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HomeMy WebLinkAboutMiscellaneous - 154 JOHNSON STREET 4/30/2018 (2) 154 JOHNSON STREET 210/097.0-0038-0000.0 I 4 JAMES A. TRUDEAU Adjustment Service Inc. James Trudeau Thomas Murphy P.O.Box 208 47 Green River Road Templeton,MA 01468 Greenfield,MA 01301 Phone: 978-939-2255 Phone: 413-774-5124 Fax: 978-939-4234 Fax: 978-939-4234 Notice of Casualty Loss of Building Under Massachusetts General Laws, Chapter 139,Section 3B September 12,2005 Building Inspector 400 Osgood Street North Andover,MA 01845 Board of Health 400 Osgood Street North Andover,MA 01845 Fire Department Dept. of Records 124 Main Street North Andover,MA 01845 Insured: Richard& Susannah Misci Loss Location: 154 Johnson Street,North Andover,MA 01845 Insurance Company: National Grange Mutual Ins.. Policy No.: 54J45321 Date of Loss: August 18,2005 File Number: 05-04190 Claim Number: N/A Type of Loss: Water Damage Claim has been made involving loss, damage, or destruction of the above captioned property, which may.either exceed:$1,000.00 or cause "Mass. Gen. Laws, Chapter 143, Section 6" to be applicable. If any notice under "Mass. Gen. Laws, Chapter 139, Section 3B" is appropriate, please direct it to the writer and include a reference to the captioned insured,location,policy number, date of loss, and file or claim number. On this date, I cause copies of this notice to be sent to the person(s)named above at the address indicated by first class mail. Sincerely, Thomas Murphy Claims Adjuster Location �� 'S No. All Cl Date L/ - D Z NORTy TOWN OF NORTH ANDOVER O � 9 * ; : Certificate of Occupancy $ C°s Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # CS U 0 ,i 3 3 Building Inspector t TOVM OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CDNSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING I BUILDING PERMIT NUMBER: DATE ISSUED: _ SIGNATURE: Building Commissioner/I for of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number- Map Number Parcel Aumber 1.3 Zoning Information: 1.4 Property Dimensions- Zoning District Proposed Use -Lot Atiea Fronto ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Provided R Provided 1.7 water S"ply M Q1_C.40. U) 1.5: Flood Zone Infoima6on 1-8 Sewerage Disposal System: Public ❑ Private Q ZOOe Outside Flood Zone ❑ Monicgral ❑ On Si6e D[sposal:System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Name(Print) Address for Service: f E2 R57o Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor. Not APPlic" ❑ 4L R pgizg h' Licensed Construction Supervisor: j, License Number 1 r°� Address 3 33 Expiration Date St Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name jQ j 6 5--7 I/ee Registration Number Address _ - z` ©Z -` 7D 3 Expiration Date Si re Tele hone j 1 SECTION 4-WORKERS COMPENSATION(IVLG.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.......0 No.......0 SECTION'5 Description of Proposed Work check all applicable), New Construction 0 Existing Building ❑ Repair(s) ❑^ Alterations(s) Addition 0 Accessory Bldg. ❑ Demolition 0 Other ❑ Specify Brief Description of Proposed Work: ��L�10 • FOCI SIIn� ,k� G1.ry�T-�eiir,C�t� CGs'7�� f��oC�„� SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be Completed b t a licont 1. Building (a) Building Permit7FeeMulti Tier2 Electrical (b) Estimated Total construct bn 3 Plumbing Building Permit fee(a)z(b) 4 Mechanical AC 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, v ,as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTIIO+N 7b OWNER/AUTHORIZED AGENT DECLARATION �2 De 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 i Print N Si a of Owner/A ent Date ` NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 sr 2ND 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIlAENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid.waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: out Lnd c!o (Location of Facility) Signature of Permit Applicant 002. Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector 1 / ' ,�lc ��om,»uln�,�al�� o� jlcrk3aT�aaelta BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 043239 Birthdate: 08/22/1961 Expires: 08/22/2003 Tr.no: 2406 Restricted: 00 SCOTT R DEVINE � PO BOX 1761/439 S MAIN ST (.r �i ANDOVER, MA 01810 Administrator Board of Building Rtgulatidna and Standards t HOME IMPROVEMENT CONTRACTOR Registration: 103637 Expiration: 07109/2002 Types PRIVATE CORPORATION TRIMMER CONSTRUCTION INC. Scott Devine 439 S.Main St./Box 1761 Andover,MA 01810 Administrator • The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print mill Name: Location: Ci - Phone (� am a homeowner perforating all work myself. �I am a sole proprietor and have no one working in any capacity Wft I am an employer providing workers'compensation for my employees working on this job. Company name Irl m f' Address L v C I surance- Z�. �O Compgnv narae: Address City: Phone# Ins�urance-Co. Policv# _ Failure to secure coverage as required under section 25A or MGL 152 can lead to the' and/or one years imp►isonment as well as civil penalties in the form of a STOP woRK ODR and a tine ofnloositlon of criminal p$100 00 a Baenalties of a ne up to$1,500.00 understand that a copy of this statement may be forwarded to the Office of Investigations of the an for fine of(se .00**)a da against me. i n. I do herby certify under pains and pen of pejury that the information provided above is true and correct Signature Date_ -- Print name Phone# 3 Official use only do not write in this area to be completed by city or town official' []Check if immediate response is requiredElBuilding Dept Building Dept ❑ Licensing Board Contact person: El Selectman's �Ce Phone# ❑ Health Department ❑ ©flier W WORKMAN'S COMPENSATION NvR � fy Town of Andover No. o ` h dover, Mass., 30 LA — COCHICHEWICK V ORATED S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT �� �' /sC,� ..................a.......................... ........................ ..... ................................................... ..... Foundation has permission to erect....�r � 'a. .... buildings on .... .... � :IV....... 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 Final this office, and to the provisions of the Codes and By-Laws relating to the Inspecti n, Aft and Construction of Buildings in the Town of North Andover. IY9 63 fteratqs+ PLUMBING INSPECTOR • VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR RoughC . ............................... .. .. 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. { Location j `) 4 :M/4,70"' No., l'YJ Date TOWN OF NORTH ANDOVER JaidMOKp Certificate of Occupancy $ � - • Building/Frame Permit Fee $ Foundation Permit Fee $ � s�cHus Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ i TOTAL $ Building Inspector 4 10627 01/13/97 12:24 195.00 pplD Div. Public Works BUILDING RECORD i OCCUPANCY 12 INGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES _ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS I RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE _ B i 7 I3 �eyLlO�e.( CONCRETE BL'K. PINE _ BRICK OR STONE HARDW D PIERS PLASTER __ '/ e.mo _ DRY WALL ,l UNFIN. 3 BASEMENT I AREA FULL FIN. B'M'T' AREA _ ✓1�v 0 '14 1/2 FIN. ATTIC AREA _ N_O B M'T FIRE PLACES _ HEAD ROOM _ MODERN KITCHEN 4 WALLS I 9 FLOORS K CLAPBOARDS B 1 22 J 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH _ ASPHALT SIDING HARDNN'D _ ASBESTOS SIDING _ COMfAGN VERT. SIDING ASPH. TILE STUCCO ON MASONRY _ STUCCO ON FRAME Hl BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR I� POOR ADEQUATE NONE 5 ROOF _7710 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 I 11 HEATING WOOD JOIST 14 PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. 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 r OIL B'M'T2nd ELECTRIC 1st 14 13rd "CHEATING PER3irr NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP 4-40. Cl,j-7 LOT NO. 3& 2 RECORD OF OWNERSHIP IDATE BOOK 'PAGE ZONE � SUB DIV. LOT NO. KGS 57 LOCATION PURPOS OF BUILDIN OWNER'S NAME e CP Y� ..j, NO. OF STORIES SIZE OWNER'S ADDRESS lJ.%6`�.� �• 2 BASEMENT OR SLAB /1 1 1'�_ y ARCHITECT'S NAME /U„ J�}n Ove SIZE OF FLOOR TIMBERS 1ST 2ND 3RD BUILDER'S NAME - SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES—SIDE 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 .fj„`__6 �ti.R7 _51�OL_�� IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OFC E "L I(/ IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER y1 GS IS BUILDING CONNECTED TO NATURAL GAS LINE G5 INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST EST. BLDG. COST PER SQ. FT.�OZIJCJ 11 O PAGE 1 FILL OUT SECTIONS 1 - 3 _ PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED d el-J WILDING INSPECTOR SIGNA RE OF OWNER O T RIZED AGENT F E E Ic�(S�— OWNERTEL.# JaS,7 " tG3 PERMIT GRANTED 19 CONTR.TEL.# &Pq_ C2�F3 CONTR.LIC.# s H.I.C.# S Y v 7 �1ORr of y -- ToVM over No. D 11- * _� - -- Pj * 9 . * - dover, Mass., 9 19 O LAKE COCHICHEWICK q4 T E D p'Q� 'C J BOARD OF HEALTH Food/Kitchen Septic System P ERMIT T eel/ BUILDING INSPECTOR THIS CERTIFIES THAT........................................ ........�...�.1!!�.E..........'��. . . ..... �........... Foundation has permission to ........... buildings on ........./.S`..........�d. 1.S.0..!4........... `7. ............. Rough • 0!� / I /��.l� aaa........................ Chimney to be occupied as..............................k�r,�'...........��..•............K. .r.1 . .... ....... ......... ..... .. ... . ..application. on file in provided that the person accepting this permit shall in every respect confor to the terms of the app• Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Towr: of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT_ EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST AR(T Rough Service UILDING INSPECTOR Final Occupancy Permit Required t0 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. I ' i Town.of North Andover a NORT►y OFFICE OF F?0`tt�to e•e�OA COMMUNITY DEVELOPMENT AND SERVICES 146 Main Street North Andover,Massachusetts 01845 �,'Q�,,,to WILLIAM J.SCOTT SACMUS�� Director In accordance with the provisions 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 111, S 150A. The debris will be disposed of in: 6:danfi u�Qsle- � -,ts (Location of Facility) Or Signature dvrmit Applicant 1Y1?7 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. • v BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 I Location r � No. -a1" ? Date /q/z--540- NORTH TOWN OF NORTH ANDOVER p Certificate of Occupancy $ + Building/Frame Permit Fee $ — i Foundation Permit Fee $ JACMuse Other Permit Fee $ !� Sewer Connection Fee $ Water Connection Fee $ TOTAL $ _ � + 6uilding Inspector I i f c� Div. Public Works ro 1 a PEaAmr NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, Y ... OVER N , MASS. PAGE 1 MAP 4-40. I LOT NO. 2 RECORD OF OWNERSHIP iDATE BOOK 'PAGE ZONE SUB DIV. LOT NO. LOCATION A / PURPOSE OF BUILDING OWNER'S NAME✓ L7fyee- N l /w" �� !I/ h NO. OF STORIES SIZE OWNER'S ADDRESS `�� ,tlrC^ BASEMENT OR SLAB ARCHITECT'S NAME /tom SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME A eA �Ja,��� J� 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 �dC4 Re p/Ace- IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OFC DE 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 I FILL OUT SECTIONS I - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FIIFD I o �S BUILDING INSPECTOR SIGNATURE OWNER OR AUT-HO AGENT FEE (! OWNER TEL.N PERMIT GRANTED tv!"� 1�J CONTR.TEL.# 3"3J Z�9 CONTR.LIC.# ���3 7 ,112 H.I.C.# BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 3 1 2 13 CONCRETE BL'K. PINE __ _ BRICK OR STONE HARDW D —_ —_ PIERS PLASTER _ DRY VJAII _ _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ 1/1 1/2 1/. FIN. ATTIC AREA N_O B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH _ ASPHALT SIDING HARDW D ASBESTOS SIDING _ COM/,ACN VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BILK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIORI� POOR ADEQUATE NONE 5 ROOF 11 10 PLUMBING GABLEMIP BATH 13 FIX.) GAMBREL MANSARD TOILET RM. 12 FIX.) FLAT SHED WATER CLOSET _ J ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. 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 NO HEATING OFFICES OF. T _ TO`VIl_Of ,�_,_ -_ �--'r_� _x,120 M3►tlStfeef ---- APPEALS _ North Andover, e�y. ^� NORTH ANDOVER BUILDING t ,e M8ssachtJS@tts O 1845 CONSERVATION DMISION OF HEALTH P"N-NING PLANNING & CO,MMUNITY DEVELOPSIENT KARE-N KP.`EI_,SO`• D(RECTOR - In 1C:^,r:.nG' with Ii1e S 5+. a conL(t•Cn of Bulldins P-,-m,.t Norther 's^ t ct dctr:s resulting irCm this work shall be disncsed 0=1 ,n a prcperiv `.i,._rs= --Clid ; t�J Z5 c: by MGL c111, S i ne debris will be disooser' cf L,..•.`.tint-. Cf =ccait ) ic:lat::re of Pcrrnit nt T le -2K, Dale r•, NOT=: Demolition permit from the To---a of ;forth Andover =Ust be obtained for this project through the Office of the Building Inspector. r i • ••• ••`••• V••••� �•• unsrvrlM Mrr'L.JVh11%Jri f%jn rrnra11 Iv L%j rL-kd4ti&uusv (Print a Type J NORTH ANDOVER, . Mass. [)ate _.19 `/ 7 Building Permit it 3 L Lot Location . 5 �O �S D lel 5 T Owner's ' Name &;5Y 4'4;q'1 New O Renovation Replacement 0 Plans Submitted: Yes❑ No.❑ FIXTURES ........ w s 11 » J M O X = r how w s■ 0 s M 3 O s e: as X Is r1 0. i 1 _ IL �. J M r M : = sr 9aX s >, ar Y 0 7 s er S X 4 ~ r ! I 0 i i i 0 N V y 1- 0 ` a �. = O ` = o i K r 1 o u a=i o sua—OaYT. sAetMtiNT IST FLOOD 2NOFLOOR 3 >t110 FLOOR 4TH FLOOD aTH FLOOR eTH FLOOD. TTHFLOOR eTH FLOOR Check one: CadVieate Installing Company Name 1W Ul`TTF �LG 7_fiG Q Corp. Address N/ /3 14 G11 Ay,:9012 A p Partnership O Firm/Co. Business Telephone e Name of Licensed Plumber ;r o //i Gr INSURANCE COVERAGE: checkone 1 have a current ilabllty Insurance policy or Its substantial equivalent. Yes V'- No ❑ If you have checked yM. please Indicate the type coverage by checking the appropriate box A liability insurance policy Ea' . Other type d indemnity [] Bond O OWNER'S INSURANCE WAIVER: 1 am aware that the Ilcenies does not have the Insurance coverage required by Chapter 142 of the Masa. General Laws, and that my signature on this permit application waives this requirement. Check one: Signstuf of Owner or UMner s Agent Owner ❑ Agent ❑ I=certify that all of the details and Information I have submitted for snleredl In above application are true and smurate to the best of my knowisdpe and that ai plumbing work and Installations performed under the p mail lasued for title appNcatIM will be In compliance with ail pertinent provisions of a btassachusetts Slate Plumbing Code and Chapter 142 of y»Genera)laws. 8Y �! Trite urs o cense um Cftyflown Ucense Number APMOVED (OFFICE USE ONLY) Type of Plumbing License: Master ❑ Journeyman (7�— y Date 9�' 9. _ 7 3228 t 40R71y TOWN OF NORTH ANDOVER 0 P9RMfV' OAR PLUMBING 'SS,CHUS� L66` This certifies that . . . . . . . . . . . . . . . . . . . . . . . has permission to perform . . a,u.k!4.° 'ti.s. . . . . . . . . . . . . . . . plumbing in the buildings of . . . !. 'y at./.. . �.a L!► s r r�" . . . . . . . . . . . . .. North Andover, Mass. FeeLic. No/��`�ra .2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6 PLUMBING INSPECTOR a — 3z , d WHITE: Applicant CANARY: Building Dept. PINK:Treasurer n z� MASSAGHOsETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) Mass. Date PermO it Building Locatlon � `Oli��j ' Owner's Name �l Type of Occupancy : , New p Renovation ❑ Replacement [vr Plans Submitted: Yes❑ ' No ❑ y • y W N V) W ¢ y ¢ O y _. y C1 m F- . LU W ¢ Q �- V J W n O l:1 � C j m N F' y Uj¢ O CL LU W J F C t �W. , N O > IL !- UJ J fy. uci < w > ¢ w O = < Cr 1 o o W ¢ O �4u1 U. M o C J U ¢ > G i F- O SUB—BSMT. BASEMENT I 1ST FLOOR I 2140 FLOOR I I I I I I ORD FLOOR 4TH FLOOR I I STH FLOOR I I I I I I 6TH FLOOR I I I I 7TH FLOOR I I 87H FLOOR I Installing Company Name rAL fd114Al pit X NF47TN s Check one: CertKlcate � Address_ 9 F l7017 S 7/2(EE% C Corporation NO, ANDO VDNA. 0 18 4 5 ❑ Partnership Business Telephone 508-689-9233 ❑ Firm/Co, Name of Ucense•d Plumber or Gas Fitter 70SEP11 K. CALLAKAN INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes P No ❑ If you have checked Yes, please Indicate the type coverage by checking the appropriate box _ A liability Insurance policy t3 Other type of Indemnity❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the Ilcensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit appllcatlon waives this requirement- Check one: Signature of Owner or Owner'sAgent Owner❑ Agent ❑ I hereby cartlty that ail of the details and IntormaUon I have submitted (or entered) In bove appllcatlon are true accurate to the best of my knowledge and that all plumbing work and InsWIaUons performed under the permit sued for appllcauo I e c0 ance with all pertinent provisions of the Ma.ssachusatU Stale Gas Code and Chapter 142 of the neral law Te of Ucerua: Title Plumber natur o Gens er or as titer G-asfitter cilyn.own Master cense Number N-3 4 4 0 v Journeyman T� t 2420 Date.Cl .�,/ .:?. ......... of N�oT 6,ti 'TOWN OF NORTH ANDOVER �` PERMIT FOR GAS INSTALLATION CHUSEtty p O This certifies that . . �?�.l�?�f�� .t. . . . . f�'~ . . . . . . . . . . . . . . has permission for gas installation . . . . . . . . . in the buildings of . . .13 q n 1 -:�7. . . . . . . . . . . . . . . . . . . . . . . . . . . . .. at ti . . . . . . . th Andover, Mas Fee.,-9s..: . . . Lic. No.. `�.`!� . . . '. . . . . . GAS INSPECT WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD:File MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) ,n / 1CHU�G by AA ) �" , Mass. Date 19 Permit# 22507 --kl X S Building Location f 5 y y to S�r� Owner's Name r --�2 Type of Occupancy New ❑ Renovation ❑ Replacement, Plans Submitted Yes ❑ No ❑ _ Y w cA Z tr N Lu O U m _ Z J c ~ Q } Z Z p F W m u) � w O = O cc W Q = Z � to a 0= � Q W cn w z Q=� z �- Cn O z O ~ F- ¢ [0 Z w O C Z Q w LLJ 2 � = O 0 = u- O O 3 o 0 UaC > o n0 H O SUB-BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name i Check one: Certificate Address O rp X 7 { C Corporation G Partnership Business Telephone 2 !5-7— y 5 7Firm/Co. Name of Licensed Plumber or Gas Fitter__ INSURANCE COVERAGE: 1 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 of coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNERS 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: Signature of Owner or Owner's A ent Owner ❑ Agent ❑ 1 hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best-of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By Trpe of License Title ❑ Plumber GasfitterSignature of Licensed Plumber or Gas Fi ter City/TownImisMaster ` APPF30VED OFFi E USE ONLY) ❑ Journeyman License Number To 2507 Date. . . NpRTh ,t �X TOWN OF NORTH ANDOVER .. a 0 5� PERMIT FOR GAS INSTALLATION A 'a 9SSACHUSEt This certifies that . .+� . . 0 ... . . . . . .. . . .. . . has permission for gas instal on �.. . . 'o g _ . . . . . � in the buildin f . ,� . at . . . . . -' • . . . . . .. North Andover, Mas Fee. .2rl . Lic. No.1.,0'.Y1.7 . . . . . . . . . . . . . . . . . . . . . . . . .Is". GAS INSPECTOR WHITE:Applicant CANARYBuilding Dept. PINK:Treasurer GOLD: File Y r 011e (Iommonwealtll of Musfindluoetto Office Use Only Department of Public Safety Permit No._ } BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Occupancy & Fee Ch 3/90 (leave blank) f� APPLICATION FOR PERMIT TO PERFORM ELECTRICAL V All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 n (� (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date City or Town of &I. ow To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 154 0 JQN0 �j-r Owner or Tenant __ Ke-7 Lime t`'1 SS Q t-;n,4 f 4 Owner's Address /vD ✓ Is this permit in conjunction with a building permit: Yes ; No (Check Appropriate Box) Purpose of Building 1geryoLJ0 -/low/' Utility Authorization No. Existing Service �5�Amps-Ids / /`7� Volts Overhead W Undgrd ❑ No. of Meters—�— New Service -C Amps Volts Overhead R1 Undgrd ❑ No. of Meters Number of Feeders and Ampacity /I ii �G- / Location and Nature of Proposed Electrical Work Po U� ! eA I f�� �(/o,4,-o Al + r\1'4 cA-e� k-em o D-e L No. of Lighting TOTAL Outlets No. of Hot Tubs No. of Transformers KVA A ove In- No. of Lighting Fixtures SwimmingPool rnd. ❑ rnd. ❑ Generators KVA +, No. o Emergency Lighting No. of Receptacle Outlets No. of Oil Bumers Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones Tota No. of Ranges No. No. of Detection and of Air Conditioners Tons Initiating Devices Heat Tota Tota No. of Sounding Devices. No. of Disposals No. of Pumps Tons KW No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices Municipal No. of Dryers HeatingDevices KW Local[] Connection ❑Other No. ot No. of Low Voltage No. of Water Heaters KW Si ns Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusttes General Laws have a current Liability Insurance Policy Including Completed Operations Coverage or its substantial equivalent.YES NO O 1 have submitted valid proof of same to this office. YESX NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE W BOND ❑ OTHER❑ (Please Specify) -J-.M )lions LtQ6f h*4Y 9- / Estimated Value of Electrical Work E (Expiration Date)/fir Work to Start 1 a 9 / Inspection Date Requested: Rough Final Signed under the penalties of perjury: FIRM NAME S o U .Al LIC. NO. � .Licensee Signature _JJLIC. NO. Address SCh Pc�n '��o �Gl�Q/)') /11lip aaD29 Bus. Tel. No. 6 0 3— 1/ 9 Alt. Tel. No. 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 f (Signature of Owner or Agent) Date..../.'.....E � -..:2..7 �= 724 t HCRTM 1 0 TOWN OF NORTH ANDOVER I PERMIT FOR WIRING s SSACHus� This certifies that ............ ....... ,lr.le,.... ......... ........ has permission to perform/.'441...1. h ...�- .. ... . 1 ! � ... ' .l wiring in the building of. �.. �.-.�:.�L�{...................................... / �(...... ,. fL r�:,:?�.� S�..................... .North Andover,Mass. at.. .�. .. i Fee'4.00.."` .Lic.No<�- .J.l sc ................ � EL .. ECTRICAL INSPECTOR IQ3/y D O 200.00 PAID WHITE:Applicant CANA Building Dept. PINK:Treasurer 04e Ttltl milowealt4 of I alifin ljttoetf8 Permit Noffice Use Only. �epnrttnent ofPublic ttfetg Occupancy& Fee (CheckedU BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3190 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICALG l y WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date _ �- - - 9 7 City or Town of. .1/",,-A /)n (1e"y/Z To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) ZSu J Aha on SJ- Owner or Tenant u�i L,,,,v � ��(r�� ,�� Owner's Address v Is this permit in conjunction with a building permit: Yes ❑ No ❑' (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps New Service Amps Volts Overhead ❑ Und rnd t! 9 No. of Meters _/ Volts Overhead ❑ Und rnd � No. of Meters 9 t— 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 K VA No. of Lighting Fixtures Swimming Pool Above In- grnd. ❑ grnd. ❑ Generators KVA ( i No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets I No. of Gas Burners , �[ FIRE ALARMS No. of Zones No. of Ranges i No. of Air Cond. T°tal No. of Detection and tons Initiating Devices No.of Disposals No.of Heat Total Total Pumps Tons KW No. of Sounding Devices No. of Dishwashers I No. of Self Contained Space/Area Heating KW Detection/Sounding Devices No. of Dryers I Heating Devices KW Municipal Local Other Connection ❑ No. of No. of Low Voltage No. of Water Heaters K'N Signs Ballasts Wiring No. Hydro Massage Tubs — ( No. of Motors Tola1 HP OTHER: _ (res �n��.•c r• 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 NO I have submitted valid proof of same to the Office. YES O NO 0 If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE (X BOND G OTHER Ll (Please S . - pacify) General Liability 12/31 97 Estimated Value of Electrical Work$ (Expiration Date) Work to Start Inspection Date Requested: Rough Signed under the Penalties of perjury: Final FIRM NAME Boissonneault Electric Corp. All 823 Licensee foe /7,7 ' /• LIC. NO. Signature--- J-11(-( GIl/ UC. NO. Address 4--7 S?1 Pm Road Dracut YEA 01826 Bus. Tel.No. (508 ) 454-0383 OWNER'S INSURANCE WAIVER:1 am aware that the Licensee does not have 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—ser or Agent) –Telephone No. _ PERMIT FEE S .c.�c TO 859 Date...... �......2.7 TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING SSA�MUS This certifies that ..... ......... . has permission to perform �W.(-%........................... a c Ando wiring in the buff of... ....1 1,T at..... .......... .............. .North Mdo &ers, Fee.—.�......"2 .. Lic.No.3;;a�. ................ ..................... Li�RI A L i NSPECTOR 04/10/97 1439 30.00 PAID WHITE:Applicant CANARY:Building Dept. PINK:Treasurer 3645 Date....3... ..-.. ........... MORT11 °;• '"° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �,SS^CHUSE� This certifies that .................�V I....C ........ .......... .. . .................................................. has permission to perform K.. IC ° ....... ................................................................ wiring in the building of.....2.............'`Z r`... �l \ S C . .............................................................. at... .....I.....�.a?...!....SUN...................................North Andover,Mass. 8IE �A _� .� WT Fee....�5........ Lic.No. �3 (o I f A( �] LECTR aL INSPE, OR Check # `3�� Com»ieetwea[Ih o� as�ac�ittde�f9 OffiCial Use Only 2,l .rf,-w.t o�,}ire �ervices Permit No. 3� ' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11;99] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with(he Massachusetts Clcctricnl Code(MEC),527 CN1R 12.00 (PLEASE PRINT IN INK OR TYPE:ILL IM'ORIL 1170th) Date: �s)c� �City or 'Town of: r /�n 1/1,t! To the Ito of By this application the undersigned es tics of his or her intention to perform the e1eR teal work described below. Location (Street & Number) Owner or Tenant R t C J f-7i Y CI` Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Bos) Purliose of Building ��/� I l(nry Utility Authorization No. Existing Service Amps / Faits Overhead ❑ Undgrd ❑ No.of Meters . New Service 47 Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 1 i-1 Ax K o rf+s Completion of the(olhnyi+ table nray be Waived by the hu ccior o!'{Hires. No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Falls No.of Total Transformers KVA No. of Lighting Outlets No.of Hot Tubs Generators hVA ` No.of Lighting Fixtures Shimming Pool above ❑ In- ❑ t o.o mergency ig itmg rild. rnd. Batte •Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARIMS 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 No. of Waste Disposers J flea TotalPulils Number Tons KW No.of Sell=Contained Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ tNIunicipal ElOther Connection No.of Dryers Heating AppliancesK1V Security Systems: No.of Devices or Equivalent jNo.of NaterKNV No.of No.of Data Wiring: Heaters, Signs lis Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.otMotors Total HP 1'elecommunications NViring: No.of Devices or E uivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. I'lie undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE n' BOND ❑ OTHER ❑ (Specify:) Estimated.Value of Electrical Work: (When required by municipal policy.) (Expiration Date) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certifi-, under the pains and penalties ofperjrrrJ•,that the information ou this application is trite and complete. FIIUM NAME: Buddy Electric Inc LIC.NO.: 120171 Licensee: Vincent B. Danders' JR Signature LIC-NO.: 23684 E (If applicable, enter ••e<<nrpt-in the license number line;) Bus.Tel.No.: 975-4455 Address: 24 Colgate Tyr �-Ard nyer , Ma 01 R45 Alt.Tel.No.:OWNER'S INSURA—CE NVAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,1 hereby waive this requirement. I am the(check one) ❑ owner ❑ owner's agent. Owner/Agent Signature •felephone No. P1'RJ11T FEE: S