Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Miscellaneous - 108 MAIN STREET 4/30/2018 (2)
108 MAIN STREET "' 210/029.0-0031-0000.0 'i+.�r • ,Y µ.ms: y Date. .... ............... OF NOpTI�,�O TOWN OF NORTH ANDOVER p PERMIT FOR WIRING $sACHUS� This certifies that ................................:��.......!." has permission to perform ................ ..... ................................. wiringin the building of...... .. .. ........................................................................ at . -S.....:........ .-.. ?...............................North Andover,Mass. Fee.P?.. d...........Lic.N ...........................LE....CTRT-R- ....L..........EC.T.OR........................... EICAINSP F Check# l/ Official Use Only Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 3/7/16 City or Town of: N.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) 108 main street Owner or Tenant TD Bank Telephone No. 978-684-6612 Owner's Address 9000 Atrium Way,MT.Laurel ,NJ 08054 Is this permit in conjunction with a building permit? Yes [T No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. N/A Existing Service Amps Volts Overhead ❑ Undgrd No.of Meters New Service N/A Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Move outlets and light fixtures as needed during remodel,wire drive thru equipment 1 Completion of the following table maybe waived by the Inspector of Wires. No.of Recessed Luminaires 24 No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA V No.of Luminaires 12 Swimming Pool Above ❑ In- 1:1o. o mergency ig mg rnd. rnd. Battery Units No.of Receptacle Outlets 30 No.of Oil Burners FIRE ALARMS No.of Zones addres 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 I.Nu.m.b.e.r Tons KW No.of Self-Contained Totals: "'..... """""" Detection/Alerting Devices Municipal No.of Dishwashers Space/Area Heating KW Local❑ ® Other Connection No.of Dryers Heating Appliances KW Security Systems:* 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 desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work:$10,500.00 (When required by municipal policy.) Work to Start: 3/7/16 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee r « provides proof of liability insurance including completed operation coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: New Horizon's Technologies Inc. 0Z LIC.NO.: 17126A Licensee: Kenneth J.Babineau Signature t LIC.NO.: 31704E (If applicable, enter "exempt"in the license number line) Bus.Tel.No.: 978-422-6393 Address: 4 Campground Rd Sterling MA 01564 Alt.Tel.No.: 508.735.4377 *Per M.G.L. c. 147,s. 57-61,security work requires Department of Public Safety"S"License: 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: $02/D R I I V I The Commonwealth of Massachusetts { Department of industrialAceldents Yt_ r I Congress Street,Suite 100 Boston,MA.02114-2017 �t www mass.gov/dia Workers'Compensation bsurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Please Print Le 'bl A ' licantlnformation Name(Business/Oiganizaiionllndividual): J l Address: City/State/Zip: 51��C%moi !'�I DlS6y Phone 4: Are you au employer?Check the appxopxiate box: Type of project(required): ees m to 111 and/orpart-time,).* 7. ❑NeVST'dOnsfiSUotlon lam a employer with e � • P y ( 2.El I am a sole proprietor or partnership and have no employees Working for me in 8. Remodeli ug any capacity.[No workers'comp.insurance required.] 9. Demolition 3.[]1 am a homeowner doing all work myself[No workers'comp.insurance required.] 10 0 Building addition 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 11.❑Electrical repairs or additions E, 'ZO Plumbing repairs or additions proprietors with no.employees. 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13••0 Ro6f repairs These sub-contractors have employees and have workers'comp.insurance.t 14. Other 6.Q We are a corporation and ils,officers have exercised their right of exemption per MGL c. 152,§1(4),and we have no employees:[No workers'comp.insurance required.] *Any applicant that check's box#1 must also fill out the section below showing their workers'compensation policymust s information: i Homeowners who submit•this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such #Contractors that check this box must attached additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. , X am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. 5 G L 5�� v t �- �S. (o. Insurance Company Name: ___/ //Z�_ Policy#or Self-ins.Lie.#: 5 Expiration Date: 3 City/State/Zip: Job Site Address: 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 f this statement may be forwarded to the Office o Inveesl as civil penalties in the form of a STOP WORK tigations of the DIA,for insER and a fine of up to urance 0 a day against the violator.A copy o coverage verification. X do hereby certify�u de;.the��s- iid enalt' s ofperjury tliat the informationprovidedbove�true and correct. Date. b/ SiMature: —C 393 Phone#: q )r (/ Official use only. Do not write in this area,to he 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* 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 enferprise,and including the legal representatives of a deceased employer,or the receivef'or tmstdd 6f 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•wlid,has not produced-acceptable evidence of compliance with the insurance coverage requiired." Additionally,MGL chapter 152,§25C(1)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 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 IndustrialAccidents. Should you have any questions regarding the law or if you are required to obtain a wdrkers' 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-NUSSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia j COMMONWEALTH OF MHUSETT&><'.. , o s s - • • � j j t SUES TH.E ;FOLLOWING C4£CNSE AS < w ' i R 'Gl`S °f_RE MAS;TE: ::;:EkECTR I CJ!AN <> p� :r J NEtif;z>'H R I ZONS TECHNOLOGIES I=NC. 1 K'E KI N ET 1.:>'BEt >(t A U =s, 4 CAMPGIUTJD' ROAD:;..;:>. uj I N G <. !� 01564-141 17126 A: >::;:> '073 !1;6;>;> '; >'< 67859 z AS�S�CHEUSETTJS �� LICE— USA. MA tNOFMq SS �[},✓i�' �' 9;END 4d N�IMRER�>f��)Y/1/1 f .........YS102 ; � 4 PADDOCK ROAD N RUTLAND,MA 07543.2023 �� L!9 DD 01-07-2015 Rev 07-15-2009 // i Date . Sti,ILRa ids TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that . . . �-- has permission for gas installation .•.� .� ' . . . . . . . . . . . . . . . . . in the buildings of. e—, PA� o-� 1 at . . . . . . � . . fir', -�1 ?QT� ,North Andover, Mass. Fee . Lic. No.� .�. . . . .. . . . . . . . . . . . . . . . . . . . . . . GASINSPECTOR Check#-1 8477 ' MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK VYY77 I CITY w1 _ _ ✓I -,.�-� - �I MA DATE v �— PERMIT# W, -JOBSITEADDRESS __W.___rvim;✓�__,- /C�_�OWNER'S NAME GOWNER ADDRESS TEL __ FAX TYPE OR OCCUPANCY TYPE COMMERCIAL _. EDUCATIONAL Ll RESIDENTIAL®' PRINT CLEARLY NEW:[Q RENOVATION:Q REPLACEMENT:[ PLANS SUBMITTED: YES❑-i NOD APPLIANCES 7 FLOORS-- BSM 1 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVES DIRECT VENT HEATER , -_I I i —11 DRYER FIREPLACE FRYOLATOR - FURNACE u GENERATOR GRILLE ...- INFRARED HEATER LABORATORY COCKSl :-1 f1 KEUP AIR UNIT GIVEN F'OOLHEATER �rl . I :.-J. ROOM/SPACE HEATER I --_ -J ROOF TOP UNIT (—` TEST _____f l� —� �_f I-.�_1.- ----! _ -: _... ___f —_( J _ Tf _�J•___ I _ f( UNIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHER - ----- P.u- (I INSURANCE COVERAGE have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES 1 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW 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 0 AGENT �]( SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information I have submitted or entered regarding this application ar ue and ccurate to the st of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in m lianc '11 i all ertine provisi of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUM BER-GASFITTER NAME ,. - --- �I LICENSE# 036 IGNATURE MP 0 MGF JP —JG�F LPG] CORPORATION 0#� �PARTNERSHIP Q# LLC ._i# COMPANY NAME: `tyrz ADDRESS �JL� t_Y_____.....___.._.__._.._._._---_.__-.------- -� CITY v-.-.--..--vt` r/„`'t U �9 STATE ZIP d lel TELJz FAX jC LPff /S `7, �1EMAIL.- ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# v"4 l PLAN REVIEW NOTES 1 t The Commonwealth of Massachusetts Department of Industrial Accidents 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 Name (Business/Organization/Individual): Address: P 0 /3 o, S (� City/State/Zip:!I U 01b I- Phone#: -2 /�(, �' Z(D Are you an employer?Check the appropriate box: Type of project(required): 1. am a employer with_-),-- 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑Ne construction 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet.t 7• Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.] employees. [No workers' comp.insurance required.] 13.0 Other `Any applicant that checks box 41 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 their workers'comp.policy information. am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site nformation. nsurance Company Name: 00 'olicy#or Self-ins.Lic.#: Expiration Date: ob Site Address: City/State/Zip: IAtach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). ailure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a he 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 f up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of ivestigations of the DIA for insurance coverage verification. do hereby certi and the pains and pe lues f perjury that the information provided above is true and correct. i nature: Date: /2 / "7i lone#: 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#: COMMONWEALTH OF MASSACHUSETTS M.MR• • • f f! • • .. PLU KERS AD GA .<LICENSED ASA"' PUNtBER ISSUES THE ABOVE'LICENSE 70 ROBERT' J: 'SAL NiM , 50 BO.XFORD ST � . N ANDOVER MA` 01845 3'2" 1. '42706 8036 0501/14: 1 :. i \� I 1 f Date . . . -/ Z_ , TOWN OF NORTH ANDOVER PERMIT FOR WIRING L-LG This certifies that . . /, �,�� has permission to perform . . J. �lG�c�y�A� . L-f9.�� iv9 . . nn / wiring in the building of . .7-1) . . .(_?,,,0.. . . . . . . . . . . . . . . . at . . .I X F Mrf!f4� . .5.T. . . . . . . . . . . . . . . . . .North Andover, Mass. Fee . .)� -��L,ic. No. . ��ySRA . . . . . . . . . .It //f��� ELECTRICAL INSPECTOR Chr�k# 1. 1191 Commonwealth of Massachusetts Official Permit No. 1 i G 1 Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C),527 CMR 12.00 (PLEASE PRINT WINK OR TYPE ALL INFORMATION) Date: �— City or Town of: NORTH ANDOVER To the In pector of Wires: By this application the undersigned gives notice of hi or he intento perform the electrical work described below. Location(Street&Number) r Owner or Tenant Telephone No. Owner's Address Is this permit in conjun 'ow�n,,with a building permit? Yes El No ❑ (Check Appropriate Box) Purpose of Building W,ry 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 Elect ical Work: Completion of the followin table maybe waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ o.of Emergency Ligliting rnd. rnd. 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 No.of Alerting Devices g Tons No.of Waste Disposers Heat Pump ''Number Tons KW No.of Self-Contained p Totals: Detection/Alerting Devices " No.of Dishwashers S ace/Area Heating KW Local❑ Municipal ❑ Other p g Connection No. of Dryers Heating Appliances KW ecurity Systems:* Y No.of Devices or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Te1No.of Devices or Eq uivalent 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 waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify,under the 'ns a ey�a ies ofperj ,tltnt the information on this application is true and complete.�J FIRM NAM Ls GTA IL �p>' fC,'C—, LIC.NO.: Licensee: Signature , LIC.NO.: (Ifapplicable, ter "exe t"in t e lice se nu ine.) Bus.Tel.No.: 7 3769 Address: {l. Alt.Tel.No.: *Per M.G. c. 47,s.57-61,security work requires Department of Public Safety 'S"License: Lic.No. � OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑ owner's agent. Owner/Agent PERMIT FEE: $ Signature Telephone No. 6223 Date....�.�. .l �oS.. t HORTF�� 3:;•';�``°-�•_'40 TOWN OF NORTH ANDOVER PERMIT FOR WIRING SS CMUSE� This certifies that ......... ���- ........... .................................. ................................ has permission to perform ......(. ?a r wiring in the building of.......... 'U..... ! !e.T ................... ......... 8 ,North Andover,Mass. at................. ............................. .o a Fee...•��5 .. Lic.No./...��.5�.2-�........! ....�.�. '! • ELECTRICAL INSPECTOR ` ��- .� Check # r r , . �'�sset�•-�[ � �+'aileQ-�� ] �e-xuspeet�ou�'ec�uixec�($�O.OD)�� � �'nspectQxs'cap�ze�ufs: ': O (luspeetoreSlguahweµxto knitzals) plate �us�ecto 'c elxfs; o fts�'Bctoxsf ggnature.-mo' ' Ys) gate i aspectoxs'comments: [1n sp ectoxs�,�ignatwre o?iziftas) Pate . ssel.--[ a'rIe --je�xnspect�ioa�xequixe ( OAD) pectoxs9 eo�ram.eAfs: ( tsp eetoxs' zgnatuxe n onitials) pate ' - ectoxs'cox�xn.erifs: .. �luspectoxs'�zgnatuxe�xio JinzfiaTs} date . n R TA G-.6! A'i2xi.'7FYl RTi`I *ff T,'P O Q)TV AVD-f.P..I T d'D17 q'7'iT V,,W WRF:dPMA Tn•R'i,,1ft'+.qPP ?T'i'.'n 2'q WYnro �1 4 The Commonwealth of Massachusetts Ut. Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/ilia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information /Please Print Leizibly Name (Business/;,Pr anization/Individual): �C./L�C�J�`�L C �v�t`�_ Address: ( caw City/State/Zip: Ll% �✓ [ j Phone Are an employer?Check the appropriate box: Type of project(required): 1. I am a employer with 4. ❑ I am a general contractor and 1 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. ? ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition j working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]i employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. i Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. 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 and job site information. Insurance Company Name: © Policy#i r Self-ins.Lie.#: �Cw C d 3d Expiration Date: d /h�8-ill T ./�, Job Site Address:__ City/State/Zir: /� /4 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. f do hereby Certillunder tli ains ndpenalties ofperjury that the information provided above is true and correct. 3i nature: Date: ?hone#: 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#• r j 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, i express or implied,oral or written." f 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." J 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 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 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 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 5-26-05 www.mass.gov/dia 7-ZO,D 9Date..... : t f NORTH, �: "- 0, TOWN OF NORTH ANDOVER i � PERMIT FOR WIRING This certifies that .............P��7 .................. ...................... has permission to perform .......... 49....... .f,/ ......................... . ----��-- ....��`�J t ..k. ................................... wrong m the building of.........l........!,l at... ./©?S ' .....S.a''..................... NotAndover Mass. ... , F=—r .. Lic.No.f4 ,4............ F .. . ..........................4.�........ `ELECTRICAL INSPECTOR ` Check # ©�'Q/_� 88 : 8 Official Use Only Commonwealth of Massachusetts Permit No. F Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (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: b City or Town of North Andover To the Inspector oJ Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 108 Main Street Owner or Tenant TD Bank North Telephone No. Owner's Address Same as above Is this permit in conjunction with a building permit? ❑ Yes ❑ No (Check Appropriate Box) Purpose of Building Commercial 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 Old work,2 new outlets. f f Completion o the following table maybe waived by the Ins ector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminarie Outlets . No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ o.of Emergency Lighting rnd. grnd. Battery Units No.of Receptacle Outlets 2 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 No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Nuber I.Tons KW No.of Self-Contained Totals: mDetection/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 No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: t No.of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: $600 (When required by municipal policy.) Work to Start ASAP Inspections to be requested in accordance with MEC Rule 10,and upon completion. 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 ® BOND ❑ OTHER ❑ (Specify:) GENERAL ACCIDENT INS. 7/31/09 (Expiration Date) I certify,under the pains and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: REILLY ELECTRICAL CONTRACTORS,INC LIC.NO.: Licensee: JAMES J.REILLY Signature Wi'l LIC.NO.: 16666 A (If applicable,enter "exempt"in the license number line)) V I Bus.Tel.No.:508-230-8001 Address: 14 NORFOLK STREET,EASTON,MA 02375 Alt.Tel. 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: Signature Telephone No. lip Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. K� 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: 11-11-2005 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 below. Location(Street&Number) 108 MAIN STREET Owner or Tenant TD BANKNORTH Telephone No. Owner's Address 108 MAIN STREET Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate Box) Purpose of Building BANK Utility Authorization No. NA 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: RENOVATION,COUPON BOOTH OUT&NEW FLOOR BOX No. of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans No. of Tota Transformers KVA No.of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ In- 171 o. o mergency Lighting d. d. Battea Units No. of Receptacle Outlets 4 No.of Oil Burners FIRE ALARMS No.of Zones No. of Switches No. of Gas Burners No.of Detection an Initiating Devices No.of Ranges No. of Air Cond. Total No.of Alerting Devices Tons g No. of Waste Disposers Heat Pum Num er Tons KW No. o Self-Contained Totals: ....... ... . Detection/Alertina Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems: No.of Water No.o No.o No.of Devices or Equivalent Heaters KW Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydro massage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licen- see provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certi- fies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: $ (When required by municipal policy.) (Expiration Date) Work to Start: 11-11-05 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 application is true and complete. FIRM NAME: WILLIAM J.IANNAZZL INC. LIC.NO.: 13592A i Licensee: WILLIAM J.IANNAZZI Signature LIC.NO.: 13592A Address: 191 CHANDLER ROAD ANDOVER,MA 01810 Bus.Tel.No.:-978-686-7300 Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ •T f Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 2- BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked IV — [Rev. 11/99] leave blank C 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: 11-11-2005 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 below. Location(Street&Number) 108 MAIN STREET Owner or Tenant TD BANKNORTH Telephone No. Owner's Address 108 MAIN STREET Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate Box) Purpose of Building BANK Utility Authorization No. NA Existing Service Amps Volts Overhead ❑ Und d gr ❑ No.of Meters New Service Amps Volts Overhead ElUndgrd ❑ No.of Meters Number of Feeders and.OVaAy Location and Nature of Proposed Electrical Work: RENOVATION,COUPON BOOTH OUT&NEW FLOOR BOX No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans No. of Tota Transformers KVA No.of Lighting Outlets No. of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool ove ❑ In- ❑ o.o Emergency I mg d. d. Battery Units No. of Receptacle Outlets 4 No.of Oil Burners FIRE ALARMS No. of Zones No. of Switches No.of Gas Burners No.of Detection an Initiating Devices No. of Ranges No.of Air Cond. Tota No.of Alerting Devices Tons g \l;7acta P7CTlf)cprc Heat Pump Num.er Tons......... KW No.o Self-Contalne T `"t Detection/Alerting Devices ` •� Municipal 1 Connection El Other ity Systems: Date.... o.of Devices or E uivalent �'.. ............................. Wiring: o.of Devices or Equivalent f N0R7►, communications Wiring: ?•'"?�'� , off TOWN OF NORTH ANDOVER Co.of Devices or Equivalent " PERMIT FOR WIRING ;Sh of electrical work may issue unless the licen- ACMUsubstantial equivalent. The undersigned certi- fice. This certifies that 1 (Expiration Date) has permission to perform f i'? 7`, r <', olicy.) ......................F......................................... wiring in the building of /( ule 10,and upon completion. ......................... is true and complete. at..... ... ... ... ;. "��!` /- i - r%—..•`�.. ...............................�.....••••••••••••..... , North Andover,r, Mass.,, NO.: 13592A Fee.......... LIC NO: 13592ALic.No. ? L , ELECTRICAL INSPECTOR J Bus.Tel.No.:-978-686-7300 Cltieck # ! _ � ` Alt.Tel.No.: ance coverage normally required by law. :Xier's agent. FEE: $ U46132 Date.../P=.... ..f>........ = 5 t HOR71{ °f,"`°;• '"° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING 71 wOwwn°��`y'h 7sgACMUSE� This certifies that has permission to perform tai.........Aaa,l.e.�-5..................... wiring in the building of...77 A...41oR.r,!P.. t! ............................... at....... ...... 1. ...... .;................... .North Andover,Mass. T Fee...77.2.- Lic.No.1..'.. `�.2 A`.......... �� ... ELECTRICAL INSPECTOR/ 'Check # /5�� Commonwealth of Massachusetts Official/U�Use Only Department of Fire Services Permit No. 6 f 3 2— BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ev. 11/991 leave blank APPLICATION FOR PERMIT TO !PEE ORM ELECTRICAL WORK All work to be performed in accordance with the Masetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 10-11-2005 City or Town of: NORTH ANDOVER to the Inspector of Wires: By this application the undersigned gives notice of his or her int tion to perform the electrical work described below. Location(Street&Number) 108 MAIN STREET Owner or Tenant TD BANKNORTH Telephone No. Owner's Address 108 MAIN STREET Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate Box) Purpose of Building BANK 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: RENOVATION OF COUPON BOOTHS No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans No. o Tota Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures I Swimming Pool Above. E] In- El o mergency mg grnd d. Battery Units No.of Receptacle Outlets 2 No.of Oil Burners FIRE ALARMS No.of Zones No. of Switches I No.of Gas Burners No.of Detection.an Initiating Devices No.of Ranges No. of Air Cond. Total No. of Alerting Devices 2 Tons Heat Pum Num Tons KW No.o Self-Contained No. of Waste Disposers Totals: er Detection/Alertin4 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.o Water KW No.o No.o Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydro massage Bathtubs No.of Motors Total HP Telecommunications Wtrmg: A No.of Devices or Equivalent VOTHER: 'INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licen- see provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certi- fies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work: $500 (When required by municipal policy.) Work to Start: 10-11-2005 Inspections to be requested in accordance with MEC Rule 10,and upon completion. I cert fy, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: WILLIAM J.IANNAZZI,INC. LIC.NO.: 13592A Licensee: WILLIAM J.IANNAZZI Signature LIC.NO.: 13592A Bus.Tel.No.: 978-686-7300 Address: 191 CHANDLER ROAD ANDOVER,MA 01810 Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. 43y my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent PERMIT FEE: $ -� `Signature Telephone No. Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 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: 10-11-2005 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 below. Location(Street&Number) 108 MAIN STREET Owner or Tenant TD BANKNORTH Telephone No. Owner's Address 108 MAIN STREET Is this permit in conjunction with a building permit? Yes ® No ❑ (Check Appropriate Box) Purpose of Building BANK 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: RENOVATION OF COUPON BOOTHS No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans No.of Tota Transformers KVA No. of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures I Swimming Pool Above ❑ In- ❑ o.ot Emergency Lighting d. 9Md. Batte Units No.of Receptacle Outlets 2 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches I No.of Gas Burners No.of Detection an Initiating Devices No. of Ranges No.of Air Cond. Total Tons No.of Alerting Devices 2 No.of Waste Disposers Heat Pum Num er Tons KW No.o Self-Contained Totals: ....... ..... Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection urt No.of Dryers Heating Appliances KW SecNo Systems: of Devices or Equivalent No.of Water No.o No.o KW Data Wiring: Heaters Signs Ballasts No.of Devices or E uivalent No. Hydro massage Bathtubs No.of Motors Total HP Telecommunications Wvmg: No.of Devices or Equivalent OTHER: 1JSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licen- ce provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certi- is that such coverage is in force,and has exhibited proof of same to the permit issuing office. 4ECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify :) timated Value of Electrical Work: $500 (When required by municipal policy.) (Expiration Date) I I rk to Start: 10-11-2005 Inspections to be requested in accordance with MEC Rule 10,and upon completion. frtify, under the pains and penalties of perjury, that the information on this application is true and complete. :M NAME: WILLIAM J.IANNAZZI INC. LIC.NO.: 13592A ensee: WILLIAM J.IANNAZZI Signature s — LIC.NO.: 13592A Bus.Tel.No.: 978-686-7300 tress: 191 CHANDLER ROAD ANDOVER,MA 01810 Alt.Tel.No.: h1ER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. ny signature below,I hereby waive this requirement. I am the(check one)Elowner ❑owner's agent. 6/Agent ent. er/Agent ature Telephone No. PERMIT FEE: $ s ] i �v0 R k ?O��t`' c % 4 atn■ 1` LPL MiLMEwKw V S CA TOWN OF NORTH ANDOVER Sign Permit Date: January 6, 2006 Permit Number: 34-06 THIS CERTIFIES THAT, Banknorth Group - TD Banknorth Has permission to erect a 611/4" X 59%" Ground Sign-Not Illuminated On 108 Main Street MAP 029.0 PARCEL 0031 provided that the person accepting this Permit shall in every respect conform to the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Sign Regulations in the Town of North Andover. Violation of the Zoning of Sign Regulations, Section#6 Voids this Permit INTERNALLY ILLUMINATED SIGNS ARE PROHIBITED Inspector of Buildings a.v 40.0016V r 3/0N'9A M o�NO R-TH.ANDOVER n 100 08pod Street SIGN PERMIT APPLJCA?ION 772 $010voot:.OWR-� Site Owner J�it/al�it/L GZAA O relCe i�'L�Yo JApplMant N Site Address � , /yl�I/�/ .'� Site of Proposed Sign k��'S/" A- m EslimatedCost of Sign Mao D 2 9.1 Pane, How attached: (a)Against the wall ( ) illumination: (a) Not iflumlnated (b)Root, { ) (b) Intematy illuminated ( ' (c) Ground { (c) Ememally illuminated ( ) (d) Other ( ) Proposed Colors: Background Materials: Lelte do Border r imoul!ld AttacdaneMs: No permanwMemporary sign*W be erectted,or In Photograph.,of building enlarged until an application an the appropriate form M Material sample flurnished.Oy the Sign OMeer filets been filed with the U) Color samples Sign 011ioer containity such Infbrmatton including site or Plot Pan(Required for all fte-standing signs) pholograph%plane and scale drawings.as he may Drawings of proposed sign require,a peren0 for such erection,aftemdon, Other,seedy or enargetnent has been issued by him. Such permit shall be issued only d the Sign Oficer determines that the sign comples or will comply with all appNcable provisions of the WLaw. z Wel sign overhang any pubic roesd or walkway: Yes { ) No a ca If Yes,Name of Agency who will provide lability Insklrance- a Ix L u, AN 114COMPLErE APPLICATION WILL NOT BE ACCEPTED. N Date Feed; z Wo—* ko SignAre of Applicant CD Z ¢ o TOWN OF NORTH ANDOVER 400 Osgood Street SIGN PERMIT APPLICATION Site Owner ,, Tel plicant �!JGl�i�'t>•ZV,V W 3 Site Address SAA? � ,;911'/ � �r Size of Proposed Sign e1�V 1. ii Estimated Cost of Sign 0V ea a Z> Mag © '9' Parcel How attached: (a) Against the wall ( ) Illumination: (a) Not illuminated (b) Roof ( ) (b) Internally illuminated 1 (c) Ground (i.� (c) Externally illuminated I ( ) (d) Other ( ) Proposed Colors: Background . Materials: Lettering Border / Required Attachments: No permanent/temporary sign shall be erected, or / Photographs of building enlarged until an application on the appropriate form J Material sample furnished by the Sign Officer has been filed with the Color samples Sign Officer containing such information including Site or Plot Plan (Required for all free-standing signs) photographs, plans and scale drawings, as he may Drawings of proposed sign require, a permit for such erection, alteration, Other, specify or enlargement has been issued by him. Such permit shall be issued only if the Sign Officer determines that the sign complies or will comply with all applicable provisions of the By-Law. Will sign overhang any public road or walkway: Yes ( ) No (� If Yes, Name of Agency who will provide liability insurance: AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED. Date Filed: Sign re of Applicant �Plr)9,$'3-/-�X;�- JAN-4-2006 22:54 FROM:CAP CONSULTING 15088531176 TO:1978688%42 P.1 CAROLYN A . PARKER • , November 4,2005 ° Town of North Andover 120 main Street North Andover,MA 0I845 Attu. Mr.Gerald Brown Site 0035528 Building b3pector 108 Main Stntat ° N.Andover,MA.01845 Delivery:Regular Mail Deaf Mr.Brown, d Enclosed please find(2)two Sign Permit Applications and(2)two colored copied of site specific signs for the existing Banknorth,451 Andover Street,N.Andover,MA.The sign modifications are ° being proposed due to tha recent merger betwemt TD and Banknorth which will now become TD Banknorth.The location is a bank with drive-W tellers and an interior 24-Hour ATM machine with(2)two main signs:(1)one Pylon and(1)one wall sign.We wish to reface the pylon sign maintaining the same size and sgwme footage andel remove and replace the exis ft plate tetters with new as shown on the enclosed drawings. All odw signs are parking,directional or interior signs. Also enclosed please find an m4borimtion letter from Banknorth.The comactor scheduled for this she is-Back Bay Sign,Spmetvillk MA,a copy of their Worker's Compensation hatmace is enclosed. Lastly,please find check#622 in the amount of$60.00 for the sign permit fees_Please review the enclosed Sign Permit package and if you find eve ything is in order please renin the punts to me .in the enclosed self-addressed stamped envelope.Nyou have any questions or need additional information please call me at(508)8532167.Thank you in advance for your time in helping to •expedite this matter. S' ly, CwdlynA*arker Cc: NRS sign Industries File RECEIVED • JAN 5 2005 • BUILDING DEPT. SPECIALIZING IN THE PETROLEUM INDUSTRY 3 lalion Avtnue�Womater,MA 01606•Tel:50B-853-11,67•Taz:508-8534176•Cell:'774 239-2781 •capconsulting@verizon.nec Rua 19 2005 12-32PM HP LRS RDFT FRX AORA UER 1114GA 1 t P UAWL T #N:�uK tNl..t C O*tx"McCarthybs Tffk9 Cdi7t�lCATZ IS=UEDASA SKATTIM OF OyPtiMAT10 Y Agency Ind ONLY AND CONFERS NO ROGiWTS UFON:-W CMTtmATEp A Rub Intdrsa►tional United Co !{MOOL TM CERTIR"Tl#OM KO AVEND,ormWO 0 299 9a Its r dvals St _AIJER'THE COVERAW APPOADFO JkY TPW POucws aE..xt Wil aington MR O%aff7 Phone: 978-657-5100 Far:976-654-9 a5 "SURERSAFFOR N4000VE 1� uaiti agruRtA Z9rsiasc�nti.ssisttllx Ens. Ca.: t a k Day Si I.x,C !�* ContnedD �4�Skt� arm_ 3 &;MCI �t fl MMC: Nati.ona2 fire Ins. Co. � f Scosmeerville H& 02145 COVERAGES 7pK VOUWBOF OdURAMEUSMKW*HArEvMtMMEa Ta16+�J�Eb �> KIP�tME�I+CrPF�loaSlalr.�rEo.R� +�M wolfs xs,rE cvsc:or�or*iowat�vtvCartMCroa OPOOOMWwrymneww Ov"MTweOrrrrrMIMMAreiIMM OR >xA1`PGQTAW.TME�MIBVMNCEAs7dR0�trMTlEMdl.>;JBt tR�ttt+3�JMIECT'r`OA.LT4�lEll�S�U3ta'mANOC4N0�Id��ROf��1 PDLr#F-S.AdpfEGMAr1E WTV VV"My"WE KgM ROODUMCM PAUP.AFS. LTR J1NI!!!1[ UMM CfsERAi tlR*L,rtr GM t s 1 DODO A r x-!COMM)CAL LOAM 07.07775 046 20/02/04 10000 a,,NA MIM LX aeeua; MFS a 00�fqft eksn+? f 5000_ X t ftnefit Liab eye" 120000 j WK!!4AGM--ATEs 2000D OfMLAc3Q""TEw rPV'k breK PROM=-MUPOPAaaj i 20dCpj i IGOOD AS1T04MODtLELtAa1LQ1' O!!lAtl3i/�M7 ,S 10000 C i AWAUTO o } 7789867 10/02/04 10/02/05 I (� AU OwnW AuTOffi s x !C;NWULEDAUIM WMDAUNM GAitR�GRLL*JWry AUTO OKY-FAAFCNXWT S ! ARYM 70 FA ACC S - 1' nuraamr. Aft a �xtl AlERE#Ahli+�hltTTi' ! JACHOWANW4041 $600001 ]� �j occ CLA�sUw C10777SJ22 10/02/04 10/02/05 Aa aR _ !a 50000[ � 's �X— F1etM" $10000 F i S i w[RKERO CCMr aftym An x 9 ealnor"s'CNealm WC171753 04 10/02/04 10!02/05 FLL9NAG WT $100000 •m►RReaeereswbr�u�r�.rau�a� _ oavlc ►aeata�rcxyelbr EL COME-EAfMKO" 3100_00_0 � c Prns+ bwa. f ! EL DIIFASE-�al..wun-r�t�OOQ00 � 1 - ! oaSCq�P7lpuoFc� tROGI�TfIMi►�'[�d-E7Fi R'IRIDDI�f!`JlIiCNLPIEOVISIO� GQ!ri:ft*4t a h0ld*t Is Addil.tSAM911 .In rad only wftA respe is ganera3 ILabillty Ccvarago and only sdtth s+e.opects w r parrfosaed by a,nanred on their beha)X. Addld mI irlftf e+i ww-51p bftfttf3(flrNOftCKftWk 120 CRxadc Mme6 Cancartit NC 2 027-NW SiSo Mdask-at ft l'o W 2616 Srma1- Raad,t fWwfc`FL 32a0t NW Sin 1WHOto forMckJaW360 CTider AVS,MOwe$Ow& .Nt 41053 CERTIFICATE HK"ER CANCELLAUM NW Sign Industrie �A�+►o.,�A.o�o sw o:Ic l a�► m �„� DAslrWWW,TMMUM WmL 10 DAISY ..360 Crider Ave MEl=70MOWVi"TtWLMMUM,OTwL&T,&MFALMmW, Moo CstOwltl, NJ 08033 +e+=no 1 11 art 1,A t rn►W AW Mw ter,,,ZxmmM n AW TRM lIErMIswR1TR1TRtl'E, ,, ACORO 25 t200l1M ,may ri Existing # 1 Sign Inventory Proposed Sign Inventory 971/2" Qty Description RC# # Qty Sign Code Description 1 Plate Letters 035528 1 1 PL-15-6-GRN-B-20 Green Plate Letters 2 1 Illuminated Pylon 035528 2 1 REFACE PYLON Illuminated Pylon 3 1 DIF Directional 035528 3 1 REFACE DIR D/F Directional Banknorth 00 Banknorth co 4 1 Parkin Sin 035528 4 1 P-18-12-P Parkin Sin N (05 1 Door Vinyl 035528 5 1 DV-25-MA Door Vinyl r 6 1 'Door Vinyl 035528 6 1 DV-25-MA DoorVinyl 7 1 Hours Plague 035528 7 1 ALM-OVR Hours Plaque (top portion) " " " }' ❑ Plate Letters- PL-15-6-GRN-B-20 8 1 Clearance Sin 035528 8 1 1-18-12 Informational Sin Scale: 1/2" =1'-0" 9 1 S/F Directional 035528 9 1 REFACE DIR S/F Directional 10 1 S/F Directional �O35�52 1 REFACE DIR S/F Directional 11 1 Non Illum ATM Header 1 ALMLOVR Non Ilium ATM Header Existing Plate Letters: 12"x 87 5/8" _ Com . NOTES Parking Aluminum panel finished PMS # for Bank 5535 Dk green, with applied 3M Scothcal VQ-10018 light green& r { • • white vinyl graphics. Mounted on pole '# 04 1finished PMS #5535 dk green. Parking Sign P-18-12-P Existing D/F Pylon: 22"x 16" 4 g Scale: 3/4"=1'-0' Existing D/F Pylon: 61 1/4"x593/4" Existing D/F Directional: 16"x 24" kr l I ; R Banknorth Banknorth EXIT 24-H •ur ATM Existing D/F Pylon: 22"x 16" ® Door Vinyl -DV-25-MA ® D/F Directional NOTES Applied 3M Scotchcal#VQ-10018 light green 0 Pylon Reface NOTES vinyl &white vinyl graphics. NOTES Aluminum face finished PMS#5535 Dk Green with applied 3M,applied 3M Scotchcal#VQ-10018 light green vinyl rule White plex face with applied 3M Scotchcal#VQ-10019 Dk green vinyl background, applied 3M Scotchcal# line, 3M Scothcal 3650-10 white vinyl. CUSTLWvIER. Banknorth �� VQ-10018 light green vinyl rule line, Removed copy a ���y <0 ADDRESS: 108 Main Street n° North Andover, MA Existing D/F Pylon: 22"x 16" SITE#: 035528 Date:8-2-05 �• P° Customer Review: THIS IS AN ORIGINAL UNPUBLISHED DRAWING CREATED BY NW SIGN INDUSTRIES,INC. IT IS REVISION DATE �2 FILE NAME: Main❑Approved as submitted PROVIDED FOR THE EXCLUSIVE USE BY THE CUSTOMER AND FOR THE PROJECT NAMED IN THIS 1.add bar to#1 9/13/05 mg NW SIGN INDUSTRIES app SALES REP: DOH DESIGNER: -MI,11'h' HN f T f AL ❑Approved as noted TITLE BLOCK. IT SHALL NOT BE PROVIDED TO ANY OTHER SIGN MANUFACTURER OR USED FOR of New Jersey I NW SIGN IN USTRiES ANY OTHER PROJECT WITHOUT THE WRITTEN PERMISSION OF NW SIGN INDUSTRIES,INC.THIS r IQ _I, HEREORAWINGISANINSTRUMENT OFSERVICE AND SHALL REMAIN THE EXCLUSIVE PROPERTY OFNW 360CRIDERAVENUE y ❑See Notes-Resubmit Drawing for Review and Approval SIGN INDUSTRIES,INC. MOORESTOWN,NJ 08057 � NAME DATE ©NW SIGN INDUSTRIES,INC.2005 (856)802-1677 • fax:(856)802-0412 �� j T Ail 12" Banknorth NOTES Nlu ® - «r, �! "°""N.A. Aluminum panel finished PMS # !~ 5535 Dk green,with applied 3M Clearance L" .1 01, Scothcal VQ-10018 light green & `p white vinyl graphics. Aluminum Overlay 8 li NOTES = " Aluminum overlay finished PMS#5535 Dk Green f < a � i� {.7 Information Sign - 1-18-12 with applied 3M,applied 3M Scotchcal #VQ-10018 + ilNr.�ti. Scale: a/4"=1'-0" light green vinyl rule line, 3M Scothcal 3650-10 Existing Hours Plaque:16"x16" Header: 6" high white vinyl. Existing Clearance sign: 22"x 16" r.�rA� �r,rw i flanknorth Existing S/F Directional: 16"x 24" Existing S/F Directional: 16"x 24" Side B Side B Existing Non Ilium Header: 8 7/8"x 53" ® Banknorth Banknorth • + Banknorth ARKING DRIVE-UP 7LTDIS KEEP LEFT ENTER ® ATM Header Reface o S/F Directional Il� S/F Directional NOTES NOTES White aluminum face, applied 3M Scothchal#VQ-10019 Dk Green vinyl NOTES background. Applied 3M Scotchcal#VQ-10018 light green rule Aluminum face finished PMS#5535 Dk Green line and Logo box. Removed copy. with applied 3M,applied 3M Scotchcal#VQ-10018 Aluminum face finished PMS#5535 Dk Green light green vinyl rule line, 3M Scothcal 3650-10 with applied 3M,applied rule lin 3M Scotchcal 3650-1 018 WSTOMER. Banknorth white vinyl. light green vinyl rule line, 3M Scothcal 3650-10 -+ y white vinyl. <,�� 0 ADDRESS:R, 108 Main Street North Andover,MA A SITE#: 035528 Date: 8-2-05 FILE NAME: Customer Review: THIS IS AN ORIGINAL UNPUBLISHED DRAWING CREATED BY NW SIGN INDUSTRIES,INC. IT IS REVISION DATE �2P° - z Approved as submitted PROVIDED FOR THE EXCLUSIVE USE BY THE CUSTOMER AND FOR THE PROJECT NAMED IN THIS 1.add bar to#1 9/13/05 mg NW SIGN INDUSTRIES gyp" SALES REP: pOH DESIGNER: M INITIAL TITLE BLOCK. IT SHALL NOT BE PROVIDED TO ANY OTHER SIGN MANUFACTURER OR USED FOR J y NW SIGN IND' CSTRIES ❑Approved as noted ANY OTHER PROJECT WITHOUT THE WRITTEN PERMISSION OF NW SIGN INDUSTRIES,INC.THIS 0 NeW erse i, —k HERE DRAWING]SAN INSTRUMENT OF SERVICE AND SHALL REMAINTHE EXCLUSIVE PROPERTY OF NW 360CRIDERAVENUE ❑See Notes-Resubmit Drawing SIGN INDUSTRIES,INC. MOORESTOWN,NJ 08057 for Review and Approval 856 802-1677 • fax: 856 802-0412 v� NAME DATE ©NW SIGN INDUSTRIES,INC.2005 ) ) ,�; i _�- �� . -. '� _ �_- -- �� _ _ . f -- - - r - - - j�j -- �- --- - - - - i `� ._ _ _ �= .� _ _ - - � - - - � � � - - CAROLYN k PARER November 4, 2005 Town of North Andover 120 Main Street North Andover,MA 01845 Attn: Mr. Gerald Brown Site#035528 Building Inspector 108 Main Street N. Andover, MA 01845 Delivery: Regular Mail Dear Mr. Brown, Enclosed please find (2)two Sign Permit Applications and (2)two colored copies of site specific signs for the existing Banknorth, 451 Andover Street,N. Andover, MA. The sign modifications are being proposed due to the recent merger between TD and Banknorth which will now become TD Banknorth. The location is a bank with drive-up tellers and an interior 24-Hour ATM machine with(2)two main signs: (1)one Pylon and(1)one wall sign. We wish to reface the pylon sign maintaining the same size and square footage and remove and replace the existing plate letters with new as shown on the enclosed drawings. All other signs are parking, directional or interior signs. Also enclosed please find an authorization letter from Banknorth. The contractor scheduled for this site is Back Bay Sign, Somerville, MA, a copy of their Worker's Compensation Insurance is enclosed. Lastly, please find check 9622 in the amount of$60.00 for the sign permit fees. Please review the enclosed Sign Permit package and if you find everything is in order please return the permits to me in the enclosed self-addressed stamped envelope. If you have any questions or need additional information please call me at(508) 853-1167. Thank you in advance for your time in helping to expedite this matter. &b' wc;)4.)e� ' ly Carolyn A.Parker Cc: NW Sign Industries File SPECIALIZING IN THE PETROLEUM INDUSTRY Project Management,Permit Expediting,Drafting&Fire Suppression Plans 3 Lorion AvenueXorcester, MA 01606 • Tel: 508-853-1167 • Fax: 508-853-1176 • Cell: 774-239-2781 • capconsulting@verizon.net a Sip Schedule Existing Sign Inventory Proposed Sign Inventory . 971/2" # Qty Description RC# # Qty Sign Code Description 1 1 Plate Letters 035528 1 1 PL-15-6-GRN-B-20 Green Plate Letters 2 1 Illuminated Pylon 035528 2 1 REFACE PYLON Illuminated Pylon 3 1 D/F Directional 035528 3 1 REFACE DIR DIF Directional LBanknorth Banknorth 4 1 Parkin Sin 035528 4 1 P-1 8-12-P Parkin Sin N c� 5 1 Door Vinyl 035528 5 1 DV-25-MA Door Vinyl T 6 1 Door Vinyl 035528 6 1 DV-25-MA Door Vinyl _ 7 1 Hours Plaque 035528 7 1 ALM-OVR Hours Plague (top portion) ❑ Plate Letters- PL-15-6-GRN-B-20 8 1 Clearance Sin 35528 8 1 1-18-12 Informational Sin Scale: 1/2" =1'-0" 9 1 S/F Directional 35528 9 1 REFACE DIR S/F Directional 10 1 S/F Directional 35528 10 1 REFACE DIR S/F Directional 11 1 Non Ilium ATM Header 1110'135528 11 1 ALM-OVR Non Illum ATM Header Existing Plate Letters: 12"x 87 5/8" Hanknorth NOTES �� eie�iott1i r Parking Aluminum panel finished PMS# for Bank dz 5535 Dk green,with applied 3M 8ahith `' Scothcal VQ-10018 light green& 1' .? - ' • , white vinyl graphics. Mounted on pole i --- finished PMS#5535 dk green. . �, ' � f � -a •-� = � Parking Sign - P-18-12-P Existing D/F Pylon: 22"x 16" Q g Scale:3/a"=1'-0" 1 ` Existing D/F Pylon: 61 1/4"x 593/4" Existing D/F Directional: 16"x 24" � �';4 , E�" ® Banknorth �Et It r Fit Banknorth EXIT —' II Existing D/F Pylon: 22"x 16" Door Vinyl -DV-25-MA • ® �° ® D/F Directional - r NOTES Applied 3M Scotchcal #VQ-10018 light green ® Pylon Reface NOTES vinyl &white vinyl graphics. NOTES Aluminum face finished PMS#5535 Dk Green with applied 3M,applied 3M Scotchcal#VQ-10018 light green vinyl rule White plex face with applied 3M Scotchcal #VQ-10019 line, 3M Scothcal 3650-10 white vinyl. CUSTWER. Banknorth Dk green vinyl background, applied 3M Scotchcal# �+ VQ-10018 light green vinyl rule line, Removed copy Q ���� <0 ADDRESS: 108 Main Street L 9 North Andover,MA Existing D/F Pylon: 22"x 16" ! ` ^ SITE#: 035528 Date:8-2-05 FILE NAME: T IS IS AN UNPUBLISHED D035528 05-958 TD Banknorth Mau Customer Review: ❑Approved as submitted PROVIDEDFORITHE EXCLUSVY EXCLUSIVE THEING NW N INDUSTRIES CUSTOMER OR THE PROJECT NAMED IN THIS CREATED BY NW SIGN INDUSTRIES,INC. IT ISREVISION DATEg 1�vY SIGT ° _ �P p� SALES REP: pOH DESIGNER: mIh INITIAL ❑Approved as noted 1.add bar to#1 9/13/05 mTITLE BLOCK. IT SHALL NOT BE PROVIDED TO ANY OTHER SIGN MANUFACTURER OR USED FOR of New Jersey zv�SIGN INDUSTRIE ANY OTHER PROJECT WITHOUT THE WRITTEN PERMISSION OF NW SIGN INDUSTRIES,INC.THIS r l TUMMOMEM FJ DRAWING IS AN INSTRUMENT OF SERVICE AND SHALL REMAIN THE EXCLUSIVE PROPERTY OF NW 360CRIDERAVENUE yam'" ❑See Notes-Resubmit Drawing ti �/� o o I !ERE for Review and Approval 9 SIGN INDUSTRIES,INC. MOORESTOWN,NJ 08057 Q NAME DATE I ©NW SIGN INDUSTRIES,INC.2005 (856)802-1677 • fax:(856)802-0412 -�1„' Y.DanknetN4 NAA. ® fBanknorth BanknorthNOTES 91 Aluminum panel finished PMS # 5535 Dk green,with applied 3M Clearance Scothcal VQ-10018 light green& _ `o 9,-0" white vinyl graphics. Aluminum Overlay i NOTES Aluminum overlay finished PMS#5535 Dk Green - -' Information Sign - 1-18-12 _Lj 7A with applied 3M,applied 3M Scotchcal#VQ-10018 r' Wit. Scale:3/4"=1'-0" light green vinyl rule line, 3M Scothcal 3650-10 , Existing Hours Plaque:16"x16" Header: 6" high white vinyl. r- Existing Clearance sign: 22"x 16" Banknort,h °MN•1• yam. � J aV+� L------- r' Existing S/F Directional: 16"x 24" Existing S/F Directional: 16"x 24" Y _ Side B Side B Existing Non Ilium Header: 8 7/8"x 53" D DRIVE-UP • + Banknorth PARKING C KEEP LEFT ENTER ® ATM Header Reface S/F Directional Il� S/F Directional NOTES NOTES White aluminum face,applied 3M Scothchal#VQ-10019 Dk Green vinyl NOTES background. Applied 3M Scotchcal#VQ-10018 light green rule Aluminum face finished PMS#5535 Dk Green line and Logo box. Removed copy. with applied 3M,applied 3M Scotchcal#VQ-10018 Aluminum face finished PMS#5535 Dk Green light green vinyl rule line, 3M Scothcal 3650-10 with applied 3M,applied rule lin 3M Scotchcal 3650-1 018 CUSTOMER, NA Banknorth white vinyl. light green vinyl rule line, 3M Scothcal 3650 10 yam+ Y t ADDRESS: white vinyl. ���` o,�, 108 Main Street North Andover,MA SITE#: 035528 Date:8-2-05 FILE NAME: Customer Review: ❑Approved as submitted THIS IS AN ORIGINAL UNPUBLISHED DRAWING CREATED BY NW SIGN INDUSTRIES,INC. IT IS REVISION DATE 2P° r A dr PROVIDED FOR THE EXCLUSIVE USE BY THE CUSTOMER AND FOR THE PROJECT NAMED IN THIS 1.add bar to#1 9/13/05 mg NW SIGN INDUSTRIES 0.p SALES REP: pOH DESIGNER. M h R t T 1 f�L I�Approved as noted TITLE BLOCK. IT SHALL NOT BE PROVIDED TO ANY OTHER SIGN MANUFACTURER OR USED FOR of New JerseySIt STRIES ANY OTHER PROJECT WITHOUT THE WRITTEN PERMISSION OF NW SIGN INDUSTRIES,INC.THIS NW GN INP _ DRAWING IS AN INSTRUMENT OF SERVICE AND SHALL REMAIN THEEXCLUSIVE PROPERTY OF NW 360 CRIDER AVENUE HERE �See Notes-Resubmit Drawing SIGN INDUSTRIES,INC. MOORESTOWN,NJ 08057 9~0 �o�� O oPIDD NAME DATE for Review and Approval ©NW SIGN INDUSTRIES,INC.2005 ( ) ( ) 856 802-1677 • fax: 856 802-0412 � Location Ila 09 No. 23 - 3,1r -o6 Date TOWN OF NORTH ANDOVER + ; , Certificate of Occupancy $ Building/Frame/Frame Permit Fee $ s+CHU 9 Foundation Permit Fee $ Other Permit,Fee $ l TOTAL $ �d N Check # l� 1 189 ,18 `Building Inspector/ IAORTH 6w COC It ZWKM ,-� 0,94 Or '�igSSAC HUS��,t� TOWN OF NORTH ANDOVER Sign Permit Date: January 6, 2006 Permit Number: 33-06 THIS CERTIFIES THAT, Banknorth Group - TD Banknorth Has permission to erect a 16 3/8" X 72"Wall Si -Not Illuminated On 108 Main Street MAP 029.0 PARCEL 0031 provided that the person accepting this Permit shall in every respect conform to the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Sign Regulations in the Town of North Andover. Violation of the Zoning of Sign Regulations, Section#6 Voids this Permit INTERNALLY ILLUMINATED SIGNS ARE PROHIBITED Inspector of Buildings i ! X5.33 91 TOWN OF NORTH ANDOVER 400 Osgood Street SIGN PERMIT APPLICATION Site Owner 0"AeA10/e771 6 Jed U)° Tel#a ��J��'o l�/�c9pplicant 60 3—116 Site Address_ 10S' >(/77i�1A1 Size of Proposed Sign Estimated Cost of Sign Mao 0-�5;, � Parcel 190&/ How attached: (a) Against the wall ( Illumination: (a) Not illuminated (� (b) Roof ( ) (b) Internally illuminated (c) Ground ( ) (c) Externally illuminated ( ) j (d) Other ( ) Proposed Colors: Background_ Materials: _V_/&J! 1& Lettering Q,,,e e � �4L).-X17}.3 Border Required Attachments: No permanent/temporary sign shall be erected, or Photographs of building ✓ enlarged until an application on the appropriate form t Material sample furnished by the Sign Officer has been filed with the Color samples Sign Officer containing such information including Site or Plot Plan (Required for 11 free-standing signs) photographs, plans and scale drawings, as he may Drawings of proposed sign i5 require, a permit for such erection, alteration, Other, specify or enlargement has been issued by him. Such permit shall be issued only if the Sign Officer determines that the sign complies or will comply with all applicable provisions of the By-Law. i Will sign overhang any public road or walkway: Yes ( ) No If Yes, Name of Agency who will provide liability insurance: AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED. Date Filed: 1l Al ! � S' nature of Applicant N 1M Of NQM ANDMR i CL 400 Osgood Stmt I SIGN PERMIT APPLICATION Site owtrerGI�W ,_ Te2&A�8✓�''�-�36Coptica �°D /t6 �' N -/ Site Address„/ if /yl"W 77W—AT= Size of Proposed Sign Jz. Estimated Cost of Sign 1 co Mao o�a 9.Q Pae oo�� How attached: (a)Against the wall T, _ (� likrminatlan; (a) Not illuminated ( y/ (b)Root ( ) (b) Internally Ruminated (c) Ground ( }. (c) Exh ma4 illuminated ( ) (4) Other Proposed Cobra: Background, W1 LC NMlertals:- AA0M46W AW ✓/AI ' Letters llt3" Sofder itequlrod Machmellt9: No permanenVtemporary sign shag be erected.or CD Photographs of building +o enlarged until an appOWAdon on the appropriate f0M Material sample '' furnished by the Sign Officer has been flied with the Color samples ✓' Sign Officer containing such Infa msilon including Site or Piot Plan(Required t�pl1 fine-standing signs) photographs,plana and scale drawings,as he may y Drawings of proposed sign require,a permit for such erection.aiteragion. Other.:ipscey or enlargement has been Issued by him. Guch permit shalt be issued only if the Sign Officer determines that the sign complies or will comply with all apple provisions of the By-Law. $ Wil alp overhang any public road or wak*", Yes ( } No(y/ >f Yes, Name of Agency who will pmulds rability insurance: v AN INCOMPLETE APPLCATION WILL NOT BE ACCEPTED. cNu Date Filed: 3 rmturo otApptlraint v ti Location — � No. '- r' %- Date NORTN TOWN OF NORTH ANDOVER O:t. o ; ,•yC 9 ` Certificate of Occupancy $ Building/Frame Permit Fee $ SAG MUS Foundation Permit Fee $ Other Permit Fee $ Y TOTAL $ Check # f, C 'd:�6 3 Building InspOor t.1oRTiy � 0 (1-9.0 :64 SSACHUSti� �1 TOWN OF NORTH ANDOVER SIGN PERMIT \ DATE 1/15/2002 PERMIT # 06-2002 This is to certify that Bank North has permission to erect 2-16"x22"/3-241lx36"directionaU1-1'x7'4"walul-5'x5' ground signs on/ at 108 Main Street Providing that the person accepting this permit shall in every respect conform to the terms of the application on file in this office, and to the provisions of the Codes and By-laws relating to the sign regulations of the Town of North Andover. Any violations of the Zoning Regulations regarding Section 6 of the Zoning By-law will void this permit. INTERIOR ILLUMINATED SIGNS ARE PROHIBITED 0) o Inspector of Buildings Date t NORTH t"do " TOWN OF NORTH ANDOVER 3 SIGN PERMIT APPLICATION 5 cHuss�< Site Owner ,�� �— /!/ar/�?, Applicant� c Tel: FFF ,933 Site Address 0&,i Size of Proposed Sign`s !r l`77, Pi'i rn r.7 S O.✓._i to Tv 1-,/ How attached: a) Against the wall O Illumination: a) Not illuminated 7 b) Roof ( ) b) Internally illuminated (3) c) Ground 4/ ( ) c) Externally illuminated ( ) d) Other ,.2 ,; c 7-j j k/+ys Materials: Proposed Colors: Background Zr 6,? 41jtea Lettering Zi- Border. Required Attachments: Note: No permanent/temporary sign shall be erected, or enlarged until Photographs of building an application on the appropriate form furnished by the Sign Officer has Material sample been filed with the Sign Officer containing such information including Color sample photographs, plans and scale drawings, as he may require, and a permit for such erection, alteration, or enlargement has been issued by him. Site or Plot Plan (Required for all free-standing signs) Such permit shall be issued only if the Sign Officer determines that the Drawings of proposed sign sign complies or will comply with all applicable provisions of the By-Law. Other, specify Will sign overhang any public road or walkway Yes ( ) No (L�� -If Yes, Name of Agency who will provide liability insurance: AN INCOMPLETE APPLICATION WILL NOT BE ACCEPTED DATE FILED: -Permit Fee: SIGNATURE OF APPLICANT revised:jm-9/2001 f`kQ �aORTh aaw_ O r► L •yA c«.«c w..c«,� sSACHU`�ti� TOWN OF NORTH ANDOVER SIGN PERMIT DATE 1/15/2002 PERMIT # 06-2002 This is to certify that Bank North has permission to erect 2-16"x22"/3-24"x36"directionaU1-1'x7'4"wall/1-5'x5' ground signs f on/ at 108 Main Street E Providing that the person accepting this permit shall in every respect conform to the terms of the application on file in this office, and to the provisions of the Codes and By-laws relating to the sign regulations of the Town of North Andover. Any violations of the Zoning Regulations regarding Section 6 of the Zoning By-law will void this permit. INTERIOR ILLUMINATED SIGNS ARE PROHIBITED 1 Inspector of Buildings Date f i e , t 16" is L Banknorth CLEARANCE � .` p Clearancev ' EITHER SIDE =0N 9 N Either Sid ALUMINUM FACE TOP FINISHED WHITE, BOTTOM FINISHED iM BANKNORTH BLUE. APPLIED BANKNORTH BLUE LOGO. APPLIED WHITE REFLECTIVE G2 - REGULATORY SIGN ° COPY AND ARROWS SCALE: 1 1/2" Existing Elevation 16" 1 s" ,J7 Banknorth CUSTOMER N Bank Caeromer PARKING a C* ft"ftBmr ONLY u"ur��o vanes - _ e0 t QYKRe E[K K N Customer Parking Only : ALUMINUM FACE TOP FINISHED WHITE, BOTTOM FINISHEDco Y 1 Unauthorized Vehicles a BANKNORTH BLUE. APPLIED towedwill be BANKNORTH BLUE LOGO. owners expense APPLIED WHITE REFLECTIVE Police Take Notice! COPY AND ARROWS. 2" SQ. POLE MOUNTED DETAIL POST. Scale: 3/8" = 1'-0" G1- REGULATORY SIGN CUSTOMER: SCALE: 1 1/2" — 1'-0" BANKNORTH `Ro° 1414s ADDRESS: 108 MAIN ST Existing Elevation yS NORTH ANDOVER, MA I SITE#: 11A 1019-01 Customer Review: El ! `\Approved as submitted THIS IS AN ORIGINAL UNPUBLISHED DRAWING CREATED BY NW SIGN INDUSTRIES,INC. ITS REVISION DATE FILE NAME:yS� 01-12S8BANKNOATH 108 MAIN ST NOM ANDOVER,MA..CDR PROVIDED FOR THE EXCLUSIVE USE BYTHE CUSTOMER AND FOR THE PROJECT NAMED IN THIS 1.Chan es to#'s 1,2,3, &5 MM 12-24-01 y' SALES REP: DESIGNER: INITIAL l�Approved as noted TITLE BLOCK. IT SHALL NOT BE PROVIDED TO ANY OTHER SIGN MANUFACTURER OR USED FOR NW SIGN INDUSTRIES � �- _ � DOH mlh ANY OTHER PROJECT WITHOUTTHE WRITTEN PERMISSION OF NW SIGN INDUSTRIES,INC.THIS . 'NW SIGN GROU + HERE See Notes-Resubmit Drawing NW SIGN INDUSTRIES, P i DRAWING IS AN ENT OF SERVICE AND SHALL REMAIN THE EXCLUSIVE PROPERTY OF 360CRIDERAVENUE cua O O NAME for Review and Approval ©INCMOORESTOWN,NJ 08057 -- -� d �'� � 11(��UU�JJ�11 DATE NW SIGN INDUSTRIES,INC.20D1 (856)802-1677 • fax:(856)802-0412 •B-Q i 16" 14" + 3 a B knorth I u -lobby Hours 3�4 n I - 1 Yar' 34r Mon-Thur 9:00 1�4 r' 3�4 n 'Friday9:00 6:00 1 I 9:00 , „ , ALUMINUM FACE, TOP PORTION FINISHED 2 3i8° WHITE WITH APPLIED BANKNORTH BLUE VINYL LOGO. BOTTOM PORTION FINISHED J2 HOURS PLAQUEBANKNORTH BLUE WITH APPLIED PPLIED WHITE SCALE: 3" = 1'_p» VINYL COPY. Existing Elevation r..�., :: a �_•.,.,��,�,.,� .y-''p" �_, 10 DSM =—.� L Banknorth Drive-Up Parkingco 0.90 ALUMINUM FACES FINISHED BK NORTH - EnterBLUE. TOP PORTION TO HAVE APPLIEDOPAQUE WHITE VINYL BACKGROUND WITH BLUE VINYL LOGO. APPLIED REFLECTIVE WHITE COPY ANDARROW *FONT: HELVETICACONDENSED BOLD. Y71 CUSTOM F3 S/F DIRECTIONAL FRONT - _, r scale . 3�" T VIEW Existing Elevation Customer Review: m yo` oA CUSTOMER: BANKNORTH 'qt ADDRESS: `s� Approved as submitted THIS IS AN ORIGINAL UNPUBLISHED 108 MAIN ST DRAWING CREATED BY NW SIGN INDUSTRIES,INC. li IS tis NORTH ANDOVER,MA PROVIDED FOR THE EXCLUSIVE USE BY THE CUSTOMER AND FOR THE PROJECT NAMED IN THIS INITIAL Approved as noted 717LE BLOCK. I7SHALL NOiBE PROVIDED i0 ANY OTHER SIGN MANUFACTURER OR USED FOR REVISION , ` 11A HERE ANY OTHER PROJECT WITHOUTTHEWRITTEN PERMISSION OF NW SIGN INDUSTRIES,INC.THIS 1'Chan es to#'s 1,2,3,&5 DATE 10-19-01 ❑See Notes-Resubmit Drawing DRAWING IS AN INSTRUMENT OF SERVICE AND SHALL REMAIN THE EXCLUSIVE PROPERTY OF MM 12 24 01 NW SIGN INDUST s FILE NAME: NAME DATE for Review and Approval DT I 01-12886ANKNORTH108 MAINSTNORTH ANDOVER,MA..CDR NWSIGNINDUSTRIES,INC. RIESSALES REP: D ©NW SIGN INDUSTRIES,INC.2001 360CRIDERAVENUE 'NW SIGNGROUP�` OH D ESI6NER: Rllh MOORESTOWN,NJ 08057 �----�— (856)802-1677 • fax:(856)802-0412 .1 Oro 24 -10UR(C e f- i e Ovect M., REMOVE EXISTING SIGN. _ DIRECTIONAL SIGN SCALE: 1" = 1'-0" i P." a s a:55 A." Existing Elevation 7' - 3 5/8" - R.E.F. Andc"rBank D1 L DIMENSIONAL LETTERS ® SCALE: 3/4" = 1'-0" ~ z` 0.375"ALUMINUM PLATE LETTERS FINISHED BANKNORTH ' WHITE & BANKNORTH BLUE RETURNS FINISHED TO MATCH FACES. MOUNTED WITH WELDED STUDS (AS REQ'D)AND CONSTRUCTION ADHESIVE IN PATTERN DRILLED MOUNTING HOLES. yo• ., CUSTOMER: BANKNORTH Existing Elevation ADDRESS: 108 MAIN ST 'p�° mss° NORTH ANDOVER, MA ys SITE#: 11 A 10-19-01 Customer Review: THIS IS AN ORIGINAL UNPUBLISHED DRAWING CREATED BY NW SIGN INDUS IES INC. IT REVISION v FILE NAME: Approved as submitted DATE r say 01-12588ANKNOAfN108 MAIN ST NORTH ANDOVER,h1A..CDA INITI_ PROVIDEDFORTHEEXCLUSIVEUSEBYTHECUSTOMERANDFORTHEPROJECTNAMEDINTHIS 1,changestO#'S 1,2,3,&5 MM 12-24-01 y' SALES REP: DESIGNER: AL ❑Approvedasnoted TITLE BLOCK. ITSHALLNOTBEPROVIDEDTOANYOTHEflSIGNMANUfACTURERORUSEDFOR NW SIGN INDUSTRIES DOH MIh ANY OTHER PROJECT WITHOUTTHE WRITTEN PERMISSION OF NW SIGN INDUSTRIES,INC.THIS 360CRIDERAVENUE NW SIGN GROUP_i 1'x , HERE ❑See Notes-Resubmit Drawing DRAWING IS AN NW SIGN INDUSTRIES, OF SERVICE AND SHALL REMAIN THE EXCLUSIVE PROPERTY OF MOORESTOWN,NJ 08057 ��.C'' �� e NAME for Review and Approval s DATE ©NW SIGN INDUSTRIES,INC.2001 (856)802-1677 • fax:(856)802-0412 1� z• 1 I 24„ 7 ®Banknorth I I DRIVE-UPlip [ • 1 KEEP LEFT l M m ..r'.momo [ CIA �® r 0.90 ALUMINUM FACE FINISHED BANKNORTH BLUE. TOP PORTION TO HAVE APPLIED OPAQUE WHITE VINYL BACKGROUND WITH BLUE VINYL a�llre■■� CUSTOM F3 S/F DIRECTIONAL FRONT VIEW Scale : 3/a" LOGO. APPLIED REFLECTIVE WHITE COPY AND = 1'-O" ARROW. *FONT. HELVETICA CONDENSED BOLD. Existing Elevation -I - LP 24" C INIF 0.90 ALUMINUM FACES FINISHED BANKNORTH BLUE. TOP PORTION TO HAVE APPLIED OPAQUE co WHITE VINYL BACKGROUND WITH BLUE VINYL LOGO. APPLIED REFLECTIVE WHITE COPY AND N ARROW. SAME COPY ON BOTH SIDES. *FONT. HELVETICA CONDENSED BOLD. a CUSTOM F3 DIE DIRECTIONAL FRONT VIEW CUSTOMER: BANKNORTH Scale : 3/4" = 1'-O" %o ,,f ADDRESS: 108 MAIN ST s° Existing Elevation NORTH ANDOVER,MA- ss -• SITE#: 11A 10-19-01 Customer Review: \/ U FILENAME: ❑Approved as submitted THIS IS AN ORIGINAL UNPUBLISHED DRAWING CREATED BY NW SIGN INDUSTRIES,INC. IT IS REVISION DATE V/ 01-1258BANKNORRi 108 MAIN ST NON AIII)MR.MAZOR PROVIDED FOR THE EXCLUSIVE USE BY THE CUSTOMER AND FOR THE PROJECT NAMED IN THIS 1.changes to#'s 1,2,3,&5 MM 12-24-01 _ y° SALES REP: DESIGNER: INITIAL ll Approved as noted TITLE BLOCK. IT SHALL NOT BE PROVIDED TO ANY OTHER SIGN MANUFACTURER OR USED FOR NW SIGN INDUSTRIES -- - DOH mlh ANY OTHER PROJ ECT WITHOUT THE WRITTEN PERMISSION OF NW SIGN INDUSTRIES,INC.THIS 360CRIDERAVENUE NW SIGN GROUP' 177trnll,(or Ill>7Td:r HERE See Notes-Resubmit Drawing NW SIGN INDUSTRIES,INC.WING IS AN NT OF SERVICE AND SHALL REMAIN THE EXCLUSIVE PROPERTY OF i ° J�`' O O for Review and ApprovalMOORESTOWN,NJ 08057 � 1/�U�JI} NAME DATE ©NW SIGN INDUSTRIES,INC.2001 (856)802-1677 • fax:(856)802-0412 �� e 593/4" NOTE: / INSTALLATION CREW TO INDICATE WHERE REFINISHING IS co NECESSARY. REFINISHING TO TAKE PLACE IN SPRING. co � - A""""ter•_ rElanknorth REMOVE EXISTING SIGN. INSTALL NEW WHITE Existing Elevation PLEXI FACE WITH APPLIED BANKNORTH BLUE REFACE PYLON VINYL LOGO. SCALE: 3/4" = 1'-0" NOTE: INSTALLATION CREW TO INDICATE WHERE REFINISHING IS NECESSARY. REFINISHING TO TAKE PLACE IN SPRING. e Re Ovecl An PYLON SIGN REMOVE EXISTING SIGN. SCALE: 3/4" = 1'-0" CUSTOMER: BANKNORTH �5 A Existing Elevation o `pRoo A,r�S ADDRESS: 108 MAIN ST ` ySl NORTH ANDOVER,MA SITE#: 11A 10-19-01 •0?n"I Customer Review: (� ,.` j FILE NAME: ❑Approved as submitted THIS IS AN ORIGINAL UNPUBLISHED DRAWING CREATED BY NW SIGN INDUSTRIES,INC. ITIS REVISION DATE r �\`ll t� 01-1258 BANKNORTH 108 MAIN ST NORTH ANDDVER,MA..CDR PROVIDED FOR THE EXCLUSIVE USE BY THE CUSTOMER AND FOR THE PROJECT NAMED IN THIS 1.changes to#'s 1,2,3,&5 MM 12-24-01 'y' SALES REP: DOH DESIGNER: R1Ih INITIAL i]Approved as noted TITLEBLOCX. IT SHALL NOT BEPflOVIDEDT0ANY0THERSIGNMANUFACTURERORUSEDFOR NW SIGN INDUSTRIES ARAWINGISANINNY OTHER CTRUMEN OF THE DSHALLREMAERMISSION OF NTHEEXW SIGN EXCLUSIVE THIS 360CRIDERAVENUE 'NW SIGN GROUP i "n It►lP-A HERE See Notes-Resubmit Drawing DRAWING ISS INSTRUMENT OF SERVICE AND SHALL REMAIN THE EXCLUSIVE PROPEflTY OF MOORESTOWN,NJ 08057 for Review and Approval NW SIGN INDUSTRIES,INC. o�, O NAME DATE ©NIN SIGN INDUSTRIES,INC.2001 (856)802-1677 • fax:(856)802-0412 Location No. C;) Date /7 63'— t � MORTIy TOWN OF NORTH ANDOVER f? • • OR • Certificate of Occupancy $ ' a r SACHUS t� Building/Frame Permit Fee $ Q Foundation Permit Fee $ r Other Permit Fee $ TOTAL $ Check # �3 rt 13647 ✓ Building Inspector r TOWN OF NORM ANDOVER BUILDING DEPARTMENT APPLICATIONtTO CONSTRUCT REPAIR,REI IOVATF„CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILI)ING OTHER THAN A ONE OR TWO FAMILY DWELLING This Set-ion for Official Use BUILDING PERMIT NUMBER: � � /� DATE ISSUED: SIGNATURE: Building Buildin Commissioner/12or f Bwldin nate 1.1 Property A 1.2 ,Vsess-ors Map and Parcel Number V 108 K 4ap Number Parcel Number Rn 1.3 Zoning bttomunion: l.4 Pt�Di wisiuns: Zonin Distrid Frontage ft 1.6 BLII.IDING SETBACKS(ft) M Front Yard Side Yard ,' Rear Yard Required Provide- R red Provided R red Provided Q i 1.7 Water Supply'\4.QL.C. . 1.5. Flood 7.one Jntoramtion: 1.8 Sewerage Disposal System; Public ❑ Private ❑ ZO°e Outside Flood Zone ❑ ;Nluuicipd Onsite Disposal system ❑ Q 2.1 Chv of Wrd ��11 Vn / Name(Print) address for 'niCA Signature ;Telephone, 3q 2.2 A thorized ent CUD > Name Print 14 Address for Service: Z z " r 1 Pgnature Tel hone -- --— M+� CL al+r ".f�� v °}' 203.1 licensed Construction Supervisor Not Applicable 0Address License Number O Licensed Constrsetionupeniso --- �iration Date Signature " _ Telephone r 3.2l;egi5tered,3'.)me Tmproverntnt Contractor ----- Not Applicable I-; - *W Come'1y Name `— ---- Registration Number M Address _--- ---- ---------- — _ Expiration Date z Signature Telephone SECTION 4-WORKERS COA&ENSATION(141 C.L C 1152 1 25c(6) � -- — -- Workers Compensation Insurance affidavit must be•:omplcted and submitted with this application. Failure to provide this adidavit will result in the denial of the-- I he~ i:.suance of the building pennit. Signed affidavit Attached Yea......V No.......G SEC:'TION 5-PROFESSIONAL DESIGN APM CONSTRUCTION SERVICES FOR DUMPINGS AND STRUCTURES SUBJECT TO CONSTRUCTION CONTROL PURSUANT TO 780 CMR 116(CONTAINING MORE THAND 11,008 C::E`.OF ENC'IMED SPACE) 5.1 Re isterc:d Architect: u 14- au` +Ibnd MA(VO ASSO� Name: I C�'n re,SS. Porflai)d Address (0U Signature Telephone 5.2 Registered Professiansl Englnwr(si:. Area of Responsibility Name: _ Registration Number Address: Expiration Date Signature Total Not applicable ❑ Name: Registration Number Address Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature _ Telephone Expiration Date I Name area of Responsibility Address Registration Number Signature Telephone Expiration Date 5.3..C rA contracCur � � I Not Applicable ❑ Company Name: VA n/ >L,� !) Responsible in Charge of Construction V ;BCI'Id 1 S ➢ESCt�IPi'[41�i I3I+I'RaPt34F.D�Y9')Rl� (eleek all applicablc) — - --New Construction ❑ Existing Building ❑ Repair(s) J Alterations(s) ,addition = � , Acees Demolition C Other Specify Brief Descrip n of Proposed Work: — -- -- �- OA� Ah� nwlr S r� §161014 7-USE G#60 AND CONSTRUCTION TYPE. USE GROUP(Check as applicable) _ CONSTRUCTION TYPE _ A Assembly ❑ A-I ❑ A-2 A-3 IJ IA A4 ❑ A-5 ❑ IB B Business C 2A C Educational ❑ 2B F Factory ❑ F-1 ❑ F-2 ❑ _ 2C ❑ H High Hazard ❑ 3A G IInstitutional ❑ I-1 ❑ 1-2 ❑ 1-3 3B G M Mercantile FJ 4 _ 11 R residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 c, 5B ❑ IJ Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34: — Proposed Hazard Index 780 CMR 34: BUILDING AREA EXIS'IT_NG 'if aplid cable) _- PROPOSED--_ -- Number of Floors or Stories Include ---- Basement levels Floor Area per Floor(sf) Total Total HeighLCft)_--- -------------------- — -- --------- ---� srcclQ s „ Independent Structural Engineering Structural Peer Review Required _ Yes No ❑ SECTION 10a Owner Authorization- TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT —_—,as Owner of the subject property Hereby authorize act on My behalf, in all matters relative two work authorized by this building permit application ,Signature of Owner Date I rr rr ,as Owner/Authori,7ed Agent Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of peduFy^ I 04 L Print Name MtgI mture of Owner/Agent Date ;SECTION 11-ESTIMATED C4NSTYtUCTIUK COST item Estimated Cost(Dollars)to be 0MCL4L USE ONLY Completed by permit applicant 1. Building /�`� fl (a) Building Permit Fee Multi Tier 2 Electrical (b) Estimated Total Cost of Constriction from(6) 3 Plumbing Building Permit fee (a)c(b) (�O 4 Mechanical(HVAC) �J 5 Fire Protection 6 Total (1+2+3+4+5) Check Number 1' A. •'' e i NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIIv1}3ERS lam— 2 ° 3 kD SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATLRIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE — The Contmonivealth.of Massachusetts Departhteni of Itt dustrial Accidents Offuce of Investigations 600 Washington Street Boston, MA 02111 www.rrrass.gov/dia Workers' Compensation Insurance Afri avit: Builders/t;nntractors/Electricians/Plumbers A licant Informs#ion Please Print Legibly Ob Name (F3usinesslOtganization/Individual): o` ON Address: i C / Cit /State/Zi. Phone#: � Are you an employer? Ghec th ,appropriate box: . Type of project(required): 1.[► I am demployer with 4: ❑.l atn:a,general contractor and 1 6. ❑ N- w construction employees(full-and/or.part-time).* have hired.the sub-contractors 2.❑ I am a sole-proprietor or partner- listed on the.attached she:,.:t Remodeling ship and have na employes These sub-contractors have 8. ❑ Demolition working for mein any capacity. . workers' comp: insurance. 9. ❑ Building addition [No workers' comp.insurwce 5. ❑:We are a•corporation and-its required.] officers have exercised tlieir 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing�ll w A right of exemption:per.MGL 11:❑ Plumbing repairs or additions myself. [No workers' co c. 1-52;§1(4);and we.have no IZ:❑ Roof repairs insurance required.].t7 . employees:. [No workers' i3.0 Other comp.insurance: d:.] require ' . *Any applicant that checks box fl-must, lso fill out thesection below:showing their:workers'compensation policy information: t Homeowners who subrnitthis.a[6daviFpndieatmg.they-ate doing alt work.andAhen.hi a outside_contt.actois.mustsubmit a new affidavit indicating such 1Contraclors tbatc check this boxxcrust:att ci ed>an':ad litional::sheet showing:the-riaThe of the:.su&contractors:and-their workers'comp:policy information. I am art employer that is providing workers'cornpe+isatibrt insurance fore noy employees Below is the policy and job site i+iforntation. V� Insurance Company Name: i Policy#or Self-ins.Lic.#: p — — l Expiration Date: XAJob Site Address: h&&2�ity/State/Zip: Attach a copy of the workers' compensation policy declaration page(sbowing.the.policy number and expiration date). Failure to secure coverage-as required udder Section 25A of MGL c 152.can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or,o:nemyear•imprisonrnent,-as well as.civil penalties in theformo:f a STOP WORK ORDER and a rule of up to$250.00 a day against the violator. Be advised:that a copy of this statement maybe forwarded to the Office of Investigations:of the DIA for urance.coverage.verification. i I do hereby certify under the paths acrd petwities.of perjury that tlte:ittfor-rnation pr-ovided ab ve ' true and core Signafore: Date: Id W6 Phone#: _ F use only. Do trot iv.ite ur this area;to be completed by eity or toreni oflf eiaL Town: Permit/License# Authority(cii deo e):. .�. d of:llealth :Buil: luW epartrnent 3.City/Town Clerk 4:Electrical Inspector 5.Plumbing Inspector erct Person: Phone#: I I 9/29/2005 9:22 AM FROM: Fax TO: 9784530635 PAGE: 004 OF 005 ACORD,;, CERTIFICATE OF LIABILITY INSURANCE OATE(MWDDNYYY) PRODUCER 09/29/2005 (978)459-0505 FAX (978)934-8761 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION James L. Cooney Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 327 Gorham Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Lowell, MA 01852 ALTER THE COVERAGE AFFORDED BY THE POLlC1ES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED Eastern Installations CO., Inc. INSURERA Safety Insurance Company _-.... P. 0. Box 28 IN~suaERa AIG TPA-AI Dracut, MA 01826 INSURERC, Great Amer. E&Q (S.H.Smith & Co) INSURERD: North River Ins. Co.(S.H.Smith & Co) 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. ILTR JSRN NSR 0,01Y TYPE OF INSURANCE POLICY NUMBER POLICYEFFECTIVE POLICY EXPIRATION UNITS GENERAL LIABILITY EACH OCCURRENCE $ 11000,000 X COMMERCIAL GENERAL LIABILITY GLO5849824 10/20/2004 10/20/2005 DAMAGE TO RENTED r $ S0,0001 CLAIMS MADE O OCCUR MED EXP IAny one person) $ Excluded C ( _ PERSONAL&ADV INJURY S 1,000,0 _ GENERAL AGGREGATE $ 2,000,0 GEN'L AGGREGATE LIMIT APPLIES PER. PRODUCTS-COMPlOP AGG $ 11QQQ,QQ POLICY X( Ea LOC ' AUTOMOBILE LIABILITY 2909377 11/23/2004 11/23/2005 COMBINED SINGLE LIMIT ANVAUTO (Ea accident) $ 100000 ALL OWNED AUTOS A I BODILY INJURY X SCHEDULEDAUTOS (Par person) $ X HIRED AUTOS BODILY INJURY X $NON-OWNEDAUTOS (Per accident; -- PRO'ERIY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANY AUTO OTHERTHAN EA ACC S AUTO ONLY AGG $ EXCESSIUMBRELLA LIABILITY 5530865931 10/20/2004 10/2D/2005 EACH OCCURRENCE $ 2,000,00 D -XI OCCUR CLAIMS MADE AGGREGATE g 4,000 00 --' S DEDUCTIBLE $ RETENTION $ -- a WORKERS COMPENSATION AND WC775-99-85 10/20/2004 10/20/2005 WCS jUfi I OTH- E14Y PRO RIETORK.ITY WC681-26_14 10/20/2005 10/20/2006 E.L.EACH ACCIDENT $ B �ICERIMEM ER PEKCLWE ECUTNE 500,000 H yes.describe under El DISEASE-EA EMPLOYEE S S00,000 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 5QQ QQ OTHER 1 DESCRIPTION OF OPERATIONS I LOCATIONS!VEHICLES!EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS fillWrights TIFICATE C LLATI N SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE i EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL Town Of No. Andover 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Building Dept. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NOOBLIGATION ORLIABILITY 400 Osgood Street OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. No. Andover, MA 01845 AUTHORIZEDREPRESENTAnvE Gerri Brown/GBR 4e'."ACORD 25(2001168) ©ACORD CORPORATION 1988 PDF created with FinePrint pdfFactory trial version http://www.finePrint.com �le {noryvmauu�a,/i o�'�/�aQaaclacra�lta WARD W-SVALb.JN RI=GJJ AfMS License: CONSTRUCTION SUPERVISOR Numb6n-CS 017199 Birthdate: 0311 E)pir:0V;T 2006 Tr.no: 17762 Restricted. CHARLES L TOUPIN 2 MAYFLOWER LANE PELHAM, NH 03076 Acting 0 _mi.__ her V%ORTFI Town of �: 19Andover No. zS7 LA o dover, Mass., /D COCHICMEWICK � 7 ADRATED PPRP �G, BOARD OF HEALTH Food/Kitchen PERMIT Septic System l BUILDING INSPECTOR THIS CERTIFIES THAT ....................... . .......®N.. .... .... .......d.$......................................... ...................... Foundation has permission to erect.......... �a�........ buildings on � .�� ....... Rough ........................ .................. ............. ........► to be occupied as......... 1.....................................................�d fJp 0 ,.. 0� .. .................... � �A ` Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final Ws office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings In the Town of North Andover. 01 a// a / PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Roush Final PERMIT EXPIRES IN 6 MONTHS ARTS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST C Rough 100000q,0 ...... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Location /09 No. -333 Date NORTF� TOWN OF NORTH ANDOVER : : Certificate of Occupancy $ �' b' •'�� 30 cMBuilding/Frame/Frame Permit Fee $ usE 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ d CI,2 Check # r 16680 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING %MW This Section for Official Use OnI BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: rA BuddiU Conmfissi r of Buildings Date 1.1 Property Address: 2 1.2 Assessors Map and Parcel Number: c2 Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sf) Frontage(ft) 1.6 WELDING SETBACKS(ft) M Front Yard Side Yard Rear Yard Required Provide Required Provided Re red Provided 1.7 Water Supply NLG1..C.40.�i-54) 1.5. Flood Zone Information: 1.9 Sewerage Disposal System. Public 0 Private ❑ Zone- Outside Flood Zone 0 Municipal On Site Disposal System 0 g ria k ' RT) 2.1 Owner of Record e ,41 /t Name(Print) Address for Service: M Signature Telephone X ,3. thorized Agent > Nam Address for Service: Z 0 Signa Telephone z M 3.1 Licensed Construction Supervisor Not Applicable 0 Address License Number 0 n Licensed Construction Supervisor: Expiration Date ic S— lgnre Telephone r 3.2Regiifffed Home Improvement Contractor Not Applicable 0 Company Name., Regi Number Address Expiration Date Signature Telephone G) 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 Yea.......11 No.......❑ SECTIOAT S-1PRdF$SSIONAL DESIGN-5ONSTRt7CTION SIRVICES +`f$?E 1 1N `A1�ID 3 TUR t3B, " CONSTB fICTI4N C(1riiDL Tb f8Q fL 1�lRi6(+E[1�1�T l ,llfl C Tr OF E:NC1D 5.1 Registered Archtect: +' ya Name: Address Signature Telephone .5:2 Reg�sbered:Ptrsfe�.sliea�Bri�sn�ei�i�} �, Area of Responsibility Name: Registration Number Address: Expiration Date Signature Total Not applicable ❑ Name: 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 F Telephone Expiration Date Not Applicable ❑ Company Nam Responsible in Charge of Construction 5�� ,�ij�J!Es�' ''CXi€�►1�3:�?� �Q (ck all.applxcal�le� �' New Construction ❑ Existing Building 0 Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly 0 A-1 0 A-2 ❑ A-3 0 IA ❑ ❑ A-5 ❑ 1 B ❑ B Business 2A ❑ C Educational ❑ 2B 0 F Factory ❑ F-I 0 F-2 0 2C ❑ H High Hazard ❑ 3A ❑ I Institutional ,,, v,-.0 1-1 ❑ 1-2 0 I-3 0 3B ❑ M Mercantile n -❑ 4 ❑ R residential ❑ R-1 ❑ R-2 ❑ R-3 0 5A ❑ S Storage ❑ S-1 ❑ S-2 0 5B ❑ U Utility ❑ Specify: M Mixed Use 0 Specify: S Special Use 0 Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34: k .00 u�� ; BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floor s Total Area s Total Height ft Independent Structural Engineering Structural Peer Review Required Yes ❑ No ❑ SECTION 10a Owner Authorization- TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I> as Owner of the subject property Hereby authorize to act on My behalf,in all matters relative two work authorized by this building permit application Signature of Owner Date i Mile I, as Owner/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury Print Name Signature of Owner/Agent Date 140 Item Estimated Cost(Dollars)to be F a ( r s Completed by permit applicant _. _ : : F >F 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) 39) �- 4 Mechanical(HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) Check Number ti F. qtr ! 'Ft , F`F''}i..�: �'•: s t. k ,. a...� 7> {! x n r >.. `2`d"�'. r '�. s S"fi. >; U t-�.�srarw. a t `gw k§' iF'�:.':k.��`�,d:6t.It I�. .av r:.,,,V1 ..7 .. :'`3 S 'itV u.r,� k r�.'pP rr 'ZtaW xtt'r�,.Yt�r :���.N;'i5� te;:;•t^ s N�.*�A; .(1 �,?�1�.�r's .r5..' 'yt r� .tit sY 5'rs �.�':'.:in Naa, i NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINMERS Vil2 No 3RD SPAN DEMENSIONS OF SILLS DEMENSIONS 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 �r .r r t w: , A-�rsz'raE x t' ' T•Y ���"` 1.`e*.r 5¢.>r�" g..' k. .-� 4 �'- a+ �!' !v^,;� S F�+'' iced•` 'ye,Z.£:tie� ,r � z�., Y*.'a > .� ��r � .f r NvR � M Town . of E over No.33.? Y ti dower, Mass., Ap�` T O� LA COCMIC V AERATED S H E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT.....B.A0... INSPECTOR �......... .. ..... BUILDING.�.............�.....�......................................................... ................. Foundation has permission to erect...A?W-A*04-tk�.... buildings on �d S l4�N ........... Rough ........................................................... to be occupied as........ .....�001A C.IC....... to Jq A .....I..3................................................................ Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-La s relating to the In spe ion, Alteration and Construction of Buildings in the Town of North Andover. a/ ao � PLUMBING INSPECTOR a f VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR Rough ........... .. .. .. .. .................................. .................. ........ ........ Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det. t 44 �74 &MM'aAo"eAea la i. BOARD OF BUILDING i License: CONSTRUCTION SUPERVISOR Number: CS 045259 r Birthdate: 05/22/1960 ' Expires:05/22/2003 Tr.no: 10332 .Restricted To: 00 ROBERT V CROWLEY JR 80 JARVIS CIRCLE MA 02192 Administrator ' i 6 PER311T NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP iJO. 7 2 RECORD OF OWNERSHIP (DATE BOOK ;PAGE ZONA SUB DIV. LOT NO. -I c I LOCATION / PURPOSE PURPOSE OF BUILDING OWNER'S NAME NO. OF STORIES SIZE LJ OWNER'S ADDRESe BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET "' POSTS DISTANCE FROM LOT LINES— IaES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS CODE V 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 INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FIIc;2 AND APPROVED BY BUILDING INSPECTOR /97 DATE FILED C BUILDING INSPECTOR SIGNATURE OF OW=ORAU IZED AGENT F E E OWNER TEL.k PERMIT GRANTED CONTR.TEL.# ✓ " t:Z ` �6 19 ---! CONTR.LIC.# Oa ! y 7 H.I.C.# Z22 ac3 ` 7 T40 R Ty Town of yt � - Andover L °o;s LAKE �, , dover, Mass., coc HICMEWICK v BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System ' BUILDING INSPECTOR THISCERTIFIES THAT.................................................... ... .�..r...L:��.�.............................................................................. Foundation has permission to orae!--.... j.. .. S.n p '7-��..... buildings on ......1..�.�..............���././.�.... ................ Rough tobe occupied as...................................................R.(!.t-24?..FP..............C�.�.V...................................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST -TS ELECTRICAL INSPECTOR Rough ............................... ..... ........................- .... Service ... . ... .. ..... .... ...... LDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove R Rounal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. Location No. Date '� TOWN OF NORTH ANDOVER . o Certificate of Occupancy $ Building/Frame Permit Fee $ �cMus s� Foundation Permit Fee $ CM Other Permit Feb $ _ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ ""''� Qj Building Inspector ;p f� Div. Public Works `Ao DTH qti SLE 6 •La116 i 0 TO T O W N O F _ N 0 R T H A N D 0 V E R �. ?�•�� � - - m # s—r•, p 4 LwK9 ' 1. � . �A LOCI/IC Nk.VICN`y �S"ATEO q SACHl15G s i DATE: �'�� 1��� NORTH ANDOVER, MASS . ,•F. 1 . PERMITOo?. S I G N PERMIT a .k THIS CERTIFIES THAT. ..K�9��+ A'... ` © CkkAK`� %CA& &y% "Pe I - •t lea t fti�M ! 4P. .o n . tU8 MAI . . . . . . . . has permission to ere(* Q0 9'4%V. 1d.. •�• - �iiw li.. T•leW t..ac.cs. provided that the person accepting this permit shall in every respect conform jto the terms of the application on file in this office , and to the provisions of the Codes and By-Laws relating to the Sign Regulations in the Town of " . North Andover. VIOLATION of the Zoning or Sign Regulations , Section #6 , Voids this Permit . - i . . f • i . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Building Inspector �Z'4S i SIGN PERMIT APPLICATION NORTH ANDOVER BUILDING DEPARTMENT Division of Planning & Community Development Date Filed: .S fj 1. Site Address ZQ8 /v rT7Q MP4/;0 2 . Owner • Avow nxj 1a 3 . Applicant S 4 . Number of Signs_ Size of Sign(s) 5. Site of Proposed Sign(s ) t4in /J 6 . Materials : Alux't LtT7-r4--S 7 . How attached: (a) Against the wall (�J (b) Roof ( ) (c) Ground ( ) (d) Other ( ) 8 . Illumination: (a) Not illuminated (b) Internally illuminated (c) Illuminated from separate service ( ) 9 . Proposed Colors : Background Lettering Cajrj IC-k4. Border fps 10. Will sign overhang any public road or walkway : Yes ( ) No (b) 11 . If Yes , Name of Agency who will provide liability insurance : 12 . Attachments : -',Photographs of building ( ) Material sample ( ) Color samples ( ) Site or Plot Plan (Required for all free-standing signs ) ( Jo ) *Drawings of proposed sign ( ) Other, specify 1:-AC E: Ck,,,vg L 13 . Is Board of Appeals decision required? Yes ( ) No ( ) Signdture of Applican 5 1995 1988 .�, ;. 3` �3�� 3�;3' ae � #' :�''����8 '� '✓">.Z s .'>o �:; .. F �33.' �".. „x�+' �. 9 -re's yf t , ' .. ' AAM y AndoverBank .. ..."x. .�r I' IR : gg7i £S 3 F stk' . E' E� z ' Y ys : k�. rt G�INC.O INTERIOR / EXTERIOR SIGNAGE & SCREENPRINTING 508/686-1841 or 794-2071 FAX 508/686-1841 40 MYRTLE STREET LAWRENCE,MA 01841 SIGN PERMIT APPLICATION NORTH ANDOVER WILDING DEPARTMENT Division of Planning & Community Development Date Filed: s f� 1. Site Address Z28 2 . Owner . 14(VDOdFIL. )5 rg,y 1-- 3 . Applicant S 4. Number of Signs Size of Sign(s) 5 . Site of Proposed Sign(s) ZXIS l 6 . Materials : S%C1 7 . How attached: (a) Against the wall ( i (b) Roof ( ) (c) Ground ( ) (d) Other ExjS S7)g� ELeq ( ) 8 . Illumination: (a) Not illuminated ( ) (b) Internally illuminated (c) Illuminated from separate service ( ) 9 . Proposed Colors : Background Lettering G�ajr,1 /�a,l, Border 10 . Will sign overhang any public road or walkway: Yes ( ) No (b) 11 . If Yes , Name of Agency who will provide liability insurance: 12 . Attachments : ',Photographs of building ( ) Material sample ( ) Color samples ( ) Site or Plot Plan (Required for all free-standing signs) ( to ) -',Drawings of proposed sign ( ) Other, specify 7c- Ac C Chw.vg L Cir?S 13 . Is Board of Appeals decision required? Yes ( ) No ( ) J -7 „. Signature of A ✓ icant n 5 1988 ' THC- CIRRUS. { 6-L i Andover Bank INTERIOR/ EXTERIOR SIGNAGE&SCREENPRINTING 508/686-1841 or 794-2071 FAX 508/686-1841 40 MYRTLE STREET LAWRENCE.MA 01841 Location /0 K /I'/ 4< �� J No. Date 110 S, 4 Of NpR7H 1 TOWN OF NORTH ANDOVER 1 p? .it�.o .�•a�pp� I „ Certificate of Occupancy $ * °* Building/Frame Permit Fee $ '� �. Uv 'STACMUSEt Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ C /� Building Inspector 10/05/95 4:34 98.00 RAI6 Div. Public Works PER31rr NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP iJO. LOT NO. 2 RECORD OF OWNERSHIP (DATE BOOK 'PAGE ZONE SUB DIV. LOT NO. I LOCATIQpL• 'Oa rn j•l S� .mss PURPOSE OF BUILDING 1A1v /1c4� 2 p ` OWNER'S NAME NO. OF STORIES '/ SIZE OWNER'S ADDRESS log /i/I g1WxI� �o e6 7� ,L�� BASEMENT OR SLAB ARCHITECT'S NAME /'Cvc,�D% /, J✓ �l �//�(,Sa.0 SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME /7e7lr,''/J/O 00,Vr-r ,y $N SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR " GIRDERS •AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW /V(' SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE /,es, 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 INSTRUCTIONS / 3 PROPERTY INFORMATION SEE BOTH SIDES /�/7N1� /� LAND COST 7� / J (� EST. BLDG. COST �3 O O O, 00 PAGE 1 FILL OUT SECTIONS 1 - 3 /�O�1i7 e�P (�L�Cj EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED IJ BUILDING 1 PKCj*R SIGNATUiRE OF OWNER OR AUTHORIZED AGENT F E E 2*-. d0 OWNER TEL.# 71-I9 9000 PERMIT GRANTED CONTR.TEL.# 09 3 7 4,,4�/11'3 3-3 Idly9 �— CONTR.LIC.a O T 7 0T Y H.I.C.k �d Q 5-37 SEP 2 5 t995 C)tc ��,�� BUILDING RECORD 1 OCCUPANCY 12 1 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS I RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 3 1 2 13 CONCRETE BL K. PINE BRICK OR STONE PIERS PIASTER _ DRY WALL UNFIN. 3 BASEMENT 11 AREA FULL FIN. B M'TAREA J— V, 1/2 1/1 FIN. ATTIC AREA _ N_O B M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDW D _ ASBESTOS SIDING _ COMMON VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK N MASONRY ATTIC STRS. 8 FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE HIP BATH 13 FIX.) GAMBRELMANSARD TOILET RM. (2 FIX.) FA_Tj I SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC tsr 13rd NO HEATING NORTH Town of r 6Andover 0 No. 4 P fi � zo -, or '� dover, Mass., �c7` `� 199 �J COCHICMEWIC K AORATED PPa,`�� S BOARD OF HEALTH - I Food/Kitchen PERMIT T D Septic System n /' BUILDING INSPECTOR THIS CERTIFIES THAT................, ft1� ,�1�J.�P.2........���k. ?. `...................................................................... """' Foundation � �qM has permission to erect..../j'�Q.� i..C.q�....... buil ngs on ......��.. ..... 9.'.n......6 .7 ..�....... !�G....�. � Rous, � � �''C 7 Chimnc to be occupied as..,*,..� ,Irt......0../<..............�.../.x ..•.C.ac,,o......�a.��0. provided that the person accepting this permit shall in every respect conform tb the terms of ttfe application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION S ARTS ELECTRICAL INSPECTOR Rough {............. .............................. Service BUILDING INSPECTOR - Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT O•Sr-/� ( Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT ►q PA apt !�#l�EPT OF PUBLIC SAFETY -. - - `1010 ONWEALTH AVE. � ..- _ .. _ •s0 02215 �. _ {# � t w 1 - ,'/.ne'�ammcxu.nal'Di� ..r<�aaiac�imle/lt w' .1L I..E N S E -CON SUPERVISOR •. HOME IMPROVEMENT CONTRACTOR= Registration 108531 i w.f EFFECI DATE LIC O. Type ' PRIVATE CORPORAMN t iN 5. Expiration 08/19/94 KEV _N"T ?ETRILLIC Petrillo Constr. Carpentry -57 ASHI �3STON ST i ,� Kevia#T. Petrillo '!4ET UEN' SSA 01844 -53 Milton_St. . ". ADMINGTRATOR Lawrence MA 01841 ' NOT 7L SIGNED BY LICENSEE AND GFFIGALLY ice'.•1 •-•. .t �r- ! - ST 'k OR-SIGNATURE OF THE COMA16SS10NER q 1 I t he northe�lst independent living program, inc. September 28, 1995 Mr. Mike Young Andover Bank 61 Main St . Andover, MA 01810 Dear Mr. Young: I thank you for your request to my program for advice concerning the access improvements you will be installing at your No. Andover branch office. As you requested, it is my opinion that relocating the designated accessible parking space from in front of the Town Tull to the front of the Bank would be beneficial for your customers. Having the apace in front would make it easier for people to access the ramp you will be installing for the Sank. The' space could also be used by persons having business at the Senior Citizens Center,. Town Nall, and the stores, etc. in the area. I will be happy to discuss the other questions you may have for me . I hope the ramp can be installed this Fall . Sincerely, r Jim Ly s . , Director Community Development JL:ng OCT 2 ip(-r Full community participation 20 Ballard Road, Lawrence, Massachusetts 01843 through education, training (508) 667-4288 (Voice[[) Fax: (508) 689-4488 and advocacy by and/or Amesbury Office: 69 Main Street, Amesbury, 'MA 01913 United ww people with disabilities. (508) 388-0677 (Voice/FaW7Y) of mo".—a vo., ..FROM 5086894468 09-29-95 11 : 26 AM P02 AAS AD AndoverBarik September 29 , 1995 Town of North Andover Building Inspector 120 Main Street North Andover, Ma. 01845 Dear Sir : This is notice that Andover Bank will be installing a new ATM in the North Andover Office this year . I will give you drawings once the machine has arrived. This machine will be handicap accessible . I 'm also including a letter from Mr . Lyons requesting the relocating of the designated accessible parking space to in front of the bank. I hope that this information will allow Andover Bank to start the installation of the ramp. If you have any other questions please call me at ( 508 ) 749-2280 . Sincerely, 4 *,j!=, Michael F . Young A.V.P. & Security Officer o c T 2 1gc Andover Bank,61 Main Street,Andover, Massachusetts 01810 (508)475-6103 Wholly-owned subsidiary of Andover Bancorp,Inc. .�`. . or T t 74 I-le, s�� �4;{ j '{x t t•��t Y:� 1 w � • � �pyy,� �a�x�r�' � 1 Q� ori,bs•d�• � s.yy'. . �::_ :,.' .'�r cam. `'•'' •r., a' � ,".�'t; l,i+ . �`��,�.. ' ., Mfr.•' �,•' � z '''� �'t ..i ' / p'T`K r ;��rJ'r-I^'(j i j''•.<d �id'� f i /• '1 �r,��. �\/�/O i 'j i ,t�•g.. fir,.. �'{�': ,�,�' Mui � ;�_ ��,��1� ; , p1)LA r4lti, I 1 A NK Y AF 0. , ^_ t �• a`tit. ..Y..� I �i`�•' �� w� `�rf� ,%�q�� !� '` �,L "da:�,^;J- " '.� , .'�iw}r'� { r y� ��•� "�t���}�"l,,ft ,j!��, ( I i'� �e K � J.t: 4' ry'�!. �.'R75�` �j•'!'•aii li,y t, ~ .,fi{' T�+ l`I, t 'r ) r °�' '' r '� r�"t� �av� '•.• .� PRC) 0 S E D HAJMD CAP %AMP �. � �, � S� f, Y�. > 4r bi��. ?� rya`s _ i 1 I •� {� ' . (�j%_Xj�y./,��d�r,i�^ .� ,5• tY p� S���Z '� x ` Lr` I V �+'• '+': Ile?�..} (• n � T v. '�:: •., �"• .?,£;'.' �.r..pn...._'.`:. tea.-...: ' :_.. ,.... ��.��� .. � \..,. _�r�a:- ...-..: i.,.. i .. •'�. y%ti;. ....- .. yam.... w .....� .w...._�... Date. N2 4 31 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING • o ,' a sScMusf� This certifies that . . . . . . -�--. . . . . . . . . . . . . . . . . . . . . . . has permission to perform . . . . . . . plumbing in the buildings of . . . '.^. ..`-. . .. -.; . . . . . . . . . . . . �" ' 1"- - ' : . . . . . . , North Andover, Mass. at . . . . . . . . . . . . . . . . . . . . . . . . . f Fee . ��Lic. No.?-�41. . . . . . . . </ PLUMBIN�INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer .+.n.�.arwrlu.7cI IQ urvrhUHM APPLICATION FOR PERMIT TU UU PLUMtIINU (Print or Type) ff / NORTH ANDOVER, Mass, Data l 0 �1 Bultdlno /� �� ermit ya31 Location ,�1i? , Owner's J ' Name dev�r New ❑ Renovation ❑ Replacement ❑ Plans Submitted: Yes❑ No.❑ FIXTURES � w = M z Y J M O = s • } Y r M al u < M b1 X M < t S �! w ! p A o r H w H u s� — w 16 s: a, aL Y Y < w O <414* A O �. po a fig < !• s J 0 < s s < 0 V ! 1 • w e O s ! s • is • a e < 0 s Is o sure-9sMT. •ASSMXNT 1ST 1810011 &NOFLOOR SAO FLOOR AITH FLOOR •TH FLOOR STH FLOOR, YTH FLOOR 11TH FLOOR / Check one: Cadlilcate Installing Company Name% ndovtr �� 03 Corp Address r D ❑Partnership - ueAc ❑Firm/Co. Business Telephone .Name of Ucensed Plumber J INSURANCE COVERAGE: ec e I have a current ilabli ty Insurance policy or Its substantlal equivalent, Yes No ❑ If you have checked y", PleaseIndicatethe type coverage by checking the appropriate box A Itabllly Insurance policy Cd 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 Masa. General Laws, and that my signature on this permit application wolves this requirement. Check one: gli-NMING of Owner or Owners ACent Owner ❑ Agent ❑ I hereby certify that all of the detsNs and intwmallon I have submttted sot entered)In above appfkatim are true and accurate to the best of my knowledge and that so plumbing wwk and InitaAattons performed under the perrM Issued for We appikatlon wit be in cmVilance with aN pertinent provisions of te Massachusetts State Ptumbing Code and Chapter :4Znua EY This c� Ctty/Town Uconsa Number APP WEO(OFF)CE USE ONLY) Type of Plurnbtng Ucense: Master ❑/ Journeyman 0