HomeMy WebLinkAboutMiscellaneous - 111 BARKER STREET 4/30/2018 111 BARKER STREET �
2101030000.0
J
4
I
h
I'
.i
2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance-with the provisions of M.G.L.c.143,§3L,the �
permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed
on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166,§32,an
firm or corporation stated on the permit application. Such entity shall be responsible for the
electrical permit shall be issued to the person,
notification of completion of the work as required in M.G.L.c.143,§3L.
Permits shall-be limited as to the time of ongoing construction activity,and maybe-deemed_by-the-Inspector_of-Wires abandoned_and_invalid-iflie—. ._
or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written
application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written
request of either the owner or.the installing entity stated on the permit application.
The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of
the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this
purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With
limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was
"in effect or existence'during the qualifying period beginning onAugust 15,20DZ and extending through August 15,2012.
ff
e I—Permit/Date Closed: ^� *'xNote:Reapply for new perm!k7mit Extension Act—PermitMate Closed: ��\\
t 0062 Date......7...:.
�' yORT1�
TOWN OF NORTH ANDOVER
~ p PERMIT FOR WIRING
��SS�cHusE�
This certifies that .............0..6RI.P:! V to
f
has permission to perform .............jl.&........... ..................................................
wiringin the building of...................................................................................
�/l h..r.n-........�'.:'.-................ ..North Andover,Mass.
jo
Fee...: . 7:7:7.". Lic.No....313 .... y!.'{ ..
ELECTRICAL INSPECTOR
Check # �.
Commonwealth of Massachusetts Official Use Only
Department of Fire Services Permit No.- 90 -5 2—
Occupancy
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONSUV ev. 1/07
(leave blank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
II
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:
City or Town of: NORTH ANDOVER To the Inspector of Wires:
By this application the undersigned gives notice of his or he * tendon to perform the electrical work described below.
Location(Street&Number) & !��
Owner or Tenant -Telephone No.
Owner's Address
Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters
Number of Feeders and Ampacity
Location n Nature of Propo d Electrical Work:
Completion of the followingtable may be waived by the Impeclor of Wires.
No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total
t Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- El Battery
o Emergency Lighting
d. rod. Batte Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No.of Detection and
Initiatin Devices
No.of Ranges No.of Air Cond. Tons Tons No.of Alerting Devices
No.of Waste Disposers Heat Pump I Number I TonsKW No.of Self-Contained
Totals:I Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KWMunicipal al❑C ion El Other
No.of Dryers Heating Appliances KW rtty sums:
No.of *es or Equivalent
No.of Water , No.of No.of to Wiring:
Heaters Si s Ballasts Nr of v or,E uivalent
No.Hydromassage Bathtubs No.of Motors Total HP a mmnaratmrt Warm
N of vi. or Equivalent
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 insXwnice including"completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coverNKis 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,tha the informah on t ' application is true and complete.
FIRM NAME: ► ' LIC.NO.._
Licensee:- Signatur _ LIC.NO.:
(If applicable, n e x mpt' ' the license number line.) Bus.Tel.No.-
Address: a�2 -- ../ ��— A��Z_ /Iv Alt.Tel.No.: — (�
*Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE. S
Date. . .
89 , 0
f o'<"oRT:�Mo TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
,SSACMUS� i
This certifies that Y(o. . . . 11K
` has permission to perform . .,� 1�t14!1 . 5WK l cJo 4
����r plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . . . . .
at . . . . . .��. . ). . North Ando Mass.
J-3J•.5.0.Lic. No..?V.37 . . . . . . .`r), . .
PLUMBING INSPECTOR
I
Check
i
r
f
I
4
f
t
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
City/Town: �-�r
cwt/Z ,MA. Date: / Permit#
Building Location: Owners Name: (U//�
Type of Occupancy: Commercial❑ Educational❑ Industrial❑ Institutional❑ Residential
New:❑ Alteration: Renovation:❑ Replacement:❑ Plans Submitted: Yes❑ No❑
FIXTURES
DEDICATED
� z
SYSTEMS
Vf
�
LU
aac ' yyNx QQQ z VVaV,l W1A z ~ YC Q
ZaSQ uZ O
to (A W W V
cc 0 Z U LL xQ Z V !3Z WH
3WUj
O � z LU LU LU
W U 0 > o 0 z F x V1v Lou:
o aaaat
d�jQ3H:
a 3
SUB BSMT.
BASEMENT
1ST FLOOR
2ND FLOOR ✓
3"D FLOOR
4T"FLOOR
ST"FLOOR
6T"FLOOR
7T"FLOOR
8T"FLOOR
/ Check One Only Certificate#
Installing Company Name: ����� E=+�� ✓�i' �oa� G
� � S ❑Corporation
Address:S Savni City/Town: ` State: A
;FirmlCom a ",ship
Business Tel: 93�3�2'7�� Fax: pany
Name of Licensed Plumber: A) j
INSURANCE COVERAGE:
1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes No❑
If you have checked Yes,please indicate the type of coverage by checking the appropriate box below.
A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the
Massachusetts General Laws,and that my signature on this permit application waives this requirement.
Check One Only
Owner ❑ Agent ❑
Signature of Owner or Owner's Agent
I hereby certify that all of the details and information I have submitted(or entered)regarding this application are true and accurate to the best of my
Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all
Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
By Type of License:
Title ❑Plumber Signature of Licensed Plumber
GG
City/Town aster
License Number:
APPROVED OFFICE USE ONLY) ❑Journeyman
FINAL INSPECTION BELOW FOR OFFICE USE ONLY PROGRESS INSPECTION(S)
FEE: $ PERMIT#
APPLICATION FOR PERMIT TO DO PLUMBING
NAME&TYPE OF BUILDING
LOCATION OF BUILDING
SKETCH
PLUMBER
LICENSE NUMBER:
8
PERMIT GRANTED F-1 DATE:
PLUMBING INSPECTIOR
TOWN OF NORTH ANDOVER
APPLICATION FOR PLAN EXAMINATION
Permit NO: %EVItIORTANT:
« Date Received
Date Issued: tf
A licant must complete all items on this page
LOCATION P I lac r ke r S+-.
Print
_PROPERTY OWNER
Print
MAP NO:O.3Sy PARCEL:0/03 ZONING DISTRICT: Historic District yes no
Machine Shop Village yes no
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑One family
❑Addition ❑Two or more family ❑ Industrial
Iteration No. of units: ❑Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other
5
00-
S eptic lWell, ` �Wetl_'ands ", 'D i Waterslie'dlDistriet T
-J
DESCRIPTION
-
DESCRIPTION OF WORK TO BE PERFORMED: __`/
V\arn/ E� � j,n� t3�1�1n r7���. �,.. f�'I ae /..rS 7-�� Y7yfe
5�V)Le 2f . t'11rve Y�Uwe� f�n� Lc1r1� � c� Ct -S
AA(z eL S h P PO4gl A6 r
Identification Please Type or Print Clearly)
OWNER: Name: " t Phond:
Address: 111 8 G r- Ike✓' 5�- &-
CONTRACTOR Name: [A1n CrrA S �tyL ��C�ir t s �w ai ssp Phone:
Address: /Z VVVI,,\TrA,c, n r�,f e S G,^C cA 03 k2 3
Supervisor's Construction License:
qZ 7 3 Exp. Date: 2-a It
Home Improvement License: /b ySd 3 Exp. Date: /0)2 t i® 1 1
ARCHITECT/ENGINEER Phone: -
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT.$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F.
Total Project Cost: $ &Y) ,/0, FEE: $
Check No.: �l 7 Receipt No.: yaa�
NOTE: Persons contract' with unreg' d contractors do not have access to the guaranty fund
Si riatiare::of.A ent/Q.`:.._ .-. 9-6 f;:contractor ;
Building Department
The following is a list of the required forms to be filled out for theappropriate ermit to be obtained.
qpermit
Roofing, Siding, Interior Rehabilitation Permits
❑ Building Permit Application
❑ Workers Comp Affidavit
t
❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses
❑ Copy of Contract
❑ Floor Plan Or Proposed Interior Work
o Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
Addition Or Decks
❑ Building Permit Application
❑ Certified Surveyed Plot Plan
❑ Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses ;
❑ Copy Of Contract
❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And
Hydraulic Calculations (If Applicable)
❑ Mass check Energy Compliance Report (If Applicable)
❑ Engineering Affidavits for Engineered products
NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
New Construction (Single and Two Family)
❑ Building Permit Application
a Certified Proposed Plot Plan
❑ Photo of H.I.C. And C.S.L. Licenses
❑ Workers Comp Affidavit
❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And
Hydraulic Calculations (If Applicable)
o Copy of Contract
❑ Mass check Energy Compliance Report
❑ Engineering Affidavits for Engineered products
DOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit
n all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals
iat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. one copy And proof of recording .
Lust be submitted with the building application
Doe: Doc.Building Permit Revised 2008mi
Location
�o���— .?
No. -Date
TOWN OF NORTH ANDOVER
3 0
F w
D
Certificate of Occupancy $
Must Building/Frame Permit Fee $ fid
JAC
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
U
( i-
24UU2
Building Inspector
+ ORTH
Town F
of And
No.
z-: A K E -o dower, Mass,
A_ COC HI C HEwICK
A00ATE0
SS BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
{
BUILDING INSPECTOR
THIS CERTIFIES THAT �D rJ. �', v
' ............................................ Foundation
L
has permission to erect........................................ buildings on ../� ................................. Rough
to be occu ied.aS v 1 C�'i o �c Chimney
p ..................c1sa./%...................................................................................
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
1 Final
PERMIT EXPIRES IN 6 MONTHS
ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION STARTS Rough
...................................... .' :.:...:::" r.. ............................ 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 FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
SEE REVERSE SIDE Smoke Det.
i
Massachusetts dome Jnr°�yement' S
am le Cont
U r� ct
This in solibasic
sfies all '
requirements of the
language to protect homeowners. See O state s home impi ovement'Contractor Law
Seek legal advice If necessar , �� sOn (MGL chapter I42A),but does not include standard
lvlassachusetts consumer guide to home imprpvement"before agreeing to any work Planning orresidence.You Ints
c should first obtain a co
Office of Consumer Affairs and In— Regulation's Cansumer InfOrmtitioa Hotline at 617-973-8767 or]=888-283-3757• copy of"a e
y brain a free copy by calling the
Iffotneowner Information
Qontractor Information
�((/�JP� � ompanY ame ,• �
treel Addr (do not use Post OF6Box adressdf vL Gl/�
% ) Contractor/Salesp=RQU/OwnerNrime
t�f
ty
State ' � 5-11—C l' .$'
Ct /fawn Ztp Code usiness Address(must include a street ad
,l dress
rpm
Daytiine Phoae Evening Phone ` Z rti 1 t V
IV I own State 11 Zip Cade
Marlin%ddri,(1erect from above)
Business Phone ederal EmployerID or S.S.Number
PMV=lacurequtccctbelmerthemdmr- name pmvemeatcowntter
Ad=Idateootracton travel I Rei-Number rxphatio date
The Contractor agrees io do the'follawing work for the Homeo Der;i ono? � t7• j 6 ?�
1111 1 11 1cin a in e w r comp e e specs / / �0�2 /2O)1
fiV� ,p g e( e, rau , e o m in e e
e �`le - be A.- �� on ere s •.
•./�s�►/1 �.� -� 57vt� �� r 7Lj�e — �
P-w �(A t Yr c, lnvG 14 tlgf
s, �' e` 'N��// � i
a
o, z l lc4 c Q
10
Regtilred.Eermits-The followinuilding permi are required Proyrosed Stott and C pletlon Schedule The fQIIawin schedule
and ill he secured bX the contractor as the homeowner's agent, be adhered to unless circumstances beyond the contractors control arise will
(OwJners who secure their own permits will be
exclilded from the Guarant3�Fund provisions'of
MGL chapter 142A.)' Date when contractor will begin contracted work.
'y Date when contracted work will be substantially completed.
Total Contract Price'and Pn inngnt Schedule
The
Y
Contractor agrerr to perforin the wor- furni '
sb the
Lt material and labor
specified above for the total sum of
Paynients will be made according to the following schedule:
A'-!L_upon signing'contract(not to exceed 1/3 of tbe'total contract'
rice or
P the cost of'specia]order items,whichever is greater)
by / 1 or upon compledonnf
byy .orupon completion of
neon completion of the coTittact. (Law forbids demanding full payment until contract is cam toted
The following materia]/e rmustspecial P to both party's satisfaction)
Ordered before the contracted wart beg ns in order $
to be paid for
t to meet the completion scbpdule.(**) -------- to be paid for
NOTES:(*)Including all finance charges(**)Law requires that any deposit or down- a
not exceed the greater•of(a)one-third of the total contract price or P yuaf c required by the contractor before work begins may
Pri (b)the actual cost Of any special equipment or custom made material
Which must be special oidered n advance to meet the completion schedule,
Express Warranh
Is lain expresswarrir' bean nr t t a t
Subebutractors-The contractor a "'c'eO actor!'_N o Yes al!terms of the warren must bo attic ed o the centrnct
grecs to be solely responsible for cotiapdetion of the work described regardless of the actions of any third
party%subcontractor utilized by the contractor. The contractor further gpep to be so leiy'resPhnsiblefor allPayments
ate ria s and labor underthis•a cement
Contract Acceptance-Upon•signing,this documentbecomes abinding contract under law. Unless oted wi allsubcontractors
slits document,
for
contract shall not imply that any lien or other security interesthaa been placed on the residence. Review the following cautions and notices
carefully before signing this contrack mens,the
• Don't be pressured into signing the cantruct Take time to read and fully understand it Ask questions if a
• ' ng is unclear.
:!L1111 re the contracto has a valid Home m ove eat Co
subcontractors to be registered with the Director of Home Iutprovement Contractor Registration, you may inqutire about contra
doMItmow
The law requires most home improvement contractors and
registration by;writingto the Director at One Ashburton Place,Raom 1301,Boston,n,MA 02108 orb calling 617.- cur
• Does the contractor have insurance? Y g 727-3200 or
Check to see that your contractor•is properly insured.
Know your rights and responsibilities*. Read the
,in
Infarniatioln on the reverse side of this form and get a cogy of die
Guide to the Home•ImprovemeDt Contractor Law, ;
Consumer
You may cancel this agreement if it has been signed at a piece otKer•than die contractor's norma!place of business, rov'
contractor in writing athis/her main office or branch office by ordinary mail Posted,b
third business day following.the signing of this agreement. See the attachect notice of cancellation form for an explanation of ou rionfy the
P d, y telegram sent or by delivery,not later than midnight of die
DO NOT SIGN TFIIS CONTRACT IF T']EtET� �•�� ova right.
f Two idcndcsl copies thc.contract stbe completed and signed. ARE ANY Birt�.iV K,t'jp 111
. J u sued �t6C0Fyshoutdgotnthcho ACES...
wna.The ether copy should be kept by the contractor.
Homeowner's Sign Te
r a a tar's Sisnature -
• Date '
Contructar Arbih-ation
The Dome Improvement Contractor Law provides homeowners withthd ri' it to initiate H
l;l an arbitration action(as an
. alternative to-court ac
bion 'if theYh
have a dis u
te�with� a contractor.
The same right is not automatically affordei to a'
contractor,however. The contractor would have to resolve any dispute he/she has with a homeowner in court unless
both parties agree to the optional clause provided below. This clause would give the contractor the same right to
arbitratiori as�is afforded to the h6meowner by the Home Improvement Contractor Law.
The contractor and the homeowner hereby mutually agree in•advance that in'the event the contractor has a dispute
concerning this-contract,the contractor may submit the disputa to a private arbitration firm which has been approved.13y
the Secretary,6f the-Executive Office.of Consumer Affairs and Business Regulation and the consumer shall.be required
to submit to such arbitration.as provided In Ma9sacbuusetts General Laws,chapter 142A.
H'omeowner's Sign tore Contractor's Signature
NOTICE;The signatures of the parties above apply only to the agreement of the parties.to alternative dispute resolution
initiated by the contractor. The homeowner may initiate alternative dispute resolution even where this section is not
separately signed by the parties.
Homeowners Rights
'.A homeowner's rights "
g vender the Home Improvement Contractor Law(]VIGL chapter.142A)and outer consumer
protection laws'(i.e.MGL chapter 93A)may not be waived in any way,.even b a eemenL However' home ers
Y !n" awn
may be excluded from certain rights if the contractor the choose is noe •
Y , .t properly registered�s prescribed by law:
Homeowners who secure their own building permits are automatically excluded from all Guiranty•P.and provisions of
'thd Home Improvement Contractor Law. The contractor's
• � responsible for completing the work as described,in a
timely and workmanlike manner. Homeowners may be entitled'to other specific legal rights if the contractor guarantees
or provides an express warranty for workmanship or materials. In addition to guarantees or warranties provided,by the
contractor,all goods sold in Massachusetts carry an implied warranty of merchantability and fitness for a particular
purpose; An enumeration of other matters'on which the homeowner and contractor lawfullyagree maybe added to the
term's of the contract as long as they do not restrict a homeowner's basic consumer rights. If you have questions about
Your cansumWhomeowner rights,contact the Consumer Information Hatline(listed below).
Execution of Contract v = •.
The contract must be executed in du ]icate and should '
. _�_ d nol;Ue signed I geed until.a copy of all exhibits and
documents
have been.attached. Parties are.also advised not to sign the document until a '
• .„ i;n ll blank sections ns have been ,
filled.in or marked as void,deleted,or not applicable. One original signed copy of the contract with attachments is to-
be given to the owner'and the other kept by the contractor. Any modification to the original contract must be in writing
and agreed to by both parties. Co'n'tracted work may not begin uaitil both parties have received a fully executed copy of
the contract,.and the three day recission period has expired.
Accelerated Payi tents
A contractor may not demand'payments in advance of the dates specified on the payment schedule in cases where the
homeowner deems him/herself to be firiancially insecure. However;In instances where a contractor deems him/lierself
-to be financially insecure, the contractor may require that the balance of funds not yet due be placed iu a joint escrow
account as a prerequisite to continuing the contracted worlc, Withdrawal of r rids frown said account-
.0 requite the
signatures of both parties.
Additional Information
If you have general 'questions or need additional information about the Home Improvement Contractor Law or•other
consumer rights,or•1'f you wish to obtain a free copy.. "A Consumer Guide
Law,"contact: to the Home Improvement Contractor
Cdnsumer Information Hotline
Office of Consumer
Affairs and Business'ltegulatioa
.10 Park Plaza,Room 5170,Boston,;MA 02116
(617)973-8781 or 1(8.88)2833757
If you want to verify the registration of a contractor or if u
about the contra you have questions or need additional informations specifically
ec
or registration component o.f the Home lm ra ,. P �....rcally
vement Co
. P Contractor Law,contact;
Director of Home Improvement Contractor
Re i
stratonBureauoBwldin e ila ons '
and Standards
One•Ashburtoia Place,koom.L301,Boston,MA 02108 `
(617 727-3200 or -
. ) 1 800-223-0 3 . . .
93
For assistance with informal mediation of disputes or to register formal complaints against a business,call: '
Consumer Complaint Section
Office of the A�.ttorne
I y General
(617)727-8400 ".
AND/OR
•BeiterBusiness Buteau
(508)652-4800
.(508)755-2548
(413)734-3114
i
r'f
CM Construction Contract MR-01-2011
Chris Morrissey/Owner Date: 9-Mar-11
CSL License#92773/1-1IC License# 164563
12 Montana Drive
Sandown, NH. 03873
Phone (617)947-0077
FAX (603)887-6339
TO: Bob Cupka Job Name: Cupka Bathroom
111 Barker St. Location: N.Andover, MA
N.Andover, MA. Job Number: MR-01-2011
SCUPE OF WORK
Provide all labor,equipment and material required to complete the following scope of work:
Work is to included:
Master Bath(OPTION A)
Work Is to include:
Remove and dispose of drywall around shower unit as needed
Remove and dispose of flooring and subfloor and replace with new subfloor as needed
Remove partition wall between shower and vanity
Remove a portion of the wall between the Master bath and the Master closet for new Shower area
Reframe Master closet,drywall and finish paint ready
Remove/Relocate heating element in closet
Install 42"x 60"shower pan with corner bench seat
Install rough plumbing as needed to hook up supply lines,shower drain and vent as needed
Install drywall on existing ceiling and finish paint ready
Install new shower valve
Install drywall around shower unit as needed
Install tile backer around shower unit as needed
Install tile backer on floor
Install tile(Diagonal Pattern)on floor with decorative inlays
Install Wall tile around tub/shower unit
Install glass shower door
Install wainscoting trim system on exposed walls
Install vent/light and vent through attic
Paint ceilings,trim and walls
Install Vanity,toilet,sink faucet,shower faucet and bathroom accessories
I
ERM AND CONDITIONS
A 20%deposit is due upon the signing of this contract,and the remaining
payments are due as listed on the attached Payment/Invoice Schedule.
Home Owner is to supply all finish material,including bathroom fixtures,furniture,tile,and accessories.
CM construction is to supply all labor and building material,including,trim,bathroom shower pan,and glass doors.
All labor and material is guaranteed for 2 years from date of completion.Any change from the above specification to be
Any change from the above specifications is to be done as an extra charge by written change order.
Any additional work that is needed due to unforeseen circumstances will be discussed with owner before any work is
performed.Additional work is charged at$65.00 per hour plus material.
All home improvement contractors and subcontractors shall be registered and that any inquiries about a contractor
or subcontractor relating to a registration should be directed to:
Above pricing is based on specific pricing for material and overall quote is subject to change if optional material
is chosen.
Office of Consumer Affairs and Business Regulation
en Park Plaza,Suite 5170
Boston,MA 02116
Phone:(617)973-8700
Home Owner has three days from date signed to cancel contract as stated in MGLc 93s48;MGL c 140D s10
or MGL c 255D s 14
By signing this contract you are allowing CM Construction to perform the work as described above at said location.
DO NOT SIGN IF THERE ARE ANY BLANK SPACES:
CM Construction Owner's
Chris Morrissey/Own Authorized _
Signature: Signature:
Date: Date: 3111 /J0J/
i
i
NThe Commonwealth of Massachusetts
r_ g Department of Industrial Accidents
rn Office of Investigations
' 600 Washington Street
Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Prinf Legibly
Name (Business/Organization/Individual):
Address:-,M"VALQ i0 ry P
City/State/Zip: �c- o[ ,ti e,7J,973 Phone#: 6 /7 X17- a777
Are you an employer?Check the appropriate box: Type of project(required):
1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2.�am a sole proprietor or partner- listed on the attached sheet.t ❑ 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.E] Roof repairs
insurance required.] 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.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
$Contractors that check this box must attached an additional sheet showing the name of the sub-contractors acid their workers'comp.policy information.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lie.#: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the fonn 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.
I do hereby certif under the pains€lndpenalties ofperjury that the information pro vided above is true and correct.
Signature: Date: 2 t
Phone
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License#
Issuing Authority(circle one):
1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three aparhnents and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or-on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required."
Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s) of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to cavy 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 confinnation 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 pen-nit/license number which will be used as a reference number. In addition,an applicant
that must submit multiplepermit/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 pen-nit 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-MASSAFB
Revised 5-26-05 Fax#617-727-7749-
www.mass.gov/dia
�3c�rkiqT Proposek
� R
C:D
`1
0
a � t
�eul
La
60
o
$ fo
N � �o
��" ,{q�4^.,�,,. a -�•�'�°`Y' � +C � SZ'°% bk+ " S sl: ..;y,.: ,#�,�. _. I
'+ M
Dc1�art
f mcrt of P
"-�Qa{'d O Building Ru'=ulati uhGc S.tfet�
A �O e� . �OnS Itnt�`�[�n t
t
s hstruction.Su � dart.:
{ * i icense. C'$ pervi5or `Lice'
92773e"i
u
« $ " 74 t € Restricted to: 00
4�
CHRISTOP
= Y -
.r
* _ 176 I STREETR 'MORRISSEY r
t A SOI.rTH BO�TO 21
g 3 � !V, MA 0 27 ,
Exp*
ratron: 4/15/
{amrni srnnrr 2011
gJt' Tr#. 14492
9#tice of Coa mcr Affairs&Busrtl�ss Ji ulatkr,, t`
HOME IMPROVEMENT CONTRACTOR
�� rs
Registeatron� t64563
expiration 10/71/ 01} T 2&J820
' F 3 ;
Type: ►ndlvidual a R
Cr#NSIOPh1ER .10RRISSEY
CHR1S1'OPHER MORRISSEYAt
'
12 MONTANA DRIVE . � z
d
SANDWICH,NH 636 n erseaday..
`' T '
,j ¢. c
Al
�s'{
r
� s
�� =tom �' t�"• �' ��,-::ref o � �. �� k,. _ .�,a.'.��
t >
? 4 �,.#. T„v 31..2 f� • � $� n- 1"
"
tt4,v,
�` c e. ° s i •sem -"iP" ° Y
Jr
WIt-A
# k
rt �
'z a'
17
i i✓ `
I
Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑
TYPE OF SEWERAGE DISPOSAL
Public Sewer ❑ Tanning/Massage/Body Art ❑ S��' mg pools ❑
Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑
Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑
THE FOLLOWING SECTIONS FOR OFFICE USE ONLY
INTERDEPARTMENTAL SIGN OFF - U FORM
DATE REJECTED DATE APPROVED
PLANNING & DEVELOPMENT ❑ ❑
1
COMMENTS
CONSERVATION Reviewed on Signature
COMMENTS
HEALTH Reviewed on Signature
l
COMMENTS
Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes
Planning Board Decision: Comments
1
Conservation Decision: Comments
Water & Sewer Connect"ton/Siunature&Date Driveway Permit �
DPW Town Engineer: Signature:
Located 384 Osgood Street
FIRE DEPARTMENT - Temp Dumpster on site yes no
Located at 124 Main Street
Fire Department signature/date
COMIVIENTS
i
i
I
Dimension
i
Number of Stories: Total square feet of floor area, based on Exterior dimensions.
Total land area, sq. ft.:
ELECTRICAL: Movement of Meter location, mast or service drop requires approval of
Electrical Inspector Yes No
DANGER ZONE LITERATURE: Yes No
MGL Chapter 166 Section 21A—F and G m1n.$100-$1000.fine
NOTES and DATA-- For department use
i
0 Notified for pickup - Date
Doc:.Building permit Revised 2008
The Commonwealth of Massachusetts Office
Use Only
/ Permit :10.
i Department of Public Safety t.
60ARD OF FIRE PREVENTION REGULATIONS S27 Occupancy b Fee Checksd
CMi�1200 3/90
Cleave blank)
` I
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
AH work to be performed In accordance with the Mauachuseru Electrical Code.527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL I RHATION) l Date
D City or Towfi 0f_,,!�?, .12W,41AzeevTo the Inspector of Wirest
The undersigned applies for a permit to perform the electiica1 work described below.
Location (Street & Number) /'// �_� �� 2
Owner or Tenant �Uf�jf
Owner's Address
it
Is this permit in conjunction with a building permit: Yes ❑ No ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization NO.
Existing Service Amps / Volts Overhead ❑ Undgrd❑ No. of Meters
New Service Amps / Volts Overhead ❑ Undgrd❑ No. of Meters
Number of Feeders and Ampacity
Location and Ma!*re of Proposed Electrical Work
No. of Li ting Outlets No. of Not Tubs No. of Transformers TooVtal
No. of Lighting Fixtures Swimming Pool Above In-
d. ❑grnd. ❑ Generators . INA
No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting
BatteU Units
No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones
No. of Ranges No. of Air Cond. Total No. of Detection and
tons Initiating Devices
No. of Disposals No. of Heat Total Total
No. of Sounding Devices
No. of Dishwashers Space/Area Heating KW No. of SaltContained
Detect o
i
onContained
Devices
No. of Dryers Heating Devices KW Local❑Municipal
Connection❑Other
No. of Water Heaters Sig s Ballasts Low Voltage
Wirng
No. Hydro Massage Tubs No. of Motors Total HP
OTHER:
• i
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Lays
I have a current Liabilit Insurance Policy.including Completed Operations Coverage or its substantial
equivalent. YE NO[] I have submitted valid proof of same to this office. YESQ' NO ❑
If you have chec YES, please indicate the type of coverage by checking the appropriate. box.
INSURANCE BOND ❑ OTHER❑ (Please Specify)
Estimated Value of Electrical Work $
(Expiration ate
Work to Start Inspection Date Requestedt Rough Final
Signed a.-ler the penalties of perjury:
FIRM NAME �1 LIC. N0. 9!/a 3
Licensee D Signature IC. m.
Address)0-0_ yD .dL9/ D/��-�' Bus. Te 0..9�,p <3.5;-/ yz Zf.,5-'
Alt. Tel. No. y7 /0 ��/-���;<
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or is sub-
stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit
application waives this requirement. Owner Agent (Please check one)
Telephone No. PERMIT FEE S
Signature of Owner or gent
Date.. .........................
/. ..5. ..
N2 .. .... .. ......
0 TOWN OF NORTH ANDOVER
0
PERMIT FOR WIRING
CHU
This certifies that ........................................................
has permission to perform...................
.............................................................
wiring in the building of ..... .............................................
...............
at... . ..................... .North Andover Mass.
......... .............
Fee-................... Lic.No/ .. ...............................................................
ELEcrRicAL INSPECTOR
05/15/98 15:04 35-00 PAID
WHITE:Applicant CANARY:Building Dept. PINK:Treasurer
4
� ,
-,Location
No. Date
MORN TOWN OF NORTH ANDOVER
p Certificate of Occupancy $
Building/Frame Permit Fee $
s�cNuSFoundation Permit Fee $
2 Cdbw Permit Fee $
i
O Sewer Connection Fee $
,Fee $
TOTAL $
Np�Ty� Building Inspector
I
PERMIT NO. 17 APPLICATION FOR PERMIT TO BUILD********NORT I ANDOVER, MA
MAPNO. Cp I.OT.NO. /J S 2. RE 'ORI)OFOWNERSHIP DATE BOOK PAGE
LONE SUB DIV. LOT NO. � v /j .-OIL 621A e-,.
LOCA I[ON r /r/5T
/// ��u, 7 J511-
OWNER'S
PURPOSE OF BUILDING ��fa D�
OWNER'S NAME �� ✓ NO.OF STORIES SIZE
OWNER'S ADDRESS �� BASEMENT OR SLAB
{ ARC[IITECF'S NAME SIZE OF FLOOR'l IMBERS I 2 ND 3
BI ALDER'S NAME
� �u SPAN�.p
DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS
DIS I'ANCE FROM STREET DIMENSIONS OF 1 US'I'S
J DISTANCE FROhI I..OT LINES-SIDES >38/ REAR DIMENSIONS OF GIRDERS
AREAOFLOT /`/�a� FRONTAGE HL'IGITFCII'FOUNDATIOrl fIIICKNESS
{ 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 TOREQUIREMENTS OFCODE IS BUILDING CONNECFED*10 TOWN WATER
BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
eNSfU('FlONS 3. PROPEWIX INFORMATION LAND COST
EST. BLDG.COST
RVE I FILLO(1TSECTIONS 1-3 EST. BLDG. COST PER SQ. FT.
EST. BLDG. COST PER ROOM
ELECTRIC METERS MUS('BE ON OUTSIDE OF BUILDING SEPI IC PERMIT NO.
A'FTACIIEDGARAGES MUST CONFORM TOSTATE FIRE REGULATIONS a. APPROVED Ell':
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR BI ill. G INSPECTOR
DA'I E FILED [ ✓ ' �!/ OWNERS TEL#
CONI'R.'IEI_# ?� 06 'J 7/,�_
CONTR.LIC# O,je�(>70
Q(li� JR.O�OWNERORAU'((OI21 AGL•NT
FEF.
PERL.IITGRANTED � j��?�����
19
FORM U - LOT RELEASE FORM
MAY 13
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from.
Boards and Departments having jurisdiction have been obtained. This does-not relieve
the applicant and/or landowner from compliance with any applicable or.requirements.
****************A** ********APPLICANT FILLS OU THIS SECTION***********��*****''***
APPLICANT ��1 /��'� � '�/G�� ,ti -J PHONE
LOCATION: Assessor's Map Number PARCEL
PARCEL
SUBDIVISION LOT(S)
STREET////�9�A&�b , ST. NUMBER
USE ONLY********* *********
RECOM DATIONS OF TOWN AGENTS:
ol
CONSERVATION ADMIN!§TRATOR DATE APPROVED
DATE REJECTED
COMMENTS 11K lDO
TOWN PLANNER DATE/APPROVED
DATE REJECTED
COMMENTS
i
I
FOOD INSPECTOR-HEALTH DATE APPROVED
DATE REJECTED
1
i 1 CTOR-HEALTH DATE APPROVED 3-
DATE REJECTED l
COMMENTS 4�%- S �--
i
c
PUBLIC WORKS -SEWERIWATER CONNECTIONS
DRIVEWAY PERMIT •
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTOR DATE
I
LOT S
142.66
20' WIDE UTILITY EASEMENT' '
yp Ll
�s
00
LOT ?
� EX�� ;• v� 3 5
� I
35 5
I - � to �� I
` 0 0'
BARKER.:,..-.,. . . . ST
-lUBL.0 - A (ABLE �IVIOTNS
40' MARCH 18, 1986
F1
;I
ZONING DISTRICT .
R 2---RESIDENCE 2 DISTRICT
t
NOTE:-
.. PROPERTY .LINE DATA TAKEN .FROM. A PLAN BY
THOMAS Ei NEVE. ASSOCIATE.S INC. 447 QLD BOSTON,,. AD -+
U S.RO 'T .I "T"bF'SFIELD MASS. DATEb:0tTO8Ek 18' 1 85
P"
HEREBY CERTIFY THAT THE FOUNDATION ON
i
`HIS PROPERTY IS LOCATED AS SHOWN ON P!At S
}:
AND COMPLIES WITH THE ZONING REQUIREMENTS
OF THE TOWN OF NORTH ANDOVER,MASS`
R.L S bif EUGENE
NEVE i
Ill.31724 /04
41 Lot SJ
IN MY OPINION THIS FOUNDATION JS NOT
IN A FLOOD HAZARD ZONE AS SHOWN ON THE
U.S.O H.U.O FLOOD HAZARD BOUNDARY MAPS.
ALL S0A?A4CE W4rAPSAW4
PeR srATZ evAom, mm � � DAwAI .4ow I,11.GHQ Aw
+-'-,58RA/; s• f �l D7 N60 BY P02L. lFi1�T �.��� 3-03 BAR5 in/ S2,VD aEAM
40
r
SILK/F/E M0 OF AUWp BEAM
_
��-
lop
.N/.V. Hp7MAX V-cf wAP.L
r 3' xJP.�,Qa,7F - "
3 ..: ` _
:.:. �.: /L.lS7ZR t7VTi,Pc' rroa� V r0.
7FRES +✓/01VIA/b 9vsRC 4•- NA=,L 3B�xt4h"0-c.B�M 1+tiN'5 `
- •.ya. �,L �... —L��:OAS ^' •q GR10(INO
Q 1!1L71/A7 �O T OFG ALT — -
S R COT
EL E
S•,�vl3LE
\ r a
Cur AS .vTE_D cL Y SLO"
l ) A�WIN iSCr RaArp Poly=
J t
CY.1NN OIRF.CI 7a DUMP p /6. UT ucc,4LT6#PN.4TE
. REsiO,CN7IAL� Q7MN&PC/AL 6 .V/N � 61A�ts aL.EY 7=0"
• laW
FEw N 9u r 7_L3y q•.
-L EY e-0-
\ CLGI�R .wzovF 'x'3 QARS
'• _1 �/T Q C. QOTeV h{i1Y'J'7Yp.
STANDAl�D W,,411 .S�'T/O/V
Z7,
/2'a �B 7 .�
ON
C STRUCT/ON NOTES
GENERAL
• •CONSMUCTION "ALL MNAORAsf 7V C/TY OEPT • ItE/NFORC/n/G STFEL !1 CpN�rpp y/
..: y c;: : i OF.QLD 6 �'SAFE7Y.Q7QE STA/V0,4�PDCS: TD AS.T./L�( DESA/G NAT/ON•S A-/3 t i4�OS
j: o. • ' /B" '� +4 D-FV//VG 80AJW /1R7T_4%WA!/7X7_ON Ral f'LS YL PS XIIAzZ BE A iH//{///1lUM OC WOW
LLQ'7,LGIN- '&_AFPM ,4T Ad 4RD. D/AME'1E7�" QiP.�'wi4/EAE XXX/CF,S
d1rYZ4LTH DE7_T. AtERMY•IC
_BF.OU/RFD AW
pump OGGl1A'
: ... i4L1.. . 1r f+r�►t QLIA/1TE QgAA TFr',1,r/D/V
,
. . :y�._.'.,,. •� DES/6/V • 611N/TE S.4L4L[ tE AfG4GV/NE.N/.�D 4f'O
,4'0104/ED 0NZV4f47144LLY. A0ZY _ZV44Z AW
w T.N/S DE514/V aWAft PA& 7D Zaa44 49DE AVIO D/N,E PA.PT CEA4rA 7- TD A&W A+V A .WLF
E4MJAL/ZER L/w/E 6D UJ'LT/V A ,PE4sDjvAWUY LEVEL .t/72� PARTS JiM10 /.'4YY !/LT t?7,NP.:�7PlEilOTi4/
CQM►a owe.Y . 6ATUA►oCvIMP ih`'�,4PT/40 ilf4T!/�ML &V Ai70 {N/T,OVN ZAWr 34WO Psi as aur DAYS
OF 7bP OF A ,Vp �i4,y� AW FYCEPT/O eg + iW,47ZV-CE.NF,NT AMrV .£//,& /YbT E.1�Ep
AUTi7MAT/C SURFACE SA7MMER WILL .PVUJ.W S!/PPLFA E41rRARY ZwW,L #IMLW 3/t 6AL5 WATL°/p AtOW S,42e Oc CiT
q r 2-'13 8mr(EW) f E/YCE • Cv�PF GUN/7g B -,4 L/G.VT W,4T1r,P SPW),
---•--� — o 11AYNEf,' JIM" )'"PIZ E APOWY14 GV LLLWp/_A4At",E TSF T/,�f A lily .r,/4P •�E/2N A4,lS
. � NDER lY.4TFR L/6,t/T' d'Y/T1Y DICAtL C/1)'01rTbi�YN O,PLI/iv,4ACE NOTE : i
o 4:/lT•E5'Tb W SEZF AMMA116 f -1,17 •/Mq. =_SELr ATTd -TMT!L,/�1/ ORAIV/�S
• E2.EC%.P/C�4Z S11i4LL CO/V/4l.PA! 7D STATF
PLAw C` ,WO LOCAL ,P�ui,TE.MENZJ'0 .
`
v BOTH Wi4 y'!
> . • �P�zN Uf MASS S //NM/�/� O L
A!L�U.EF X4LVE STANDARD �✓ ,0
,tea 9c N,oMr':
OXrA
. •N
COLLFC'j/ON • . ' TIMOTHY —`—"-
TUEF /FiPL'Q,O) :•a £ WALKER --
C J CIVIL -- -- ---- -
/BX/8xr4 v No. 31376 p a SCALE. �y/O,V�' APPROVED BY j DRAWN 9Y rKl
6fi�✓�LSU/1!W
DATE: 'r— Z Z - 9�. LICENSED PR'OFESSIOl1/►L EN41N[[R
Ti1r10THY WALKER - CONSULTING EN6tIVEEIt
MAIN pUTL ET �L • ' '
f 9 WOODSIDE AVE. WESTPORT CT 068 0
--. p yw'>W/ ?E GutiATt'/°b'ML Lsollt M0. DAAYfrtNA NuR
- is fr,aoter sr �
A�Atnv BJH tEAZIt�9 i'fA � -�l =
gVIKA MIIPM 1&464)e —11 x 17 0
ACL S&RA4 F /ta4rZf X A"
PIER S-4r--eVAlM•4= I� OM*IN :NNO r dq"AWC:
PA MIVINED BY POOL MAVr �.�...j �3-,73 BARS /n+ 619Np c7EAM
VP OF B1OWD 41E.4M
MAX YE•P!.'WWZZ _
— __i. I •R�. -r 7XI4.Vf/Ty0/v P4wr ( -L 1 V-p-1 01
SIfETY �/ 1 w/D/Y/NG /3D.sRC NA7LfRIL 3 B�iRi 0/2 GLc.Baro WAYS
�C'EO Gw CbVM 1 -— �-� -- �:aMA/_ _ �.q, GR06W0 j _ _ �- �L ry 3!401
�aeL. S'R lu SARS�r— - ECfY4=0'
\-5-ANa 4Z
Cur ofr.45 ;VTEO cL c)r SLO"
�` TA77c ' b S Raoios�—"
W DRAIAI REL/EF rllcvE
ASN
JFES/D& DIRELY f TVAimp ur 4Wc,4L7FVoWTE
RFSrveyv7lAL� CbMAI&Pt"JAL 6 A/IiV A 61ARS - RL.EY. 9=0"
r CLEAIP
W/YN&4co s• •�� s FLED 71-q
n i *0. b,.,1�LN. 7Y10
LID/Z" Q C. aors/ HMYS 7"v
STANDARD WALL SE�'T/ON
*�eaQs�roc. ''t L CO/VSTRUCT/ON NOTES
•CONSTRUCTifC1N "ALL MNWA/ 7V C/7Y DEPT • IrEIAlolO 'C/NG ,STFEL -i AU CBj 0,'QZW -f
STANOA�P1xS. TO il.S 7A'(, DES/G♦1/A►T/D/V.S A/S t A30S
777"h---: /�' a olV/IYG SOARD'IIt7T.-AWXAfl7lW ON pWLS LAPS .S'//ALL BE A Al/iY/iH!/M Ar *;Wl,prior
ILFSS'7AWN- "r6/�EPTf,/ ,4T BQAI45D. D/AgETEIP" SOL/CFS
.0' 1 ;. • ou�T +CAUFAWTN DErT, AZOOMI -A3W4l1AW ILP dCGI/�f'
•, ,• _L_ iAL1. .C? GK��P L.Z�!E PmtsUN/TE C95&S'Ti4Ql�
• �'`-, -'� • •' �n • 4efN/TE s�4LL tE�bG4Gs/�.vE.N/.r�D .aWO
Y�_ APPG/.ED O-V4WA 7'14ZaL.LY• .M/X -44.10 BE
out •y,... ., • � � .. � .
• •- M 7N/S DES-1411/ l?W V,?A& 7D L044L 4WZW ANV O/NL• P.4 P7' CEAIfer/Y•T• 7V -QPaf .4AV 4 AN[F
ZOUAL&W LIA/E �e 1 84S6a USN A A!Im1s4/1s4sLy zewx .f-1 W PAR7X -TAW.0 /.•4%t L/LT. aWp j;WSW7i�V
COA*N owt.Y 6A; Mo�.tAMP AND-4,01, WWW Af4T!/P,EL �WN,v H�-1nwm 2AIWr -:wwo Psi d -W,0 AYS
OA'70P G9' ASND BF.4,�1, ANN EXL'EPT/ •
A!l7DMAT/C SURRAGE SA%MMER '. i.. 111//LL .P�UI�Pl� SlII�PLEA�2�NTRA/PY -lvr/ZWW� W4TE/P-CEMENT /� 7,1/ .S,s,&Z IW7 ejg=W
4'W,2W 3/Z 6A4.4 fArL'R Ara' -CAC,- ac CZWWT
OVA-- G W17,F AY.4 L/6A? ff,.47f,P jrw
• OIYNER J9VALL 1'? ylaE cZ%V yAe /i1/ Z2WPL/�"„E TiWWF T/A iRr.9 444- A�aAp _QpAZy A4,lS OM
UNDER lY.4TZ�JP L/6�t/T tWI)W Zara& C,/T7'aFI'VA*N 0,CW,,V,4A9W /VOTE
e : G.473S Td AF SEZ,F t1.WA446 F L,47&IIA49. T lLl,V D,p.�IV/SPS
o :° • E.1�C7',P/CAL J'A64L1 CD/YRL jf Tb STATF - AT_LlC6rED
Pt.17a t AWD LOCAL .PBwi�!'E.ME/VZS. -
c
° J'
0 .
f/IZWQSTAT/CW
A. m4LVE
�Ptss DARD ✓// M/V6
( ; 7 gkof MAr O G
o
COLL //ON TIMOTHY ry
TL/OF FRL�,O> e::a WALKER u /DIADREtS: -
'• � CIVIL �'. ---------- --
: �' �No. 31376`p y SCALE: APPROVED BY%`V DRAWN BY rKl.
,� 6�✓.�SU/IAP Amo c�STE2- ��Q DATE: J- 22- 9,2 LICENSED PROFESSIONAL ENGINEER XEv O
"r F�sS�ONALE"�`� TIMOTHY WALKER — CONSULTING ENGINEER
A
MAIN OUTLET � . ,
19 WOODSIDE AVE. WESTPORT CT 06080
6►(!Af%/J�' t1Cllls>! 110. DRAW "$G Nuhmm
13 wow/tor sr I► '1s 12-20 -0).
A��tr7v BlA eX/LA -Afoo � 00
1r'R�MI!/OiT 111A8-0t11 x 17
�4O R T
Town of - over
No. / 19
m
1 * - _
S—" P- 19
s � dower, Mass.,
O LAKE L'Y'
'94_GOCHILHEwICK 1•
9 004 E D APP��
S BOARD OF HEALTH
I
� Food/Kitchen
Septic System
PERMIT T D
BUILDING INSPECTOR
{ THIS CERTIFIES THAT............................... .. ................ ......
....................................................................... Foundation
has permission to erect........r (..............—bW*wjeron ....... . ... ......... ................................ Rough
tobe occupied as........................................... ......(........................ ..........���..v.. .............. Chimney
provided that the person accepting this permit shall in every respect confo the terms of the application on file in Final
P P P g
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
ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION ST,ART5
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
P Y P Final
No Lathing or Dry Wall To Be Done
i FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector.
Burner
Street No.
Smoke Det.
4 V 9Date. !�/
A
TOWN OF NORTH ANDOVER
p ,^,tip
p PERMIT FOR GAS INSTALLATION
SSACHUSE
d
O
This certifies that . . . . .S-14 . . ...�;.�.� . .. . . . . . . . . . . . . . . . . .
has permission for gas installation . . ����: . . . . . . . . .� .
in the buildings of . . 1 ��f./.+. . . . . . . . . . . . . . . . . . . . . . . . . . . .
at . . . . . . . . . . . , North Andover, Mass.
AS INSPECTOR R
WHITE:Applicant CANARY: Building Dept. PINK:Treasurer
i
MASSACHUSETTS UNIFORM APPUCATON FOR P TO DO GAS FITTING
`Type or print) Date 60 19
NORTH ANDOVER, MASSACHUSETTS
4lT z '` k
Building Locations ,/ /�'� �� / Permit#
Amount
Owner's Name �U
New Renovation ❑ Replacement ❑ Plans Submitted ❑
V � F
z d z F C z Z C F.
c W
W
W F C >
Wq W L .W. x a W
z -t w C z C =_
SUB -BASEM ENT
BASEM ENT
1ST. FLOOR {
2ND . FLOOR
3RD . FLOOR
4TH . FLOOR
STH . FLOG R
6T H . F L O O R
7T 11 . FLOOR
8'f ll . FLOGR
(Print or type) (� Check one: Certificate Installing Company
Name • / ❑ Corp.
Address S v lJU LV j ❑ Partner.
v, -,(/.(a PZ -77r.7 o
Business Telephone (� 2 ❑ Firm/Co.
Name of Licensed Plumber or Gas Fitter
i
INSURANCE COVERAGE Check one:
1 have a current liability Insurance policy or it's substantial equivalent. Yes [3— Nor]
If you have checked yes,please indicate the type coverage by checking the appropriate box.
Liability insurance policy Other type of indemnity ❑ Bond ❑
Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the
Mass.General Laws,and that my signature on this permit application waives this requirement.
Check one:
Signature of Owner or Owner's Agent Owner ❑ Agent ❑
i hereby certify that all of the details and information I have submitted(or entered) in above application are true and accurate to the
best of my knowledge and that all plumbing work and installat' performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachus S to C e and apter 142 o the Gen r Laws.
By: ignature of License lumber Or Gas Fitter
Title �Plumber I' 6
City/Town Gas Fitter 7cense ( um S e
Master
APPROVED(OFFICE Use ONLY) ❑ Journeyman