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HomeMy WebLinkAboutMiscellaneous - 1178 Salem Street 8s9 M s+ BUILDING BILE I _. .- �. /, I 4 �� i 02/14/20,01 13: 46 7813912909 BAF;CARGTTA F:;MILY PAGE 02 JAMES 0,. 'D Y P.E. : (978) 687"-6360 599 Canal Street Res: (678) 373-1395 Lawrence, MA 01640-1233 December 13, 2005 'own of North A adover Building b-L Toector 27 Charles Street North Andovm MA 01845 Re: 1178 Salem Street -North Andover, MA Dear Building Inspector, At your request I inspoc ted fie Earning of the newly raised ceiling(first floor living room) and found that it has been installed according to plan. Should you have any questions please call me. Very truly yours, James A. O'lDay P.E. CP4L ria,227�3 wAL i I 1187 SALEM STREET 210/106.q_0043-0000.0 Zoning Bylaw Denial Town Of North Andover Building Department 400 Osgood St. North Andover, MA. 01845 '`sem'`` Phone 87848844 Fax 878.6884542 Street: /� a Ma Lot: O9 Applicant s Request G �% 4* L2-/Q,6 cation is Please be advised that after review of your Application and Plans that your Application DENIED for the following Zoning Bylaw masons: Zoning -/ Notes Item Notes Item A Lot Area F Frontage 1 Lot area Insufficient 1 Fronts a Insufficient 2 Lot Area Preexisting 2 1 tront8Q8 Com ies 3 Lot Area Complies 3 1 Preexisting frontage 4 Insufficient Information 4 Insufficient Information B Use 5 No access over Frontage Building 1 Allowed G Contiguous Bu g Area 2 Not Allowed 1 Insufficient Area 3 4 Use Preexists 2 Com ies S 'al Permit Required 3 Preexists CBA 5 Insufficient Information 4 Insufficient Inforrnation C Setback H Building Height 1 All setbacks comply1 Height Exceeds Maximum 2 Front Insufficient 2_ Complies 3 Left Side Insufficient 3 Preexists M He' 4 Right Side Insufficient 4 Insufficient Information 5 Rear Insufficient i Building Coverage 6 Preexists setback(s) 1 Coverage exceeds maximum 7 Insufficient Information 2 Coverage Complies D watershed 3 Coverage Preexisting 1 Not in Watershed 4 Insufficient Information 2 In Watershed J Sign 3 Lot prior to 10/24/94 1 Sign not allowed 4 Zone to be Determined 2 Sign Complies 5 Insufficient Information 3 Insufficient Information E Historic District K Parking 1 In District review required 1 More Parking Required 2 Not in district 2 Parking Complies 3 Insufficient Information 3 1 Insufficient Information 4 1 Pre-existing Parking I Remedy for the above is checked below. Item * Special Permits Planning Board Item 0 Variance Site Plan Review Special Permit Setback Variance Access other than Frontage Special Permit Parking Variance Frontage Exception Lot Special Permit Lot Area Variance Common Driveway Special Permit Height Variance Congregate Homing Special Permit Variance for.Sign Continuing Care Retirement Special Permit Special Permits Zoning Board Ind dent Elderly Housing Special Permit Specisi Permit Non-CorrIbIrming Use ZBA Large Estate Condo Special Permit Earth Removal Special Permit ZBA Planned Deyelcpmerrt District Special Permit Special Permit Use not Listed but Similar Planned Residential Special Permit Special Permit R-6 Derwitv Special Permit Special Permit prewdsting non nformin Watershed Special Permit The above review erld atiactsd eoWlermtim of much Is based an the plans and infarrrarUon sub Mad. No definitive review and or advice shall be bead on verbal sxplandiors by the applicant nor aw such verbal mplanabons by the Vom t serve to provide dafini n www m to the adore reasons for DENIAL. Any irwwwwies,mitis &V bft,. ft,orother aubsequo t changes to the Morn om au ruled by the appticart shay be grounds for ON review to be voided at tts dismat m of the BLAding Depwbnu*The alhched doaoo t tibd'MM Raiaw Narratira WM be attached*- , and incorporated herein by re(sreras. The buildup department vA retain all plans and.docrmertafion for the above Ilk.You nnst file a mw building pan*appicaum form and be&Us perRMtirrg psoas. 111,21,96 O uilding Departm t official Signature AppReceived Application Denied r%aninl i.`—+• If r....wd MI.—AI..e.nHavTafa• Plan Review Narrative The following nanative is provided to further explain the reasons for denial for the application/ permit for the property indicated on the reverse side: B- 41 f/tE o %W OG/` 0 G dd�l t'/ .S'v ¢ • �`o u./ � �OC�� �iV6f 6v�� Referred To: Fire Health Police Zoning Board Conservation Departmwd of Public Works Planning Historical Commission Other BUILDING DEPT 4;iLocation1427 � (-et1 No. � Date s 011 NORTH TOWN OF NORTH ANDOVER .' so a + ; , Certificate of Occupancy . $ Building/Frame Permit Fee $ -' Foundation Permit Fee $ r, Other Permit Fee $ TOTAL $ 41 Check # 18781 �'Jd Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT EM RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: 3 DATE ISSUED. 05, SIGNATURE: — Building Commissioner/I r f Buildings Date SECTION 1-SITE INFORMATION O1.1 Property Address: 1.2 Assessors Map and Parcel Number: ik Sd(" St r � Map umber Parcel Number � 1V . �ltv�OJer Rgf'i 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area Fronts ft 1.6 BUILDING SETBACKS fl Front Yard Side Yard Rear Yard R red Provide Rjogfired Provided Re gwred Provided 1.7 Water Supply AGI-C.40. 54) 1.3. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private 0 Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSIIIP/AUTHORIZED AGENT Historic District: Yes No 2.1 Owner of Record woo a r-ty lu a bs4c, ! !9.7 -(;otem S N, A ver• Name(Print) Address for Service- Si re Telephone , 2.2 Owner of Record: - - Name Print Address for Service: rn Signature Telephone i SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable�( I'k�Ml2own.er t�LG2�C� rvl�tv✓� - � i� � ' ,. Licensed Construction Supervisor: License Number Address N f� ty!A Expiration Date ic Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable Company Name 1,jf ZLA- f 4 N/ M Registration Number (VIA rm Address r— / Z N/A Expiration Date G) Signature Telephone V i r s Y 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.......❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) 0' .- Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other g Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be Q COAL(JS1C ONLY Completed by permit applicant VV ,z 1. Building (a) Building Permit Fee T+1 Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(e)X(b) 4 Mechanical (HVAC) 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property A Hereby authorize .1k- to act on My alf,in all matters relative to work authorized by this building permit application. q0 it— � � Si e oftwner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, AAQ� Sw ,as Owner/Authorized Agent of subject +d property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge .r and belief 4Aa_ V �� Print N ^. I IV 5hoS Si ature o O er/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB RD SIZE OF FLOOR TINIBERS 1 2 3 SPAN DIMENSIONS OF SILLS DRAENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CH VMY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE TOWN OF NORTH ANDOVER N OFFICE OF BUILDING DEPARTMENT 400 Osgood Street ooyQ, North Andover, Massachusetts 01845 .y �S5.4C'rrU Gerald A.Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: JOB LOCATION: 11,97 S00em St- 6. A /u Number Street Address Map/Lot HOMEOWNER i-Actrry (.1 e} 6*-cr 9-7�3 314 S20k 97? 640 50&,k Name Home Phone Work Phone PRESENT MAILING ADDRESS 14-7 -7 Sic l e rn S}' NJ I Aver jA-1A Q f$ 5 City Town State Zip Code The current exemption for"homeowners'-was extended to include owner-occupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned"homeowner"assumes responsibility for compliances with the State Building Code and other Applicable codes,by-laws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Form Homeowners Exemption Schedule of Proposed Interior Work Location: 1187 Salem St, North Andover MA 01845 Homeowner: Harry webster(978) 314-8208 Job Description: Interior Rehabilitation to repair damges due to interior fire/smoke damage(No structural work) Trade Estimated Price Demo 1,200.00 Electrical 1,200.00 Sheetrock 5,000.00 Paint 2,000.00 Cabinets 10,000.00 Door&Window Finish Trim 2,000.00 Install New Florring 15,000.00 Windows/Slider 4,100.00 Insulation 3,000.00 .., .. stunt Tataa��3 .. 3000 The Commonwealth of�Vassachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant information Please Print Legibly Marne (Business/Urganiration/In(lividual): - j,rr-t/ tK)tb9+er- Address: (U-7 Sakk--s S4- City/State/Zip: N . &a GLQver- _ MA Phone #: ct-7& 31� tf 20� Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. El am a general contractor and 1 * have hired the sub-contractors 6. ❑ New construction employees full and/or part-time).* 2.❑ 1 am a sole proprietor or partner- Iisted on the attached sheet. * E] Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its officers have exercised their 10.0 Electrical repairs or additions required.] of 391 am a homeowner doing all work right of exemption per MGL I I.❑ 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' 13,] Other%-1 rte r ReJW, comp, insurance required.] *Any applicant that checks box#I must also till out the section below showing their workers'compensation policy information. r 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 rim an employer that is providing workers'compensation insurance fir my employees. Below is the policy and job site information. Insurance Company Name: Policy 4 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 tine 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 under the pains and penalties of perjury that the information provided above is true and correct. . 4ianatur Date: I t-t s-D 5 phone-'t: - — - — -- -- — - t)ljicial use only. Do not write in this arca,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): A. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6.Other Contact Person: Phone#: 1 I � � 5�1� ���� � y �t c�y�s2 p 5 �er— U r T To see if the Town will vote to amend Section 8.5.6.G of the Town of North Andover Zoning Bylaw so as to state the following: G. Calculation ofAllowable Residential Except as noted in Subsection H below,the maximum number of buildable lots and/or dwelling units in a PRD will be equal to the number of buildable lots and/or dwelling units which would result from an approved conventional subdivision plan. In order to determine the residential density of a PRD,the applicant must submit to the Planning Board a plan which: 1. meets the criteria of a Preliminary Subdivision Plan as defined in Section IV of the"Rules and Regulations Governing the Subdivision of Land" in effect at the time of plan submittal; 2. is fully compliant with the"Zoning Bylaw" in effect at the time of plan submittal; and 3. requires no zoning variances. The Planning Board will use this plan to determine the maximum number of buildable lots and/or dwelling units allowed in a PRD. N®RT H TO" of : 4 _ Andover O � w T No. y I �s oS — C% _-+ A dover, Mass., •. • COCKICMEWICK y1. RATED Is BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....0.a.r.r... ...... S Cr.................. ................................................................... Foundation has permission to erect...lre .. %.. ............... bui ings on. .l.r r....af�.1A�. ... ' .......�.I ....��fj.Ie M� Rough ........ to be occupied as.....�.'�.. .ol�......... ..�.r!'/..... .Q.��.. .�............................ Chimney provided that the person ccepting this permit shall in every rd�eGt conform to the terms of the application on file in Final this office, and to the provisions of the. Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI TART Rough ....................................... Service BUILDING INSPECTOR Final Occupancy Permit required t® Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Location 11537 4rr� No. 3 Date gORTIy TOWN OF NORTH ANDOVER Of . o y�ti a41 9 ' Certificate of Occupancy $ �ssACMust< Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 15186 Building Inspector i TO OF NORTHANDOVIERpw 4 ► BUILDING DEPARTMENT T `( \PPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING IT 3U LDING PERMIT NUMBER, DATE ISSUED: A-1 ONCE ` SIGNATURE: Building Commissioner/inspector of Buildings Date ECTION 1-SITE INFORMATION C 1.1 Property Address: 1.2 Assessors Map and Parcel Number: p 72 { Map Number Parcel Number 4 t,V /Jd✓�1.� !� A; 1 4. Property Drmetrsiohs: 1.3 Zoning lnfmmation: Cr' tonin District.. . Ilse Lot Area;s ^" 1:ronta e"(ft); L6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Povide R *reel Provided R red Provided t \.J A Mood Zone Informahor, 1.8 Sewcraga Disposal System r1.7 water Supply M.G.LC.40 34 k•a, Zone Outside Flood Zone 0 Municipal 11. On Site Disposal System F1' �?ublic ❑ Private 0 .:SECTION 2-PROPERTY°OVVNERShIIP/ YT ORIZED AGENT 2 1 Owner of Record) / zA E Name(Print) ` Address for Service: :Signature Telephone 2.2 Owner of Record: 0 Name Print Address for Service: �q Signare Tele phone .SECT ON 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable 0 Licensed Construction Supervisor: License Number Address Expiration Date Signature Telephone 3. Registered Home Improvement Contractor Not Applicable 0 '� '� yLr 2 Company Name Registration Number 55: l/g p(�2� grtiC--2 /yl.t Address 5 4- 1 z 22 2 (� t L 0_ [�Z�. 2 Expiration Date Signature _ Telephone SECTION 4-WORI{ERS COMPENSATION XG.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and s., nutted with this application. Failure'tb provide this affidavit will result in the denial of the issuance of the build permit. Signed affidavit Attached Yes....... No.. ...(J_. SECTION 5 Desch tion of Pro""osed Work"(chEkA a ycable New Construction 0 Existing Building Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. 0- Demolition' 0Other 0 Specify Brief Description.of Proposed Work: t J CVA AIG SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to € ' I Com leted:bpermit a li'cant g (a) Building Pemut Fee I NIi[ltr her, : . ! 2 Electrical (b) E'stimated`Total Cost of fConstruction &t.)G�. i 3 Plumbing Building Permiffee(a).x(b) 4 Mechanical HVAC 5 Fire Protection 6 Total._; 1+2+3+4+$ Check Nirfrber' SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WIZEN OWNERS AGENT OR CONTRACTOR AP IES FOR BUILDING PERMIT �l t as Owner/Authorized Agent of subject property Hereby authorize �. V�`- Fe- \ rte } .r» ,_ ''3. to`act on. t _' My behalf,in all matters relative to work authorized by this buil mg permit applicaiion Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject / property Hereby declare that the statements and information on the foregoing application are true.and,,:accurate.,to the best of my knowledge and belief M Print Name Si nature of Owner/Agent Date NO. OF STORIES p SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS I ST 2 3 - K,GHTOFFOUNDATION IONS OF SILLS ONS OF POSTS ONS OF OIRDERS OF FOUNDATION THICKNESS OOTING x L OF CHIIvfNEY ING ON SOLID OR FILLED LAND ING CONNECTED TO NATURAL GAS LINE b I : �odc -- g tii s��d Wiwi 3 , `;hOME!AaRG'% Nfe1'T CONTRACTR" d " 4m. y h Yh _t v EDQIE VIE"L'S CARP-_ENTRY EDWARD VIE L JR.' 55A'PORTLAND ST. ' LAWRENG ,MA 01843 GG .. �.✓ Adminisiratior i 4 j ��'�� � y 4 (f #t * card of u�ld�ng"fgalahons,and F taridaras� f31 T M ;ulnar CP'T CON�KAUTOR w, RegistwaficE+�13 X26 r x< o11/2�2s)42 .j EDDIE VIEUS CARP NTR�f aERVI 9 EDWARD VIE, JR i 55A PORTLAND LAWRENCE,MA 01843 `{ Administrator I , North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number "3n3 is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Location of Facility) n S77-77 ignature of Permit Applicant 11Z3o C? Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector GENERAL CONTRACTING SERVICES 55A Portland Street Lawrence, MA 01 843 1-978-423-7105 CONTRACT This Agreement is made between Harry Webster of 1187 Salem Street in the town of North Andover MA. And General Contracting Services this the 19th day of November in the year 2001_ (Description) New kitchen cabinets New bathroom Job Total: $ 26,000.00 Deposit: $ 13,000.00 Payment: as needed Balance based on allowances used Note: Any changes due to allowance overages will follow with a change order and a full price. Where as an adjustment to the account will increase by the difference. All jobs accepted by General Contracting Services are subject, however, to strikes, accidents, or details occasioned beyond the control of General Contracting Services. All sketches furnished by General Contracting Services shall remain the property of General Contracting Services and no use of same shall be made,nor any idea obtained therefrom be used, except upon compensation to be determined by General Contracting Services. By signing the acceptance the customer(or his/her representative) agrees to all terms and conditions as outlined, and binds hinAerself to accept the contract in its entirety. The customer also promises to pay any and all attorneys fees and/or cost(s) associated with the collection of the amount stated herein this contract. All materials are guaranteed to be as specified. All work to be completed in a workman like manner according to standard practices. Any alteration or deviation from specifications involving extra cost will be executed only upon written change orders, and will become an extra charge over and above the original contract price. The terms of the contract are not to be varied, except in writing, signed by a duly authorized officer or agent of General Contracting Services. This contract covers all of the agreements between the two parties hereto, and is governed by the uniform Commercial Code and other applicable state laws. Any request for a delay of said delivery of goods, merchandise, and site labor by the customer which exceeds a ten(10) day period shall cause customer to be liable to General Contracting Services for any damages caused by such delay, including but not limited to, storage charges on goods or merchandise, and General Contracting Services shall have the option to invoice customer and receive payment within ten(10)days. General Contracting Services guarantees its products for a period of one(1)year from the date of delivery against defects in workmanship or materials. General Contracting Services cannot be held responsible for damage to work after delivery to the delivery site. In any event, General Contracting Services' liability is limited to the repair or replacement at the option of General Contracting Services of such work that is defective in either workmanship or material. General Contracting Services I3Y Date: Al Edward E. Viel, Jr. Customer arry Webster //v IV&4- EY= - Date: 11112 --.- 4 172 83314 4 98 31 578 —.1-49518 46112 6172 --------------- I I I II I I 1 I II I I I 1 N vmm C_BT 831 I � 3�971ry11/�3ti2 620 m 4 1336 I I mm DBJ 0rn U 112 612 T —0rn —�iIII I�II imCn' M a I 672 B24 I ry a vj BTj 0 to — � va 36 EH 8-- 0 F 72 } 40 121114 Floor Ian HARRY WEBSTER WEBSTER Room 1 Nov 30, 2001 - Doe EEO' I a. an Perspective HARRY WEBSTER WEBSTER Room 1 Nov 30, 2001 NATIONAL GRANGE MUTUAL INSURED` INSURANCE COMPANY 55 West Street, Keene,NH 03431 Te tepho ne:1-888-646-7736 CONTRACTORS POLICY DECLARAT Named Insured and Mailing Address EDWARD 'E VIEL DBA Policy Number: 14PI66885 GENERAL CONTRACTING SERVICES Account Number: CAC I66885 55 A PORTLAND ST LAWRENCE, MA 01843 Agent: CHAS F HARTSHORNS & SON INC Producer Code: 200167 AGENT PHONE : 781 245 4300 POLICYHOLDER INFORMATION Named Insureds Business: CARPENTRY INTERIOR Entity: INDIVIDUAL Policy Term: 12 Effective: 09/20/01 (12:01 A.M. Standard Time at the address Expiration: 09/20/02 of the Named Insured stated above) In return for the payment of the premium and subject to all the terms of this policy, we agree with you to provide the insurance as stated in this policy. See the attached schedules for Description of Premises, Property Coverage, Optional Coverages, Forms and Endorsements applying to this policy and Mortgagee Schedule if applicable. BUSINES'SOWNERS LIABILITY COVERAGE LIMITS OF INSURANCE Liability & Medical Expenses - each occurrence S 300 ,000 Personal and Advertising Injury Limit S 300 , 000 Products-Completed Operations Aggregate Limit S 600 ,000 General Aggregate Limit S 600 ,000 Fire Legal Liability - any one fire or explosion S 500 ,000 Medical Expense Limit - per person S 10, 000 Business Liability and Medical Expense: Except for Fire Legal Liability, each paid claim for the above cover- ages reduces the amount of insurance we provide during the applicable annual period. Please refer to section D.4. of the Businessowners Liability Coverage Form. For.policies subject to premium audit: Annual Audit Applies. Estimated Annual Premium: S 539 TOTAL PREMIUM AND CHARGES $ 539 GaAs.f,NpR1$lt=15 SON,INC.AGsITS Countersigned: �� 64-5470(9100) 10/15/01 NEW BUSINESS LH °� V4ORTF1 C> E> e)dj Town of over 0 o� CoCH.� \11 dower, Mass., "Ac �. ADRATED PP? C2 'R D . S H � BOARD OF HEALTH PE MIT T Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT7a.!&+14.h..Nt�R,J.t3�,e ., 'QQ� ..lt*� Lra CI Qa- . ...sqm. A-�& Foundation has. permission 5.11W.................... on ..L.1.S.7.....SA14^4.....%'.VC-MOT 7....................... . Rough to be occupied Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. ., -- �,o lamv. L.�-3&Awr PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final. UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR Rough Service BUILDING INSPECTOR Final Occupancy. Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner — Street No. 4 SEE REVERSE SIDE Smoke Det. ..rr UU0=VA Vrr A&ALaWjUI I Pemdt Na �' BAAIfD OF FIREPRE'VF1 7nV RitX,71fA77aYS527 CMR izo Clceupattcy R Fees Checked �- APPUCA77ONFOR PERMFrTO PERFORM ELECTRICAL WORK _ t ALL WORK TO BE PERFORMED IN ACCORDANCE WTrH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Data Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perforin the electrical work described below. Location(Street 3 Number) Owner or Tenant 14 q r r"I Owner's Address Is this permit in conjunction with a building permit: Yes[a'No [:3 (Check Appropriate Boa) purpose of Building s ;+el/o-Yi l Utility Authorization No. Existing Service Amps�.V olts Overhead Underground No.of Meters ,ye"tt S Amps / ots Overhead Underground �� VlNo.of Meter Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Na of I3andna Oadw Na of Hot Tuba No.of Trsostbeuers Total Na of Lfahiin{Plasms Swiromina Pool Above Bei er KVA rl KVA No.of Recepucie Outbts No.of On Burners No.of Emaaeoey Liandna Bmwy Unity No.of switch Oak" No.of OU Bunters Na of Ranam Nm of Air Cad. Total FIRE ALARMS No.of Zama Tom No.of Disposde Na of Hat Tool ToW Na of PuTon Kw Dever No.of Dishwuhms Space Arm Hanna KW Na of Souudtna Devices Na of Saw Congbted No.of Dryers Heathy DevicesKw LDel aJ3oombs Davlcn No.of Water Hestan Kw Na of Na of Conmcdo w a signs Boil" No.Hydro Mausae Tuba Na of Motors Total HP 1 OTHER, s � tatar�Cbtes¢P+ra�aotb�e�iembafMes:fia�Galmlla� _ lhaneacwQtLieti(YJu== YBCmI ar1hwzkm&dv&Vwdof=eqdzOft YM ilssttbstayial iIrywi necfiolmdYB4,pbwiKkaltetWcifw%wpby d�nddrig W5URANM v "D 13 t7I1'a ED tPI�SSpedf� P�tpatloOlaib t F`neledValsafDectical Walt S WadclDSM ja7eyionlaneRec}rsteid Ra* 'c End S�gtedunder Ptrstlibof FiRMNAI� � L. •7 rY�G' F^ (� /L l I�aQia:Na i '7 r r Stgnoue �- ` &akl TeLNn AkTel,Na OWI�R'S IIVAJRAI�WALVQt;Ianawaiedetihel�Itel IheiramnCtxna�ear�a>lssesielegiivsbYffimcfsedt�'N�herlbC,enaalLa�is irdthetrr>yi�>�iernlhbpmrttappicsdrnytsi�eatbiatequiemat Please check one) Owner Ageet Telephone No. per ,FEB 1 6237 f —' Date t NORT" TOWN OF NORTH ANDOVER p PERMIT FOR WIRING. This certifies that C .........G."........................ �.....�"L... has permission to perform ..... �-! K y Gvf3s 3 wiringint/he building of�..^...............................................�............................. at....... .(..�� ........�-?.... .C. �......S� ,North Andover,Mass. 369 --� r Fee..................... Lic.No.............. .................... ................ ..... ELEI ZALINSPECTOR Check # f � DEFA1l7IIIDY1'OFPEMW AFETY pemdt No. �0 2 3 7 BOARDOFF=PRE'VF1V1110dVRlx[JlA11g11tSM70R,aa �p�R Fees CAecked �•�•� A.PPUCA77ONFOR PFRMITTSO PERFORMET- CI ICAL WORK All.WORK TO eE PERFORMED IN ACCORDANCE WrM THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRDa IN INK OR TYPE ALL INFORMATION) Date i'e?-©u Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street 3 Number) Owner cc Tenant I T r-!:^4 Owner's Address Ls this permit in conjunction with a building permit: Yea No (Check Appropriate Boa) Purpose of Building >���t t�O tii'f l l Utility Authorization No. Existing Service Ampa ...L.VVolts Overhead Underground C3 No.of Meters New Service Amps. Volta Overhead Underground C3 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No.of Ughdng Oudw No.of Hot Tubs No.of Tnasibrmas Total No.of Ugbdnl Milan Swbnm ttg Pool' Above Bebw KVA �� KVA and No.of Receptacle OutIW No.of 00 Butner No.of Finageocp Ughting Battery Udti No.of Switch Outisu No.of Oo Batumt No.of Ranges No.of Air Cond. Tota FIRE ALARMS No of Zbees TOM No.of Disposals No.of Heat TotalToW No.of Deactian and Pone@ Tom KW No.of Dishwashen Space AHeather KW Na.�Devices Arm Daviega Na of Saf Contained ! KW No.of Dryer Heatieg DovtcDaytonDemctia wsom fts Devices � oMunicipal oOthar No.of Waxer Hasten KW No.of No.of Connections sign Bailasb No.Hydro Massage Tubs No.of Moux Tota HP A OTHER* hum=Cbrathge PumMbderec}shmftdMWmdu G0IzWL" ]hWanaertlidith4arc pCftididr;Cbr#--0 orerakdo apivtift y� NO Ihtaesutrri�dvaidpho --oNeO�Yl� lryiuhmechaJWYKpts=idcaledregPeofwm�by ctheddr>Rdhe bagcL NSIALANCE BCND 1:3 ama o ow** EftnddVa!> dBwti Whk S WbtkIDStXt -DWRe jftd Ro* liar FINNAM Fla If- C L timwNa 17 ti &IiInTdNn ALTdNa C11it+NFlt'SIIVSCJItAMEWANFR;Ianwraedhatdrticaiscdeiramtneoo�e�orhs�hrmrriiec}ivnlntara+quiedbyN��Cah�llButa artddhetrr>ysigih�seondispertn"tappiallamvi�iteslhyrequihsnest (Please check one) Owner Agent 31snalum oz Owner or XgUE Telephone No, pER r FEE s Date. f NORTpy, x�;.- TOWNd NORTH ANDOVER .- "PERMIT FOR PLUMBING ,SSACHUSE� This certifies that . . .�. f .7. . fT'. . . . . . . . . . has permission to perform . . . . U, r'? ! 4,? . . . . . . . . . . . plumbing in the buildings of . . .. . . . . . . . . . . . . . . . . at . . �. l. . . S' . .. .. . . .. . . . . . . . . . . . .. North Andover, Mass. Fee t' . . . .Lic. No Gq�� L . . . . . . .� ��..���- �,_. . . . . /PLUMBING INSPECTOR Check # GG V 6681 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date Building Location //F7 S'-/- Owners Name Cvt•�f�5/ Permit# Amountj ' Type of Occupancy idt.�-' New 0 Renovation 0 Replacement Ell Plans Submitted Yes No ❑ FIXTURES Sri ce r- rl I SiB>H�1C &14NII�il' 1SIC RIOQt �G 3�I1 RIOQt 4M EUM SIH RIO(R } 6IH Fl" 71H11" SIIi RLOLR (Print or type) t Check one: Certificate Installing Company Name' (/lvYt C /�/rit`Y r s�I��"i�y ❑ Corp. Address l 3 � t�'t 5/- /vim r�' � �� El Partner. vtillq- of � � Business Telephone —&FS 7 — G (t Firm/Co. Name of Licensed Plumber. Insurance Coverase: Indicate the pe of insurance coverage by checking the appropriate box: Liability insurance policy 13 Other type of indemnity ® Bond Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance signature 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 Massachusett State lumb' C=denapter 142 of the General Laws. z BY igna o is s Type of Plumbing License Title 1�o S yid City/Townc m Master Journeyman APPROVED(OFFICE USE ONLY • Q� 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*********************** APPLICANTPHONE__ LOCATION: Assessor's Map Number , 166A PARCEL SUBDIVISION LOT (S) STREET 1.l Y7Sctl" 1• ST. NUMBER cSl �*****************************OFFICIAL USE RECO NDATIONS OF TO GENTS: CONSERVATION ADMINISTRATO DATE APPROVED 1 DATE REJECTED COMMENTS TTrogosJ S" -W I be- l ocAel 7 .So l A-u-) Crp,1�7 TOWN PLANNER DATE APPROVED , DATE REJECTED COMMENTS FOOD I SP TOR-HEALTH DATE APPROVED DATE REJECTED . / P C NSPECT -HEALTH DATE APPROVED DATE REJECTED-_---!Y/- COMMENTS EJECTED !Y/-COMMENTS PUBLIC WORKS -SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised M7jm TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT WAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING . . . . r BUILDING PERMIT NUMBER: DATE ISSUED: i SIGNATURE: Building Commissioner/12gwor of Buildings Date SECTION 1-SITE INFORMATION A 1.1 Property Address: 1.2 Assessors Map and Parcel Number: C Oo� od� Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area 'Frontage(ft) 1.6 BUILDING SETBACKS ft �,I . ti Front Yard Side Yard Rear Yard Required Provide ReqWred Provided RegWred Provided 1.3. Flood Zone Information: C 1.7 Water Supply M.G.L.C.40. 34) 1.8 Sewerage Disposal System: Public Private ❑ zow Outside Flood Zone ❑ municipal ❑ On Site Disposal System WIN SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT -' L !'� E s _ n 2.1 Owner of Record NA-7 S�lLw Name(Print) Address for Service RR 7 kC S Signature Telephone 2.2 Owner of Record: Name Print Address for Service: lal Signature Telhone SECTION 3-CONSTRUCTION SERVICES P 3.1 Licensed Construction Supervisor: Not Applicable �. Licensed Construction Supervisor: C License Number Address Signature Telephone Expiration Date r 3.2 Registered Home Improvement Contractor Not Applicable 0 v Company Name Registration Number M Address r Expiration Date Z Signature Telephone SECTION 4-WORKERS COMPENSATION(N.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 it. Si ned affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work check all a cable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ A ❑ ddition Accessory Bldg. Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a) x(b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in 11 matters relative to work authorized by this building permit application. St tune of r Date �— SIECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief r Print Name Si ature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB RD SIZE OF FLOOR TIMBERS 1 2 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CH VINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE TOWN OF NORTH ANDOVER AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c. 142 A requires that the"reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units...or to structures which are adjacent to such residence or building" be done by registered contractors, with certain exception, along with other requirements. Type of Work: S-fa Est. Cost�� Address of Work !!R7 SU betm Owner Name: ��►r1 �' Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): For office Use Only Work excluded by law Pemit No. Job under $1,000 Date Building not owner-occupied Owner pulling own permit Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FIND LINER MGL c. 142A. Signed under penalties of perjury: I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property: Date wn Name I - r� � � �.. � ° � r , _'�. �'� '"is • 'g C ~�� LS�'t'FJ L� L 1F Afo FT. 27 �AVAL4ARY 1%9 CPo o rz G rye N. � s .a rV,",R lb I/oma 0 7c� 0 w c't# � � 5�ln tr 3.) y �r' s p � .7 ��� t; ��f'gs �S T�t, 3�: A ' � _ € 1�1 �t' �k o VA tjKVL Ov, :7� i) Ilhi •.SIL Suanlvl ;l ,�l �� oo� 0 .c9 ' � .•., ���',.?} s,. �'�' � �f�9����!� ��� �...� �E� � �,, f � yam\ �'� `� <y� 31 ; o r 41 oo� Ppj C ` 'O o, , 3' S�.$►k 64I W k- i to-w S�°QS'�4"K ala°191Oy1( r- '4 ®' . .-r•e.:-c �. .>. •n.�.; s.. iC�.f C.1 it ►K{ 300• 00 Ln `F - .� h� cAVi � '!, 1' r' ' n+.[ ..,,,,, _ .... c x�t'...�,...e.es.<�c+c'•e-c„a>..a.sx++-v+c�:r:ac.+.r.+`me_r_,-.c:r.-.s.-.cri+. C",o+"y=«Csr...-.ti..•z.a�ise►'h,L.e�.,e..:.-=r�":•e:�t-'+:�'f.�s�^c.�r.+�*.,..�.rer--••, i FO . MCR LY 2 IM T�• ��. l N �.: 1_ i\ N [:� �' Q w E C o. E 5 E MEN T V1 !ti Ci F. NC,klNL, Of:)S \Al IDE , Q L�� �� 5!�._acs*-- /S fl'r�d a 5 IYGYV IYIN fVnV LG IIV V. - VY.GJ f NEW DIST. BOX INLET = 93.90 NEW DIST. BOX OUTLET = 95. 73 -' PI`S'*1 INLET INV. = 93.68 # 'J PIT 2 INLET INV. =93.63 BOTTOM OF STONE ELEV. N UNDER PITS = 90.5 5 r Z ON y G�m A c cp �o c x Ox <L y \GJ / ro o p u m ` oJENS Q \\ O \\ \\9 U \ RWITH13E2 LEACH PITS Ba5' 500 GAL. JP\� 2 ENS SHALLOW FITS WITH 24" \ \ 2 .9� OF 3/4"TO 1 V2"AROUND \ � AND 12"OF STONE BENEATH \ .i \ 96 K TKO 2\ p,2 DESIGN CRITERIA— BASE6 UPON A 10 MIN PERC RAT 2 BOTTOM AREA= 191x 1211x 0.55 GAL/SO.FT. =125 GAL. 9 SIDEWALL AREA=(381+241)x 3.08 (HEIGHT) N x 1.0 GAL./SQ. FT. = 191 GAL. co _ TiTOTAL 16 GAL. 316 GAL/DAY x 2 SEPARATE PI i S = 632 GAL/DAY Y SPECIFICATIONS I' I. ALL CONSTRUCTION TO BE IN ACCORDANCE WITH TITLE 5 OF THE STATE SANITARY CODE 2•. USE EXISTING DISTRIBUTION BOX AS A :MANHOLE. PLUG 2 OUTLET PIPES AND USE ONE OUTLET PIPE.TO VENT EXISTING SYSTEM CONSTRUCT MANHOLE TO GRADE. 3. UTILIZE FOURTH OUTLET PIPE TO CONNECT.TO NEW LEACHING PITS. MAINTAIN A GRADE OF 0.006 TO NEW MANHOLE AND NEW DISTRIBUTION 60X. 4. PROVIDE BELL TYPE VENT FOR EACH LEACHING PIT. THIS LOT IS NOT LOCATED IN THE F E.M.A. FLOOD PLAIN. NO WETLAND WITHIN 100 FFFT nF PRnPnCFn CVQTPfkA 3 `� 7 Date.... �`.4A.... N a NORTH 1 TOWN OF NORTH ANDOVER PERMIT FOR WIRING S�CMUSf This certifies that .. .... ' ................... has permission to perform �l `Z��`' / Oiring in-the building of ` /". f ./i ....................... ................................................. f ! ,North Andover,Mass/ t...... ......`..�..1....... �..............� .... .... Lic.No.1.:..: Z1........ <ELECTRICAL INSPECTOR Check # Lff �� WHITE: Applicant CANARY: Building Dept. PINK:Treasurer THE COMMONWF9LTHOFMMSSACHUSEM Office Use only DEPARTt1MNT0FPUXJCS4[1= Permit No. BOARD OFFMPREVENHONRF.GULAHONS527C ]200 Occupancy&Fees Checked APPLICATIONFOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) DateC J� l Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes No a (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead O Underground No.of Meters New Service Amps / Volts Overhead ® Underground No.of Meters --� jNumber of Feeders and Ampacity Locatiffn and Nature of Proposed Electrical Work 6 —'�rQa/ -/ z'16ZI104 No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total ' KVA No.of Lighting Fixtures Swimming Pool Above 0 Below Generators KVA round ground No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners 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 Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices ! No.of Self Contained Detection/Sounding Devices No.ofd Dryers Heating Devices KW Local Municipal Other Connections No.of Water Heaters KW No.of No.of _ Signs Bailasis No.fIydro Massage Tubs No.of Motors Total HP OTHER• blsuranwCowraW_R=Ianttotheregtmerf x8ofNb%wln>setlsGer)ealiaws lhawaa>uemI-iabtkhia==PbhcyiwkdTComplele Covw,�poritssubsLY1alecpvalffrt. YES NO Ibawwbrruat dvandpfoofofsametDdrOlfim YESF)mhavedrd�dYES,pkw--tld�the typeofoovaageby dwIdng the. a�box u INSURANCE BOND OrIIIFR (P9 mSpectfy) ExpirationDale. EMm&d Valwofflec"Wolk$ WotktoStatt Irq)ecimD&Requested Rough Final signed under ePi2nalliesofpajtny FIRMNAME r i !/��/a IiceliseNo. Licensee 4�L Bose No3L Bu4iessTd.Nol017bJ/_1=G1/-0'/ AItTeLNo. 6eb-17 OWNER'S INSURANCEWANERIamawarethatthel-mmdoesnothavetheinstuatxeoovaageoritsab9an>ialegwvalentasragt iedbyNb%achusemGeneral Lam and lhatmysignawreonthispenrutapphcalionwaivesthisrequitUTUI \ (Please check one) Owner ED Agent d Telephone No. PERMIT FEE$ Ly (/ tgna ure ot Uwner or Agerit N° 3550 Date.................................. ;� Cf NORTH TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ,SSACMUS� t r` This certifies that .: � .....-�..- �"���J has permission to perform ::. .......................................... wiring in the building of.., ............................................ ................:...:..................... ............................. ,North Andover,Mass. � Fee ....-........ Lic.No.............. .........r �......:�:......�......S. �.................. ��—ELECTRICAL INSPECTOR Check # G WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Official Use Only i ;e /�/tZ7/y� Permit No. �CSz5y- y . Occupancy&Fee Checked��r ! BOARD OF FIRE PREVENTION REGULATIONS.527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code.52/7 CMR 12:00 (Please Print in ink or type all information) Date b'&q4f-�1 I To the Inspector of Wires: Town of North Andover i The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number Owner or Tenant Ila- e^t Owner's Address rn� —/ t is this permit in conjunction with a building permit Yes @' No ❑ (Check Appropriate Box) I Purpose of Building Utllrty Authorization No. Existing Service Amps Volts Overhead ❑ Undgmd ❑ No.of Meters iNew Service Amps Volts Overhead ❑ Undgmd ❑ No.of Meters Number of Feeders and Ampacity I Location and Nature of Proposed Electrical Work d ��[``P�S/� L✓6/!rs DUy2l�>S /{/ / Ti!,�'�/ Total No.of Lighting Outlets No.of Hot fuse No.of Transformers KVA Above ❑ In ❑ No.of Lighting Fixtures © Swimming Pool grnd ❑ grnd ❑ Generators KVA No.of Emergency Lighting No.of Receptacles Outlets o2 No.of Oil Burners Battery Units No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone Total No.of Detection and No.of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No.of Di sal No. Pumps Tons KW No.of Sounding Devices No./of Self Contained No.of Dishwashers Space/Area Heating KW Detection/Sounding Devices ❑ Municipal ❑ Other No.of Dryers Heating Devices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Bailases Wiring No.Hydro Massage Tuds No.of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES= NO = have submitted valid proof of same to the Office YES= No = If you have checked YES please indicate the type of coverage by checking the appropriate box INSURANCE = BOND = OTHER = (Please Specify) (Expiration Date) Estimated Value of Electrical Work$ u Work to Start Inspection Date Resquested Rougl Final Signed under the Pe alties of pe FIRM NAME /d ENo. LIC.NO. ���2 Liensee �` �/ / C�L7�G/V Signature LIC.NO. "53 Z/ s.Tel Addres t3 � �/)/f'C�U ` e-x ,, r� Alt Tel.N. OWNER'S INSURANCE WAIVER: I am aware that the Licens does not ye the insurance coverage or its substantial equivalent as required by Massachusetts General Laws.And that my signature on this permit application waives this requirement. owner Agent (Please Check one) Telephone No. PERMITTEE $c5Z5�� (Signature of Owner or Agent) Date./.—. . ' "aRTM TOWN OF NORTH ANDOVER 3?O6t��•o �•��OOL PERMIT FOR PLUMBING ,SSACNUSE� This certifies that . . . . . . . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . . . . . . . . . . . . . . . . at. . ./ ..<. .7. . . r4 << . . . . . . . . . . . . . .. North Andover, Mass. Fee.C!2. ?. Lie. No..2 . . . . . . . . . . . . .C.�: . . . . . . . . . . . P UMBING INSPECTOR Check # 1 t, � r 5114 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS �RC�JUI�� Date Building Location t. 6k Owners Namec t(' Permit#e-44 ^r Amount � Type of Occupancy New Renovation M Replacement E] Plans Submitted Yes No FIXTURES F � H C CIO con ►., p.1 v � U Smusa WaV M M FLOM ZD)H J00R 3M 1H J0M 4III)FLOCit 5M HDM 6M 1HIOM 7M HjOCP. gm HJOCl2 (Print or type) Check one: Certificate Installing Company Name - ❑ Corp. Address wPartner. Business Telephone Firm/Co. Name of Licensed Plumber: C i' Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy ❑ Other type of indemnity ❑ Bond Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above 4reeinsuran ature dor Agent ❑ I hereby certify that all of the details and information I entered)in above application are true and accurate to the best of my knowledge and that all plumbing work andrmed under Permit Issued for this application will be in compliance with all pertinent provisions of the Mass bing Code and Chapter 142 of the General Laws. By: igna r o ense um er ype of umbing License Title �.�\� City/Town icense um er Master Journeyman APPROVED(OFFICE USE ONLY k r � Date................. ................ �aOR7F1 ` TOWN OF NORTH ANDOVER PERMIT FOR WIRING 41 ,SSACMUS� Thiscertifies that ................ ......................... ...............n.............................. has permission to perform ........ C�> e 04 1',1 �. ,wiring in the building of.../....U.�.. ..L......................................................... at......ll..�..,,7...... .�t.!..1`i.t......�................ orth Andover,Mass: Fee...L,I� .: 0.. Lic.No. :P..��.4.......... ..... ............. ... LECTRICAL INSPE Check # G' -COMMOMEALTHOFMAMMI SEM office Use only = Ul J %�� DF.f'.9lRTMFN!'OFPtIBLICS9FElY /\ Pemtit No. BOARDOFFIREPRET�FM ONR GUL4TIOA SS27GtMIZ-W Occupancy& Fees Checked APPLICATTONFOR PERAffTO PERFORMEME=. CAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date��f ',1 e z Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) ���G'r, t�7� Owner or Tenant V/-,C)— Owner's -,C1,Owner's Address Is this permit in conjunction with a building permit: Yes M No (Check Appropriate Box) Purpose of Building Utility Authorization No. _ Existing Service Amps / olts Overhead UndergroundNo.of Meters New ecvice Amps Lvolts Overhead UndergroundNo.of Meters Q Number of Feeders and Ampacity LocdQion and Nature of Proposed Electrical Work' IVAOWA/li 111/- ;j RDQ,a; // ✓ .f� �/1%j'�+i�r No.of Lighting Outlets No.of Hot Tubs No.ofTransfonnets Total No.ofLightiog Fixtures `Swimoting Pow. Above' Below KVA i✓ Gaxrstrna KYA No.of Receptacle Outlets No. � No,of 00 Burners; Na of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges i No.of Air Cond. Total FIRE ALARMS No:ofZonEs Torts No.of Disposals No.of Heat Total Tocol No.of Deteetioo and purops Tots KW loitimiogDevi es 1 Vo.of Dishwashers Space Am Heating KW No,ofSoundmaDevices No.Of"fCotdamed DeteeFiodSoandiogc[kvices lo.of—f%yers' Heating-Devices KW Logi Municipal Other lo.of Waterer Heaters KW No.of Na of Connections signs Bailasis o.HydroMassage Tubs No.of Motors Total HP rdt0e(,p�0c�A>FSt1al*bfhet�11t011F.KS�('�79�I81�15 eaazaaltLiabtYly�ratc�ePcityirtdudctg Co► aitssti��aiegtnekri YS NO eatlxn9o0dW6dp0ofifsane1Ddre0ff=YM ND Ifjwh�edtadaedYlrS,pie.�seinTi�etf�typeefa�►a byd g ') . .. JIL4Nt� BOND bStat = -- _ - - - dund�t�iel?laraltitsc£pajta}r. __.--- INAME �v ,q�/�l�G/�<c/ ,! ,C�. _ ---.-•ter A1LT&Na ER'SPsSLRANCEWATVER,IarnmvaedmtdcLimmIMpg_hMtcm%==aMWordsskgUdeqrQhtasmgmndbyNlamtmsft neral -- tmy ltaspem rwanesthisFaTilrsrsert .e check one) Owner � Agent � [�O, t� Telephone No. PERMIT FEE 1 ( 0 4057 Q Date.... .` Z:..... Of ,C o7 TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �,SSACMUS� • t •ti `�'' This certifies thatA.... ....!.................................................A...................... has permission to perform :2.2� .............. ....................... wiring in the building of...�!- ... ...................................... at..&.19. .. .. .... ,North Andover,Mass. Fee.. .. ......... Lic.No.............. .. .�. ! ..........: --.................... -- ELEcrmcAL INSPECCOR Check # 7a Commonwealth of Massachusetts QfficiakUse only Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/991 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( C,52z_ R1.00 (PLEASE PRINT IN_ OR T A IN ORMATION) Date: I City or Town of: - To the Inspe for of Wires: By this application the undersign ' iv s Aiis r her intention to perform the electrical work described below. Location(Street&N er) Owner or Tenant Telephone No. 75 Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No,of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of Security system Completion of the followin table maybe waived by the Inspector of Wires. No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool Above ❑ In- ❑ NO.01 Emergency Lighting rnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. of Zones No.of Switches No.of Gas Burners o.o Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat TPump Number Tons KW No.Detection/AlertingofSelf-Contained Devices No.of Dishwashers Space/Area Heating KW Local ❑ Connection El Munical No.of Dryers Heating Appliances Kit Security Systems: No.of Devices or Equivalent No.of Water No.o No.o KW Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: J:o.of Devices or Equivalent 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 ❑ BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of#15ctric 1 Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify, under t epain kand penalties of perjury,that the information on this application is true and complete. FIRM NAME: LIC.NO.: 15J3C Licensee: John S. Bassett Signature LIC.NO.: 1533C (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: 603 594 5928 Address: Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Lie, see 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: $