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HomeMy WebLinkAboutMiscellaneous - 1160 GREAT POND ROAD 4/30/2018 (26) NG FILE Date... ......... t NpRTM 1 TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ♦ r ♦ oma+ ����• 7SgACMUSEt This certifies that ............................. fes.. .��............................................ has permission to perform ,� ..,.. ................ ter...' .....-......................... wiring in the building of �`� 4 ,& at................ .............................................................. .North Andover,Mass. r n � \ Fee.l............ Lic.No/71;��. .......... � .....` .. ."':.. ELECTRICAL INSPECTO �� Check # 84 / / Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. ` BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checkedr kv [Rev. 11/991 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(NEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE A L INFORMATION) Date: City or Town of: d ri�'r To the Inspector of Wires: By this application the undersigned gives notice of hi or her intention to perform the electrical work described below. Location(Street&Number) O � Qh Owner or Tenant /�j/���! S CA Gt9'z Telephone No. Owner's Address Is this permit in conjunction with a building pe mit? Yes ,W No ❑ (Check Appropriate Box) Purpose of Building 7 � � Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Li: ` � ` 151��Go a�O4 2 Completion 6fthef&,7vvYing table may 5e waived by th-m!"r ector of Wires. No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans — No.of Transformers KV.L l o.of Lighting Outlets No.of Hot Tubs — Generators kvA No.of Lighting Fixtures Swimming Pool Above ❑ In- El No.—OT Emergency ig mg — rnd. arnd. Battery Units No.of Receptacle Outlets Z No.of Oil Burners % FIRE ALAR:.iS No.of Zones No.of Switches �$' No.of Gas Burners — No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. -3 TotTons D•� No.of Alerting Devices No.of Waste Disposers Heat Pum Number Tons No.of elf- ontained Totals .__.... ......._..........._...._._._..............._............. Detection/Alerting Devi"s . No.of Dishwashers Space/Area Heating KW — Local ❑ Municipal ❑ Other Connection No.of Dryers f Heating Appliances _ KW _ Security Systems: No.of Devices or Equivalent No.of Water — KW _ o.o _ o.o _ Data Wiring: Heaters Signs Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs — No.of Motors Total HP i Telecommunications Wiring: No.of Devices or E uivalent OTHER: ' Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The ' undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® OND ElOTHER ❑ (Specify:) Estimated Value of Electrical Wor (When required by municipal policy.) (Expiration Date) Work to Start: //JZ— Of Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify,under the pains and penalties ofperjury,that the information on this application is true and complete. FERM NAME• ( LIC.NO.: j Licensee: � ��/ /9, �IlyGlil/ �(� Signature LIC.NO.:r O� (Ijapplicable,enter"exem t"in the license number line.) Bus.Tel.No.•.5-ak-J';12-?360 Address: f Arc,lM 6 Alt.Tel.No.:-,?'J7— - OWNER'S INSURANCE WAIVER: I am aYwe 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. $7& e, f �� s The Commonwealth of Massachusetts Department of Industrial Accidents l e Office of Investigations L 600 Wash�` °'`•%' ington Street Boston MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leo_ibiy Name (Business/Organization/Individual): Address: 9- -7' City/State/Zip: /6 Z Phone 2- Are you an employer?Check the appropriate box: � Type of project(required): I am a employer with.- !� — 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. # 7•)a Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. El We are a corporation and its 9. Building addition required.] officers have exercised.their 10:❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.7 Plumbing repairs or additions myself. [No.workers' comp. C. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' COMP. insurance required.] 13.0 Other +Any applicant that checks box 41 must also fill out the section below showing their workers'compensation policy information. Homeowners who submii.khis afiidavii indicating trey are duiEte Ell Stark azid iben hire outside ecntraciors muni submit a new atndavit indicating such. $Contractors that check this box must attached an additional sheet showing the name ofthe sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for ny,employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-.ins. Lic.#: 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 may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un&er ains pen 'es of perjury that the information provided above is true and correct Sisnature: Date: (J 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. Plumbin]]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 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 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 compl eteiy,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 not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office oF Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/ficense applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to.thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents. Office of Investigations 600 Washington Street Boston, MA G2111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26=05 Fax#617-727-7749 v^m-mass.gov/dia Date. OF HORDTH 14' n a 3� ° �4 TOWN OF NORTH, NDOVER 41 , p PERMIT FOR.GAS INSTALLATION t '1s,9SS,C NUSEt This certifies that .� : `'"''�. . <?. . . . . . has permission for gas installation . .��` -- in the buildings of ! -� %g- �. . . . . . . . . . . . . . . . . . . . at �!l�'. �:/ %� -. �-North Andover, Mass. Feeh� . : . . Lic. No. �! -'� . . �., Ale,e7p .. . . . . . . . . . . / GAS INSPE&OR L v rr Check# -. 6664 MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FTTTI NG (Type or print) Date NORTH ANDOVER, MASSACHUSETTS Building Locations /,Pox, 2j Permit# Owner's Name ?koo k G!! °6 Amount New Renovation Replacement �o D Plans Submitted ❑ v� U a V y W s OF UO m rA F S CK 02 y F w a p _O G Z W += w W W zw v, z E c a > w V F Z F Z x W W W w F W F W O F F `�' z kB1 B -BASEM ENT V > op SEMENT T. FLOORD . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7T H . .FLOOR 8TH .' FLOOR (Print or type) Name �I x Check one: Certificate Installing Company Address Zb �i-i73 13 Corp IDD �� ,y � Partner. Business Telephone, 77 inn/Co. ♦ Name of Licensed Plumber or Gas Fitter_ SP FINSURANCECOVERAGEk oger t liability Insurance'policy or it's substantial equivalent. Checcked desplease in ' to the type coverage by checking the appropriate box.Yes No0nce policy Other type of indemnity D Bond 13 Owner's Insurance Waiver: I rn 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. Signature of Owner or Owner's Agent Check one: Owner 13 Agent 13tted(or entered)in above application are true and accurate to the t hereby certify that all of the details and information 1 have submitted best of my knowledge and that all plumbing work and install o s performed and compliance with all pertinent provisions of the Massachuse tate Gas Cod Cha rm�t Issued for this application will be in te' 42 of the General Laws. By: ignatur of Licensed Plumber Or Gas Fitter TitlerVI Plumber City/Town, [3 Gas Fitter License Number E3Master APPROVED(OFFICE USE ONLY) Journeyman Torun of North Andover HORTN 'OFFICE OF 3?o�ss1�OG COMMUNITY DEVELOPMENT AND SERVICES i. .- 27 .27 Charles Street North Andover, Massachusetts 01845 �9ssacNus���y WILLIAM J. SCOTT Director (978)688-9531 Fax(978)688-9542 _ s CHIMNEY APPLICATION AND PERMIT DATE_ PERMIT #��,��� LOCATION ( Q G, I OWNER'S NAME �/Zaa is 560 BUILDER'S NAME /%�U12.oA U �x,)sY- (� -� • ' MASON'S NAMESD>(/l-zV MASON'S ADDRESS MASON'S TELEPHONE Z 3 3 pd ZZ MATERIAL OF CHIMNEY Cj9'1 L/ i INTERIOR CHIMNEY EXTERIOR CHIMNEY 5z NUMBER AND SIZE OF FLUES 7— THICKNESS OF HEARTH ]�F Will chimney or fireplace conform to requirements of t e code and have rules and regulations been received: DATE SIGNATURE OF MASON r CONTR. LIC. # 3 EST. CONSTRUCTION COST/CONTRACT PRICE PERMIT GRANTED a `1 0 FEE -'� ROBERT NICETTA, BUILDING INSPECTOR, INSPECTED REMARKS RECEIVED li` to 6 2001 SOLID BRICK REQUIRED BUILDING DEPT. THIS PERMIT MUST BE DISPLAYED ON THE PREMISES BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Town of North Andover NORTk OFFICE OF ��Oy ttLO e''1�'OOL COMMUNITY DEVELOPMENT AND SERVICES p 27 Charles Street " North Andover,Massachusetts 01845 "ssq�H�s���y WILLIAM J. SCOTT Director (978)688-9531 Fax(978)688-9542 CHIMNEY APPLICATION AND PERMIT DATE /d/ I PERMIT #-/c/Y31 LOCATION //(ted �i2e1�1G OWNER'S NAME 117-21 a is U6/00 BUILDER'S NAME �y �XJSY �!9VC a MASON'S NAME MASON'S ADDRESS 1) MASON'S TELEPHONE 7e/ 233 oz,-,77,/ f Il j MATERIAL OF CHIMNEY J'1'j J —S//�y /J ✓'GK INTERIOR CHIMNEY EXTERIOR CHIMNEY i NUMBER AND SIZE OF FLUES X h THICKNESS OF HEARTH ' -- 8 I Will chimney or fireplace conform to requirements of Ithe code and have rules and regulations been received: DATE D f SIGNATURE OF MASON CONTR. LIC. EST. CONSTRUCTION COST/CONTRACT PRICE PERMIT GRANTED FEE I i ,ROBERT NICETTA, BUILDING INSPECTOR INSPECTED REMARKS SOLID BRICK REQUIRED THIS PERMIT MUST BE DISPLAYED ON THE PREMISES BOARD OF APPEALS 688-9541 BUILDINGLT 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 I • • ' Town of North Andover %AORTN OFFICE OF Olt 11,1,�aD COMMUNITY DEVELOPMENT AND SERVICES 9 # - 27 Charles Street North Andover, Massachusetts 01845 WILLIAM J. SCOTT 9SSgCHUSe� Director (978)688-9531 Fax(978)688-9542 CHIMNEY APPLICATION AND PERMIT DATE_/zz1le -8 PERMIT # ! IS LOCATION //Gd OWNER'S NAME &', BUILDER'S NAME MASON'S NAME &Xsa jxx q-�� MASON'S ADDRESS MASON'S TELEPHONE_x 79-/ 233 ©UZ7.— MATERIAL OF CHIMNEY INTERIOR CHIMNEY EXTERIOR CHIMNEY e. NUMBER AND SIZE OF FLUES -Z, g2 A THICKNESS OF HEARTH ✓ Will chimney or fireplace conform to requirements of the code and have rules and regulations been received: .k DATE G1 SIGNATURE OF MASON CONTR. LIC. # 32-0 EST. CONSTRUCTION COST/CONTRACT PRICE PERMIT GRANTED FEE j ,�-- ROBERT NICETTA, BUILDING INSPECTOR INSPECTED REMARKS SOLID BRICK REQUIRED THIS PERMIT MUST BE DISPLAYED ON THE PREMISES BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 LJ'W�u1J�iJU� Construction Company, Inc. May 31, 2002 North Andover Building Dept. Mr. Robert Nicetta 120 Main Street North Andover, MA 01845 Re: Brooks School Dear Sir, This letter is regarding the (4)Faculty Housing units located at Brooks School. We have contacted our mason contractor, Colella Masonry of Saugus,g MA, and have scheduled the parging of the fireboxes for Monday June 3, 2002. I apologize for this oversight and I will assure you this will be corrected immediately and prior to occupancy. Thank you for your cooperation with this project. Sincerely, Brett Murphy Vice President J i otary Commission Expires: 11-Xa-M State of: Massachusetts County of. Essex P. O. Box 1510 ■ Newburyport, Massachusetts 01950 (978) 465-0381 Date. . . .. /K. .rF . ./ .. .. MORTM p TOWN OF NORTH ANDOVER • - PERMIT FOR GAS INSTALLATION 1 h gs,SSAf MUSE�t This certifies that . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . permission for gas installation . . . . . . . . . . . . in the buildings of . . . ... •<.. . . . . . . . . . . . . . . . . . . at//�(. . . . . . :`. . . . . . . . .. . . , North Andover, Mass. Feed%. . . . . . Lic. No.. .�. ... . . .. ... . �U f . . . . . . . . . . GAS INSPt= Check# 37 MASSACHUSETTS UNIFORM APPUCATON FOR PERNM TO DO GAS FITTING (Type or print) Date NORTH ANDOVER,MASSACHUSETT Building Locations Permit# o $ ve_�oly, v Owner's Name U NewE]FZ Renovation ❑ Replacement ❑ Plans Submitted ❑ z o a x U Od A L7 OV oc > 0 00 SUB-BASEM ENT BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR 8TH. FLOOR / (Print or type) ( t on • ertificate Installing Company Name oro. Address I I r� J J ❑ Partner. Business Telephone — ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter LLU INSURANCE COVERAGE Check one: I have a Furrent liability Insurance policy or it's substantial equivalent. Yes ❑ No❑ If you have checked M,please indica a type coverage by checking the appropriate box. Liabi.. —insurance policy Other type of indemnity ❑ Bond ❑ M 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 ofthe details and information I have submitted(or entered)in above a ' tion are true and accurate to the best of my knowledge and that all plumbing work and installat pe under Perm ssu fo i application will be in compliance with all pertinent provisions of the Massachuse State a of a neral Laws. By: Signature of Licensed Plumber Or Gas Fitter Title ❑ Plumber City/Town ❑ Gas Fitter License um er APPROVED(OFFICE USE ONLY) ❑ Journeyman 31 ' Date . . ...... ........ 40RTN TOWN OF NORTH ANDOVER o � PERMIT FOR GAS INSTALLATION f 9 ,SSACMUSEt This certifies that/. . .. . . . . . .! . .'. . . . . . . . . . . . . . . o has permission for gas installation .: ��.�ri-?'.- � r %. . . . . in the buildings of . . . . . . . at ��l:� ?�4.r% ��. . . . . . . . . .. North Andover, Mass. �J Feer r.'. Lic. NoA0 InI . . . . GAS INSPEC Re WHITE:Applicant CANARY:Building Dept. PINK:Treasurer z t o MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTING ype or print) Date `L19 — NORTH ANDOVER, MASSACHUSETTS �9rvdlcS SGtJOol Building Locations /<< z°n QS Ply -IOU S Q- Permit# 2//0 !!G0 Gr e07 pond Amounts NO nt-h jq/'1 iya VP/" , ')til Q'- Owner's Name New❑ Renovation ❑ Replacement ❑ Plans Submitted ❑ _ c _ L zc w z z c w v c z n C =� z � C x w d cn Z n SU B -BASE VI ENT tz B A S E M EN '17 I S T. F L 00 R 2 2IND . FLOOR 3RD . FLOOR 4T H . F L O G R 5'r H . FLO G R 6T [I FLOOR 7T 11 FLOOR , 8TH . FLOOR (Print or type) 1 �o Check one: Certificate Install' g Company Name ILA, �e f2o c� PIQ t Aber�c 11/e0'l'!/7! (201-P � Corp. l���C Address Box 72 g ❑ Partner. Business Telephone 9 74 97 4-2-99 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check n : I have a current liability Insurance policy or it's substantial equivalent. Yes r-" Nom If Leal you have checked yes,please indicate the type coverage by checking the appropriate box. Liability insurance policy (�hk Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver: t 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 installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Cha r 142 fthe General Laws. ow � � ( L A By: Signature of Licensed Plumber Or Gas Fitter Title ❑ Plumber . 8 S 97 City/ own ❑ Gas Fitter -cense umber Master APPROVED(OFFICE USE ONLY) Journeyman Location ' No. Date NoRT)f TOWN OF NORTH ANDOVER F „ Certificate of Occupancy $ Building/Frame Permit Fee $ �SJAcHuset Foundation Permit Fee $ Other Permit Fee $ 1 _ Sewer Connection Fee $ ."-Water Connection Fee $ ��,-.OTAL $ y Building Inspector ,4CJ+ e Div. Public Works s'E�Rat t No. 29 APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. /PAGE 1 rnAAP 4,40. LOT NO. 12 RECORD OF OWNERSHIP (DATE BOOK PAGE NE I SUB DIV. LOT NO. —I I LOCATION 0 PURPOSE qS.8 MWWMG f + OW ER'S NAME No nr STORIES OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME �`� � ,.,� I, SPAN -- DISTANCE TO NEAREST BUI.DING `x/i•'•o DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR •• GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION ,/O IS BUILDING ON SOLID OR FILLED LAND ILL BUILDING CONFORM TO REQUIREMENTS OF CODE 444f!e IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY 00, IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS I - 12 SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS P S MUST BE FILED AND APPROVED BY BUILDING INSPECTOR '000 G/�E FILED /161 !% BOARD OF HEALTH SIGNATURE(:rF-0WIq-EFi-0X AUTHORIZED A ENT FEE Da PERMIT GRANZ", OWNER TEL. y _C�6 PLANNING BOARD _ CONTR.TEL. CONTR.LIC.#moi yv R 5 9 BOARD OF SELECTMEN &6n," BUILDING INSPECTOR BUILDING RECORD 1 t a r 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE d t 2 13 CONCRETE BL K. PINE BRICK OR STONE P —_ —— PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ 114 1/1 '/, FIN. ATTIC AREA _ N_O B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES ASPHALT SIDING D ASBESTOS SIDING COMMCN _ VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRICK N MASONRY ATTIC STRS. 6 FLOOR I_ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLEHIP BATH 13 FIX.) _ GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE - •-•• FORCED HOT AIR FURN. r ; TIMBER BMS. 3 COLS. STEAM STEEL BMS. 6 COLS. HOT W'T'R OR VAPOR v WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd 11 NO HEATING COMMONWEALTH DEPARTMENT OF PUBLIC SAFET'e� OF 1010 COMMONWEALTH AVE., ` MASSACHUSETTS BOSTON,MA 02215 LICENSE EXPIRATION DATE CONSTR. SUPERVISOR 07/31/1994 EFFECTIVE DATE LIC-NO. . i RESTRICTIONS NONE007/31 /1992 040329 PCHARLES S MIERS = 6 FERN ST SS N 020-34-0992 mWINDHAM NH 03087 PHOTO(BLASTING OPR ONLY) FEEo;O.00 1 +i NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY �• HEIGHT: STAMPED-OR-SIGNATURE OF THE COMMISSIONER Q DOB: 12/03/1944 Cl ) THIS DOCUMENT MUST CARRIED ON THE PERSON CF v SIGNATURE OF LIC NSEE THE HOLDER WHEN EI•- / n / c-tinq OTHERS-RIGHT THUMB PRINT GAGED IN THIS OCCUPATIOtl. // r �`,2f�LC/J COMMISSIONF ' (c'i ✓�ie"Vamr�nonuie¢Gl�a�✓VLnJA�c��utedJ �\ HOME IMPROVEMENT CONTRACTOR Registration 111,613 a Type - PRIVATE CORPORATION Expiration 04/13/95 C J MIERS 3 SON INC C STEPHEN MIERc 21 WEST SHORE RD ADMINISTRATOR WINDHAM Nil 03081 NORTH o" 0 T f Andover 0 � n dower Mass. 1983 SpA COCHIC 11 > > DRAT E D P'? �� �-qs BOARD OF HEALTH Food/Kitchen PERMIT D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.................... . ..... ... ...... . ..... ... ..... ....... ................. Foundation has permission to.weet-. ie c•ao.. . .... .. .... ......... .. ugh • to be occupied as........ .... ... • imney provided that the person ceptin is permit all in every respect conform to the terms of the application on file in Final this office, and to the provisions o the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUC ON TS t ELECTRICAL INSPECTOR Rough s.......... 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 FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner PLANNING FINAL CONSERVATION FINAL Street No. C09M Smoke Det. CEMED /MATED FiNIAl ., � _ DRIVFWAY ENTRY PERMIT _._ BROOKS SCHOOL PURCHASE ORDER 1160 GREAT POND ROAD ALL SHIPMENTS,INVOICES 3 NORTH ANDOVER, MA 01845 AND CORRESPONDENCE MUST • O Oro TEL: (508) 686-6101 • FAX: (508) 685-4092 SHOW THIS NUMBER. DATED: 5/26/93 C. J. MIERS & SON, INC. BROOKS SCHOOL D ROAD .T O) SHIP NORTH ANDOVER,1160 GREAT MA 011845 21 WEST SHORE ROAD TO ATTN: F. MARINO WINDHAM, NH 03087 FOB SHIP VIA DELIVERY DATE DISCOUNT TERMS I ITEM NO. ARTICLES OR SERVICES • • AS PER YOUR LETTER DATED MAY 18 1993 WE ACCEPT youg RECOMMENDATIONS FOR LABOR AND MATERIALS FOR REAR ROOF OF HEADMASTER'S HOUSE WORK TO BE COMPLETED PRIOR TO JUNE 30 1993. I I MAILING OR DELIVERY CHARGES, IF APPLICABLE, MUST BE SHOWN SEPARATELY. LOCAL, STATE, • $6397.00 FEDERAL TAXES, IF APPLICABLE, MUST BE SHOWN SEPARATELY. SUBMIT SEPARATE INVOICE IN AUTHORIZED SIGNATURE TRIPLICATE FOR EACH PURCHASE ORDER. DO NOT DATE INVOICE PRIOR TO SHIPPING DATE. NO INVOICE WILL BE PROCESSED ON PARTIAL DELIVERIES.FULL PAYMENT WILL BE MADE AND DISCOUNT COMPUTED FROM DATE OF FINAL DELIVERY OR DATE OF RECEIPT,WHICHEVER IS LATER. FOR INTERNAL USE ONLY REQ > ACCT NO. NO. BROOKS SCHOOL PURCHASE ORDER 1160 GREAT POND ROAD ALL SHIPMENTS,INVOICES , NORTH ANDOVER, MA 01845 AND CORRESPONDENCE MUSTa 00351 ' TEL: (508) 686-6101 • FAX: (508) 685-4092 SHOW THIS NUMBER. DATED: 6/8/93 C. J. MIERS & SON, INC. BROOKS SCHOOL T1160 GREAT POD ROAD O SHIP NORTH ANDOV RN MA 011845 21 WEST SHORE ROAD TO WINDHAM, NH 03087 ATTN: FRANK MARINO ATTENTION: MR. C. STEPHEN MIERS FOB SHIP VIA --t--DELIVERY DATE DISCOUNT TERMS ITEM NO. ARTICLES O. 1. IN KEEPING WITH YOUR PROPOSAL DATED JUNE 1 1993 7 7 I WE ACCEPT YOUR PRICE OF 2561.50 TO FURNISH LABOR AND MATERIAL AS NOTED. WORK TO BE COMPLETED ON OR BEFORE JUNE 30 1993. I INN MAILING OR DELIVERY CHARGES, IF APPLICABLE, MUST BE SHOWN SEPARATELY. LOCAL, STATE, TOTAL il $2561.50 FEDERAL TAXES, IF APPLICABLE, MUST BE SHOWN SEPARATELY. SUBMIT SEPARATE INVOICE IN AUTHORIZED SIGNATURE TRIPLICATE FOR EACH PURCHASE ORDER. DO NOT DATE INVOICE PRIOR TO SHIPPING DATE. NO INVOICE WILL BE PROCESSED ON PARTIAL DELIVERIES.FULL PAYMENT WILL BE MADE AND DISCOUNT COMPUTED FROM DATE OF FINAL DELIVERY OR DATE OF RECEIPT,WHICHEVER IS LATER. FOR INTERNAL USE ONLY REQ > ACCT 15050310 NO. NO.