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Miscellaneous - 120 SANDRA LANE 4/30/2018
/ 120 SANDRA LANE - - J210/097.0-0084-0000.0 i �I 2.. Date.. .......... ..... ..... A Of '40Rr TOWN OF NORTH ANDOVER PERMIT FOR WIRING CHU This certifies that ............. ........... has permission to perform ....to .a.- wiring in the building of............ x..................................... at......... .........4—: North Andover,Mass. Fee...... . Lic.No........ ..... . ....... ��....... ... .a LIA? ELECTRICAL INSPECTOR Check 4 87b2 Cn~nwaa[Lit o� a9�at/ttr�a[� For Office Use Only (Rev.11/99) ?�� r� cc�� c7 Permit Number: L_ 1.JsPai[msn[o`,}i�a�iwicsd Occupancy&Fee BOARD OF FIRE PREVENTION REGULATIONS APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK (ALL WORK TO BE PERFORMED WITH THE MASSACHUSETTS ELECTRICAL CODE 527 CMR 1 PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date: sv-yuz City or Town of: A/D ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location: (Street&Number) 2 L.> S*d4o 1,c� n Owner or Tenant: Y1 Wt-� I V1 S moi' Owner's Address: �YYI"P Is this permit in conjunction with a Building Permit? Yes o No >- (Check Appropriate Box) Purpose of Building:��►'1. /� 1: L Utility Authorization#: Existing Service: Amps / Volts Overhead ❑ Underground.❑ #of Meters New Service: Amps / Volts Overhead ❑ Underground.❑ #of Meters: ,ter Number of Feeders and Ampacity: Location and Nature of Proposed Electrical Work: ZO®�»,�n � e,� P/Ovi No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans No. of Transformers Total KVA No.Of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool: Above ground ❑ In Ground ❑ #of Emergency Lighting Battery Units No.of Receptacle Outlets No. of 011 Burners Fire Alarms #of Zones #of Detection&Initiating Devices No.of Switches No.of Gas Burners #of Sounding Devices: #of Self Contained No.of Ranges No. of Air Conditioners TOTAL TONS: Detection/Sounding Devices Local❑ Municipal Connection❑ Other ❑ 1 No. of Waste Disposals Heat Pump Totals: Security Systems: Number: TONS: KW: No.of Devices or Equivalent r No.of Dishwashers Space/Area Heating: KW Data Wiring,No.of Devices or Equivalent: No.of Dryers Heating Appliances KW Telecommunications Wiring:No of Devices or Equivalent: No. of Water Heaters KW No. of Signs:______#of Ballasts: OTHER; #of Hydro Massage Tubs No. of Motors Total HP INSURANCE COVERAGE:Unless waived by the owner,no pe t for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or Its substantial a alent. The undersigned certifies that such coverage is In for ,an has hibited proof of _me to t permit issuing office. CHECK ONE: INSURANCE BOND o OTHER o Please specify: J Estimated Value of Electrical Work$ _—� (When required by municipal policy) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. `�� certify,under t/h1 pains /n�dpenaltles, f perfu the Information on this application is true and complete. Firm Name: V v 6� (.✓!i�i nit, LIC.# 33 Licensee: a Signature: LIC.#. r C4 / If ppim le,ente `e a pt"In t. license number line Address: lJ `� r6 G l � Bus.TeL + Alt.Tel.# 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❑ OR Agent❑ Signature of Owner/Agent: Telephone# PERMIT FEE:S--� Date... .�...7r...��. gORTM °f' •�"� TOWN OF NORTH ANDOVER PERMIT FOR WIRING • � a S _)••• CHU This certifies that .......A,, .....kj,4t .. 7nv............................................ has permission to perform ... FP !! . .k.tTy wiring in the building of.......... ......... ..�.. ..... ......................... at...jz'. ..5 I.tl p.?,4...../.1�...............��LEMUCAL ..'North Andover,Mass. Fee. . Lic.No.IMS ............( Saq... ... � !�!. ..... Ir�srecroe t Check # 8775 Commonwealth of Massachusetts Official Use Only Department of Fire Services Pernut No. '. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT WINK OR TYPE ALL INFORMATION) Date: — B City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) d O 9c4 jj 1 Owner or Tenant s4g:; Telephone No.G Owner's Address Is this permit in conjunction with a building ermit?yes Purpose of Building . Re 5 td of f ra f Z No (Check Appropriate Box) Utility Authorization No. Existing Service oZ On Amps //a d Volts Overhead ❑ Undgrdo 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 I r]n G wok' �cUlld, 4 Completion of the ollowin table m be waived b the Inspector o Wires. No.of Recessed Luminaires No.of Cel-Sus No.u, Total . p.(Paddle)Fans Transformers KVA No.of Luminaire Outlets. No:of Hot Tubs Generators KVA No.of Luminaires L Swimming pool Above ❑ In- o.o mergency lg g Above rnd. ❑ Batte Units - No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and No.of es Ran Total Initiatin Devices Ranges No.of Air Cond. No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number _ons KWNo.of Self-Contained Totals: """"_ '" Detection/Alertin Devices No.of Dishwashers Space/Area Heating K �❑ Muni W � cipal Connection El other No.of Dryers Heating Appliances K, Security Systems:* No.of Water No.of0. No.of Devices or Equivalent Heaters Imo' Sis Ballasts. Data Wiring: grnNo.Hydromassage Bathtubs No.of Devices or E ..:valent No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or E ..:valent Estimated Value of Electrical Work: L..U O Attach additional detail if desired, or as required by the Inspector of Wires. (When required by municipal policy.) Work to Start: 6` �—O 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 the licensee provides proof of liability insurance including" work may issue unless 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:) I certify,under the ain and en ties o p ��) �f P ie ofperjury,that the information on this application is true and complete_ FIRM NAME: 1ja (,�u I�n 1�G /1 C 9� (,Jg LIC.NO.: ��03�3 Licensee: _ Sigrnarture(Ifapplicable, enter "ere LIC.NO.:ptinthelicnnumbeli . O/ U�Address: it Bus.Tel.No.:Sc ' 1 1-4 4 *Per M.G.L c. 147,s.57-61,security work requires D I vt„S7 Alt Tel.No.: Q apartment of Public Safety S License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement I am the(check one) ❑owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE. $ a, re � F^ l i The Commonwealth of Massachusetts k- ! Department of Industrial Accidents it •- Office of Investigations 600 Washington Street {� Boston, NSA 02111 www.mass gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Eiectricians/plambers Applicant Information Please Print Legibly NameBusiness! l Organizafion/Individ ual): Address: City/,State/Zip: Phone#: . Are you an employer?Cheek.the appropriate box: Type ofproject 1.❑ I am a employer with 4. (required): ❑ I am a general contractor and I employees(full and/or part-time).* have hared the sub-contractors New construction rs 2.❑ I am e:sole proprietor or partner- listed on the attached sheet$ 7. ❑Remodeling ship and have no employees These subcontractors have $. (�Demolition working for mein any capacity. workers' comp.insurance. eom . insurance 5. g• El Building addition [No workers ' p ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doting all work right of exemption per MGL 1Plumbing repairs or additions myself. [No workers'comp, c. 152, §t(4),and we have no insurance required.).t employees. [No work=' 12.[:]Roof repairs comp. insurance required.] 13.❑.Other "�Y applicant that checks borC#I must also fill out the section below showing their workers'compensation oil t Homeowners who P� p cY informatio submit n this a�dav' tt indicating they are doing all work and then h' i ;Contractors that check this box oust Attached an additional sheet hire outs contractors must submit a new affidavit indicating such showing the name of the sub--contractors and thei ant an employer that is ntr workxts`comp.P Policy infom�adon. f viding:workers'co enation ►np insurance or a to ees: .f m1' Below information. � y is the policy and job site . Insurance Company Name: ' Policy#or Self-ins.Lie.#: Expiration Date: ------------ Job Site Address: ' City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing theotic number P Y rand 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 under the pains and penalties of perjury that the information provided above is true and correct. d SignaLure: Date: Phone#: Offl[1B f use only. Do not write in this area,to be completed by city or town official Town: Permit/License# Authority(circle one): d of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing inspector rt Person: Phone#: I Information and Instructions r r L 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 shaU 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 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 coritacting 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)acid phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to cavy workers'compensation insurance. If.an LLC or LLP does have employees,a policy is required. Be advised-that this affidavit 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,notthe Department of Industrial Accidents. Should you have any.quesdons�mgarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the nuxmber 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 permittlicense 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 starnped 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. 1 Y The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel.4 617-727-4900 ext 406 or 1-8.77-MASSAFE Revised 5-26-05 Fax 4 617-727-774 www.mass.gov/dia _. r t , ,• V , s 0 z. a `� µ u, Y Date..Ai �--,/—.°.fes. ..... ,4OR7►, 3?° f( °� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING SSAC04US� w This certifies that 1:. �_ :e' �'..........................��..............................!.�....................... has permission to perform '`�.:.:.'1'-L���- '� .' �:...................... ............... . . ............... wiring in the building of... - ................................................. t at../ .....: `..... ..... .... ,North Andover,Mass. Fee..................... Lic.Nod .. y LECfRPE Check # 8701 ;jRam Commonwealth of Massachusetts Official Use Only own Department of Fire Services Pernut No. >O J Occupancy and Fee Checked 'S BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(NJE ),52 CMR 12.00 (PLEASE PR VTININK OR TYPE ALL INFORMATION) Date: 13 U City or Town of: NORTH ANDOVER To the Ins actor of Noires: By this application the undersigned gives notice of his gr h r m, ntion to per form the electrical work described below. Location(Street&Number) 126 Owner or TenantST-GUr, f2/s�yt e Telephone No. Owner's Address .� Is this permit in conjunction with n building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Sl6I(� /I�✓►, t Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Und rd g ❑ No.of Meters Number of Feeders and.Ampacity Location and Nature of Proposed Electrical Work: ��01 Zoo�� Com letion of the ollowin table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cel-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- ❑ o.o mergency ig g d• rnd. Batte Units --- �No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiatin2 Devices No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump slumber Tons KW _ No,of Self-Contained Totals: -' "' Detection/Alertin Devices " No.of Dishwashers Space/Area Heating KW Local tEl Municipal Connection ❑ Other No.of Dryers. Heating Appliances KW Security Systems: No.of Water No.of Devices or Equivalent No.of Heaters KW No.of Data Wiring: Signs Ballasts. No.of Devices or Equivalent No.Hydromassage Bathtubs No.of MotorsTotal gp Telecommucation nis Wiring: No.of Devices or E uivalent OTHER: �- Attach additional detail if desired,or as required by the Inspector Estimated Value o lec 'ca]Work: of Wires. (When required by municipal policy.) * Work to Stark INSURANCE E: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability ins ce including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cove is in force,and has exhibited proof of s e t the Mut issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) �li � � I certify,under the pains and penalties perju , that th inf9zmation on is appltcation is true and comple FIRM NAME: � G( LIC.NO�� , Licensee: /ij (J Signature (If applicable, enter"el-xi"in4e license num rune. - LIC.NO.: Address: lG /:gal Bus.Tel.No.�-t'7 Alt.Tel.No.T- ."r 7 3 / *Per M.G.L c. 147,s.57-61,security ork requires D artment of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one) ❑owner ❑owner's agent. Owner/Agent Signature Telephone No. t �' �//.. ,A� `_ s l Location 10 SANcP�'�No. �� Date 4012Th TOWN OF NORTH ANDOVER . 0 + Certificate of Occupancy $ _ rig s'SSACMUS t� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Sy _-- Check # 15885 Building Inspector v ~ TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A�Op�NE OR TWO FAMILY DWELLING ..: "✓. 'i ,;.: .w,� Y.2�q�?z{R` ^'raz°" ;��_ ���. +�.;fFa�i��� - k �ba' V BUILDING PERMIT NUMBER. DATE ISSUED SIGNATURE: Building Commissioner/Inspector of iddinis Date Z SECTION 1-SITE INFORMATION O I.1 Property Address: 1.2 Assessors Map and Parcel Number: 20 scm m Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Re red Provided 1.7 Water Supply M.GL.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: n Public ❑ Private ❑ Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record Lew Name( nnt) Address for Service: Signature Telephone 2.2 Owner of Record: Name Print Address for Service: O Z M Signature ,' Telephone SECTION 3 CTION SERVICES 90 3.1 License ,supervisor: Not Applicable ❑ SCD Licensed Co�n4tntction Super: 0 L�3 o ? O �o_ j / A cot r S� License Number mn Addres (J'�"1� /J 7� _ > L g ,� Expiration Date a e Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ 0 Lo mm t-a.Q C-617, '7lc c%ion -r-&C Company Name Registration Number V2 Addres Expiration Date ^ Si ature Telephone Y/ � w 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) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIALUSE-DAILY 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 AUTH6fflZATJbN TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, ,as Owner/Authorized Agent of subject property Hereby authorize to act on .My behalf,in all matters relative to work authorized by this building permit application. 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 Print Name Signature ofOwner/Aent Date YYY so= 1- 11,11i'mm; 0011mm- NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS iST2 ND3 SPAN DIMENSIONS OF SILLS DM ENSIONS OF POSTS DIN4ENSIONS OF GIRDERS IIIE'IGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHRVINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 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 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) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector I i _ BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR A 1 = = Number: CS 043239 Birthdate: 08/22/1961 Expires:08/22/2003 Tr.no: 2406 Restricted: 00 SCOTT R DEVINEr' / IN ST PO BOX 1761/439 S MA ( � Z The Commonwealth of Massachusetts Department of Industrial Accidents d Office of Investigations Boston, Mass. 02111 5�lb Workers'Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for my employees working on this job. Company name1 �1.� —�c21' .S%fi.�T/c�✓\ 1UC Address �� sIl cZ Gk a0l, S I v City Ain j Phone# 233� Insurance Co. /,t xt/' Policy# VC Company name: Address City: Phone#: Insurance Co _ Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of,a fine up to$1,500.00 and/or one years'imprisonment_aswelLas_civil..penattiesin2heformofa STOP WORK ORDER.and..a.fine_of_(.$1D0M)-aday againstme. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the p hs and penalties of perjury that the information provided above is true and correct. SignatureZ- Print name _ 17��/Ir►C Phone# 9;7-f--9��,� Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensina ❑ Building Dept ❑Check if immediate response is required .❑ Licensing Board ❑ Selectman's Office Contact person: phone#: ❑ Health Department ❑ Other Sob Si Pings)-e v eve R �y, Sta�hF � Oe✓i� 1 a,0 Sand m °Q Tc,mwlcf �'n5-ftiavT/ Nor+k Ar%dotxr, 'ii'911Sit, Ma�►� STt� CRt Ano✓c P, Mfg I . i I ' i 0 0 i 4 } E4,91na, r%,A Floor l i I {s I I Mi I . I NORTH ED Town 0 ...: . Andover O 0 -�oC L dower, Mass., %ADRATED � S H E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT......... .V.. N............/ /.. +... ...a. .. .................................................. Foundation has permission to Keit...Raltklk............. buildings on ....I._a.O....g.a.. ..M ....... ..I........ Rough to be occupied as..�.�.��'�'�.R... .rw.....C•.401 or C 64k0+4i....C�.l I rr Chimney provided that the person accepting this permit shall in eve respect coto the terms of the application on file n P P P 9 P every P PP Final this office, and to the provisions of the Codes and By ws relating to the nspection, Alteration and Construction of Buildings in the Town of North Andover. Q' r � 8SQ dp� PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST S ELECTRICAL INSPECTOR Rough .;!.!:�............................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. r SEE REVERSE SIDE Smoke Det. Location No. 42� f ��` y Date �oRT� TOWN OF NORTH ANDOVER p Certificate of Occupancy $ 41 . o Building/Frame Permit Fee $ ,SSACNUSEt� Foundation Permit Fee $ Other Permit Fee $ .5_ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Ins`Wctor i3 0 v Div. Public Works PE1Zh11T NO. APPLICATION FO ***N0RT11 ANDOVEIR, MA �"y - -- _._.......-------- -------- ------------._ ..--- Z. Itk1 Ul(11(1F(1\\'NI RI•.SIIII' D I 1100K I1A(:F. --- -- - /l INU SIIIB ufv. 1 111 Nn. • ,, IM MON I N ('1111 IY�!:1 X�111111 1)IIJ(i a WS O. " � — SIZE Nt). lX SI(MILS ---- l 1\\NLNAML �/C G (AVNI:R'S ADI)KESSLl HASEMLNF OR SLAB) /-1 IST 2 ' 3 r AR(I III FUCS NAME . SIZE OF I I.Mlt I IM1iERS lit III DER S NOME ii �/� 1 SPAN T DISIANC17 IUNLAKFS1 BUILDING I)IMI=NSIONS01 Sit.1 S DIS I ANC L I RUNI SI RELI ip 1 UTAIF.NSIIXJS(>f l'(161 --_ ---_ --_---- 11151 ANCE FROM I(JFLINES-SIDES REARDIMENSI(XJS Of GIRDE`I A R LA OF I()F IMMAGE IILIGIII(JFFOIINDATI(V T11ICKNESS ISBIIILDIN(iNEW SI L1? 1MAING X IS BUILDING ALTERATION IS UUII.I)IN(i ON SOLII)CXt FII t ED LAND \\III.DtJll.l)INGC(NJFO(IMTORI'(,XIIREMEN'1'SON7C(N)E IS III IILUIN(iC(NJNECILI)'101OWNWAIFH ISIIUII.1)IN6CONNEUIU) 10 NAIURAL(;ASI.II-A_ 1"16 --. - INS I I ici iUNS 3. PROPL11 Ll' INFORNIA 1 ION LAND COSF VV ESI.ULIXi.CO6F _ Vmif:.I Fit 1.(XII SE('11(1NS 1-3 ES 1. 131.1X;. COSI PER So .FI.ES 1. 1311Xi.C(1S1 PER WXX.1 El R-FRIC ME1 LRS Nit IS I-BE ON Of I SII)E ON BUILDI NG SLVI IC PLRMI I NO. AI'1 ACI IED GARAGES Nit isi o ro"m Fl1STAIEFIRLRE(;IILA-IIONS J. Amt vu.1)Ul PLANS Mt IST BE 111 LD AND APPROVED(1Y I11111.DING INSITCIM BUILDING INSVE(A 0IF DA 11:P1111) p OWNERS 11:1 / �r �� r� CJ I R. 1('N /pry�, t N YV i SI<:NA I I IM.0I l)WNI:K 1)It Al l l It 1llil)AGI NI L - 111, ( ILLI'.a t//G _ SEP 2 1QQ9 ,_ 1.1 ltnlll lai:\IJI11>� ' 19G-DEP r P -- -- -- —----------- --- '----- — ---- -- i'RUf�..E li\t e 1 t I c �i Robert C. Railey Finish Work a Specialty $ Quality Workmanship x Building & Remodeling Free Estimates > a � 499 Waverly Road Builders License #025620 3 ' F North Andover, MA 01845 Home Improvement Telephone (978) 682-7087 Contractor#100239 TO JOB LOCATION Mr. & Mrs . Peter Belanger 120 Sandra Lane North Andover, Mass . same L , L_ DATE DATE COMPLETED TERMS CONTRACT PROPOSAL BILLING PAGE-NO.--J-- -X X [OF-- -PAGES JOB DESCRIPTION: Roofing Installation The contractor shall remove and dispose of all existing roofing shingles on the main house!, ell section , and rear entry porch area . This shall be accomplished by the use of an on site dumpster. q All existing drip edge shall be replaced with 8" aluminum stock (white) New roofing shingles shall be installed after the application of a conti.nuous 4 run of GRace Ice & Water Membrane for the first 36" of roofing surface starting at the soffit edge. -y Shingles shall be -I.X0 Chateau series (30 yrs . asphalt) in the Architectural style. Color selection shall be by the owner. The existing ridge plywood areas shall be cut back on each side of the ridge to accommodate Coravent ridge venting material and a shingled cap to match the roofing color. The necessary permit requirement shall be the responsibility of the contractor. There shall not be any felt (tarpaper) installed to shingled surfaces . There is no provision in this quote for the replacement of chimney flashings or any masonry work ( if required) . Hereby Propose to furnish labor and materials complete in accordance with the above specifications for the sum of $ Forty-four Hundred seventy-two and - 00/100 -------------- ($4472 .00 ) With payment to be made as follows: One half due upon completion of main house ; one half rille PGR GOMP o-h i nn of @I ! apo r€ar—porc-h are-as- - All reasAll material is guaranteed to be as specified.All work is to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above Authorized specifications involving extra costs will be executed only upon written orders and will Signature ' l� become an extra charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado and other Note: Thi pr posal may be withdrawn by us if no necessary insurance. accepted within fi 0 days. Acceptance of Proposal-The above prices,specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Paymentwill be made Signature as outlined above. Signature Date Accepted I 11 ( o C. ,. , . y t ,. Cl- !. f { � £ :l. f T �?i t { f i ! 1 F E s 't ' ,_t' t t :-.t e rr {r1 - f FI + § F{ @ _� - --.- - 1 - P .. .. ;r,- rr ! .I, K71r�` rt "�}ta ik 4+�5 7 _. .. .: 11 I .r:.. t - t}y, � ii t.�i f r 5 35 7 'y i - ' ` "' t y i..y £ r - i .t i 1 1. - 11 F t f `S z+M:�;..°.m.� _.....,.3,.,._�•.'_ Ri "+.••'fes' ` �,�.+� i _ t. j .. i f t� \ ts Y - : - ,.' - , C —o U 'yi i_! .. ,.:.. :, Jl" m Ir i 1 f! 3 ' {: it s PD it r .r Y l l+1 Iw... m i- "+ if J I = -1 J m I i:. J , f I i.' i , f.n i I jf;; u, N `i14 a x YF , _ _ 9 3 S #'r u m -. AE t >w 1}t� _ �; a <" o } h f � f 1 }.y: hr lrf fin} ?i o a - W�pp. o 's 1�1. r F U S t 1 4. t �� Ci rn .,, .. .: r { G. 1. -te'•.:^ is i. ; .. '� :tt r c t i I .: S .pig - ._ .. •:. ra' F — - - h. '� ;;_ { ; ;. ��t x. E: - - xJ � ` ,i �: ` . E .. ;, % . , ,. , _ : :. ... ',... . a , ,. = r ._:.:' . : ... r - . .- F Y a Yj :i - - t _ ; - .-..'t 4. o - '. .,. - — - . - - >:. .. - - ._...-... ... - � - , 0 .- .1.... - '.._. .. - 4 .. ..:-. - _ Y .. _ .. - , -':.. --. .. - ._ - . . . C_ .-. _ - ._ 4 - .. _ .. - - .. .. - ., r - _ I _ - ' - I— .. - _ - .. , .:. .-t - ...._ _ - f 4 t -.., - .. " ;, .:-: :. - - - .. .. -. - _. - .. +1,� _ _, % . Ill Town of North Andover f AORTi, - - - - - OFFICE OF ,�0`t,"o ,s . a . L COMMLWITY DEVELOPMENT AND SERVICES ° .. : 27 Charles Street x ° North Andover, Massachusetts 01 8,15 WILLIAM J. SCOTT J SAC HUS`j Director (978) 688-9531 Fax (978) 688-9542 In accordance with the provisions of MCL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MCL c 11, S 150 A. The debris will be disposed of in: (Location of >=aci it`j) Sic natur f-Permit Applicant z AK— D& NOTE: Demolition permit from the Town of North Andover must be obtained for this project throng-h the Office of the Building Inspector BOARD OF APPE:�S 63S-9541 BULDENG 68S-9545 CONSFi2VAT?ON 683-9530 HE7 603-95-0 ?LAL,NMNG 68S-9535 � NORTFy Town o . .f - dover Z F*j LO dover, Mass. DRATED P•?�G,`�� S 54 BOARD OF HEALTH Food/Kitchen mrmm Septic System THIS CERTIFIES THAT......................................... .... ..................... .............. . ............................................ ............... BUILDING INSPECTOR IT T D Foundation has permission to arae .. ............. buildings on ........... ................... .......... Rough t0 b8 OCCUPIed as ...... .. . ......... .... i ..................................................... Chimney .... . . . .... provided that the person accep ' g this permit shall in every respect confor.........m 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 PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STC ,�� Rough ELECTRICAL INSPECTOR ` ugh .................................................................................................................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. t / Location No. ' 4 7 Date -5' 'U (2d MCRTN TOWN OF NORTH ANDOVER f R + , Certificate of Occupancy $ �s GNUE< Building/Frame Permit Fee $ t- sAs Foundation Permit Fee $ Other Permit Fee $ � d TOTAL $ �� Check # Building Inspe66r TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMygOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. DATE ISSUED: SIGNATURE: Commissioner/I t of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: ax 4 ;_ /1) /0�9 00 Map.Number Parcel 1.3 Zoning Information: 1.4 Property Dimensions: 11-6 Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Recluired Provided Required Provided 1.7 Water S .G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public Vr Private ❑ Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Name(Print) Address or Service �tM- Wgf 1W Signature Telephone Q 2.2 Owner of Record: O Name Print Address for Service: z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: License Number Address � 1-70 �!��7�0� Expiration Date ic Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ ompanyName //v i` �� Z) /V/- Registration Number Address Signature Telephone Expiration Date SECTION 4-WORKERS COMPENSATION(M.G.L.C 152 § 25c(6) Workers Compensation Insurance affidavit Inust be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buildiodpermit. Signed affidavit Attached Yes......6L No.......❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Exis�pg Building ❑ Repair(s) ❑ Alterations(§)t Q Addition ❑ Accessory Bldg. ❑{`"" Demoliiton ❑ Other ❑ Specify t� Brief Description of Proposed Work: '�• -' , Ui/a Lo D ALL if t/1-7-1 L-L� � , GN FL d SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be �FFICIAI`USE-:0 y Completed by pennit applicant 1. Building (a) Building Permit Fee 6d 1) 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 1, 46&�rT �y- 2& ,as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, /L��� � - �/l+ 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 RfiPrint Name I ature of Owner A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR ITABERS 1 2 RD 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING x MATERIAL OF ClMvINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE ¢ NORTH Town o . -f r L A E a �` dover, Mass., c23 —OD COC HIC HEwICK � 7� AERATED F' �� `s BOARD OF HEALTH PER T Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT,.............. .... .................. ..................................... .. ....................... Foundation has permission toe buildings on / .................................... . ........................ Rough to be occupied aChimney .. . .. ........................................................................................................................... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST 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. l SEE REVERSE SIDE Smoke Det. ^ 1 r . �/1LP. j/JQi/97/))20'Y/A,UP,2GL/d- O`I�.�G�4JCLCldLIJBCtf S s ris:; ;�_3 =u: ?1 The Commonwealth of Massachusetts — > Department of Industrial-Accidents Office of Investigations --= s� Boston, Mass. 02111 Workers' Compensation Insurance.4da�iit Name Please Print Name: Location: Ov Cit/ � IrJ� Phone 20 f�- %lJ 9) /I am a homeowner pe.k rming all work myself. I am a sole proprietor and have no one working in any capac:ty CI am an employer providing workers' compensation for my employees working on this job. Comoanv name: Address Cihr Phone T Insurance Co. Pelicv m I , Comoanv name: Address Cih/: Phone Insurance Co. Folie Y Failure ro secure coverage as requires under Section 25A or vIGL 152 can lead to the imposition of chminal penalties of a rine up to 51,500.00 and/or one years'imprisonment as weal as c:vil penalties in the f.crm cf a STCP'NCRK ORCER and a Rne cf(5100.00) a day against me. I understand that a cdpy of;his staement may be fcrN rded to the Office cf Investigations cf;he CIA for coverage verification. I do hereby certify under the pains and p nalt' i pe. ury that the information provided accve is true and correct. Z Signature Date �1 Print name /��/✓ tom' rZ Fhane �Z 7dY2 Official use only do not write in this area to be completed by c3y crown cric:ai City or Tcwn PermitlUcensiro Building Dept ❑Check d immediate response is required ❑ Lic-easing Board r-j Se!ectman's Office Contact person: Phone m: health Department Other PLoc at!on ✓a /,jiK it a *No. Date W ' 1 it •P. o<�°" T TOWN OF NORTH ANDOVER r` p Certificate of Occupancy $ • Building/Frame Permit Fee $ Hust� Foun tion Permit Fee $ Permit Fee ,Z O$ 5 Sewer Connection Fee $ Water Connection Fee $ TOTAL $ 5 w ,r 3 Building Ins6ector M O O Div. Public Works PERMIT NO.-. 411 APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 'MAP 4-40. LOT NO. 2 RECORD OF OWNERSHIP iDATE BOOK PAGE ZONE I SUB DIV. LOT NO. / ''7 —I i) V 31 Q LOCATION L PURPOSE dF BUILDING OWNER'S NA4E G"1X NO. OF STORIES SIZE OWNER'S ADDRESS ✓h �•1/� BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME ,F SPAN -- DISTANCE TO NEAREST BUILDING `Z/ sCJ / DIMENSIONS OF SILLS _ --- DISTANCE FROM STREET /��LCJf POSTS DISTANCE FROM LOT LINES—SIDIES \^ f REAR " GIRDERS AREA OF LOT C'• FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION JTXL OF CHIMNEY IS BUILDING ALTERATIONV 11V J trVI IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE `f: I� IS BUILDING CONNECTED TO TOWN WATERLT`� BOARD OF APPEALS ACTION. IF ANY 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 ~ 4. COST PER SQ BLDG. . PAGE 1 FILL OUT SECTIONS 1 - 3 EST. ' PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR J 'I ) 1 DATE FILED �J� lD NUILDINO INeP[CTOR SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE �� OWNER TEL.# v f PERMIT GRANTED �j CONTR.TEL.# Oy ✓ a �✓ 19 CONTR.LIC.# LJ ✓� �� H.I.C.# 6 te) ,�--3 �70 � 1 BUILDING RECORD 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 I 2 13 CONCRETE BL K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT 11 AREA FULL FIN. B'M'TAREA _ y, 16 FIN. ATTIC AREA _ NO BMT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARD%P✓'D _ ASBESTOS SIDING COMMCN VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR I_ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR I 1 I POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH 13 flX.) _ GAMBREL MANSARD TOILET RM. I2 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR 8 GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO g FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. r TIMBER BMS. b COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G i UNIT HEATERS GAS 7 NO. OF ROOMS OIL B'M'T 2nd _ ELECTRIC 1st 13rd NO HEATING r •ee—. OFFICES OF: -_ T _--- _rTowT1.Of ::, ,12o Main s'czeez . -- APPSALS NORTH ANDOVER Andover. BUILDING 't '" Massdi lhiU etts o i 845 CONSERVATION DIVISION OF HE.-\LTH - PLA-\N1NG PLANNING & COMMUNITY DEVELOPMENT KARIr`H.P.`ELSON.DIRECTOR In ar ^rdance�with the S ::. 3 cor,d ' � itien of Building Per-nit Number -/ s :hit �c , •is resulting f crn this work shall be disrnose of in a by 1tGL c i II. S :Su. . i ne debris will be dispose:! cc in: l Z_ s5. Sicnature of Pe:mit gip, icnt • Date NOTE: Demolition permit from the Tou-a of North Andover sust be obtained for this project through the Office of the Building Inspector. a r - NORTH Town of dover No. qil M ort lover, Mass., s` ZZ 106 ACOCHICHEWICH P,ERATED p'P �,`°J c S BOARD OF HEALTH Food/Kitchen PERMIT . .T Septic System D/3C�'- � BUILDING INSPECTOR THIS CERTIFIES THAT.7m. .... .4`` $N -'....... ...... ............................................ ....................................... Foundation has permission to Wt....�-�''c' buildings on ..........1..'�-v.... x..2!5 ��' .............. p buildin Rough t r to be occupied as... 411M. .1.!�k- -... . .p: .. -...vl1 y.4...S.l.�/.N..t"r'...a ....0 .� i�tl chimney rovide that the person accepting this ermit shaft in eve respect conform to the terms of the application on file in P � P P 9 P every P 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 PE I T T EX =S 6 MONTHS HS Final UNLESS CONS UCT10 TS ELECTRICAL INSPECTOR Rough .......................... ................ . .... .... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough P p Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. i (('r.Jdrrr.XrGJe��, - i I� i HOME IMPROVEMENT CONTRACTOR" Registration 100239_„_ j Type - INDIVIDUAL �._. — - p - Ez iratioR 06/15/98_ ROBERT C. BAILEY 499 Waverly Rd �ndover MA 01845 ADMINISTRATOR s MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) NORTH ANDOVER Mass. Date 4/22 19 9 7 Permit # 3 Building Location 120 Sandra Lane Owner's Name Belanger Type of Occupancy Residential New ❑ Renovation ❑ Replacement IN Plans Submitted: Yes ❑ No ❑ FIXTURES i w N Z Y a rI r-I cn o Z W >-N Q V N o C7 ¢ ¢ 14 1-1 N o Z w 4 w ¢ _ ¢ N Z o Z Z a z N N x J n - N cn x ¢ r a w N Z ¢ a o z a c 3 x rid rd _ ¢ m ¢ cn w ' f( vi - o a cn Z Cr a ¢ o w N N ¢ W w d N O a J N ¢ J - p ¢ p LL S xi r�i x W z a z 3 3 o Z = 3 Y a o r a x a w u � w � 1 ►- o > r o = a o �, r Z o o a Z Z w o c� T. N H 3 s[ J m cn o o J 3 z N cn a 0 o m a 3 ¢ m o M rd SUB-BSMT. BASEMENT 1 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name Heritage Htg, &Plg. Co. Inc. Check one: Certificate Address35 Pleasant Street IX Corporation 714 Stoneham, Ma 02180 ❑ Partnership Business Telephone 617-438-7776 f7 Firm/Co. Name of Licensed Plumber Gordon Switzer INSURANCE COVERAGE: i have a curreni iiabiiity insurance poiicy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes N No ❑ If you have checkedrtes, please indicate the type coverage by checking the appropriate box. A liability Insurance policy (K Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner ❑ Agent ❑ Signature of Owner or Owner's 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 the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of Pe General Laws. By Title Signature o Licensed Plumber _ Type of License: Master EX Journeyman E]City/Town_ APPROVED(OFFICE USE ONLY) License Number $3 2 2 BELOW FOR OFFICE USE ONLY FINAL INSPECTIONS SKETCHES PROGRESS INSPECTIONS FEE NO. APPLICATION FOR PERMIT TO DO PLUMBING NAME&TYPE OF BUILDING LOCATION OF BUILDING PLUMBER PERMIT GRANTED DATE 1g PLUMBING INSPECTOR w Date. . . �. y 7 3344 / 40RTH °'.«• �'"o TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING ,SSACHUS� This certifies that eA, . .�. �`. ./. . . . . . . . . . . . . has permission to perform . . .A!0:.7 . . . . . . . . . . . . . . . . . . . . . . . s plumbing in the buildings of . ./3 � . . . . . . . . . . . . . . at. . . Sf9!-• . . . . ., North Andover, Mass. Fee.,R Z ". . .Lic. No..A.l1 L . . . . . . . . . . . . . . . . PLUMBING INSPECTOR 04/29/97 14:54 27.00 PAID ;i WHITE: Applicant CANARY: Building Dept. PINK:Treasurer M 00 CIffice Use Only ` //> y u ` t �hP LIITIITIIIIIIllI>' � 1 B� fi�LIIP Permit No. V l�� Spar`lirnt Qf VUhliL �fE Occupane/& Fee Checked ! 3/gq (leave blank) ` BOARD OF FIRE PREVENTION REGULATIONS X27 VAR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 00� (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date QM or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. �,,/ i e) tt.e )ell Q LG K /L�d/->A l�rr/ Uege Location (Street & Number) �ry�> Owner or Tenant G� '�"'' �--rte" � �L'rr/� e���'� �-�`• Owner's Address Is this permit in conjunction with a building permit: YesX No I. (Check Appropriate Sex) Purccse of Building Utility Authorization No. Overread Una rnd No. of tileters Existing Service Amps _J �Jci. g Volts Overr:eae _ Uncgrnd No. at Meters New �er�ice Amps _J — Numcer of Feeders and Amcacity L ccatien anc Nature of Rrcpcsed Electr.cZi :^lcrx , /�a>ar9'T'/t9l1771� rD /2'.Sc✓P .� // _p /L ! !r?D`�itACa� s.�',w_�4/ -err I — !o(al C: / j Na. =5 No. of ransformers KVA No. of _::qn ing Outlets ((( I Aacver- In- -- No. of Llg^ung Fixtures i Swimm ng Pcot g,na _ cmc. Generators KVA No. at Emergency Lignting No. of =ecectacie Outlets No. of Oil =urners i 3arery Units No. of Switch Outlets No. or Gas 3urners I FIRE ALARMS No. at Zones Total No. to -election-ng cavic anc No. cf Ranges I No. gt Air C:.r.c. tens initiating Oavices . Na.af Heat Tbrat otai No. of 0isoosals � Pur-s Tans K�rV No. at Bouncing Cevices - No. a Seit Cantainea ScacetArea Heatlra K''/ Oerec::oniSounaing Devices No. of Qisnwasners .- I i — Munic:cat Other No. of Or/ers Hearns 0evxW es KLccai _ Connec:tan No. at No. of Law Voltage No. of '.Vater Heaters KW i Signs 3a las zs Ninric No. Hyero .Massage Tubs I No. of Motors o(al HP OTHER: INSURANCE COVERAGE: Pursuant to the reauirements or massac'csa s general Laws - NO _ I I have a current Liaotiity Insurance Policy inducing C:,m_!etec Oeerauens Coverage or as suostantial eeuivaient. YES - have suomiKea vatic proof et same to the office. YES - NO _ If you nave cnecxea YES. otease inaicate me type at coverage cy checxing the actor orate cox. GtQ br �rTC! �B �J INSURANCE 3CN0 = OTHER = (P!ease Scec:fy) (Exoiranon 0atei Estimates Value of E!ectncat Work S _ Roti n Werx ;o Stan Inseecaon Oa;e �acues:ec: 5 Signea uneer the Penalties at perjuryA b LIC. NO. Q/•3 FIRM :NAME SLn �_r� 1(�sA--� . S;gnature LIC, u0. Licensee 3us_ Tel. No. Alt. Tet. NO. Aggressas OWNERS INSURANCE WAIVER: I am aware trial the _:censee aces not nave me insurance coverage or it suent. a l ecuivale A Agent auirea ov Massacnusetts General Laws. ano tnat my, signature an :his permit application waives this reauirement. Ow1n r 9� tP!ease cnecK one) _ c _ Y e([///J` elecnone No. PE-MIT rE_ l (Signature or owner or Agenn TO (J{ e! �� Date......... (y.. !.... 3 7 ♦3 V f NORTF, TOWN OF NORTH ANDOVER - PERMIT FOR WIRING ,SSAcm This certifies that ........... ?.. .:1C1.i2. ........ .................. has permission to perform ...... e. wiring in the building of...... .�.(.Q.�t.. ................................................ at c / ..... ........1 c�?i6i......L-. ................. ... .North Andov , ' f Fee../S...(�.... Lic.No.4.�( ... ......... .... ........... p ,`,` t ELECTRICAL INSP OR 1 28/ `^� C Y (?8/28/96 11:04 15.00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer N ►1 gMA-MM.PEFtM\T ��OIN�I O��IOR�� Ail Permit NO: `/ Date Received . w°gwreo 01 45 �SSACHUS�� Date Issued: IMPORTANT: Applicant must complete 4IJ tems:on this page 'ol Ulu A#Tl�#I r P ER" �' NE, Gil PCt. ZQ`N1N1S 'RICT �sor0istn res + x . TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building < ne famil Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other - aterlSe�+e� DESCRIPTION OF WORK TO BE PREFORMED: . C uln r"S Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: �l^H��rf P � '� �t � ���� •+�+r' `�nai �Z. ' '. :,�'' ���y '� .;''„�'C""�"`. �, ��� T`5u".� � A., a X,y,.+�,'`�+� -. n.: z It'd- S, " la r � �q+',la@rV�SO'f'S� I�StrU �!© '�:'4C�Pe s' "iiwe � a fa i.��ta-�" �'r 5. tx, ,��,. ^?« �ry�`� �* S. -,r�.. ss. .r rt M.b ,�"�_ �� �`�"�}�•� .ice *�# "�yy ,",nNt' ' V,: .;-c-; craeTlroveencerse � ,; _ � x 2Dte ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BOLDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. qS Total Project Cost: $ I,,O.50 AP FEE: $ 2 Z'I X' �- = Ll Check No.: Receipt No.: � NOTE: Persons contractin it u r gist ed contractors do not have access to the guaranty fund gtureofYA-.ent/t3wner ` �¢ ' °Sgnaturg of.contrae#or.� _viu 4k BUILDING PERMIT NORTH q TOWN OF NORTH ANDOVERr`6 ''- °p APPLICATION FOR PLAN EXAMINATION * Yy* b T ' 'y �A-o,P < Permit NO: �/ Date Received 7 p�gATEP �SSACHU`��� Date Issued:-J- d IMPORTANT:Applicant must complete all items on this page LOCATION "Pie PROPERTY OWNER 7eVe— Printk< rng/ey Print MAP NO: PARCEL: ZONING DISTRICT: Historic District yes Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential New Building ne famil Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District Water/Sewer (� 1 / DESCRIPTION OF WORK TO BE PREFORMED: l 4 d /2 e Lk-1 Identification Please Type or Print Clearly) OWNER: Name: Phone: Address: CONTRACTOR Name: 'r t f Phone: �Wl l �1 Address: Pd an 3 Qd c-4 L i1 iu /y)a Supervisor's Construction License: L 7 4LS Exp, Date: . Home Improvement License: I I a I n a Exp. Dater 91ao c> ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ �il° ,DS'o ADO FEE: $ -229 XZ = Ll S Check No.: Receipt No.: NOTE: Persons contractin it u r gist ed contractors do not have access to the guaranty fund Signature of Agent/Owner w` Signature ofco,ntractor Xyz Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS f 'Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments r� Conservation Decision: Comments Water & Sewer Connection/Signature & Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use) ❑ Notified for pickup - Date Doc.Building Permit Revised 2008 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract o Floor Plan Or Proposed Interior Work Li Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (if Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Application Revised 2.2008 NORTH Town 0 t over . . No. y9z 0 LAKE dover, Mass., 0 COCHICHEW11 Of?ATED C5 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ........................................................................................... .......SA0 .......Kill 14. Foundation has permission to erect....................................... buildings on......(zo........T#.VUWd ................... Rough o,. Aw Chimney .....1.4 to be occupied as.... ...........?................................................................................................ provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough &I a Final WW_1 JK?L PERMIT EXPIRES IN 6 MONTHS qq UNLESS CONS S ELECTRICAL INSPECTOR T11TDAT)1�T _7_-_- 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. SEE REVERSE SIDE Smoke Det. s The COMmonwealth of Massachusetts Department o Ind.f ustria114ccidents. H Off ceo InvestiQ F c f eQtlOns 600 Washington Street L'oston , MA 02111 ww rv."uus.govIdia Workers' Compensation Insurance.Affidavit: Builders/Co A Iicant Information ntractors/Eleetricisns/PIumbers �7 �,,/ l Please Print Lm_ blv 1Vaine (Business/Organization/Individual): Address: fil N AN, City/State/Zip: _ _VIA Phone#: Are yo:" ao' employer?Check the appropriate box: 1•❑ I a employer with 4. ❑ I am a genera7conand Type of project(required): lYeas(full and/or part-time)-* have hired th '6• ❑ New construction am asole proprietor or partner- listed on, the a7• ❑ Rem odeling. ship and have no employees These Sul>-contractors have workin for in an capacity. workers 8. ❑ Demolition g y p t' ' comp. insurance. [No workers' comp. insurance 5..❑ We are a corporation and its 9• ❑ Building addition required.] officers have exercised.their 10.❑Electrical repairs or additions \ 3.❑ I an a homeowner doing all work right of exemption p myself. [No.workers' comp. c. 152 er MGL I I.❑ Plumbing repairs or additions §1.(4), and we have no I2.❑'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 oil r7mnlCOWnerE WIiQ SilbnllS fllfE aiidevii IndlCfIIi@�atey are uuill-aN vv%,F;;tea, �=� P cy iniormatioa. xConuactors Ilial check this box must attached an additional sheet showirtg then r of outside eontraeiorb muni submii a new atndavit indicating such. rine a•the sut -comaaetots and their workers'comp,policy information. I am an employer that is providing workers'compensation insurance or a In ees. Below is the oli , information. f Y p c.� and job site Insurance Company Name: Policy#or Self-.ins. Lid.#: Expiration Date: ------------ Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declar-afion page(showin;the policy number and expiration date). .Failure to secure coverage as required under Section 25A of MGL c. I52 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, ance coverage vas well as civil penalties in the form of a STOP WORK ORDER and a fine of es to.5250.00 s day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of.the DIA for insurerification. I do hereby certify er the pains andpenaides ofper-jurj,that the information provided above is true and correct Sigrfature: Date: Phone.#: Official use only. Do not write in this area, to be completed hJ:city or town official City or Town: Permit/L,icetese# Issuing Authority(circle one): 1. Board of Health 2. Building Department 3. Ch3/Town Clerk 4. Electrical Inspector 5. Piumbitzg Inspector (.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"..very person in the service of another under any contract ofhire, ' express or implied;oral or writt,art." 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 incluciizsg 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&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 o r 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 mf 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-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 afncLavit 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 parent of Industrial Accidents. Should you have any questions reg�rciinv the lam, or if you are required to obtain a workers' compensation policy,please call the Department at the nm- nber.lised belovr. Self insLired 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 foryou to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permittlicense number which will be used as a reference number. In addition, an applicant that must submit multiple permit/iicerrse applications in arty 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 burnleaves 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 lndustrial Accidents. Office of IavesfibatiEons 600 Wadiington Street Boston, MA 02111 Tel. # 617-727-4900 m t 406 or 1-877-MASSAFF Revised 5-26=05 Fax 4 617-7-7-7749 vAw l.mass.Dov/dia PJM Finishes 30 Franklin Street Tewksbury, Ma. 01876 Christine Kingsley 120 Sandra Lane North Andover, MA 10845 Dear Christine, Please find below my kitchen proposal at your Sandra Lane home. In developing this proposal every attempt was made to include everything necessary to transform your existing kitchen into the kitchen of your dreams. This is based on the estimate I did for you in your home. Hopefully it clearly represents your goals. I will use my 25 plus years in the business to construct your project in a way that will least impact your life. I will use only the best time proven professional practices and the best people to ensure perfection. Thank you in advance for the opportunity to work with you. Peter J. Michals U) Scope of Work: 1. Installation of plas is divider wall to isolate kitchen space 2. Demolition of existing cabinets and removal from site 3. Installation of cabinets provided by Jackson Kitchen Designs 4. Necessary plumbing to reconnect new fixtures 5. All work to be paint ready (includes all plaster) 6. Supervise the installation of counter tops 7. Install all appliances supplied by owner I agree to do the above-proposed work for the sum of$5350.00 TERMS: $700 Deposit at signing of proposal $2,000 upon commencement of work $1,500 after cabinets are installed Remainder upon completion I I - - ✓ILG lOO�l�i Yl2(Y7Z(I/2lGLLfL 6�/!/(,(y ,tCOP.� pard of Building Regulations and Standards construction Supervisor License ;.. License: CS 47465 Birthdate;_5/7/1963 Expiration: 5/7/2009 Tr# 15786 Restriction: 00 PETER J MICHALS IV 140 CHESTNUT ST WILMINGTON, MA 01887 Commissioner 5E _(�{� ✓/2e �G�YU�I207'Gli/f:(.LII./G �s�� I narq 61 Luli(�IYIb t�c:vu:::Cr�uaauil=.�. i _��_ HOME IMPROVEMENT CONTRACTOR _ Registration:. 112702 t Expiration;-,4[20/2009 Tr# 261071 `�� Type; DBA PETER J MiCHALS IV CARPENTRY PETER MI(:HALS'IV, 140 CHESI NUT S—',:' l� �- I WILMINGTON,MA 01887 a Administrator S I Location No. r _ Date 101 NaRTN TOWN OF NORTH ANDOVER O !O. { ' Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # � 21V8 Building Inspector