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Miscellaneous - 122 BOXFORD STREET 4/30/2018 (3)
122 BOXFORD STREET 2101104.D-0060-0000.0 \ y i i I j 891 1 Date.YA/ t�'<",O RT:'�o TOWN OF NORTH ANDOVER ° PERMIT FOR PLUMBING •'SSACMUS� This certifies that . . x�-t' . . . :,• • • sn •h•l�L-• • • • • has permission to perform . . .K1 ,1. .�: .C`,�.��!t.tsX�411s�• . plumbing in the buildings of . . 5�,ri_.- .(�o. . . . . . . . . . . . . . . . at . . . ). . . . ..;c va��. . . . . . ... . . . . North Andover, Mass. . ' re ,,Uy. .Lic. No. Q .l_� . . . . a 1� . . . PLUMBING INSPECTOR Check r J l.. MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS / 1 1 Date Building Location lQ� }•� � s� Owners Name i''�'* �AeS(0 i 6LOIPermit# n �' Amount o Type of Occupancy /� New Renovation Replacement Plans Submitted Yes No FIXTURES z d z H > w x a U O a x w w d A Q Z a a z a w Q o o F � d o o U 3 x� J) B ksBMFvr Erfilm M Heat 3M Fit= 4M ROM say» 6M FKM 71K HfM sni-HIM (Print or type) Check one: Certificate Installing Company Name 17A-/��WQ �►A1r" LLL Corp. �d'E�LaM. 14+ I Address - � Partner. 0"x0Business Telephone Firm/Co. Name of Licensed Plumber: C, ✓� 1M Insurance Coverage: Indicate 1h type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity El Bond El 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 i Signature Owner Agent I hereby certify that all of the details and information I have submitted(ore ered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations perfo d under Permit Issued for this application will be in compliance with all pertinent provisions of the Massac s tP6 Plu 142 of the General Laws. By: Igna cense um er pe of Plumbing License Title ,h'Z'1 (— City/Town r7cense MOM Master Journeyman a APPROVED(OFFICE USE ONLY i I i i 4 -- - L Hr. �t 1 a I I COMMONWEALTH OF MASSACHUSETTS IN ku moo:.• •. . LICENSED AS A MASTER PLUMBER ISSUES THE ABOVE LICENSE TO: JASON W THOMAS - a - 13. JACKMAN RIDGE RD IU WINDHAM NH 03087-1670 10315 05/01/12 , 795950 : 4 L e S 0 0 3 Date...... ....................... 3r°�';r`` -••_:"�,� TOWN OF NORTH ANDOVER PERMIT FOR WIRING S CHUS EL CL -A.4: S�• � This certifies that ....t.......�FL.G..........-...T�. ...�2.......... � z has permission to perform . �-t 7-c`/ ,v S!//S .........:.............. wiring in the building of......... �i2 f d f; at........ Zz.. � ........ ................4 North Andover,Mass. Fee.....G1.- '.....' Lic.No. P 4....I 7............./Al �&S�E��/ r Check # 19 �. !9\1- Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 1104 3 Occupancy and Fee Checked y BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 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 IN INK OR TYPE ALL INFORMATION) Date: APRIL 5,2011 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) 122 BOXFORD STREET Owner or Tenant PAUL PASSARIELLO Telephone No. Owner's Address SAME Is this permit in conjunction with a building permit? Yes UX No U BLDG PERMIT# Purpose of Building SINGLE FAMILY DWELLING Utility Authorization No. N/A Existing Service 200 Amps 120/240 Volts Overhead❑ Undgrd❑X No.of Meters 1 New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: KITCHEN REMODEL,ADD SUB-PANEL Completion of the followin table may be waived by the Inspector of Wires. No.of Recessed Luminaires 10 No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets 18 No.of Hot Tubs Generators KVA No.of Luminaires 18 Swimming Pool Above 0 In- 0 No.of Emergency Lighting grnd. grad. Battery Units No.of Receptacle Outlets 6 No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 4 No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained _..........._... Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal 0 Other Connection No.of Dryers Heating Appliances Key Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent 1 OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: $3,000.00 (When required by municipal policy.) Work to Start: 4/5/11 Inspections to be requested in accordance with NEC Rule 10,and upon completion. INSURANCE C n ess waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECKONE: INSURANCE ❑X BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties ofperjury,that tke information on this applicadon is trae and complete FIRM NAME: MIKE'S ELECTRICAL SERVICE OF SOUTH HAMPTON,INC LIC.NO.: A10421 Licensee: MICHAEL KELLER Signatu LIC.NO.: E25006 (If applicable,enter"exempt"int the license number line.) Bus.Tel.No.: 603-394-0117 Address: 27 WOODMAN ROAD,SOUTH HAMPTON,NH 0)382f'' 382 Alt.Tel.No.: 603-231-_6068 *Per M.G.L.c.147,s.57-61,security work requires Department of Public Safety"S"Licen LIC.NO.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signa- ture below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent PERMIT FEE:$ Signature Telephone No. r e J l J v The Commonwealth of Massachusetts Print Form Department of Industrial Accidents Office of Investigations 600 Washington Street UV Boston,MA 02111 www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): MIKE'S ELECTRICAL SERVICE OF SOUTH HAMPTON, INC. Address: 27 WOODMAN ROAD City/State/Zip: SOUTH HAMPTON, NH 03827 Phone#: 603-231-6068 Are you an employer?Check the appropriate box: Type of project(required): 1.0 I am a employer with 2 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑ Remodeling ship and have no employees These sub-contractors have g. Demolition working for me in any capacity. employees and have workers P Y coin insurance. 9. F]Building addition F [No workers comp.insurance P required.] 5. ❑ We are a corporation and its 10.�Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.0 Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152, §1(4),and we have no employees.[No workers' 13.E]Other comp.insurance required.] *My applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they 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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: INTERGUARD Policy#or Self-ins.Lic.#: MIWC128360 Expiration Date: JULY 16, 2011 Job Site Address:122 BOXFORD STREET City/State/Zip:N.ANDOVER, MA 0184E 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 J 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. Si atur. Date:APRIL 5, 2011 Phone#: 03-231-6068 Oficial use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Y I 1 1 � � • r s Location No. Date NORTH TOWN OF NORTH ANDOVER r ,ti 3? � 0� ~ s Certificate of Occupancy $ Building/Frame Permit Fee $ swCHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ r Check # 14351 Building Inso for TOWN OF NORTH ANDOVER BUILDING DEPAR'TMEN'T APPLICATION TO CONSTRUCT REPAI$RENOVATE, OR DEMOLISH w'ONE pOpR■rTWO FAMILY DWELLING iV1V�V� BUILDING PERMIT NUMBER: / �'— DATE ISSUED: C SIGNATURE: Building Commissioner/In ctor of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 00 0 Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: S�4 Zoning District Proposed Use Lot Area(sf) Fronta ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private p Zone Outside Flood Zone ❑ Municipal 0 On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record me(Print Address for Service: Vc Z 9 3 0 _ 0 Sign ie v Telephone 2.2 Owner of Record: Ne Print Address for Service: AN Si na` Telephone SEC ION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ ll11 c. Licensed Construction Supeepgs :w\� License Number dress l5 J1•�a� () p v ✓�� 3 Expiration Date Si nature Telephone g P 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number A Expiration Date Si nature Tele hone 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 buildinE permit. Signed affidavit Attached Yes......],I, No.......0 ' SECTION 5 Description of Proposed Work check au applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: ' J I 4- `L / SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost Dollar to be FOFFICIAMUSE(3NLV Completed by ermit applicant ' N I. 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 I, C�i V •�. / s caner/Authorized Agent of subject property Hereby authoriz fin... to act on y bel f,ii all matt rs relati v authorized y building permit application. Viol Lure of Owner Date ( ( SECTION 7b OW`NER/AU(TH IZED AGENT DECLARATION 1, 2.�. /"� �,� 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 Pri t � 1 r1L/ Sin tue of Owner/Alent Date NO. OF STORIES SIZE -�— BASEMENT OR SLAB l —t' SIZE OF FLOOR TIlvIBERS I 2 3 SPAN DIMENSIONS OF SILLS — DINIENSIONS OF POSTS z DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS ` SIZE OF FOOTING X MATERIAL OF CHEVINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE i FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from Boards and Departments having jurisdiction have been obtained.This does not relieve the applicant and or landowner from compliance with any applicable requirements. .................................................n.�....................../.. APPLICANT �c%c,, I` n, )t L•..,, l �� (� Pe,-,9 ,.�)JPHONE ✓5�3 3 7 ASSESSORS MAP NUMBER L"� LOT NUMBER SUBDIVISION LOT NUMBER STREET �L�-- STREET NUMBER 17,'z-, �.■......... .......................................... :..s........■ OFFICIAL USE ONLY .�C......�......S OF TOWN AGENTS .....................r:7.4�.'�:... �. �. ■...a-r. ................■...........■■....r......■■.■.■ ■.......■ DATE APPROVED < < QV C ERVATION ADMINISTRATOR DATE REJECTED COMMENTS DATE APPROVED TOWN PLANNER DATE REJECTED COMMEN"I'S DATE APPROVED FOOD INSP OR DATE REJECTED 77 DATE APPROVED C CTOR-HEALTH DATE REJECTED COIviMENTS40, S'� PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE i I � I ' I V v �`� b - ® ZL - II I 4 , S 88.04'30" E 221.83' No 4. G�PGE 0 p O O • a fn A� 1p O. •i 00 il �4 ti� 33 t A ? - N O N 19'34'00" W---� N 39.37' w b o r+ o o N 11'56'50" E 16.00' 6p•30' S ,803'10" E R=800.00 L=104.95' BpXF � R D S TREE T 1 { 108.3 TOP EL _ AS `\ r , DH FE ILS EXIST. 1000 GAL tjt�, ;. t,a SEPTIC TANK O i. T.B.M. 18 MAPLE MAIL-100.Q0' v 1 , r. EXIST. `BOX u Pi 3 _ bjFAcsE LEDGE OUTCROP oJ 4' _ M AREA , IP F N D TOP EL 103.9 TOP EL 101 .2 �' - ibY TOP EL 101 . 1 i EXIST. COLIC• r-�,i ' ALIN ACCORDANCE '` 0 't �l REI . t,. _ 1 T SES D�_T�,�L_.WI TH i OP ELE J VAR. �. { S.BND. FND HELID FOR E: • .� I k NORTFy E ..Town of ' X ©ver O rJ No. GAS' dover, Mass., T �- LA O COC NIC ICTCo Al DRATED S u 4 n BOARD OF HEALTH Food/Kitchen PERMIT T D i Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..�..eie. 1pme��...�.........141J.. ...............01..�.��.r.�.L�.. ........................... � Foundation has permission to erect... .f .. .0-....... build' gs on ...... ..OZ.a...........SOpr ............ .............. Rough • I Chimney to be occupied as....6-a-po-sr..........��.... ..1.. ....��....................................................................................... provided that the person acceptin(Tthis 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 relatinglo the Inspect'o Alteration and Construction of Buildings in the Town of North Andover. /27 /O[// `O PLUMBING INSPECTOR 77 • VIOLATION of the Zoningor Building Regulations Voids this Permit. I Rough 9 9 PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST S ELECTRICAL INSPECTOR C Rough ............ ................................. . ......................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building i 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. Smoke Det. SEE REVERSE SIDE TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING 'y BUILDING PERMIT NUMBER. DATE ISSUED: M SIGNATURE: Building Commissioner/I or of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: ? .4y-LA-9- Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided RegLured Provided 3 o 1.7 Water Supply M.GL.C.40. 54) 1.5. Flood Zone Information: _ 1.8 Sewerage Disposal Sys : n Public ❑ Private Zone Outside Flood Zone Municipal ❑ On Site Disposal System SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record e(P ' ) Address for Service: �DG Signature VTelephone 2.2 Owner of Record: ;, w - O Name Print. Address for Service: z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ 1 . v1 :_— J jLicensed Construction Supervisor: �) (.� O License Number Add s �f1 > ✓ �j Expiration Date Signature elephone P 3. Re istered Home Improvement Contractor Not Applicable ❑ v 1-1� Company Name Registration Number r Addre r 7 � Expiration Date ^� Si nature Te ne Y/ SECTION 4-WORKERS COMPENSATION(KG.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 buil4ing permit, Signed affidavit Attached Yes...... No.......❑ SECTION 5 Description of Propos-ed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: A41:) SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be .' :bFVICIAL USE,QNLI' Completed by permit applicant I. Building (a) Building Permit Fee Multi lier 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 I, Pe, L ,as Owner/Authorized Agent of subject property Herelw authorize to act on i at..n a er 'tela to work authorized by thi uid� g permit application. i nater Owner Date SECTION 7b OWNERIAUTHORIZED AGENT DECLARATION I, k. U V 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 l Prin Si at e of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TF\4BERS 62er' 161 2 ND 3RD SPAN =--- DIN ENSIONS OF SILLS DIN ENSIONS OF POSTS yup DMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING `-X l MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE ........ �723- - • r -- I r - -r- , r , r t-- r � - T i r r r r t - r i r r - -r I r r I h {pew I I V^r Ydri V V! r. t - r —+- r , -' - r r + r ' I r r r - - t T i -� -+--•` .. --�---} .. r �.. __..T.- _ ... _ .. r _ + a- r- -a.- y r _- _ __-.T - t-_'�' - i . T T t r r }-- r - .._ t I i I *-+-�----T - I -._.rt.-. __,. - ,-�,-�--1-- - r • - -� ��-�r�-.wti�t -� I "---• • r r r .-y'—r I r _ - �� —Y _ _ -- —.t—_+--- r -,.—.._t_r._ w.a�,+�-! �9+�Vr � ,j/']JR�FD�, / .. -+ r ._— _+—r- r -'.�- - * i-—'---+— +�`.r��E1_ «�.—., - - r 'SJ _ - r- —. r _ 7 _ ... _.f _-+—�- C-1-, a-`-..r_ r - � •--r— • _-r --+ r I I r I � I I Y' 1 ' � I I , I I r r I I � , 11 , 14 ' I r I I I I ( I I t. I r V r The Commonwealth of Massachusetts y Department of Industrial Accidents Office of Investigations , Boston, Mass. 02191 Workers'Compensation Insurance Affidavit Please Print Name: AIL,v Location: >� City K')z " Phone aam a homeowner performing all work myself. �I am a sole proprietor and have no one working in any capacity am an employer providing workers' compensation for my employees working on this job. Com an name: Address City: N, / Phone#: Insurance Co. ,w`4 "- `L G-ati Policy# Company name: Address City- Phone* Insurance Co Policv# 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 as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. !do herby y and apa fndpenakti sof perjury that he information provided above isSignature � Date l ?tel ` y Print name `�,,L..S 1 ""`�(D�-�! Phone# l>�y� 573 I 3 Official use only do not write in this area to be completed by city or town official' ❑ Building Dept ❑Check if immediate response is required Building Dept ❑ Licensing Board ❑ Selectman's Office Contact person: Phone#: ❑ Health Department ❑ Other FORM WORKMAN'S COMPENSATION I Date. . 0 TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING ,SSACHUS� This certifies that . . . . . . . . . . . . . has permission to perform- .��. . . .� . ��v .: . . . plumbin in t e b it ings at . . . . . . .zz. .. . . . . . . . . . . ., North Andover, Mass. Fee_ V-. . . .Lic. No.. - :Z . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR � Check # .6194 MASSACHUSETTS UNIFORM APPLI ATION FOR PERMIT TO DO PLUMBING (Print or Type) n / Y 2,Z1 L Zgjn�n16Q1ass Date Q Permit # Building Location Owner's Name���a� Assia rAf-Z6 Residential Type of Occupancy --A/ tial _- — 4 � New ❑ Renovation Replacement (S Plans Submitted: Yes❑ No D FIXTURES o z ►- i O b N N W x J QV h N D O W N 2 N 4 Cr Z O 2 ` p, O — W F- W ¢ _ ¢ N — LL Z J N H N T H U U z Cr CO ¢ N W Q ~ = D ¢ W F W Q N J En c ¢ J Z p ¢ p LL W Q 3 3 O z x d O 1•- Q x d W W x i•' i' i+ �- V > H O W a N F Z O O N Z z W 1- O Q F Q Q = VI N Q Q O Q J Q ¢ ¢ a Q O 4 1-1 m rti rt1 b td SUB-BS MT. BASEMENT / IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR I STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company,Nam`e Heritage Htg. &Pig. CO. Inc. { Check one: Certificate Address + 3S Pleasant Street ` 1 IX Corporation 714 R Stoneham; Ma °02180a 6 C7 partnership I ? ee Business Telhon ' 1 - ,p +. 1.. Z81,=438-7776 � f il-1 Firm/Co. Name of Licensed Plumber r � •Gordon Switzer INSURANCE COVERAGE: A• I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes ® No ❑ If you have checked Yes, please indicate the type coverage by checking the appropriate box. A liability Insurance,policy 13 Other type of Indemnity .❑ Bond ❑ , t 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 Stale Plumbing Code and Chapter 142 of the General Laws. •r f8t'gnature of Licensedumber Title -Type of License: Master[g Journeyman E] City/Town . 8322 APPROVE ONLY) License Number f ' s i BELOW FOR OFFICE USE ONLY FINAL INSPECTIONS SKETCHES FEE PROGRESS INSPECTIONS } NO. f APPLICATION FOR PERMIT TO DO PLUMBING NAME 3 TYPE OF BUILDING LOCATION OF BUILDING PLUMBER PERMIT GRANTED DATE 19 _ PLUMBING INSPECTOR PER31IT Nom.- «� APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGF 1 MAP "0. LOT NO. 2 RECORD OF OWNERSHIP IDATE (BOOK ;PAGE ZONE I SUB DIV. LOT NO. LOCATION PURPOSE OF BUILDING T,.;> OWNER'S NAME LL ,, NO. OF STORIES SIZE C•� OWNER'S ADDRESS �/� /) ,� BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD y BUILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER 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 PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 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 DATE FILED U ILDINO 1 NSPKCTOR SIGNATURE O OWNER ORA THORIZED GENT F E E ��� OWNER TEL.# , PERMIT GRANTED CONTR.TEL.# 19 CONTR.LIC.# H.I.C.# i I . I i i i i i �. 4 " r10RT Town of _ - over No. 60 63 i . dover, Mass., 19 9A_C OCNICNE WIC K•-r,%. X1#4 E BOARD OF HEALTH Food/Kitchen PERMI -T T Septic System THIS CERTIFIES THAT.................... � ....... .... .... . iL�J� .� BUILDING INSPECTOR ........................................................... Foundation has permission t&*Feet ....... .. .. .. ... ... . buildings on ........, .. ..........:4� b... !� Rough to be occupied as........................:..................... . . ...�. Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Final 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 CONSTRUCTIONS T ELECTRICAL INSPECTOR Rough ....................... .............. .... ................ ... .......................................... Service UILDING 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 BeDone Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. Smoke Det. c IL PERMIT NO. — APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP NO. LOT NO. 2 RECORD OF OWNERSHIP DATE BOOK PAGE ZONE I SUB DIV. LOT NO. II— LOCATION"e PURPOSE OF BUILDING f OWNER'S NAME NO. OF STORIES /J� SI OWNER'S ADDRESS ace BASEMENT OR SLAB ��v ARCHITECT'S NAME SIZE OF FLOOR TIMBERS 1ST 4,�Cj02ND /J 4VJ 3RD BUILDER'S NAME n I_ I - SPAN -- DISTANCE TO NEAREST BUILDING�'w✓ DjMENSIO14S OF DISTANCE FROM STREET 6 , POSTS DISTANCE FROM LOT LINES-ASIDES�I���GD REAR GIRDERS AREA OF LOT .� J•' Q/FRONTAGE V/ P HEIGHT OF FOUNDATION THICKNESSY/ /fV IS BUILDING NEW YJ SIZE OF FOOTING `,Q X �! IS BUILDING ADDITION MATERIAL OF CHIMNEY 60f/ CIAO,- IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND o I L ct WILL BUILDING CONFORM TO REQUIREMENTS OF CODE , IS BUILDING CONNECTED TO TOWN WATER M-6 BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER IN o IS BUILDING CONNECTED TO NATURAL GAS LINE [\-J D INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST o®'o _ 9 EST. BLDG. COST PER SQ. FT. PAGE t FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. 6017 ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS �"A ;f-roi Sec -7/ 1,P7,r PLANS MUST BE FI AND APPROVED BY eBUILDING INSPECTOR DATE FILED • BOARD OF HEALTH SIGNATOR WNER A TH Z AGENT F E E AV rr PLANNING BOARD PERMIT GRANTED 19 _ BOARD OF SELECTMEN BUILDING OR BUILDING RECORD" 1 OCCUPANCY 12 SINGLE FAMILY I sroRlEsTHIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT`AND DICSTANCE.FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- _ APARTMENTS I RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE _ _ &.. 1 2 13 , CONCRETE BIL K. PINE BRICK OR STONE HARDW'D PIERS PLASTER _ DRY WALL, U N F9`Itl> 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ V. y, '/ FIN. ATTIC AREA _ NO BMT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS II 9- FLOORS CLAPBOARDS B 1 2 3 _ DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH - ASPHALT SIDING HARDV✓'D _ ASBESTOS SIDING COMMON _ VERT. SIDING ASPH. TILE �— STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STIRS. & FLOOR I_ BRICK ON FRAME .- CONC. OR CINDER BLK. �- - - •� STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I ( POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH (3 FIX.) GAMBREL MANSARD TOILET RM. (2 FIX.) _ FLAT SHED WATER CLOSET ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES -- TILE FLOOR _ TILE DADO•" - 6 FRAMING II 11 HEATING - e� WOOD JOIST PIPESS LEFURNACE - _ FORCED HOT AIR FURN. TIMBER BMS. &COLS. I STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS , 7 NO. OF ROOMS GAS OIL B'M'T 2nd ELECTRIC 1st 13rd I NO HEATING a N° 2828 Date.... .../ ..�J/. NORTH TOWN OF NORTH ANDOVER PERMIT FOR WIRING °r;; �SsAcwusE� (� This certifies that ...... ...!........................ .�.:....... �. .......�........................... ,has permission to perform r 'Z ...... ..... . ......................................................... wiring in the building of... rt..- ?.. P........//()............................................ � J «at.... .. . '... ./(..1� .'i? ......�1..........................North,,Andoovve�r;Maasss.� Fee... .��. '.w Lic.No.../ .1J0 ............... ........ .t. ,!../..4. .l:... Ell INSPECTOR Check # WHITE:Applicant CANARY: Building Dept. PINK:Treasurer . .� 11L wmmulyWEALl"ur mAx."c"liml 113 ULI A;USC WHY DEPARTAffiVTOFPUBUCSAFM Permit No. BOARD 0FFTREPRENFVTI0NREGULATT0NN527CMR 120 ' Occupancy&Fees Checked APPLICATION FOR 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) Dat 41 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) 0), 'Sox For- [) 'St Owner or Tenant-G}r I'C '?a C., 1 Owner's Address an Y-r.t< Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building &() C-1-e- � {,/ Utility Authorization No..�� Existing Service Amps / Volts Overhead Underground No.of Meters New Service Amps / Volts Overhead Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work eloc4e_ ;k CcrrSG Pon f' Open e,-S f lelyr-,� SL-/ Pvc Pi No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.-of Lighting Fixtures Swimming Pool Above Below Generators KVA and ound 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.of Dryers Heating Devices KW Local Municipal Other _ Connections Flo.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER IrMra=CaAra RERUtiDthetemuuartatLsofMa &hBedsC irdLam Iha%eaa=tLiabtlitylrnra=Pchym6-&gCan>*t CovaaWcritsabstar ialegivalat YES ® NO Iha%esthn&dvandptoofofsametotheOfoe YESF-1Ifycuhawdie WYES,pk=indic*thetypeofoa�aagebyd�lgthe M BONDO�J CE LSpey) EtmatedvahlecfEkfiiral Wade$ WcrktoStm InspectionDaleReWested Ratgll Fatal SigrW unckr"fi%mIties ofpajtay; FIRM NAME LiotrneNo Sig, Lioa>SeNo 9 v 9 BmiressTd.Na '] r ScItmS4 !oG/difn mfil 01VF AIL Tei Na1W XO OWNER'S INSURANCE WAIVER,latnawxethattheLJomwdmnot t, etheictstrj=wvw Pori) WAyAialetaste4zudbyMassxhmilsGalealLaws anddrltmys althspmikwp5cMmwaissthism4ni Midi (Please check one) Owner Agent Telephone No. PERMIT FEE J V Location No. �r Date d Z MORTM TOWN OF NORTH ANDOVER _ t y • i ; , Certificate of Occupancy $ Building/Frame Permit Fee $ s�cNus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ! a �t l� 15537 Building Inspector s � TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIJ RENOVATE, OR DEMOLISH�AONE OR TWO FAMIL��--Y DWELLING � 44, JQW BUILDING PERMIT NUMBER. n DATE ISSUED: r / aO O SIGNATURE: BuildingCommissioner/I t of Buildin Date Z SECTION 1-SITE INFORMATION 0 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 1 ZZ �raQ?7 ST ✓ d �/ 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 RaqlfirCd Provided ReqWrcd Provided v 1.7 Water Supply M.GL.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System 0 J SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record !� ineT"�� A�S .tiL1E �ZZ C�ol� o�L1� �T tV, AsvpJ�y�Yt Name nt Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: O Z rn Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: +lic, O License Number Address - �jzyloz � Expiration Date � Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name &� I a 3 rn Registration Number � WC p.2.ry Address 3 3^ -7`'f oo �' Z� f 2__ r 1 ` Expiration Date ^z Si nature Telephone v' 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 buildg permit. Signed affidavit Attached Yes.......V No.......❑ SECTION 5 Descri tion 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 OFFICIAL USE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee Q 6 7, Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a) x (b) 4 MechanicalHVAC 5 Fire Protection 6 Total 1+2+3+4+5 1 1 �-►0-7, ^— 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 a Y—Imagers e to act on My be alf r v work autho ' d by this building permit application. C.L Q Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, / ' r7 ..1 0 X%55,9e 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 le loq eZp9y5'R F•Ir, L Lo Print ^ q 6 2 Si ature of Owner/A I ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIIv1BERS Isr2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DilviENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIlvINEY IS BUILDING ON SOLID OR FILLED LAND IS 13UILDING CONNECTED TO NATURAL GAS LINE NOTICE OF CANCELLATION You may cancel this transaction,without any penalty or obligation,within three(3) business days from the date stated below. If you cancel,any property traded in,any payments made by you under the Contract or Sale,and any negotiable instruments executed by you will be returned within ten(10) business days following receipt by the seller of your Cancellation Notice,and any security interest arising out of the transaction will be canceled. If you cancel,you must make available to the Seller at your residence,in substantially as good condition as when received,any good delivered to you under this Contract or Sale; as you may,if you wish,comply with the instructions of the Seller regarding the return shipment of the goods at the seller's expense and risk. If you do make the goods available to the seller and the seller does not pick them up within twenty(20)days of the date of cancellation,you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the seller within Forty eight hours of cancellation,or if you agree to return the goods to the seller and fail to do so,then you remain liable for performance of all obligations under this contract. To cancel this transaction,deliver a signed and dated copy of this Cancellation Notice or any other written notice,or send a telegram,not later then midnight of March 28,2002. PRO-CARE,INC. 3 NORTH MAPLE STREET WOBURN,MA 01801 781/933-7400 I hereby cancel this transaction (Date) (Buyer's Signature) Buyer acknowledges receipt of two complete filled in copies of this notice and understand the terms of cancea. March 24,2002(Date) �r�E,�,u Buyer's Signature) (Date) (Buyer's Signature) NOTICE OF SCHEDULE CHANGES The contractor agrees that when delays become known to the contractor,the contractor will advise the owner as soon as is reasonable. DELAYS IN COMPLETION DUE TO HIDDEN CONDITIONS The owner hereby acknowledges and agrees that in certain remodeling work,the demolition portions of the pre-existing structure may reveal additional defects,conditions or the need for additional work,which must be repaired,altered or carried out in order to commence or to complete the work as described under the contract. In such case(s),the owner agrees that the duration of the work and the scheduled date of completion may differ from the date as stated on the payment schedule,and such variation which is not avoidable by the contractor shall not be considered a violation of the contract. ADDITIONAL WARRANTY INFORMATION All warranties for equipment supplied by the contractor under this agreement shall be those given by the manufacturers of such equipment,which shall be and are hereby passed through directly to the owner. Under such manufacturers warranties the owner may be required to register or mail in a warranty card and other evidence of ownership and use of such equipment in order to activate such warranties. The owner's failure to mail in or register such documentation,which failure voids the manufacturing warranty,shall not create any responsibility for the contractor to warranty such equipment. The warranty gives the owner such specific legal rights,and the owner may also have other rights which may vary from State to State. Under Massachusetts law,sales of good carry an implied warranty of merchantability and fitness for a particular purpose. All material is guaranteed to be as specified.All work to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from the above specifications involving extra cost will be executed only upon written orders,and will become an extra charge over the contracted price.All agreements contingent upon strikes,accidents,or delays beyond our control. SUBCONTRACTING Contractor agrees that,notwithstanding any agreement for materials and/or labor between contractor and a third party,contractor is responsible to the owner for the completion of all the work described in a timely and workmanlike manner. DISPUTE RESOLVEMENT Any controversy or claim arising out of or relating to this contract,or breach thereof,shall be settled by arbitration before one arbitrator,administered by the American Arbitration Association(AAA)under its Construction Industry Arbitration Rules,and judgement on the award rendered by the arbitrator may be entered in any court having jurisdiction thereof. If the arbitration process results in a monetary reward to the contractor,the customer will pay the AAA's administrative fees. In all other cases,the fees will be split evenly by both parties. As an alternative to arbitration,both parties may voluntarily agree to have the matter settled in the appropriate Small Claims Session of the Trial Court of Massachusetts. Such an agreement must be put in writing and signed by both parties. If either party does not agree to submit the action to Small Claims,the arbitration clause contained herein shall be in full force and effect. NO ACCELERATION OF PAYMENTS BUT ESCROWING ALLOWED The contractor may not require payments to be made in advance of the times specified on the previous page for the reasons that he deems himself or the payments to be insecure. If,however,he deems himself to be insecure,he may require,as a prerequisite to continuing the work described herein,that the balance of the payments in this contract that are in the control of the owner,shall be placed in joint escrow account that requires the signature of the contractor and the owner for withdrawal.All payments must be made in 24 hours of co pletion of each sWe. INSURANCE Contractor will be responsible to owner or any third party for any property damage or bodily injury caused by himself,his employees or his subcontractors in the performance of,or as a result of,the work under this agreement. Contractor agrees to carry insurance to cover such damage or injury. CONSTRUCTION RELATED PERMIT ACQUISITION The contractor under provisions in chapter 142A of the general laws is required to apply for and obtain all construction-related permits. The contractor shall not be deemed responsible for delays in the work as described in this agreement caused by regulatory,permit granting or inspectional agencies,authorities or individuals. Notice: If the owner obtains his/her own construction related permits for the work described under this agreement,the owner is hereby advised that in the event of a dispute,judgment and nonpayment of the contractor,the owner will not be entitled to make claim to or collection from the guaranty fund established by chapter 142A,M G.L. MODIFICATION The agreement,including the provisions relating to price and payment schedule are not to be changed except by written statement signed by both the contractor and the owner.However,cancellation by owner is allowed with the three day Notice of Cancellation. COMPLETION The owner is hereby advised that he/she should not sign this agreement unless and until all blank sections have been filled in or marked as void,deleted,or not applicable,and until all exhibits and related or referenced documents that are incorporated herein are attached hereto. COPY OF AGREEMENT TO BE GIVEN TO OWNER This agreement is governed by the State of Massachusetts.It must be executed in duplicate,and an original,signed copy hereof given to the owner at the time of execution.No work under this agreement shall begin prior to the signing of the agreement and the transmittal to the owner of a copy thereof. JOB SITE SIGNS The contractor will be allowed to place a"Job Sign"at the project location from the contract signing until the completion of the work as described herein. TERMS A finance charge of 1.5%per month(annual rate of 18%)will be charged on balances over 30 days.If referred to our Attorney,all cost of collection,including reasonable attorney fees shall be paid by the debtor.All outstanding balances shall accrue interest at the 15%per moth(18%per month,18%per annum). fi The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations . Boston, Mass. 02111 Workers'Compensation Insurance Affidavit F . Please Print Name: Location: Cfty Phone am a homeowner performing all work myself. 01 am a sole proprietor and have no one wonting in any capacity 1 am an employer providing workers'compensation for my employees working on this job. Comp-any name: Address M A I C fir: vPhone k '1 F l `� 7�f 0 0 k-'>P-I • ticv C-oo-1 Lt S I C-gno v-name: Address City Phone* nsitfr- 0e—C o. Egg atrur®to secure coverage as requir l under Section 25A or MGL 1,52 carr lead to the hroosidon d criminal pe»allies.d a fine up to s1.500.00 and/or one years'imprisonment a9�wa'U as dvd penalties in:the form of a STOP WIORK ORDM and a fine of($10000)a day against rte. I understand that a copy of this statement may be forwarded to the Office of investigations of.the DIA for coverage verification. I do herby certifyand the pains and penatles of perjury that the intonation provided above is true acrd-correct Signature Date_% J©Z Print name. \—nc,�,1� --�'p�,n,�L,cr�,� Phone# 7`foc) Official use only do not write in this area to be completed by city or town offtial Building Dept©O/reck if immediate response is regerired BUilding Dept D Licensing Board Contact person: phone# p Selectman's ClflceD Health Department Other ?V WORKMAN'S COMPENSATION i f i PRO-CARE, INC. 3 NORTH MAPLE STREET WOBURN,MA 01801 PHONE:781/933-7400-FAX:781/933-1222 Client: PATTY PASSARIE LO Home: (978)738-0986 Property: 122 BOXFORD STREET N.ANDOVER,MA 01845-3222 Type of Estimate: Homeowner direct Dates: Date Entered: 3/6/2002 Estimate: PASSARIEI LO/BATH THIS ESTIMATE IS BASED UPON A VISUAL INSPECTION OF THE PREMISES ONLY. HIDDEN DAMAGES(I.E.,ROT, MOLD/MILDEW OR ANY DEVIATION FROM STANDARD CONSTRUCTION PRACTICE),NECESSARY RELOCATION OF PLUMBING OR WIRING,AND/OR MANDATORY CODE UPGRADES WILL BE CORRECTED AT AN ADDITIONAL EXPENSE TO THE PROPERTY OWNER.ALL PRICES INCLUDE LABOR AND MATERIALS,THIS ESTIMATE DOES NOT INCLUDE PERMITS IF REQUIRED. • PASSARMLW/BATH Room:Bathroom LxWxH 8'4"x 8'0"x 8'0" Demolition-labor 1.00 EA Drywall repair-shower walls&misc. 1.00 EA Framing repair-prepare for the finish work 1.00 EA Underlayment-Accuply 1/4" 66.67 SF Floor preparation for sheet goods 66.67 SF Vinyl floor covering(sheet goods)-allowance$200. 1.00 EA Toilet-allowance$200 1.00 EA Sink-single-allowance$100ea 2.00 EA Sink faucet-Bathroom-allowance$65ea 2.00 EA Bathtub&walls-allowance$400 1.00 EA Shower faucet-allowance$110 1.00 EA Vanity-allowance$500. 6.00 LF Cabinetry-full height unit-allowance$225 1.50 LF Countertop-laminate-allowance$150. 6.00 LB Bath accessories-toilet paper&towel holders-allowance$75 1.00 EA Light fixture-Detach&reset 2.00 EA Exhaust fan-allowance$125 1.00 EA Shower door-allowance$225 1.00 EA Mirror-Detach&reset 1.00 EA Paint baseboard heater 4.00 LF Seal then paint the walls and ceiling(2 coats) 328.00 SF Room:Mscellaneous Plumbing repair-allowance$1500 1.00 EA Note:Connect all the plumbing fixtures Electrical repair-allowance$800 1.00 EA Note:Connect the electrical fixtures Debri removal&clean up 1.00 EA Permits &fees (Bid item) 1.00 EA Grand Total 11,407.85 PASSARIELW/BATH 05/01/2002 Page: 2 1 ' , ✓,� {�anvraaxuiea��i o�..11,��r,� ! BOARD OF BUILDING REGULATIONS 1 4. License: CONSTRUCTION SUPERVISOR Number. CS 055348 Birthdate: 06/2411961 Expires:06/24/2002 Tr.no: 27492 Restricted To: 00 1 FRANK J TAMBONE JR r 31 DEBRA DRIVE "�' J� TEWKSBURY, MA 01876 Administrator I i i r North Andover Building Department i Tel: 978-688_954 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 c11, S150A. defined by MGL The debris will be disposed of in: +'•CGU s (Location f Facility) Signa re o J f Permit Applicant -=Z4 Date NOTE: Demolition permit from tie Town of North Andover must be obtained for this project through the Office of the Building Inspector i ., i i I I i 4 f i li i i I '."'�-"a.�..a✓.z.i+'. -•..rC-.-3.+�5�-£......- ...,:.,.w. t Y - .-.—�--'t"`•..r'...'aws....C'FAt,.'t�i.'v—._� _..�.ccni.�- �._.�_.._... .. paw 0 3-107.I Pro-Care, IPro-Care copy. Please return 3 North Maple Street with your Woburn Ma 01801 deposit check. 781-933-7400 Fax: 781-933-1222 Reg.# 122843 CONTRACT Patty Passariello March 13, 2002 122 Boxford Street N. Andover, MA 01845.3222 I, Patty Passariello (Vlie)hereby authorize Pro-Care to perform painting,construction and/or restoration services at the above location PRO-CARE PROPOSES hereby to furnish material and.iabor, complete in accordance with the listed specifications for the sum of: $11,407.85 PAYMENTS to be as follows: 0 $3,407.85—Deposit 0 $4,000.00—Substantial completion of the floor installation 0 $4,000.00—Completion of the project *Payments may not be in order. Payments do not represent the value of each item J t NOTICE: No agreement for home improvement contracting shall require a down payment(advance deposit)of more than one-third of the total contract price or the total amount of all deposits or payments which the contractor must makd in advance,to order materials and equipment whichever amount is-greater. All home improvement contractors and subcontractors engaged in home improvement contracting,unless specifically exempt from the registration by provisions of Chapter 142A of the general laws, must be registered with the Commonwealth of Massachusetts. •Inquiries about Registration and status should be made to: Director,Home Improvement Contract Registration,One Ashburton.f lace, Room 1301, Boston MA 02108(617)727-8598 ACCEPTANCE OF CONTRACT-I have read all pages of this document including the following pages and adept the prices. Specifications ant(conditions stated. I understand that upon signing,this proposal becomes a binding contract. You are authorized to do work as specified. Payment will be made as outlined above. You,the buyer may cancel this transaction at anytime prior to midnight of the third business day after the date ofth saction Cancellation must be done in writing. Signature a '" ® Signature Sigh Pro-Care,Inc.Authorized Signature- Pere V � CONTRACTOR-PRO-CARE,INC.-3 NORTH MAPLE STREET-WOBURN,MA 01801 REGISTRATION# 122843 BUILDERS LIC.#056834 TELEPHONE#(781)933-7400 NORTH Town of 4 Andover 0% No. s77 A o �` dover, Mass., COC HIC HE WICK A ` DRATED PP� ,��CS S E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System �A BUILDING INSPECTOR THIS CERTIFIES THAT......... ie� .......... ................... ... .. /.. •../... ....................................................... Foundation has permission to erM.... .....q6.j... buildings on... .... Q..VP 0%01 .5 Rough n .............. Rou to be occupied as......... N d.....F..p!..... A l /N S I! � 1% 104l.14 /V � 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 I spection, Alteration and Construction of Buildings in the Town of North Andover. ���/L>/� pjc i �. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. _s Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION FYTS ELECTRICAL INSPECTOR Rough J."I00"�� ........................... . .. 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 Dec. E E 44� f i I I M 4 j M I I f i E 4 i i i i i i .. Vit' - � I � � Date. . :w TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSAC04US� This certifies that : .`�`.`�- -� . . . has permission to perform .��.�!%' . . . . . . . . . . . ,� " plumbing in the buildings of . . . . . . : . . . . . . . . . . . . . . . . . . . at . . . . �^-�—�.! . . . . . . . . . . . , North-Andover, Mass. Fee.,�/7 . Lic. No. --)16111 . . . ./.�Lti , -. . . . . . . . PLUMBING IN TOR Check # 5295 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS r7 Date Building Location -PermitT,A,LS' �p . Amount r./�J,' Owner v- 1 - i &r C New Renovation Replacement ® Plans Submitted Yes No FIXTURES Ce z H Cn w x x d A A SM-Bga BASHOUNr ISE HJOCR 3o HDM 3l)FIO(gt, 4M HDM 5M FIDCIR 6M HIM 71H HDM i slH ROUR t (Print or type) ,Q 1� Check one: Certificate U Installing Company Name +' g e rs r /� r5• `-5 Corp. Address 0/ ``e ,,-a7 ( El Partner. %7=t tl v-0 -V 61 e7 Business Telephone - / _ Q-Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy ® Other type of indemnity ❑ Bond ❑ ti 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 f Signature OwnerElAgent ❑ 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 Massachuse State Plu bing Code and Chapter 142 of the General Laws. By igna ure 71 i7icenseaum er lType of Plumbing License Title //J>7 Y City/Town iceuse NumDer Master Journeyman ❑ APPROVED(OFFICE USE ONLY 393 ' n Date..... .-/Q..... f NORTp, .'"tD °•"�o� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING SS US r This certifies that ...W4 I et- S7 OC lewd o S ............................... ........................................................ has permission to perform .....BA.'�. ,n o d .......2. t.0 cQ"...I........... wiring in the building of....M.f...... s S a I.d..................................... at.... da -&J - ........................................... ........................... ,North doves,Mass. ( Fee... I...... Lic.No. ....... t 4!.A.. . kt ELECTRICAL I SPECTOR Check # n\ The Commonwealth of Massacpysetts FOR OFFICE USE ONLY fc 3 b� Department of Public Safety 9;_J 0P PermitN°. 80ARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Receipt No. 'ti V APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work will be performed in accordance with the Massachusetts General Code.527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 4 - 9 - O 2- City or Town of /y o i?-tA/z) Pa o If 12- To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below: Location(Street and Number) J 0 X Jw R D 91-. Map: Lot: Owner or Tenant P i�s s A/2 L j, o Zone: Owner's Address 30,,;ns, C Is this permit in conjunction with a building permit? Yes E�No❑ (Check Appropriate Box) Purpose of Building 1[15F SI d e K c e- Utility Authorization No. Existing Service Z 0 6 Amps T o / G Volts Overhead EZ-' Underground ❑ No.of Meters J New Service Amps / Volts Overhead❑ Underground❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work_&J t'tr 6 e,1 h, U' dy r•-t No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above gmd. ❑In-grnd.❑ Generators KVA No.of Receptacle Outlets No.of Oil Burners No.of Emerg.Lighting Battery Units No.of Switch Outlets No.of Gas Burners FIRE ALARMS No.of Zones No.of Ranges No.of Air Cond. Total Tons No.of Detection and No.of Total Total Initiating Devices No.of Disposals Heat Pumps Tons xw No.of Sounding Devices No.of Dishwashers Space/Area Heating KW No.of Self-Contained No.of Dryers Heating Devices KW Detection/Sounding Devices No.of Water Heaters KW No,of Signs No.of Ballasts Local❑ Muncipal Connection❑ Other No.of Hydro Massage Tubs No.of Motors Total HP Low Voltage Wiring OTHER: io INSURANCE COVERAGE:Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent.YES E9-NO❑ I have submitted valid proof of same to this office.YES C-(O❑ If you have checked YES,please indicate the type of coverage by checking the appropriate box. INSURANCE E4OND❑OTHER❑(Please Specify) (Expiration Date) Estimated Value of Electrical Work$ 7 a o c> Work to Start 6 -/ 6 -- D 12- Inspection Date Requested:Rough n 2-Final Signed under the penalties of perjury: FIRMNAME Walter B. Stockwood Inc LIC.NO. A4622 Licensee Walter B. 3toc,wood Signature '+�� O. E .3344 Address 31 Sixth Road, T- oburn, MA 01801 Bus.Tel.No. 781-935-8181 Alt.Tel.No. 7R1 -729-0994 OWNER'S INSURANCE WAIVER:I am aware that the Licensee DOES NOT HAVE 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. PERMIT FEE$ 3 Sil a O (Signature of Owner or Agent) it V I ` i`` i { ` I I II I. II I I y ja i I ' Location lr�c� No. � Date �a ' �30 HQRT1y TOWN OF NORTH ANDOVER h p Certificate of Occupancy $ Zs C •Eta' Building/Frame Permit Fee $ �_� � Mus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # �� 6 J Building Inspects r TOWN OF NORTH ANDOVER ` BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING t.. ; A ,.- "- WELDING PERMIT NUMBER: DATE ISSUED: Iz -3e-a3 X SIGNATURE: f Building Commissioner/Inspector of Buildings Date — e z SECTION 1-SITE INFORMATION O 1.1 Prop Address: 1.2 Assessors Map and Parcel Number: 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 ReqIIired Provide Regutired Provided Re red Provided � 1.7 Water SupplyM.G.L.C.40. 34) 1.5. Flood Zone Information: 1.8 Sewerage System:SP�1 Ys Public ❑ Piivate 0 Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System 0 SJECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1Owner of Recor z z or Name(Print) Address for Service: Signature Telephone 2.2 Owner of Record: Name Print Address for Service: z M Signature Tale hone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Constructi upervisor: Not Applicable ❑ Licensed Construction Supervisor Pe License Number �,�A7—ress \�� E iratio ate ic Signature Telephone is 3.2 Re . red Home Improvement Contractor Not Applicable ❑ i�rzo/� �7j 7�S Company Name Za3 2 Registration Number A d ss // Arai CDate /1 Signature Telephone 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.......0 SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition ❑ q Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: / SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be C>Fk"ICI "U�{)NLY Completed b ermit a licant ° g (a) Building 1. Building Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(e)X (b) 4 Mechanical(HVAC) ,/ c� 5 Fire Protection 6 Total 1+2+3+4+5) Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OW S A EJ,4T OR.CON CTOR APPLIES FOR BUILDING PERMIT 1, as Owner/Authorized Agent of subject property Herebbuthorize ( to act on My b�Ii in a atters re ive to work authorized by this building permit application. , ,,Signature of weer Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, 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 Si ature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINIBERS iST2ND 3 SPAN DIMENSIONS OF SILLS DINIENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHRVINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE t fie l�arnmcoouue¢�C a���,aoaactivaelf Board of Building Regulations and Standards . HOME IMPROVEMENT CONTRACTOR Registration: 103762 Expiration 7/9/2004 Type: Private Corporation CARROLL SONS ROOFERSINC. Paul Carroll PO BOX 484/60-64 Medford Street Somerville,MA 02143 Administrator ✓fie -Vamnimanuea�,/ a�✓�,craaac�zccaetCa BOARD OF BUILDING REGULATIONS ` License: CONSTRUCTION SUPERVISOR Number: CS, 027033 Birthdate: 06/27/1939 1 Expires: 06/27/2004 Tr.no: 28661 Restricted: 00 PAUL R CARROLL 6 ICHABOD LN BILLERICA, MA 01821 Administrator 1� - - -�__-_ i I� I _____-�, SINCE Carroll Seamless Gutters, "lnc. (617) 868-2673 1963 64 MEDFORD STREET - P.O. BOX 291 - SOMERVILLE, MA 02143 To Mr . & Mrs Paul Passarello Datpec . 20 , 2003 v (Name) Address 122 Boxford St . North Andover ,MA (No.) (Street) (City or Town) CARROLL SEAMLESS GUTTERS, INC.hereinafter called the Company,proposes to do the following work on the properties of the owners/owner situated at Same (No.) (Street) (City or Town) according to the specifications and terms set forth below Apply 3/8 inch insulation to all sidewalls . Cover all soffits with white center vent soffit panels . Cover all trims including all windows with aluminum coverage . Reside all walls with vinyl siding . Install new high end sliding door on rear of house . Clean and remove all debris . Install new aluminum gutters and pipes . Siding Brand - Slider Brand- Siding Color— j ooh aGw Sr�Ucr Payment upon Completion Halfway TERMS 1.Cash Price $ 13 , 7002, Less Deposit$ 4, 500 3.Completion Balance $ 4, 700 .00 You may cancel this agreement if it has been consummated by a party thereto at a place other than an address of the seller, which may be his main office or branch thereof, by a written notice directed to the seller at his main or branch office by ordinary mail posted, by telegram sent or by delivery, not later than midnight of the third business day following the signing of this agreement. This proposal shall be binding upon the Company only upon its written acceptance hereof, or by its commencement of performance of the work herein provided for, and in either event such acceptance or commencement of performance,together with this proposal shall and does constitute the entire agreement between the parties herein with relation to the subject matter hereof, and all understandings and agreements, verbal and otherwise, in relation thereto are as herein expressly set forth. No alteration whatsoever of this agreement shall be made except by and with the Witten consent of an officer of the Company.It is further understood and agreed that:(a)The Company shall not be liable for any damage of any kind caused during the progress of the work, or thereafter, by fire, lightning, hail, hurricane, cyclone, or any damage to the interior of building or its contents. (b)The Company shall not be responsible for damage or delay due to strikes, accidents or other causes beyond its reasonable con- trol, or winds up to 50 M.P.H., ice back ups or ice damage MA Lic.# 027033 MA Home Imprv.# 1 2 OWNER( ) R ERT R O E SS ERS,INC. Accepted By: Accepted ACCEPTED:CARROLL SONS, INC. Owner(s)acknowl- edge(s) receipt of a Home Telephone 1-978-738-0986 By: true copy thereof Cell-1-617-549-7734 Approved By GUARANTEES Products are covered by the manufacturer's Guarantee.Your right of implied warranties of merchantability and fitness for particular uses as described in MGL ch. 106. RIGHT OF ACCESS The owner agrees to give the Contractor access to the premises for fulfillment to the Contractor's obligation. --=-.a=--z-- �r.---=-_�__=W=.Z7-=-------------------------=i=---=-----_—n.:n—n ----_- ---.-------------------- - NOTICE OF CANCELLATION You may cancel this transaction without penalty or obligation,within three business days from the above date. If you cancel,any properly traded in, any payments made by you under the agreement,and any negotiable instrument executed by you will be returned within ten business days following receipt by the seller at your residence, in substantially as good condition as when received, any goods delivered to you under this agreement, or you may if you wish, comply with the instructions of the seller regarding the return shipment of the goods at the seller's expense and risk. If you do not make the goods available to the seller and the seller does not pick them up within twenty days of the date of your notice of cancellation, you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the seller, or if you agree to return the goods to the seller and fail to do so,then you remain liable for performance of all obligations under the contract. To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice or any other written notice,or send a telegram to: (Name of Seller) (Address of Seller's Place of Business) not later than midnight of (Date) I hereby cancel this transaction (Date) (Buyer's Signature) ��.. FA�..;��-_—_a:1..—•..r-�....,r_.-YR�.+'»7�I:K '�--�• Tri-'�'"."..-r`. . ti^yy ♦o.rvr'._I"�J_.1�r 1 1 a`,...J.M.�-T. �e+�". f i - Town Of 2 Andover No. L A K dover, Mass., CHICHEWICK ORA T E 0 U BOARD OF HEALTH Food/Kitchen PER D Septic System BUILDING INSPECTOR THISCERTIFIES THAT.................................................................................................................. j...... .. .... ....... Foundation has permission to erect........................................ /0201 -.— buildings on ......................... Rough ............................. Ao tobe occupied as... . ....... ... ....... . ...... ............................................................................ Chimney provided that the p son ac ptingthWpermit'shall In eve spect conform to the terms of the application an file in Final this office, and to the provisions of the Codes and By-La 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 S 7S Rough 00^ YK.....1.0.404. ... .............................................................. 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. Date..... . ....... t NORTH " TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSACMUSE� This certifies that .....: �f�..r.................. �.................................... has permission to pe form Az"n.f...A..'.".,.f!",/ wiring in the building of.....,,..... / .............................. ,,. ...If. ........... ,North Andover,Mass. Fere ��G`d... Lic.No'�,�! ?1. 7.. �.. . 14 :. ........... D LECTRICAL INSPECMR t Check # ��55 � 5 "a ' _ ..,.,•,"_' vrrtu;tf fisc Urily — D ��f Permit No y✓��I t ctr nt2n1 pf BOARD OF FIRE PREVENTION REGUL.AT1 NS Occupancy and Fee Checked �F?4 (Rev. 11/991 APPLICATION FOR PERMIT TO p ----ticaveb�ai(k) ` RFOR1�/I ELECTRICAL^�/ All work W he perforntcd in accordoncc Witt, ncc i\I:,ssa1riu;ctrs C1cor'Cal Codc(,'t[C) 527 CMrZ 12.00 WORK R WLEA,SEPRIrVT1rV INK OR TYP3L-ALL IMtn_. 110N) ll�lc: City or Town of: _ _ — O C, By this are pplication the uitdersi��re�di'ivcs notice 0)—t_ - — T� llte/lrs�e�lor J - rr int ntro;t to crfS. orm the electrical �oork�lescribed Localiutr (Street .0 tVunnc�r) Owner or Tenant - Owner's Address Tclepltone ,\o o Is this permitin conjunction Willi a buildint pernii? Yes'� --- i N 1'urlwse of Building` (Chock APPropria(c Bos) — — Ulility �kol rizatiuu NO. Exislinb Scrvice _ Amps 1 1'alts 01'crltcad {— I `"''--'---_--- Ncry Service LJ Uudgrd❑ No. of,Meters - _ Amps - / _\•orfs Ovcrlrcad Number of Feeders and Ampaci(y Uudgrd No. of llelcrs Location and Nature of Proposed Electrical }Nock: 4 _—___ Cumplpl on r(iJ,e 0111n,irre ruble nrny be wail. b�Me/r_��ccror o!llrirrs_ No. of Reccssc(I Fi.Ytures -- ,V o,of Ccil.-Srtsp. (1'ad(Ilc) Farts No. of .f otal-r No. of Lighting Outlets ------ formers Prausformers 'O a No. of!lot Tutus --- No. of Li Ittino —•--- Generators I' " g b Fixtures Swimrrring Pool Above ❑ I rnd. ❑ r o.o auergeuc} ,tg tang --- �rnd. _ Battc Units �' i No. of Receptacle Outlets _ o, o Oil Burners FIRE AL No. of Switclie es ---.- ALARA-IS 1'0. of Zones 73urners No.of Detection and NO. of Ranges — 7nitialino Devices No.of Air Cond. Total No. of waste Disposers fIcat Yunrp :Vuntber I oTons NO- Alerting Devices __Totals: _ K_1V__ No. of Self-Lonjained No. of Dishwashers be Tons - Detectiotr/Alerting Devices _ Spacc/Area }!eating Kl1' Local [] Municipal No.of Dryers _ }Ica ting f> -- M niicipal l U Other PFlrances K%V Security Systems, t\'u. of 1Vater "--- _ No. of No.of Devices or E' trivalent Heaters a� ,r —T_ No. of _ Si rs Ballasts nal•^• 1\';ring: +eta. Hydromassage 13at1+tubs No.of Devices or E( uivalettt No.oft\lotors Total lip 1'elecomnrunicalions liririttg: ' OTHER: E b to.of Devices or uivalenE ----- a lrNs(tR\NCE COVEIUIGE. Unless waived by the o« ter,r, 10 perlm itr for/the(Ri`fo ma c or as required b,!rhe hrspecror of Wires. Lire licensee provides proof of liability insurance including "completed o eration"covers P e of electrical «ork may issue unless undersi;ncd certifies that such coverage is force,and has exhibited proof ofsame to thee eornut is$f its �sin�f1a1 equivalent. The CHECK ONE: IN'RZiliNCE _ office. tR,ry s' sTEM kgs OND ❑ OTHER IGR ❑ (Specify: f C Som.;y.c,�: ..r� Estimated Value of Elecuical Wolk: (E.�piration Date) ___ (When required by municipal polic).) Wo k- to Start: '7 --Q lrrspections to be rcquestcd in accor(13irce Wilk EIEC RUIe 10, and upon /e(•rtify, rurJcr Ilre lrnirr.t rrrrrll:rrrrtllirs u Tr r a th'it rhe infix runrioil nrr (his n171rlica(iurr is true nrr!colitompelion. Licensee: _ — LIC. N0_ �% ��� tl�nr fico �'`"'� _�—•--i`-F—"�'�,L.�— Sisrtnttir'c cr^rcr c^rrrpr r—]hc lrccn�uurl-c•r Biro) Address: AN / Bus. Tel. No . O\\'NER'S ]t 'S -AN E 1Vr �— ��__.—__ _ �(��Y� .�►/ am a tare Iltaf the Lrcrtrsce dors nor rnre the liabt ul„I i,�surntce coy era�c nornially reyuir(d by 1,«. Uy lily signaluic below, 1 hereby waive Ibis rc.gtrircnrcnt. 1 am the (chock OTIC) [] Owner/:\aetrf Owocr ❑ o«rrcr's aZ:rnt. Sibnature Telr.phorre N,>. i i - � i I xL � I IA `'\ y T