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HomeMy WebLinkAboutMiscellaneous - 134 CROSSBOW LANE 4/30/2018 (2) c - l 134 CROSSBOW LANE 1 210/106.B-02040000.0 LZbertutual® Liberty Mutual Insurance New England Region Central Property Unit INSURANCE 75 Sylvan street Danvers,MA 01923 Tel:(800)566-0323 August 6,2015 Town of North Andover Attn:Building Inspector 120 Main Street North Andover,MA 01845 Re: Property Address:134 Crossbow Ln,North Andover,Ma 01845 Policy Number: H3221216373711 Underwriting Company: Liberty Mutual Fire Insurance Company Claim Number:032324509-0001 Date of Loss:7/9/2015 Attn: Town/City Official Pursuant to M.G.L. c. 139, § 3B, please be aware that a homeowners insurance claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or causes the condition of a building or other structure to render Mass. General Laws, Ch. 143, 5 6 applicable. You are required to notify Liberty Mutual by certified mail in accordance with Mass. General Laws Ch. 175, §99, if you intend to initiate proceedings designed to perfect a lien pursuant to Mass. General Laws, Ch. 139, � 3A &B, or Mass. General Laws, Ch. 143, 5 9, or Mass. General Laws,Ch. 111, § 127B. This letter should not be construed as a waiver or estoppel of any of the terms, conditions or defenses afforded by the policy or applicable law. Please direct your notice to the attention of the undersigned and include a reference to the above captioned property address,policy number,claim number,and date of loss. Sincerely, Liberty Mutual Support Liberty Mutual Insurance New England Region Central Property Unit 1-800-566-0323 q Location cO No. 334 Date —0 C( MORTM TOWN OF NORTH ANDOVER 4L Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL Check # 2 'k 17792 A111 Building Inspector 4 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPA15,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING s4 F x � CO a ,a �vs n zea Di1' �,. BUILDING PERMIT NUMBER. DATE ISSUED. _ rn D - X SIGNATURE: Building Commissioner for of Buildings Date z SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: O Map Number Parcel Number �J 1.3 Zoning Information: 1.4 Property Dimensions: Zoning Distad Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R 'red Provided v 1.7 Water Supply M.G.L.C.40.1§54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal 0 On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes NO rn 2. Owner of Record S C4 (et" (3q Gb5Shc,,1 LA /�3• OJV�A� 1UP-L o ame ri ) Address for Service fitAll,b SignaTelephone 2.2 Owner of Record: 4 O Name Print Address for Service: Z ^s rn Signature Tele hone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ 'T( rn 0�j 5P ct G �( '7, ncensed Constructio Supervisor: J 9 License Number Mn Addres 1 Expiration Date E Signature Telephone r - Registered Home Improvement Contractor Not Applicable ❑ v � Cj ntpany Name rn V L ^ P� �„,. 'ALA Registration Number r Addressy ` /i"" 0` r Expiration Date Signature Telephone YI t t SECTION 4-WORKERS COMPENSATION(NLG.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: k e, i J nu ca l I 1 ww�� s l��ti�ln, tn;n ice- 4-wCktr 3°a°, q� o k1 'Ou25 '36,4r . 1 n,5)-wVl L'A4N w ° c4v SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USETONLY C m leted b rmit a licant a s y u.,. 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b). Estimated Total Cost of Construction 3 Plumbing Building Permit fee(e)X (b) 4 Mechanical HVAC rJ J) 5 Fire Protection IC/ t✓ 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUELDING PERMIT V as O er/i�fi�A on2ed t of subject property Here u e J to act on M b afters relative to ork au rized by this building permit application. Si a e 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 Si ature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR T MBERS 1 2ND 3 SPAN DEMENSIONS OF SILLS DIMENSIONS OF POSTS ` DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS v SIZE OF FOOTING X MATERIAL OF CHIIv1NEY 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 c 11, S 150 A. The debris will be disposed of in: (Location of acili tY) Signature of Permit Applicant Date t NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector I The Commonwealth of Massachusetts " Department of Industrial Accidents d Ofrice of Investigations Boston, Mass. 02111 . Workers'Compensation Insurance Affidavit Name Please Print Name: I dYlh Location: 1 6C.,C--J(prJ,0 City 'C(A�e lr CS l �� 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. Comoarn ams: cl, Address Cihf. N �--N kAA-►, Phone# In nce �JvrVn 6vt<1Q.-,t/\ JAS e�t►S 9011cV 0c6(,1 i3�'77XZ2�Z/77cs Comoanv name: Address City: Phone# Insurance Co. PoIlcv Al Facture to secure coverage as required under section 25A or MGL 152 can lead to the imposition of criminal penaitles of.a fine up to$1,500.00 arid/or one years'Imprisorunent as vNell.as.ciadl peoaitiesJn befm da.STOPWORK-ORDER AW.a fine of.(i IIID O�ami agairmt.me 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 CW*under d► ins na of perjury that t r+fi�maltion provided above is true and correct U Signature Print name rn� n Phone# a"1 33� � Official use only do not write in this area to be completed by city or town official' i City or Town Permif/Licensi I + P ❑ Building Dept []Check if immediate response is required Ltensing Board ❑ Selectman's Office Contact person: Phone# ❑ Health Department Cl Other TOWN OF NORTH ANDOVER AFFIDAVIT Home Improvement Contractor Law Supplement to Permit Application MGL c. 142 A requires that the "reconstruction, alteration, renovation, repair, modernization, conversion, improvement, removal, demolition, or construction of an addition to any pre-existing owner occupied building containing at least one but not more than four dwelling units...or to structures which are adjacent to such residence or building" be done by registered contractors, with certain exception, along with other requirements. Type of Work: Est. Cost �� �eju Address of Work «�I Cj`�O" too'i L-P-1 o Owner Name: Date of Permit Application: < < oy' U<I hereby certify that: Registration is-not required for the following reason(s): For office Use Only Work excluded by law Pemit No. Job under $1,000 Date Building not owner-occupied Owner pulling own permit Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FIND LINER MGL c. 142A. Signed under penalties of perjury: hereby apply for a permit as the agent of the owner: -64 �� � S r• r, la�a°13 Date Co tractor rVme Registration No. OR: Notwithstanding the above notice, I hereby ap fora rmit as the owner of the above property: Date Owner me Proposal Unique Design Builders, Inc. I1 l Crossbow Lane North Andover,Ma. 01845 978.337.9363 November, 12004 Proposal Submitter[to: Work to he performed at: Steve and Alice Fraleigh 134 Crossbow Lane 134 Crossbow Lane. North Andover,MA 01845 North Andover,MA 01845 Project: Remove shingles from existing house goof and inktall new. Work to he performed: Remove shingles from the existing house roof Nail off roof plywood sheulhing with ring shank nails. Install ice and water shield three feet upon all eves;then install#15 felt paper 0n complete roof. bistaII e"white aluminum drip edge on all roof edges. Install 30 year IKO Cambridge dual black shingles with continuos ridge vent with caps at roof peak. Remove and dispose ofall job related debris from site. We hereby propose to furnish plans,permits,labor and materials and complete work in accordance with specifications outlined above forthe sum of --------------------------------------------------------------------- $8.000.00 ----------------------------------------------------—---- ------------------ ------------------------------EIGHT THOUSAND DOLLARS..AND 00/100-------------------------------------------- All material is guaranteed to be as specilied. :All wort:to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from speciiicationS above will be an extra charge over and above amount proposed specifically herein. Payment Schedule Payment#1 $4,000.00 Due upon acceptance of proposal Payment#2 52.000.00 Due upon completion ofraar 1'001. Payment#3 $2,000.00 Due upon amipletion ofliont roof. Respectfly submitted. moth?]. Date Acceptance of P oposaI— he: ove process.shcci licalions,:uul conditions:tic satisliictory and are hereby accepted. You are authorized to dolt to wor a spe led. 1'nvmcnt\\,i 11 be rendered as outlinccl ahovc. Signature ,feveand a Fraleigh Date of Acceptance 1 _F � , ✓fie -PomrmwmuseallC� o�./�aaaac�ucoel,2a j Y i BOARD OF BUILDING REGULATIONS'' Ij License -CONSTRUCTION SUPERVISOR Number CSS 071493 j But hate,-02/11/-959a7-7 w a t+ExpiPea;0211,1%2006 Tr.no: 275431 � Restricted 0� � ( r'� = � TIMOTHY G SPRI,NGx i ! 111CROSSBOW I ANE G` NO ANDOVER, MA 01845 , Commissioner I I _ O . � ✓fie L�omvrrwowrea� o��/�aaaacfuiGeG�b Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR 'f"� Registrations 127293 Expiration 10/5/2006 T e Individual Yp, I 1 TIMOTHY SPRINb; t a TIMOTHY SPRING 111 CROSSBOW NORTH ANDOVER,MA 01845 Administrator x.10 R T►y ovm of O _ 0 ti.. 1 No. X33 ow sovow C% �s- o, dover, Mass., `d o GOCMICMEWICK y,A. AERATED 0'P�,��� S V BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT.........� � A Lt.�� ��+�l�/ I� BETTED INSPECTOR �{ � TNG ... ........................................... Foundation has permission to erect. �...f....... buildings on C/ e""' 053. 60 �� Rough ... .............. ........................... /�Q 0 R*S Oro/r<AJ C t. Chimney 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 re ting to the Inspection, Alteration and Construction of Buildings In the Town of North Andover. /d (P lo02d y PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS �S 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 Fina, 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. GENERAL BUILDING NOTES/CHECKLIST- NOT LIMITED TO ITEMS BELOW POST ALL LOT NUMBERS,ADDRESS, AND PERMIT(COPY OK)..or no inspections INSPECTIONS: (Minimum) Excavation , Footing, Foundation, Frame, insulation, Final. FOOTINGS: Continuous Full 2x4 Keyway Continuous strip footings for interior columns FOUNDATION: Rebar as required Anchor bolts or straps Damproofing Foundation drain-pipe/stone/fabric filter/cover and outlet connection. FRAME:Fireblock-over girts/plates between floor joist Penetrations for plumbing, heat, elec, etc. Walls at stair stringers. Windbrace corners and center bearing partitions. Size ridge to provide full bearing at rafter cuts. Hip and Valley rafters-watch bearing at walls. Ridge&Hip- Provide proper connections. Cathedral roof rafters provide'proper connections and use"Hurricane Clips"tie to plate. Stair stringers-watch cuts and heal support. Joist hangers-fully nailed w/hanger nails. Sill plates 2-2X6(1 PT)w/sill seal. Girls-solid brick or steel plate bearing at foundations '/" air space at sides in foundation pockets. Lateral bracing at ends. } Certified calculations. required for Beams/LVL's Trusses. Solid bearing support for Headers/Beams etc. Check headroom clearances-stairways, under beams Attic Access. (min. 22x30 w/3'headroom above). Crawl space access. (min. 18x24). Bath exhaust fans to have metal duct to exterior(not in soffit). Firecode S/R wood frame of"0"clearance fireplaces&stoves Window Schedule or Every Habitable Room Must Have: Natural light equal to 8%of floor area. '/2 of required glazing shall be openable. Bedrooms required min. 20x24 egress window or door. Vent attic spaces-"proper vent", soffit and required ridge vents. Firecode under stairs if used for storage FIREPLACES: Separate permit required. Inspections at Footing-Smoke Chamber- Finish Smooth parging, clean joints, 8"solid @ combust. Surf. DECKS: Separate permit required: Lag to house, provide flashing. Rails min. 36" high, Baluster max space 5"on center. Over 8' above grade, use 6x6 posts w/lateral bracing. Lag all posts and rails. Pier footings down 48", Conc. pad at stair base. FINISH: Handrails returned to wall/newall post. Guardrails required alongside open cellar stairs. Exterior grading complete. Certificate or occupancy required prior to occupying structure. Temporary Stairs required for inspection. Re-inspection fee- $30.00(Be Ready). Certificate of Occupancy required prior to occupying structure. 6 6 2 Date`............ ................ 'AORT" 0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING c" This certifies that ....... �........................ Ahas permission to perform ..... ................................... :wiring in the building of... .......................................... .............................. North Andover,Mass. Fee."....;.............. Lic.Noo.'?'4�. —4- ...... ..... ..... ....... EcrR ICAL INsp EcrOR 03/26/99 08:36 40-00 PAID WHITE: Applicant CANARY: Building Dept. PINK:Treasurer Office Use On r �1hP LIIllIIIlIITIIUPttjth IIf Iffitt55cachmseff5 Permit No. z' -- _��d Be artment of ubliL ENiffi � � 11 Occupancy& Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 1 "90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL NFORMATION) Date 2 — 2z �� Cit or Town of /V � �— Y —•+'� «s t'.rQ To the Inspector of Wires: The udersigned applies for a permit topfor perform the electrical work described below. c/ Location (Street & Number) _ �l Owner or Tenant Sra i �/_L'q le Owner's Address Is this permit in conjunction with a building permit: f Yes LY No ❑ (Check Appropriate Box) Purpose of Building�s �c /��:.: G y �!� Utility Authorization No. Existing Service Amps _J ' Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets I No. of Hot Tubs I No. of Transformers Total KVA No. of Lighting Fixtures 7 Swimming Pool Above In- grnd. ❑ grnd. ❑ Generators KVA / No. of Emergency Lighting No. of Receptacle Outlets [O I No. of Oil Burners Battery Units No. of Switch Outlets V--No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges ( No. of Air Cond. Total No. of Detection and tons Initiating Devices No. of Disposals ( No.of Heat Total Total r Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices No. of Dryers Heating Devices KW LocalMunicipal ❑ ' ❑Other Connection FNoof No. of Low Voltage No. of Water Heaters KW Ballasts Wiring No. Hydro Massage Tubs otors Tot alHP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws t� I have a current Liability Insurance Policy including Completed Operations Coveraoe or its substantial equivalent. YES have submitted valid proof of same to the Office. YES ��VIVO [ If you have checked YES, please indicate the type of coverage by checking the appropriaatt box. INSURANCEC+rYOND p OTHER p (Please Specify) Estimated Value of Electrical W rk S (Expiration Date) Work to Start —Z Z– Inspection Date Requested: Rough ,Z 3 �Final Signed under the enalties of er)ury: FIRM NAME Zie /z. G/G 3� L UC. NO. Licensee Signatur LIC. NO. Addre-$zz - G Bus. Tel. No�1�'��� �G Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licens a does not ha v the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) (Signature of Owner or Agent) Telephone No. PERMIT FEE S it x-6565 Location / crc-`,S/ocL )A/l1� No. Date NORTq TOWN OF NORTH ANDOVER f 1 Certificate of Occupancy $ i Building/Frame Permit Fee $ s�cMusFoundation Permit Fee $ E _ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ i 3U' 08 Building Inspector Div. Public Works 312219'315a�: 97,00 PAID PERMIT NO. 06a APPLICATION FOR PERMIT TO 13UIL1)********NORTIIAN VCR, MA M.P NO.,✓-?_I(Vtoo-b-ozoi-01100.0 10T.NO. �--._ 1.�!� 2. RECORB OF O11'NERSIIII' DATE BOOK PAGE TUNE SUB I)1V. 1.0'1-NO. \ LOCA I ION �.,/ PURPOSE OF BUII DING /�..Sl✓l (� °( �� 'EN �A 5L `C- 1 I:V 00 000 u/k OWNER'S N?J,fE V/� !�� u( I((e tjy�re` � � NO.OI:ST(NIILS SIZF. OWNER'S ADDRESS ( C(\O%boo I.04Q. BASEIAENT OR SLAB RD ARCI IllE(-I-'S NAME.,-'' SIZE OF FLOOR I IMBERS 1 2 3 131111 DL•R'S NAME "rrnotb r- SPAN DISI ANC E I O NEAREST BUILDING DIMENSIONS OF SILLS DIS I ANCE FROM S TREE F DIMENSIONS 01:POS IS DISTANCE FROM 1.OT LINES-SIDES REAR DIMENSIONS OF GIRDERS AREA OF LOT FRONTAGE I IEIGI IT OF FCAINDATIONJ TI IICKNESS IS BUILDING NEW SIZEOF.HX7IING X IS BUILDING ADDI I'I(NJ MATERIAL OF Cl IIMNL•Y IS BUILDING ALTERATION IS BUILDING ON SOLID CAMLLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECI-ED'10 TOWN WATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CCNJNECI ED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INS'1lI TIONS 3. PROPERTI'INFORMATION p e� � �7 p©g L.ANDCOST ES 1'.BLTXi.C(sf '� 00(0 •�� PAGE'I FII.I.OI IT SECOOJS 1-3 V EST..BLDG.COST PER SQ.FT. ES T. BI 1)(1.COSI PER ROOM EI EC"TRIC METERS MUS T BE ON OUTSIDE OF BUILDING SEI'FIC PERMIT'NO. A I-I ACIIE0 GARAGES MUST C(NNfoRm TO SLATE FIRE REGULA N(NJS 4. APPHOVE:I)BY: P`.ANS MUST BE FILED AND APPROVED OY B11ILDING INSPECIOI BUILDING DING INSPECTOR DhIE FILED ✓� 3'�'+' OWNERS'IE11Y-: 0013 9-21 6(0 !t CONTRA t:l.n MICR I1 4� 6, I C(NJI'k.I.IC'H >m i � tiIUOli IGNA RI:(N: INN )I(All"I,,,h�I '1:D A(il'.NI 1 _�__„_. .�J, Plli PI IZflIT GRAN I11) a -" ............. A/1/' ® CERTIF- ATE OF INSURANCE; ISSUE DATE (MM/DD/YY) 3/17/99 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE NORTH ANDOVER INS POLICIES BELOW. AGENCY INC COMPANIES AFFORDING COVERAGE 9 WAVERLEY RD NORTH ANDOVER MA 01845 COMPANY LETTER A MARYLAND CASUALTY ........................................................................................................................................................ COMPANY B _._......................._.......................................- .._.......................... LETTER INSURED _................................................_........_.....................................................-...................................... .. COMPANY C TIMOTHY SPRING LETTER 111 CROSS BOW LN COMPANY NORTH ANDOVER MA 01845 LAR D COMPANY E LETTER COVERAGES ... _.. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ._......................_..........................................._..........._.........._....................................._.,.....-......................................_............_....._._............................................__._.........._.................... CO POLICY EFFECTIVE :POLICY EXPIRATION LTR: TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YY) DATE(MM/DD/YY) OMITS GENERAL LIABILITY SCP 3 2 9 7 7 2 8 3 4/28/98 4/28/99 GENERAL AGGREGATE $1 f.000 000 COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. :$1, 000, 000 ...................................................................................... CLAIMS MADE;X I OCCUR.! PERSONAL&ADV.INJURY s 5 0 0 000 OWNER'S&CONTRACTOR'S PROT. EACH OCCURRENCE s500, 000 ........................................................................................ FIRE DAMAGE(Any one fire) $ ...........I.......... .. ... .......:........ ........................... _........._............................... . .... __ MED.EXPENSE(Arty one Person)'$1 O 0 0 0 AUTOMOBILE LIABILITY COMBINED SINGLE $ LIMIT ANY AUTO ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (P.......................................... (Per person) $ HIRED AUTOS BODILY INJURY (Per accident) $ NON-OWNED AUTOS GARAGE LIABILITY _.... PROPERTY DAMAGE $ EXCESS LIABILITY EACH OCCURRENCE $ .........................................._._:..._.................................. . UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM ..... ._.. ... . WORKER'S COMPENSATIONSTATUTORY LIMITS ..... ................ EACH ACCIDENT :$ AND .....................................:._..........._........................ DISEASE--POLICY LIMIT $ EMPLOYERS'LIABILITY ......................... .__..-............................ DISEASE--EACH EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS GENERAL CONTRACTOR CERIWICA`f HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE " EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE TOWN OF NORTH ANDOVER LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR BUILDING DEPARTMENT LIABILITY OF ANY KIND UPON THE COMPANY;4S AGENTS OR REPRESENTATIVES. NORTH ANDOVER MA 01845 AUTHORIZED REPRESENTATIVE r. EVA KLISIEWICZ ACpFG 25 S CI[$;Q� ACpR CpRPpRA710N 1990; ;;� _ �,�.,.._ _ _✓fievU�oarv�nancuealC� o�"�-`�daclec.te� 1 DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Number: Expires: Birthdate. CS 071493 02/11/2002 02/11/1959 I Restricted 1o: 00 TIMOTHY.G SPRING 111 CROSSBOW LONE NO ANDOVER, MA 01845 i I i I I 'j t.s.he--s►9�S Tm ooh S F�Clr �'l �` COn�cwr - i� i (3) 1314 Y,q MICRp-LAA BW I � ---------;------__------ - r-_461l►.4 Z. 10'FIR.3�i, suN ROOM ' i ST.ID W PtIL AppeoA IV I TO 6E RFr.�av�,D 1 - --..--- - --- -- - _ — — --- - ---._... .............. -- (4) 8"Fui.7'5( Exis-nN� 4" Soup 5 � -- P(v3,Sud USN� = 1 6" � y 4 40'2 5'11 20'1 2'6 11'8 Existing Sun Room N Proposed (3) 1 314"x 9 1/4" Micro-lam beam. Set on solid 2" x N 4" posts, which bear on (3) 2" x 10" floor joistlbeam Existing Kitchen M xisting Dining Room UP Fraleigh First Floor Plan ts.desgm Tinnoth;t Spring Guneru Ccntracn;, _ • NORT#j Town of 0 over 0 No. 0&L zip 407 /qP ge 0L M.,:0,:H1 over, Mass., OOATED P'f 54` BOARD OF HEALTH Food/Kitchen PERMIT T Septic System BUILDING INSPECTOR ................................................. Foundation THIS CERTIFIES THAT...61.eve...oo-....At............. ........... ... has permission to erectle 94*4*L­­­ buildings on.....1.34.... bow ,,...... w!!�!!........ - Rough C to be occupied asl.f!4N.rt��! V�14 10 614 tok9j. -Sol* rielp rK Chimney provided that the person accepting i6*p"e­r�Ws"h­a"Ifin,...e"v**e**r'y***respect"*conform*, application'on file'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 * 8 PERMrr EXPIRES IN 6 MONTHS Final 00 UNLESS CONSTRUCTION STAR ELECTRICAL INSPECTOR C 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 BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. � 4 3983 e pORTM o?�<<��•';.��oo� TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING i oma+ �. ��•+I - This certifies that has permission to perform .�.. plumbing in the buildings of . . . . . � � �. . . . . . . . at. . . . . . / . . . . , No��h Andover, Mass. Fee.,Zl . .Lic. No. . . . . . . . . . . . . . . . . .. . . PLUMBING Il��t�C OR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer C MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS � -�• Date C Building Location �/ CSU S�(�Q w (,�v��'ners Name /��� Permit 4 f Amount Type of Occupancy New ❑ Renovation �� Replacement 0 Plans Submitted Yes No FIXTURES z x H z 0 o un � Cr z A �a a F U d O x a z z .� ►moi ►•� GQ r/1 A A �l + F to IT. U -�. d a A O SlRESM BASEWM ISI:FLDCR 2M FLDQt M FLOOR 4M FUM SM FL" 6TH H DM 7IH FLDat SIH FLDCR i (Print or type) /1 Check one: Certificate Installing Company Name �~ E] Corp. Address S rd S ❑ Partner. Business Telephone [a Firm/Co. I Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: ❑ Liability insurance policy Other type of indemnity El Bond Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner ❑ Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations perfor►ned under P unit Issued for this application will be in compliance with all pertinent provisions of the Massac '�etAtate Plu"ing Cod ' d C er 142 of the General Laws. r By: S rgnature ot Licenseeum er Type of Plumbing License Title �j 3 5 City/Town C se UMDer Master 13-- Journeyman ❑ APPROVED(OFFICE USE ONLY