..&.J..P.. ! r%c... A �........... North Andover, Mass. Fee. Z 2� Lic. No../?'x..S. S. ....../-!�-...... . PLUMBING INSPECTOR Check # 6770 ;,j it MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, Building Location New Renovation 13 Replacement r FIXTT TR F_C Plans Submitted Yes ❑ No ❑ (Print or type) t Installing Company Name Address Name of Licensed Plumber: Insurance Coverage: Indies Liability insurance policy Check one: Certificate ❑ Corp. Partner. Firm/Co. 107 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 Signature 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 per under Permit Issued for this application will be in compliance with all pertinent provisions of the Massae usetts St de and Cha ter 142 of the General Laws. By: ipre o tcense um er 7ype of Plumbing License Title City/Town 49 )cense um er Master Journeyman ❑ APPROVED (OFFICE USE ONLY ,.i I', 0. Box # 2229 SALEM, N.H. 03059 TEL: 603-896-6505 FAX:SAME CALL AHEAD INVOICE NUMBER: INVOICE DATE: RDULPH H. WOLF MA. HAS TER PL UMBER # 12299 lffftl 17 25-JUL-05 CUSTOMER: WOODRIDBE HOMES CO-OP TELEPHONE: ADDRESS: 10'WOODRIDGE DR. FAX: CITY, STATE, POSTAL com NO. ANDOVER, Mei. 01$45 $O NUMBER: 10 WOODRID6E ORDER DATE GARY: POOL AREA 'rSTART ENDD RANDY 1.50 $90.00 25-JUL-05 135.00 0.00 $0.00 9 )nnc Invoice TOTAL ACTIVITY COST: $135.00 �. 1) :r/9C ST 9® REPLACE SILLCOCK U9 PO01t v AREA 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 TOTAL MATEMALS COST-- OST:NET. NET.10 DAYS THANK. YOU TOTAL BILLING: $135.65 Invoice t tF HoarM _„ off,....'° '•��'< Date. C TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING / This certifies that ..... �.� j l .3...- .................. has permission to perform ...... .�t ............. plumbing in the buildings of .. LAI. �'.° .�.!�..i �.`............... at .....`'?..!..5 `.'• .. ........... , North Andover, Mass. Fee. 3.t '"'�.. Lic. No.. �....... ...... ..1 --� .-�-�_...... . PLUMBING INSPECTOR Check # 6772 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER. MASSACT4TT.4FTT.c W New Renovation Replacement eg Plans Submitted Yes ❑ No ❑ FIXTURES . i iFI ------------------------- • i i ' 5 t ------------------------- , ----------------------.-- MMMMMM MM M t „ i■nnn�nn��n�■���n��■�n���MM t ,, MMMMMW■ MMMMMMMW MMM === i„lMMMMMOMMMMMMMMMMMMM����M� snnn��nnnnnnn�nnnnn���n��� -(Print or type) Check one: Certificate Installing Company Name k / / l o � corp. Address iD % / ��7"/` ewe Partner. LU 7 Business Telephone Firm/Co. 7 0— Name of Licensed Plumber: Insurance Coverage: Indicate t type of insu ante coverage by/checking t=e�� appropriate bo Liability insurance policy Other type of indemnity Bond 0 Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above threeinsurance Signature IOwner ❑ 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 per d nder Permit Issued for this application will be in compliance with all pertinent provisions of the Massachu etts Stat 1 ode and Chapter 142 of the General Laws. By: ignae oicense um er Title f Plumbing License City/Town tense u e Master Journeyman APPROVED (OFFICE USE ONLY 8. H WOLF PL U. BLffG & HEA TTNB INVOICE NUMBER: WRI13 INVOICE DATE: 12-JUL-05 P. 0. BOX # 2229 SALEM, N.H. 03079 RANDOLPH H. WOLF TEL: 603-898-6505 MA. MASTER PLUMBER # 12299 FAX:SAME CALL AHEAD CUSTOMER: 'WOODRIDGE HOMES CO-OP TELEPHONE: ADDRESS: 10'WOODRIDGE DR. PAX: CITY, STATE, POSTAL com NO. ANDOVER, MA. 01845 PO NUMBER: 29 GIRSON CT ORDER DATE GARY: .. , .� 1 ) ANDY 5:50 $90:00 12-JUL-05: 495.00 0.00 $0.00 TOTAL ACTIVITY COST: _.__. $495:00_... fl 1UNI 1). T4E TIPPER WASTE 17 GA. BRASS REMOVE/INSTALL TUB 65.00 3) 1/2 C 90 DRAIN/ SHOWER VALVE 1.05 2) 1/2 CXMA 2.00 2) 1/2 C COUP 1.00 1) 1 /2CXPE DROP 90 3.25 10`) 1/2 COP TUBE L 10.00 4) 1/2C MIL HANGER 6.00 3) 1/2C CLIP 0.45 0.00 0.00 TOTAL MATERIALS COST: $88:75 NET. 10 DAYS THANK YOU Invoice TOTAL BILLING: $583.75 Date .. "pR,„_ p� ,..° 1ti0 TOWN OF NORTH ANDOVER 40 PERMIT FOR PLUMBING .. S�ACHUS� This certifies that ..... ................. has permission to perform ... . !''' !. ...0 . /w plumbing in the buildings of ..l.S- .v. v,.�. c f :ti ............... at ... �3..i.. r . .� �- ............... . North Andover, Mass. �-F Fee . �. �..... Lic. No../ ). t. S c ........ PLUMBING INSPECTOR Check # e- ..'6775 i MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location ' %A) -d cl New Renovation 0 Owners Na of Occu J, rl rad�kk Date B f (� Permit #Z Amount--4Z0' Replacement 19 UTVTT Tnr. O Plans Submitted Yes 0 No ❑ (Print or type) /' Check one: Certificate Installing Company Name Q L. v ❑ Corp. Address Partner. usrn Oelephone Firm/Co. n Name of Licensed Plumber: Insurance Coverage: Indicate the type of in. urance coverag y checking the appropriate bo Liability insurance policy iff 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 Signature IOwner El Agent El 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 pe rme under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts Stat d Chapter 142 of the General Laws. By: rgn re of Licenseaum er Title Type of Plumbing License City/Town 41cense um er Master Journeyman APPROVED (OFFICE USE ONLY t` 1 ----------------MM MM--' mmmmmmm MM mmi Z mmmmm MM mmmmmmm�����n�mm es' mmmmmmmmmmmmmmmMM■�������e� i MM t ..MMMMMMMMMMMMMMM MMMMMM=MMMMMMMM MM���i MMMMMMMMMMMMMMMM MM W, I zMMMMMMMMMMMMMMM mmmm OM1 ,,., MMMMMMOMMMMMMMMMM�MMMMOMM, (Print or type) /' Check one: Certificate Installing Company Name Q L. v ❑ Corp. Address Partner. usrn Oelephone Firm/Co. n Name of Licensed Plumber: Insurance Coverage: Indicate the type of in. urance coverag y checking the appropriate bo Liability insurance policy iff 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 Signature IOwner El Agent El 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 pe rme under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts Stat d Chapter 142 of the General Laws. By: rgn re of Licenseaum er Title Type of Plumbing License City/Town 41cense um er Master Journeyman APPROVED (OFFICE USE ONLY R. H WOLF PL UMBMG d HEA TMG P. 0. BOX # 2229 SALEM, N.H. 03079 TEL: 603-$98-6505 FAX:SAME CALL AHEAD INVOICE NUMBER: INVOICE DATE: RANDOLPH H WOLF NA. MASTER PLUNDER # 12299 CUSTOMER: WOODRIDGE HOMES CO -0P TELEPHONE: ADDRESS: 10 WOODRIDGE DR. FAX: -�QR CrrY. STATE, POSTAL CODE: NO. ANDOVER, Mak. 01$45 PO NUMBER: ORDER DATE GARY: EMERGENCY PLUMBER' i 1 DATEi NDY 1.00 -JAN-VS RANDY 1.00 $$0.00 24 -JAN -05 $0.00 :0.00 $32.50 RECEIVE WR 1 05 2 1 -JAN -05 " GIBSON 0.00 $$0.00 A JAN 2 7 2005 NET. 10 DAYS ' THANK YOU TOTAL BILLING: $90E 70 Invoice Da //�I ,ORT" TOWN OF NORTH ANDOVER 0 PERMIT FOR PLUMBING This certifies that .... {. U. ( . -/7 �- j ...................... has permission to perform ........................ i. plumbing in the buildingsiof ...W. ............... at ... 2.).... e-. .......... North Andover, Mass. Fee.. Lic. No.. /.Z f � ....... 1. 11 ........ UMBING INSPECTOR Check # 6762 C ,' 14 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location Renovation FIXTIIRFC Dat v 4D Permit # 7 Amount p, Plans Submitted Yes 11 F (Print ortype)ype) 4 1 Check one: Certificate Installin CompanyName O b Corp. i Addres ,� Partner. a 7 Business a ep one 42 3 1:1 Firm/Co. 0 1 n. Name of Licensed Plumber: j / ,A N 9 ( D LA )N L4 9O ( _1%_f Insurance Coverage: Indicate the ype of insuran 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 Signature IOwner 11 I hereby certify that all of the details and information I have submitted best of my knowledge and that all plumbing work and installations per e compliance with all pertinent provisions of the Massachusetts S e By: Signa ye 1-1censeaTit Agent ❑ entered) in above application are true and accurate to the iedp r Permit Issued for this application will be in 4 Code d Chaps! ^^ Ise r' neral Laws. .r.' ype of Plumbing License �tle City/Iown i nse um er Master /� Journeyman ❑ APPROVED (OFFICE USE ONLY�J Invoice J. H. WOLF PLU R 6 4 HEA TLNG M11010E NUMBER. NVO10E RATE - P O ,SOX # 2229 SALEM, N.H. 03079 "N, VOL PWOLF TEL: 603-234-_9931 AM MASTER Pl.WIREIT if 12299 WR132 CUSTOMER: WOODRIDO£ HOMES CO-OP TELEPHONE: ADDRESS: 10 WOODRIDGE DR. FAX.- C17Y, STATE. POSTAL CODF-- NO. ANDOVER, HA. 01,645 PO NUMBER., 25 OIBSON CT. ORDER Dai TE BrORK REQUESTED BY GARY - 5 i RANDY 0.00 $0.00 22 -SEP -05 395.00 0.00 $0.00 0.00 $0.00 0.00 $0.00 PFI? UNIT HEATER NYWIR 40 CAL. 1) 314CXM A 2) 314XC FA $2.50 EA. 2) 314C 90 2) 314X3-112 ORS NIP $3.75 EA. 29 314 COP TUSAE ..L .. $ 1.50 PEAR 3) SLK NIP 21314C SLIP COUP 21314 CST 45 MET. IODAYS THANK YOU TOTAL A CTI YFFY COST. - REPLACE WATER HEA TER 5.00 1.40 7,50 3.00 3.15 1.10 0.00 0.00 TOTAL AIA TERIALS COST` Invoice TOTAL BILL M& $347.40 � s. ... .t .�.�rar--'fir. ^ ..-� �-^.•^" ' .,.:.. K ' _ ..:K� ,1.1n[...:,,ep.�I.'l.r. ' Date. . �f� ...... . f F NORTH TOWN OF NORTH ANDOVER �;- f{ PERMIT FOR GAS INSTALLATION This certifies that ... W.6 .I .0 .. ct ...................... has permission for gas installation .-!.t"(` .................. in the buildings of ...w. o G. �- .r. �. � .!•� ..................... at North Andover, Mass. Fee. Lic. No.) 21.E 5 ..... 1.t .... . i AS INSPECTOR Check # 5400 MASSACHUSE M UNIFORM APPLdCATON FOR PERAW TO DO GAS FrMNG (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Locations -< J % w v v" /Y) >�Y _(',�0 �„ Owner's Name New Renovation Replacement Plans Submitted 11 Permit #Lid= Amount .$ il0 (Print or tyP"V� , 1�� A � C� one:Certificate Installing Compaury Name 1 ,9 17]� V E A Corp. Address�0 Partner. Business Teleptione 1 VI Fi o. Name of Licensed Plumber or Gas Fitter ` L T INSURANCE COVERAGE• ChecVon I have a current liability Insurance policy or it's substantial equivalent. Yes NoO If you have checked Yes, please i9dicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity 1:3 Bond 0 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 13 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 pe ed der Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts St�%"".. hapter 142 of the General Laws. tie ty/Town VED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas F•tter PlumberZ Gas Fitter tc nse um er Master Journeyman I a; ME; m 2 FLOOR -ND. (Print or tyP"V� , 1�� A � C� one:Certificate Installing Compaury Name 1 ,9 17]� V E A Corp. Address�0 Partner. Business Teleptione 1 VI Fi o. Name of Licensed Plumber or Gas Fitter ` L T INSURANCE COVERAGE• ChecVon I have a current liability Insurance policy or it's substantial equivalent. Yes NoO If you have checked Yes, please i9dicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity 1:3 Bond 0 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 13 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 pe ed der Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts St�%"".. hapter 142 of the General Laws. tie ty/Town VED (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas F•tter PlumberZ Gas Fitter tc nse um er Master Journeyman h Date.-/ 041Ae. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that .... � !. .... /.? !.5 has permission to perform .... r?�. �.�. i ..�/! /............. . plumbing in the buildings of ... L-4--.c�.� . 1?.. A.: - P . ............. . ^} at .... 16 .... --/ ............... North Andover, Mass. Fee. .3 Z:.. Lic. No. /. I J� S. S . .. ✓-,...... . .j. PLUMBING INSPECTOR Check # 6780 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS 14 Building Locatio `� Date Owners Name ®(% D Permit # Amount ffA7 r l d T pe of Occupancy New Renovation Replacement Plans Submitted Yes ❑ No ❑ FTYTT TR F C (Print or type) / Check one: Certificate Installing Company Name J0Z❑ Corp. Address 1:1 Partner. Busme a ep one Firm/Co. Lai Name of Licensed Plumber: Insurance Coverage: Indicate the type o i—fl—nce covers by checkine the appropriate b(/x: Liability insurance policy M Other type of indemnity13Bond1p D 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 Signature Owner ❑ Agent 11 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 per d rider Permit Issued for this application will be in compliance with all pertinent provisions of the Massach �etts Sta e a Chapter 142 of the General Laws. By: igna o icensea riumuer Title T e of Plumbing License City/Town i ense um Master Journeyman APPROVED (OFFICE USE ONLY V� R. f IfOLF PLUNBLIV6 d HEATfNO P. 0. BOX # 2229 SALEM, N.N. 03079 TEL: 603-$9$-6505 I"AX:SAME CALL AHEAD INVOICE NUMBER: INVOICE DATE: R 1?OLPH H. WOLF AIS. HAS TER PLUNDER # 12299 k 11 s 13-JUL-05 CUSTOMER: WOODRIDO£ HOMES CO-OP TELEPHONE: ADDRESS: 10 WOODRIDGE DR. FAX: cmt, STATE, POSTAL coD£: NO. ANDOVER, MA. 0184 5 PO NUMBER: 16 FIELDSTONE ORDER DATE GARY: PLUMBER •START / END DATE :._.... RANDY 1:00 $90.00 13 JULY os 90.00 0.00 $0.00 A • TOTAL ACTIVITY COST: $9A.00 • i 1).1/2C DIM COUP REPAIR PIPING TO OUTSIDE 2.50 SILLCOCK 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 TOTAL MATERIALS COST: $1x.50 NET. 10 DAYS TRANK YOU TOTAL BILLING: $92.50 Invoice Date. . A. e ...... T Of j 0 TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ...... (A.-. 0 J. t /.. 1.5 ................. - has permission for gas installation .... ............. A, in the buildings of ....W.. W.Q. � .f;? t. A 15.. .................. at ............ North Andover, Mass. Fee... 3.2- Lic. No../.l. L. 5 Y. . . . . . - . . GRAS INSPECTOR Check # 54U3 N ASSACHUSI+JM UNIFORNI APRICATON FOR PERNIlT TO DO GAS MING (Type or print) Date NORTH ANDOVER, MASSACHUSETTS Building Locations , C -q- - 1"),9a71j6ArP 4ei,,10Permit # �Yo, Amount $ 'L1 4f—, Owner's Name New El Renovation Replacement Plans Submitted ❑ • • • (Print or type) Name Address Name of Licensed Plumber or Gas Fitter C one: Certificate Installing Company 0 Corp. Partner. E] Firm/Co. INSURANCE COVERAGE• Check n I have a current liability Insurance policy or it's substantial equivalent. Yes NoO If you have checked yes, ple a 'ndicate the type coverage by checking the appropriate bo . Liability insurance policy Other type of indemnity Bond 0 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 13 Agent 0 t 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 [��ehrtli Chanter 142 of the General Laws. tie ty/Town VED (OFFICE USE ONLY) , ignature of Licensed Plumber Or Gas Fitter Plumber / ;4 Z-- :2 S Gas Fitter tMMulummner Master Journeyman R {L WOLF EL UMBI1VG d HEAT ZNG INVOICE NUMBER: WR 12 2 INVDIC£ DATE:��-AgUB-OS P. o. BOX # ��29 SALEM, N.U. 03079 RANDOLPH f WOLF TEL: 603-89$-6505 MA. MASTER PLUMBER # 122Y3 FAX:SAaM£ CALL AHEAD CUSTOMER: WOODRIDCE HOMES c0 -OP TELEPHONE: ADDRESS: 10 WOODRIDOE DI,. FAX: CrrY, STATE, POSTAL com NO. ANDOVER,MA. 01$45 PO NUMBER: 17 FIELDSTONE ORDER DATE GARY: IIELP ER START END DATE kNDYAMOUNT . ..,:. 1:00 $90:00 ' 7 ` :2 �=�UC-05 0.00 $0.00 90.00 TOTAL ACTIV" COST. $90.00 jqSFS PER UNIT� �• NONE REMOVE / INSTALL 0AS AMOUNT ' o 0.00..: RANGE 0.00 . 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 TOTAL MATERIALS COST: N£T. 10 DAYS THANK YOU TOTAL 16IIsLIIYG: $90.00 Invoice x Date. a "°RTM TOWN OF NORTH ANDOVER { PERMIT FOR PLUMBING • o�+ ` a ' S�ACMU51 This certifies that ....1.� ,L/ != %? j .................... ti has permission to perform ....L'! _.6W, �.•................... . a[ plumbing in the buildings of ... ....... .............. at ...)., .. �= . ............ v1 .. ....... , North Andover, Mass. Fee. 3A ..... Lic. . ....... i :.. � ...... ` /PLUMBING INSPECTOR Check # e`, 6761 4-' MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date/2'�� Building Location Owners Name �ilJ a tiCI Permit # r Amount g Lam% / Type of Occupant New 0 Renovation Replacement Plans Submitted Yes ❑ No ❑ VTY TRFC (Print or type) r/001L Check one: Certificate Installing Company Name ❑ Corp. �i Address 1 Partner. r4 -7� Business Telephdne 19 372 e Firm/Co. Name of Licensed Plumber: 19 Insurance Coverage: Indic to t�tyype surance 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 Signature IOwner 11 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 p •formed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massa husetts Sta and Cha ter 142 of the General Laws. By: 1 1 re o Llcenseci r1untur-1 Title ype of Plu in License City/Town11 m a Master Journeyman ❑ APPROVED (OFFICE USE ONLY isnseu /�' v R. A WOLF PL11MBNG 8 MEA TMG INVOICE NUMBER: 10.131 INVOICE DATE: 21 -SEP -05 P. O. BOX # 2229 SALEM, N. I. 03079 TEL: 603-898-6505 FAX:SAM£ CALL AHEAD R NDOLP11 H. WOLF MA. MASTER PL U MBEIT # 12299 CUSTOMER: WOODRIDGE HOMES co-op TELEPHONE: ADDRESS- 10 WOODRIDGE DR. FAX: CITY, STATE, POSTAL CODs: NO. ANDOVER, MA. 01$45 PO NUMBER: 5 EMERSON CT ORDER DATE GARY: STARTDATE1 RA14DY 2.00 $95.00 21 -SEP -05 � . 190.00 0.00 $0.00 TOTAL ACTIVITY CosT:. - _.. $190.00-- 2) 1/2C 90 INSTALL SIDLE LEVER 0.75 11} 1/2C TUBE WASHING MACHINE MIXLN6- 1.00 VALVE 0.00 0.00 0.00 0.00 0.00 0.00 0.00 0.00 TOTAL MATERIALS COST: NET. 10 DAYS THANK YOU TOTAL Bl" -G: $191,15 Invoice k. Date. . �. ".0�T :�tio TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ...... ` ........... has permission to perform .... .'� . . .. . S plumbing in the buildings of ..:1�.G .� �� f F at ... ' ..."�? c ....... ........ ,North Andover, Mass. Fee. 3 .�..... Lic. No./?-. L.l..r LUMBING INSPECTOR Check # 6766 �e MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location + Owners Name' Y� �Aye DatePern # ? ` Type of Occupancy Amount Z New Renovation Replacement Plans Submitted Yes No ❑ FTXTT TR F.0 (Print or type) Installing Company Name Agdress Check one: Certificate ❑ Corp. Partner. Firm/Co. Name of Licensed Plumber: e ' ( / Insurance Coverage: Indicate type of insurane 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 Signature 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 p o d under Permit Issued for this application will be in compliance with all pertinent provisions of the Mass chusetts St e and Cha ter 142 of the General Laws. By: i ure o censeMUMS— 'Tr Title ype of Plumbing License fP City/Town i ense um er Master � Journeyman 11APPROVED (OFFICE USE ONLY R H WOLF PL UMBM6 d HEA TMG INVOICE NUMBEft: lffftl 27 INVOICE DATE: 12 -SEP -05 P. 0. BOX # 2229 SALEM, N.H. 03079 TEL: 603-696-6505 FAX:SAME CALL AHEAD RANDOLPH H. JAOLF MA. MASTER PL UMBER # 12299 CUSTOMER: WOODRIDGE HOMES CO-OP TELEPHONE: ADDRESS. 10 WOODRIDGE DR. FAX: CITY, STATE, POSTAL CODE: NO. ANDOVER, MA. 01$45 PO NUMBER: 1 D DEVON ORDER DATE GARY: START / END DATE RANDY 3.00 $95 . .00 19 -SEP -05 285.00 0.00 $0.00 TOTAL ACTIVITY iaOST.- IlIIplljll�llll J11!111111111�1 MATERIALS OTHFIZ FX,PFNSFS PER UNIT11 1)1/2CMA INSTALL TUB/SHOWER 1.00 2) 1/2 C go VALVE 1.00 2) 119C MIL HANGER FOR NEW TUB 3.00 2') 1 /2)COP TUBE 2.00 1) 1/2C SLIP COUP 0:50 0.00 0.00 0.00 0.00 0.00 TOTAL MATERIALS COST: NET. 10 DAYS THANK YOU TOTAL BUJING: Invoice Aw TOWN OF NORTH ANDOVER 10 S PERMIT FOR PLUMBING 40 This certifies that ... H .� ............... . has permission to perform_ ..... .................... /i plumbing in the buildings C at...... ............. , North Andover, Mass. Feee. Lic. No... . . (.. ........... . PLUM W NSPECTOR Check # %zd MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS I ?� Date � ►-� �O Building Location L/ `!'jt/ Owners Name �� � �i� !/�'1il ps Permit #ro If� p Q/)m I n G � r r0 Type of Occupancy Amount New 0 Renovation Replacemenq Plans Submitted Yes ❑ No ❑ (Print or type) n , ( Check one: Certificate Installing Company Name w (� (�j/% ❑ Corp. Address 1 W S 4-- Partner. tEWN, Business Telephone v -z 3- v — Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicata.1be type of insurarVe coverage by checking the appropriate box: Liability insurance policy Other type of indemnityElBond 11 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 signature Owner ❑ Agent 0 I hereby certify that all of the details and information I hav41atio 'd (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and instrf I id under PermitIssued for this application will be in compliance with all pertinent provisions of the Massachusing Co an f the General Laws. By: 71 A ign re 1cense u er ype of PlumbiL ense Title 12 .' City/Town ricer Master um e Master Journeyman ❑ 11 APPROVED (OFFICE USE ONLY `219 i'. r W1.13-1711MM..--..-..-W------.-. .`D mmmmmmmmmmmmmmmmmmm MM WSROWUMMMMOMMMOMMMMMM FEW M MM i 1 o $:' ..m-.-.--..-.-M-.---®U="-'"0"TEzMMMMMMMMMMWWMMMWMMN --- No W111.'181rI-V=MNMNMMMMMMMM mmmm MM MM 1 ' MM NNW 149 1 a Irf-'s.' MOMMOOMMMMM MMMMMM NNW -.-..---.M----.------NNIM (Print or type) n , ( Check one: Certificate Installing Company Name w (� (�j/% ❑ Corp. Address 1 W S 4-- Partner. tEWN, Business Telephone v -z 3- v — Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicata.1be type of insurarVe coverage by checking the appropriate box: Liability insurance policy Other type of indemnityElBond 11 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 signature Owner ❑ Agent 0 I hereby certify that all of the details and information I hav41atio 'd (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and instrf I id under PermitIssued for this application will be in compliance with all pertinent provisions of the Massachusing Co an f the General Laws. By: 71 A ign re 1cense u er ype of PlumbiL ense Title 12 .' City/Town ricer Master um e Master Journeyman ❑ 11 APPROVED (OFFICE USE ONLY `219 t Date . / Z!� `I .' ......... 3= �` TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION s a 9 y1 CH This certifies that ...tv4 -: fir./, �.� �.. `�...................... has permission for gas installation ...,, . , . , , , in the buildings of ... (r. at North Andover, Mass. FeeLic. No.. ` .0 ..... .... . .�...... -cr .. .... . GAS INSPECTOR Check # /6/ , 5.370 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print at Type) .Mass. Date LZ— � �f 1g G� a Permit st��o - Building Location __ �1�� I �% Owner's NameyAl . Re; 4'T'De.✓ LL � � L !4ao��s�v� Gt tom[ Type of Occupancy 3p� 6 New ®/ Renovation ❑ Replacement ❑ Plans Submitted: Yes No r7 stalling Company Name Youngblood Co., Inc. Check one: Certificate Jdress 32 Ashland Street Corporation Haverhill, MA 01830-4143 ❑. Partnership lsiness Telephone 978-373-5607 [] Firm/Co. 3me of Licensed Plumber or Gas Fitter David Youngblood SURANCE OVERAGE: lave a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. Yes LK No ❑ you have checked ves, please Indicate the --type coverage by checking the appropriate box. 6iability insurance policy LXX Other type of indemnity ❑ Bond ❑ - 142. NNER-S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by %apter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: nature at Owner or OwnersOwner❑ Agent C]Agent reby certify that all at the details and information I have submitted (or entered) in above application are true and accurate to the best of my :wtedge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all anent provisions of the Massachusetts Slate.Gas Code and Ctaoter 142 at the General Law . TMe of Ucense: Plumber S,gnature of cense- P r as r=ttter 9'Gastitter J -Master Ucense Number gown �= Soumeyman h H c W N N Q r Ul Uj C7 J W W < m ut 1- ¢ a Q - W < y Q Q c 1- N LU W = (� W K lY < [L Q 41 C7 < W}W. N Q tL < W ? u. 4 < O O lil a 4 LL a U c > p Fes- sue-asMT. BASEMENT 1STFLOOR I i I ZN0 FLOOR 3RD FLOOR I_JZJ 4TH FLOOR I STH FLOOR I 6TH FLOOR 1 TTHFLOOR 37K FLOOR stalling Company Name Youngblood Co., Inc. Check one: Certificate Jdress 32 Ashland Street Corporation Haverhill, MA 01830-4143 ❑. Partnership lsiness Telephone 978-373-5607 [] Firm/Co. 3me of Licensed Plumber or Gas Fitter David Youngblood SURANCE OVERAGE: lave a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. Yes LK No ❑ you have checked ves, please Indicate the --type coverage by checking the appropriate box. 6iability insurance policy LXX Other type of indemnity ❑ Bond ❑ - 142. NNER-S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by %apter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: nature at Owner or OwnersOwner❑ Agent C]Agent reby certify that all at the details and information I have submitted (or entered) in above application are true and accurate to the best of my :wtedge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all anent provisions of the Massachusetts Slate.Gas Code and Ctaoter 142 at the General Law . TMe of Ucense: Plumber S,gnature of cense- P r as r=ttter 9'Gastitter J -Master Ucense Number gown �= Soumeyman D 2• I- r LL W J d _ o o n "' fn o r ~ W U Q Q C W 2 U. Z d Q O n O W ¢ ¢ J Z 1- O ~ � n W p J W _ 3:: Q G• O m O < m a O O U y ~ ¢ J C 4 m O na. u! _ I U J Q J W W S. J a I Date... ew, o'<".� �7 :�� TOWN OF NORTH ANDOVER 40 p PERMIT FOR PLUMBING ,SSgCMUs� This certifies that .... !!t..-.. C ;,- has permission to perform ±� plu bin in the buildings of�jCY .� ! .......?�� . at ..�!... . /.r" /. �� Imo./. � f� ...... , North /Andover, Mass. ZP �.: Fee � ..... Lic. No.,....l..Z.� � /IN . .- PLUMBING INSPECTOR �r -Check z � 6480 /r MASSACHUSETTS UNIFO (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location zd CATION FOR PERMIT TO DO PLUMBING // Date ^-3_0 Name&AVy7jdae 11"W S Permit # Amount ipancy New 1:3 Renovation Replacement FIXTURES :TI t1' Plans Submitted Yes 0 No (Print or type)// Check one: Certificate Installing Company Name/J// � 11'1�J V&W/00ElCorp. c Address '`�7E61,z--, 0 Partner. usmess e ep one�- �-c'y a Firm/Co. Name of Licensed Plumber: �Nj \cA J L LSG n Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 0 Other type of indemnity 11 11 ❑ 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 Signature Owner El I hereby certify that all of the details and information I have submitted (or entere best of my knowledge and that all plumbing work and installations performe ndi compliance with all pertinent provisions of the Massachusetts State Plumb4 Cod By:igna ure o icense mer Type of Plumbing License Title:" 3/ 3 City/Town License INumDer Master APPROVED (OFFICE USE ONLY Agent plication are true an curate to the ,ed f t is a lic n will be in ;r 2 ' al Laws. Journeyman � \ Official use only Commonwealth' of Massachusetts Department of Fire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/99] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (NEC), 527 CMR 12.00 (PLEASE PRINT WINK OR TYPE ALL INFORMATION) Date: _03/21 /20 5 City or Town of: North Andover To the Inspecto By this application the undersigned gives notice of his or her intention to perform the electrical work described beow. Location (Street & Number) 10 Woodridge Road Owner or Tenant Woodridge Homes Telephone No. 978423-7867 Owner's Address Same Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Boa) Purpose of Building Residences Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Und rd Q g ❑ No. of Meters New Senice Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters d` Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Supplied and Installed 10 — T101 Timeclocks N COmDletion ofthe following tahlp may hp wnived h„ the INCTo t.,r nfTd.v n No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers - KVA No. of Lighting Outlets No. of Hot Tubs Generators K -VA No. of Lighting Fixtures Swimming Pool Abov ❑ In- ❑ rnd. grnd. o. o Emergency Lighting Battery Units • . No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS I No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number Tons KW No. of Self -Contained Detection/Alerting Deices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW ecuntySystems: No. of 'Devices or Equivalent No. of Water K'W Heaters No. of No. of Signs Ballasts Data Wiri ng• No. of Devices or E uivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: NTC- of De7-iccs o:- Equivalent FOTHER- .=Attach additional detail iNesired, or as required by the Inspector, of [Fires, INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: $1.250.00 (When required by municipal poli(Expiration Date) cy.) Work to Start: 09/08/2004 Inspections to be requested in accordance with NEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete FIRM NAME: Landers Electrical Co., Inc. LIC. NO.: A5912 Licensee: Vincent B. Landers, Pres. Signatur� F; - ;� LIC. NO.: A5912 (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.- 978-686-3828 Address: 1000 Osgood Street, No. Andover. MA 01845Alt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally lwln,,, T hnrnl.,, .,.ni,.n th;c .en„i.n..,n„r T n,„ tl,n lnl,n t. nnnl n _in_ n innr'e n.,nn4 16f- ` 0-0 LANDERS ELECTRICAL CO., INC. 1000 OSGOOD STREET— P.O. BOX 783 —NORTH ANDOVER, MA 01845 Phone 978-686-3828 — Fax 978-682-1646 Woodridge Homes RECEIVED ATTN: Gary Webster DEC 2 2 2004 10 Woodridge Road No. Andover, MA 01845 BY INVOICE December 17, 2004 INVOICE # 040428 09/09, 09/09/04 Supplied and Installed 10 - T101 Timeclocks Material & Labor as per quote: $ 1,250.00 TOTAL DUE THIS INVOICE: $ 1,250.00 TERMS: Net Due Upon Receipt of Invoice 2.0 % Per Month Finance Charge on Balances Over 30 Days THANK YOU Commonwealth of Massachusetts oiTcial Use Only =E ,. Department of Fire Services Permit No. S;1, ?2— BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 11/99] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICA WORK All work to be performed in accordance with the Massachusetts Electrical Code (NEC), 527 CMR 12 - (PLEASE PREUWINKORTYPE ALL INFORMATION) Date: 03/21/2005 City or Town of. North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described b Location (Street & Number) 10 Woodridge Road Owner or Tenant Woodridge Homes Telephone No. 9784x/867 Owner's Address Same Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Bog) Purpose of Building Residences Utility Authorization No. Existing Senice Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters © Number of Feeders and Ampacity I Location and Nature of Proposed Electrical Work: Supplied and Installed Light Pole C� Comnletinn nfthe fnllnu,i„o t�hlo ,. h,,,t 1....t.- T_____ N S `7,) No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans ..»,V—'ya1it:11 ewura/ Trims. No. of Total Transformers KVA No. of Lighting Outlets _ No. of Hot Tubs Generators KVA T11o. of Lighting; Fixtures ove ElIn- Swimming Pool ,irnd �rnd n o. o Emergency Tg ng Eattery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and InitiatingDevices No. of Ranges No. of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number ............................................................................. Tons KW No, of Self -Contained Detection/Alertin 2r, Devices No. of Dishwashers Space/Area Heating' KW Local El Municipal El Other Connection No. of Dryers No. o Water Heaters KW Heating Appliances KW o. o No. o Signs Ballasts ec nty of�tems:eviceor E uivalent Data Wiring: No. of Devices or, E uivalent No. Hydromassage Bathtubs No. of Motors TotalHP Telecommunications Wiring: No. of Devices or E uivalent OTHER Attach additional detail if desired, or as required by the Inspectorof Wires. INSURANCE COVERAGE: Unless Nvaived by the owner, no permit for the performance of electrical work may issue unless the licensee pro -ides 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 X BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: $1.000.00 (When required by municipal policy.) (Expiration Date) Work to Start: 09/20/2004. Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under thepains and penalties of perjury, that the information on this application is true and complete- FIRM omplete- F RM NAME: LIC. NO.: A5912 Licensee: Vincent B. Landers, Pres. Signatur3,--: i5 -_ f %,enc LIC. NO.: A5912 (If applicable;;. enter -axemp - in the license number iine.) Bus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, No. Andover. MA 01845 Alt. Tel. No.: OWNER'S INSURANCE WAIVER I am aware that the Licensee does not have the liability insurance coverage normally 1-1-- T 1--l.., T nm tAn lnl,nr.L/////nn//�f 1s,(n'J///^/n..mnr n nr'n nnor.t LANDERS ELECTRICAL CO., INC. 1000 OSGOOD STREET— P.O. BOX 783 —NORTH ANDOVER, MA 01845 Phone 978-686-3828 — Fax 978-682-1646 Woodridge Homes RECEIVED ATTN: Gary Webster 10 Woodridge Road DEC 2 2 2004 No. Andover, MA 01845 INVOICE December 17, 2004 INVOICE # 040416 09/20/04 Supplied and Installed Light Pole Material & Labor as per quote: $ 1,097.50 TOTAL DUE THIS INVOICE: $ 1,097.50 TERMS: Net Due Upon Receipt of Invoice 2.0 % Per Month Finance Charge on Balances Over 30 Days THANK YOU Date.................................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .... . ..................4..G...... A ........ . .......................................... . . ........ has permission to pe orm Z .—.LM .. . ......... . ........ wiring in the building of .... ............................ North Andover, Mass. at Fee.) ................... Lic.No�'?'.. ELECTRICAL INSPECTOR Check # IWO 1 "'681 b Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULAMONS APPLICATION FOR PERMIT TI All work to be performed in accordance with the (PLEASE PRINT IN INK OR TYPE ALL INFOTI nd City or Town of: North Aover By this application the undersigned gives notice of hi or'ei Location (Street & Number) 10 Woodridge Road Owner or Tenant Woodridge Homes Oliicial U"( Permit No. Occupancy and Fee Check [Rev. 11/991 leave blank ZFORM ELECTRICAL WORK efts Electrical Code (MEC), 527 CMR 12.00 Date: 03/21/2005 To the Inspector of Wires: to perform the electrical work described below. Telephone No. 978423-7867 Owner's Address Same Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Box) Purpose of Building Residences 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: Supplied and Installed 10 — T101 Timeclocks Completion of the followin table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Bove ❑ -❑ o. o Emergency Lighting rnd. rnd. Batte Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating nevices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security stems: No. of Devices or Equivalent No. of Water KW No. of NO. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desirec4 or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER [- (Specify:) (Expiration Date) Estimated Value of Electrical Work: $1,250.00 (When required by municipal policy.) Work to Start: 09/08/2004 Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Landers Electrical Co., Inc. LIC. NO.: A5912 Licensee: Vincent B. Landers, Pres. Signatur ',u LIC. NO.: A5912 (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, No. Andover, MA 01845 Alt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally ronnirnA l.v ln.v T.T.. m.: ni Tnnfi.rn lwln..: T hurnlw ..,nivn thin rnn..irmm�n4 T — Oho !,hent- nnn\ n n.:mnr n nt.mnr°c n.rn..4 a�� >� No. of Ranges No. of Air Cond. Total Tons 11 No. of Alerting Devices No. of Waste Disposers Heat Pump Number Tons ................................................. KW No. of elf -Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security stems: No. of Devices or Equivalent No. of Water KW No. of NO. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desirec4 or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER [- (Specify:) (Expiration Date) Estimated Value of Electrical Work: $1,250.00 (When required by municipal policy.) Work to Start: 09/08/2004 Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Landers Electrical Co., Inc. LIC. NO.: A5912 Licensee: Vincent B. Landers, Pres. Signatur ',u LIC. NO.: A5912 (If applicable, enter "exempt" in the license number line.) Bus. Tel. No.: 978-686-3828 Address: 1000 Osgood Street, No. Andover, MA 01845 Alt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally ronnirnA l.v ln.v T.T.. m.: ni Tnnfi.rn lwln..: T hurnlw ..,nivn thin rnn..irmm�n4 T — Oho !,hent- nnn\ n n.:mnr n nt.mnr°c n.rn..4 a�� >� s i Date... HORr►, 3j 4,ppL TOWN OF NORTH ANDOVER PERMIT FOR WIRING -'7g��EC• s^GNUS , l � This certifies that ......� fikk--, ............................................. has permission to perform .......�..... .?. ........................... wiring in the building of .......... ... .:....... .. ........... at & �.1.. . , . ,North Andover, Mass. Fee�!.:0...... Lic. No.. 1............l.. ,fz y ELECTRICAL INSPECTOR Check # 56,82 I - Commonwealth of Massachusett Official usey,� Department of Fire Services Permit No. lG'Uv5 BOARD OF FIRE PREVENTION REGU TIONS Occupancy and Fee Checked [Rev. 11/991 leave blank APPLICATION FOR PERMIT T PERFORM ELECTRICAL WORK All work to be performed in accordance with the assachusetts Electrical Code (NEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFOTI N) Date: 03/21/2005 City or Town of: North Andover To the Inspector of Wires: By this application the undersigned gives notice of hi orer intention to perform the electrical work described below. Location (Street & Number) 10 Woodridge Road Owner or Tenant Woodridge Homes V Telephone No. 978423-7867 Owner's Address Same Is this permit in conjunction with a building permit? Yes ❑ No X (Check Appropriate Boa) Purpose of Building Residences 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: Supplied and installed Light Pole Completion ofthe following table may be waived by the Insvector of Wires. No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above rnd_ F,In- rnd. ❑ o. omergencyigng Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: er Num........... ............................. Tons KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑Other Connection No. of Dryers Heating Appliances KW ecunty ystems: No. of Devices or Equivalent No. o Water KW Heaters o. o No. o Signs Ballasts Data Wiring: No. of Devices or E uivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Winng. No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: 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 X BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: $1,000.00 (When required by municipal policy.) (Expiration Date) Work to Start: 09/20/2004 Inspections to be requested in accordance with NEC Rule 10, and upon completion. I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: Landers Electrical Co., Inc. In LIC. NO.: A5912 Licensee: Vincent B. Landers, Pres. Signature `� %� -I,— LIC. NO.: A5912 (If applicable, enter "exempt" in the license number line.) Bus. Tel. No..• 978-686-3828 Address: 1000 Osgood Street, No. Andover, MA 01845 Alt. Tel. No..• OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally rnrn rnii 1— 1— P] — n;r f .rn 1-1— T l.nrnl--;i tl,:n rnrn.irmm_4 T nm A— nnn\ n n n.:mnr°n nnnn4 Date .!?0.�... . TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING SSACMUS� jjf_ / ) T . This certifies that � .. .�.................... has permission to perform .: .......... plumbing in the build-ings of ....,.....:. at ........ worth Andover, Mass. Fee. `-N ° .. Lic. No JP...... ��1111`. . PLUM1IN INSPECTOR Check # 631.2 MASSACHUSETTS (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location/0 WnV e: k Q > New Renovation I (Print or type) Installing Company Name i a AdWess Z' LO - 4. Lip w. , lti APPLICATION FOR PERMIT TO DO PLUMBING N Replacement FIXTURES 0 1 Date. d -- O P Perini AmountS"� Plans Submitted Yes WI No ❑ I` Check one: Certificate �i wl i h ❑ Corp. Partner. Firm/Co. Name of Licensed Plumber: J V ( b UL Insurance Coverage: Indicate th type of insu ce 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 A Signature Owner � Agent I hereby certify that all of the details and information I have submit d (or entere ve application are true and accurate to the best of my knowledge and that all plumbing work and installation under Perinit Issued . application will be in compliance with all pertinent provisions of the Massachu P in 1 g Code and C er 142 of the Laws. By: i ure o is se um er Type of Plumbing License Title � :21R / f City/Town License um er Master Journeyman11 Of ❑ APPROVED (OFFICE USE ONLY Date... . ......... . p TOWN OF NORTH ANDOVER • - PERMIT FOR GAS INSTALLATION s - + F, �9SSAC'NU`�ES l This certifies that ................ � ....................... . l' has permission for gas installation ��� ............ . in the buildings of . ..� . ! : Vis .................. . a '12"' ...... . , North Andover, Mass. � ... / ` h'. Fee......... Lic. No......a..... .. ,-.......... GAS INSP@ T. �k .'• �;. Check # 5G j MASSACHUSETTS UNIFORMAPPUCATON (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Locations r_ m Owner's P New ❑ Renovation ❑ Replacement 0 TO DO GAS FfYMG Date IWI SON Plans Submitted ❑ Permit #� Amount $ t j Print r e q ,� I ,w Check one: Certificate Installing Company Name Ip W I OW U 1�Gt, 1 ❑ Corp Address Zia❑ Partner. ( To Business Te ep one 1,20 �Ftrtn/ Name of Licensed Plumber or Gas Fitter1214� TQ INSURANCE COVERAGE Check I have a current liability Insurance policy or it's substantial equivalent. Yes No ❑ If you have checked yes, ple se indicate the type coverage by checking the appropriate box Liability insurance policy Other type of indemnity ❑ Bond ❑ 0 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 1 have best of my knowledge and that all plumbing work and instal compliance with all pertinent provisions of the Massachuset By: Title City/Town APPROVED (OFFICE USE ONLY) enterea) in aoove appncatton are true ana accurate to the aedAaderPerm4t Issued for this application will be in e and Chapter 42 o�eneffiLLaws. Signature of Licensed Plumber Or Gas Fitter Plumber Gas FittertL cense um er Master Journeyman � a w a 0 x w m w M H x x � O 0 O W F z a0i rn W [-4� ¢ z O O A z F co a CW7 &.4 z z F twr w O O z W pCA z It rWF� A a ORS A a F O x C7 UO O -BASEM ENT B A S E M ENT ISUB 1ST. FLOOR 2ND . F L O O R 3RD. FLOOR 4TH. FLOOR 5 T H. F L O O R 6TH. FLOOR 7TH. F L O O R STH. FLOOR Print r e q ,� I ,w Check one: Certificate Installing Company Name Ip W I OW U 1�Gt, 1 ❑ Corp Address Zia❑ Partner. ( To Business Te ep one 1,20 �Ftrtn/ Name of Licensed Plumber or Gas Fitter1214� TQ INSURANCE COVERAGE Check I have a current liability Insurance policy or it's substantial equivalent. Yes No ❑ If you have checked yes, ple se indicate the type coverage by checking the appropriate box Liability insurance policy Other type of indemnity ❑ Bond ❑ 0 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 1 have best of my knowledge and that all plumbing work and instal compliance with all pertinent provisions of the Massachuset By: Title City/Town APPROVED (OFFICE USE ONLY) enterea) in aoove appncatton are true ana accurate to the aedAaderPerm4t Issued for this application will be in e and Chapter 42 o�eneffiLLaws. Signature of Licensed Plumber Or Gas Fitter Plumber Gas FittertL cense um er Master Journeyman DEFARTA1ENT0FPU&JCSAFE7Y [Pen—nit No. 1 OARDOFFIREPREVF.MONREGULAT ONS527(lMl2ia0ccupancy a Fees Checked APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 _LEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 05 Town of North Andover To the Inspector of Wires: --- The undersigned applies for a permit to perform the electrical work described below. nn Location (Street & Number) /0 IA16 6 0 ` 'l l & E - (Q M M UIV 14 rJ JG�,4 Owner or Tenant Woo Il A t t) (C -e 61, atND G tl Owner's Address S n M tr E0 rcpl --^�� conjunction with a building permit: Yes IQJ No (Check Appropriate I ding Ut AmpsVolts Overhead Underground Amps�Volts Overhead Underground Q ers and Ampacity ature of Proposed Electrical Work ithorization No. No. of Meters No. of Meters Uets No. of Hot Tubs No. of Transformers Total KVA xtures Swimming Pool AboveBelow Generators KVA roun ground Outlets No. of Oil,Burners No. of Emergency Lighting Battery Units ii tlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Air Cond. Total Tons No. of Detection and No. of Heat Total Total Pumps . Tons KW Initiating Devices No. of Sounding Devices ers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other Heating Devices KW Connections aters KW No. of No. of Si s Bailasis age Tubs No. of Motors Total HP - _LeJ OcAfQ e-xisTt_�A ,02 11%ew ► �+�4yO✓% - AU.- Q LO w QrLk �v� Putslantblheregmana><soill�d>u�sGata�alLaws IhaveaattratLidALyLsaa= bhcymclA gCa VI& CDm rdgecrilsatkff balequivalart YES NO Ihavest*niiWdvafrlp dofsmr1Dd Offim YES Ifycuha%echadcedYES, pkffic r�lhetypecfcovtcWby dieckkigtheappe box WSURANCE10 BOND M OTIIFR (P1Y) V O's EslzmakidVal�eofEbcb3cal Wodr $ / I Wadc�statt /'� /U - U1' htspaca7or,D*Reges�d Rotagtl ' .� � �— U 5' Falal G,,,4( sigrwunckrTiei ofpajtayr f — ray �ry FIRMNAMjE J s l RT& -- f tV6 i L�"( alt I C, r /s' C ii=wNoL _/ Ll! 2- n Litxr>see 1- n , t II U Ht,�.s-u►^ � -'Re �L . � �,�, BusvltssTdNa - - s3 Alt Tel Na (?Wl M'SINSURANMWAIVER;IamawarethattheLioatsedoesnothavetheir�t z=amr,WoritstrialNwvalartasregt> byM Gaallaws �atmysigna�Ireenttuspamrtapplrc�alwaivesttlislegt>aernalt (il'ease check one) Owner Agent Telephone No. PERMIT FEE $ signature or Owner Or Agent ' wo � OK - 0 Date....'..1�-... pft`o`°T,"1�a TOWN OF NORTH ANDOVER Y p PERMIT FOR WIRING This certifies that /� �. ! has permission to perform ..... A�Rq. n !.x�� I r-4 ...................... r k./G% / ' 'ng in the building of ....1 ......!�'G%-P R.1.P.0 ............................. at�... ,fir ,,,, ill.. ........................ . North Andover, Mass. Fee..�'�.�`. -Lic. No. t 7!�i7�...........�....�......... 27L-.2,. ') �j � ELECTRICAL INSPECTOR Check # 7LZ.2, 551- 111E (.ULVILVIUIV WPAUH UP CHUJra I N' Office Use only DF.P.4RTi1�VI'OFP IICS9FEIY permit No. r BOAROOFFIREPWREGUTAHONS527(.M12-00 L6 , / 1 Occupancy & Fees Checked APPLICARON FOR EERWITO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN AORDANCE LTTE` THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 _ (PLEASE PRINT IN INK OR TYPE ALL INFORMATIO � Date ��� 0S Town of North Andover To the Inspector of Wires: -----The undersigned applies for a permit to perform the electrical work described below. nn Location (Street & Number) I � o ��� /� M UN2 VI Owner or Tenant Woo 6 1Z l t) 8;-e aora i G -"a Owner's Address S 19 M a Is this permit in conjunction with a building permit: Yes r No Purpose of Building (Check Appropriate Box) Utility Authorization No. Existing Service AmpsVolts Overhead M Underground M No. of Meters New Service Amps / Volts Overhead Underground No. of Meters _ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA round round No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Dissals No. of Heat Total Total Pumps . Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW V No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW 0 Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER" 1 �eJ O C A-te 1? 'X I ST t J 62 tb l --Loa- V e W 1� ► ` "b %� cJ O� tALk.— LO e.t.a otLk IhaNeaomadliabkykaw& Pbhyi rk&gCc n#& CDNaawaitssubsbmwtx*QiaR YES NO IhaNesthnimcivalidpaYofsatmodrOffim YES( lf)aAmedxrl®dYES, plea9 M51ca ftVpeofcovfraWby drckingthe*M INSURANCE BOND OTHER �u(Prm Spec i y) _ s '• S WodcmSEswrxMdVaJueofE1cclacalWak$ G� tatt �� ��—h �%� >`spacrionDareRec�md Roughf '/'� 057— � (,✓, Signed undcr'&Ft nalbesofpajury z — FiRMNAME `7 1 A 1-1.�T-AI i, t wr-C Lit mNio. ",Y / �/ 7— A Licame Lkaw,To "roe_- BusirmsTelNa AI'U (�Ht,4su►'— J f —�f 1 t rv1 4 e (t, WelJ A><Tel No. OWNER'SINSURANMWAIVII2;IamawatetuftLxffwdmmthavetheirmaamoo ak3abtxltial arddatmysgnahneonduspmrdaMhcmmwaimsdmmgtmanat � �'Massadu sGalaalLaws (Please check one) Owner 0 Agent Telephone No. PERMIT FEE $ signature of Owner or Agent Location i No. L/.� Date N°RTN TOWN OF NORTH ANDOVER 41a Certificate Occupancy of $ s�CH Building/Frame Permit Fee $ 7 Foundation Permit Fee $ Other Permit Fee $ :v i TOTAL p Check # f r �'8uilding Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: G �� ` DATE ISSUED: SIGNATURE: L Building Commissioner for Ouildings Date SECTION 1- SITE INFORMATION I' 1.1 Property Address: 1 r 1.2 Assessors Map and Parcel Map Number Number: Parcel Number 3.2 Registered Home Improvement n ctor //� { Company Ame 1.3 Zoning Information: Zoning District Proposed Use Registration Numbs 1.4 Property Dimensions: Lot Area Fronts ft 1.6 BUILDING SETBACKS ft Signature Telephone Front Yard Side Yard Rear Yard Required Provide Required Provided red Provided 1.7 water supPlyivi:��t,.e.ao' ;34)"v Public ❑ Private h" . ; *` 1.3. Flood Zone Information: ZO°6 Outside Flood Zana ❑ 1.8 Municipal sewerage Disposal system: ❑ On Site Disposal System ❑ aJL%,iivi1a-rnvrJ&aMii vVVI'lMiLarmiriAulnvaai,n.yAai<trirl vJ��T.J'JCT: i I - .1 SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 Workers Compensation Insurance affidavit must be completed and subn in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......0 No ....... 0 SECTION S Description of Proposed Work check a0 appReable New Construction ❑ Existing Building ❑ Repair(s) Accessory Bldg. ❑ Demolition' ❑ Other dW k Failure to provide this Alterations(s) ❑ 1 Addition ❑ ❑ Specify Brief Descnption of Propose or . [A, `� 06, vivo-rultw t Ti QTiMATTi11 VnNQTV1Tf TinN rn4ZTR result 4,V4kVs Item --- -- -- --- -- - Estimated Cost (Dollar) to be Completed by pernut applicant OFFICIAL USE ONLY •_.. 1. Building r/ I Ll 6 (a) Building Permit Fee Multiplier 2 Electrical(b) LQ Estimated Total Cost of Construction 3 Plumbing 0 Od Building Permit fee (a) x (b) a 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 b Check Number SECTION 7a OWNEK AU Intik IGA11VP1 1V nr1 l vmrl,Z 1Z" Wt=11% OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date__ SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I as Owner/Authorized Agent of subject property Hereby declare that the statementsd information on the foregoing application are LTue and accurate, to the best of my knowledge and belie� 6-d A Print Name Si ature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS I 2' 3 SPAN DIIVIENSIONS OF SILLS DINIENSIONS OF POSTS DUVIENSIONS OF GIItDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY 1S BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE E m --k w O u w a Y= O Q0o x w a ,� x a � ANG x a iD U w Z v E 1, 1 $-' > IS,y Y= O Q0o 4&4 ,� ANG a x COD W ti o~c W V y c o m c •cam o � o N C V aN ev m c .c o o DEQ .. v 0 d H .aOt c d .Sc" . O O .m3 Mon _m '= C N N N m a� LZ • c oQ N •I N O ca '� Z or a= C, N d J C w N c s awm ZIN 4 U O O CD O 40 L 0 ZCD CL O H p c CD cm i O CD — .y CD m m � H� CD z1ft 0 Q M: cna c CO2 � c ev .390 CD CO2 Z 4D V y CL O C O y E 16 "o GENERAL BUILDING NOTES/CHECKLIST- NOT LIMITED TO ITEMS BELOW POST ALL LOT NUMBERS, ADDRESS, AND PERMIT (COPY OK)..or no inspections INSPECTIONS: (Minimum) Excavation, Footing, Foundation, Frame, Insulation, Final. FOOTINGS: Continuous Full 2x4 Keyway Continuous strip footings for interior columns FOUNDATION: Rebar as required Anchor bolts or straps Damproofing Foundation drain - pipe/stone/fabric filter/cover and outlet connection. FRAME: Fireblock - over girts/plates between floor joist Penetrations for plumbing, heat, elec, etc. Walls at stair stringers. Windbrace corners and center bearing partitions. Size ridge to provide full bearing at rafter cuts. Hip and Valley rafters - watch bearing at walls. Ridge & Hip - Provide proper connections. Cathedral roof rafters provide proper connections and use "Hurricane Clips" tie to plate. Stair stringers - watch cuts and heal support. Joist hangers - fully nailed w/ hanger nails. Sill plates 2-2X6 (1 PT) w/sill seal. Girls - solid brick or steel plate bearing at foundations '/ " air space at sides in foundation pockets. Lateral bracing at ends. Certified calculations. required for Beams/LVL's Trusses. Solid bearing support for Headers/Beams etc. Check headroom clearances - stairways, under beams Attic Access. (min. 22x30 w/3' headroom above). Crawl space access. (min. 18x24). Bath exhaust fans to have metal duct to exterior (not in soffit). Firecode S/R wood frame of "0" clearance fireplaces & stoves Window Schedule or Every Habitable Room Must Have: Natural light equal to 8% of floor area. % of required glazing shall be openabte. Bedrooms required min. 20x24 egress window or door. Vent attic spaces - "proper vent", soffit and required ridge vents. Firecode under stairs if used for storage FIREPLACES: Separate permit required. Inspections at Footing - Smoke Chamber - Finish Smooth parging, clean joints, 8" solid @ combust. Surf. DECKS: Separate permit required: Lag to house, provide flashing. Rails min. 36 " high, Baluster max space 5" on center. Over 8' above grade, use 6x6 posts w/lateral bracing. Lag all posts and rails. Pier footings down 48", Conc. pad at stair base. FINISH: Handrails returned to wall/newall post. Guardrails required alongside open cellar stairs. Exterior grading complete. Certificate or occupancy required prior to occupying structure. Temporary Stairs required for inspection. Re -inspection fee - $30.00 (Be Ready). Certificate of occupancy reguired prior to occupying structure. 4A North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11,S150A. The debris will be disposed (Location of Facility) _Signature f Pgrmit Applicant 10/0, NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector The .Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print C' N Phone U G 7 7 L( S- 0 I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity ffI am an em er providing work ' compensation for my employees working on this job. Comrrarn rtame:--�i1�..1 � 6 l g rl(0 ' )Z-7/5 -7? r Address 3-3 �- Failure to some coverage as required under section 25A or MGL 152 can lead to tits impasew of aiminN panaftlea of.8 fine LIP to andlor one years' imprieorwnont_ore_ra a.as_clA4=akimlfl lhGhm x(A STOP.V.YDM ORM RAW.a.rm of ($IOD.01)Axr agohd.me, 100 understand that a copy of this statement ay be forwarded to the Office of Investigations d the DIA for coverage verification. I db hereby certiy under the pa penalties of perjury that the information provided above Is true and correct. Signaturep t0 6)y Print Offk-lal use only do not write In this area to be completed by city or tam official' e f s1,5, ? ?e(,5 City or Town P sina ❑ []Check if immediate response 18 required Building Dept ❑ Licensing Board Contact person: Phone # ❑ Selectman's Office ❑ Health Department ❑ Other ACORD. CERTIFICATE OF LIABILITY INSURANCE DATE PRODUCER 978-975-4344 WILLOWS /INTERNET INSURANCE AG. INC 522 CHICKERING ROAD 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. POLICY NUMBER NORTH ANDOVER, MA 01845 POLICYEXPIRATION INSURERS AFFORDING COVERAGE NAIC # INSURED INSURERA: NORFOLK & DEDHAM INSURER B: NORFOLK & DEDHAM D.C. CONTRACTINC, INC. DAVID GULEZIAN INSURERC: ARBELLA PROTECTION & NORFOLK & D 428 PLEASANT STREET INsuRERD: AIG INSURANCE NORTH ANDOVER, MA 01845 INSURER E: COVERAGES 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. IS— R OD' T POLICY NUMBER POLICYEFFECTIVE POLICYEXPIRATION LIMITS GENERAL LIABILITY I EACHOCCURRENCE I S 1,000,000 A I X COMMERCIAL GENERAL LIABILITY R0401723A 07/01/2004 07/01/2005 PREMISES (Ea occurence) is 100,000 MED EXP (Anyone person) 1 S 5,080_ CLAIMS MADE l"I OCCUR PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE j S 2,000,000 j GEN'LAGGREGATE LIMIT APPLIES PER: PRODUCTS)COMPIOPAGG 1$ INCLUDED POLICY F_ PRO) LOC JECT 1 I B ( I 1 I AUTOMOBILE LIABILITY ANY AUTO ALLOWNEDAUTOS SCHEDULEDAUTOS 90151692 i 06/12/2004 06/12/2005 COM B IN ED SI NG LE LIMIT $ 1,000,000 (Ea accident) i BODILY INJURY (Per person) i $ ( X HIREDAUTOS NON )OWNED AUTOS I BODILYINJURY S (Per accident) i —J PROPERTY DAMAGE $ (Per accident) I I I I C GARAGE LIABILITY I ANY AUTO i f EXC JESS/UMBRELLA LIABILITY X I—,1 OCCUR CLAIMS MADE I I 0001370 12/10/2004 6/10/2005 AUTO ONLY, EA ACCIDENT I $ OTHER THAN EA ACC $ AUTOONLY: AGG i 5 EACHOCCURRENCE I $ 1,000,000 AGGREGATE $ 1,000,000 i DEDUCTIBLE I RETENTION $ I _ k I $ WORKERS COMPENSATION ANDWC STATU) OTH) I D I EMPLOYERS'LIABILITY I WC333-27-74 03131/2004 03/31/2005 TORY LIMITS ER ANY PROPRIETORIPARTNEWEXECUTIVE OFFICER/MEMBER EXCLUDED? E.L. EACH ACCIDENT Is 100,000 If yes, describe under E.L. DISEASE) EA EMPLOYEE $ 100,000 SPECIAL PROVISIONS below OTHER E.L. DISEASE) POLICY LIMIT $ 500,000 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS TOWN OF NORTH ANDOVER, MA DIVISION OF PUBLIC WORKS 384 OSGOOD STREET NORTH ANDOVER, MA 01845 25 (2001108) SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 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 AUTHORIZED CORPORATION 1988 90ARD: UI M4 i U� sA ttj V A Ueense :WN RU CION StJPiW1RVISfJR . y; Number CS, 001821 ( N k Birthdate: �xpirei�9 1bP0fiS05:' Tr.io: '6242 DA1!!t� i' GU LEVAN 428 PLEASANT ST :, rN MbOVER, ANA .13845 As9m rits#tet4`r � L Board of B6i uildiP9 Regulations and Standards HOMi►MPROVENIENT CONT t Registration y' RACTOR Expiia#fob; 120199 11/1/2006 h 7�Pe: 1nilivtdnai DAVID w GULEIAN DA'ViiS GULEZIAN 428 PLEASAiV. `. TtS7 s NOR01846 TH ANbOV. a,- ti r a j °'� Administrator Location 2 No. 6 . Date r MORTp, TOWN OF NORTH ANDOVER f ,' y " Certificate of Occupancy $ �'�s'•^°''<�' S MUSt Building/Frame /Frame Permit Fee 9 $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $Q Check # e, --,-)- �7/) V; --L, '1Bui.ding Inspector.�" N , The Commonwealth of Massachusetts State Board of Building Regulations and TOWN OF NORTH ANDOVER Standards BUILDING DEPARTMENT Massachusetts State Building code 780 CMR I TO CONSTRUCT REPAIIt, RENOVATE, CHANGE THE USE OF OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING 0,3 Dat e. Issued: / /Q l.1 Property Address 1.2 Assessors r Map Number 1..3 Zonin¢ Infomratim� .. _ _ Front I107 Water Supply 9M.O.1-C.40.4 S 54^) 1.5. Flood Zone Public O Private Y Zone Cl_ F2. Owner of Record !�ocxme (Pri-2 , signature 2.2 Authorizeden :^ Nab- (31dr Name (Print Tvin a 3.1 Licensed Construction Supervisor: .�wia►��II �gtii.!/JIB ` f A�'..i. �.. r � � Revised 197 JMC Yard 1.8 Sew a Disposal System: Outside Flood Zme a Municipal eb On Site Disposal Systan --- 10 wc�ocl�srl d e 1'2 ej Telephone 97 4082 7093 Address 3 rtS k W t'4 v,,d 'vh4 Telephone O (p ZO I THAN 4000 CUBIC FEET OF ENCLOSED SPACE Not Applicable Q License Number Q Expiration Date _ 3 IS z�i �(OZC7 ne ' Not Applicable Q Registration Number ! O � 9 U �_ � —7 Expiration Date 50 � Co Zc� IN SECTION 4 WORKERS' COMPENSATION INSURANCE AFFIDAVIT 1M.G.L. a 152 § 25C(6)1 Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed Affidavit Attached Yes No Ll SECTION 5 - PROFFESSIONAL DESIGN AND CONSTRUCTION SERVICES - FOR BUILDING AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116 CONTAINING MORE THAN 35,000 C.F.OF ENCLOSED SPA 5.1 Registered Architect: No Applicable Name (Registrant): Address Registration Number Signature Telephone Expiration Date 5.2 Re istered Professional En ' eer s Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name): Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date 5.3 General Contractor Not Applicable 13 Company Name: Responsible in Charge of Construction Address Signature Telephone SECTION 6 - DESCRIPTION OF PROPOSED WORK check allapplicable) New Construction Q I Existing Building Repairs U Alterations Addition [j Accessory Bldg. Q 1 Demolition 13 1 Other [3 Specify Brief Description of Proposed : Clow S o -r SLA, yj gd - , s F n s. v - A-3 1A 1B Q O SECTION 7 - USE GROUP AND CONSTRUCTION TYPE USE GROUP Check as applicable CONSTRUCTION TYPE A Assembly A-1 A4 A-2 A-5 A-3 1A 1B Q O B Business 2A 2B 2C Q Q El E Educational 0 F Facto 0 F-1 F-2 H High Hazard 13 3A 3B Q 13 I Institutional D I-1 I-2 I-3 M Mercantile 4 13 R Residential 13 R-1 R-2 R-3 SA 5B 0 Q S Storage 13 S-1 S-2 U Utility Q Specify: M Mixed Use a Specify: S Special 13 Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS. ADDITIONS AND/OR CHANGE IN USE Existing Use Group: Existing Hazard Index 780 CMR 34 Proposed Use Group: Proposed Hazard Index 780 CMR 34 SECTION 8 - Building Height and Area BUILDING AREA Existing ifapplicable) Proposed Number of Floors or stories include basement levels Floor Area per Floor Total Area Total Height ft SECTION 9 - STRUCTURAL PEER REVIEW 780 CMR 110.11 Independent Structural Engineering Structural Peer Review Required Yes 0 No O SECTION 10a - OWNER AUTHORIZATION - TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, %-,D z-OL.AICZ-o As Owner of subject property hereby authorizq T 7 4o GpjW --Qn to act on my behalf, in all matters relative to work authorized 6y this building permit application. Signature of o Date revised bldg form/state JMC SECTION l Ob - OWNER/AUTHORIZED AGENT DECLARATION I, , as Owner/Authorized Agent hereby declare that the statements and information on the foregoi g application are true and accurate, to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Print Name Date SECTION 11 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollars) to be completed b permit applicant Official Use Only 1. Building (a) Building Permit Fee Multiplier 2. Electrical (b) Estimated Total Cost of Construction from 6 3. Plumbing Building Permit Fee (a)x(b) 4. Mechanical AC 5. Fire Protection 6. Total = 1+2+3+4+5 Check Number acl BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR t Number: CS 033843 Birthdate: 03/15/1955 Vv Expires: 03/15/2006 Tr. no: 18496 Restricted: 00 JOHN T HAFFEY } 3 WILLIAMS ROAD WAYLAND, MA 01778 Acting Ca — oner X! W 00 J_ ti Z ~ m 0 O U-9 ( LL E < CO C: --) n CO The Comm nwea .th'tof� sa usetts .- o . „ 1r�r as 1. 4• Deortmentoflrtrltt f'.,'c'hYents Office of°.lnv$sfl atlons 600 Washlrgton:Sfiiaet Boston; Mass: • 021.11 Workers' Compensation Insurance Affidavit City: N o rt4,n a vido ue r YKA phone # ❑ I am a homeowner performl09 all work myself, ❑ I am sole proprietor and. ave no one working in any capacity t. I am an employer providing workers' compensation for my employees working on this job. Company name:. I' ` E.� o-{� Bu r ldTO -- Address: 4 3 U, Tr (a i - City: W 4 � f Yt%j (� l `7 Z phone # .S;D S• CO 2425 `i �— Insurance co. A VY1QlL ' �, r'�` � policy # W c—toz 151 3 S - O VP 12 ❑ I am sole proprietor, gen.oral contractor, or homeowner.(clnclo one) and have hired the contractors listed below who have: the following workers' compensation policies: 'r Company name: City: Dhone # Insurance co. policy # Company name: Address: City: ; phone # Insurance co. - ���_policy # Failure to,#@cure ooveragq as.:fagyXg0...unser,-jecpon,F.pf+;gr.m�� �occai year's Imprisonment as well as;civl[p.onaltlea in the form of 8 STOP,WQR this statement may be forwardgd tq-the`Office of Investigations of thq D(A, 1 do hereby certify under the pains and penalties of pedwy that the Print ),f Cdriiinal penalties'Of a fine up to $1,500.00 and/or one $100.00 a day against me. I understand that at copy of above is true and correct. ye�.tcM # 50 S- (n ZC) `3 t (0 8 Official use only dQ�ot;wrlte (n this area to be complatadlby�cJEyotrvm roff(clal . n ' I demltUlldense 1i • ' ❑ Building Department City or town: :,.. ! ,il ; I] t.icensing.Board I r rylA,w�F ' .: . required : �„t Selectriien's Office. E1ctieck H immediate responae'ls 0Health Department ooS!tiaa person: ..: ,� ,.�,„ � �'E 1' �. .4 .f•r� .��4'l 'p�..,rf�s +` 1. ! .> ... ! , ...5. r5:•'�yr�:ayl, �. �11/�/\,�1i' `�.'(���ga .,�i It 41i'ti �t Ih�\�� ' `'.� 111'.2Yl�y� 141th1.�`{�yj], �G�al�'z;�1(1.1,•...S�:.Gr,'.tK'ii/• '� i�'�j{it�% f rcl fT y\ y \_;•'•1,.«;, : t =s:=,l ��y���r"�t'•�lY.r�.i 1 1 a��:.�i..,l.ti..`r'. y..,.�. ri LL�t�. 44--F '4. I':1•. " "Vi '(}r'T{C�' Miv}t jl�Ir.,,.),yr:%h4i,yiH;}�µ7`t+r`�y '�diSl :,h 1�� /b i\l lr 4 { 1�.'��l`.�^V 1.' �j�{r�• � �. ), l!'. i ) .;:4 ! �,I, iii .•�M l iy .� , 1 .l• . i, rt. °) . d 1 •r plr\� Y1ii .� � North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. The debris will be disposed of in: moss — (Location of Facility) ig'nature f bPefmit Applicant ?Z-Zvoy Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector O O i 1 w H A � ` C U o � x W 0 C O A V R7 .c v cn a a A v U w o4 w c:4 w O a4 w cA o cn 0 cn W J f1 y y O Ci 0 CD Q ev CO2 O V .n CO2 c 0 O S a ccCOD r-7 ` C o � 0 C O V d C R A m C L A a'O ECD 8 e: d 0E cm ti :mc E O �N �� H Z C y m ,cc C � Qj J- :'E m at. f ., ` �� 0 p CLS 16.:m CO) m ; cc �r= A: r' o o CM" Ea m c� o `o : ari C ` C Of 3oa COD W oC -re ++ H W � E rL Z o d C3, H = m�O� ,o Go O � =w .0 a0.0 f1 y y O Ci 0 CD Q ev CO2 O V .n CO2 c 0 O S a ccCOD r-7 i• J Wood Ridge Homes, Inc. 10 Wood Ridge Drive North Andover, MA 01845 Seller Information Name: Wood Ridge Homes, Inc. Address: 10 Wood Ridge Drive North Andover, MA 01845 September 29, 2014 TOW RECEIVED n r 4OT Exemption Request 2014 SEP 30 AM 10- 52 TO tVil! N B r �. N'DO d' y Buyer Information Name: Barkan Properties, LLC Designated contact person: Ned Epstein Email: ned.epstein@jterealtyassociates.com Phone number: Phone- 978-258-1516 Second contact person: Colin A Coleman, Esq. Email: ccoleman@innovativeblg.com Phone number: 781-444-2333 x103 Property Information Address: Wood Ridge Homes, Inc. 10 Wood Ridge Drive North Andover, MA 01845 Address: The Barkan Companies 24 Farnsworth Street Boston, MA 02210 Designated Contact Person: Peter Barkan, Manager Email: PBarkan@BarkanCo.com Phone number: 617-482-5500 Second contact person: Michael Callahan, Esq. Email: callahanmichaelf@comcast.net Phone number: 781-258-1471 Name of Tenant Organization, if any: Wood Ridge Homes, Inc. Board of Directors, Attention Karen Ste. Marie Basis for Exemption Request Us.6(i): re: taking by eminent domain or a negotiated purchase in lieu of eminent domain s.6(ii): re: forced sale pursuant to a foreclosure Os.6(iii): re: deed -in -lieu -of foreclosure s.6(iv): re: sale to a purchaser pursuant to terms and conditions that preserve affordability Rs.6(v): re: project -based section 8 Us.6(vi) re: sale to an affiliate of the owner Us.6(vii) re: 15 year remaining term on existing affordability restriction Page 1 of 7 pe Wood Ridge Homes, Inc. 10 Wood Ridge Drive North Andover, MA 01845 Programs under which Affordability Restrictions are Currently in Place: Terminating ect based section 8 contract federal Low -Income Housing Tax Credit program !nt supplement assistance ction 202 ction 221(d)(3) BMIR ction 221(d)(4) ction 236 section 515 section 521 rental assistance Urban Development Action Grant Housing Development Action Grant section 13A project based MRVP contract Massachusetts low income housing tax credit program apter 121A September 29, 2014 Termination Date (XX/XX/XXXX) 11/1/2019* *This is the current termination date if no sale were to occur. Barkan Properties, LLC is seeking a 20 year HAP contract renewal that would preserve Section 8 financing until at least 2039. Page 2 of 7 M Wood Ridge Homes, Inc. 10 Wood Ridge Drive North Andover, MA 01845 September 29, 2014 Programs under which Affordability Restriction will be in Place Subsequent to Sale: ame as Above roject based section 8 contract ie federal Low -Income Housing Tax Credit program action 202 action 221(d)(4) action 236 ?ction 521 rental assistance roject based MRVP contract lassachusetts low income housing tax credit program HARP r 121A Transaction !r- MassHousing financing Termination Date (XX/XX/XXXX) 5/1/2039* 5/1/2045** * Based on an estimated closing date of 5/1/2015. Also assumes the approval of a 20 year HAP contract extension and a preservation exhibit continuing the remaining four years of the current HAP contract. ** Based on an estimate of credits being granted as of 5/1/2015. Page 3 of 7 Ln § q \ \ < / 2 } £ / tw 2 2 / / < \ % 1 4 \ k � 0 .A 0- Et 00 f _ - c 9 C ƒ - 00 E / \\ 2 > % m 2 . \� / $ 00 p t.. z .t y a u . co : u _ ~ W�\ \ co $�..r4 Ln c ... « 2 q q o \ k m J � � \\\ co �\ ... m : , q _ . m " \ ■ � .e:. »� � � .\\J . Co E w 3 S§ 0 4-1 ,0 4� ° £ m- 5 k 4 E/ 2§� 0 � 0 .A 0- +� = E O o ° o t2 C c ami U i X 41 +p V O X vi N V N 00 pp N 3: C 'U 4' ~ 4-1 .0C L Ln H CO 'O w OQ 4' O N fl� t N O Q H O •Q E U 0 0 ,? N a O 3 00 E E m _, o o Ln - o _ C w i O mv E a!v o f0 to o ns �o o w N 3 a o 4 3 o Q 1� o c cLo w w o += o °° 30 ,� o C ` o a o U m o U a m ° o. co +J aU x to m M +' * OC N + C O op N M .a Om U 01 U N OC lD + U m N 0) + m M t coW M D: ,. 4 - co m N r -I d' 01 + D: O r4 r 0 Ln m N N iF 0 O w C4 C N Ol EV m ri J M 3i V? VT C A�, N m m o m m L I N ri •tA ri in O c m N N m t .r +� 3 '3 o v v o c_ E Y G 00 ( m�_ °'A E C O a a u C i Q a 0 0 \ +_' (U (UL L C O a Q :3 acv �� voM� Wood Ridge Homes, Inc. 10 Wood Ridge Drive North Andover, MA 01845 September 29, 2014 Affiliate Information (if applicable) Brief narrative describing the relevant entities and basis for claiming affiliation to Seller: (Also provide a chart) N/A Brief Narrative Describine Sale (as per suggestion of Harriet Moss): This Narrative is a supplement to this M.G.L. c.40T Exemption Request Form submitted jointly by Barkan Properties, LLC ("Barkan") and Wood Ridge Homes, Inc. ("Wood Ridge"). The parties are seeking an exemption from the requirements of M.G.L. c.40T under Sections 6(a)(iv), for sales which will preserve affordability, and (v), for sales of property receiving only Section 8 assistance and for which the Buyer intends to renew the Section 8 contract. Wood Ridge is an affordable housing cooperative located in North Andover, Massachusetts. It is comprised of 230 units, all of which are assisted under the current Section 8 HAP Contract that runs concurrently with the existing MassHousing financed mortgage. The property receives no other public assistance. Wood Ridge's Board of Directors recently decided to seek a buyer for the property. Because most Board members are also Wood Ridge shareholders and residents, one of their main goals has been to preserve affordability in the event of a sale. Barkan has made an offer to buy the Wood Ridge development on terms that the Board believes are favorable to the community. Barkan will preserve affordability at Wood Ridge in several ways. Barkan plans to transfer and continue the existing Section 8 HAP contract, and it will also request a twenty year extension of the HAP contract. In addition, Barkan is applying for Low Income Housing Tax credits that will be subject to a thirty year affordable use restriction. Finally, Barkan will be receiving MassHousing financing. Based on the above, the parties contend that this sale qualifies for an exemption under M.G.L. c.40T6(a)(iv) and (v). We ask that you grant the exemption requested in this Exemption Request Form. Page 6 of 7 Wood Ridge Homes, Inc. September 29, 2014 10 Wood Ridge Drive North Andover, MA 01845 Notification: If required, a complete copy of this 40T Exemption Request has been simultaneously provided to the parties specified at M.G.L. Ch. 40T §6(b). Please provide name and address of: Municipality's Chief Executive Officer: Andrew W. Maylor North Andover, MA Board of Selectmen 120 Main Street 120 Main Street North Andover, MA 01845 North Andover, MA 01845 Tenant Organization, if any: Wood Ridge Homes, Inc. Board of Directors 10 Wood Ridge Drive North Andover, MA 01845 Legal Services Organization (name): Northeast Legal Aid 50 Island Street, Suite 203A Lawrence, MA 01840 D"ate: September 29, 2014 Seller Certification: With respect to the information provided, and the representations made, by Seller, the undersigned certifies that the information provided herein is accurate and complete. Wood Ridge Homes, Inc. By:a-t Karen Ste. Marie, President Buyer Certification: With respect to the information provided, and representations made, by Buyer, the undersigned certifies that the information provided herein is accurate and complete. Barkan Properties, LLC By: ter B a, anager Page 7 of 7 N2 3Date .................................. 496 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ........ .......................................... has permission to perform ............. wiring in the building of ............................. at .... /i ............. . North Andover, Mass. . Feg I � ......... Lic. No/ .. ...................ELECTRICAL INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer O UI'e g0HE11011H118111` of funflo djuBettB Permit Noetce U$6 Only.4� III[gllrtintnt of Public Puftt>0 Occupancy b Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 peeve blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK s All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date -/ Quo or Town of To the Inspector of Wires: The udersigned applies for a permit to perfor the ele trical work described below. Location (Street & Nu��nber) D Oner or Tenant &/v0 �. �,.• // w�. —Q r Owner's Address Is this permit In conjunction with at building permit: Yes lJ No (Check Appropriate Box) Purpose of Building �U Existing Service Amps ��iP Utility Authorization No. _/ Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps _J Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nalttre of Proposed Electrical Work Gvl/yj=_ fr'D!Z Nn. of Lighling Oulinta No. 01 1401 Tbhs g fin. of t.lghting Fixtures Swimming ! --g Pool — Ahnve lit. , grad..0 grad. U No. of Receplacie Outlets No. of Oil Burners No. of Switch Outlets No. of Gas Burners oto. of Aa"g's , No 01 At. CoM. Total tons No. of Disposals No. of Dishwashers ------------ +� No. of Dryers No• of Water Healers No. Hydro Massage Ibbs OTHER: 3D N �,u / Gh7- Ne. of Ttanslermere Total KVA Oenerelote KVA No. of Ernergency Lighting Battery Units FIRE ALARMS No. of Zones No. of Detection and Infilet" Devices NO.Of Heat Total Total Pumps Tons KW No. of Sounding Devices No. of Self Contained Space/Area Heating KW 0e1e01OWSounding Devices Heating Devices kW Local❑ Municipal Connection [1 Other KW Signs of No. of Low Vollege Signs lltWiring No.�01MIor�a---�,TolalP INSunANCE COVERAGE: Pursuant to the requirements of Massachwetts general Laws Ihave have i current alnbinty Insurance Policy including Completed Operations Coverage or Its substentl61 iqulvelent. Yt $ cher submitted valid proof of same to the Office. YES .^ NO Q II shacking the appropriate box. u ave checked YES, please Indicate the C Ne C I INSURANCE CX BOND 0 OTHER C (Please f;peeify) j!Y type of coverage by Estlmated Value of Electrical W9rk Work to Start � tExW► tion Oale► signed and t Pena111 Inspection Data Requested: Rough e perjury, �IriAl FIRM NAME Licensee — / / LIC. No/ S'� Signature tJC. d Address N ��. Bus. Tel. No. ���i SO QuIved S INSURANCE WAIVEp; I am aware that the Licenses does not have the Insurance colist. NO. verage stage or its substantial e gutted by Massachusetts General Laws, and that my signature on s not have %he Instlon waives ag at itse bet pal �alent as to - (Please check one) A"M Telephone No. PERMIT FEE i • (Signature of (Tuner or Agent) • s -058S 3396 Date. `,�`.f�- ......... H�"TH TOWN OF NORTH ANDOVER pg o ,n,1.OL p PERMIT FOR GAS INSTALLATION t. ti This certifies that .. �.. �. �:.... '4 e� . ................. has permission for gas installation .. ! .,C..f.--i................. in the buildings of i. ! �. ! .r1. l.. .................... at i.G.%.. J2 ��. , North Andover, Mass. Fee. 1.5..:.... Lic. No../ ?. ? S S . .. �.-� �. �._........ . GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer I .f MASSACHUSETTS UNIFORM APPLICATON FOR or print) iNuKIH AN/fDUVER, MASSACHUSETTS Building Locations �2- e Ud a l df ,i1 Owner's Name New ❑ Renovation ❑ Replacement DO GAS FITTING Date 11l ��- -069 S`D PPermit # 3 F Amount S Plans Submitted ❑ (Print or Addres ��y � /dl.. r V Business Telephone 7 Name of Licensed Plumber or Gas Fitter (D( Check one: Certificate Installing Company ❑ Corp. 11 Parmer ❑'F^/C o. INSURANCE COVERAGE Check 1 have a current liability Insurance policy or it's substantial equivalent. Yes No ❑ If you have checked ves, please indicate the type coverage by checking the appropriate box. Liabilin, insurance policy Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver: [ am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the on this permit application waives this requirement. Mass. General Laws, and that my signature Check one: Sienature of Owner or Owner's Agent Owner ❑ Agent ❑ I herebv 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 install on 'ormed under Permit d for this application will be in compliance with all pertinent provisions of the Vlassachuse fid pter 142 of the eneral Laws. tie tyiTown PPROVED wFnci? USE OK Y) / Signture of Licensed Plumber Or Gas Fitter �9Plumber ZZ Fitter 71C,-nSe i umper ,Gas ivlaster Journeyman i :3R D FLO OR 7T If. FLO OR (Print or Addres ��y � /dl.. r V Business Telephone 7 Name of Licensed Plumber or Gas Fitter (D( Check one: Certificate Installing Company ❑ Corp. 11 Parmer ❑'F^/C o. INSURANCE COVERAGE Check 1 have a current liability Insurance policy or it's substantial equivalent. Yes No ❑ If you have checked ves, please indicate the type coverage by checking the appropriate box. Liabilin, insurance policy Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver: [ am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the on this permit application waives this requirement. Mass. General Laws, and that my signature Check one: Sienature of Owner or Owner's Agent Owner ❑ Agent ❑ I herebv 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 install on 'ormed under Permit d for this application will be in compliance with all pertinent provisions of the Vlassachuse fid pter 142 of the eneral Laws. tie tyiTown PPROVED wFnci? USE OK Y) / Signture of Licensed Plumber Or Gas Fitter �9Plumber ZZ Fitter 71C,-nSe i umper ,Gas ivlaster Journeyman i Location wooOf t? t q E q No. 3a L Date f . NORTH TOWN OF NORTH ANDOVER p Certificate of Occupancy $ Building/Frame Permit Fee $ �'�s'•••" •'t�' \ sA-1 Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ C wilding Inspector 12722 2 7/ 2 08105/38 08:34 1 G5• r Ndtt Div. Public Works Location No. j 1 Date �oRTM TOWN OF NORTH ANDOVER 3?� ..,off Certificate of Occupancy $ p �7 , d c) Building/Frame Permit Fee $ s••°•'<� Foundation Permit Fee $ SAC NuSE Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ -' i ? tf� Building Inspector ( 7(18/05/98 08:34 25. f>n RUM Div. Public Works n Q l+ a N a a V C C C a Z y u J i X.. 9 z J X X X u — a — Z— R, Q W W W n T Z N v N r Z 4 z z W J C 3 C ` N In = ; Y W y M LA 4J = W Z Z Ln— Z G — uj r. Z O � C6 W s C L) Q W L a. — w w } Z 4 _ Z N , C — n v !, y W Z A_ 2LU W W 3 w L:j W Z ' .. N v W C LLL ✓ w W N Z z y _ K W —< Q 2 0 LU Z �( a a a V C C C a Z y J i X.. 9 J X X X u — a — Z— R, Q W W W n T Z N v Z C it1 •� � L _ C 7 a a a V C C C a Z y J i X.. v Z C it1 •� � L _ C 7 F f_� �iie �omvina�uuea�c o�✓�iaaaa�ivaeka (' OEPAR NT OF PUBLIC SAFETY Coosi }% 11.RERVISOR LICENSE p -= Elpires: Birthdate: ;9 23/2000 09123/1965 — -- ROB ' = T iNIER JR r 133 LOWELL ST C i NE.TNUEN, NA .01844 I CN K� 1 O z O ou c� gCL T cn 9 Q a w° m C2 T U w w aOw a w a w; a�' c w a�4 � w cc 6 C/)cn o 5 0 •m c ct; o � : C N O C O • v V •d = CL C ev ev CO C O � CO) Ea 3 LD o c N EE o m co :vs Of m C d w:. N R O m C � N N = ai`m3 •• c m� c o N•g — m L C H N O C O m m ACDy t O Q! moa CIO m • • V Cos. Z O «:coo c a Q y m c c = m :oa po N � o O� m CO)LD LU •H d t O C Z ac •E C=a aU AD FE •h o0 y O. m� O� J S emv .00 0O F- L 4-a�m �10 0 I 2 0 y GD .E Cu L Cu C O co C3 _O 3: CO) 0 y C O V O .0 _cc d CO) CD CD O O0. CZ c 4 c c -5.0 cc CD Z s CD C. C#* C Location /y L0EI)v No. Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ SGS Building/Frame Permit Fee $ Foundation Permit Fee $ l� Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL Buildintor 1,11 i►�� f' I/[ "ZtS 28.0f) Palo NTQ p g q Div. Public Works APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 MAP 410. LOT NO. I 2 RECORD OF OWNERSHIP IDATE BOOK :PAGE ZONE SUB DIV. LOT NO. LOCATION ®; o O ✓ale y°\� t ` a0v,M PURPOSE OF BUILDING �: r� � vN OWNER'S NAME , _ 1 o O `' � f""cl NO. OF STORIES 0 SIZE si _ &/Ma/ r4 OWNER'S ADDRESS ! _�1 O � 1� ` ,`� W aJ BASEMENT OR SLAB �n (G w �� ^�1� •�'NTV'AC'�`� + !/ ,G•C JIS(T ARCHITECT'S NAME SIZE OF FLOOR TIMBERS 2ND 3RD BUILDER'S NAME �' �t % C. 1� SPAN -- DISTANCE TO NEAREST BUILDING# R ,z.c k e - 11 7 DIMENSIONS OF SILLS a �I DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES - SIDES REAR " GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION /J f THICKNESS IS BUILDING NEW a S' 7 SIZE OF FOOTING /O 1/ 010 H X IS BUILDING ADDITION `/e -s ^- IS BUILDING ALTERATION y/o ���IN To lht1N� MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND b `t J t` l WILL BUILDING CONFORM TIIO� REQUIREMENTS OF CODE ✓Lps { IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE Y J INSTRUCTIONS SEE BOTH SIDES �L� `� iir L A, PAGE I FILL OUT SECTIONS I - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED 7 s I& " y+ SIGN/ ! F E E ZED AGENT PERMIT GRANTED r ILL Ire IL I I SEP 1 O"T" 1E 1 __ r- z '" I�'`L�'&�triltl4':i:.t'v� -7 S' bad' pv w/A 3 PROPERTY INFORMATION LAND COST - .F EST. BLDG. COST e p ood. — `t EST. BLDG. COST PER SQ. FT. A EST. BLDG. COST PER ROOM V SEPTIC PERMIT NO. 4 APPROVED BY t BUILDING INSPECTOR OWNER TEL. # 15 -OF a � 2 7CFa CONTR. TEL. k CONTR. LIC. N. V A®J x H.I.C.# iS VIM SINGLE FAMILY STORIES MULTI, FAMILY . OFFICES' ' APARTMENTS- t CONSTRUCTION 2 FOUNDATION I �7I} 8 INTERIOR FINISH 3 „I . 2,. I,3= PINE HARDW D,— _ - PLASTER CONCRETE CONCRETE BL K. BRICK OR STONE PIERS — DRY VJAII — _ _ UNFIN. Y 3 BASEMENT AREA FULL FIN. B M T' AREA _FIN. ATTIC AREA _ NO B M'T' FIRE PLACES _ HE .O - i- MODERN KITCHEN _ _ 4 WALLS �I " 9., FLOORS CLAPBOARDS `. CONCRETE EARTH HARDW D COMMON B I3 _ _ _ DROP SIDING WOOD SHINGLES -ASPHALT SIDING ..ASBESTOS: SIDING. ,VERT. SIDING ASPH. TILE STUCCO ON MASONRY _ STUCCO ON. FRAME BRICK ON MASONRY - ATTIC STIRS. &FLOOR BRICK ON. FRAME - CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME - SUPERIOR I� POOR ADEQUATE' NONE 5 ROOF 10 PLUMBING GABLE I HIP - .BATH j3 FIX.) GAMBREL MANSARD TOILET- RM. )2 FIX.) WATER CLOSET _ _ FLAT I-SHED: 'ASPHALT SHINGLE LAVATORY WOOD SHINGES --1` KITCHEN SINK' SLATE - NO PLUMBING _ _ TAR'-S,GRAVEL STALL SHOWER ROLL` ROOFING MODERN FIXTURES _ - TILE FLOOR _ ` TILE DADO 6 FRAMING II 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT' AIR FURN. -TIMBER BMS. & COLS. _ STEAM - �STEEL BMS. & COLS. HOT W'T'R OR VAPOR- aWOOD RAFTERS _ AIR CONDITIONING - RADIANT H'T'G UNIT .HEATERS, NO. OF ROOMS GAS .OIL _ 2nd _ 7y1 - 13rd. -I ELECTRIC NO HEATING - cz 73 0 04 0 I= C: Qj -C u . 0 E v - >1 U) u = oU0 w z z a zC: 0 to g2 >- u U �7, w 4 0 w In, 0 > w U)v ccs 0 0 c0 wV) y 0 E C/) co My� _ -- z o z a.CC 0 t5 0 LU co Ea CO2 r C:) CO CM LU Co < coLU L CA co 8: .�E.S U) cm cm C-) cm oc C13 0 co CL) CL C ZI, CD as co tm co CO CL -a cm CO vo ca CO CD cm Cc o co cm CD CD cmco) CD :z co C.3 < Z CL LL C.3 Ci c' > 2 M C, cm A2O 'D s Q co .2 F— uj w COO 40 uj s -c; C5 CL < CO) LO) CL -.S C,* E C.) CD cr: LU C.) CD LU L.3 co CD CL CD,— OLD :2 < coa = CD -j LU M C3 :2 •= CD L- a_ U) d. ,k F- Co w Cf) Z 1 O !-L^L V' M 1 CL O= O ED cc j w. w n' n ~ aao� O (� _V 0: L s W _ an_1 s�arw Q 0Fro- wF Qz �U ; N -M W ti ? V �% F-aCL ZO ZZ m 7 t U q 0 F- �nnn/// -j F-Qd j „m w IL�Zm co 2 (p P G2N q 1 cr Lu Ir Ota- co ~ a c W M "= 1 Wa07d 1 a M LL Z z ? N In azaxd Y=�\ ca=rl-Po aa otirK - FOLD ALONG LINE wool lz M U O Or w i IL 4 O N p a M w z<' 1, H rn Z U on w° Z V W ►� O Q '.. N= m Q�► Uim J CJ C? LU U O m IL V} W s"L 4 'm ¢ a o O N F' O LJ� q v) M ttF-� w Q+ o o Z cr -) n+ o G9 J Q 0,,m J N z UA 0 �22F j ori 90 Q to O a QaF- N 2 ) M WatL' LL \ E zN \ WLU ZNp D O m O LL d a N X- w 4 -7NS e . --- -- ON Qa z 3 O zra m O = S N l!1 'a = Xcij Z O o O x w O o - W H O\ wr 2 D �t a r Q �v ` 2 (L = N z O O w- r^ o a Q N U) F Q 0 O\ rT Oe)rJ a o m -< o a O Q V Z O Z `_ O z \ Q Q v\+ F-LU Q U z m m in ?- `IrO o a Q la .�...»• W Q� C7 o FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or ,landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLI CANT : it) O U `- J Co ot,_J 67 LOCATION: Assessor's Map Number Subdivision -treet /0 o o �� c�zt AO cj Phone & 19 d_ ` �0 5? .3 Parcel Lots) St. Number ************************Official Use Only************************ OF TOWN AGENTS: onservation Administrator Comments Town Planner Comments Food Inspector -Health Septic Inspector -Health Comments Public Works - sewer/water connections - driveway permit ,,,,ZFire Department Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Received by Building Inspector Date ��2 ,�: .,rr`S } �•�, �".''� : t•-�;4 7d �° � v '�� - $ �' 'fir .'vr ���. r�,R°.. � r ',. �O� °rix •v v; r �6v- � r '✓,t vr1 :.ta' >w � q MOW � "'' D'�.3�'� a' t'" iTM a5�•' \ 'a l • 4 }. i -�; t �°�y r � 1 :. r � .b'J r air a- s'� �:t _ .,. •� 4 '3 { t 3 t ra Ar � r Y L ` 9.4 { f t'y-. f 'i� n r.. 'a :. - 1.+. I x r d r s i L a...,,• ".'.moi S• �7 1 r _ „s T- '• �. ; . e. YC .til, l � � � ,�� w �,� I � � •, , 1 .. .� � • •T' - - .:: t Ayi._ 1 � ,�• ✓•j. ,.��f-: r. ' - ax ^�34.' 1 �?.� 7 „ „,1 - , J�� ... � s � . D :«k r� s' *;? x �* 8 f a3�� �� tt'+"' r tr�'.4�.� q..i��•.'�•as y. �� �"Y 1... �� i s .. e t L }• x'�f. �� '' � � s �4t r e �� T I� ,is � l F 'Nyle '� .., 4A �� 9�'S`�M• ,.y : a �a C .R ts"3 �� ,.-'tie $ s;� •b"`�,�'��� � � k,sxl .J±"L�'J"� :�yya K� av7i'ry�_ ' �' �— x.a� ytl/;°�: \y/��'Q '.✓4 '. �: .�T� -y%`t ��1'+ J � �f�ay �"'��a��- •v+'-... O � �I. 'ViRViet9i'w� •.� Q "Y d __-77771 ,.1 1K t i. ' S� 3 6 i.• A � .10 �.. � � e � r'l,f �, 3 j sA� y�! l t / : -•..� xtJ�'1A�y.,r. ��""'��n��;� t: � '' �,,y+..�aa 3e",F .F ...�rc'�' ^'�e - �r x,t � , /. "/• .Y"4�' I �� � " .. _<�: . � .. C7j7 * � c.�, Esc-��r /%. A .,` �'.. r tF� e • vIt ella IL IX n � '� tits � •� � � j r� — - - - - — t T is "�� i sjey.��:: 7� �. - • � � . ,, yea r�k�w ? y .. / - ^fr�IS4 i4 3. Rtfi'��"h°`tr'J• 1� c ;ix s t .. { 4��`�.' . _ J,� L" x a. +I Syi � �� � •'kY, rrt �, � ♦ - b � I � �.5 e { ...ls� . � _ �y ' ��, Z �.i .i � �T,�`y. �°' Y .' 2`5 C"i.# E I st ` 1 t�'•^r �, +S.C'��'t-4/ 7' i• '.s' S.5 ,1 r`• ^ �5,� c '� r }5� � �� � 'i�t Iry �rt�``t`e it x '� "� � '.- ...ytJ s ����i _ ..�.�►> a R s -" ..�, X .,c> t �1 t°� t ��� � ��•^ i x ', r YTM•-g��. >�'S'ii� sr --i i t ..:' .'}� .. . l wcA�wT� �gARN �• Al If \ 1 t7 --,-J-L�- � � I I { I j r � { I i ix I--� ' --�-- ' ► I - r � I f r I - -- ; , cv —fi- 1 1 Ile 1-7 I I r , y _ p I � { i i I � 1 I I• i I i ,., j i I r I i I , —a---1---+- -- – I �_! i � 1 -i_ �--1—�—►--x__1__1 � _� �_ ►_� j_ �.�__ i i► I ; 1 j i �- Jill 1 It , I _ I I j �� I i l j_ � ► I i �� i- �� ;; 1 1 I �- - Wood Ridge 10 Wood Ridge Drive North Andover, Massachusetts 01845 Telephone 682-7093 TDD Line 1-800-545-1833 Ext. 143 September 13, 1994 Town of North Andover To Whom It May Concern: We, the Management Agent of Wood Ridge Homes, hereby give Gibney Construction permission to build a maintenance garage revision located on Wood Ridge Drive, North Andover, MA. If you should have any questions, please contact our office. Sincerely, BARKAN MANAGEMENT COMPANY eiin'ld4a�U. Feeney�en Property Manager w