HomeMy WebLinkAboutMiscellaneous - 1135 GREAT POND ROAD 4/30/2018 (2) cc
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9903 Date...
....... .......
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ............. ............................we,�e/ ........
. ......... ......... .. .......
has permission to perform ........
... ...............................................................
wiring in the building of...
................. .........................................................
at.....
............. ................................�,N- 0 h Andover,,Mass.
N. Fee ... Lic.No....11.711............o ..
Ch I eck # CrIUCAL iNS'P-E'C-7`D*I'R
� 1
Commonwealth of Massachusetts
Official Use Only
Department ®f Fire SeM'ices Permit No.
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked I
[Rev. 1/07] leave blank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL
All work to be performed in accordance with the Massachusetts Electrical Code ®��
(PLE,MEPRMTMLVK OR TYPEALL INFO ��
City or Town of �. 770N) Dafe:—a/.3 / V
By this application the undersi ed gives no ' e of his or her intentio n perform the electrical To the Inspector of Wires:
Location(Street�&Number) 3 work described below.
Owner or Tenant e4��
��p
Owner's Address Telephone No.
Is this permit in conjunction with a building permit? Yes
-
Purpose of Building ❑ No 3 9LDG PERMIT#
Utility Authorization No.-Z6
Existing Service /4- Amps /cab_ /p%G Volts Overhead
❑Overhead yUndgrd P'*"' No.of Meters
New Service Amps c>6 /2_ yolts -
Number of Feeders and Ampacity E Undgrd ❑ No.of Meters
Location and Nature of Proposed Electrical Work:
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil.-Sus . No.of
p (Paddle)Fans Transformers Total, ,
No.of Luminaire Outlets No.of Hot Tubs KVA`
Generators KVA
No. of LuminairesAbove
Swimming Pool rnd. ❑ ❑ °•° mergency ig mg -
rnd' Batte its
No,of Receptacle Outlets
No.of Oil Burners FIRE ALARMS No.of Zones
No. of Switches No.of Gas Burners No.of Detection and
No. of RangesTotal InitiatingDevices
No.of Air Cond. No.of Alerting Devices
Heat Pump Number Tons ns
No. of Waste Disposers K.�6' No. 13 ed
' Totals: ......_....�.................. .
Detection/Alertin Devices
No, of Dishwashers Space/Area Heating IOW
Local❑ Municipal
No. of Dryers Connection ❑ Other
rY Heating Appliances KW Security Systems:*
No. of Nater No.of No.of Devices or E uivalent
Heaters KW Sis BBallaass ts Data Wiring:
Ballasts
No.Ilydromassa No.of Devices or E uivalent
� a Bathtubs
g No.of Motors Total]UP Tel Wiring:
�.�
OTHER: No.of Devices or E uivalent
Estimated Value Of Electrical Work: Attach additional detail if desired, or as required by the Inspector of Wires.
Work to Start: (When required by municipal policy.)
/��P 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 cover is in force,and has exhibited proof o same to the permit issuing office.
CHECK ONE: INSURANCE ff BOND ❑ OTHER
I certMP, sender the pales andpenalties ofper that the (Specify:)
) `?�' !��Y ��� eG
MM NAM. , jury, information on this application is true and complete,
�e•c.�l roC'�s
Licensee: /d11 K� / � LIC.NO,:
(Ifapplicabte, er `exempt"zn i le ense number line.) Signature LIC.NO.: �•"3/
Address: J� —
I1 ^ �/ Bus.Tel.No.:9 72_TO-2 j
*Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"Licen Alt.Tel.No.:
OWNEW S INSURANCE WAIVER: I am aware that the Licensee does not have the liability �C'NO.:
required by law. $y my signature below,I hereby waive this requirement. I am the(check ane)[]ow�nercoverag eine normally
Owner/Agent ❑ agent
Signature Telephone No.
PERM7TFEE: $
ELECTRICAL PERMIT NO. INSPECTION REPORT:
r
ELECTRICAL INSPECTOR-DOUG SMALL
1.ROUGH INSPECTION:
Passed—[ ] Failed—[ ] Re-inspection required($50.00)-[ ]
Inspectors' comments:
(Inspectors'Signature-no initials) Date
2.FINAL INSPECTION;
Passed—[ ] Failed—[ ] Re-inspection required($50.00)-[ ]
Inspectors'comments:
(Inspectors'Signature-no initials) Date
3.UNDER GROUND INSPECTION:
Passed—[ ] Failed—[ ] Re-inspection required($50.00 -
[ l
Inspectors' comments:
T
(Inspectors'Signature-no initials) Date
4.INSPECTION—SERVICE:
DATE CAL ED NATIONAL GRID: NAME:
Passed— Failed—( ] Re-inspection required($50.00)- [ ]
Inspectors' comments:
i
.7 ;l
(Inspectors'Signature-no initials) Date
5.INSPECTION-OTHER:
Passed—[ ] ailed—[ ] spect1ou required($50.00)-[ ]
Inspectors' comments: %'
I
(Inspectors'Sign ure-no initials) Date
DOOR TAGS ARE TO BE FILLED OUT AND LEFT ON SITE IF THE AREA TO BE INSPECTED IS NOT
ACCESSIBLE AND A RE-INSPECTION OF$50.00 IS TO BE CHARGED.
g F
The Commonwealth of Massachusetts
Department of Industrial,Accidents
Office of Investigations
600 Washington Street
Boston,MA 0211.1
UIP www.rnassgov/dia
Workers' Compensation Insurance Affidavit: Builders/Contraclors/JElectriciansfPlunbers
Applicant Information Please Print Leaibl�
Nat o(B.usi cess/Organization/Individual):
Address:
City/State/Zip: caif�, ��`� M - Phone#: ! S"8<) 9-P., f
Are you an employer?Check the appropriate box: Type ofproject(required):
[2.
.[�]''I am a employer with 4. El am.a general contractor and I
6. E]Now construction
employees(full and/orpart time).* have hired the sub-contractors
❑ I am a sole proprietor or partner- listed on the attached sheet.? 7. ❑Remodeling .
ship and have no employees These sub-contractoxs 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 10.El Electrical repairs or additions
required.] officers have exercised their
_ 3.❑.I am a homeowner doing all work right of exemption per MGL 11.El PIumbing repairs or additions
myself. o workerscomp. 152 1(4) and we have no
� ' . c. ,§p � 12.❑Roofxepairs
insurance required.]i employees.[No workers'
comp.insurance required.] HFI Other
!Any applicant that checks box#1 must also fill outthe 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.
I am an employer that isproviding workers'compensation insuranceformy employees Bellow is thepolicy andjoh site
information.
Insurance Company Name: �'i
Policy#or SeIf-ins.Lie.#: 2 Hf-/Q: Expiration Date: '7/GLO i t
Job Site Address: city/state/zip: /� a�✓/ � �'
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
flue 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 maybe forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
I do hereby certify under the pains and penardes ofperjury that the information provided above is true and carr eet.
Siamafore: &Z ® Date: a
Phone#: 5 2
F6.0ther
only. Do not write in this area,to be completed by city or town official
n: Perm�itMcense#
hority(circle one):
ealth 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
son: Phone#:
Date.S.- r.3. .�.z.
NOR7M TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
'Lee
sSACMus�
This certifies that . . .�!.�. `.�. . . . . . �1 . . . . . . . . . . . . . . . . . . . .
has permission to perform . . . .P r �.�. 14 �. . . . . . . . . . . . . .
plumbing in the buildings of . . . . . . . . . . .
at. . .//.3. ? /'�td¢{. .,�J�.!� .�._, . . , North Andover, Mass.
Fee. .9. '. . .Lic. No..GJ.�;C!. . . . . . . . �. . , . . . . . . . . .
CPLUMBING INSPECTOR
Check #
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5166
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�- Town of North Andover fAORT11 ,� f
Office of the Planning Department
F A
Community Development and Services Division
27 Charles Street " °+.,-_,-• �F,
North Andover, Massachusetts 01845
Telephone (978)'688-9535
Town Planner Fax (978)688-9542
Notice Of Decision -
Any appeal shall be filed J
Within (20) days after the
Date of filing this Notice
In the Office of the Town r :;
Clerk Date: September 23, 2004
Date of Hearing: Sept. 21, 2004
Decision: September 23, 2004
Petition of: 1135 Great Pond Road, Brooks School
Premises Affected: 1135Great Pond Road, North Andover 01845
Referring to the above petition for a special permit from the requirements of the North
Andover Zoning Bylaw Section 4.136.
So as to allow: the construction of a screened porch to the rear of an existing single-family
f Non-
Disturbance home. Activities will be located within the Non Disturbance and Non-Discharge Zone
associated with bordering vegetated wetland resource areaslocated in the Watershed Protection
District on the property of Brooks School.
After a public hearing given on the above date, the Planning Board voted to APPROVE,
the Special Permit for Watershed Protection District, based upon t e following conditions:
Signed•
Alberto ogles, Chairman
Cc: Applicant George White, Vice Chairman
Engineer Felipe Schwarz, Clerk
Abutters Rick Nardella
DPW John Simons
Building Department James Phinney
Conservation Department
Health Department
ZBA
Mi/Mydocuments/11�35 Great Pond Rd.
BOARD OF:APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
v
1135 Great Pond Road= Brooks School
Special Permit-Watershed Protection District
T.h.c, Planning Board makes the following findings regarding the application of Brooks
School, 1160 Great Pond Road, North Andover, MA 01845, filed on August 13, 2004.
']'he area affected is located at 11315 Great Pend Road in the R-2 Zoning District, Map
103, Lot 2. The lot was created in 1967 and is subject to the Watershed Protection
District provisions for lots created on or prior to October 24, 1994. The applicant is
requesting a Watershed Special Permit for the construction of a screened porch to the rear of
an existing single-family faculty home. Activities will be located with the Non-Disturbaricc
and Non-Discharge Zone associated with bordering vegetated wetland resource areas
located in the Watershed Protection District.
FINDINGS OF FACT:
In accordance with 4.136.the-Planning Board makes the finding that the intent of the Bylaw,
as well as its specific criteria, are met. Specifically the Planning Board finds:
a, -
1. That as a result of the proposed construction in conjunction with other uses nearby,
there will not be any significant degradation of the quality or quantity of water in or
entering Lake Cochichc:lick. The Planning Board bases its findings on the
following facts:
a) The proposed auxiliary structure will be connected to the house and to the North
Andover Town sewer system;
'o) A covi riaiit will be placed in the 'cal d restrii twig Arid 11rIiititig ilii Types of
fertilizers that can be used on the site.
c) The topography of the site will not be altered substantially.
d) The limit of clearing i5 restricted to the minimum neces:iUry to construct thrc
proposed structure and appurtenances.
2. There is no reasonable alternative location outside the Non•-Dist.urbamcc Zone, for
any discharge, structure or activity, associated with the proposed project.
�. in accordance With Section 10.31 of the North Ando,,,-,r Zonint Byla , lhPl-nni�rr.
Board makes the following findings:
a) The specific site is an appropriate location for the proposed use as all feasible
storm water and erosion controls have been placed on the site;
b) The use will not adversely affect the neighborhood as the
LASiv accessory to ;in.
existing school facility;
c) There will be no nuisance or serious hazard to vehicles or pedestrians;
Wl n
d) Adequate and appropriate facilities are provided for the proper operation of the
proposed use;
e) The Planning Board also makes a specific finding that the use is in harmony with
the general purpose and intent of the North Andover Zoning Bylaw.
Upon reaching the above findings, the Planning Board approves this Special Permit based
upon the following conditions:
SPECIAL CONDITIONS:
1) This decision must be filed with the North Essex Registry of Deeds. The following
information is included as part of this decision:
a) Town of North Andover Planning Board Application for Watershed Special Permit
filed by Brooks School on August 13,2004; including:
• Narrative,dated August 9, 2004;
• Turf Management Program, dated 2/12/04(2 pages);
• Recharge Calculations and ,plans prepared by John Scott, P.E. of
RFS, dated 8/13/04;
b) Plans entitled: Brooks School, Great Pond Road North Andover MA Goulet
House—Porch Addition, Site Plan pages 1 &2 dated 8/4/04•
The Town Planner shall approve any changes made to these plans. Any changes
deemed substantial by the Town Planner would require a public hearing and
i
modification by the Planning Board.
2) PRIOR TO ANY WORK ON SITE:
a) A performance guarantee of two thousand dollars ($1,000) in the form of a check
made out to the Town of North Andover must be posted to insure that construction
will take place in accordance with the plans and the conditions of this decision and
to ensure that the as-built plans will be submitted.
b) The limit of work as shown on the plan must be marked in the field and must be
reviewed and approved by the Town Planner.
c) Erosion controls consisting of haybales and silt fence must be installed along the
limit of work behind the proposed houses. The locations of the erosion controls
must be approved and reviewed by the Town Planner.
d) The site shall have received all necessary permits and approvals from the North
Andover Conservation Commission, Board of Health, and the Department of Public
Works and be in compliance with the above permits and approvals.
a '
3) PRIOR TO THE ISSUANCE OF A BUILDING PERMIT:
a) The Planning Board must endorse the final site plan mylars and three copies of
the signed plans must be delivered to and,reviewed by the Planning Department.
b) The decision must be filed with the North Essex Registry of Deeds. One certified
copy of the recorded decision must be submitted to the Planning Department.
c) Only organic or slow release lawn or garden products shall be used in lawn care or
maintenance within 325' of Lake Cochichewick or within 325' of wetland resource
areas. The applicant shall incorporate this condition as a deed restriction,-'and a copy
of the recorded deed shall be submitted to the Town Planner and included in the file.
4) PRIOR TO THE RELEASE OF THE PERFORMANCE BOND:
a) The applicant shall submit an as-built plan stamped by a Registered Professional
Engineer or Land Surveyor in Massachusetts that shows all construction, limits of
disturbance, existing topography, storm water mitigation structures and other
pertinent site features. This as-built plan shall be submitted to the Town Planner and
the Department of Public Works for approval. The applicant must submit a written
certification from the design engineer that the site was constructed in accordance
with the approved plan and any changes or deviations from the approved plan must
be specifically noted in the certification letter.
b) The Planning Board must by a majority vote make a finding that the site is in
conformance with the approved plan.
5) In no instance shall the applicant's proposed construction be allowed to further impact
the site than as proposed on the plan referenced in Condition# 1.
6) No.open burning shall be done except as is pernnitted during burning season under the
Fire Department regulations.
7) The Contractor shall contact Dig Safe at least 72 hours prior to commencing excavation,
8) The provisions of this conditional approval shall apply to and be binding upon the
applicant, it's employees and all successors and assigns in interest or control.
9) This Special Permit approval shall be deemed to have lapsed y 3 Deo (two years
from the date of issuance) exclusive of the time. required to pursue or await
determination of any appeals, unless substantial use or construction has connmenced
within said two year period. Substantial use or construction will be determined by a
majority vote of the Planning Board
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
+ (Type or print)
NORTH ANDOVER,MASSACHUSETTS
Building LocationDate —3 — /3—U
Owners Name3r-0 0 Permit#
Amount
T e of Occupancy
New Renovation Replacement Plans Submitted Yes ❑ No
FIXTURES
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IS'>C Frit �
�II.)FIDQR
3M)H CM
4M IL"
SII�)NZDCI2
6TH KOM
7M Hi OM,
SI HJ00R
ET
(Print or type) I ` Check one:
Installing Company Name v Certificate
rp-
Address V' s
Partner.
Business Telephone - Finn/Co.
Name of Licensed Plumber.
Insurance Coverage: Indicate the type o urance coverage by checking the appropriate box:
Liability insurance policy Other t of indemnity
type 11 Bond ❑
Insurance Waiver. I,the undersigned,have e
gn been made aware that the licensee of this s application does not have an
three insurance y one of the above
Signature Owner 0 Agent Q
I hereby certify that'all of the details and information I have submitted(or entered)in abov plic n are true and accurate to the
best of my knowledge and that all plumbing work and installa ' s pe o d der P t I r this application will be in
compliance with all pertinent provisions of the Massa hu is St 1
an 42 of the Genera]Laws.
By. igna ure m e
Title Type of Plumbing License
City/Town
License er Master Journeyman ❑
APPROVED(or-FtcE USE ONLY
1135 -. cQCc(t
Location 0�
No. �"o Date p11 d�
NORTp TOWN OF NORTH ANDOVER
O �
i Certificate of Occupancy $
J�CwUs Building/Frame Permit Fee $ _
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
t Building Inspector
t
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' TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
PLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
�L .;..,. ;"� ��.:._.."3^"'?',.w�""'�-'`,"'W �x w' ��c�•Z���i�.t�.':�I,� 1Y.1A1"t.TSC V� ;" +�. �:�.."www.`",.;�5'f";?K Yt �•T' a'^ `Y .1.
JILDING PERMIT NUMBER: DATE ISSUED: rn
3NATURE: �
Building Commissioner/IRUE
for of Buildings Date
CTION 1-SITE INFORMATION Z
1.1 Property Address: 1.2 Assessors Map and Parcel Number: O
G-,ZCI R64--,o izo,10
Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
aing District Proposed Use I Lot Area(so Frontage ft
BUILDING SETBACKS ft
Front Yard Side Yard Rear Yard
R 'red Provide Regaired Provided Re 'red Provided
v
Water Supply M.G,I..C.40. 54) 1.3. Flood Zone Information: 1.8 Sewe0ge Disposal System:
uric , ❑ private ❑ Zone Outside Flood Zone p Municipal 8� On Site Disposal System. ❑
:CTION 2-PROPERTY OWNERSHIPlAUTHORIZED AGENT "O L� I1 uj 'trj c : eS 0 rn
Owner of Record
3 S'- 6-t2E-.,9 i IOdALo /20.10 d
me(Print) 4 G e 13*j,crWS Address for Service:
'7' -- '� 2 s 2 8 0 r'
;n reV Telephone
2 Owner of Record:
2oo�cSl><aQL
vame Print Address for Service: O
atu're Telephone
;CAAww
TION 3-CONSTRUCTION SERVICES 70
1 Licensed Construction Supervisor: .. Not Applicable ❑
t
=sed Construction Supervisor:
O
License Number
1dress
_ Expiration Date -
=nature
Tele phone
?Registered Home Improvement Contractor Not Applicable ❑ v
)mom y Name - rn
Registration Number
rM
idre:q r
Expiration Date Z
' afire Telephone G) .
SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6)
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
Signed affidavit Attached Yes.......❑ No.......0 e
SECTION 5
Description of Proposed Work check all a hcable
New Construction ❑ Existing Building ❑ Repair(s) 0 Alterations(s) 0 Addition
Accessory Bldg. ❑ Demolition 0 Other ❑ Specify
Brief Description of Proposed Work:
(f'O 1-S rVV C,7" LD )( 14- 5 CW CCA-e%o /06. C'l�
SECTION 6-ESTIMATED CONSTRUCTION
COSTS •
Item Estimated Cost(Dollar)to be OFFIeL4L USE ONLY
Completed by permit applicant
1. BuildingQ a . (a)::Building mi
uilding Pert Fee
1'7d Multi lier
2 ElectricalO d (b) Estimated Total Cost of
i U O U Construction
3 Plumbing Building Permit fee(a)X(b)
4 Mechanical HVAC
5 Fire Protection
6 Total 1+2+3+4+5 ! g-70 a VCheck Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERbIIT
I, �j(ZOO�s S e I,FtJ01_ J 0 f{.� "Tj�bV✓fbS as Authorized Agent of subject property
R 6+�9lF�4-J /I Gck
Hereby authorize C O►ti S�U C L O to act on
My be in afters relative to work authorized by this building permit application.
l
Si��,/.f Owner Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
I, 5(ZOo lGS sctf d 0 t Q 01 f.v 1 P-d kAt Q ./-S eZ T ,as veer/Authorized Agent of subject
property
Hereby declare that the statements and information on the foregoing application ate true and accurate,to the best of my knowledge
and belief
Print
sip2.1e of er/A ent Date
NO.OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TINIBERS l ST 2ND3RD _
SPAN.
DRVIENSIONS OF SILLS
DIMENSIONS OF POSTS
.:A
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CHINMY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
t
S®lay.T iD Io V"\(-
FORM
"\(-
FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve
the applicant and/or landowner from compliance with any applicable or requirements.
*****************************APPLICANT FILLS OUT THIS SECTION***********************
APPLICANT �12 C-901!S S C C+_00 PHONE 9 /1 � 2-C
5A, Tre�a9�;
LOCATION: Assessor's Map Number PARCEL
SUBDIVISION LOT (S)
STREET 3 —k*"&,\-b Vc)A-D ST. NUMBER
**************** **********************OFFICIAL USE
REC MENDATIONS OF TOWN AGENTS: -X� O�
1 CONSERVATION ADMINIST TOR DATE APPROVED ` 20. 04
T€�R CTED
bra-C(avts3VGI7
-----�� 1 TvQ v reeiq-,, v►,Fl-' (*
COMMENTS k)Jds too,, 0-1 �c uJ�l' C' ia+6i►� iI�
T WN PLANNER DATE APPROVED -, �J
DATE REJECTED
61,
COMMENTS
FOOD INSPECTOR-HEALTH DATE APPROVED
DATE REJECTED
SEPTIC.INSPECTOR-HEALTH DATE APPROVED
DATE REJECTED
COMMENTS
PUBLIC WORKS -SEWERIWATER CONNECTIONS
DRIVEWAY PERMIT
FIRE DEPARTMENT
RECEIVED BY BUILDING INSPECTOR DATE
Revised 9197 jm
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• ' • �.CaeKs SCtI�L,
FROM :RONDEAU CONSTRUCTION INC FAX NO. :603635BOSO May. 1B 2004 12:49PM P1
RONDEAU CONSTRUCTION, INC.
Over 20 Years Experience P.O. Box 522
Dracut, MA 01826
(978)815-3777 FAX(603)635-8080
E•Mail: rondeauinc@aol.com
May 18, 2004
Brooks School Job Location: Goelet House
Normand Grenier
1160 Great Pond Road /
North Andover,MA
Screen Roof Estimate
Cement piers will be installed at all support posts.
3► 2 x 10 pressure treated framing will be installed and attached to existing house.
Y 1 x 4 mahogany decking will be fastened to framing.
> 4 x 4 cedar posts will be installed and exterior trimmed with 1 x 6 primed pine.
Y Roof structure to be 2 x 10 rafters with 1 x 6 and 1 x 3 fascia trim.
Y Gable edge will be sided with cedar clap board.
y Roof will be covered with ice and water barrier shield and shingled to match
existing house.
Y Wall and hall will be flashed as required.
Y Interior of construction to remain rough.
➢ Full length screens will be installed between 4 x 4 posts.
Y
One coat of white paint will be applied on all primed trim.
Total costa include labor, materials,permits,
Insurance and removal of all related debris - $109470.00
i
If you have any questions or would like to schedule for the above work to be
completed.
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,..�3Ho O•� ?' �N 1 1 \Gs ;.rte.
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41
pts �/. �- •+ �f.l }��
2. $•per s'
ae, Lake
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COVENANT OCT 2 02004
NORTH AM
I, James R. Pugh, Assistant Treasurer, an officer of Brooks Sch66f(6� E�Movl'?�i, I
as certified in the Corporate Resolution dated May 1, 2004, am authorized to transact
official business on behalf of the School. Brooks School owns land in North Andover,
Essex County, Massachusetts recorded with the Essex North Registry of Deeds in Book
557,Page 131,with an address of 1135 Great Pond Road(the"Property).
On September 23, 2004, the North Andover Planning Board issued a Notice of
Decision for the School to construct a screened porch. Under the terms of the permit,
Brooks School, the owner of record, hereby covenants and agrees with the following ry
paragraph:
"Only organic, slow release lawn or garden products shall be used in lawn
care maintenance as defined in the Town of North Andover Zoning Bylaw
where those zones occur on the property."
Notwithstanding the .foregoing, the School shall not be liable for change
violation of said restriction resulting from causes beyond the School's control, including;'
but not limited to fire, flood, storm, earth movement, and acts caused by trespass on sai
Property not contributed to by acts or omissions by the School, or from any prudent
action taken by the School under emergency conditions to prevent, abate or mitigate
injury to the Property resulting from such causes.
In witness whereof, James R: Pu has
' Pugh, caused these.presents to be executed in CM
.�
his capacity as Assistant Treasurer on behalf of Brooks School, this 18a' day of October, c
2004. . .;..
cry
Brooks School
James R. Pugh,Assistan fTea�su�_rer
VT
COMMONWEALTH OF MASSACHUSETTS
Essex,ss October 19,2004
Then personally appeared James R. Pugh, Assistant Treasurer, of Brooks School,
1160 Great Pond Road, North Andover, and made oath the foregoing was the duly
authorized free act and deed of said Brooks School,before me,
Helen K. Pes a, otary Public
My commission expires: HELEN K PESTANA
Ic
Commonw=of M lassuh
My Commission ExpI=
A ril 4,2008
i
a
1= ULl
181 Comm Street
10/20/06
MONS AW
4 31 RK v Type PL 5100
Soo
150.
33 Flyant chm, 150 of-,
_.:._ of NEW
✓tom � �
BOARD OF BUILDING REGULAIONS_
License CONSTRUCTION SUPERVISOR` : .
Number 6S 081755.
Birthdate: 04/23/1964
Expires 04/23/2006 Tr.no: 81755
Ile Stdc-ted OU
GRATIEN D MICHAUD
104 THORTON Ste-
LAWRENCE,
T LAWRENCE, MA..01841 `
Administrator
t �
I
I��
NORTH
Town of :
No.
. _ LAKE
over, Mass., • -0 4pady
COCKICKEWICK V
Is
RATED
BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT (� I���W � C 40c)
..... .... .. ......................................................................................................::.... Foundation
g
has permission to erect........... ,x A rva*
��........ . ............. buildin s on O� Rough
. .................................................
to be occupied as �✓ / Chimney
p ................:.......................................................................... ......................... ...
provided that the person accepting this permit shall in every respect conform to the terms of the application on fi in Final
this office, and to the provisions of the Codes and By ws relating to the Inspection, Alteration and Construction of
Buildings in the Town of North Andover. !� w3 PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPEC'T'OR
UNLESS CONSTRUC'I"IO S S . Rough
e
ENO
.. Service
.. . ... .. .. . . ..... .
.............................
DING 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.
The Commonwealth of Massachusetts
d Department of Industrial Accidents
Office of Investigations
Boston, Mass. 02911
Workers'Compensation Insurance Affidavit
Name _ co Please Print
Name:
Location: A6,% t IkkIt/t�O o,� S
City Phone #
I am a homeowner performing all work myself.
I am a sole proprietor and have no one working in any capacity
0 1.am an employer providing workers'compensation for my employees working on this job.
Comaany name: -
Address
City: Phone# ��� _ Z�" Y 9 7,;k,
Insurance Co. 121Ety66111,25 s Polio# /7 03
r
Comoarn/name:
Address
City: Phone#
Insurance Co. Policv#
Future to secure coverage as required under Section 25A or MGL 152can lead to the imposition of criminal penalties of.a fine up to$1,500.00
and/or one years`imprisonment-as v¢ell_as_civil..penalties to Zhe form d-..STOP WORK..ORDER..and..a fine of.$100.00
understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
me I
I do hereby certify under the pains and penalties of peory that the information provided above is true and correct.
Signature
! Date Q/
Print name Phone#
Official use only do not write in this area to be completed by city or town official'
City or Town Permit/Licensin
Building Dept
❑Check if immediate response is requiredEl Licensing Board
Selectman's
Office
Contact person. Phone#. I] Health Department
Other
r
` Date....�f:. .... .........
NORTH
°!, :•�"° TOWN OF NORTH ANDOVER
1°- P
PERMIT FOR WIRING
i- SACHU
This certifies that .<.1:'. !+n...... - -'................................................
has permission to perform ...:..3 ................
wiring in the building of..., ,. k- -�r�? per.........................
r.
.��ti
.. ,North Andover,Mass.
Fee ............... Lic.No.
EtECTR1cAL INSPEC DRQ"
Check #
5401 w
THE COMMONWF.ALTHOFMASSACHUS Office Use only
DEPARTARMOFPUBLICSVE[Y Permit No. .Bio
BOARDOFFIREPREVEMONRFGUMHONS CW12.0
Occupancy&Fees Checked
APPLICATTONFOR PERMIT TO PEU ELECTRICAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSS ELECTRICAL CODE,527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
Town of North Andover To the Inspector of Wires:
The undersigned applies for a permit to perform the electric 1 work describ below.
Location(Street&Number)
Owner or Tenant x95-777 S D L
Owner's Address
Is this permit in conjunction with a building permit. 73 Y sTi (Check Appropriate Box)
Pu ose of Buildin
rP g Utility Authorization No.
Existing Service Amps� Volts Overhead Underground No.of Meters
New Service Amps / Volts Overhead Underground No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work zy,767 S643D--� A),"
No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total
KVA
No.of Lighting Fixtures Swimming Pool AboveBelow Generators KVA
round round
No.of Receptacle Outlets — No.of Oil Burners No.of Emergency Lighting Battery Units
i J
No.of Switch Outlets f
/ No.of Gas Burners
e No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones
Tons
No.of Disposals No.of Heat Total Total No.of Detection and
Pumps Tons KW Initiating Device's
No.of Dishwashers Space Area Heating KW No.of Sounding Devices
No.of Self Contained
Detection/Sounding Devices
No.of Dryers Heating Devices KW Local Municipal Other
Connections
No.of Water Heaters KW No.of No.of
Signs Bailasis
No.Hydro Massage Tubs No.of Motors Total HP
OTHER-
lbaNeacumtLktkkuwancePolicynrhxkgCmVWQpffawmCDverWorgsakswnWegmalffI YES a NO
Ihawatt niWdvalidproofofsmvD1heOffim YES � Yycuha%edrd®dYES,pleaseincl�*detypeofcoverageby
dreddwdre . box
INSURANCE BOND OTHER (Please Spedfy)
fEViafimDale
WodctoShmt ! 2-Z2 E=WdVahr dE1ecbcalWak$
°nom Rough Feral
SFIR�NAME Rmkiesofpe�tay Z> �Z>
Lioa►seNo. /W6 3,
5crosee sigttartne �- Liw>9eNo
�G��J sT ��/1���r' lam/d�`-��
Tel No. Gd 77 6�2 62 6 Z
Ar�&ess r Alt Tel Na 2-Y 325 7 3 5!
OWNER'S INSURANCEWANER,Iamavvatethatthelio Wdoes nothaiethemammoovw4porzakslantialequiAa1asregmWbyMa%xhusczC onallaws
and thatrnysgnatureon drispuniapplicatim wai%esdiis regrtiret ifft
(Please check one) Owner Agent
Telephone No. PERMIT FEE$
Signature ot Uwner or Agent