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Miscellaneous - 160 WEYLAND CIRCLE 4/30/2018
N .5922 Date ...... . .0 ..... 0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ............ I .... T. -J. ... 6-1 .... 4 ...................t..`.......................... has permission to perform...... M�f7- 17�140 ...................................................................... wiring in the building off...... 5707.7 . .......144 7A. (!�7. ............................ 1 at ...... ..... . North Andover, Mass. Fee..`? ............. Lic. No ............... Check # el Date. ....� . NORTN 3? °' TOWN OF NORTH ANDOVE 3 • PERMIT FOR GAS INSTALLATION SA US ; . This certifies that ... !L <!'�`... F: �- ! ....... . .r has permission for gas installationA . ... ..... . ...... .. . in the buildings of . ......................... at �� ... f�� .r`G':�� . , North Andover, Mass. Fee..'d!. Lic No..l�'<?.3 ....... GAS INSPECTOR Check # 6323 MASSACHUSETTS UNIFORM APPUCATONFORPERMTT TO DO GAS FITTING (Type or print) Date NORTH ANDOVER, MASSACHUSETTS Building Locations �� c L Permit # & Amount $� G'1. Owner's Name K New Renovation Replacement 0- Plans Submitted (Print or type) '�' Name 'I f (3 /t . Name of Licensed Plumber'or Gas Fitter Check one: Certificate Installing Company Corp. e Partner. Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance' policy or it's substantial equivalent. Yes U_ NoO If you have checked ves, please indic -the type coverage by checking theappropriate box. Liability insurance policy Other type of indemnity Bond 13 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 13 1 hpri- tl rarfi4;1 +1,M n11 ..0 ♦L.e A -.-:I- __J Lr_-_--`'-- ' '- _ „"V� ,,,,,,,,,,,QU kV, cmcreu) in aoove plication are true and accurate to the best of my knowledge and that all plumbing work and ' a ations p med under Permit I sued for this,,application will be in compliance with all pertinent provisions of the M achuse a Co a an ha t r 1 2 of t neral Laws. By: Title City/Town, APPROVED (OFFICE USE ONLY) ---Signature of Licensed Plumber Or Gas Fitter Plumber 97-D3 p Gas Fitter License Number Taster 0 Journeyman w U z v� W, z O O14 C7 O C W F w w z U x a a w F o=. o g w ., c U x a z w > a H '' m � z O z W o � x a � oOc > o a H O SU B -BASEM ENT BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR 8TH. FLOOR (Print or type) '�' Name 'I f (3 /t . Name of Licensed Plumber'or Gas Fitter Check one: Certificate Installing Company Corp. e Partner. Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance' policy or it's substantial equivalent. Yes U_ NoO If you have checked ves, please indic -the type coverage by checking theappropriate box. Liability insurance policy Other type of indemnity Bond 13 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 13 1 hpri- tl rarfi4;1 +1,M n11 ..0 ♦L.e A -.-:I- __J Lr_-_--`'-- ' '- _ „"V� ,,,,,,,,,,,QU kV, cmcreu) in aoove plication are true and accurate to the best of my knowledge and that all plumbing work and ' a ations p med under Permit I sued for this,,application will be in compliance with all pertinent provisions of the M achuse a Co a an ha t r 1 2 of t neral Laws. By: Title City/Town, APPROVED (OFFICE USE ONLY) ---Signature of Licensed Plumber Or Gas Fitter Plumber 97-D3 p Gas Fitter License Number Taster 0 Journeyman nrl A (PLEASE PRINT Town of North AI The undersigned Location (Street 8 Owner or Tenant Owner's Address Is this permit in a Purpose of Buildi Jim LUIVuvIV[vrrcfiLj,17Ur r >►t,avusilu ��^•C�`� -��� DEPARTV WOMBIICSAFM Permit No. .J l dy`� BOARDOFFIREPREVEVT70NRB UTA77ONS527O Rn -00 Occupancy & Fees Checked Existing Service I Amps I V v1L3 New Service I Amps�Volts vvcuLoau vuumpVuuu L J Overhead Underground Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work / y LIU. v1 LYIGLGLb No. of Meters No. of Lighting Outlets No. of Hot Tubs' No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below GeneAtors KVA round1:1 round No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained DetectiordSounding Devices Local Municipal Connections r7 Other No. of Dryers Heating Devices KW No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydra Massage Tubs No. of Motors Total HP QTHER- Cbvzr4r- Pats "lotbe IhaNes hAWdvafidlmafq9=10ft0ffM YES INSURANCE BOND p GRIER r-1 woikmsto°'3-�(� ( I —f SigiedutiderlTie �' ` / J b/, FIRMNAME oritssubslantialeWivalfft YES NO ffyoubawdrdodYES, pk=nk*theWgforn,mVby Estun*dVakieafFJecftialWdk $ C%b Final om) Li=wNo. TV3 Iiorm9ee � I -0je lte Vt `.► (/ n,,Af sigirw � l ` ' ' Bt�lessTelN�o.coa C� l Gken r h/t/ �c1V >°y1 Alt Tel No. .pWN ,SpaRANcEwAlvEp,;IamawaetutheLioffwdomnotharetheit>Staarosubson ialqzUa taswgzedbyMassaditmsGen =Laws and that my sigrtahae on this pewit applicatiai wars this iegtmailat ,(Please check one) Owner Agent Telephone No. PERMIT FEE $ signature of Owner of Agent 1rm I,VLYImunrrcriwn yr-- DF.PARTMENTOMBIICSAFE7Y Permit No. 7i^� BOARDOFFIREPREVEMONREGiLAT ONS5Va a12•W Occupancy & Fees Checked ` APPUCA71ONFOR PERMUTO PERFORMELECTRICAL W ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, S27 CMR 12:00 j (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) DatlL Town of North Andover To th sp for o Wires: The undersigned applies for a permit to perform the elect'cal work described below. �v�/'/ n Location (Street & Number) l,�I C i2G Owner or Tenant ftoc le 10 Owner's Address I` Is this permit in conjunction with a building permit: Yes No ✓ (Check Appropriate Box) P 1 _ Purpose of Building 5( ( 7' - - Utility Authorization No. Existing Service Amps/ Volts Overhead E3 Underground a No. of Meters New Service Amps�Volts Overhead r__1 Underground � No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work =Ae / u No. of Lighting Outlets No. of Hot Tubs ' No. of Transformers TOW KVA No. of Lighting Fixtures Swimming Pool Above El Below El Generators KVA round ground No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP 1 PtEM11Dthetegtmanods ubmidbdvaG Pwd bthe0ffice YES S C V&ft Amm LA> M Onim rJ Stat °�.� r htVecfimDateRegttesled .t ClvclCevh� Q sigrnhae c n ft parrit applicafiar WJ'M Ibis re#artat Zeck one) Owner 1:1 Agent YS or stirkat W gtti kq . YES rl NO ri ffyeuhmdied®dYES,pleaseindic*thet eovmWby 0 Estim*dVakxofDecftxdWedc $ Rao Fiml -0 C I.ic=Na S' �, � ' �• LioarseNo d�Ueh 'l✓J AItTeLNa the insuarloe orneagz arils subAarrial egtrivalalt as regtited by Massad�ls Galeal Iaws Telephone No. PERMIT FEE $ Location Civ-, No. Date 7` kORTN TOWN OF NORTH ANDOVER 1 Certificate of Occupancy $ wu Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ ' Check # r. — ✓ J ✓ Building Inspector F-1 TOWN OF NORTH ANDOVER ` BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: i SIGNATURE: Buildin Commissi I oner/Inspector of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 1,60 WV u I dL DVA C c rJe - � aS8 Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning Distrid Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Rapired Provided ReqWred Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private d Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record f _(� ory Se skf'iUGS wo b0 (•✓� Ia u-u(7Y af-aP Name (Print) Address for Service Signature Telephone x q7S-- 79/-/73QL 6 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CQl TRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Door N iC 0 tips t S Licensed Construction Supe isor: jDLicense 0��s Se��LCe g SPC - Number Address --1 � 6 � � 11 s'� %�'G � 7 7J.3 U ///Co Expirato o ' n Date Signa Telephone 3.2 Registered Home Im ovement Contractor Not Applicable ❑ 06rAiNlc •jv(Ju�S /J ��0 7 (O Company Name Registration Number jP,jP i s S` l% C C Y- Address C) vv 2 t iff�� Expir ton We D Signature Telephone OU M X Z O NO v n M SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and Submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. 0 Demolition ' ❑ Other 0 Specify Brief/' . Descriptionjof Proposed Work: Q i / / Rl� se P—Li I SF,CTION 6 - F.STTMATFD CONSTRUCTION COSTS I Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE ONLY'", 1. Building D OOe co (a) Building Permit Fee Multiplier 2 Electrical e0o• 00 (b) Estimated Total Cost of Construction 3 Plumbing Zoo &, • p} Building Permit fee (a) X (b) 4 Mechanical HVAC pa -cc 5 Fire Protection 6 Total 1+2+3+4+5 oZ000 - 00 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, K0 ti SC J � r i J Ct,Wd js , as Owner/Authorized Agent of subject property Hereby authorize Du p V � S 6" U 1c" �N c- • to act on My beh n all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief t: � N 'C or yo J - iS sero e P 5 Ui c. - J Print Namol Va Signature of Owner/A ent Date MR MAN NO. OF STORIES SIZE �V�SEMENDDR SLAB S OF FLOOR TIMBERS 1 2 ND 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DINIENSIONS 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 FORM - U - LOT RELEASE FORM s P`N �< ( f f INSTRUCTIONS: This form is used to verify that all necessary approval / permits from Boards and Departments having jurisdiction have been obtained. This does not. relieve the applicant and or landowner from compliance with any applicable requirements. APPLICANT KO (V5 e. ,S KrI u A u'0 s r PHONE '/V ASSESSORS MAP NUMBER 6 LOT NUMBER C 5 8 SU3DIVISION LOT NUMBER STREET el AN b 1 I Je- STREET NUMBER /00 OFFICIAL USE UNLY RECOMMENDATIONS OF TOWN AGENTS DATE APPROVED CONSERVATION ADMINISTRATOR DATE REJECTED CONIIyIEN'I'S DATE APPROVED TOWN PLANNER - DATE REJECTED 1 CONI NII IEENTS DATE APPROVED FOOD INSPECTOR - HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR - HEALTH DATE REJECTED COMMENTS PUBLIC WORKS - SEWER / WATER CONNECTIONS PERMIT ��DnnRIVEWAY T / C C FIRE DEPARTMENT � DATE APPROVED DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE 716 Lowell Street Methuen, MA 01844 (508) 687-7930 RESIDENTIAL CONTRACTING AGREEMENT Read this agreement and make sure you understand it before signing it. This agreement has legal force and effect and binds those who sign it. Notice: All home improvement contractors and subcontractors engaged in home improvement contract- ing, unless specifically exempt from registration by provisions of Chapter 142a of the general laws, must be registered with the Commonwealth of Massachusetts. Inquiries about registration and status should be made to the Director, Home Improvement Contract Registration, One Ashburton Place, Room 1301, Boston, MA 02108. Designated Registrant's Name: DUDJ 5 def ekes ryC Registration Number: 119176 Salesperson's Name: De -M �Wc iDJfl,)� S This agreement is made on 11115-1.1000 between ©U (Jy : 5 P f- RJ 1,C e h1 C - (DM) (CONTRACTOR) of 716 Lowe(( St- jMf__. MR- QLtV 976£977g 30 (ADDRESS) / (PHONE NUMBER) hereinafter called "Contractor" and Il d {U e S f C t ! VA. Y,/,o S (OWNER) of 16a WR4 (OLNd (fAc.(e- I). i��Nc�t uPr MA.Oxg4/3' 97-6 -7 9Y- 17.3 ( ) (PHONE NUMBER) hereinafter called "Owner". I. DETAILED DESCRIPTION OF WORK TO BE PERFORMED Contractor agrees to perform in a good and workmanlike manner all work detailed below. Such work consists of the following: r u -s b, RG z P tMe ,-).� (),, w Q f,p � (L - w ;- iA rt, f ) nl, -*1 . W DETAILED DESCRIPTION OF MATERIALS TO BE USED Materials to be used in performing the above described work consist of the following: ov XI. COMPLETENESS OF AGREEMENT FOR EXECUTION The Owner is hereby advised that he should not sign this Agreement unless and until all blank sections have been filled in or marked as void, deleted or not applicable, and until all exhibits and related or referenced documents that are incorporated herein are attached hereto. XII. COPY OF AGREEMENT TO BE GIVEN TO OWNER This Agreement is governed by the Laws of Massachusetts. It must be executed in duplicate, and an original signed copy hereof given to the Owner at the time of execution. No work under the Agreement shall begin prior to the signing of the Agreement and transmittal to the owner of a copy thereof. "Ird"TTMCI T/% d" 1 LTI'IrT l\1V 11117 lV %1A1I%I-- The owner may cancel this agreement if it has been signed by the owner at a place other than an address of the contractor which may be his main office or branch thereof, provided that the owner notifies the contractor 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 attached Notice of Cancellation. HOMEOWNER: DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Owner's Signature Da i ed ax�aw'�� -14A�,5�o Contractor's Signature ate Vgned H - GG 25M 6/92 HOME IMPROVEMENT CONTRACTOR Registfation 112176 Type - PRIVATE CORPORATION Expiration 03/02/01 DUPUIS SERVICES, INC. DOMINI' F. OUPUIS �ce�r�o7 7y rLOWE.LL ST 1 ADMINISTRATOR METHUEN MA 01844 1 I - .'x- :• -cr- _-_:. /`,tet -a-. /GG eowt YGO9Z6I{P.CLIUL 0/� /v L(U7efC0 .BOARD OF BUILDING REGULATIONS License: CONSTRUCTION. SUPERVISOR Number: CS 058317 Birthdate 11/08/1963 :Expires: 11/08/2001 Tr. no: 8658 e Restricted To: 00 DOMINIC F DUPUIS 720 LOWELL ST METHUEN, MA 01844 Administrator r ACORD �„ CERTIFICATE OF LIABILITY INSURANCE DATE 03/01/2001 PRODUCER M. J: FOSTER INSURANCE SERVICES INC. 9 WAVERLY ROAD NORTH ANDOVER MA 01845-2415 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR rALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURED Dupuis Services Inc 716 Lowell Street Methuen MA 01844— INSURERA:GRAPHIC ARTS MUTUAL INSURER B: INSURER C: INSURER D: INSURER E: rnvERer.Fc 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 POLICY EFFECTIVE DATE MM/DDIYY POLICY EXPIRATION DATE MM/DD/YY LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMSMADE OCCUR ` " BOP3001953 / / —�-` 064,01/2000 / / 06/01/2001 EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire) $ 50,000 MED EXP (Any one person) $ 10,000 PERSONAL & ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: POLICY JE LOC PRODUCTS - COMP/OP AGG $ A AUTOMOBILE [xx X LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BAC3001954 / / 06/01/2000 / / / / 06/01/2001 / / COMBINED SINGLE LIMIT (Ea accident) $ 500,000 BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY ANY AUTO / / / / AUTO ONLY - EA ACCIDENT $ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY OCCUR F-1 CLAIMS MADE DEDUCTIBLE RETENTION $ / / / / / / / / EACH OCCURRENCE $ AGGREGATE $ _ $ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 3001955 06/01/2000 06/01/2001 X TDRYLIIMITS OER -- E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE -POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CFRTIFICATF HOLDFR I I nnmmnNAl- INSURFn. INSURER LETTER- CANCELLATION TOWN OF NORTH ANDOVER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Building Department EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 010 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT North Andover MA 01845— FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. REP TIVE-� ACORD 25-S (7/97) / © ACORD CORPORATION 1988 " T. INS025S (9910) ELECTRONIC LASER FORMS, INC. - (800)327-0545 Page 1 of 2 • Town of North Andover Q� tta 6Tfi i Building Department 27 Charles Street ' North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 oft- 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 cl 1, s150a. The debris will be disposed of in /at: _ r � Facility Q /✓ � Signat_ur�e of Applican �'57/,;7 c,0 1 Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. C/) m Cl) 0 m C �M to CD CO) 10 CD O CA O CA O CA d Cl) CD 0 CD CD y� CD CA < c?�O m 2 O -•yOQ H S:c 0 .0 CO) ao m n O comaC Z �� Vi CA =r EL m m co O —i O m m C a O O Can. A D W O I c ?= = • : lb CL n o O :� CL V rVI O m H � V / O n C 00, • O d N so H ds aC000) Er CD V O x:06 o A co o� zCA es � 0 t) H O � : :� dtwd n G o C MA o d Z o o ►� . � w N oGc Cil � ro � � =, aGo r o � w � wG � o a o• G7 � z . ^ N x g 0 C N2 2368 0.1 pORTp 1114, 0lip 9 • i ^ # Date....:..��`...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies ...;.....-ate.........:�................................... has permission to perform ......... .'...................................................................... wiring in the building of j. --���'� , North Andover, Mass. Fee..................... Lic., NoF4.�,�l. � ............................................................... ELECTRICAL INSPECTOR Check # `' / WHITE: Applicant CANARY: Building Dept. PINK: Treasurer .� 3i 5' is -5 telt TMC0AW0NWB4LTH0FARMC WS M Office Use only nE? vTOFPUB1JCs1F= a°t 3 Permit No. BOAMOFFMPREVEMONREGU HOAS5270MIZ-M Occupancy & Fees Checked MAPPLICATTONFOR PEST TOPERFORMELEC'TRICAL 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 e5 1� U Town of North Andover �� , v e Ipsp.ator of Wires: The undersigned applies for a permit to perform the electrical work described below. MAP PARCEL Location (Street & Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Purpose of Building �� Y7 Gj Yes U No " (Check Appropriate Box) .,� -e Utility Authorization No. Existing Service �220 0 Amps 00 a YOVolts Overhead Underground New Service �_ Amps / Volts Overhead Underground No. of Meters No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work7777..- "r1 h G� �e t1 i 2 r A sBl % yr a :» t o Ile" �P No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. 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 Bumas FME ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and _ No. of Disposals No. of Heat Total Total "y Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained No Dryers Heating Devices KW DetectiordSounding Devices Local Municipal _ Other Conncctions No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP II Cooagr.. R=attto@Ier 4MM3el SdNb. C=WdILMo Ilme%l n&dvalidproofcfsa=1o&Ofca YES ar>lialgjivala>t YES �/ NO if whawdmd®BYES,plea9 MdC*tbCt FofoWeag--bydmckzrgthe ?9MSPedY) EViradcxilDale Estn)&dValueofElechiwl Work $ ij=wi,b. 1a -33-7A Licmill o imTeLNo. AkTeLNa OWNERSD4SURANCEWAIVER Iarnaw&ediAthel=wdoesmthavedrr owaWcritsststn a egrialartasreq edbyMa%a=BWW allaws aadd-&rrysigr>t=cnthispear><tapp}i rwai�slhLsregmanart (Please check one) Owner AgentED j Telephone No. PERMIT FEE $ L�Or signature o wner or Agent Location6114 No. Z3 _ Date r- a- 4 T TOWN OF NORTH ANDOVER p Certificate of Occupancy $ Building/Frame Permit Fee $ y� CNUs �� Foundation Permit Fee $ Other Permit Fee $ u; M Sewer Connection Fee $ Water Connection Fee $ TOTAL $ jrC,,guilding Ins actor 9 V.2 Div. Public Works 1 Location J � yzZ_9� No. _ Date Th TOWN OF NORTH ANDOVER p Certificate of Occupancy $ Building/Frame Permit Fee $ ;' d *+nO ► Et�' Foundation Permit Fee $ ld d 1 s1CXU5 Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ - •" - TOTAL e - ' 3:P�- 64/24/% 11:49 971.E 6 Building Inspector 150.00 PAID Div. Public Works Location /o/o 44 t, No. b Date TOWN OF NORTH ANDOVEW 104 33 d - 2 -gr Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ A�0, 10:43 Sewer Connection Fee $ /nw-42% 46a Water Connection Fee $ TOTAL $ o B �9 sP� � 4�f 111:49 1 4 00.40 PAIR v` '13, Div. P lic Works u J m C Z t f d u t W M 0 W 0 IK fL L 4 Olz OQ J J V � � J W 3 o F o u 0 u u = y V OOp mr awp p p P^ m p y T 0q 0m N N n m Nn Nn < yD D* p n x Zm :D D0cmODOOO y D8cgm OA Dc; NZO Zn w O mmn7C 7 -I D ND A�w OGf N + " 0000 OO nO yNNO �3� O mi m T DN;O Quo =N ZZpZZ000NNIOn 0.., nmm w ZDy O mF^N T< ZI p;n 3ZZZ�'pZ ON 3 Y N+m 0 y;3 P w �m mZ y DZD,p�n�Z.� M O_ as * 't%i non NmS;x C mNOmm' DN �.ON •.; mn C << D a T Z p m; 0 N m y 0NN Z pfZ/1 n ,y N v Z II _ILL IIINII I ! 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This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ******************Applicant fills out this section***************** APPLICANT: T Z( L,� 1 p� 6 ��/ �i {�' Phone LOCATION: Assessor's Map Number Parcel Subdivision ::T-70 X id o ) Lot(s) Street �6d���0 ({I frc% St. Number _l ************************Official Use Only************************ RECOMMENDATIONS TOWN AGENTS: Date Approved Co e ation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Food Inspector -Health Septic Inspector -Health Comments Date Approved Date Rejected Date Approved Date Rejected Public Works - sewer/water connections-�-1� - driveway .permi�tp 4_a_ Fire Department �` ' Ze t� Received by Building Inspector Date 4 v 0. ,a I� .. 2(0.33• a � 2.33 .. �. 5' •� - Z.IIo' � M P�COP05E� N ni N '501 ;i39Z� �2.•s3' O ; L' 0 VVeyZAIVO 1°eoPOs6-I9 maZf GOC,4 AayV Rz. 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CD 0 4v, rrkD o rn 0 <V 0 r -L rD Z CD rDw C/) tz 0 0� CO.= CD: C) So rD >rD 00 rD 0 V)ITI CL rD Z rDw C/) tz 0 0� C) So rD >rD 7) Cl) P"�tii I k ITI :z -r� tTl I C/) C� C/) M Eocation/ � No. i a ."� �e Date MORT1y TOWN OF NORTH ANDOVER 0��,a0 .0.4 O i? i '� O F 9 # • Certificate of Occupancy $ �ssAcNUsE<�' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ eel TOTAL $ i -Check # Z� 13 7 15 Building 6pector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING ,ten BUILDING PERMIT NUMBER: DATE ISSUED: �� Q i O Q V 60%0�� SIGNATURE: ��a .0*0 Building Commissioner for of Buildin Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: o Westlawd Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required— Provided Required Provided 1.7 Water Supply M.GLC.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private ❑ Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record 6yi-SR 5Kf-i k)WJoS ( C) lawa t'c.�� Name (Pant) Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ 00YAA�NIL Ov.D✓k- 5 Licensed Construction Superviso : �++ License Number Addre _ —1 aR,Cv alc C� 0 7 (� 3 D xpiratio Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ t DUDJer C e 5 c - /, ? �g Company N me Registration Number 3 6 a O / Z l�tJ ` f '5,/ ! [ Address 2-it�?1C 7 D Expiration Oate Signature Telephone T�qq M X Z O t G, F, J SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. affidavit Attached Yes .......❑ No ....... ❑ -Signed SECTION 5 Description of Proposed Works(check all applicable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: Re©ucLic_ Met 4A �ar�rraav�► I�te�,'le V,Ja11S. /c/aGr�s Ir✓s �,g,ZZ /1/.�O_Gt✓ W2>1Pit SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant i}FFICIALUS]G"ONLI' 1. Building // (a) Building Permit Fee Multiplier `5 2 Electrical d' QC7 (b) Estimated Total Cost of Construction vO0 3 Plumbing 0.00 Building Permit fee (a) X (b) /. 3 �• 4 Mechanical HVAC �-- 5 Fire Protection 6 Total 1+2+3+4+5 Q p8. 06 Check Number SECTION 7a OWNER AUTHORIZATION TOIBE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT t I, �lo N�e J1<(-1 UGtWCJ5 as Owner/Authorized Agent of subject property Hereby authorize i Q v v to act on Myhflin all matters relative to work autho4zed by this building permit application. 0 Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name Signature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR T HERS iST 2ND 3RD SPAN DINIENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUU DING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE In accordance with the provisions of MGL c 40 S 54, a condition of Building Permit Number Is that the debris resulting form this work shall be disposed of in a property licensed solid waste disposal facility as defined by MGL c 11, S 150A The debris will be disposed of in: Location of Facility Signa f Permit Applicant Dates NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector t The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print Name: Location: City Phone am a homeowner performing all work myself. 01 am a sole proprietor and have no one working in any capacity xI am an employer providing workers' compensation for my employees working on this job. 1� Company name: u p J Z -S Sefy i—c e S 171uC - Address 716 Lo W e, City: 1/Yl,�'f uG N U►'1 A-- d t Phone #: 97,849'7 7gr 3 a / Insurance Co. 17a Q k i C- is t" %S Wt v 4-.ra Policy # 3&0 1 9 g -5 - Company name: Address City Phone #: Insurance Co Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. 1 do herby certify under the pains and penalties of perjury that the information provided above is true and correct. `� Cinnnfiirc A/�rin.�� �w� 40--l': A Date 3/,;7, p /QD Print name Do rn %-)V .Z v Q S Phone # W,697 7 f 3 a Official use only do not write in this area'fo be completed by city or town official' ❑ Building Dept C3 Check if immediate response is required Building Dept ❑ Licensing Board ❑ Selectman's Office contact person: Phone #: ❑ Health Department ❑ Other FORM WORKMAN'S COMPENSATION I ACORD,,,, CERTIFICATE OF LIABILITY INSURANCE ATE D3/i7//D00 4 03/27/200 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION M.J. FOSTER INSURANCE SERVICES ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 9 WAVERLY ROAD HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. NORTH ANDOVER, MA 01845-241 LIMITS P:978-686-2266 F:978-686-6410 INSURERS AFFORDING COVERAGE INSURED INSURER A: GRAPHIC ARTS MUTUAL Dupuis Services Inc INSURER B: 716 Lowell Street INSURER C: INSURER D: Methuen MA 01844 - INSURER E: FIRE DAMAGE (Any one fire) $ 50,000 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 POLICY EFFEDATECTIVE POLICY EXPIRATION DATE (MMIDDIYY) LIMITS GENERAL LIABILITY NORTH ANDOVER MA 01845 REPRESENTATIVES. AUT �EPRES ITATIVF_ EACH OCCURRENCE $ 1,000,000 A ® COMMERCIAL GENERAL LIABILITY BOP3001953 06/01/1999 06/01/2000 FIRE DAMAGE (Any one fire) $ 50,000 ❑ CLAIMS MADE 111 OCCUR MED EXP (Any one person) $ 10,000 ❑ PERSONAL & ADV INJURY $ ❑ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $ ❑ POLICY ❑ PRO ❑ LOC AUTOMOBILE ❑ LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ 500,000 (Ea accident) A ❑ ® ALL OWNED AUTOS SCHEDULED AUTOS BAC3001954 06/01/1999 06/01/2000 BODILY INJURY (Per person) $ ®HIRED ®BODILY AUTOS NON -OWNED AUTOS INJURY $ (Per accident) PROPERTY DAMAGE $ (Per accident) ❑ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ❑ ANY AUTO ❑ OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS LIABILITY EACH OCCURRENCE $ ❑ OCCUR FF__11 CLAIMS MADE AGGREGATE $ ❑ DEDUCTIBLE $ ❑ RETENTION $ $ WORKERS COMPENSATION AND WC SCRYTATLIMU- OTH- A EMPLOYERS' LIABILITY 3001955 06/01/1999 06/01/2000 E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - EA EMPLOYEE $ 100,000 E.L. DISEASE - POLICY LIMIT $ 500,000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER I I I I ADDITIONAL INSURED: INSURER LETTER: CANCELLATION ACORD 25-S (7/97) 1✓ ©ACORD CORPORATION 1988 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 010 DAYS WRITTEN TOWN OF NORTH ANDOVER NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL NORTH ANDOVER TOWN HALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR NORTH ANDOVER MA 01845 REPRESENTATIVES. AUT �EPRES ITATIVF_ ACORD 25-S (7/97) 1✓ ©ACORD CORPORATION 1988 u BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number. CS 058317 Birthdate: 11/08/1963 Expires: 11108/2001 Tr. no: 8658 Restricted To: 00 DOMINIC F DUPUIS 720 LOWELL ST METHUEN, MA 01844 Administrator • HOME IMPROVEMENT CONTRACTOR Registration 112116 Type - PRIVATE CORPORATION Expiration 03/02/01 DUPUIS SERVICES, INC. DOMINIC F. DUPUIS LOWELL ST ADMINISTRATOR METHUEN MA 01844 716 Lowell Street Methuen, MA 01844 (508) 687-7930 RESIDENTIAL CONTRACTING AGREEMENT Read this agreement and make sure you understand it before signing it. This agreement has legal force and effect and binds those who sign it. Notice: All home improvement contractors and subcontractors engaged in home improvement contract- ing, unless specifically exempt from registration by provisions of Chapter 142a of the general laws, must be registered with the Commonwealth of Massachusetts. Inquiries about registration and status should be made to the Director, Home Improvement Contract Registration, One Ashburton Place, Room 1301, Boston, MA 02108. Designated Registrant's Name:y(J Registration Number: 1710 c t�" 06-9:3/ 7 Salesperson's Name:Oro bv i s DolovE5 This agreement is made on 3/13/00 between Dv pv 1-5 Se f o ice_S C A/ oii / .SDATE) -I (CONTRACTOR) of 7110weG1 -6 InefA• MR- 61fYzl 7?93 0 (ADDRESS) (PHONE NUMBER) hereinafter called "Contractor" and A0 /y Se K rt-yctw U 5 (OWNER) of (PHONE NUMBER) hereinafter called "Owner". I. DETAILED DESCRIPTION OF WORK TO BE PERFORMED Contractor agrees to perform in a good and workmanlike manner all work detailed below. Such work consists of the following: DETAILED DESCRIPTION OF MATERIALS TO BE USED Materials to be used in performing the above described work consist of the following: -G r -a N ► fe 17 le To 13e 10 3fa l Led Lu 11. PRICE Contractor agrees to do all work described in Section I for the total price of $000. 00 III. PAYMENT Payment will be made as follows: 3[ 3 1/31 % (Sr(9®f7 . too) upon signing Contract; 7. % ($ 006. 00 ) upon completion of ; '5 3. % ($ coo.00 ) upon completion of -Talo_ ; and the remaining % ($ 000.00 ) upon verification of the work by Owner and Contractor as having been satisfactorily com- pleted, which verification shall take place promptly after completion. Notice: No agreement for home improvement contracting work shall require a down payment (advance deposit) of more than one-third of the total contract price or the total amount of all deposits or payments which the contractor must make, in advance, to order and/or otherwise obtain delivery of special order materials and equipment, whichever amount is greater. IV. COMMENCEMENT AND COMPLETION OF WORK Contractor will not begin the work or order the materials before the third day following the signing of this Agreement, unless specified here in writing. Contractor will begin the work on or about ;3,420/00 (date). Barring delay caused by circumstances beyond Contractor's control, the work will be completed by (date). The Owner hereby acknowledges and agrees that the scheduling dates are approximate and that such del ys that are not avoidable by the Contractor shall not be considered as violations of this Agreement. V. NO ACCELERATION OF PAYMENTS BUT ESCROWING ALLOWED The Contractor may not require payments to be made in advance of the times specified in Section III (Payment) above for the reason that he deems himself or the payments to be insecure. If, however, he deems himself to be insecure, he may require, as a prerequisite to continuing the work described herein, that the balance of the payments under this contract that are in the control of the Owner, shall be placed in a joint escrow account that requires the signature of both the Contractor and the Owner for withdrawal. VI. INSURANCE Contractor will be responsible to Owner or any third party for any property damage or bodily injury caused by himself, his employees or his subcontractors in the performance of, oras a result of, the work under this Agreement. Contractor agrees to carry insurance to cover such damage or injury. VII. SUBCONTRACTING Contractor agrees that, notwithstanding any agreement for materials and/or labor between Contractor and a third party, Contractor is responsible to Owner for completion of all work described in a timely and workmanlike manner. VIII. CONSTRUCTION -RELATED PERMITS The following construction -related permits swill be necessary in order to complete the scope of work included in this Agreement: U U (d iiwc, PeSP�1,i-� P(Jv,,, LiWG PevP-,i+- . L' JP c7 ir,'cQ I Armt4. The Contractor under provisions of Chapter 142A of the General Laws is required to apply for and obtain all construction -related permits. The Contractor shall not be deemed responsible for delays in the work described in this Agreement caused by regulatory, permit granting or inspectional agencies, authorities or individuals. Notice: If the homeowner obtains his own construction -related permits for the work described under this agreement, the homeowner is hereby advised that in the event of a dispute, judgment and nonpayment of the contractor, the homeowner will not be entitled to make a claim to or collect from the guaranty fund established by Chapter 142A, M.G.L. IX. MODIFICATION This Agreement, including the provisions relating to price (Section II) and payment schedule (Section III) cannot be changed except by a written statement signed by both Contractor and Owner. However, cancellation by Owner is allowed in accordance with the Notice of Cancellation (annexed). X. WARRANTIES The Contractor warrants that the work furnished hereunder shall be free from defects in materials and workmanship for a period of f yeo k following completion and shall comply with the requirements of this Agreement. In the event any defect in workmanship or materials, or damage caused by the Contractor, his subcontractors, employees or agents, is discovered within one year after completion of any job, including cleanup, the Contractor shall, at his own expense, forthwith remedy, repair, correct, replace, or cause to be remedied, repaired, or replaced, such damage or such defect in materials or workmanship. The foregoing warranties shall survive any inspection performed in connection with the agreed-upon work. All warranties for equipment supplied by the Contractor under this Agreement shall be those given by the manufacturers of such equipment, which shall be and are hereby passed through directly to the Owner. Under such manufacturers' warranties, the Owner maybe required to registeror mail in a warranty card or other evidence of ownership and use of such equipment in order to activate such warranties. The Owner's failure to mail in or register such documentation, which failure voids the manufacturer's warranty, shall not create any responsibility for the Contractor to warranty such equipment. This warranty gives the owner specific legal rights, and owner may also have other rights which vary from state to state. Under Massachusetts law, sales of goods carry an implied warranty of merchantability and fitness for a particular purpose. XI. COMPLETENESS OF AGREEMENT FOR EXECUTION The Owner is hereby advised that he should not sign this Agreement unless and until al l blank sections have been filled in or marked as void, deleted or not applicable,n�I until all exhibits and related or referenced documents that are incorporated herein are attached hereto. XII. COPY OF AGREEMENT TO BE GIVEN TO OWNER This Agreement is governed by the Laws of Massachusetts. It must be executed in duplicate, and an original signed copy hereof given to the Owner at the time of execution. No work under the Agreement shall begin prior to the signing of the Agreement and transmittal to the owner of a copy thereof. TTr�TTTfI Tr% !• ♦ %Td TIT 1\l V A& l V l V <. A l I %, -- The owner may cancel this agreement if it has been signed by the owner at a place other than an address of the contractor which may be his main office or branch thereof, provided that the owner notifies the contractor 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 attached Notice of Cancellation. HOMEOWNER: DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. /1310 Owner's Signature Date Signed &;U�- La�— a Contractor's Signature�6ateA gned H - GG 25M 6/92 6. The following terms may be added, if desired, to clarify situations in which the Contractor will not be responsible for delays (for example, delays due to hidden conditions, etc.): VARIATIONS IN SCHEDULED START AND COMPLETION OF WORK The actual dates that construction will commence and be completed may vary due to: the time required to apply for and obtain necessary permits; delays caused due to necessary inspections; delays in the scheduling of work crew(s); the presence of hidden conditions or necessary additional work discovered during construction; or delays in the receipt of equipment and/or materials which must be ordered and/or delivered to the site. NOTICE OF SCHEDULE CHANGES The Contractor agrees that when any such delays become known to the Contractor, the Contractor will advise the Owner as soon as is reasonable. DELAYS IN COMPLETION DUE TO HIDDEN CONDITIONS The Owner hereby acknowledges and agrees that in certain remodeling work, the demolition of portions of the preexisting structure may reveal additional defects, conditions or the need for additional work, which must be repaired, altered or carried out in order to commence or to complete the work described under this contract. In such case(s) the Homeowner agrees that the duration of the work and the scheduled date of completion may differ from the date contained in Section IV, above, and that such variation which is not avoidable by the Contractor shall not be considered to be a violation of this Contract. 7. If the Contractor wants to provide leeway for adjusting the overall price when hidden conditions increase the amount of work required, the following term should be included: HIDDEN CONDITIONS AND NECESSARY ADDITIONAL WORK Hidden conditions may require adjustment in the overall price of the necessary work related to this Agreement. In such case the Contractor shall inform theOwnerof such conditions forthwith and where necessary a written amendment of this Agreement will be negotiated and executed by the Contractor and Owner. ENTER DATE OFTRANSAC'ITON NOTICE OF CANCELLATION You may cancel this transaction, without any penalty or obligation, within three business days from the above date. If you cancel, any property traded in, any payments made by you under the agreement, and any negotiable instrument executed by you will be returned within ten business days following receipt by the Contractor of your cancellation notice. And any security interest arising out of the transaction will be cancelled. If you cancel, you must make available to the Contractor at your residence, in substantially as good condition as when received, any goods delivered to you under this agreement; or you may, if you wish, comply with the instructions of the Contractor regarding the return shipment of the goods at the Contractor's expense and risk. If you do make the goods available to the Contractor and the Contractor does not pick them up within twenty days of the date of your notice of cancellation, you may retain or dispose of the goods without any further obligation. If you fail to make goods available to the Contractor, or if you agree to return the goods to the Contractor and fail to do so, then you remain liable for performance of all obligations under the agreement. To cancel this transaction, mail or deliver a signed and dated copy of this Notice of Cancellation or any other written notice, or send a telegram to -Sto-f Vi4CeS IA)C - (NAME OF CONTRACTOR) at __ l fo d o we 11 �� I7?e7%' MA tww (ADDRESS OF CONTRACTOR'S PLACE OF BUSBQESS) NOT LATER THAN MIDNIGHT OF O (DATE) I HEREBY CANCEL THIS TRANSACTION. (DATE) (OWNER'S SIGNATURE) (OWNER'S ADDRESS) [Two copies of this form to be attached to the Residential Contracting Agreement] H - GG 25M 092 ENTER DATE OFTRANSACTION NOTICE OF CANCELLATION You may cancel this transaction, without any penalty or obligation, within three business days from the above date. If you cancel, any property traded in, any payments made by you under the agreement, and any negotiable instrument executed by you will be returned within ten business days following receipt by the Contractor of your cancellation notice. And any security interest arising out of the transaction will be cancelled. If you cancel, you must make available to the Contractor at your residence, in substantially as good condition as when received, any goods delivered to you under this agreement; or you may, if you wish, comply with the instructions of the Contractor regarding the return shipment of the goods at the Contractor's expense and risk. If you do make the goods available to the Contractor and the Contractor does not pick them up within twenty days of the date of your notice of cancellation, you may retain or dispose of the goods without any further obligation. If you fail to make goods available to the Contractor, or if you agree to return the goods to the Contractor and fail to do so, then you remain liable for performance of all obligations under the agreement. To cancel this transaction, mail or deliver a signed and dated copy of this Notice of Cancellation or any other written notice, or send a telegram to at (NAME OF CONTRACTOR) (ADDRESS OF CONTRACT'OR'S PLACE OF BUSINESS) NOT LATER THAN MIDNIGHT OF I HEREBY CANCEL THIS TRANSACTION. (DATE) (OWNER'S SIGNATURE) (DATE) (OWNER'S ADDRESS) [Two copies of this form to be attached to the Residential Contracting Agreement] H - GG 25M 6/92 C/) M m Cl) 0 m _0 CAlb S7 CO) CD n Z CO) C -* O F• r c CL c O y C.) CD Q� O �f cr d CD CCD o CSD ov o0 c CDCl y� CD O y co CD I v CO) O 1 Z O O .nt O CD O CD Wit C O C ?� O 0 --IO S d G. Cm O G OC x CO) w to C � CDL. O C OG a- r, n 9 p w N m '' ?p �� H m p- ",L7 p C .-0 n CS m 'rl O O a x ^ x rD O O x y E� 0-90 w 0 O 1 O O N a 0 C'R = rF O O N !7 O .� N =ap act d..►� W O N ag: C. Ica 0 co ?: CL 0 C CO Ot O C O C d N N ; m d H -f CD wT�C 00 m o:0 �o tCAo' m C° o CD N .nT CD a _C: m o CLte: nn .rt_ c CD :dW C) O ro U rD + o Oy p m d p w O G OC x O rA M y w � O C OG a- r, n 9 p w O C a- r co M ►C)°3 w p- ",L7 p C 'r1 O C a QJ dCD c y Cn U C N 'rl O O a x ^ x rD O O x y E� C z ' 0 0 c 10 o • ' Date.... ... J t, J r TOWN OF NORTH ANDOVER 0. p PERMIT FOR WIRING This certifies that Iju ` ( f ��f T" ............................................................................................. has permission to perform.......�% / �f./ r (7 wiring in the building of ........... .......................... at ................... ............... .. �', North Andover, Massy Fee .5... v... Lic. Na����7% : ...`..�... ELECTRICAL INSPECTOR Check #_L�_ WHITE: Applicant CANARY: Building Dept. PINK: Treasurer J"IL LRAM l AVrrJ;e1GJJJ vi' 10 DEPARTMIATOFPUBLICSAFM Permit No. BOARD OFFIREPREVEWONRWUTATIO/ N527CMR12:Q0 UVAA Occupancy &Fees Checked PPUCATTONFOR 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 //— ,q— D Town of North Andover The undersigned avvlies for a permit to verform the electrical work described below. Location (Street 6 Owner or Tenant To the Inspector of Wires: Owner's Address Is this permit in conjunction with a building permit: Yes©(Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service 2 Amps/dVolts Overhead � Underground Q New Service +� Amps Volts Overhead M Underground M No. of Meters No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work bJ lVe 01— ',7, S 4cf d ��Sege4 r r No.bfLighting Outlets No. of Hot Tubs No. of Transformers Total I KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA ground ED ground M No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW Connections a No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP WotkbSut hW=D*Re jested sigt�edtaxla'�ieP�altiesofp�jt»��/i`{�S C FIRM NAME ftffie) a? aJ- Expiatim Dale EsiQrtatedVahteofUachxal Wak $ Rough // Q .__ Final y�w < U=wNa Z23 3 7A Ltomsee (% / r/ � /7 / �iir ���. r Signm Ltff lseNo 9,75- 3-25-,F/95- AIL 7s,F/SS AIL Td Na OWNER'SDgSURANCEWAVER;IamawmdattheL+m>sedmW$tectstraneaov orirssubstar>5alegtm>aiartasratltmadbyMassadxse�sG3taalLaws anddvtmysignatts cnftpmnitappfirabon #mmw'mlat< (Please check one) Owner M Agent Telephone No. PERMIT FEE $ 7,S_ Date.... ��....�..... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that.. /.!' U .- : V. C ........ / ... .. ........... . has permission for gas installation ..... i. < < .l'. 1.:.. C " ' in the buildings of .. ? . �'. �. { . <. ! .............................. at�...`.. ....!!......, North Andover, Mass, Feel �. � .. Lic. No.. % . ...... ..........::. J .......... . GASINSPECTOR Check # 3%-7 MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTIN (Type or print) ` 11 / Date 10116101 NORTH ANDOVER, MASSACHUSETTS UTWO � 1 II G • New ❑ Renovation 10 Replacement ❑ Permit # 3 7�7 , "Idl �"► c . .Li Plans Submitted ❑ (Print or We) n` 3 ���h one: Certificate Installing Company Name nrJwls��Q.�t9�e►.elZ `',UJ Corp. ❑ Partner. ❑ Finn/Co. Name of Licensed Plumber or Gas Fitter 7(, Wl q "c�' INSURANCE COVERAGE I have a current liability Insurance policy or it's substantial equivalent. Yes No ❑ If you have checked yes, please ' di the type coverage by checking the appropriate b . 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 otthe details and information 1 have best of my knowledge and that all plumbing work and instal compliance with all pertinent provisions of the Massachusel City/Town VED (OFFICE USE ONLY) (or entered) in above application are true and accurate to the 7sed under Permit Issued for this application will be in ode and Chapter 142 of the General Laws. Signature of Licensed Plumber Or Gas Fitter ❑ Plumber Zq�2� ❑ Gas Fitter License Number Master Journeyman - (Print or We) n` 3 ���h one: Certificate Installing Company Name nrJwls��Q.�t9�e►.elZ `',UJ Corp. ❑ Partner. ❑ Finn/Co. Name of Licensed Plumber or Gas Fitter 7(, Wl q "c�' INSURANCE COVERAGE I have a current liability Insurance policy or it's substantial equivalent. Yes No ❑ If you have checked yes, please ' di the type coverage by checking the appropriate b . 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 otthe details and information 1 have best of my knowledge and that all plumbing work and instal compliance with all pertinent provisions of the Massachusel City/Town VED (OFFICE USE ONLY) (or entered) in above application are true and accurate to the 7sed under Permit Issued for this application will be in ode and Chapter 142 of the General Laws. Signature of Licensed Plumber Or Gas Fitter ❑ Plumber Zq�2� ❑ Gas Fitter License Number Master Journeyman NORTq i? �.',� . • of 0 9 SSACMUS� This certifies that DateA� : � TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING I' /)?G (/, ,fie- /' /' /,' /7 ........................................... has permission to perform .... 1e.jr.............................. plumbing in the buildings of ... .......`................... . at .. !. �C ../� ` :1 �`�� : �s.. �.� �.'... , North Andover, Mass. C, Fee. f � .. Lic. No.. /.`� L . �. ...............!. 33 PLUMBING INSPECTOR Check # •� C r A9on MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date J (� Building Location�(p(7 (�� � �`� C`ZC Owners Name1S _ jt/(' �V�, j*&ermit # C Amount �� l n ' 7 � u l ] \ �� �� � �4�� Type of Occupancy New R Renovation 11 Replacement 1:1 Plans Submitted Yes 1:1 No FIXT11�RES N��������� (Print or type) _Check one: Certificate Installing Company Namea'wu\ <C,p,�('y�c�CZ . w►�� , -�Q ❑ Corp. Address Q Chr� Q, 2\N El Partner. Q. r\� Business Te ep one �f12; 9911 Z 1 1 Finn/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 0, Other type of indemnity ❑ Bond ❑ Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner 1:1 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 insjtts�tetmbing rformed under Permit Issued for this application will be in compliance with all pertinent provisions of the MassachuCode and Chapter 142 of the General Laws. By: 77—gnature 07 LICCnSe(Ium er Ty e of Plumbing License Title City/Town icense MOW Master ElJourneyman APPROVED (OFFICE USE ONLY of 4e Cn11mmoUMEU4 of Amsu> aftts ltpartmtat of IlabUr OtIIftttj BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Office Use OnlIV3r Permit No. `Aw Occupancy A Fee Checked 3/90 peave blank) le APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Qo* or Town of NORTH ANDOVER - To the Inspector of Wires: The udersigned applies for a pe/rmit to perform the electrical work described below. / Location (Street & Number) n,,, 3 3 y ay&rj Owner or Tenant z2x Wu)o I .b�Al Owner's Address i33 1,�,t41, a, Is this permit in conjunction with a. building permit: Yes � No ❑ (Check Appropriate Box) Purpose of Building Sih,qlB ���1% Utility%Authorization No. Existing Service Amos —J Volts Overhead ❑ Undgrnd �[ No. of Meters New Service a (AQ Amps (.2L_)J9 YO Volts Overhead Undgrnd UC No. of Meters Number of Feeders and Ampacity Locaticn and Nature of Proposed Electrical Work ew Owe -M1142 /00 u-I'tLe7,S No. of Lichnng Cutlets I No. of Hot .ubs I No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pcoi Above.— in- gyne. -_grnd. �! Generators KVA No. of Emergency Lighting No. of Receotacie Cutlets I No. of Oil turners I Battery Units No. of Switch Outlets I No. of Gas Burners FIRE ALARMS No. of Zones / No. of Air Cana. Total No. of Detection and No. of Ranges I tons Initiating Devices No. of Disoosais I No.of Heat Total Humes TononTotal Tons KW No. of Souneing Devices No. of Self Contained No. of Dishwashers / I SPaceiArea Heating KW Oetac;toroSounding Devices 11 No. of Dryers I Heating Devices KW Local _ Connec:1 n ecti Other on No. of No. of Low Voitage No. of `Nater Heaters KW I Signs Ballasts Wiring No. Hyero Massage Tubs I No. of Motcrs Total HP OTHER: INSURANCE CCVERAGEE: Pursuant to the recutrements of Massacnuserts general Laws , / I have a current Liability Insurance Policy inciueing Comoi c Ceerations Coverage or its substantial equivaient. YES L� NO = I have submtrted valid Proof of same to the Office. YES VNO = It you have checkee YES. please inoicate the type of coverage by CheCKing the appr prate box. INSURANCE J BOND = OTHER = (Please Scec:fy) (Expiration Datel Estimateo Value of E!ectrical Work S Worx to Start Inseec::on Oate Recuestea: Rough /A% 1 Final Signet undeLIC. NO. r t e PePenaltiess of p rrl FIRM NAME J L1L_ Licensee rr c La,a. r�.� r Sig nature LIC. NO. o Bus. Tel. No. (� L Address �% lyQ.r>7n shin e `t -Vel l // r All. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee cces not have the insurance coverage or its substantial eeuivaient as re- quire' by Massachusetts General Laws. and that my signature on anis permit application waives this requirement. Owner Agent (Please checK one),-�,t( Teleonone No. PERMIT FEE S " ` (Signature of Owner or Agent) x -55e5 s F' 2694 NQRTH Qf ,�Eo .a,ti0 0 � p • s Date..... 0 TOWN OF NORTHANDOVER PERMIT FOR I= INSTALLATIONA Ln t tt 1 U This certifies that L --- Q._w.. we �Q has permission for hinstallation . in the buildings ............ . at . .. !-N.0. *ty 14." ... , North Andover, Mass. Fee.3916 .. Lic. No.)/ � . INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File