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Miscellaneous - 100 COVENTRY LANE 4/30/2018
m `S MAPFRE The Commerce Insurance Companyw Citation Insurance Companyw Commerce" Gore Road, Webster, Massachusetts 01570 INSURANCE- 508.949.15001 www.commerceinsurance.com January 21, 2015 BUILDING COMMISSIONER or Board of Health or INSPECTOR OF BUILDINGS Board of Selectmen TOWN/CITY HALL Town/City Hall NORTH ANDOVER MA 01845 _ RE: Our Insured: PRAVEEN K SHARMA / MALINI SHARMA Property Address: 100 COVENTRY LANE Policyk YJ4184 Date of Loss: 01/20/2015 Filek JVVC76-HMNNH4 Claim has been made involving loss, damage, or destruction of the above captioned property which may exceed $1,000, or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If any notice under Massachusetts General Laws, Chapter 139, Section 3B is appropriate, please direct it to my attention. Please reference the above captioned insured, location, policy number, date of loss, and file number on any correspondence. LISA LEAHY Telephone: (508)949-1500 Ext: 15846 Sr Claim Representative, Property Toll Free: 1-800-221-1605, Ext: 15846 On this date, I cause copies of this notice to be sent to the persons indicated above, at the address above, by first class mail. January 21, 2015 WATER DAMAGE IN BASEMENT / TOILET LEAK AND / OR SHOWER LEAK F.. CIC 254 (Rev. 4/95) MAIL 788 9330 Date. :�•� :�� TOWN OF NORTH ANDOVER o PERMIT FOR PLUMBING This certifies that . !/ G! . �% /�.``..!/. ei�G. >'r1o/! ?...... . has permission to perform ...gfh�ho.4t? �:�N.S........ . plumbing in the buildings of ..S�r�ia `+• pO , NorthAndover, Mass. at..... ...................... Fee. W100.. Lie. No.......... �1 PLUMBING INSPECTOR Check # %'U MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORD CITYAn d O v -el- ] /V I MA DATE I a/oZ c�I� PERMIT/tl JOBSITEADDRESS v p AO 14-1 /�/ jt OWNER'S NAME] %1'ly la /1 / �%t G 'A Q r OWNER ADDRESS + `Q Q Gav' zn ]TEL] fjy IFAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL [ RESIDENTIAL PRINT CLEARLY NEW..: RENOVATION:I REPLACEMENT- PLANS SUBMITTED: YES 1 .I N0j I FIXTURES -1 FLOOR-' 13SM 1 2 3 4 5 B 7 8 9 10' 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE 3 -- DEDICATED SPECIALWASTESY$TEM DEDICATED GAS/OIUSAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER I _: J DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREADRAIN INTERCEPTOR (INTERIOR) i KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL t& SERVICE/MOP SIN I( --- - -- - TOILET -_ i URINAL WASHING MACHINE CONNECTION - - WATER HEATER ALL TYPES. - WATER PIPING I OTHER INSURANCE COVERAGE: have a ctirrent liabilityiilsitratice policy.or its substantial equivalent which ineets the requirements of MGL Ch.142. YES KI NO n / IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE.BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY f BOND OWNER'S INSURANCE:WAIVER: Fant aware iliat the licensee.does not have ihe'insurance coverage required by Chapter142 of the Massachusetts General Laws, and thatany signature on this permit application waives this requirdilent. _ CHECKONEONLY: OWNER AGENT- I SIGNATURE bF OWNEROR AGENT I hereby certify that all of [lie details and information I have submitted or entered regarding,lhis application are true and accurate to the best of my knovdedge and that all plumbing work and Installations performed under the permit issued for this application Wilt be in conhpli e' h ait P 'ne t pro ' on of the Massachusetts Stale Plumbing Code and Chapter 142 of Ume General Lags. Sv� / � PLUMBER'S NAME[ It r� ILICENSE If � MPI✓I JP1 I CORPORATION) .1111 3YOI IPARTNERSHIPI 11tj ILLCI* 0I COMPANY NAME ] Ai// 011et eell U "� ADDRESS ] a (j G , �ilv'c/ d / ] CITY] , �Qy�C�G l .....-• I STATE I %'la I ZIP ] !ELI FAY, z ail by o w LU 0�1 CL U F © u to M f 44 [u tu ® O � F P-9 v J OL a � Lu N. Z M Pk C� 'f1r�Cp�jlfiio.'��tr►ecilllt �,�1Gfrsstrcic�rs��ls ll��tix+firteirCo�'XttrTirsCe�tal•�steeitrertfs 40e ii40.;�lSIllllgft7it SYt�ef Bosrott, MA 021,11 'r � ppil�autisr�oifffrt �tt�Tcc�s�'Contlietisntniiitr�tti+n�i+�Citl'i��+i� itititcrslLronfe'11�f0i5�ie�[IlCinitslt`'lui[ii'j�alf� �Lrtlr:6tr�ir:ei,ti,Ivy�er?Ct►ccTsthenp�,!•oprit►teGos: - •. I:Q tt,ntttentplb�crt�iti► �1. [l IantngencrnlcoitlrRcto►ntitl wilt%gees{fd(nitetfarl, t tiuc):= (,otottired[Ito sttL--cowraclors •OXnittlsoIoproprietorortioqncr etttititfienUttcitetiSt�et;t stop and hat+otto cniltio}ccs 'hies . sttb•eoti(rneiors rilia ator[:iuji.for.Nofat<nycnptidily. ers comp:;nsiunttce. (I�atroFccts�cQtitp:Jnsttt�uco �. VeArzecbiporaliountidits nxjidRtF,j 311 I:,0nt.tifianieowiierd6itignUiXotfi Qhicers havo c.Kercised Fhcir rfjhtofc eauptiottpt:rMGL ttt3 eiC jHa•jro&-tre comp. fusurnrtcoretwedjt •0. I52, fit -1), riudieelgive Ito otity?[oycei.['ti or><e e (h_tct;;<txG.� l`t t;ucsirJ,o fill cu! aYad"CAnn --/a 911 ���jtb-bf I»•ojcetireiluiiiilij; G: b ifieiE t iis(rdton 7. d Itetnotii:ling $•+ �D'etitolfGoit �. []'liiiildutgt<tiditiot� I0,arleclt4caliepnitaorntCditions Q �rilntbiugtekjtOoradd itiout m.Ef 1Zoo1'repaht O'D Oti,cr ltutfntiFttipJ�t�c+rllrRtirliiol[rlitrgr,+ortc+1,s'cnril,.c��rsrdioirLrsrrrrirrrerntt+eirtvlrc�s 13e[w,*lrtlreE�altei+attt[fn[islfe�� li�artttotlott. Inst,rauccCongtnnytitiultt� .. . holit:�sfkorSe(fins laic.Ik . ��jiicitti�nl)ate:� - . 4t Site tt ilStatclzij);.. /lffnclt n col,k bf (tiCt�'f1YIi(!t'$� CE�tpp Eit,si<I011 ilbliyJ� (�ecfrit'nt ipir (tnge (sJt41s'tlt (1i61io1[cS' jiti� icl�gt [lltfi $l�itiiiiQt[ tiII[C?. r<�iftlrc toso�lrre+tatt:iitgens requited underSei;tiolt 2518. ofMGfrc. f 52cmt Ceatt (o (ltc fi►ij,ositio,tQfcri»,i,inip�ttafdcspia t fits ujr to:St,SOQ.btt attdfototit{year fu,pt,so,nne+,t,. l,s. titc1C ns cie[[ pe,iailics. in the fort►t oEtt STOP:\t'UIZ[C Oitd);IZ iiritlii,IC ofup(05250.ODnetay'l�aFiuttGFt�iotntot: Uottdt�iseitl6�thcopy�bft[ussiatetne,tiuzy�befonvariietltot[teOfficeof -tales Rations ofI MDR --for fasumticeco>ierogerec�iticatiotr. Xtivl earj. --- �� �17 60vitrltrsy=.ot I'm pa riot tl+ri2lrr[i is area, to ht, conuiteled 4p.Cio artai'rr o'?ffe al. Cita• or [ oii�tta_ .... •I'etiiiit(Lieglisc IP Is�ti6ig.liii[fiarif�t: (cnzte ottc); t. i3gsrttofHOldt 2.BuitdingDeparlinc:113.CitjfrotviiOe.& 4, LF;ctrlcgltuspee(or &.1411mbfag111slieftot` 6. Qt[tet hiforM0400 and 10*fte, t It asszfcliu$��isGeneralLatusoTfapfer?i52ret�(ii es ctlleiitpIagersiolJiYat'id'a:i�iorf€crs' 1001, ,pwi& J� eapres.011tall, p6d6a�ecfi pt" he169ftlo or oii-.0roaterlogll:enlivgifitoyf�g.,clp Howeverrub tTu-qe4ipafh)ieiljs;andjvIjo resines liereworthe occuplit-oprijo hollsuorallollier-who, 611P16ys-,p-arsong J6*do.jIaii&Mlice-, Con.strYetton orr6paw r-%,vo'rK' on slid! (tjV6jljh,- jjujfse filerato4ballinotbecallgo of M-%- Chapter 02 py pe-rillitto oftrifte, -.1 blighless, 0M.--tonstrilet btilldings in flio . r0goreqtdveo? Additroaally MGL Ich 41) to r I S-% §25C(7) *8 1 " it CS , Vt i t I I a r Chet 0111 n 10) lvv eal 11111 or a fLY 0 f its p o I i t6l. A d Nis i o n $ shtif 1 400 into any coijtract for t1to Per f0M)a Ro of Pub) is ivork- witil acceplabTa evidence. orqomplia lite 1,1161 V, la in ince Please f llfoll€.66 OMpkt .1, V ' .1 -f MCPAfti SUPPIYAlb-conthatfoi(g) along 10th the iceifi*&4e(s) p Iii6ib.e-rsorl)arbiersi',Ireitotrequiredtoqar4elvi)rk,exeGoiiipeii§ati'oilinsurance. If amLLCorLLP does haw ftPloYcos, fl.Policy is required. -B edvisedthattlilis -iul-clat;ifilltLyb6sfibniiqe(itothe=Depadiiientof Industrial Acotdeiifs-.forcoitriminti(iitofilisiii-aitco.coverago. A�fsbl)esilre-tosigitAlid(Intetlitpffldlvit The. 6110davirshould be returileirfo the. city or town fillat (Tiolipplicatioil for the petli it or license is befnz-,, requested,, not thaDeparinieWl of IndwskinlAccidetits. Slioltl(I pa llavp ally,pueslibils re-ga"AIX-1110 hiv ft i fyg�u are reqith-ed to -obfaht a workers, ipgiytegation Ijolicy, please call th, ee1i , " 'Volf-iffWreit coil aiiiesihottictenfertltcir Cikv or To - . jv�ji offichals " ; - hPlet"114 . . q0I Af (AgAaffldavlt for youd fi If biffin iho�.0y6ilt the Of rjce�bf fn . estij tio s. Please -ba Surd (0 fill in refcremd-filimben. I-Wa(idilion, allapplicant Matimistsubibit. 1110CIple-permittlicellset applica(tolisrli arlyghrtil year, nee(Ionty salt»tit one affidavit indicating ctnrent p0lie-yinforination (cIfy- or - ftleVittliathasbeen qffj-ct,,j'j[ysjanIpad Ormark-dd hY 1110 elly or toinmay be-providW to ilia _.. f4,�Vli)2'A CQPY ofthe a NiVicant as proof thafa vafid !iffidavitils'dil fit6forhture-perniltorperil' s; of licenses- Aliejv�feLdavj(llluS,[ - fic filled ollf eadl lit notrelated to ankbushless orcoibmercial vojituko Oe-adoglic-ensp, oeliefnnkito bum leaves etc) said person isXorrqui irad to completeflds: ti.-ffidaiif. 11-1a 6h,14- 0fjmkftIp0oIS would 11W O'kilkybirril advance, M610 N,011,111116 aiikqdostioil§, (10 not telej)IIbile-olidf-ax Thp, 1361jadmeilt of office 600AVashington streot Boston, MA. 02111 -or TPA.0617-72MPODW40 - 77-:MASsAr-B � � 6 Iz eivlc-qd AOW,721-7749 I Date.. Z/Z.®! ........... . TOWN OF NORTH ANDOVER 9 PERMIT FOR- GAS INSTALLATION This certifies that ......... . ..... A,00d � :.' �j?S ........��r has permission for gas installation ....5../* .............. in the buildings of ... 1,-?kr.W..4 ........................... at .... Av... �, h .. . .......... North Andover ass a.Fee�:SLic. No. ql.. ./hlf,-. GAS INSPECTOR Check # = MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING City/Town: /yO • n JQ V CK- MA. Date: ---a Permit# i(,O C'O-✓c r ,��j 4/*1,* Building Location:_ /!r' Owners Name: 9 �r q i' Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential er- New: ❑ Alteration: ❑ Renovation: 0' Replacement: ❑ Plans Submitted: Yes ❑ No ❑ Mv-ri 13C - - - - - - - - -W � z Lu - - fA _ WW couj o7 L) :C (n 1�0R' � Z F- UO � WZ w w O 1— mv>> o Q LU o�a w X 3 LU Q' W U W W Z Lu O �O W F 0 x LLL1-1 Lu x W W W Z W O U o W Z W o J 1— f— O Z J 0 co w w -m W O Z C7 O O u- to 0��> Z I- x 0 Lu >>> p 46 u_ x x 11 SUB BSMT. BASEMENT 1 FLOOR 2ND FLOOR 3 FLOOR 4 THIFLOOR 5 FLOOR - 6 FLOOR 7 FLOOR 5 FLOOR te # Installing Company Name: _ %� c� �len 0 ✓G U17 Check One Only Certificate L Address:City 01 orporation G r /y( / � f,� Li Partnership Business Tel: �? - Fax: f2r-- If yS � 9 y.' -`- ❑ Firm/Company Name of Licensed Plumber/Gas Fitter: r%`j . 4'r- k. I - INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes,IKNo ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A 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 Signature of Owner or Owner's Agent Owner El Agent El By checking this box ❑, I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and -- ...y .....," c.,yc JUUlndL du Piii trio ing worK ana mstauations perrormed under the permit issued forth application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and �ter_142 of the General Laws. � B I le �+ /Z �, Type of License: y lumber Title Gas Fitter Signatur Lic used P er/ fitter Master Cit /own ❑Journeyman License Number:A POC l �6� USE ONLY► ❑ LP Installer �— The Commonwealth of Massachusetts Department of Industrial Accidents Office ofInvestigations 600 Washington Street Boston, MA 02111 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers nniiennt 1-nfnrrn0"-- � iou�c rruii Le Dl ' Name (Business/Organization/Individual): lir rii/rr . - - Address: =- - - – – — /w City/State/Zip: y xijr Phone #: Are you an employer? Check the appropriate boa: 1. ❑ T am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time). 2. ❑ I am a sole proprietor or have hired the sub -contractors listed partner- on the attached sheet t Ship and have no employees These sub -:contractors have working for me in any capacity. [No workers' insurance ers' comp, insurance. 5. comp. VWe are a corporation and its required.] 3. El. I am a homeowner doing officers have exercised their all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no in required.] t employees. [No workers' comp. insurance required.] *Any applicant that checks box #1 must POW till out the section below show Wo + °ir w f — 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 LICY Intormation. Homeowners who submit this affidavit indicating they are doing all work and then hireutside 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. Insurance Company Name: Policy # or Self4m. 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 ofM.GL 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 und�h;jgiins andp�r.alk�'e�s ofpe5pKyy that the 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): I. Board of Health 2. Building 6. Other Department 3. City/Town CIerk 4. Electrical Inspector 5. Plumbing Inspector ,.-e .c3 Contact Person: Phone It: VV U.. ,,, • 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 m 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." • 'Y. • 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 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 'we app)ica+i n for the p e7F Jitori hcel'_.se i8 being request-- , not f= Dep artme_tt 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 pernut/license number which will be -used as a reference -number. In addition, an applicant that must submit multiple permittlicense 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 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 Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-8.77 MASSAFE Fax # 6.17-727-7749 Revised 5 -26 -OS u,.rmass..gov/dia I CAD Peter I Lanell Regional Sales Manager Eastern Region 201 Broadway / Cambridge, MA 02139-1901 (617) 868-2800 x232 / fax (617) 577-8085 FORM U TOWN OF NORTH ANDOVER LOT RELEASE FORM SUBDIVISION Coven* T ASSESSORS MAP �0q C SUBDIVISION LOT(S) Lq+ Z PERMAJ�ENT ADDRESS (ASSIGNED BY D.P.W. STREET (,Men-fr,/ 1 A nP Q APPLICANT Vie, � �L.ecr��l ` PHONE(5 -Z5,60 —� DATE OF APPLICATION k)qo,st � �'l , (q. q V TOWN USE BELOW THIS LINE PLANNI G BOARD DATE APPROVED? qi T N PLANN DATE REJECTED CONSERVATION COMMISSION A DATE APPROVED _f/11 CONSERVATION DATE REJECTED BO RDAOF HE TH061/ —A /j t 'V DATE APPROVED �I HEALTH SANITARIAN DA'Z'E REJECTED DEPARTMENT OF PUBLIC WORKS DRIVEWAY PERMIT SEWER/WATER CONNECTIONS FIRE DEPT. ct'�Ge, RECEIVED BY BUILDING INSPECTION DATE 9p, 17 .. .�. .; r. .•ter-«_,- I^I•�._ r, .. �. This form shall be signed by the agents of the Planning and Health Boards, the Conservation Commission prior to the issuance of any building permits for the subject lot. This form shall not releive the applicant from the compliance of any applicable Town requirement or Bylaw. Location /'� ) (- n, I'=-kiT &?-1 J d No. Date //�V� Y�If AORTN TOWN OF NORTH ANDOVER „ Certificate of Occupancy $ • i a ` Building/Frame Permit Fee $ #ne ►A' ,SJ+cMU Foundation Permit Fee $ Other Permit Fee $ SO , Sewer Connection Fee $ Water Connection Fee $ RECEN'ED RA1'WIL $ sc NOV 4 1991 Building Inspector No. Andover Collector Div. Public Works N THALS I i011.1 )ING 1..'J A NN I N DA TE. LOCATION Town of, 1. I JIV1';I4 IN ()I-' P1,A,NN1NGv -& ("0W1[%1LJlN1*1'1' <f -.K) u ( ---A-) -(J-2 I :Aklilq I I.P. NI:I.tic )N. I )II (I: (:'I ()It CHIAINLY APPLICAU1011 ANO I'LK'M11' co PER11IFF. # OWNER'S NAME: .GUILVER'S NAME:f�i�N QG{ L n ��s - Y'IA SON'S NAME: I a!!j -7) 6 4ASON'S ADDRESS: /S- f36:11JIU��- j. fASON'S TELEPHONE: 7. IATERIAL OF CHIMNEY: NFERIOR CflA-INEY: alt 6-- -mcuolz dumju JUMBER AND SIZE OF FLUES: 7HICKNESS OF HEARTH: X- /zx :jitt CIVD)Iney an. ()i)Lep-eace conomill to 4he Imp.imille)l.C.6 oo the code (1)111 have Aucc-5 am( -egutat.iou,s been /Lece.�ved: IATE: .:IGNATURE OF MASON: 'PERMIT GRANTED: FLE 50, 00 O.BERT NICETTA UILDING INSPECTOI NSPECTEO.- BlARKS: SOLID BLOCK REQUIRED 7-111S PERRL 1r MUSF GE VISPLAYLO 014 111E PRLAIISES u. r F:w t. ; y: < rhe .: a` yn aa'w-+ r, rtr y. ,.,-� t 10 -I ` : r r!';: a-,. 1 ! -.Irk f -;I tv " 1 __,., '•�"! " +u :ft K 17 -. r..4 S'uS 4 r. -vvyncyR' ,P�, • 1•i.9. � s"' : *'r7' •, `Fli- ;iOx � _ i V Y{t+ , 1 ^ t .r -I . ti y L,i y i r,) Yai* wr I. ' # ^1'Al „ Y to 1t;!'ri•., ffJrr y" ,, ,. . mu Yrr . � r +i` A i �, r 42 ir,���//t ; f t€ r rz -rS.�i _ }'� . .i r ;M;}r t`` . ' r i y,+ n}r s A�_ '+ ,' - 0,x+5 ,i•r { ay } d^" irX , r y r i + ',L r` �,. _ r++y, _r y § t r . i, r •i, in y, J „+....n.; cry .. � •. S ii ,"f %' ;" .. k r r , 7, v t ,rk t d � I r, t 3 t y ', r , sa 3 >YR m > r ,, p i,, 4i txy t� 1 a I-. t' . 3 t= f '+ t -Y'� x f J .�d r f J �' �'� l'S�i[ SC'f.ct,4 , ` . 7 .. 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Mil H E i G. 0 E cx Z zi i- E C in CL G V to w WD .J )b)b)-) 0tM jo W c—scan -Lar21o� T� o� rti o T-�t 2l0 ,L yl �.�t '?io,� ►^� o-•� �lczu�d s n 4E:� rr t a'1 S n rl c�4F}S 5-1-'�S �j o 0 •ssd��a-��.oar-,d ri�-aofti •SS r31�oa rti o � 1^1 l d a1.1...b��o^1 SCOTT L. GILES, R.P.L.S. 50 Deer Meadow Road North Andover, MA 01845 683-2645 ?117 /'?/ i��'w ?J "A ;- fe: � :.q� . ''� � � -� +1;+ � s ;ti�: ,. ,. �'Vx:tc-t s° i I R �i d 4 m 0 u Location f [� C{ 01/�1.��'2G , �� ijr No. Date MORTH TOWN OF NORTH ANDOVER 3'ri •BOOL Certificate of Occupancy $ 151, ML- Building/Frame /Frame Permit Fee o s $ r3 Broe S Foundation Permit Fee $ ss,KMuE Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ l $ y c1v 1 Building Inspector ector `_. 8045 Div. Public Works P19E11tIT NO. ���— APPLICATION FOR PERMIT TO BUILD —NORTH ANDOVER, MASS. PAGE 1 mnr wU. LUI NU. 2 RECORD OF OWNERSHIP IDATE BOOK 'PAGE ZONE 1 SUB DIV. LOT NO. - 4 Lo Ir Z LOCATION s PURPOSE OF BUILDING Tt OWNER'S NAME �,�Q� 'T. /yCn�/) 0 C NO. OF STORIES ! SIZE (o Slaa OWNER'S ADDRESS 0 /1o" VVVT LAnL �- BASEMENT OR SLAB K A Cf -•SC OIL1 �ON� ARCHITECT'S NAME oy�^�l-\ O`y,� s w_1- SIZE OF FLOOR TIMBE tS 1ST to 2ND �jj� 3RD �/'"j BUILDER'S NAME r�' , SPAN 10 DISTANCE TO NEAREST BUILDING f;fV` DILyr, Ijh� I+'G 7 NVi aV DIMENSIONS OF SILLS 1/+�, POSTS V DISTANCE FROM STREET �y If DISTANCE FROM LOT LINES - SIDES N u� REAR �y � 5� GIRDERSS- Z A 10 AREA OF LOT 6 (yOtk .l. Q FRONTAGE 1 J HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW Wft SIZE OF FOOTING 17 it '� X c IS BUILDING ADDITION ie: - �� � yn__ M Y�.V� MATERIAL OF CHIMNEY t4'A ��IS BUILDING ALTERATION J IS BUILDING ON SOLID OR FILLED LAND�� p WILL BUILDING CONFORM TO REQUIREMENTS OF CODE �C IS BUILDING CONNECTED TO TOWN WATER W%A INSTRUCTIONS SEE BOTH SIDES PAGE I FILL OUT SECTIONS 1 - 3 PAGE ::41LL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST B�E17 j� ED O APPROVED BY BUILDING INSPECTOR DATE FILED �f RE OF ENT FEEZ-IaQ C� ~ 'a. — t wl Alf? PERMIT GRANTED 13 19 IS BUILDING CONNECTED TO NATURAL GAS LINE WA 3 PROPERTY INFORMATION LAND COST A EST. BLDG. SLOG' COST Cj pl000 EST. BLDG. COSTPERSQ. FT. EST. BLDG. COST PER ROO 0 SEPTIC PERMIT NO. A 4 APPROVED BY OWNER TEL. # CONTR. TEL. # co AUG 17 r�,N �/A BOARD OF HEALTH t' PLANNING BOARD BOARD OF SELECTMEN " 1 ` C-&71- &D7 BUILDING INSPECTOR a BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILv OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES, GA - APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. ADD %T% 0tJ w._T vvlo t'�� z4 " R q1'= y013 CoN0. OF ROOMS GAS OIL QV_ LnQ`t LAQ 6 B'M'T 2n_d6 _ ELECTRIC v fv`� 1st III 13rd I NO HEATING I CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH B I 2 (3 PINE HARDW D PLASTER CONCRETE CONCRETE BL'K. BRICK OR STONE PIERS DRY VIAII —�(— _ — _ _ UNFIN. 3 BASEMENT AREA FULL FIN. B M T AREA _ '/. 1/2 '/. FIN. ATTIC AREA NO 8 M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN _ 4 WALLS I 9 FLOORS CLAPBOARDS 8 _ 1 R 2 �_ 3 _ _ DROP SIDING WOOD SHINGLES CONCRETE EARTH ASPHALT SIDING HARD" D ASBESTOS SIDING VERT. SIDING _ COMf.ACN ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME _ BRICK ON MASONRY ATTIC STIRS. 8 FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR I� NONE ADEQUATE '5 ROOF 10 PLUMBING GABLE GAM] FLAT HIP BATH (3 FIX.) MANSARD TOILET RM. (2 FIX.) SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING X TAR 8 GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS ADD %T% 0tJ w._T vvlo t'�� z4 " R q1'= y013 CoN0. OF ROOMS GAS OIL QV_ LnQ`t LAQ 6 B'M'T 2n_d6 _ ELECTRIC v fv`� 1st III 13rd I NO HEATING I Location llii) �: �'/ �2f _ � /,�� No.Date "/- A-,, TOWN OF NORTH ANDOVER ` 16'110 p Certificate of Occupancy $ ' Building/Frame Permit Fee $ UFoundation Permit Fee $ ,SSACMSEt n Other Permit Fee $ Sewer Connection Fee $ rConnection Fee $ FJ TOTAPNT No D- ab �'er cc/,e ct�,r Building Inspector Div. Public Works Location M Date TOWN OF NORTH ANDOVER p Certificate of Occupancy $ ;, ; = Building/Frame Permit Fee $ bAo.t Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ RECEiVc0 PMMW&nnection Fee $ NOV 41991AL $ No. Andover Collector Building Inspector Div. Public Works Location/( /1� Y 4 p t No. r� {: Date �pRTN TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ ✓ �° '� Foundation Permit Feeft'5$ i Za 41 Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee i $ TOTAL , 16 '19g' i Building Inspector / Div. Public Works Location No Date �ORTN TOWN OF NORTH ANDOVER p .ao ,ti0 � Oz. p Certificate of Occupancy $ Building/Frame Permit Fee $ f 3.2 ��~', oto Foundation Pit Fee $ CM'i+ Permit � Other Permit Fee $ Sewer Connection Fee $ .c Water Connection Fee $ - . TOTAL $ Building Inspector Div. Public Works Location No.. Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee Other Permit `Fee�� Sewer Connection Fee Z ; Water Connection Fee TOTAL j I Building Inspector ' CDiv. Public Works PER'MlT 90. ti APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. W U L � & A y^ / PAG>; 1 NEAP 4,10. 104 C LOT NO. Z� - I 2 RECORD OF OWNERSHIP (DATE BOOK 'PAGE ZONE k_ SUB DIV. LOT NO. L.O zq Ggenlr LOCATION l� CoveMr We N. A, n\)t1 _ PURPOSE OF BUILDING S+v^!`G gamt 14 Q&i �,A�• j 1• Y3o"A(o OWNER'S NAME pkf ` LaM,I IL^ NO. OF STORIES 2 SIZE cJQ r --r+ ` 1 OWNER'S ADDRESS '75 ,* wA � I MA Q ai R -o 067 I/�`,/y(��jp./1y�S BASEMENT OR SLABVJ ARCHITECT'S NAME A.,nML�+`,Y-c�Ajor C V\C, S J j)t�) `� `I� SIZE OF FLOORTIMBERS�X IISST+I'�` x 1,0 2N 2ND 2x y10 3RD 1 BUILDER'S NAME hof(\ "4j1.1..op Wh ^• �G Loy-) SPAN 110 ()(. 14--Fry bi_fl DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS `.D y DISTANCE FROM STREET 40 � POSTS .3 W,, U1's7y A'5 DISTANCE FROM LOT LINES - SIDES �•r REAR Zoo FT " " GIRDERS AREA OF LOT ial�('4I� l �•r FRONTAGE ISO V -T l\ ` HEIGHT OF FOUNDATION �� /_ �� THICKNESS I� 1�1 IS BUILDING NEW -S SIZE OF FOOTING �a I� /�`�v X ����y fil u" (14' IS BUILDING ADDITION" 0/4 MATERIAL OF CHIMNEY IS BUILDING ALTERATION O/A IS BUILDING ON SOLID OR FILLED LAND Sol ` WILL BUILDING CONFORM TO REQUIREMENTS OF CODE ycs IS BUILDING CONNECTED TO TOWN WATER LS ,I BOARD OF APPEALS ACTION. IF ANY p IS BUILDING CONNECTED TO TOWN SEWER es IS BUILDING CONNECTED TO NATURAL GAS LINE *s INSTRUCTIONS r SEE BOTH S1 ES PAGE 1 FILL OUT -SECTIONS I - 3 PERMIT FOR FRAMUBUILDING PAGE 2 FILL OUT SECTIONS 1 - 12 ATTACHED GARAG SUST MUST CON S TE LIRE REGUL7CT�OWS' �U� 3 PROPERTY INFORMATION LAND COST 110, 000 EST. BLDG. COST -L? q , SOQ EST. BLDG. COST PER SQ. FT. 74 /SQ eT EST. BLDG. COST PER ROOM 'Z51 S 0O SEPTIC PERMIT NO. 4 APPROVED BY PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR 4/f7SZlr�y 7 1j71� d DATE FILED SIGNA,TUREAF OWNER OR AUTHORIZED AGENT F FEE // 7b, SCJ PERMIT GRANT D c 19 3 o?6 si I an o p/ •®Idd 33J *31b® JNIB11nG/3MBi 80J 11W83d CONTR.TEL. CONTR. LIC. BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN 'NV"ld 101d S30V ld3H SIHl '43SOdWlH3dnS '013 'S3!JVU -V0 'S3H0210d H11M 'S°9N1a11n9 d0 SNOISN3W14 lOVX3 4NV S3NM 101 WOMA 30NV1S14 aNV 101d0SN01SN3W10 lOVX3 MOHS1SnW N01103S SIHl al I AONVdn00o t alOD3a JNIO11A9 0NIIV3H ON TI Pic I +`L 1! 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O w W q O ¢ \ 7Z.N I W 1A O (=ry pp0 gwio LL, = O \ y¢wtW7 OM H0r0 LLi t� 3 U. 1 s 0 ci Q W F- So O� 1 z ¢ a m H p p.z P o O Q V Z p T- q- i H M(-) W a \� iV O co W Gf X Mw z to ° LL ®. W Occ cn O at v Q QL fs� c�C 1z ig- f i i - a- tk7 Q` x - 4� i U _ f C6 a- tk7 Q` x - i C6 40 CNO A71 Q �^ t N Date .�1,�C C?...... . 3? ` TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION L y,SS�., SEt This certifies that .......................... has permission for gas installation ... ,-c . A.41 .% 1. t.:'� ........... in the buildings of .. T /./'f .L :1 ........................... . at .,,! .P:...��'.:. % ............ North Andover, Mass. Fee. . . Lic. No../(....... ...�........ GAS INSPECTOR Check # )I`i (� i 6913 _*4 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING �f . City/Town / � . Date: g Buildin Locatic Owners Name Type of Occupancy: Commercial g Educational Industrial£ a Institutional a Residentia l New:L-_j Alteration k__Renovation,' ^y Replacement Plans Submitted:. Yes= s No: FIXTURES INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes!A-Ad If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy Other type of indemnity Bond Li 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 AgentLj _.._. Sianature of Owner or Owner's Aaent" By checking this box ❑; I hereby certify that all of the details and information 1 have submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. r-- ------------- —e r_._.. Type of License: Plumber _w... 3 ✓ Gas Fitter _ Si nature of Licen d lumber/Gas Fitter Titley Master g Journeyman City/Townl w i License Number: u n000nvcn IncrIiXi 1 i ii n%u vi LP Installer iY WW Y Vj D m w = W W O U fn to H = CO W U) I— co W 0 Z I_ 0 Z J_ O >. IX W y W � W O Q W O 0 W Z t -- w N U w g m O W > Z I" W U W Z W >- W W W O J cn J W F- Q Z H Q 9 rn = O Z J m W 0 W a Z I— W N 0 ~ H Z W W W W 0 U W � O O u. Q W 0 0 W x W z > 0 g 0 CL Q a 0 W W H>> Z W Q Q Q H 0 SUB BSMT. BASEMENT 15T FLOOR 2 FLOOR 3 FLOOR 4 FLOOR i FLOOR 6 FLOOR 7 FLOOR 81HFLOOR Installing Company Name. Check One Only Certificate # t ►tC C ✓ Corporation n Address:'/.�/) '"` €_. 7` j City/Town (f,/ State: t � � • y„ � Partnership Business Tel: Fax Firm/Company,,, Name of Licensed Plumber/Gas Fitter:,^-�„ %_i'�,'� „, INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes!A-Ad If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy Other type of indemnity Bond Li 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 AgentLj _.._. Sianature of Owner or Owner's Aaent" By checking this box ❑; I hereby certify that all of the details and information 1 have submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. r-- ------------- —e r_._.. Type of License: Plumber _w... 3 ✓ Gas Fitter _ Si nature of Licen d lumber/Gas Fitter Titley Master g Journeyman City/Townl w i License Number: u n000nvcn IncrIiXi 1 i ii n%u vi LP Installer It m z n z a M v In Pn It tz tTl r O O O M C n� O z r C� M Location No.Date r TOWN OF NORTH ANDOVER Certificate of Occupancy $ Eco' Building/Frame Permit Fee $ AC MUS Foundation Permit Fee $ Check # r 18637 Other Permit Fee TOTAL /, Building Inspector() 1.1 Property Address: 0o CoV0.n i 1.2 Assessors Map and Parcel � t Map Number Number: o Parcel Number 1.3. Zoning Information: Zonin District Proposed Use 1.4 Property Dimensions: Lot Area Fronto ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard R 'red Provide ReqWred Provided ReqWmd Provided 1 1.7 water Supply M.G.L.C.40. 54) 1.3. Flood Zone Information: Public ❑ Private ❑ Zone Outside Flood Zone ❑ evr�rrnaS ol nin imimifT\J 1.8 Municipal Sewerage Disposal System: ❑ On Site Disposal System ❑ ------------------- �.......__.._aaa.w aiavavL.1L•L A%7r1\1 ' ""`�'v VloUllJt. rt:J IVO 2.1 Owner of Record A PRAM► GU -N MA LI0) 9HAW I00 COVNTRY L A Wt Name lint) Address for Service: NORTH AO, Qvff.K,� MA OR14 � Signature Telephone 91.9 25R L p 2.2 Owner of Record: Name Print SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone 3.2 Registered Home Improvement Contractor Company Name Address Address for Service: Not Applicable ❑ License Number Expiration Date Not Applicable ❑ Registration Number Expiration Date Ma M �v aaaal z O SRCTION 4 - WORKERS COMPENSATION (M.G.L. C 152 2506) 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 .......0 No ....... 0 SECTION 5 Description of Proposed Work(check au a ble New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: Y r &t fnve 1 SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICUL USE ONLY 1. Building. Z (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x (b) 35 �- 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 Y QtC Q Y _, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalfn all matters relativ to work authorized by this building permit application. Signature of Owner — Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, 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 Si ature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINMERS 1ST 2 ND 3 KD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE WOOD STOVE INSTALLAHON CHECKLIST F_'[1tT flUt Permit A building permit is required for the installation of any -,olid fuel burning appliance. The building permit and installation inspection are limited to the stove installation and -not to the stave construction, :.� Stove .-.i A. New Used B. Typelradlant Circulating C. Manufacturer lib. No. NamelModel No. E61 A Collar size Dimensions/ Height b� 4 ��� r - Length Chimney A. New Existing S. Size (flue area) C. Other appliances attached to flue (Number and flue size) D. Prefab (Manufacturer—name and type) E. Masonry/tined Flue liner Unlined •pro.. m������.., F. Height (refer to diagrams) cap avu, Ic' 2 NNL 3MIK !o CHIMNEY HEIGHT Hearth (non-combustible) Af A. Materials B. Sub -floor construction C. Minimum dimensions (refer to aiaaram) Clearances and Wall Protection t,see stcve i A. Type of wall protection provided B. Clearances (refer to diagrams) Ftlltrl�,r;t n c!etrances ---= "�*pRr•iER H AHIH WALLICENTER. Harman Stove Company - Add Beauty and Warmth to Your Home. Pellet Stoves, Wood ... HOME I PRODUCTS I SUPPORT I WHAT'S NEW? I WHERE TO BUY I GALLERY I SAFETY I ABOUT US Harman P61A Pellet Stove Discover The Powerful Difference Of A Harman The Harman P61A Pellet Stove retie on state-of-the-art technology to automatically adjust themselves to your desired room temperature. Simply pour your pellets into the convenient top - loading hopper and set the temperature dial on your P61A. If the room is much cooler than the set temperature, the P61A will produce a large fire in order to quickly reach the desired temperature. If only a slight increase is needed, the P61A will burn a small fire. This way, no energy is wasted by overshooting your predetermined temperature level. In addition to adjusting temperature levels, the P61A will automatically adjust themselves for fuel quality. An ESP (Exhaust Sensing Probe) analyzes the output of the fuel being burned and adjusts the feed rate accordingly to increase fuel quality. The P61 models have the widest heating range of any pellet stove. The P61A can burn any brand of wood pellet regardless of the ash content. This allows you to buy lower cost pellets and achieve the same results for less. Enter ZIP code Enter your zip code The P61A's high efficiency allows you to burn less fuel to heat the to find Harman same area as the competitor's stoves. Since the stove adjusts dealers near you. automatically to produce the correct amount of heat, it is the best choice even if you never need 61,000 BTUs. Ash removal is quick, 171r*ia its?=ir easy, and can be done while the stove is in operation. Normally ashes need only be removed every one to two months. To perform annual cleaning, simply unlatch and remove the blower cover located behind the ash pan. Now the venting system can be easily cleaned with a vacuum cleaner and brush. Page 1 of 2 Constant Tempera The P61/P61A will pr exact amount of hea heat your home to tl temperature. The tei remains constant wit ups and downs that other brands of pelle P61/P61A does not L thermostat as do oth stoves, but rather a probe that sends infc the microprocessor c This information is u the proper amount o right time to keep yc comfortable. The P6: has a Stove Temp M allows you to set the temperature as desk the room temperatui Click here to download a brochure about the benefits of heating your home with a Harmi Stove. Features ESP Control Room Sensor Patented Feeder Patented Burn Pot Large Ash Pan Swing Open Ash Door Accordion Heat Exchanger Options Side Heat Shields Hopper Extension Ceramic Log Set For a Wood Fire Look Tile Pack Gold Door Gold Air Grill http://www.harmanstoves.com/features.asp?id=21 9/16/2005 Harman Stove Company - Add Beauty and Warmth to Your Home. Pellet Stoves, Wood ... Page 2 of 2 Air -Cooled Combustion Blower Super Easy Cleaning Over 100 Square Inches Of Glass P61A Automatic Ignition 0 back We suggest that our pellet Harman Stove Com hearts prodacts be Installed "° t", � r d does not sell direct ad asewlced by professionals (1 public. We have no who are certified In the U.S, by direct or internet s the National Fireplace Msiltue ILL (101) as NF1 Pellet Speclallow ' Year warZt, Find a certified Har Includes Stove Company ser Parts & LaWr MADE IN U.&& Harman Stove Company Harman Stove Com 352 Mountain House Road does not sell direct Halifax, Pennsylvania 17032 public. We have no direct or internet s Copyright ©2004 Harman Stove Company. All Rights Reserved. Find a certified Har Stove Company ser dealership for purc Comments About Our Website stoves or parts or t service for your prf Dealer Corner http://www.harmanstoves.com/features.asp?id=21 9/16/2005 Harman Stove Company - Add Beauty and Warmth to Your Home. Pellet Stoves, Wood. HOME PRODUCTS I SUPPORT I WHAT'S NEIN? I INHERE TO BUY I GALLERY I SAFETY I ABOUT US Harman P61A Pellet Stove .,, Specifications Fuel Bio -Mass Pellets BTU Range 0 to 61,000 Heating Capacity 2,000+ sq ft Hopper Capacity 72 lbs Blower Size 135 cfm Flue Size 3 inches Outside Air Size 2-3/8 inches Fuse Rating 5 amp Weight 249 lbs Depth 29-1/2 inches Height 34-1/2 inches Width 23-1/2 inches Testing Safety Testing (by Warnock Hersey) ASTM E1509 Mobile Home -Approved Enter ZIP code Harman P61A Pellet Stove Enter your zip code Clearances and Dimensions to find Harman dealers near VOLU. Page 1 of 4 http://www.harmanstoves.com/specifications.asp?id=21 9/16/2005 Harman Stove Company - Add Beauty and Warmth to Your Home. Pellet Stoves, Wood ... Page 4 of 4 F(k . . Harman Stove Company Harman Stove Com 352 Mountain House Road does not sell direct Halifax, Pennsylvania 17032 public. We have no direct or internet s Copyright ©2004 Harman Stove Company. All Rights Reserved. Find a certified Har Stove Company ser dealership for purc Comments About Our Website stoves or parts or t service for your pri Dealer Corner http://www.harmanstoves.com/specifications.asp?id=21 9/16/2005 Harman Stove Company - Add Beauty and Warmth to Your Home. Pellet Stoves, Wood ... Page 3 of 4 w'uN uacvv 3PS" C n! 4. 23112" Is. ©n http://www.hannanstoves.com/specifications.asp?id=21 9/16/2005 Harman Stove Company - Add Beauty and Warmth to Your Home. Pellet Stoves, Wood ... Page 2 of 4 http://www.harmanstoves.com/specifications.asp?id=21 9/16/2005 �mc •cam o � c ` GO � C C-1 C7 d C tp l0 CED CL m C i V E Q C m o d� N E � .?: A C.)w .: �ts mi a I=.— V: I c ::. E tog C3 �3� N cm O N C C � m y M to c � O H m yCJ m O O CI :}'+r C � CO2 IA QO v y O C W Z =O O` C CL c Q m i O C = m � :• N a 10 o wN m.0..t COD �A =0 � lo" F N CL Aj Z W E o�vN o C.) ICD m*g oCM f g _ .0 ` N C2 F- a � Z a 5 Cn O C!) W 0 as o, Ca o ■�—M CD , C40 O O '1 m m CD 0 CD �3 'O O O O a C Q c ca v CL 0ta) C CD CL C.3 vs c C C cc y C2 a oa u w° U)cdc� Z ni Cl c wo to 4 U w a wo' CISCd w w ao' u � w � w a cA o z cn o cn �mc •cam o � c ` GO � C C-1 C7 d C tp l0 CED CL m C i V E Q C m o d� N E � .?: A C.)w .: �ts mi a I=.— V: I c ::. E tog C3 �3� N cm O N C C � m y M to c � O H m yCJ m O O CI :}'+r C � CO2 IA QO v y O C W Z =O O` C CL c Q m i O C = m � :• N a 10 o wN m.0..t COD �A =0 � lo" F N CL Aj Z W E o�vN o C.) ICD m*g oCM f g _ .0 ` N C2 F- a � Z a 5 Cn O C!) 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C�14S INSPECTOR Check # 31f % �/ 4102 MASSACHUSETTS UNIFORM APPUCATON FOR PERMrr TO DO GAS FITTING (Type or print) Date ��' o7 NORTH ANDOVER, MASSACHUSETTS Building Locations /A) wl,/- k Owner's Name New Renovation Replacement U Permit # Amount $ 30 411 Plans Submitted 0 or type)A C C ;�� n C e Certificate Installing Company Name— Name of Licensed Plumber or Gas Fitter � �,4-f 111 1j 1 W V Partner. Firm/Co. INSURANCE COVERAGE Check one: I have a current liability bmuance policy or it's substantial equivalent. Yes [:] No O If you have checked M please indicate the type coverage by checking the appropriate box Liability insurance policy 0 Other type of indemnity [j 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: Sixnature of Owner or Owner's Agent Owner 0 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 performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massaclu;setts Stay Ga Codd and Chapter 142 of the General Laws. (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber L Z 12 Gas Fitter ICenseNumber i, Master Journeyman r IMMIJ or type)A C C ;�� n C e Certificate Installing Company Name— Name of Licensed Plumber or Gas Fitter � �,4-f 111 1j 1 W V Partner. Firm/Co. INSURANCE COVERAGE Check one: I have a current liability bmuance policy or it's substantial equivalent. Yes [:] No O If you have checked M please indicate the type coverage by checking the appropriate box Liability insurance policy 0 Other type of indemnity [j 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: Sixnature of Owner or Owner's Agent Owner 0 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 performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massaclu;setts Stay Ga Codd and Chapter 142 of the General Laws. (OFFICE USE ONLY) Signature of Licensed Plumber Or Gas Fitter Plumber L Z 12 Gas Fitter ICenseNumber i, Master Journeyman r ., s Date .... �/ 3 TOWN OF NORTH ANDOVER p PERMIT FOR WIRING This certifies that..T .. �?..r-�.. ..` �.Fc. I..!...... .......- .............................. has permission to perform wiring in the building of d l/ at %Q �uvP" �� .Orth Andoveass� Fqq� . !k� Lic. No. 1�. �.. ....' '�, r. ee GX............... ECTRICAL INSPECTOR Check # 4337 �%irrt«t °d �a8![e Sa�dgr BOARD OF FIRE PREVENTION REGULATIONS.527 CMR 12:00 Official Up Only , Permit No. Occupancy & Fee Checked APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR% 12:00 (Please Print in ink or type all information) Dated To the Inspector oP fires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Owner or ,0 v Owner's Address &�L / /-e Is this permit in conjunction with a building permit, Yes V No ❑ (Check Appropriate Box) Purpose of Building E)dsting Service Amps Volts Nerervice Amps Volts Overhead ❑ Authorization No. Undgmd 0 Undgmd ❑ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work i No. of Meters No. of Meters No. of Lighting Outlets No. of Hot fuse Total No. of Transformers KVA Above ❑ In ❑ No. of Lighting Fixtures. Swimming Pool gmd ❑ grnd ❑ Generators KVA No. of Emergency Lighting No. of Receptacles Outlets No. of Oil Burners Battery Units No. of Switch Outlets No of Gas Burners FIRE ALARMS No. of Zone No. of Detection and Total No. of R n es No of Air Cond Tons Initiating Devices Heat Total Total No. of Di sal No. Pumps Tons KW No. of Sounding Devices No./ of Self Contained No. of PL6hwashers S ce(Area Heating KW Detec ionlSounding Devices ❑ Municipal ❑ Other No. of Dryers Heating Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW signs Bailases Wirinq No. Hydro MassageTuds No. of Motors Total HP INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO = have submitted valid proof of same to the Office YES = NO = If you ha ecked YE lease indicate the type of rage /checking the appropriate box INSURANCE = BOND =OTHER _(Please Specify)�l�L ��' 2���"S (Expiration Difte Estimated Value of Electrical Works Work to Start _ Inspection Date Resquested Rough Final Signed under the Pena ' quay n , /� �^ �3 FIRM NAME �hUa/✓ �%�l�l� �U_/%�` _rT LIC. NO. NO. --- Bus. Tel No. Address / ( 6 Alt Tel. No. OWNER'S INSURANCE WAFV9R: 1 am av&4e that the Licenses does not haye,the insurance coverage or its substantial equivalent as required byFMachusetts General Laws. And that my sjgnature on this permit application waives this (ggtiirement Owner Agent (Please Check one) ` Telephone No. PERMITTEE (Signature of Owner or Agent)