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Miscellaneous - 116 MARBLERIDGE ROAD 4/30/2018 (3)
116 MARBLERIDGE ROAD 21010378-0011-0000.0 �1 i �G 4-142 S Curr® T =0mrs A better environment inside and out.M wwoow Farms Enhancing Impact Performance with Safety and • Tensile Strength and Elongation(ASTM D882) Security Film • Break Strength(ASTM D 882) Solar Gard Armorcoat films help shore-up a commercial • Tear Resistance(Graves—ASTM D 1004) and residential structure's glass windows,providing an additional shield against breakage and the damage that • Puncture Resistance(ASTM D 4830) can result.Applying safety and security films can make the difference between being able to utilize existing window systems and having to replace them at great expense.Film can bring ordinary glass into compliance with a number of recognized U.S.and European safety standards,which ANSI: American National Standards Institute make annealed glass as safe as tempered glass. ASTM: American Society for Testing Materials CEN: Comite Duropean De Normalisation (French)This is the same as the EN. CFR: Code of Federal Regulations Consumer Products Safe Commission CPSC• C Safety EN: European Normal FBC: Florida Building Code GSA: General Services Administration HPW: H.P.White Laboratories NIJ: National Institute of Justice Window film brings window or door glass up to standards that 1. make annealed glass as safe as tempered glass. SBCCI: Southern Building Code Congress International Impact Standards UL: Underwriters Laboratories Impacts that causes glass to break is categorized into five basic types: How Impact Performance is Determined 1. Human impact(accidental) 1.Human Impact 2. Breaking and entering U.S.Standards 3. Er"`a,1me weather(hurricane) The two most commonly used standards to test human 4. Bomb blast impact in the United States are ANSI Z 97.1 and CPSC CFR uM 5. Ballistic 1201,Category I and 11.To determine resistance to human impact,the lass specimen receives an impact from an P 9 P P There are standards for each type of impact to determine impactor on a pendulum that is released from a prescribed whether or not glass will break and,if it does,the effect of height.The impactor is a leather"punching bag"loaded the break.Specific film characteristics determine safety and with 100 lbs.of lead shot. security performance.These characteristics and approved methods used to assess performance are: ,r n 77 economical and time-saving solution.The current standard 3.Extreme Weather(Hurricane) 9 for blast mitigation in the U.S.is the GSA Standard Test Safety and security window film can mitigate damage that Method for Glazing and Glazing Systems Subject to Air- results from extreme weather conditions,such as a hur- blast Loading,a modified version of ASTM 1642-96. ricane.In the U.S.,hurricane resistance standards consist of firing missiles,large and small,into a glass specimen to In Europe,the International Standards Organization(ISO) determine if it can withstand the impact and then subject- 16933 standard is similar to the GSA.At this time,rather ing the impacted specimen to region-specific cycles of than testing to the European standards,the majority of film static air pressure. manufacturers test to GSA,which is generally accepted The large missile used in testing is a 2"by 4"piece of throughout the world. lumber of weight ranging from 4 lbs.to 9 lbs.and fired at To see video footage of bomb blast testing click here. speeds of 40 fps(feet per second)to 80 fps.Small missiles are 10 2-gram steel bearings fired at 130 fps. Impacted There are four GSA levels of protection for buildings—A,B, specimens receive cycles of air pressure ranging from 50 to C and D.with A the lowest protection and D the highest. 100 lbs.psf,depending on the specific region,or wind- The levels determine what steps must be taken to protect a borne debris zone,for which the specimen is being tested. building from damage and injury to employees in the event of a blast.A and B levels represent protection for low-risk To see video footage of missile testing for hurricane resis- structures and aren't mandated or controlled. tance click here. Solar Gard Armorcoat film has demonstrated blast mitigat- U.S.Standards for Hurricane Resistance Testing ing properties at Level C and Level D.GSA requires the creation of overpressure and impulse on the specimens Southern Building Code Congress,International(SBCCI) with either an open air explosion or shock tube,achieving: Standard 12-99 Florida Building Code(FBC)TA 201-202-203 Level C–Overpressure of 4 psi and Impulse of 28 psi, milliseconds American Society for Testing Materials(ASTM)E-1996 (E-1886 methodology) Level D–Overpressure of 10 psi and Impulse of 89 psi, milliseconds Miami-Dade,PA 201,PA 202,PA 203 , Solar Gard Armorcoat films are rated effective for These standards use the same missile methodologies, Level C protection in gauges from 4-Mil to 14-Mil with but vary in terms of size and number of missiles required. "daylight"applications and attached systems. Solar Gard Different regions require different standards.While other Armorcoat 14-Mil film with afour--sided mechanical attach- countries have standards,most defer to the InternationalArmorcoat system is rate effective for Level D protection. Building Code,which cites the ASTM E-1886 Standard Test Method and the ASTM E-1996 Standard Specification. w` Solar Gard Armorcoat 8-Mil film,when anchored with the o Dow 995 structural sealant,meets the rigorous require- Overpressure—Pressure above normal atmospheric pressure ments of ASP4 E 1$86 and E-1996 for large missile impact Impulse—Length of time and amount of pressure that is put on the (Missile C–4.5 Ib.2"X4"at 40 feet per second)and cy- structure cling. It his also feet the requirements of the Miami-Dade Witness panel-A foil-covered foam material placed 10 feet behind small missile impact and cycling requirement(PA 201"and the specimen being tested to determine if any glass shards have PA 203). THIS DOES NOT MEAN THIS FILM AND AT made contact TACHEMENT SYSTEM HAS CODE APPROVAL OR NOTICE OF PRODUCT ACCEPTANCE. Code or product acceptance is only-given to the entire glazing system and Performance not for products that enhance the performance of just the glazing. To be considered effective for blast mitigation by GSA standards,the filmed glazing must achieve a performance 4. Bomb Blast MitigPtion condition of 4 or better,with 5 being failure.The perfor- mance conditions are as follows: When glazings need to be brought up to the published requirements fAlast protection,window film is a more t Al o [ All of these standards consist of firing various caliber bul- 1 lets at glass specimens from a range of 25'with a wit ess .. No break panel behind the specimen to see if impact occurs. Based 2 on the thickness of the glass and film application,certain 3-A Break—no particle entered structure Solar Gard Armorcoat films meet standards of HPW-TP-Break—no particle entered structure R,0550.02.Contact your BeLLrepresentative for test ae rk more than 1 meter(3.3 feet) results. 3-B Break—no particle entered structure SUMMARY more than 3 meters(10 feet) 4 By testing to standards for,h.uman impact, Break—particle struck witness panel entering,`extreme weather,bomb blast,and ba listicar- at 10'but no higher than 24"above pact,Solar Gard Armorcoat can demonstrate the effective- 5 floor nets of our safety and security films,offering customers a Failure particles enter structure costseffective solution to protect people and interiors. For — explanations or more information regarding tests or test and strike witness panel above 24" results,contact your Solar Gard Armorcoat representative. Solar Gard Armorcoat GSA performance ratings are as follows: • 4-mil film:3-B Daylight applied • 8-mil film:3-A Wet glazed to the frame with Dow 995 structural sealant • 14-mil film:3-A Mechanically anchored. Ballistic 'esently,there are no films installed on glass less than 'in thickness that provide adequate ballistic resistance. Im can,however,improve the ballistic resistance of glass sere ballistic resistance already exists. ere are a number of standards used for ballis i iistance tecU�" t c ng.Some of the most commonly used are: • UL-752(Underwriter's Laboratories) • NIJ-STD-108(National Institute of Justice) • CEW1063(Europe) ' HPW TP-0500(H.P.White Laboratory) F ArliOtCOar �.nh� a'' wvvwsolargard.o r Solar Gard®films,manufactured by Bekaert Specialty Films,LLC '51ss4 Rev 10/08.0 2W8 gra,,s p4540 Viewridge Avenue,San Diego,CA 92123 eciahy Pilins,LLC•A0 Rights Reserved.wuar.sdargard.eorri 877.273.4364 } Drop heights range from 12" to 48",depending IiWftMB on the standard's requirements: Class 1—1,200 mm Type A—Annealed glass w ' Class 2—450 mm Type B—Laminated glass ►ID� (IMIM, 48'• Category I=18" —Toughened glass Class 3—190 mm Type C Gass A= I Category On4mmand 6mmg li=48" Class B=18" Class,Solar Gard Armorcoat films Class C=12" achieved the following EN 12600 ratings: • 4 mil—2(B)2 A glass specimen is deemed a failure if it breaks with an 7 mil_2(B)2 opening large enough allow impacteeclimens msteel ust pass pass through.Four of the fived sp • 8 mil—1(B)1 pass to get passing results. 10 mil—1(B)1 Solar Gard Armorcoat films have been tested to both the • ANSI and CPSC standards and achieved passing results on 14 mil—1(B)1 both 1/s" and 1/4"glass for the following: Using the rating of 2(13)2 for 4 mil window film as an example,6 mm annealed glass with Solar Gard Armorcoat M film installed achieved Class 2(450 mm drop height),Type 8 mil filmsCategoryI=18" 4,7mii—Bmilfilms B(laminated glass)with the final 2 indicating the maximum drop height(Class 2,450 mm)where no penetration 8 mil filmsCategory tl=48" 7 mil—B mil films occurred. —8 mil films 2. Breaking and Entering Solar Gard Armorcoat film also gets passing results on Law enforcement will tell you that a "smash and grab"thief mil film for ANSI 297.1 Class C and gives himself 20 to 30 seconds to break a window,enter wired glass with the 4 I for 7 mil film for CFR 1201,Category II• the building and then flee.Safety and security film holds the shattered glass in place,impeding ng the h intruders efforts With his timing off,the thief typically 9 P o Compliance Labels and leaves the scene. Labeling showing compliance with the standards is to be applied to the lower left hand comer of the filmed window. * The type,size and identification that must be on the label are defined in the standards.Labels are available from your r 1 Bekaert representative upon request. ,c 2 „ � A European Standards + The prevailing standard in Europe is the EN 12600,which is very similar to the U.S.standard,except the impact is pro- W, , vided by a "twin tire" impactor rather than a punching bag. EN 12600 uses a rating system of 1 to 3,with 1 being the � in st,rather than a pass/ rating and the lowe highest 3 being of break. fail system that defines drop height and type Solar Gard Armorcoat Safety and Security Film holds shat- tered glass in place,impeding an intruder's entry. This fea- ture is further enhanced if the film is anchored to the frame 10098 A J Date : ���. . . . •a TOWN OF NORTH ANDOVER _ PERMIT FOR PLUMBING This certifies that . . . . ' 15. . .T /�.ft. . has permission to perform . . <1h-P4- .��?.�?? .c . . . . . . . . . . . plumbing in the buildings of. !`r ✓ i` - . �//�.d!�.P.c A 64 at . . . ..1.� /.�R-+ � ?-- . . . ,North Andover, Mass. Fee a 7 . . . Lie. No. .�w/ ��. . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR Check MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY B�ilh MA DATE % PERMIT# l JOBSITE ADDRESS?N", ^b/Pcti1G�,� /�u� it OWNER'S NAME POWNER ADDRESS I TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL© EDUCATIONAL D RESIDENTIAL PRINT CLEARLY NEW: DI RENOVATION:Ed REPLACEMENT: Q PLANS SUBMITTED: YESEk' NOD FIXTURES-1 FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM I I I ..—1 I Wl J _ G _ —! ._ _. ! DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER i ___ —I _._ DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK —i ----_I LAVATORY =1 __ _J --i _..__J _._..J ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET 1 � _ _._ _ I .____.__I URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING _f .--i —_[ OTHER ---- __ ___J I i __.i _ ------J - f F INSURANCE COVERAGE: 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. Y 0 1 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 0 OTHER TYPE OF INDEMNITY D BOND [71 2— OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Ch o e Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER DI AGENT D( SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information I have submitted or entered regarding this application are true and curate to the 4st of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in complia ith all Pe ' en rovision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME —.---IILICENSE# SIGNATURE MPD JP CORPORATION0# PARTNERSHIP P#®LLC I COMPANY NAME l�',^� i� �+ ADDRESS F _ I I CITY ! Lt/ I STATE ZIP TEL FAX CELL EMAIL ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# ��-�l Com/7 PLAN REVIEW NOTES 2 lcx The Commonwealth of tllassachusetts - Department of IndustriglAccitlents Office of Investigations qu 600 Washington Street Boston.,MA 0211.1 www.mass gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/EIectricians/Plumbers Applicant Information Please Print Legibly Name(Business/Or anNation9ndividual): Address: City/State/Zip: �45� 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. El Now construction 7f employees(full and/or part-time).* have hired the sub-contractors Remodeling T am a sole proprietor or listed on the attached sheet.c z . ❑Remode ship and'have no employees These sub-contractors have 8. ❑Demolition working for mein any capacity. workers'comp.insurance. . g, 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 12.0 Roof repairs insurance required.]t employees.[No workers' comp.insurance required.] 13.❑Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they Ate 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 showW 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 anal job site information. Insurance Company Name Policy#or Self-ins.Lia#: Expiration Date: Job Site Address: City/State/Zip: Attach a.copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required-under Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. Xdo Hereby cert un Ilepains a enalties ofperjury that the information provided above is true and correct. - Sienature: Date: 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.CitylTown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other - - - Contact Person: Phone#: i Information and Instruction-S 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 oftire; express or implied,oral or written." An em ployeiis defined as"an individual,partnership,association,corporation or other legal entity,or any two ormore of the foregoing engaged in a j oint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required" Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any ofits political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are notrequired to carry workers'compensation insurance. If an LL C or LLP does have employees,apolicy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage, AIso be sure to sign'and date the affidavit. The affidavit should be retumed 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-andprinted legibly. The Depaitmerit leas provided a space atthe bo-E 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 Min the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications'many given year,need only submit one affidavit indicating current policy information(ifnecessary)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 maybe 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: Tho CQjnMQxtwoaith ofMfassac wetts Depaxtme.ut ofJafttxial Accidents Office of h1vostigatio.'m 600 Washiagtou Street Boston?MA021X1. Tel,,#617-727-4900 ext 406 oz 1-877�UASSAk'F Revised 5-26-05 FAYO 617-727-7749 { 'COMMONWEALTH OF MASSACHUSETTS k. }'LUM;BERS ANDIG.ASfiTTEft LICENSED AS A JOURNEYMAN PLUMBER ISSUES THE ABOVE LICENSE TO: GARY '.A :P:ARADIS 16.• PlLLSB,URY RD 'SAND.OWN ; NH 03873-2701 30165 . 05/01/14 283251 Date TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION J I y ! , This certifies that . . A �`.5. . . . . . . . + . . . . . . . . . has permission for gas installation .b Q]'?!\. r�I� .5�.le . . . . . . in the buildings of. N v A e 0 r�?'�. at . . . . .�. . . . !", ��-, .J V-; ed, North Andover, Mass. Fee � �.J . . Lic. No. I�At,. Y-1 . . . . . . . . . . . . . . . . . . . . GASINSPECTOR Check 4 8820 Ov� � � �� MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY OGc//r/ d� MA DATE PERMIT# v" JOBSITE ADDRES .Si(l /% X G,o ]OWNER'S NAME !ndy'_ �/•,�' Il OWNER ADDRESS I TE FAX TYPE OR OCCUPANCY TYPE COMMERCIAL E EDUCATIONAL D RESIDENTIALEU PRINT CLEARLY NEWT-1 RENOVATION: REPLACEMENT:® PLANS SUBMITTED: YE&ffl NOQ APPLIANCES 7 FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER M _ _ - - . I_ I _ I [ BOOSTER T _ CONVERSION BURNER COOK STOVE m.�aw.J DIRECT VENT HEATER DRYER FIREPLACE ) FRYOLATOR FURNACE GENERATOR GRILLE F--71 - I INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER �( ROOM/SPACE HEATER _ ROOF TOP UNIT _ TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHER I - INSURANCE COVERAGE have a current liability insurance policy or its substantial equivalent which meets the requirements of MOL.Ch.142 I I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW f LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY E] BON c' 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 EI AGENT 01 SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and ac rate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in comp lianc all Pe ineR provi on of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME _ Y_ _.�iC�'_ LICENSE#aiSI SIGNATURE MP ED MGF El JP M JGF _[l__I LPGI F] CORPORATION[]# PARTNERSHIP # LLC[3#= COMPANY NAME:Ipa&aKa t-/` le�_ ADDRESS O CITY l __ _ _ _ �� STATE ZIP STEL FAX CELL _ EMAIL ROUGH GAS INSPECTION ,NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ Ss FEE: $ PERMIT# PLAN REVIEW NOTES A . The Commonwealth ofMassachusetts Department of IndustrinlAccidents IR Office of Investigations V. 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit:BuilderskContractorsl Electricians/Plumbers Applicant Information Please Print Lesibly Name(Business/Organization/Individual): Address: City/State/Zip: Phone#: Are you an employer?Check the approliriate 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.El am a sole proprietor or partner- listed on the attached sheet.x �• E]Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for mein 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.E]Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I LE]Plumbing repairs or additions myself.[No workers'comp. c.152,§1(4),and wehaveno 12.❑Roofrepairs insurance required.] employees.[No workers' uEl.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 aie 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 1s providing workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name:. Policy#or S elf-ins.Lie.#: Expiration Date: Job Site Address: City/StatelZip: Attach a.copy of the workers'compensation-policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. X do Hereby certify under the pains andpenalties ofperjury that the information provided above is true and correct. Signature: Date: 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 tine): 1.Board of Health 2.Building Department 3.City1fown Clerk 4.Electrical Inspector 5.PIumbing Inspector 6.Other Contact Person: Phone#: l r rV Information and InstrudRoRs 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 ofhire,. express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be.an employex" MGL chapter 152,§25C(6)also states that"every state or local licensing agency shaII 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 maybe 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-andprinted legibly: The Departinerit figs provided a space at the Iiottom- of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be.used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be.provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each year.Where a homeowner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc)said person is NOT required to complete this affidavit. The Office of investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number; The GQMMC)Rwealt� off-assar�hvsotts ZMep.az ent ofIndustdat.AccUaats Office ofJuVestigat ions 600 Waskibgton Street Boston, 021 If TQ1,#617-727-4900 at 406 o> 1-8,77:M.ASS.AFE Revised 5-26-05 FaY,#617-727-7749 t; v✓j I COMMONWEALTH OF MASS 4CHUSETTS «,LUMBERS AND>GASFITTERS LICENSED.ASA JOURNEYMAN PLUMBER 'ISSUES THE ABOVE LICENSE TO: r i . GARY 'A PARAnIS 16.':FILLSB,URY RD ;N 'SAND.OWN ; NH 03873-2701 36165 . 05/01/14 283251 Date.... ........ 14ORT TOWN OF NORTH ANDOVER x PERMIT FOR WIRING no A� k ITCA Thiscertifies that ..................1e4Q,..................................................................................................... has permission to perform 54e,-e-V1 C.�— I ....*1-* ................................................................. wiring in the building of4�N i3,%/",/ 0—� " .. ...P ............... ........ ....................................... 0.............. .............. at ...W.7 ...... .................. Andover,Mass. Fee..�- Lic.No. ... ... ............ ....J.7............ .. ............. EcnucALINSPECTO Check# 11667 Commonwealth of Massachusetts Off ial Use only o Department of Fire Services Permit No. MM Occupancy and Fee Checked \1 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(MEC),527 CMR 12.00 a (PLEASE PRINTWINK OR TYPEALL INFORMATION) Date: D 6 //8//3 City or Town of: NORTH ANDOVER To the Inspector of Wires: L By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) � #70l3/,C,Ll6(,.E16 Owner or Tenant mov t V (, MG • Telephone No. I Z� yz0 Owner's Address 18 S $g9i 12E e46 z645e /V14 Is this permit in conjunction with a building permit? Yes No ❑ (Check p ropriate Box) Purpose of Building �c cJOLL l Utility Authorization N4. /S7 1 cl 6 do Existing Service V Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service . c2®'O Amps I/Z / ZOVolts Overhead?F Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: IA,;6..r�94,e 1,)EW ZAc7 /I/pp L/lC; Completion of thefollowing table may be 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- ❑ Ao.of Emergency Lighting rnd. grnd. BatterV Units k 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 Tons II, No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: —* """ "f "" " Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal El Other Connection No.of Dryers Heating Appliances KW Security Systems:*. No.of Devices or Equivalent i 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 E uivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: Zt (When required by municipal policy.) Work to Start: W044,1' 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 covera cis in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE L BOND ❑ OTHER ❑ (Specify:) X certify,under the pains and penalties of per'ury,that the information on this application is true and complete. FIRM NAME: . /'-' �! (,—cr d Cit✓-I IY7 LIC.NO.: 4 > 22 Licensee: Signature LTC.NO.: (If applicable, nter"exempt"in the license number line.) Bus.Tel.No.: i 3 2� Address: j� U�S ( K,4 {'� s c y�� (M Alt.Tel.No. S. _' *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 [PPRWTFEE.-$Signature Telephone No. � i ❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance with the provisions of M.G.L.c. 143,§3L,th permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be file 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 electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the 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 may be deemed by the Inspector of Wires abandoned and invalid if he 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 on August 15,2008 and extending through August 15,2012. ❑ Rule 8—Permit/Date Closed: ***Note:Reapply for new permit❑ ❑Permit Extension Act—Permit/Date Closed: Trench Inspection Pass M Failed Re-Inspection Required($.)❑ Inspectors Comments: Inspectors Signature: Date: SERVICE ECTION: Pass • Failed M Re-Inspection Required($.)❑ Inspectors Comments: x fa Inspectors Signature: h, Date: PARTIAL ROUGH INSPEC ON: Pass❑' Failed Re-Inspection Required($.)❑ Inspectors Comments: Inspectors Signature: Date: ROUGH INSPECTION: Pass M Failed Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: FINAL,INSPE ON: Pass Failed Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: o� z �� Date: Tp — dam DEB WEINHOLD ...TOWN OF MERRIMAC,MA. .......dweinhold@townofinerrimac.com The Commonwealth of Massachusetts - Department oflndustrialAccidents Office of Investigations 600 Washington Street Boston,MA 02111 Uf www.mass gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Apulicant Information Please Print Legibly Name(Business/Organi'zation/lndividual): Ali6ce,,D r4T- 1 ,,,w Address: 1 T X5 1 eL/CJ City/State/Zip: �0^Nd0L P9 Phone#: �5 83 8 8 Z 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 4employees(full and/or part-time).* have hired the sub-contractors lam a sole proprietor or partner- listed on the attached sheet. �• Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. g, ❑Building addition [No workers'comp.insurance 5. El We are a corporation and its xe aired.� officers have exercised their 10.E]Electrical repairs or additions q 3.❑ 1 am a homeowner doing all work right of exemption per MGL 1LE]Plumbing repairs or additions myself.[No workers'comp. c. 152,§1(4),and we have no 12.❑Roof repairs 1 insurance required.] employees.[No workers' 1311 Other comp.insurance required.] 'Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. 7 Homeowners who submit this affidavit indicating they die 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 workerscompensation 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: /�� /�/4�"� City/State/Zip: ..moo©oyL2 G41-o, I,A.tiach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder 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 DTA.for insurance coverage verification. I do hereby cert upder"theepains an r�lties ofperjury that the informationpro videclabove is true andcorrect. - Si ature /!/C Date: 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.PIumbing Inspector 6.Other - - - Contact Person:-, Phone#: r r' Information and InstructRons Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute an employee is defined as"..e e every person in the service of another under any contract ofhire, express or implied,oral or written." An employer'is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer.." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required" Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic 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 maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage.v ge. Also be sure to sign and date the affidavit. The affidavit should be returned to the cityto th or wna t 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 r! Policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)"A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Go a.oAwealth ofMossaftsetts Department of Industrial.A,ccidonts office o1~Investigatiom 600 Wasbiugtorl Street BostonMA02111 TQL#617-72.7-4900 ort 406 or 1-877-MASSAFF, Revised 5-26-05 Fax#617"727-7749 VV1WW.mace aavhli i 1 ' �. COi1N Q . EALTH QF MASSACHUSETTS ` OF ELECTRICIANS A5,A REG JOURNEYMAN ELECTRICIAN f ,I ISSUES THEABOV'E LICENSE TO I I ANGELO R FRATALIA 18 E" RDS RANDOLPH MA 02.36.8-37.4 5310 E 07/31/13 81'9112�`'� qry i j Date......?1- 43......... NORTH oa ; ~yam TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,gBACHU 1.42 1)_Y, 0 This certifies that . .... ..... ............. .... ................ has permission to perform ........ .......................... wrong in the building of.... .......................................................................... X ........./—/"*60` North Andover,Mass. Fee 2.......I... ................. . .. ... ELFMCAL INSPECTOR Check# 11803 . 14F,,,,. '1 S � ��3 - Cornmonnam Of Massachusetts YAPbanitNOLl Dgmrhment of Fire Servkes s° -_ Occupancy and Fee Chocked BOARD OF FIRE PREVENTION REGULATIOW .111991 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Aliymiktote paftmdm= vn&fire Cade 527CMRlz00 (PLEASE PRINT N BVKOR TYPEALL Date: City or Town ok ,1 z To the Jof Wi : By this application the tnndersiped groes notice ofhis or her intention to perfarm the electrical work described below. Location(Street&Number) Z/(, y "-?/"e_ /?d o'"/ Owner or Tenant ��x fru`� Telephone.No, 751-.AV- Owner's -` -Owner's Address Is this permit in oonjuncOon with a budding permit? Yes No ® (Check Appropriate Box) Purpose of Burllding,f G' icy Utility Authorfzaiioa No. Existing Service Amps 1 . Volts Overhead Q Undgrd❑ No.of Meters New Service ce Amps { . ,Volts Overhead❑ U [ No.of Meters ., 4 Number of Feeders and Ampacity ` Location and Nature of Proposed Electrical Worms fhe rabie my be waiped by the bupatv ofWires No.of Recessed Fixtures o€Ce&-Snsp.(�Fans r Total No,of Lightning Qutit~ts No.of Het Taps Genexrturs KVA No.of i fighting Fhtures swimmingpow Above d. g Q Butte IInits No of Receptadle Ondef N&of 0it(trams FIRE ALARMS K0_ of Zones No_of Switches g ofGas Barriers ! of Detection and hwatinDevices Total No.of Ranges No.ofAir Coad. o� Tom of Alerting Devices Na of Waste spuserstdned '=V" ' ' of_ . Devices No.of Dishwashers Sp Ana Heating KW Local ❑ Kno'cl al 0 Other Na of 1hYan EkatingAppliumsKW &CENa o orEquivakut NIL of Water ftof No.a Data Wn Heaters / Y-W 6!,.s Sim Elallasts No.of Ug_ent r No.Hydromassago Badtabs N&of Motors Total HP iTe"'NM(LuomfoDne'vczkte'senosr=ejit a*r0w rtdPm r arass,eg dby brs CtorofWire� INSURANCE COVERAGE: Unless waived bythe owner,no permit fr the perfamanee ofeLectrical work may issue unless the licensee provides proof of'liW ity insurance including`completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exlu'bited proof ofsame to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Speeily-) (FxPirattce lite} Estimated Value of Electrical Work: $�/3^ 50p; (When required by municipal policy.) Work to Stam S d,0 iInspec ions to be requested in accordance with MEC Rule 20,and upon completion. X cdfy,under fffepabk andpmddes vfperjkuy,tkat the inn on A&awn Is Ow mrd calf left FIRM NAME: C-T C LIC.NO Licensee: LIG No:�l (tf�ptiaabl�enter"e�rempt"inrhe e ) Bus.TeL Address: -304/� .L Sei � � � /Sl Alt:TeL Na- _5t OWNER'S INSURANCE WMYER: Ian aware flat the I der not hm the liability msmance covMW normally required by law. By my sigoatt to below=Ihereby waive this requiremeaL I am the(cheat are)Q owner ❑owner's agent SignatureOwnedAgent Telephone No. PST PSE: 2 Z -13 77te Commonwealth ofHanwhusetts t�nntrorm.. � DWadwN oflndns&W Accidents OJT"of Inver afions p , = } > - 1 Congress Street Suite 100 Boston,SIA 02114-2017 -' www mmgov/din Workers' Compensation Insurance Affidavit;Builders/ContractorsMectricians/Plumbers A licant Information Please Print Legibly Name(Business/organization&&viduat): A)1-11,,' �c�t7 /,-,,cAddress: S fl`�'�t' .Z-s/cn� C1 �/ Ci IStategip: Phone#: Are you an empbyer?Cheek the appropriate beg: Type of project(required): I.® I am a employer with 4 _ 4. []I am a general contractor and I 6. ❑New consMiCtion employees(full and/or part-timer have hired the sub-contractors listed on the attached sheet. 7. ❑Remodeling 2.❑ I am a sole proprietor or Thewsub-contractors have ship and.have no employees 8. []Demolition working for me in any capacity. employeesand have workers' 9. ❑Building addition [No workers'comp.insurance comp msurance't 5.Q We are a corporation and its 10-[gElectrical repairs or additions 3.El I am a homes doing all work officers have exercised their 11-[]Plumbing repairs or additions myself[No workers'compof exemption per MGL 12.[]Roof repairs insurance -]t c.152,§1(4),and we have no 13.Q Other employees.[No workers' comp.insurance regrrrred.j *Any applicant that chedcs box#1 mug also fill out the section below showing the wonders'wmensation policy mon. t Homeowners vko submit the aSud;avitb&ea ingtbey we doing.an wa&wd&m him outside wahadem mast submit anew affidavit indicating such. kontmetus that chwk this box must auadied an additional sheet showing the name offt and state whether or nottbose entities have employees. if the sub-contractors bave employees,they must pmvide their work as'comp-policy m°»ber I am an Mployer thatis p vviftg'eskers'co>alFensatron ansurmacefor airy loyees Below is die poluy andlob site information. Insurance Company Name: Policy#or Self-ins.Lid_#:� 9,�fj -,i1) l�/ Expiration Date: Y Q .u� .r , //( citylstaterip:-4 J1 �,,�r �i1� Job Site Addrnss:"�.,�______ Attach a copy of the workers'compensation policy declaration page.{showing the policy number and expiration date). Failure to secure coverage'as required ander Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a fine up to$1,540.04 andlor one-year imprisonment,as wen as civil penalties in the form of a STOP WORK ORDER and a fine Of up to$254-00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA forinsurance,coverage verification. I do her under the wins mad o that the ornaad m provided above h true and convxt Simunz - Phone#: official use only. Do notwr&in this area:to be conriewd by dsty or toren offidA City or Town: PermitUcease# Issuing Authority(circle one): r 5.PlumbInspector 1.Board of Health 2.BuildingDepartment 3.CitylTewB Clerk 4.Electrical Inspector plumbing 6.Other Contact Fuson: Phone#: lot 0 .COMMONWEALTH OF MASSACHUSETTS f, � o ,o • o o ,,��h � BOA�ia Of EI ECTt l C 1 ANS SUES THE FOLLOWING L.I;.C£NSE AS A . REG#5 # RED MASTER E:LECT.RI`.CzIAN aw PAGLI'ARO ELECTRIC LLCl '.;.LEONARD PAGLIARD j. 35 OAK tSLAN0 5T REV. I' : R E , MA 0 2151— 2055 07/3l/}6 28868 °:COMMONWEALTH OF MASSACHUSETTS ° ° BOARD OF ELE`CT#2I C I ANS ISSUES THE FOLLOWING LICENSE REG JOURNEYMAN ELECTR I,C.'1/Alie tQ IZ LEONARD PAGL I ARO w W z 2 35 OAK I:BLAND ST ''�° '" �l U_ A 02151-4846 ,-EV£R28867 X0884::B:.. 07'/3�/l>6 Residential Property Record Card PARCEL_ID:210/037.8-0011-0000.0 MAP:037.13 BLOCK:0011 LOT:0000.0 PARCEL ADDRESS:116 MARBLERIDGE ROAD PARCEL INFORMATION Use-Code: 101 Sale Price 1 Book: 1669 ' ' Road Type: ,, T Inspect Date_: 06/05/2002 Tax Class T Sale Date: 05/02/1983 Page: 19 Rd Condition: P Meas Date: 06/05/2002 Owner: Tot Fin Area2064 Sale �' Cert/DoC: Traffic: M Entrance. X VIELGOLASKI, EVA E Tot Land Area 1.02 Sale Valid: A Water: Collect Id: RRC THOMAS R VIELGOLASKI Grantor VIELGOLASK.I'B THOMAS Sewer Inspect Reas: C' Address: _ _ .:.. .. 116 MARBLERIDGE ROAD Exempt-B/L% / Resid-B/L% 100/100 Comm-B/LeW Indust-B/L% 0/0 Open Sp-B/L% 0/0 NORTH ANDOVER MA 01845 RESIDENCE INFORMATION LAND INFORMATION Style: ' CL Tot Rooms: 6 . Main Fn Area 1104 Attic. y NBHD CODE 8 NBHD CLASS 8 ZONE. t Story Height: 2.35 Bedrooms: 3 Up Fn Area: 960 Bsmt Area 840 S®g Type A Code Method Sq Ft Acres, : fnflu-Y/I Valu® Class Roof G Full Baths. 2 Add Fn Area. Fn Bsmt Area: 1 P 101 S 43560 1 ✓a r 217,364 Ext Wall: WS Half Baths: Unfin Area: 294 Bsmt Grade: 2 R 101 A 0.02 94 Masonry Trim: Ext Bath,Fix,, Tot Fin Area ' 2064 Foundation CN Bath Qual: T _ RCNLD: 185897 DETACHED STRUCTURE INFORMATION _ _ . Str Unit xMsr 1: `Mss-2 E YR-SIt.Grade Cond%GoodxP/F/EtR Cost Class Kitch Qual: T :Eff Yr Bull't ,,.' 1965_ Mkt Adj: 1 1 62 S 400 _ 1940 A A /50//26 3,800 1 Heat Type: ST Ext Kitch Year Built: 1923 Sound Value. SE S 256 1980 A A /50//43 1,300 1 Y Fuel__Type ':'O .' Grade. G Cost Bl"d_g. 500. Fireplace: Bsmt Gar Cap: Condition A Aft Str Val 1: VALUATION INFORMATION Cen1.tral AC: N Bsmt Gar SF:" Pct Com lete: Att Str Va12 `' { Current Total: 427,100 Bldg: 209,600 Land: 217,500 MktLnd: 217,500 Aft Gbr SF: %o Good P/F/11 E/R: /100/100/79 Prior Total: 398,500 Bldg: 197,200 Land: 201,300 MktLnd: 201,300 SKETCH PHOTO 40 5 12 FM 30 1 'NW 1104 Sq.Ft. y R� Ctur in 18 16 b I inkAval 1 305 Parcel ID:210/037.6-0011-0000.0 as of 7/25/06 Page 1 of 1 ESRI ArcExplorer 2.0 Map Title ® core_naparcels T core_nawatersheddistrict cor ahistoricdistrict s e_n core_nazoning (ZONECODE) 21061 E 21062 21 OB3 21 OB4 21 OG B ys. y 21011 N v� 21012 ' 21013 21 OPCD 210R1 21OR2 21OR3 21OR4 210R5 3 a s h y 21OR6 21 OVC ;-,_ 210VR N Tuesday, Jul 25 2006