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HomeMy WebLinkAboutMiscellaneous - 136 HILLSIDE ROAD 4/30/2018 136 HILLSIDE ROAD 210/098.C-0019-0000.0 Dates; o 40RTm 3: 0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING ;,SSACMUSE� ! This certifies that .. G has permission perform .. ---�-4!�...�-�cc-�-:�-.ate.::{-! wiring in the building of at 113vl... ..... ,North Andover,Mass. Feer!............ Lic.No. ....:........ ............ ....... ELECTRIC i; ;E OR \S 3 Check # _ s F: 837 Commonwealth of massacnusearsPermit No. 7�• Department of Fire Services Occupancy and Fee Checked /� �.f BOARD OF FIRE PREVENTION REGULATIONS ev. 9/05J leave blank)APPLICATION FOR 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: City or Town of: ALI ,4-vI�J�JL + ' 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) i 6 R, S 10 Ower or Tenants Telephone No. Owner Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / _Volts Overhead ❑ Undgrd❑ No.of Meters Volts Overhead Und rd ❑ No.of Meters Service Amps / ❑ g New P Number of Feeders and Atmpacity Location and Nature of Proposed Electrical Work: w 4,0-- Q, Completion of thefollowing table may be waived by the Ins for of Wires. No.oTotal No. of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans Transformers KVA No. of Luminaire Outlets No.of Hot Tubs Generators KVA No. o mergency ig ng No. of Luminaires -Above -Swimming Pool rnd. ❑ rnd. ❑ Battery Units y No. of Receptacle Outlets No. of Oil Burners FIRE ALARS No.of Zones M Wo.of DetectiFn—and No. of Switches No. of Gas Burners initiating Devices Total No. of Ranges No. of Air Cond. Tons No.of Alerting Devices Heat Pu No. of Waste Disposers Totals umber ons o.o elf-Contained Detection/Alertin Devices ff al No. of Dishwashers Space/Area Heating KW Local Connection ❑ Other No. of Dryers Heating Appliances KW Security Systems: � No.of Devices or Equivalent No. o atero. o o.o Data Wiring: Heaters KW Signs Ballasts No.of Devices or E uivalent Telecommunications gg No. Hydromassage a Bathtubs No. of Motors Total HP No.of Devices or Equivalent r OTHER: J Attach additional detail if desired oras required by the Inspector of Wires. Estimated Value of Electrical Work: Gr (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify :) I certify, under the pains and penalties of perjury, that the information on this application is true and eompleM FIRM NAME: C LIC.NO.: Llcensec ,lv •"'L` co_yw tl-, - Signature LIC.NO.: (ljapplicable, enter"exempt"in the license number line.) Bus.Tel.No.:ros—3" 1451 Address: tt /Yrel-h cvrwef e)lY �S'1 AIL Tel.No.: *Security System Contractor License required for this work;if applicable,enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑ owner ❑owner's agent Owner/Agent Signature Telephone No,40 3661 M,q� FERMIT FEE: $ y Date. .l b...........:..�..... NCRTM °f'"`° '•�"° TOWN OF NORTH ANDOVER x PERMIT FOR WIRING ��ss�cMusE� This certifies that has permission to perform .......... .........��.. ?........ I wiring in the building of........A�2.so.',........................................... K ,North Andover,Mass. Fee..L{ —�- Lic.No....�gS"� C ELECTRICAL INSP CTOI Check # 0 �/y{ i 844 V r Conunonwealth o� a��a� ett� Official Use Only 2c� � /ri�D epartment ol..7`c'7 ioe Service Permit No. - Occupancy and Fee Checked / ( 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: 1t,> - 0-7- 0 City or Town of: d-F-Ttf �} bOVIE F, 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) 3ai S j Reba,A Owner or Tenant 1\nAP-"0n I Telephone No. 9��,���•5� �9 j Owner's Address Ant AS 48-b-06 t Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. i S ti Exisng Service Amps / Volts Overhead Und rd • ❑ g ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- E, No.o Emergency Lighting rnd. rnd. BattLry Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g j No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alertinia Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal El other Connection No.of Dryers Heating Appliances KW Security Systems:" No.of Devices or Equivalent 9 No.of Water Kms, No.of No.of Data Wirin Heaters g' Si ns Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP I eiecommunications Wiring: No.of Devices or Equivalent OTHER: L L a I—In LFSS i Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: q9-60 (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proofof liaNli insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cage is in force,and has exhibited proof of same to the permit issuing office. ov CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: SAFf. tA' 3 E A LIC.NO.: C- Licensee: ��� �j Signature LIC.NO.• (� (If applicable,enter." xempt"in the license number line. Bu -�S1y L Address: „> s.Tel.No.. G? 5(G3 rJfo� ss: "fV S � f7 ,� ' /?ll/�'f Alt.Tel.No.:-S4oLI *Per M.G.L.c. 147,s.57-61,security work requires De artmen f u li " q p b e Sa ety S License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent SignaturTelephone No. PERMIT FEE: $ y�. Date.Q. . . . . . . . . . . "O�T:��o TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ssAC 04U5� 16This certifies that . .Up:4-r, . has permission to perform plumbing in the buildings of . . .'. .` . . . . . . . . .. . . . . . . . . . . . . ���r�( at . . . . --"-e.".'". . . . . . . . . . . ., North Andover, Mass. Fe.e. �. . . . .Lic. No...Y. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . '` r} PLUMBING INSPECTOR Check # 780 MASSACHUSETTS UNIFORM APPLICATION FOR PERMITTO DO PLUMBING (Paint or Type) Date Permit # Building A ! Owner 's 4 AT: Location Name v -T- Type of Occupancy: New ❑ Renovation ❑ Replacement Plans FIXTURES Submitted: Yes ❑ No (�l' z z z N� N W O Z Jto ~ z W 1, a O ZY N = N = N WO 0 NY Od 2' Z 3Wd n. eiWXa z WW >- < F N Z W- & W O = ¢ W XQWncQza tt c -1 W o � + 0 aU. O Z a 1- Q tt Y Wa O O 0 Q tw- O vy O Z < O arLi J J d tt it W d 0 Q H 3 Y J m N Q p J S N W t7 t] d 3 OC m O r° SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR .._J 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR T,'--it (Print or Type) Check One: Certificate Installing Coin panyName Uptack Plumbing & Heating, Inc [a Corp. 1415 Address 32 Rochambault Street ❑ Partnership Haverhill , MA 01832 ❑ Firm/Company Business Telephone 978 372-8503 Name of Licensed Plumber or Gasfitter Leonard A. Hall I hereby certify that all of the details and information 1 have submitted(or entered)in above application are true and accurate to the bat of my knowledge and that all plumbing work and installations performed under Permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. I have informed the owner or his agent that I do not have liability insurance including completed operations coverage. Siptwe o(Oww/Agent I have a current liability insurance policy to include completed operations coverage. . By Signature of Licensed Plumber Title Type of Plumbing License City/Town 8678 APPROVED (OFFICE USE ONLY) License Number jV Master El Journeyman Date f. - �j y` TOWN OF NORTH ANDOVER p .._.. T i PERMIT FOR GAS INSTALLATION h y9S CH i This certifies that . . . . . . . . . . . . . . . . . . . . . . . .+... . . . . . . . . . . ofor as installation i 0. J. has ermissio . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at .J.43.1. . . ?5�/��..rt "" "" . . . . . ., North Andover, Mass. r GAS INSPECTOR Check# 648 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING i (Print or Type) Date —( 20 Permit # Building Owner's VAT: Location Name Type of Occupancy: GNew ❑ Renovation ❑ Replacement Plans Submitted Yes ❑ No N YW W Ic W W t) z W Lr F- CC W W W F V m '= W W O W 6 oaC Ir 10 ki- O y W OG W O W 6 = _ � W a tL > Q W W W Z Q Y W Q W W W �' W H T. Y 1- W � F- Z� I., W W O O > W H V J II--. W Q W .> OC W n ,Z' Q :o- 4 a O O W O W I- W S O O Y W 3 G Cly J 0 W > G o. 1- O SUP[—BSMT. BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR,. 4TH FLOOR 6TH FLOOR 7. 6TH FLOOR f 7TH FLOOR STH FLOOR (Print or Type) Check One: Certificate Installing Company Name Uptack Plumbing & Heating, Inc [3 Corp. 1415 Address 32 Rochambault Street ❑ Partnership Haverhill , MA 01832 ❑ Firm/Company Business Telephone 978 372-8503 Name of Licensed Plumber or Gasfitter Leonard A. Hall I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate.to the best of my knowledge and that all plumbing work and installations performed under Permit issued for this application.will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. I have informed the owner or his agent that I do not have liability insurance including completed operations coverage. Signaturc of Owner/Agent I have a current liability insurance policy to include completed operations coverage. By TYPE LICENSE• Title Pl ber Signature of Licensed Plumber or Gasfitter City/Townslitter APPROVED (OFFICE USE ONLY) u master 8678 ❑ Journeyman License Number 36 /04 Date.... ..lxl . TOWN OF NORTH ANDOVER PERMIT FOR WIRING �Ss�cMusE� This certifies that ......... /- C.�l........ has permission to perform �� �C . ...�..f�................................................. r .. wiring in the building of.............. ... fid�. ............................................... t .......... .:�.�...../TI..�/..a�....? .... ................... . orth Andov oMs.. Fee ✓`..l..w.. Lic.No�!t.�: �.....>g:aa .... ...I P R Check # /©� T2E09MV0AWFALTH0FM4maffsErl$ office Use only DAFAR2MFM'0FPVBMCS4MY BOARDOFFIREPRE3EWON Permit No. VA �'�x�'11A77011CSS27t:�1R12� Occupancy&Fees Checked — —�PPUCATTONFOR PERW TO PERFORMELE=CAL Wffe2O 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 Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perfonn the electrical work described below. Location(Street&Number) (, Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes No EJ (Check Appropriate Box) Purpose of Building/j/��,(�� j� �;�C)e �fG Utility Authorization No. _ Existing Service Amps..../ Volts Overhead 0 Ud No.ofMeters New Service Amps /_ Volts Overhead Underground -- —. erground No.ofMetevs Number ofFeeders and Ampacity — ..... Location acid Nature of Proposed Electrical Work' . No of Hot Tuba r o.of Transformers Noof Outlets Total No.ofLigh iall ixtums Swimming Pod Above Below KVA and K VA No.of Receptacle outlets No.of Oil Burners NO. of Li t �Y 1T�B Battery Units No.of Switch Outlets No.of Gas Bumers No.of Ranges No.of Air Cond. Total FIRE ALARMS •1.� _ No:of Zones No.of Disposals No.of Hem Total Total No,ofDeteetimaud tome Fobs btiti�ingDevices qo.of Dishwashers Space Area Heating KW Na of Soodiog Devices- No.ofSelfContained' DetectioWSoundid To—.fDrya's' Hearin .Devices � gDetrrexa g i KW Low Municipal Otherr FO. .'M 'Heaters KW of Connections No.of No. Signs Bailasis o.Hydro Massage Tubs No.of Motors Total HP 'HE Pauatib ratoeCotier� u 9le ���Gerraaih$t�s . eatz�artLia)a7iyhtasratoeRrtyttrkrdnBCve ai�fa�id�i►eiaf Y$ Q1VDesathmitk+dw5dpto4fofsamebtlle0&c YE5 �)COA� M' Ifjaulta►edlerlatdY�,please. J12ANC BOM. _ 'y�WalC.st d;nda.f�P�iesdpa]taY - _. --- iNAME rG I2 ,, '-$f✓a 6,k L;oaseiva A/2 1 C� 6 lJy'Z �Jr/C,lc� BrTelNtato FR'SINS[JRANC EW. AILTel.Na -15-e-6 AIVFR;lamatvarethatthei.ioa�edoes�r�otllle�e$reai�troe���� �����'�'�s�sC�eta�Laws tmys rsemftpeunitwplrahon�dzmgm, r>mi ce check one) Owner Agent Telephone No. PERMIT FEE �� Location 13 J, No. Date ` " Qa �ORTh TOWN OF NORTH ANDOVER k ~ D Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ {' Other Permit Fee $ _ TOTAL $ Check # Building Inspector 15468 TOWIOT OF NORT I AND;0 'R r � B 'MW iD PARTIVIEN'I` PPLICATION TO CONSTRUCT REPAIR;RENOVAT OR-DEMOI;ISH A ONE 012 TW0 FAMII,�'1)VV)GLLIIVG �777 DUMBER: DATE�SSt�ED i BuildingCommissioner r of BuildingsDate WTIMW 1-SITE INFORMATION 1 i ProPeatY Address: 1•.2 Assessors Map and Parcel'Number: 14 f LLi p7 O Map Number P Number 1.3 Zoning Information: j . 14. P;opaty Dimensions. im Distad Use W . _. BUILDINGSETBACKS: flt � - Fronr Yard. Side, ' r. Rehr Pro tded • Pard• RequhWNA • Provided waw 3 mly MGLC.40.. � .M-...t.. W .�-Zonaau mnatioa:-F..r DisP°sat Systbm �c 0. 1?mato ❑ 1 Ootsida Flood Zoite p Mcg p i On sde Dkposa! CTION 2 PROPER `Y OWNERSHIP/AUTHORIZED AGM. Owner of Record m to(Print) Addressfor Service n ,ature Telephone: N �Wner of Record .N me Print Address for Service: O z 3ture Tel otie.:. rn 'TION 3-CONSTRUCTION SERVICES .icefised Co1nstruction S.yuppervisor. Not Applicable 0 ised struction Suf ervisor Ucmw Number z wz tore Expiration e. Telephone egistere i Home Improveinen`t'Contractor y Not Applicable ❑ ®. any N e �M, t Registration Number !ss :ure Telephone Expiration Date i __ SECTION 4-WORKERS COMPEN5ATION GLC 152 25c _ x i t Workers Compensation Insurance affidavit must be completed and submifted u�th this appLcahon F$ilure to:provide this affidavit will result �� in'ihd depiarathe:issuan'ce 6f,,the,buildin ' rmlt. Si ''ed ' affidavit Attached Yes. ....A. No' '� ❑ "# ' SECTION 5 Desc'ci tion o1'Pro `sed w Work check aR a livable Nev Construction` ❑ Existtn Buildm ❑ epau( ) g g s ❑ Altera di R. Accessory.Bldg. ❑ Demolition a Other ❑ Specify Brief Description of Proposed Work: F Vii' �l I a CIV _ 6b� � -NON 'MYSPE API Fo .SECTION 6 ESTIMATED CONSTRUCTION COSTS,... _ Estimated Cost(Dollar)to be C• leted b ;` t licant, 1. 'Building ' Perrmt Fee--Y 4 .2 Electrical (l�) Trshinat d 'otal Cost.0 ConstM 3 Plumbin Biuldwg Penmt fee(,)..(b) 4 Mechanical AC .5 y 6 Total, .1+2+3+4 5 3 , Check Nutt►ber : SECTI 1V'`7a`OWNER AI(JTHORIZATION'TO BE Cbl�LETE�'V�HEN WNERS AGENT OR CONTRACTOR APPLIES FORzBUILDING PERMIT i I� _ as Owner/Authorized Agent of subject property y.authorize >.f' to ao on Y behalf,in all matters relative to work authorized b this!buildin y g permit application. Signature of Owner Date :l 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 trite and accurate,to the best of my knowledge and belief.... . e8 g t: Print Name Si attire of Owner/Agent Date r.. NO.OF STOR3ES SIZE BASEMENT.OR SLAB rt _SIZE OF FLOOR TIMERS 1' 2 SPAN 3 DM ENSIONS OF StLI,S _ DIIVIENSIONS:OF_POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS MMMM SIZE OF FOOTING X MATERIAL OF CH&MY 'IS BUILDING ON.SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 03-05-2002 03:3`_%FM FROM GEORGETOWN INSL!RRNCE ADEN TO 197952150?9 P-01 AOW,b CERTIFICATE OF LIABILITY INSURANCEDATE 03/0542002 FRoaucER THIS CERIIFICA IS ISS DASA MATTER OF INFORKATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Georgetown Insurance Acency, Inc. HOLDER, THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 10 West Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE G_eorrReto.m MA 01833- •1NS4AFD INSURER A:COD0QF.ECCz INSURANCE COMPANY Meadowview Construction WsLIRERB SAFETY INSUPJWCE COMPANY 92 Lamoille Ave. , INiUP.ERG: INSURER 0: Bradford MA 01835 INVJR RE COVERAGES THE POLICIES CIF INSURANCE LISTED BELOW HAVE BEEN ISSUED T()TME INSURED NAMED ABOVE FOR THE POLICY PERIOD:NOICATLD.NOTIMTHSTAND1N0AWe REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR O THER DOCUMENT NTH RESPECT TO WHICH TH15 CERTIFICATE MAY 8E ISSUE'0 OR MAY PERTAIN, THE INSURANCE AF7-ORDED BY THE POLICIES DESCRIBED HEREIN 15 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDI'O-Z CP SUCH POLICIES. AGGREGATE LIMITS SMOWN MAY HAVE BEEN REDUCED By PAID CLAIMS, vis" TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMNTS LTR CATEIWAID DATE tNDDtY A GENERALLIABILRY iPEIMING 03/09/2002 03/09/2003 EACHCCCURRENCE _ I 1,000,000 X C0MMERCI4LGE.�R.4LLIA.L'LITY 1 9REDAMAGE(Axe mefire) 6 50;000 !"AIMS MASE L" I O::GttR j / I I / / MED EYP(AnY unv Ralson) 6 5,000 PERSONAL A AOYINJ.IRY 6 1'000'm GENERAL AGGREGATE GEN LA.30Rrz3ATEWAIT APPLIESPER'; PROOhC73•COMPIOPAGG S 1000,000 Ppi�pp f— PILI:` J£CT L0� / I 1 B AUTOMOBILEvAB0..ITY !1609795 06125/2001 06/25/2002 CG1a81N SINGLE LIMIT ANY.AUTO j (Ea aaeidme) 9 ALL OW 40 AVTO$ I I / / 80DILY INJURY S:NEOULEOAUTOS (Per Person) 6 100,000 HIRED AUTOS 5001LY INJURY NOt1OYoNE0.4UTOS I' (Pala0mom s 300,000 PR.OPE-4TY DAMAGE I (PCsAaidenq 6 LOD,000 GARAGELIA.6ILITY AIJTOONLY-EAACCOENT 6 ANY AUTO � � / � I / / CT HER THAN EA ACC $ ALTOCNLY: A,,C,it CESS LIAWTY / I I / FACM OCCURRENCE 6 OC'.:•VR CLAIMS nSACE i AGGREGATE 5 6 DEDUCTIBLE Rr,elafCNI WORKERS COMPENSATION AND / Su'Si.4Tuu• nTM c EMPLOYERS LIABILITY 1 ` SL FAGAAC:f0-? f E L.Dlt!e SE•EA EMPLOYEE 6 I EL.DISEASE.POLICY LIM:T 6 OTHER DESCRIPTION OF OPERATIONSlt,CCATIONWFIBCLESMXCI.L MNS ADDeD BY ENDORSEMENTAIFECIAL MOYMNS i OPERATIONS USUAL. TO TEM )LAURA INBUZ+$p CERTIFICATE HOLDER aoomonal lNsuRED INsuReR LenER: CANCELLATION SHOULD ANY OF THE ABOVE BESGRIBEO pOLrcjgz eE CANGEILED pMFORE THE EY.PRATION DATE THEREOF, THE ISSUING INSURAM VALL ENDEAVOR TO MAIL 10 DAYS 6tTtITTEN NOTICE TO V146 CERTIFICATE HOLDER NAMrD TO THE LEFT.6UT FAILUP,E TO DO 60 SMALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UP04 THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ACORD 2$.5(718T) ®ACORD CORPORATION 1888 INS025S(mo).ot t`LEC7RO-,fC LASER FORMS,INC..(500q=7-0645 Paye I of 2 TOTAL P.01 :/lte lDdl!Ll)tO�tI.IJE�Ofv J"'^""'�tA.[dP.��d Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Registration: 120560 One Ashburton Place Rm 1301 lug Expiration: 1/30104 Boston,Ma.02108 ,,Type.: DBA MEADOWVIEW CONSTRUC?ION DAVID WEST 92 LAMOILLE AVE .- ilr'•' BRADFORD,MA 01835 Administrator Not valid without signature �!e fa„�noalbi ri x BOARD'OF BUILDING REGULATIONS t,. •. MVISOR +LJcense CONSTRUCTION SUPER Number• lS. 059803 Birthdate 08!22/1970 a 2 Tr. 1688 � t7cpires 08122/200 no: ,. - RiWldted To:. 00' DAVID O WEST 921AMOILLEAVE BRADFORD, MA 01835 Admin�trator TOWN OF NNORTH ANDONTM Office of tree.Building Department �*�'O4° Community-Development and Senices 27 Charles Stree€. North A ndoler°,Massachusetts 01845 � °,,o�Kxr.�, • � D.Robert?tilicetta, Telepltcnc(978)688-9545 BFBMing CQ)fD mISS101jer FAX(978)6$8-9542 DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and as a condition of building permit# the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, s 150a. The debris willbe disposed of at/in: 10 (,7 . rhEao �)iS(OSAL 0zoF,�n wA) (Site location) ✓ q 161 Signature of permit applicant Dat I Michael McGuire,Local Building Inspector James Decola,Electrical Inspector James Diozzi,Gas/Plumbing Inspector David West Br dfbrd,Mlle Avenue Meadowview Bradford,MA 01835 978-372-5640 fax 978-521-5079 CONSTRUCTION davewest@fastdial.net TO: DATE: FACSIMILE # PAGES: J -n cLqx sa-4 Q� � cn h p WC r- 7rl��-CL C7 5 r 5 d 4J40 L ` 7ZD 6-7 , /n-e/% c s o� eq s itpo i Lel/ Raising your expectations.:, NORTFI 0 o _ 4 Andover O ~Y•I• ,I.., N o L A o dover, Mass., I� ACOCHICHEWICK 7 � DRATED P" iC5 �S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System /J AF BUILDING INSPECTOR GC !�'I D Foundation THIS CERTIFIES THAT.......................:✓.�........ ,�.�.�...... . .ems...... ............................... has permission to erect.... 7-ov.C-)O.S e buildings on ....I...s./04......jl-A.11........... Rough C Y 145 /-I'v s C r�e rn� C! /"m rc h wW GvIN�m GUS Chimney tobe occupied as..............................'I........ ................................... ................... ............................................................... 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 Ins ection, Alteration and Construction of Buildings in the Town of North Andover. C,g C!l 9► &,13J 4 b, PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough C Service ............ 6 ..................... ...... ...................................... 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. Smoke Det. SEE REVERSE.SIDE