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Miscellaneous - 16 COURT STREET 4/30/2018
16 COURT STREET 210/095.0-0011-0000.0 8858 Date. 0 "ORT" TOWN OF NORTH ANDOVER 0t ° PERMIT FOR K/uMBING ...Q SSACMU5� �- This certifies that . . has permission to perform . . . . ..� .t!4 . . . . . . . . . . .. . . . . . . . . . . . plumbing in the buildings of . . . 17. �. . . . . . . . . . . . . . . . . . . . at . . .1 .C. �.(.. . . . . . . .r. . . ., North Andover, Mass. Fee. 2. . . .Lic. No.. ` .3 }.' . . . . . . . . ..... . . . . . . . PLUMBING INSPECTOR Check x 3 7 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town: ,MA. Datek Permit# Building Location: O CDL Owners Name: PUde- Type of Occupancy: Commercial❑ Educational❑ Industrial❑ Institutional❑ Residential New:❑ Alteration:❑ Renovation:❑ Replacement:Q� Plans Submitted: Yes❑ No FIXTURES DEDICATED SYSTEMS ac Z LU z W Y O V1 0 O H d' Z Q to } V t7 OC lu Z W CL r Y 4y to Q Ca in Z tail LU jW Z W a _Z W Z �- N L 0 Q in m � W �' �' � ¢ !1' Z H U d W S J Q OJZ)LL. F ?� UO OC 3 W O C W to Q S W W W oil 3 W W V H = n. U _ Q 30 C Z Z to H F _ to W } to-. oc a Q in to O p = O a a m m c c � x Y 5 < S cc to to � 3 3 3 0 0 3 SUB BSMT. BASEMENT sr 1 FLOOR 2"D FLOOR 3R0 FLOOR 4T"FLOOR S FLOOR eH FLOOR 7 FLOOR 8 FLOOR Check One Only Certificate# Installing Company Name: T . 9- rporation .z Address: 1110 W"Cwwown: State: ❑Partnership BusinessTellj� (��` Fax: 1 ❑Firm/Company Name of Licensed Plumber. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes VA40'❑ If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy er--- Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:l am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. f Check One Only Owner El Agent ❑ Si nature of Owner or Owner's A ent I hereby certify that all of the details and information I have submitted(or entered)regarding this 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 provision of the Massachusetts State Plumbing Code and Cha ter 142 of the General La By Type of License: , Title ❑Plumber S ature of I icenseA Mtmber Taster Citylrown ❑Journeyman License Number: T APPROVED OFFICE USE ONLY) Date. :.�.�.-.�.!.. .. . . NORTH Of ��D ,ti0 o= TOWN OF NORTH ANDOVER ,..... % PERMIT FOR GAS INSTALLATION gs�SSAC MUSE4 This certifies that . .... . . . . . . . . . . . has permission for gas installation . /.71(.1 . . . . . . . `. . . . . . . . . . . in the buildings of . . *. . . :.. .j... . . . . . . . . . . . . . . . . . . . . . . . . . . at . .'. . . . . . . . . , North Andover, Mass. Fee ?. ?. .'. Lic. No.. .. . . . . . . . . . . . . . . . . . . . . . . . GASINSPECTOR Check# J6? 6 .� 1 � .. P MASSACHUSETTS UNIk ORM APPUCATON FOR PERMTf TO DO GAS FITTING ` (Type or print) Date .0,14,- NORTH 0,1QNORTH ANDOVER,MASSACHUSE'I I'S Building Locations f� �BJ'e Permit Amount$ J. �- R � b L 0 O Owner's Name New❑ Renovation Replacement ❑ Plans Submitted ❑ d H z H x O W F a Q a a w H ° o z o x o� � � 3 a � � ° °a � � QOf SUB-BA SEM ENT Sip¢. BA SEM ENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH . FLOOR 5TH. FLOOR 6TH. FLOOR 7TH . FLOOR 8TH. FLOOR (Print or type �lil k one: Certificate Installing Company Name e �� s�1,v o � Corp. Address 1,95 /Jye�`� °' ❑ Partner. Business Telephone ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one I have a current liability Insurance policy or it's substantial equivalent. Yes No❑ If you have checked}_es,please indipAe the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: ❑ Signature of Owner or Owner's Agent 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 performed unde Pe Issued for this application will be in compliance with all pertinent provisions of the Massachusetts Stateand ap 1 o t e General Laws. By: Signature of Licensed Plumber Or Gas Fitter Title Plumber '�?$$) a City/Town ❑ Gas Fitter License Number ester APPROVED(OFFICE USE ONLY) ❑ Journeyman PERMIT NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 I MAP NO. I LOT NO. 2 RECORD OF OWNERSHIP iDATE 1. IBOOK /-� PAGE — ZONE SUB DIV. LOT NO. QHi bdISTi [.� �cr LOCATION 16 CvaIZ751IVAM,0"Ic-12 PURPOSE OF BUILDIIF% OWNER'S NAME Aaol=fir T7� v�vv� NO. OF STORIES f SIZE OWNER'S ADDRESS �I® /" s�-. BASEMENT OR SLAB sl�" ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME SPAN '+�/�/'J—!!!;& l �'•��.e _ p2 _ DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLSL _ /!ten-C✓-�'" -0^'�^" DISTANCE FROM STREET G POSTS DISTANCE FROM LOT LINES-SIDES Ze C( REAR /j/G GIRDERS ✓✓✓���TTT���-��"'��_--`�� AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW /Y a SIZE OF FOOTING X IS BUILDING ADDITION NQ MATERIAL OF CHIMNEY IS BUILDING ALTERATION �� IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO RE UIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER Y,ES BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER Aes 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 I - 12 SEPTIC PERMIT NO. ELECTRIC METERS 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_/ L�/��/�� BOARD OF HEALTH SIGNATURE OF OWN R OR AA THORIZED AGENT FEE PLANNING BOARD PERMIT GRANTED 19 BOARD OF SELECTMEN BUILDING INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILYsrORIES 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 _ d 1 2 13 CONCRETE BL'K. PINE• BRICK OR STONE HARDW D _ PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ '/, '/z '/, FIN. ATTIC AREA _ NO B'M'T FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARDVV'D _ ASBESTOS SIDING COMMCN VERT. SIDING ASPH. TILE STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STIRS. & FLOOR 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 13 FIX.) GAMBRELMANSARD 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 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 I NO HEATING 3 1 8 Date.... No f /............ ! NORTq 7 °!< :�• ° TOWN OF NORTH ANDOVER 3? e�,�, s °L - > ' PERMIT FOR WIRING ,SSACMU-4 This certifies that � ......f .//.............(—U f f has permission to perform .................................... ,e wiring in the building of..........1. z...f`...!.................................................. at......... ....(........... ...............s`North Andover,,-Mass Fee.. �..:.d J Lic.No. f �2 / / ..................... .. .......... ... ver' LECTRICALINSPECTOR Check # �'� f' WHITE: Applicant CANARY: Building Dept. PINK:Treasurer THECOMM0AWE LTHOFARMCHUSE77SENo. Office U�ly DEPART�IIDVTOFPUBLICSAFETY 1F7 BOARDOFFMEPREVEMIIONREGUL4770NS527(iWR12.100 Checked APPLICATIONFOR 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) Date 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) � U2 Owner or Tenant cJ Owner's Address Is this permit in conjunction with a building permit: Yes Q No r 2�f(Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead Underground Q No.of Meters New Service Amps Volts Overhead Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work _ 11/6 �=- J r_ � -77 IVo.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA �to.of Lighting Fixtures Swimming Pool Above Below Generators KVA ground ground 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 Pum s 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 No.of Water Heaters KW No.of No.of Sis2s, Bailasis Nt.Hydro Massage Tubs No.of Motors Total HP OTHER- InalrarxeCmtrage-Putin n tDthem mam tsdMassadREdtsGaterallam Iha%eaa="Lmhkyh ummpoiLyn figCm#At CaeagecritsWmWbdacA%dat YES NO IhwmstbmikdvabdptoofofsmxiotheOfm YES MNO r-1 lfymtmedvdzdYESsplemeirdc*thetA3eof'ooteraWbydukingthe INSURANCE BOND F-1MliER (PkaseSpecify) �/= ✓ C-27-5p /t-7 F�cpaalionD�e Est<rn dd Va)wdPlectcid Wdk$ WcYktoSurt _ hgtectimD*ReWekd Rough Feral SigredP rhiesofpetjtay f A /'� FIRMNAME (J 1% J_�k Lroamv 40Sigrlre .r icertsel�to &is¢mTe1.Na - ? AYTelNa OWNER'SINSURANCEWAIVEP,Iamawat dilth Lx=dmnotlaveth mwrano wmWorilss leWrivaiftasmgmWbyMassada>&GaxdLmvs andthatmysi ur iealllasp=*Vpha6onwaicstlrsm march (Please check one) Owner Agent Telephone No. PERMIT FEE$ Location �b Co U r No. Date ,.ORTh TOWN OF NORTH ANDOVER M y i Certificate of Occupancy $ �'�;'•^°'''<�' Building/Frame/Frame Permit Fee $ _ s�cMust 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # �S a 150/ 30 Building Inspector Jul- 16-01 01 : 06P P _ 03 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION.rO.CONtirRIIC.r REPAID RFNOVA'l OR DEMOLISH A ONE OR TWO FAMILY nwELLllvc: 7777 :. ►<.. .. .fir.. .. .T:,:,,;'_::.;::.,;: BUILDING PERMIT NUNMER: DATE ISSUED= r SICI SIGNATURE. °C Building Commissionernan for of Buildings Dally SECTION I-SITE WFORMATION 1.1 PropLity Adclicss: !.2 Assc-esnr,Kip and Parted N umbcr: i b Coo e�- 5t ree,4 — Mali Ntlntlxs Parczl Numher / 1.3 /,.tiiiug Itl(i."mition: 1.4 liroperty Dimensions: Y.onin Pr ovcd I;se FiL�0*Area(of) irrcwita (ll 1.6 BUILDING:SETBACKS ft Front Yard Side Yard Rear Yard Rc uired Providc R uirc-d Provided R uired Provided 7-7 Wager Supply T�t.(i.LC..40._ 7J) 1.5. FkKA Zone Inti"n wine: 1.R Sa.erapc IT�p.rat Syxtnm: Public I'I Privem n Ynne mwidc Flwd lune I I Muni:ipal U (7n Si1c Uixp.nal Cygrepr p SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn� 2.l ()wncr of Rccurd - " X67 n)p -.-A,- �ee+- Name(Pnnl) Address li>r Scrvicc: -- �78-a7S- ®��© Sihnulum Tolcphrinc 2.2 Owncr of Itacord: —- Nome pool O- -- Mdress for Scrvicc: —'' — z Siatlaitile fclo hone — SECTION 3 -CONSTRUCTION SERVICES _ 90 3.1 Licensed Construcli0n Supervisof. Not Applicshlc _7 I.iccnscd Consinicnon T, r: CC O O ���� ' /�/�Q Licensc Numhcr -- - Address -n _ 97a- 68a-74ov ta�1S a�o�-- � Expirulion natn . I* are r 3.2 Registered I Ionic Improvement Contructirr Not llpplicuble I I Company Nanlc - -- m S /�,eQ _ M� ltegistrulion Numhcr r ation Dam TelhonC i Jul - 16-01 01 : 06P P _ 04 SECTION a-WORKERS COMPENSATION(M.G.I- C 152 § 25c(6) Wridirers Compensation Insurance afftdavir must be completed and snbmirred with this application, hailure to pruvide this affidavit will result in the dcuial of tilt ismace of llic building i-mil, Si ncd affidavit Attached Ycs......,G No.......Li SECTION 5 Description of Pm used Wurk check I applicable New Construction I I l xisting Building (l Reprtir(s) ❑ 1Uterations(s) U Addition fl Accessory Bldg. II Demolition 11 00wr Specify 3, seasoa1 S—uentre)4Mat 1 e(' Qxj��y � Brief 1)escriptionol'Pruposcd Work: � �--�? . .. 3 -sex,n sy raQr)-, 0 Do C&N - SECTION 6-ESTIMATED CONSTRUCTION COSTS hent L•'stimatW Cost(Dollar) be ( )toSE ,out leted by pumnit applicant 1. Duilding (a) Building Pemnit Fee Multiplier 2 Electrical (b) Estimated-Intal Cost or Construction 3 I'lumhut Building Permit fcc(a) x (b) 4 Mechanical MVAC) -- 5 Fire Protection / v h Total (1+2+3+4+5' Check Number SECTION 7a OWNER AUTHORIZATIONTO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIFS FOR BUILDING PERMIT' as Owncr/Authorized Agent ol'suhjecr pruperty. to iwl oil My behalf- ill all (natters relative n)WOT•k authorized by this building prrmit application. Si milurcoff)wrier_ I)illc SF.('T1ON 711 OWNER/AUTIIORIZED AGENT DECLARATION — (, ';S�hn 6._._. ► � e ji,Owner/Authorized Agent of subject property 7 — HQcbv acclare that the;tateulents and i1 rnlatiOlt un lite lin'cguing application arc true and accurate, to the hest or illy krluwlcdgc and bclicJ' �kc Print N1t le — S64%e of OwncdA ens Date - Nh. OF STOR(I-_S SIY,1. BASI,'MF{N'1'01I SLA11 SIZE OF FLOOR 71Ml3l'RS I` 2 NO 3 ' SPAN DIMLNSIONS 01;SELLS I)IMFNSIONS 01; POST"', 0IMI'NSIONS0 (ill DJ,'-* .'j HEICI IT OF FOUNDATION THICKNESS SIZF OF FOOTING X MATERW.(=)F CHIMNFY IS 13tJINANG ON SOLID OR FTLLIID LAND IS TITALDING CONNECTED T(_)N/11'(JRAl,CTAS HNE 1 Jul,- 16-01 01 : 06P P _ 05 FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve 'the applicant and/or landowner from compliance with any applicable or requirements. ............ .. **= APPLICANT FILLS OUT THIS SECTION*"''`''"'"..*****"*��_*__:� APPLICANT 6oknw ko Uf 2S r1C. '-' PHONE LOCATION: Assessor's Map Number 4 PARCEty SUBDIVISION LOT (S) STREET '� C 5c�C'P�`t" ST. NUMBER �6 **....::.........................:_.:: ..OFFICIAL USE ONLY RECOM NDATIONS OFT WN AGENTS: CONSERVATION ADMINISTRAT DATE APPROVED lG d DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS . FOOD INSPECTOR-HEALTH DATE APPROVED ^ DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED - DATE REJECTED COMMENTS PUBLIC WORKS -SEWER/WATER CONNECTIONS DRIVEWAY PERMIT__ FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm Jul - 16-01 01 : 06P P _ 06 Town of North Andover • F Noo�rh D{,ZTLQD is q?+ Bi lding Department sL� g..; 'a o 27 Charles Street o — c North Andover, ]Massachusetts 01845 k � (973) 688-9545 Fax (978) 688-9542 ZD '► 3'Q ���Tco rPµ•~.Z�9 DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and 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 sl spa The debris will be disposed of in/at: 2 ear Dr , v Facility location i ature of Applicant� Date --- NOTE: A demolition permit CTOM the Town of North Andover must be obtained for t project thrrni.gh the Office of the Building Inspector, his wP�4f \ PLAID Or- LAPID �rLiu�� arPLi. J r (�QRTH ANDOVE2-.AL �c�7 K"ITTREDCBL� DUL-UDE t. LANDF-" .uen.<.wwe q..wr•o a-PC (V a •�Z...P.ac.�'t' ��-77--��--w+yy� � 7� 1. IL irrt.rooe. 3ycm r�v Tumor t wwa eo,eaesa ' r 1 ` bLgxx.,U. ' y •1•.ur 4 Gru.:O m OCL 6'. VGTrY .r O� `J 8 n...... ...s.o... r' opwd_�V' ouruoe + Wrrsso.c d I CDP to 'V' L�'P GY To L { unsaO • 40P GgL•A's -�8•ro K Co.,rrro 'j I �o tOLr1�wrL Yro.w rOT. " 3 QIP 1 �F�L'1'ss'tr�� I� 3 t l id' gi I3 •' u Y �• I 'e .9.N1 u nr.."".... GOUR.T (a. c.v.. w...)�•5T9—EET mss• � � o.._..,c e.Lws s...•su.i y sas+.saw�•sr+.ert++ Dw.Na o.,�rf LS•• ` 1 780 CMR: STATE BOARD OF BUILDING REGULATIONS AND STANDARDS THE MASSACHUSETTS STATE BUILDING CODE CONSUMER INFORMATION FORM-"SUNROOMS" Massachusetts State Building Code(730 CIMR,Appendix J,Section J1.1.2.3.1) The Massachusetts State Building Code (780 CMR) includes provisions to ensure that hooses and house .additions meet energy efficiency standards.1 his supplemental CONSUMER U'T+DR!/fAT:Ci`i -e Filed as oart of the building permit application when a builder/contractor or homeowner,consiructing/irstzllir,g a house addition with very large percentage of glass to opaque wall,seeks to utilize a special energy conservarior, exemption option for"sunroom"additions to an existing house(730 CMR,Appendix J,Section 11.1.1-1 1`. This FORM is not intended to prevent a homeowner from selecting a"sunroom"of any size,.configuration, t orientation, form of construction or percent glazing, but rather is only intended to assist horreowner3 in becoming aware of some of the important energy conservation and year-round comfort considerations involved in selecting and utilizing a"sunroom"addition. The connection of"sunroom"structures to residential buildings mu create comfort and energy consumption issues due to uncontrolled solar gain or uncontrolled radiation cooling of the main house.In the selection and corsauction/installadon of"sunrooms",included below is a non-sequin d,open-ended list of product and design considerations that a homeowner may wish to consider before actually consuuctinglinstalling a"sunroom".It is recommended that consumers carefully review these options with their designer.builder,or contractor,in order to minimize potential energy consumption and/or house discomfort issues. In addition,the qualifications and reputation of the company or individuals to be hired are important considerations. PRODUC17 AND DESIGN CONSIDERATIONS RELATED TO 14SUNROOMS" a Solar Orientation and Natural Shading Type of Glazing a Insulating value a Solar heat gain • Frame materials • Glazing to frame sealing and Basketing materials/seal durability and/or weather tightness of the sunroom Adequate ventilation-Operable windows and fans a Applied Shading Systems a Insulation level in floors,walls,and ceilings • Possible Sunroom isolation from the main house via a wall and/or door or slider • Heating and Cooling Methods: Efficiency,Zoning and Cuntrols Homeowner.Acknowledgment The Massachusetts State Building Code, Section J 1.1.2'.3.1, requires that the actual prnoeny owner(no( the owner's agent or representative)acknowledge receipt of this CONSUMER 11'`rFOFWAnON Fo2tit prior to issuance of a Building Permit for a project that includes"sunroom- additions to an existing residential building. [n accordance with this requirement,the undersigned hereby acknowledges that she/he has read the information in this sd�document concerning sunroom comfort and energy conservation. WA�u - 9A, Signature of.Actual Building Owner Date Print Name Address of Permitted P ect Owner Address(if different than project location) Owner's telephone number 68: 730 COIR -Sixth Edition ■ Job No. AIIView ComfortView Time Estimated Branch/Location ❑ AVR ❑ CV7 Time Matrix ENCLOSURES,INC. Date_ 9 �lcoa Of AAS ❑ CA8 Actual Time ® Salesperson_,4?,--) �,,,ef.�- ❑ CA5 ❑ CVC ❑ AVIG , ❑ MSC C mer Name JUMP&JOB PROGRESS DATE INIT. -f- Approval Address OS Approval O -FS—ApprovalCity State Zip 1 Thank You/Job Entered aZA ���`� m► - I �� 2 Intro Call Home Phone Work Phone Ms) W;>-"_6-- 3 Measure Installer Carpenter Submit CAD Receive CAD N Submit Permit 1 3 f AT MA55 4 Permit Call/Received Cx-1, La d:•�-T MA-S5 A V'P— , Breakout 5 41 ��s, 5 Room Units Ordered Room Panels Ordered W G T o ..1_4 5T �,4 /° -�� Room Material Ordered l E 6 Room Delivered j� S o P��Ss �"�J �"�,•� Room Staged (z t o cam•"` �'TS ' 7 24 Hour Call '-">i 8 Door Bag/Blind Measure -ca— 9 Sales Rep ._ c o� .5-.r /S /-'�-S c7.- w STAGE PAYMENTS ounty: Map oor ma es: Stage Payments Yes No GENERAL CONSTRUCTION REVIEW $ Due PERMITS Customer None $ Due Type i Association Other: $ Due CAD Yes o $ Due Plat of Survey Enclosed Mail Pickup None PEI Plot Plan/Trip Yes No SALES NOTES MECHANICALS _ Electric PEI Customer Electric Raceway System Yes , HVAC PEI Customer PEI Heat Pump Yes No VIISCELLANEOUS levation from Graden 2^a 3b fl+ Fear Out PEI Customeron j laul Away PEI Customer None• -OUNDATIONw flood PEI Customer None New Modify Clo ed Open Tasonry PEI Customer Existin . None Pad Footing PRE-RENOVATION LEAD INFORMATION REQUIRED? YES NO :ev. 1/10/02 c/mickeyfjobfolder/ea/Iln I PRODUCT AIIView: AVR AVI ROOF TYPE Foam OSB Existing Wood ComfortView: CV7 CV8 CVC ROOF STYLE Sin le Sloe Gable PROJECT Roomorth Prime Door ROOF THICKNESS 3" 61, ` Under Awning Roof ROOF PANEL COLOR WH SS MRP Yes No) (Bug Proof? Yes No CEILING COLOR WH SS I -BEAM COLOR WH SS ROOF ONLY Yes No Type of Posts SCREEN ONLY Yes No GL Later? Yes No WING PANELS Wing Type Foam Glass Nine WALL COLOR WH S Total Quantity of Glass Win Lites Win I r H--BZ SS APPROXIMATE WALL HEIGHT 6.5 7 7.5 MOUNTING OPTION Podo BREAKFORM House Fascia Reverse C tilever Dormer Deck Ede Yes Overhang Len th Existing Header Yes Existing Kneewall Yes (9d CEILING HEIGHT Posts Yes Is cgiling fanconsidered? ies No Other Approximate hancipoint DOORS Glass Screen BEAM Rid Cross None Total Height f Door M 7 T "AL 8"AL Wo d Lami Other Key Lock Y nit Interior color/finish Fixed Tr nH eight Split Transom Y FASCIA LOR W BZ SS Build Down Y Height Line w/existing walk Yes No GUTTER Y N Ir WH BZ/ SS WINDOWS I r m nt Total H i ht of Window (M/F) DOWNSPOUTS duantijy to GradeTie-in Fixed Tran Yes N H i ht Split Transom 'Ye No SHINGLES Y4 No Color/Type Build Down es No Height GLASS ROOFANELS Yes No Quantity HANDLE LOR WH 43L SS Brass Type of Glass/ Temp/Temp Tem /L mi Glass Tint BZJSQ AZ/SG KNEEWALL Color White Sandstone Foam Glass Wood ting Other Kneewall Height SKYLIGKtS Split Glass KW Yes No Ve6d Yes No Quantity C for White GLASS TINT BZ AZ SG500 GRP/S Y LOCATION UC BZ/CL AZ/CL CUSG500 BZ/SG500 AZ/SG500 SALES NOTES CUSB60VT BZ/SB60VT AZ/SB60VT STORM/HINGE DOOR Yes - No Type Size Color Above Storm Door Foam Glass None PRIME DOOR: Size x Existing Opening Yes No CARPET Yes o Carpet Size Carpet Colorz Rev 1/10/02c/mickeyfjobfolder/eg Page 2 SKETCH STAPLE CONTR T 1 q �I .;2? Nc, vivZjL ti� C :A1� 4 duL" Do L3 c�c 14, _ A,���,�i APPROXIMATE INSTALLATION TIME FRAME MEASURE PERSON DATE AFTER PERMIT RECEIVED, IF REQUIRED(WEATHER PERMITTING) ELECTRIC Yes No 2ND Floor Yes No CUSTOMER INITIALS �' �,�' WALL FLOOR HANGPOINT TYPE: MEASURE Rev. 1/10/02o'mickey/jobfolder/eg Page 3 ■ METHUEN (978)682-7400 F.Y. TAUNTON (508)822-1966 WORCESTER (508)756-2141 ENCLOSURES,INC. FAX (508)821-9339 FAX (978)682-0061 ® TOLL FREE (888)333-1966 AN EMPLOYEE OWNED COMPANY 15 AEGEAN DRIVE-UNIT 5 500 MYLES STANDISH BLVD. METHUEN,MASSACHUSETTS 01844 TAUNTON,MASSACHUSETTS 02780 HOME IMPROVEMENT CONTRACT MASSACHUSETTS REGISTRATION#117565 DATE: 9k, 20_0Z Page l: I, we hereby accept your proposal to furnish &11 labor and Inaterial necessary to perform the following work on the premises of the Owner located at i in the City of agll State of &A Zip o!8 Tele: 52.6275' 07� This contract h 11 be onsidered non-cancelable after legal cancellation period has expired. '�"' ' THE WORK TO CONSIST OF: ��a21 irr J�acT�►Le -r / us7ra Il A 3 Sy'95a4% g' f ,� � aGGO tJ/G¢ 7 11 r-- `_ Jr�gGC —Su" e r" rJ OA.I 'ISG � 'i�,c�a?'�e r�I ��� ►.L1 h2o,.T C�-'r �r�� � S��,�J a T ��t�, e Iii J - ►.�S'� t .��1dfLnoy I I { I� i i i C I Single Glazed AllView,Single Glazed Vinyl,AllView with insulated glass and non-thermally broken ComfortView Sunrooms with insulated glass ARE NOT designed to be heated or air conditioned. 19 (Initials) Any inquiries about a contractor or subcontractor relating to a registration should be directed: Director• Home Improvement Contractor Registration•One Ashburton Place, Room 1301 • Boston,MA 02108 or call(617)727-8598. j —go to page 2— - • -gip METHUEN (978)682-7400 �tN WORCESTER (508)756-2141 'ENCLOSURES INC. TAUNTON (508)822-1966 FAX (978)682-0061 , ® FAX (508)821-9339 TOLL FREE (888)333-1966 AN EMPLOYEE OWNED COMPANY 15 AEGEAN DRIVE-UNIT 5 METHUEN,MASSACHUSETTS 01844 500 MYLES STANDISH BLVD. TAUNHOME IMPROVEMENT CONTRACT TON,MASSACHUSETTS 02780 MASSACHUSETTS REGISTRATION#117565 Page#2: Date: 20 06-? Seller agrees to furnish labor and materials at Buyer's request, and for the contract amount, to complete the work described above,subject to the terms and conditions which appear on both Page 1 &Page 2 and on the REVERSE sides of this contract. Work to start approximately_ ° weeks from the date � of this contract and to be completed approximately_ - ' after commencement if not delayed by building permit, delivery of materials, weather, strikes, fires, or other conditions beyond Seller's control. The completion date is not of the essence. Buye epr. a is and warrants t al ti to the operty,which is to be im ro d, is in the fol wing owner(s): 1. 2 NOTICES 1. Seller and/or all subcontractors, if any, who perform on this contract, and who are not paid, may have a claim against you which may be enforced against the property being improved in accordance with the applicable lien laws. The contractor and the homeowner hereby mutually agree,in advance, that in the event the contractor has a dispute concerning this contract, the contractor may submit such dispute to a private arbitration service which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulations and the consumer shall be fired to subm' c t a itration as provided in MGLC. 142A. C tactor Owner NO ICE: The signatures of parties above apply ONLY to the agreement of the parties to alternative dispute settlement initiated by the contractor. The owner may initiate alternative dispute resolution even where this section is not separately signed by the parties. WHERE REQUIRED HOMEOWNER TO GET PERMIT. Source of Sale:_ yf' Contract Price $ 6_�?z'i THE DOWN PAYMENT SHALL BE A Down Payment NONREFUNDABLE DEPOSIT ONCE THE THREE DAY CANCELLATION PERIOD HAS EXPIRED. THIS CONTRACT CONSTITUTES THE ENTIRE Balance Due Upon Installation UNDERSTANDING OF THE PARTIES. $ �'�-3S You may cancel this agreement if it has been signed by a party thereto at a place other than an address of the seller, which may be his main office or branch thereof, provided you notify the seller in writing at his main office or branch 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. See the attached Notice of Cancellation for an explanation of this right. Customer acknowledges receipt of a copy of this contract,product warranty and duplicate notices of cancellation. DO NOT SIGN THIS CONTRACT IF THERE E ANY BLANK SP CES Date Down P t Received: (Customer Signature) By: re o PEI Rep es Su jec o the terms and con ' t hich appear on both Page 1 & age 2 and REVERSE sides rof this contract. acoRD : CERTIFICATE OF LIABILITY INSURANC OP ID DATE(MM/DD/YY) C �+ �ATI012 07/03/02 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE The James B. Oswald Company HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 1360 East Ninth Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Cleveland OH 44114-1715 Phone: 216-622-7400 Fax:216-241-4520 INSURERS AFFORDING COVERAGE INSURED INSURER A: American Motorists Ins. Co. Patio Enclosures, Inc. INSURER B: Lumbermens Mutual Casualty Co. ALL LOCATIONS Corporate address: INSURER C: 700-720 East Highland Rd. INSURER D: Macedonia OH 44056-2112 INSURER E: 3 COVERAGES 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.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY 3MG81323300 07/05/02 07/05/03 FIRE DAMAGE(Any one fire) $ 50,000 CLAIMS MADE FXJ OCCUR MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE s2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 X7 POLICY JEC Loc Emp Ben. 1,000,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ 1,000,000 A X ANY AUTO 3MJ81322300 07/05/02 07/05/03 (Ea accident) ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) S HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) S PROPERTY DAMAGE S (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIOENT S ANY AUTO OTHER THAN EA ACC $ AUTO ONLY, AGG $ EXCESS LIABILITY EACH OCCURRENCE $ 5,000,000 $ X OCCUR ❑CLAIMS MADE 3ZA00037000 07/05/02 07/05/03 AGGREGATE $ 5,000,000 DEDUCTIBLE S RETENTION $ $ WORKERS COMPENSATION AND X TORY LIMITS ER A EMPLOYERS'LIABILITY 3BG10633000 07/05/02 07/05/03 E.L.EACH ACCIDENT $ 500000 E.L.DISEASE-EA EMPLOYEE S500000 E.L.DISEASE-POLICY LIMIT 1 $ 500000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Workers Compensation is applicable in all states except Ohio. CERTIFICATE HOLDER N ADDITIONAL INSURED:INSURER LETTER: CANCELLATION BLANKCE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUT IED REPRESENT VE i ACORD 25-S(7/97) ©ACORD CORPORATION 1988 ✓7 / /l11c�Fd i;EbuiWag Regnlat o, s mud StasQ�n1� HANE IMPROViEMENT CONTRACTOR x y ReG':tratfo9: 117. Z-42 10!19!2002 i rYPe: 8upplemant Card PAA-O ENCLOtURES jt4C. � JOHN'h+ULME .�L1te��tate Ayer.ue +15arsy,NY 12705 Z' 1 ' Admikii r aW w WJlie (oarrvrruyru�r°��z n�, j�a�va�* i BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 078193 Birthdate: 12115/1964 Tr.no: 78193 Expires: 12/1512004 Restricted To: 00 JOHN G HULME zz—jd-X-4►YF 23 NORWICH LANE Administrator METHUEN, MA 01844 I II NORTH o" OE ,.. Andover 0 °� -coHl< dover, Mass., AD'SATED S H E — BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System Owl BUILDING INSPECTOR THIS CERTIFIES THAT.......yt3..D...,6..... ....P... .. . . .5.... - a.. ............................................... Foundation has permission to erect..A��C./SA......... buildings on .......f./4.......f. .v r-�.....s............................... Rough to be occupied as.... .�S. I.A►. ....... � e� Pb PG ..../ �'' 3.....,5' d1 b O N Roo * Chimney ............................. provided that the person accepting is 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-1.4ws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 9300/' // PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR • Rough Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. 10 Note: Where shown. 10 10 Z e _ / _ E Nota When _ shown, r10 Required w/ Transom ppp, - �� 6'T Requlred w/ Transom '_ ppp, `7 A DPP. /-1 � pPP. 0_ 0".i a • 1 �_ 2 2 1 1 E 2 c 1 _ p P. OFF. Single Slope Roof Enclosure Plan View Gable Roof Enclosure Plan View Nota: When e shown. Nota: Where a shown. Notal When @ shows. Note: When a shown. eRequired w/ Transom s e Required w/ Transom p Required w/ Transom a Required w/ Transom 0 4, � 15 � it 77 1 p 0►►, I 1e to 1 1 10 1 t 1 10 OPP. W.F. I ---I R R 1, i 11 1, "B" Wall Elevation , "A" k "C" Wall Elevation "B" Wall Elevation _ [;� "A" & "C" Wall Elevation A GENERAL.STRUCTURAL DETAILS FCR PEI 'ALL—VIEW' THREE SEASON ROOMS NOTE: Debut on MIs short are also In aectlon 500 of the 'All-Ylw Roams Engineering Wanuar 7 D 7 720 EAST WCHLAND ROAD 'EICLOSURESACnaxIasLA=O :4IOva .: isl 4297 SCALL: NONE DRAWN: MAD DATE 11/12/93 REVISION! APPROVEL BY: , _ ._. _sees - -•. _ .-- Concrete or Wood Floor C. NO. DATE Footing Per Local Code— Footing Per Laml Cade 'r ✓ ��. Section A Section B ALL-VIEW ROOMS -r' P2.ENGA'EERING - SECTiON 17 y. 12 1 " 13nx w. i Maw■ - wen Ezma ne- 1 t/: • t� �•.l �1 //,W R. Each spa. • T~ a Vl.w B �\ +~iwe '- TEtc Saw. •/ / a" t uy t 0..e Fr.. Hma. Vl.w A - to t j Expander • Fte.r 1 TID w...r• Fir Typ eal arlax — �:J4x 8l-. t:a .w • d/ 1 1 1oti t 1 tun 6 /t x t/ TOC 3a.- a tr1. 1 1 ♦ } RId e Beam - �- 9 9 1I C x 1/: TE]C Sr> K➢ Ti! •� •i-� /e : 1/: TOC 2a a Te.. (y hK+•^� RYA) //x r TOC Saw •T.P. ace— ' 1/3 up a 1/3 0.a1 B.&nt tee.no. 1/3 tro • 1/3 0.80.sur t.err. Concrete or Wood Floor Cant rwh or Wood Floor Detail t - Detail 2 ,.�. sees. ..._ .. .•. �- Footing Per Local code Footing Per J.oeal Cod. .+• � 1� reed U- /1 x ta•M S.r-. : t t/r w tlrer�+e. �. Section c m'a'r U-Section _ hme ' t/r ➢ x. t¢ l.•a lkty ➢ U- 1/l- / x t 1/l- Le. 04 �Pb Med.. b.. a....r 11.. #to x N.tial bb red ti.. =x x t 1/l- w orr.ce. Mi°"'r' N...�..� 1x3 Tmc. Neu.d T. R fp..d, f.we 0) f H�iiim II., r16 r..t - 0. dd .0. r(Sj Ssr. Mme•� i tiwr.d• �+b M..r•.. • rr Mee.wd w iMrid T. rR b E,rr.rr tx3 Ter. X4) p x r TOC sa..a •TAf1/3 u r t/3 o� N x I' ier.>w T.k t 1 t ore ski. Ext.Fit • W Gree ad. lyre i T re. L!L • Er*.•••r• M.etwr. 4d Tad N x 1/Y m s..- a W- 1' x r x t/t' x 1 3/l- le. Awa a Teed kr..d.r a FI-r TM t tat.. Fa.r. Ste (1) E..e.ad. r+.4 li..rrlr..d T.ld Eee...der• Cl) C!r' '�' lTJ Earl. as. W E.rr.Sid. p �•- ()- // Y1/: TOC 34n- W f2)-p x t/: TOC a••fr fossa tA.ir (_� h x r TOC 3ww • ` R'_ • T• ■ VF sr ➢r Typ. E.a+. <4 �N : Toc sew • T... lore • e.orr. Er.al- 7 K • t Each Sir (41^ I/ x T* TIDE zc . 09 Leeh � X 3 errw IN6 a 7 T1re. (:) Ea.1r sir G.r...r pr1 Neared T. rR Er....r Detail Detail a Detail a Detail a A.W-M Q-0, Anehcm At o.wx.. A•a.re Ai o..W.. Awa.re At a...r. rr 1/r / x-Ir L!, tb. 1/l- ➢ x S l} low 1/l- / x t tr 4 Orlw-Iy.M...r. yr,c�.r {i. 1/l- /: 1 1/l- y� �d U- t/r ➢ x S ly is/Sw.we D.d 0�y. y- t%r %x t/r L.. OrMrA M.i.r. Yr, prr.r 1/.Ark -rw ewes.kee roes". u.. V41 / x 1 t/r t4.ark-#%Mr.■ lel: GENERAL STRUCTU DETAILS FOR PE1 -ALL-VIEW 'THREE SEASON ROOMS Se.r.s.r ares x.rera NOTE: Data" an thb bi,,;tj an abs In section 500 of the 'AlF-View Roonm Enginoering mcmuor Ar.er..■ • tC \\ :2EAST MCHLAND � ToP.Q. 907ins MA= N 4405e (3) M SiL.gK (3 bered fflENUOS m0a69-0700 _ ruc(21ff)4a-,4"7 2 by 1-•.ern Crw.lY./r.wr) SCALE: NONE DRAWN: MW DATE: 10/27/94 atr..m..l 9rwr NOTE: . The plans, elevations, sections and details contained herein are REY OHS I/3ri/9l- _ in accordance with information contained in *Product Engineering }. APPROVED B1r: y Manual on 'All-Yew' Three Season Roomas published by Patio Enclosures, Inc., Macedonia, Ohio. Limitations for Rroduct usage +�P•W are contained in said 'Pratduct Engineering Manual-. See individual job submittal for specific projections, unit widths and wall heights. SIGNATURE ` Y P.E REG. No. DATE Detail s -.RO ALL-VIEW ROOKS r.d..w ties 1/l- 0 x r Ld las Sas.1.l- Smy PFJ ENG(NEZRING SECTIO?( 17 � 1. SKEET: 2 Uw 1/l- tr LaO.w/lel ail+bl. c.ra.b tied el-brick y. +/: TD: 3w— C3) P_3C l..00 �(, r,m ►w : � �-4.n C.�.naerp raga tae) no ft • AM A..r ♦-9. -wwr •sw� / `° • tC D.C. �fe , 1/_' TD< 5—. _ • v.r. • Ir�r tia••�ti w.. 6. rkf \. r.0 Fara �.-•..n pe : ,,^_ 'E.,c S— At s...; 'f.s�„re.•;y S.W d SL+m..l S11— S.•wd 7. ---�7/1C CSB :!B (o•e.w) • • Far Or h...r w ,rr. 1+n�•• Sbm� S1ay.� s.r�lJ ,a•r Far. �•�w la�aue� �•I C•o �L a 1,^' TDc S— • 7C �� aaoti:w+ I r/ t3 7CS 95 1/c •..d • •.Ear a w....r wr,y ►•.r ,/- . r r 1/1C M.•�.r n+..�ar.�r �.ey Dw u�d1 F�+w A►.,d—Anew r Cr. •.arm •..r rtir (,p•wd, Ie , r nx tT D.c Detail t1 Detail 7 Detail 7 Detail e bd•- 0— A..�..aFrw A. u..�� Nr+ip A. •.ar.d ///. :>•...•..r �.. S..w.d fear 1/2 . r ,/+ crls.wu. .. c... l.. ate... o.e<•p T+, • t r o.c �. M ■ 1/: Ta a•... • +C C.• p a t/t ?a ars.. • Tr • 11..r.r Arrr„�• y • Oyr�r�� •K y`~ ie ate. ` • tr o c +1+• sale ar.. f` `F17 x •,� •K ,.,,...,. CL) re. 4-..., p . r tTx a... . t7 or_ 10•• 11..1 or •.mea Dir,idr �. i".ae :. .:•... �ia Ty%. •.rp Dw 1.d, Fr•wW,y • +r DL ' •.., D...u.n Fr W" Detail ears.¢ A. �•d Detail , Detail s er�d�+��AMM6 ,r. Detail 11 GENERAL STRUCTURAL DETAILS FOP. PEI 'ALL-VIEW THREE SEASON ROOMS mr � ll.nr... •. �M NOTE D•taa•-on thla•ah*W am oleo In ved on 500 ed the 'AL–View hoorm Engineering Manuar Flrld.y A.rr.•+� str+sew+d 2111— a..1.e � 720 EAST WORLAND ROAD P.D. BOX Ias • MAC1DONu� OHIO .41056 • tC a.G 1/,C :T lay &e... • Cn9)448–p7D0 me Rgts t7_42B7 TY MtA alder 1 � • Opp-a.-tYr A ' 1/r TEu y`� NOTE Sr.r e, NONE DRAWN: MAD DATE: 11/12/93 Mk— �K The plans, elevations, aeetioru and details contained herein are. REVL90N5 11/I/44- • TddTyy in accordance with information contained in 'PnTduet Engineering Manual on 'All-Yew' Three Season Room&' as published by Patio - .• APPROVED 8Y: Enclosures, Inc., Macedonia, Ohio. Limitation for eeroduet sssoge re �r acontained in said 'Product Engineering Manua individual I/3i Qj r.•r penaljob submittal for specific ftrojections, unit vidths and wall heights. SIGNATURE p,E REG. ND. . . DATE Detail 11 _ M�1 ALL–VIEW ROOMS PEI ENMNMUAG – S=ON 17, FIEET: 3 • (M tRah � s.e+ sl.�� Mk* 3 wn t.s1W. r..a.(b.t �—) i �Rlaw 9— �-0. raewe nu....n .. (TrF, / ,Str..en..d M- S...d .E.m...a Munr..m Re., 9..... • I I I . StrVQv.e RSb--J Sear.. 1--r P.,9.,, Sic-,•. � ,af Rbp. 9.wnl I ,er 111sy. 9.an, Ina 1/: TM wawa, (V - In a 1' TICK sc. I 1•(a) - /n • Y TEX ., �•.•�,_, I I (S) E-y ]C .Z) E.d 7.. I (+) E.- 7.. �1 I (s tib P..-L M) Y.. H•wn E'^•"P-.t I IPte.... y3 Ernes..., .r C_ C+I..rrL R..r }. : ,/: 10( 3—, I , Q""" ). tr4 trp (S) E�7 3C e...r.. ei..n (s Ira. P...L W tr.w r-e.... c.r.,.ae.g P.,+).taa. lyv. P..� �a.(z i,a•, (�) - Ito a : n..a sem... P..c w . I 11 tae....e w,. P..t Detail „ Detail Detail t Detail t View AiZ7,v View A Rtdw e..n oe...e.d A%..d.... r ....., I...u.. Eas."d AR...Y... RYy. tom. t...e.n tr..d ow a-) ..w..d (R.t aa....) "(Ae.-J- t...d e.... eaa Awr"a f o...,, er.t Sa—) d.l.t ��.,y.� ttr..d aa..... A. .....-a...R...a A/Ir • k.,A n..., L.a•d (N E..v.r.. ,/: Lo L.A• t�.arw. a - AA..d..n ..1•..d pa.t ]a.. U3 Ew..r. r (4)- Ina Y TD( o c...... r r..., ] t/7 La •-.It.. ./ Ra/ (4�}e a r TEK saw. �TP-1. �__. Ores.. +w.� La 1/7 t�V.+ t..w) s3k., - Ito a T b..d �(2) bt ti L-Ith .. a.a...y . n..a....d C. (a) � P'"'' °+ o p (s>- Ito ■ t tw.d ate... t/teas La a.+ Time t. 1) ...d sbw a P..t (1y") s•+. s•i a. (� yrs. 4�{t :T TD( tr..a E.dd tr..d a . .. edh.. (2)- It a Y ars Der..a.d At..wY..n o p W E.a. Md. E.d.L A...N- I•I . 1•I I.1 ISI lal I I To( 3— (r••Lft d...Ak. Ride e..r.) , T. tl r 9 E.r. A" ]� C.rwr P.at ./1r3 Tb. 7!i- (t-Em..r Ah.n RY•. tiwn) LExyty,y W." bl s..ra... • fyRr,q Sb..0- C —t Aer.n (t) SRn T. 1+...../L-P A. SO-21W bet T. 1.1 Detail tz Detail T3 Detail ,3 Detail t3 View B M AP ter` Eets...r An.nb— GENERAL STRUCTURAL DETAILS FOR PEI 'ALL-VIEW THREE SEASON ROOMS r..d (ea a""') NOTE: DetaOs an this shest are also In ssrtlon 500 of the 'AIF-Mens Rnents.Englneertng .Lan Ia a Y M sW-d P"+ _ 721) EAST HIGHLAND ROAD (� Es.1 sr. �� o ab.aa.. - ENCLQSURESAiCu:iBOX 4e-alitio' ►ucEo a+nilsi-4si9i(4)- }70 a 2 t...d La Lay le..e Vel. w..dT La Ley s..., ./ Lay SCALE: NONE DRAWN: MAD DATE. 11 12. e.n..A @1.*W Bride NOTErt T. Pit Yr.ld. E�„r The plans, elevations, reetionr and details catTtoined heroin are REVISIONS in accordance with information contained in Product Engineering (� �,,asR.rre� ] t/: La Manua! on 'All-View' Throe.Season Rooms' as published by Patio - APPROVED 87:-- __.... .... r__....._..... Enclosur=, Inc., Macedonia, Ohio. Limitations for product usage are contained in said Product Engineering Manual. See individual . 14 o e (4) - t/� : t t/� La DrI..-1 Y+ job submittal for P 1 g SIGNATURE P.E. EG..No. DATE j sper3fic ro'ections, unit widths and wall hei hts. WIN lime` [6:T Ly Lep so.., - Detail 13 P z + ALL-VIEW RD PEI ENGINEERING'-'SE=ON-17'% 'r' a`' SHEET: 4 Lam. • yA• a _ Vr e = r'fa l Ku s n..r fr.,.� �0 pas p." Up r TVs-... • •K f••+ofK • wa..i , Rho" w.n P..t w,au.. rie. Ca r sr. Ps..7 C•. \ i , % ' . Fit.ltiq w 1wi.e (7)- }e = r tTx s.+... Wft fe = --a— "L, TDD •. x �e = 1/- tLX Se..ti EM+ 37w • 1r 6.: \ \ `TM+ wt Ea:..r.•f�'K-Oe..f M.ed+ t. 9 Fit M/F .. te.e S,.yo--d I.+=J,.r. . 1r C•C woe Em-,.r • I /.K- � ,e = jr- M S-..,T— r. P..tX I \ TM+ C. P� fns M!r Ix If w.*—a I U.L. u.. Pr D =S L4 °+. Serer Cw.r Pat Lb. 1/r / UW • tap 3kwo oft f.yt.r*..0— Ub C.L r 1k• f....+ left.. ertaa . }e If r TOC s-... wr w... Detail ,. is ,c Detail n Detail Detail . onDeo� *e a t/. MC a-... . Toa Fa/, Md. • (7J Fes• ►t..r Err.. O— wim w..+...1...... UnR a. town M...•.r.I.. UM r,,,m.r tar.. to :S 7DY S_ • tT 0.G tot S— • tw • fro... ID =r 'Mx Sr... . tr ax- tat T•. sv.s..d tar.•i� a... tea fr.e.r rw./.wn.. trn,►.r* i. u.+ spino o... UM staro Z.W UM h- 3— (wsL...J t« wa u.nr.r. �M.t w.n) t.. ud M_&W. tT = r ■Sb" VIC, /r os• oma.. r w or. s..'r� C} Ie . Fa.. f.f. F_a- Vn W h.akq 0— trot Or ritwn trw.r. �'� eir ta.R C.,tN�„,,.,. N•.e,..n w� = t/T ra se— TAa. Fa-, 9r . E.., »e. Q_ feel. M."*- atnnie..t Sr. f..t..t b" UM (w+ta..e) Q' snEtlaft Transom Without 1x3 Tube Transom With 1x3 Tube Glass Kneewall Ganging, G-Coos Glass Kneewall Ganginq Expanders GENERAL STRUCTURAL DETAILS FOR PEI 'ALL-VIEV THREE SEASON ROOMS NATE Detalls on this show are alae In seetl.n 500 of the 'All-View Rooms Engineering Nanuor s.r sat.... Itrtte.. /sm Fw P D.w UM w..+ 720 EAST HIGHLAND ROAD P.O. BOX tag • MACEDONIA. OHIO 44056 e°t'tt62 EeSW1a1C1.OSURET • tz+g46a-47D0 rNc Gt+s)46?-4267 st ..te i tT6 0 .K DATE 11/12/4: SCALE: NONE DRAWN: WD CO- Ii=tY oraREVISIONS s : NOTE: ttos Tm. I w++•fe The plans, elevations, sections and details contained herein are top ttaafr Fl.nr t.epr.d a' in accordance with information contained in 'Product Engineering - APPROVED'VY: � oew cert Fl�,,1„F Manual on 'All-Vie,e Three Season Rooms as published by Patio / g � Enclosures, Inc., Macedonia. Ohio Limitations for product usage are contained in said 'Product Engineering Manual. See indrvtdual p,E,_ REG. No. pATE ' job submittal for specific projections, unit widths and -well heights. SIGNATURE Glass Kneewall (or Sliding Unit) Below Sliding Unit r `�`. •- ,. ALL-VIEW Roo► PEI ENGINEERING - SECTION 17* t`' SHEET: 5 BUILDING PERMIT of NORTy q P � ��T LED 'bt tiO I � uJ TOWN OF NORTH ANDOVER 02 //f A APPLICATION FOR PLAN EXAMINATION (/✓J v Date Received �4"oR pay'' y Permit No#: � �S 'STED�' S� SAC14 5E Date Issued: r LWPORTANT:Applicant must complete all items on this page LOCATION C...Our V CCf / ?APrin3 PROPERTY OWNER J Print 100 Year Structure yes MAP bo /� PARCEL: 0 L2�/ ZONING DISTRICT: Historic District sOnoMachine Shop Village yes TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial epair, replacement-.- ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other °Sept%c �l%Velll i�`Floodp�lain � "Wetlands_ _ � -Watershed��®istrlctd � w DESCRIPTION OF WORK TO BE PERFORMED: ch'a7 Identification- Please Type or Print Clearly OWNER: Name: J lcJ Phone: 6 7J U Address: /& �fJUr'/ v 7/'�C� Mr7OV A O c2,-, Od Y Contractor Name: &JMCO/9Q (J 0 -A Phone: 97 Email: &a.Lo./ Address: 02..3/ iSi N ig Jf 42i), Z J A ko- 17 Supervisor's Construction License: —Exp. Date: /02 /6 ' 17 Home Improvement License: 16 � K. 9 Exp. Date: ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$925.00 PER S.F. Total Project Cost: $ ���U� FEE: $ Pb Check No.: Receipt No.: j-i 0Z NOTE: Persons contracting with unregistered contractors do not have acce" g�gartw :Sanaturexof.:AaPmt/Owner - +�IgnaturPtinfsrOnfiraCtOC ^' Plans Submitted ❑ Plans Waived ❑ Certified Piot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL y. Public Sewer ❑ Tanning/MassageBodyArt ElSTa�n""n"'gP°ols El Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank, etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM PLANNING a DEVELOPMENT Reviewed On Signature_ COMMENTS CONSERVATION Reviewed on Siqnature COMMENTS HEALTH Reviewed ori Signature COMMENTS i Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes �r- Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature&Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street NFIRS DENAR�TMENT .;hTempjDum §ter on,slteR,yes ated at 124 Man�St�eet y a � i yr "t ; ,�"� r , • '7 _ Fire Departmentsignature/date4.•:t ��-,e,f„ „�+ .y3if p t�.r`�T+» `+"wi t .S-"�4 �•� 9.` tr.}�,T..1 - "�;f�r1'•t'.?��ei'1ryi.v :� �-h j'.4{`+""�r t r�.gy•s Y r- t � t y�'� i f � •C'htorr-eta'y�"�` �$�.aw*,`- COMMENTS . Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires alpprovfasl of Electrical Inspector lies No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) ❑ Notified for pickup Call Email Date Time Contact Name Doc.Building Permit Revised 2014 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits 4 Building Permit Application 4. Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses Copy of Contract 4 Floor Plan Or Proposed Interior Work iL Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks 4- Building Permit Application Certified Surveyed Plot Plan 4 Workers Comp Affidavit Photo Copy of H.I.C. And C.S.L. Licenses Copy Of Contract Floor/Cross Section/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) Mass check Energy Compliance Report (If Applicable) Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) 4- Building Permit Application 4, Certified Proposed Plot Plan Photo of H.I.C. And C.S.L. Licenses I Workers Comp Affidavit 4: Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) Copy of Contract 2012 IECC Energy code Engineering Affidavits for Engineered products OTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg. Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:Building Permit Revised 2014 Location No. e G i Date &/2 z!!� • - TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $p-7,7,- Foundation Permit Fee $ ' Other Permit Fee $ � TOTAL i Check# 56 �, Building Inspectory NORTFl Town of 6 ndover O I � h 2� 1 ;4 owh ver, Mass, A� rA COC LAbq WIC.t`mol' S V BOARD OF HEALTH Food/Kitchen PERMIT T LD Septic System THIS CERTIFIES THAT .........P�N.. .11ts......Diet ..,om. BUILDING INSPECTOR .... .......... has permission to erect .......................... buildings on ... R Foundation ............ �. i ...... ....... ..... ........... ........... ........... Rough to be occupied as ..... . . ..... ........ ... ... .. . .. .... ....`....... chimney provided that the erson acce ti this permit shall in eve ect confirm to the terms of thea lica on p p p g p rY p pp Final on file in this office, andtothe provisions of the Codes and By-Laws rela to e I ctLo1n, Alteration and Construction of Buildings in the Town of North Andover. r ..7 PLUMBING INSPECTOR Rough VIOLATION of the Zoning or Building Regulations Voids this Permit. Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR. UNLESS CONS ION Rough Service . ... ...... .... .. ..... ........ . Fina BUILDING IN CTO GAS INSPECTOR Occupancy Permit Required to Occupy Building 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. DAVID CASTRICONE, PRES. CASTRICONE ROOFING & SIDING INC. ROOFING, SIDING & REMODELING REPLACEMENT WINDOWS HOME IMPROVEMENT CONTRACTOR REGISTRATION NUMBER 104569 231 R SUTTON STREET UNIT 3A, NO.ANDOVER, MA 01845 In North Andover 978-683-3420 In Boxford 978-887-6147 In Haverhill 978-374-7314 1/we the owner(s)of the premises mentioned below,hereby contract with and authorize you as contractor,to furnish all necessary materials,labor and workmanship;to install,construct and place the improvements according to the following specifications,terms and conditions,on premisys below de ib d. Owner's Name............... ...� t s...... ..../� .,... ..��.......................... � ►� � ..........Tel one#......��.../.]J.�.D.-.�..5,✓.... Job Address...... b �............................Ciry... .. .O.j........ tt.. i ........State...... .. Speclfrcations: ......................................................... .................................................................. ........J.... _....................... ................. .... ....... ..... ............. ................ .. .... . . .. ............................. . .. .. ..... ... z n.. . S.. �.j. '......... . / ................ iN/..... ..I^rr.1 nJ.... r.�..�. 4 .. �.. ...4../...M............... ...... .. .. .... G�. ...... ..... 41 ......0 ...F ....�� ................................................................................................................................................................................................................... . .: . .......................... �....... _ ..� . ..5.. ...., ....L �; ... .o . . .....�.,.......y,.e� ..c . .. �. ....... Five Year Workmanship Warranty(Not Transferable) Manufacturer,s Warranty as spec[ y mann The contractor as to perform the work dish the materials specified above for the SU of$....�,.8..x! 7....••....•.. Payablt<�.3.f.3 �?.......on...c� ics ....... Payable.............................on.................................. Balance payable on completion of job (honer or Owners are not responsible for Property Damage or Liability while job is in operation. Contractor is not responsible for any damage to the interior of property,including pre-existing conditions(i.e.water stains,crumbling plaster,exposed nails)or conditions resulting from application of materials specified above(i.e.objects coming loose from walls,crumbling plaster,exposed nails,dust in attic or other living spaces). Items in attic may need to be covered by homeowner.All materials are property of contractor. Any dumpster placed by contractor is for his use only.Upon completion of above woik,all undersigned agree to execute and deliver to contractor,their joint note in accordance with his(their)above obligation as requested by contractor. Upon refusal to do so,contractor may at its option declare the entire contract price or so much as then remains unpaid,immediately due and payable. It is agreed that,if permitted by law,contractor shall be paid by the owner(s)all reasonable costs,attorney fees and expenses,in addition to the amount due and unpaid,that shall be incurred in enforcing the terms and conditions of the contract and/or any lien in connection herewith.Property may M;subject to mechanic's lien if unpaid.It is further agreed that this contract may be assigned by contractor,and also that the obligations hereof shall bind and apply to their heirs,successors or estates of the parties.The undersigned warrant(s)that he is(they are)the owners(s)of the above mentioned premises and that legal title thereto stands of record in his(their) names(s).There are no representations,guaranties or warranties,except such as may be herein incorporated,if any,nor any agreements collateral hereto,nor is the contract dependent upon or subject to any conditions not herein stated.Any subsequent agreement in reference hereto shall be binding only if in writing and signed by all parties. All Home Improvement Contractors shall be registered and any inquiries about a contractor or subcontractor relating to a registration should be directed to the Office of Consumer Affairs and Business Regulations,Tel.(617)973-8700. Any and all necessary construction-related permits shall be obtained by the Contractor. Any Owner who secures his own construction- related permit or deals with unregistered contractors is excluded from the Guaranty Fund provisions of MGL c.142A. Approximate starting date of work................................................ Completion date......................................................... Receipt of a copy of this contact is hereby acknowledged,and it is further acknowledged by the undersigned that the foregoing . provisions have been read and the contents thereof understood and that no representation or agreement not herein contained shall be binding upon the parties and that all of the agreements and understandings of said parties are contained herein. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES This contract may be cancelled,without penalty or obligation,within three business days of the below-referenced date.Mail or deliver a signed and dated notice or send a telegram to Castricone Roofing&Siding Inc,,23111 Sutton St.,No.And MA 01845. 1N WITNESS WHEREOF,the parties have hereunto signed their names this...' ..k day of Accepted: o • Signed....6.;.G 2.1....../5.1( ............ Owner Signed ......................................................................:...... Owner David Castricone,President r i \ The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 t Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leeibly Name (Business/Organization/Individual): _--AV 1 T) CGAST R 1 Co NEf n.f i N s 1.D i K) -, i M�- Address: --A b 1 Sy TTi tJ S►2_-z T Q(\\v &A City/State/Zip: IJo. A N ty iyc NA D i �q s- Phone#J79 6 93,3 Yd-O Are you an employer?Check the appropriate box: Type of project(required): I am a employer with employees(full and/or part-time).* 7. New construction (2.❑1 I am a sole proprietor or partnership and have no employees working for me in 8. Remodeling any capacity.[No workers'comp.insurance required.] 9. Demolition 3.E)I am a homeowner doing all work myself.[No workers'comp.insurance required.]t ❑ Q4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.M Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13�ROof repairs These sub-contractors have employees and have workers'comp.insurance.t 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any 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. lContractors 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 isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: 12/`1 N (Tt ST^-T N Policy#or Self-ins.Lic.#: %i CU Q 5 S X911�7A 1 Expiration Date:J��( -/� Ie/ ' v Job Site Address: `4p l�6JI/f t�,i'�->✓,;/ City/State/Zip: /)a '/7}l�f)t/C'i 'ILIA O J XY Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.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. Signature: J � C Date: Phone#: -7 . (r,� 3 ..3 q au Official 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#: A CERTIFICATE OF LIABILITY INSURANCE 9/28/2015 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT Select Dept. Eastern Insurance Group LLC PHONEd. (800)333-7234 x66807 F� No:(781)586-8244 233 West Central St E-MAIL ADDRESS:selectwork@easterninsurance.com INSURERS AFFORDING COVERAGE NAIC# Natick MA 01760 INSURER A:Western World Insurance Co INSURED INSURERB:Commerce Insurance Company 4754 David Castricone Roofing & Siding Inc. INSURERc:Granite State Insurance Co. 231 Rear Sutton Street, Unit 3A INSURER D: INSURER E: North Andover MA 01845 INSURER F: COVERAGES CERTIFICATE NUMBER:CL159964794 REVISION NUMBER: 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. INSR ADDL SUBR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFF MWDD/YYXYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 !InMCLAIMS-MADE MERCIAL GENERAL LIABILITY DAMAGE TO RENTED PREMISES Ea occurrence S 50,000 A a OCCUR NPP1404373 9/6/2015 /6/2016 MED EXP(Any one person) $ 1,000 PERSONAL&ADV INJURY S 1,000,000 GENERALAGGREGATE S 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S 2,000,000 X POLICY PRO- LOC $ AUTOMOBILE LIABILITY EOMaBBIINEDt SINGLE LIMIT 5 1,000,000 B ANY AUTO BODILY INJURY(Per person) S ALL OWNED Fxx ASCHEDULED CNGCV /1/2015 /1/2016AUTOS AUTOS BODILY INJURY(Per accident) S XHIRED NON-OWNED PROPERTY DAMAGE S AUTOS Per accident 5 UMBRELLA LIAB OCCUR EACH OCCURRENCE S EXCESS UAB CLAIMS-MADE AGGREGATE S DED I I RETENTIONS S C j WORKERS COMPENSATION STATU- OTH- AND EMPLOYERS'LIABILITY YIN X tTWDR C ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEM MR EXCLUDED? N N/A E.L.EACH ACCIDENT S 100,000 (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE S 100,000 Ifyes, IPTIOunder C003989723 9/23/2015 9/23/2016 DESCRIPTION 0F OPERATIONS below E.L.DISEASE-POLICY LIMIT S 500,000 DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) ROOFING 6 SIDING INSTALLATION CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN TOWN OF NORTH ANDOVER ACCORDANCE WITH THE POLICY PROVISIONS. BUILDING INSPECTOR 1600 OSGOOD STREET AUTHORIZED REPRESENTATIVE NORTH ANDOVER, MA 01845 John Koegel/KH3 I ACORD 25(2010!05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025 mmnnsi ni Th-Arr Pr)nnmc znri Innn nrn roniefernri mnirlre of Ar:r)Pn ��,� ja�„„ta,uue�cCGla o ICcc/1,wd'rj License or registration valid for individut use only Office of Consumer Affairs&Business Regulation before the expiration date. If found return to: I ME IMPROVEMENT CONTRACTOR Type: Office of Consumer Affairs and Business Regulation registration 1.04569 10 Park Plaza-Suite 5170 xpiration: 7114/2016.^. 4 Private Corporatic`I Boston,MA 02116 _� DAVID CASTRICONE ROOFING SI.D`ING& David Castricone 231 R SUTTON ST SUITE 3A _ g�y9r� NORTH ANDOVER,MA 01845' Undersecretary Not valid without signature Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CSSL-099358 Construction Supervisor Specialty >, DAVID T CASTRICONE t 1 31 COURT STREET > 1 NORTH ANDOVER MA 01845 s n ' Expiration: Commissioner 12/16/2017 Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CSSL-099358 Construction Supervisor Specialty DAVID T CASTRICONE 31 COURT STREET 13- NORTH ANDOVER MA 01845 (�.nn Expiration: Commissioner 12/16/2017 Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Registration: 104569 Type: Expiration: 7/14/2018 Private Corporation DAVID CASTRICONE ROOFING,SIDING& David Castricone 231 R SUTTON ST SUITE 3A _ NORTH ANDOVER, MA 01845 . Undersecretary