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Miscellaneous - 177 GREAT POND ROAD 4/30/2018
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E 5 R O ƒ-0\/ 4- 0- k w E o o ,. E 2 / 9 O ƒ ƒ / _C \ o o % / 0 7 LL = c / 4» 4 2-0 0 2- m�\ Eƒ > = c 0\ w 0 LL ? / �_ \ / \ / M Q- \ > § ± p Z 6 m R/ F '� c m@ m� � 3 U 0 3 7 0 0 2 3/ m F\\ y/ E» E E § 2 / ƒ 0 / k : / § � -a E - � 2 / : LL / co � £ m 2 » 41 m 3 s V) m 3 0 \ Date..�U. .� ,�(�......... NORTH py' ao ,e,ti O TOWN OF NORTH ANDOVER D PERMIT FOR GAS INSTALLATION This certifies that . AM. !/-n G�E,k .. . VA11.. ....... has permission for gas installation ... . �t4- ....... in the buildings of .. .9, A r4 . .......................... at .../.? .I ...pd.e.i ........ , North Andover . Mass. Fee.,) Lic. No. I �IeJ44--111' X. GAS INSPECTOR Check # FIXTURES ` MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING City/Town: rU A00L 'Z MA. Date: /O i Permit# Y Building Location: 177 4�g&i9% 14' y,,4 /40 Owners Name: /,rt Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residentiale Ui New: ❑ Alteration: ❑ Renovation: ❑ Replacement: Plans Submitted: Yes ❑ No FIXTURES ` U) Z W Y tri H Ui !—W W O U 0 U) = W m= W W 0 m W N O W W z 1— NW Q W z gmO a H CI O RO F' W >W U w�I% W ozWz WW = O W F- = LL a, > 0 W Z z W >. W (7 J to 1— Q H 0 Q m z J OtL W O z 0~ m W W �' H W v o o 0 0 z z 0 a. I WW >>> 0 SUB BSMT. BASEMENT 1 FLOOR 2 FLOOR 3 KuFLOOR 4 FLOOR 5 FLOOR 6 FLOOR 7 FLOOR 8 FLOOR Check One Only Certificate # Installing Com any Name: r Q �fj orporation Address- � �?, #—� City/Town: / / State:19 El Partnership P�' Business Tel: ! �� 0 % - ,� y Fax: 7-[c> c ❑ Firm/Company Name of Licensed Plumber/Gas Fitter: INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YeSX No ❑ If you have checked Yes, please to the type of coverage by checking the appropriate box below. A liability insurance policy indi 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Aaent tsy cnecKmg tms oox Ll; i nereoy cenity tnat an of the oetaus ano mrormation i nave suom,pjea for enterec accurate to the best of my Knowledge and that all plumbing work and installations perfor d under the pe compliance with all Pertinent provision of the Massachusetts State Plumbing Code and y(teh142 of the By Title of License: Fitter S City/Town Ll.lourneyman License Num APPROVED (OFFICE USE ONLY) ❑ LP Installer this application are true and for this application will be in City/Town:. Plumbing & Gas Inspector: Date: I 045'11,6 �`7,El would like to cancel permit # For the installation of In my home/address 177 Climate Designs, LLC has completed the installation under the existing permit. Work to be completed under the new permit will be the final inspection. Sincerely, Date.�G�1.. //() 87� "oR.M TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that .jig/%' /..... A !.�.... has permission to perform ..or..i.......................... plumbing in the buildings of ... ... ..�.i Andover, �.77 N ... .... , NortlYlass at Fee . .SCS . Lic. No.., .41. a . ...... 4-.. .�� PLUMBING INSPECTOR Check # FIXTURES ,. MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING a City/Town: X/d/,t 4e— MA. Date: Permit# s Building Location:// -7 4,e16 i�t,3 Owners Name: Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential New: ❑ Alteration: ❑ Renovation: ❑ Replacement: P� Plans Submitted: Yes ❑ No FIXTURES ,. DEDICATED SYSTEMS Z Z W W H Y Q } J V) U HW G Z C Ln a y N V1 C Z Y 2 w N Q W Q Ca N Z L Q N H W Q H W Q QZ 3 o N m H C > 4n W O Q Z OC v~f y = = = Z 0 S X H v1 Z U a LL = J 3 cis 3 0 LL 3 O 3 = O 0 O O w G 0 d J Q = W w �' Z Z VI F F = O w G W H W u a H Q S a H u D H N 0 O F- 'c 5 � 0 O Z g a iY Q Q Q H 3 3 3 H <&A u a C OC 0 W Q 3 a m m o LL x Y u, i- o SUB BSMT. BASEMENT 1s FLOOR ?'FLOOR 3R FLOOR 4T" FLOOR ST" FLOOR 6T FLOOR 7T" FLOOR T" FLOOR Check One Only Certificate # Installing Comp ny Name: ACorporationO f Address: City/Town: State: k/1 Partnership El9Z?--685?— } / Business Tel: � � L"y� � Fax: �7 Z? - 685 — 0c2[ & ❑ Firm/Company Name of Licensed Plumber:jo�m 9 0� i INSURANCE COVERAGE: 71 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YeskNo ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy K 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Sianature of Owner or Owner's Aaent 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 pertormeo unaer the permit issue Tor ims app"catuon wm o in compliance vnu1 du Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the eral,$aws. By Title ty/Town .PPROVED (OFFICE USE Type of License: Sicintifure"of IA6nsed Pltkfter License Number: 75sU Date. �f pf „ao ,°,ti0 o? TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTA TION �SSAruuSEth This certifies that ... ..... . has permission for gas installation ..-P. .0 .................... in the buildings of ....�./?.�. Cl.. at .. .2.^% . C. P CA :{ . North Andover, Mass. Fee.. 3 U Lic. No.. Check # _ .3 f..,. .......... GAS INSPECTOR P PlYTI IRFC W W Lu Lu MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING N City/Town• 1D MA. Date.. � � Q�'a Permit# '-)c` �7C""�"�ON� \�y>, Owners Name:yC Building Location: Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential New: ❑ Alteration: ❑ Renovation --�R Replacement: ❑ Plans Submitted: Yes ❑ No -L PlYTI IRFC W W Lu Lu N F- m= W V J 0 U) ~ = O 0>. Q' ~ fn 0 2 w IY 0 W w N g v z w m 0 w a O H w X w F- o= LL V z W} 05 w W Z J H W N- Q z a = 1- O z -I 0 Q m W O Z w 0~ N W W Ir W W z I- 0 a 0 t=i 0 0= x O a W H>>> O SUB BSMT. BASEMENT 1 FLOOR 2 Nu FLOOR -3 'FLOOR V FLOOR -5 'FLOOR 6 FLOOR -i 'FLOOR -i 'FLOOR Installing Company Nam,\�c� Check One Only Certificate # �Q -\ `-z ` �� v S ^,� Corporation Address. l.�-'� City/Town: `` State:\'l '1"7�-���b �� , q- (3\ cta3 El Partnership Business T�� Fa �� 3 'Asd ❑ Firm/Company Name of Licensed Plumber/Gas Fitter: 4 ,*,- 3 �4 INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes N No ❑ If you have checked Yes,pl se indicate the type of coverage by checking the appropriate box below. A 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner El Agent E]Signature of Owner or Owner's Aaent By checking this box ❑; 1 hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and accurate to the nest of my Knowleage ana tnat 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 Chapter 142 of the General Laws. By Type of License: , ❑ Plumber .t.►.. Title Gas Fitter Signature of Lice4ed PI er/Gas Fitter Master City/Town ❑Journeyman License Number: APPROVED OFFICE USE ONLY ❑ LP Installer (01 Date.:..... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION y This certifies that ............... ... J' ! .. `'. j.. � •ip/ has permission for gas installation ....... in the buildings of/..:.. A � r at .177 ' ` ��r,rl/ North Andover, Mass. Fee-.. Lic. No�,�.:.. .. GAS INSPECTOR Check # �a / 595 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) _rn 71 Cin �.r!dGy/-"n Mass. Date 16=t3 4 7 Permit # /� Building Location /% h%d % df O ner's Name,/--,/- /! (r ft— / YPe of Occupancy v�'�,r,,C' /'/�.�j• �j�cry� New ❑ Renovation ❑ i Replace me Plans Submitted: Yes❑ No ❑ CLIMATE DESIGN HEATING and AIR CONDITI ONING, LI -C. -istalling 5 South Summer Street address Bradford, MA 01835" 9.78-372-9999 (phone) 978-372-0882 (fax) lusiness Telephone Lic. Plumber:h ti �•%S� SGL Jame or Licensed Plumber or Gas Titter Check one: Certiiicate "Corporation Partnership _ Firm/Co. 1ANCE C VERACE: a current liability insurance policy or its substantial. equivalent which meets the requirements of MGL Ch. 142. Yes A No G have the ked yet. please indicate the type coverage by checking the appropriate box. lity insurance policy Other type of indemnity ❑ . ■ :R'S INSURANCE WAIVER: 1 am aware that the licensee does not have the Insurance coverage required by :r 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owners Agent ❑ re of Owner or Owners Agent certity that all of the details and information I have.submitted (or entered) in above application are true and accurate io the best of rn ge and that.aJl plumbing .work and installationspertormed under the perm issued for this application will be in cbmplirnc.3'�rith all t provisions of the Massachusetts Stale Gas Code and Chapter.i42.oI th. eneral-Lay T oi.License - ' Plumber na ure Lic ..sed Plum r or Gas Fitter Gashher Masten Li cense. Number �`1 /��j�G vn .}ournayman 'ED (OFFICE USE ONLY( 9 N w ui Y Z ¢ tn N U Z N 2 in ¢ O O N = F W J N. W O U m f" _ tn O C Z O u a ¢¢ O a = w• ¢ M N W 1- < y _ W = Oa N O C a > N ¢ N W C7 Z V = ¢ W Q C yj �' W 1. W Z N tL [� W W J � ~ W !- V N > = LL O H Z V J O W S 4 < C } m . 11A ¢ O J u C > D a F- o s;'uB'-3s MT. BASEMENT / IST FLOOR 2ND FLOOR 3RD FLOOR I 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR _LL CLIMATE DESIGN HEATING and AIR CONDITI ONING, LI -C. -istalling 5 South Summer Street address Bradford, MA 01835" 9.78-372-9999 (phone) 978-372-0882 (fax) lusiness Telephone Lic. Plumber:h ti �•%S� SGL Jame or Licensed Plumber or Gas Titter Check one: Certiiicate "Corporation Partnership _ Firm/Co. 1ANCE C VERACE: a current liability insurance policy or its substantial. equivalent which meets the requirements of MGL Ch. 142. Yes A No G have the ked yet. please indicate the type coverage by checking the appropriate box. lity insurance policy Other type of indemnity ❑ . ■ :R'S INSURANCE WAIVER: 1 am aware that the licensee does not have the Insurance coverage required by :r 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owners Agent ❑ re of Owner or Owners Agent certity that all of the details and information I have.submitted (or entered) in above application are true and accurate io the best of rn ge and that.aJl plumbing .work and installationspertormed under the perm issued for this application will be in cbmplirnc.3'�rith all t provisions of the Massachusetts Stale Gas Code and Chapter.i42.oI th. eneral-Lay T oi.License - ' Plumber na ure Lic ..sed Plum r or Gas Fitter Gashher Masten Li cense. Number �`1 /��j�G vn .}ournayman 'ED (OFFICE USE ONLY( 9 IN Date ...... TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING. This certifies that has permission to perform ....... ........................... plumbing in the buildings of— ....................... at ./.% ...... ....... North Andover, Mass. . Fee-.: ...... Lic. No.Ple?*d. A.I Q- ............. INSPECTOR PLUMBIN Check # 7-295-1---�� C pf r E�� Do ►ire Z I'>It �Ity Ems- _a �' C� k O e�:dl'gi(cf�e�� IX ,N } L E z e0 �. E t2 Z '' C7 l cn - Z w i�- .? v, � X i Fd- en � j � 11 tY G � 2 ; � 0 � A C `- € W i�(G:e C.-`.,. .'-:{til(; E:✓%l: . >S�k- r'l No SAS EMENT E2?4D FLOOR FLOOR FLOOR i STH FLOOR aTH FLOOR' TH FL:jOEt Installin CLIMATE DESIGN HEATING and AIR CONDITIO Installing Company Name 5 South Summer Street NTNG, LLC Addr Bradford,. MA 01835 Check one: Lertiricate 978-372-9999 hone Corporation_. 978-372-0882 (fax)-----�= Susi ss Tele hone '- - ^ Partnership p Litr. Plumber. J + '4ame of Licensed Plumber IRS. RANCE COVERAGE: — -- I have a cut ent liability iftsurince PO4Cy Or Its zubstantaea_kralet v.,hich M -Yes the requirements of EJ,GL ti YOU Mvr_ checker es. �- 142. please t lc to � tyPe coverage by ctlecking the appropriate ko- A habiliry insurance policy Other type of Indemnity ❑ Q --A n fvStlRA.'4CE,AER: B arr, Fare ulat the iicarnsee does not have ffZ= Irtsuranc� cevera0e Ie�ulrtrrJ by . Q1aP'f--r 142 of h;n Cbtass. uenerl Laws. gn-a titai my Ylgnat�tre ®n this p�rmit appllc tic�n Waives this requirement. Check one: y+pnature of Groner or- yner's rfigent OOwner p agent [) c e o-mley cwr'�afy t t X11 of �s details and rota„ j Lion t tmija sut)rr;BVLbd lot ®nteredi in above __-- knoa�ffidg® mnd that alf plumbing work and insWI application are Wtinent prm inions of the 1 pVdo �+nder U�€° xKme+t istltsd for this ,.� and ,hate. to Rhe b-cst of my 3s. y setts Sfat6 ;n u tb :g G a a r t�2 of 4, Ig Ganeral �`pirvon veil ba in cmmpiiarc*a rArih ktl na4ure of sed.. 'urr.,be T}ra ��f:t_ieerlsa: Ifastart Jc�urne m;J (� P� r'RFI )NL pf E�� ►ire Z I'>It �Ity Ems- _a �' C� k O e�:dl'gi(cf�e�� IX ,N } L E z e0 �. E t2 Z '' C7 l cn - Z w i�- .? v, � X i Fd- en � j � 11 tY G � 2 ; � 0 � A C Installin CLIMATE DESIGN HEATING and AIR CONDITIO Installing Company Name 5 South Summer Street NTNG, LLC Addr Bradford,. MA 01835 Check one: Lertiricate 978-372-9999 hone Corporation_. 978-372-0882 (fax)-----�= Susi ss Tele hone '- - ^ Partnership p Litr. Plumber. J + '4ame of Licensed Plumber IRS. RANCE COVERAGE: — -- I have a cut ent liability iftsurince PO4Cy Or Its zubstantaea_kralet v.,hich M -Yes the requirements of EJ,GL ti YOU Mvr_ checker es. �- 142. please t lc to � tyPe coverage by ctlecking the appropriate ko- A habiliry insurance policy Other type of Indemnity ❑ Q --A n fvStlRA.'4CE,AER: B arr, Fare ulat the iicarnsee does not have ffZ= Irtsuranc� cevera0e Ie�ulrtrrJ by . Q1aP'f--r 142 of h;n Cbtass. uenerl Laws. gn-a titai my Ylgnat�tre ®n this p�rmit appllc tic�n Waives this requirement. Check one: y+pnature of Groner or- yner's rfigent OOwner p agent [) c e o-mley cwr'�afy t t X11 of �s details and rota„ j Lion t tmija sut)rr;BVLbd lot ®nteredi in above __-- knoa�ffidg® mnd that alf plumbing work and insWI application are Wtinent prm inions of the 1 pVdo �+nder U�€° xKme+t istltsd for this ,.� and ,hate. to Rhe b-cst of my 3s. y setts Sfat6 ;n u tb :g G a a r t�2 of 4, Ig Ganeral �`pirvon veil ba in cmmpiiarc*a rArih ktl na4ure of sed.. 'urr.,be T}ra ��f:t_ieerlsa: Ifastart Jc�urne m;J (� P� r'RFI )NL Page 1 of 1 L DeCola, Jimmy From: McEvoy, Jeannine Sent: Friday, March 26, 2004 1:23 PM To: DeCola, Jimmy; Diozzi, Jimmy Jim, I received a call from Dr. Ehrig who lives at 177 Great Pond Rd on Friday. He requested with great insistance, that both Electrical and Plumbing inspectors meet him on Wed morning on site to look at the work done. He claims that the work is not to code and is pursuing legal action against the contractor. He also will file a complaint with the state towards the inspectors. He wanted me to reach you today (Friday) so he could talk with you. I told him that he could call on Monday morning between your office hours. I have the file in DeCola's box for your review. His cell number is 978-314-5658, office number 978-373-7666. Good luck, he would not take no for an answer. R Jeannine McEvoy Building Department 27 Charles Street 978-688-9545 978-688-9542 FAX 3/29/04 G�- < Town of North Andover , HORTFt Office of the Zoning Board of PAppeals F? •`�' p" Community Development and Services Division 27 Charles Street " °+ •° North Andover, Massachusetts 01845 ' sSACHUSEt D. Robert Nicetta Telephone (978) 688-9541 Building Commissioner Fax (978) 688-9542 FAX TRANSMISSION TO: FAX NUMBER: FROM: Town of North Andover Zoning Board of Appeals 27 Charles Street North Andover, Massachusetts 01845 FAX: 978-688-9542 PHONE: 978-688-9541 NUMBER OF PAGES: J DATE: ` SUBJECT: C>1�n1 ofp-,'Uorf REMARKS: Board of Appeals 978-688-9541 Building 978-688-9545 Conservation 978-688-9530 Health 978-688-9540 Planning 978-688-9535 'Q Date. -3 .......... TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING -TS US This certifies that ...... .... ............. has permission to perform .................. plumbing in the bUildings of-.-. at. . North Andover, Mass. , ?/ . �.'w ............. Fee./k,".. Lic. No.,.,,,,. P � TOR Check # 5539 aS�l. MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) /j�(/ , Z A/40" r/A/Q�(/ _, Mass. Date O(� -tg&3 Permit # J - ✓? Building Locatior/!% 6*W?d MO 1249• Owner's Name/lfi?f144C New ❑ Renovation 110 Replacement ❑ FIXTURES Type of Occupancy Plans Submitted V Installing Company NameQe&Ao/ Aq!j CO. rNG. Address 1213 L)*6e1L�6g ST. Business Telephone /—am Name of Licensed Plumber Zi 2d ��9S�vAa�� PA& . Check one: Certificate Corporation 1 ❑ Partnership ❑ Firm/Co. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes )C No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A 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 under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing6 Code and Chap, r 142 olthe General Laws. By Signature of UCenSed lumber Title City/Town Type of License: Master jj� Journeyman ❑ APPROVED (OFFICE USE ONLY) Ucense Number_ /0,0198 y� NONE rrrrrrrr:rrri MEN rr:r0� - ... nr.��jrnr.�i�rnrrrrrrrrarrrarrrri ••• rrrrrrrrrrrrrrrrrrrrrrrrrr� ... rrrrrrrrrrrrrrrrrrrrrrrrrr � .. rrrrrrrrrrrrrrrrrrrrrrrrr rrrrrrr rr■ ■nrrrrrrrrrrrrr MUL.. ... ■rrrr rrr rrrrrrrrrr■ ■rrr My ••�rrrrr rrrrrrrrrrrrrrr rrrr ••-rrrrrrMrrrrrrrrrr�r•rr rrrr Installing Company NameQe&Ao/ Aq!j CO. rNG. Address 1213 L)*6e1L�6g ST. Business Telephone /—am Name of Licensed Plumber Zi 2d ��9S�vAa�� PA& . Check one: Certificate Corporation 1 ❑ Partnership ❑ Firm/Co. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes )C No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A 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 under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing6 Code and Chap, r 142 olthe General Laws. By Signature of UCenSed lumber Title City/Town Type of License: Master jj� Journeyman ❑ APPROVED (OFFICE USE ONLY) Ucense Number_ /0,0198 y� } J z O w N w U LL LL O a O LL 3 O J w m N w U h LU Y V) N Z O H U w C. V) z J Q Z LL .i' O � Z a w z h z 0 Q O J_ Z 0 0 h f. U. d a O. m w w a O } h o ,. w m w Q � a o z J a a w h z Q a 0 w h f. � d a w a N Date . .......6.... 3 ...... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION X11 This certifies that has permission for gas installation ... .......................... in the buildings of ......................... at North Andover, Mass. Feja��-9�. Lic. No.. Check # 4310 36 7 3{ MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TOrD® GASFITTING � . qT�„�•� (Print or Type),—� ,Mass. Dateo 19 ,Permit # Building Locationip' iT � /0- Owners NamP/y%/�sf Type of Occupancy New ❑ Renovation Replacement ❑ Plans Submitted: Yes❑ No& Installing Company NameMprOpJPAJ IOAN Address ♦� LUMLLE 09W- 6L9 -A2! Business Telephone Name of Licensed Plumber or Gas Fitter Check one: Certificate Corporatior ❑ Partnership ❑ Firm/Co. INSURANCE COVERAGE: I have a curr nt liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy X 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 ED I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General taws. . By _ T e of License: 60 Plumber Sigbature of Uconsed Plumber or G Fitter Title_ — Gasfitter aster License Number Cit /Town � APPROVED.(FFICE USE ONLYf Journe �nan N N W W U1 N 0 Y U "Z 0: yj vJ W rL W N 0 X O O U Z M 0 = . (� Z J O W W W r ►- <Cc Z o, 0 a X ca w W ►- a W O r a r a 0 X W Z U W = 0 W a rr O0 a > F- _ C7 ►- X F Z F W W O O > U. H U J ��. W z a. a w LU > rr a w c_ z< ►- >- a.4 �, Q a Z o o o. - w` a o cz o au x r a .0 c2 Y U. '3 o c9 'J U a> o a F- O SUB-8SMT. BASEMENT 1ST FLOOR 2ND FLOOR . 3RD FLOOR 4TH FLOOR s 5TH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company NameMprOpJPAJ IOAN Address ♦� LUMLLE 09W- 6L9 -A2! Business Telephone Name of Licensed Plumber or Gas Fitter Check one: Certificate Corporatior ❑ Partnership ❑ Firm/Co. INSURANCE COVERAGE: I have a curr nt liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy X 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 ED I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General taws. . By _ T e of License: 60 Plumber Sigbature of Uconsed Plumber or G Fitter Title_ — Gasfitter aster License Number Cit /Town � APPROVED.(FFICE USE ONLYf Journe �nan y rn . • s m y . 9 m A = -+ v r A r0 1�� g -C z' A . -o a -I -4 X o T O n m c Z rn �. '• D z r O '! '• s1 = s 1 � t A 1 r Date. / -7.a :. G i7 ........ TOWN OF NORTH ANDOVER A • PERMIT FOR GAS INSTALLATION This certifies that .C,... . ( I/' -x. �� ..................... . has permission for gas installation.. .'�. �.... �. . ............ in the buildings of .. ��i.i .. ....... ................... . at../.. ?...� ,�' �.!°. Z .,7. r . r!...North Andover, Mass. 1 Fee. X14: J.. Lic. No...3. /GAS INSPECTOR Check # / `/G C j- ✓ 426" MASSACHUSETTS UNIFORM APPUCATON FOR PERAHr TO DO GAS FITTING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date % Oat -d 3 Building Locations /27 6,Qeq -r RW A,1/b �d °d Permit # Amount $ Owner's Name C � 4 New ❑ Renovation ❑ Replacement El Plans Submitted ❑ (Print or one: Certificate Installing Company Corp. ❑ Partner. ❑ Fkm/Co. Name of Licensed Plumber or Gas Fitter 7dseA eQ Ayk.-,�j INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes M No ❑ If you have checked m please indicate the type overage 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 ofthe Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner 0 Agent ❑ t hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions ofthe Massachusetts State Gay Code and Chapter 142 offhe General Laws. (OFFICE USE ONLY) Vgnature of Licensed Plumber Or Gas Fitter ❑ Plumber If _ 3 Za ❑ Gas Fitter License Number Master ❑ Journeyman wwwwwwwwwwwwwwwwwiwwwwi wwww�wwwwwwwwwww�wiwwww 1ST. FLOOR wwww�wwwwwwwwwww�wwwww 2N L OR wwwwwwwwwwwwwwwwww�wwww i3W FLOOR wwwwwwwww�wwwwwww=ww�wwww wwwwwwwwwwwwww www�ww wiwwwwwwwwwwwwwwww www wwwwwiwwwwwwwwwwwww�www wwwwwiwwwwwwwwwwwwww�w�w� wwwwwwwwww�wwwwwwwwww (Print or one: Certificate Installing Company Corp. ❑ Partner. ❑ Fkm/Co. Name of Licensed Plumber or Gas Fitter 7dseA eQ Ayk.-,�j INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes M No ❑ If you have checked m please indicate the type overage 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 ofthe Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner 0 Agent ❑ t hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions ofthe Massachusetts State Gay Code and Chapter 142 offhe General Laws. (OFFICE USE ONLY) Vgnature of Licensed Plumber Or Gas Fitter ❑ Plumber If _ 3 Za ❑ Gas Fitter License Number Master ❑ Journeyman I Location! No. Date NORTH TOWN OF NORTH ANDOVER Of�t.a .�,h•C .. 9 Certificate of Occupancy $ cHus Building/Frame Permit Fee $ { Foundation Permit Fee $ Other Permit Fee $ TOTAL $v Check # .� S 'A O Ir l ��-- / Bwlding Inspector Is Al' TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVAT'& OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: 3 S w. DATE ISSUED: l - l®-c?0©oZ SIGNATURE: Building Commissiofi&/InMtor of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 12 2 1.3 Zoning Information: 1.2 Assessors Map and 3� c Map Number 1.4 Property Parcel Number Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required I Provide Required I Provided Required Provided 1.7 Water Supply M.G.I-C.40. § 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ 1 Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record ` Name (Print) Address for Service: Signature 2.2 Owner of Record: Name Print Telephone Address for Service: SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: Address Signature Telephone 3.2 Registered Home Improvement Contractor Company Name Address License Number iG -do-03 Expiration Date Not Applicable ❑ Registration Number Expiration Date • r • SECTION 4 - WORKERS COMPENSATION (XG.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 0 Existing Building 0 Repair(s) Alterations(s) ❑ Addition 0 Accessory Bldg. 0 Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: Sc e l 1269 / rLQr 4'q AXL- e" c�r� / SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to befiI�F'ICII, Completed b permit a licant' USS QNLY , 1. Building � �0 Voo • (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee tel X (b) / 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 0 0 - 00 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUII.DING PERMIT 1, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7bOWNER/AUTHORIZED AGENT DECLARATION 1, �1 �r� �y' As Owner/Authorized Agent of subject property V 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 -/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1sT 2 ND 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS 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 r l 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 require ents. 1a S 0 [*****************************APPLICANT *****************************APPLICANT FILLS OUT THIS SECTION***.******************** APPLICANT_ 0010.4 /= /V/(1 6 HONE LOCATION: Assessor's Map Number % �'owplffi A-AA-- rZ,/ &7 -alb RCEL- Z� SUBDIVISION / LOT (S) / STREET Gr'G9 / PDI/ ST. NUMBER_ *****************************************OFFICIAL USE . ONLY*********************************** ER FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH COMM DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTO Revised 9197 im TE WA SW 1)ts-� C4(e-c-k Ty 12/05/01 WED 12:49 FAX 781 397 9270 MAY PERTAIN, THE INSURANCF. AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH ACoRD GER1rIFK."-'A'TE OF L 'RODU0ER (781)3244.4118 F�4X (781)324-7189 The Medallion Insurance Agencies, Inc. 180 Exchange Street P.O. Box 367 Malden, MA 02148 INSURED FCMNH Inc 5 Kelly Lane-. Atkinson, NII 0381:1 MEDALLION DEVINCENTIS 4 001 BILITY INSURANCE DATE szo%oif ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW INSURERS AFFORDING COVERAGE INSURERA: Quaker Special K1SK INSURER B: Boston Insurance Services Inc INSURER C: INSURER D: INSURER It THE POLICIES OF INSURnNCE LIS -'ED BELOW HAVE BEEN ISSUED 1 V I Ht INSURED NAMtU AbUVt 11VK I nr= 1-UL1L T rCRIV V Iwuwni cv. ivv vv., I ---- ANY REQUIREMENT, TERM OR C01401TION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCF. AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE I,1M(TS SH -AWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. PULTUI LTR TYPE OF IN51JRl,NCE POLICY NUMBER DATE (MMIODM') DATE (MMIDDm) LIMITS GENERAL LIABILITY PPGL — e) :E� 11/14/2001 11/14/2002 EACH OCCURRENCE 5 1,000,000 COMMERCIAL GENE SAL LIABIL TY FIRE DAMAGE (Any one fire) $ 50,000 CLAIMS MADE ❑ OCC UR MED EXP (Any one person) $ 5,000 A PERSONAL & ADV INJURY S 1, 000 , 000 GENERAL AGGREGATE S 2,000.000 GEML AGGREGATE LIMIT APPLIES F ER: PRODUCTS - COMPIOP AGG S 1,000,000 POLICY 7j2=1COT 71 U)C AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT S (Es sccident) ANY AUTO BODII.Y INJURY 4 ALL OWNED AUTOS (Per person) SCHEDULED AUTO: BODILY INJURY S HIRED AUTOS (Per accident) NON OWNED AUTO;i PROPERTY DAMAGE S — (Per accident) GARAGE LIABILITY .-. AUTO ONLY - EA ACCIDFNT S ANY AUTO O -MER THAN EA ACC S AUTO ONLY: ACC S EXCESS LIABILITY EACH OCCURRENCE S AGGREGATE S OCCUR CLAIMS MADE l__.J DEDUCTIBLE S RETENTION 16 WORKERS COMPENSAT ON AND (i], 11/14/2001 11/14/2002 TORY LIMITS ER E.L. EACH ACCIDENT' $ 100 , OOO EMPLOYERS' LIABILITY B E.L. DISEASE - EA EMPLOYE -$ 100,000 E L. DISEASE - POLICY LIMIT 1 S 500,0 OTHER DESCRIPTION OF OPERATION 7" CATIONSNEHIC-ES/EXCLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS CEKTIFIGATE MULUtHADOITICNAL INSURED: INSURER LETTER: Dr. Erhiq 177 Great fond R41 N.Andover, MA 01345 =AX: (617)8;'5-7666 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 1Q_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, OUT FAILURE TO MAIL SU08 NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COAANY, ITS AG^ QR REPRESENTATIVES. Hilary Newman North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11,S150A. The debris will be disposed of in: n of l-acillty) Signature of Permit icant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector v BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR { Number: CS , 062017 Birthdate: 04/16/1967 Expires: 04/16/2003 Tr. no: 9178 t Restricted To: 00 FRANCIS L CONNEARNEY 15 EMERALD STREET MEDFORD, MA 02155 Administrator , . AM DEC, INC FAX N0. 781 826 0825 Dec. 20 2001 12:52PM P2 D.E.C., Inc. 720 Washington Street Oxford Building Hanover, MA 02339 6N Rt C, �zCS/pn�C Job No. Shoot No. w/ of Calculated By ZJD Date 12 • �Ci 0 / Checked By Date Scale � �Q' Sa 4. -pot-91 2- ZX12 PT �I N" ex157G V L f/P Tb_ Da /• S� PA�Z�t-LAM P5L . i COLS (SaLip �k O/V) PT ✓D1Sr flA�vGGYCS � L E��-�ZS 7Yp - I Si FL00R FRAMING ( PARTIAL) -,OM DEC,INC 17_F.P_, V XIVlY OY!!UlIl 1� FAX N0. : 781 826 0825 Dec. 20 2001 12:52PM P3 / _ h .Inh Nn bhl/KI (q A E-,)1 JE AJb(—, l.aicutatto uy talo 1— Scale :OM : DEC, INC D.E.q-, Inc. 720 )!Washington Street uxiorn uujining Hanover, MA 02339 FAX NO. 781 826 0825 Dec. 20 2001 12:53PM P4 C D f i Job No. , I'E151DOicle Sheet No. 3 of 3 '— Calculated B �— Y ,....._..�......_ Date 0/' . Chocked By pale Scale 01 Al V ,r A if1R.T�a�_�.� —.:.. r ' '.'...+t Y.:� ..J�... _.-,�.�._ .� _�_..�i„ •t I mow. v� _. � �.., r� 1 -A;` �— I.I....l. ,1 C Q M 1N1 1' R U 1✓ T.J=+_1.. L -� w M MERRIMACK ENGINEERING SERVICES, INC, PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS 66 PARK STREET • ANDOVER, MASSACHUSETTS 01810 • TEL (978)475-3555,373-5721 • FAX (978) 475-1448 • E-MAIL: merreng@aol.com December 24, 2001 Ms. Heidi Griffin Town of North Andover Planning Board 27 Charles Street North Andover, MA 01845 RE: 177 Great Pond Road Map #37C, Parcel #14 Dear Ms. Griffin: Ike I req* eti�,{stn Li 1�IN w vr, r A building permit application is being submitted separately for work to be done on the interior and exterior of the residential dwelling at the subject project site. The exterior work as proposed involves the expansion of the kitchen and to create a deck above this addition, to be accessible from a second floor room. We have met with Mr. Frank Connearney at the site and have reviewed the scope of work with him. He indicated that the roof deck will drain onto the ground below, which is and shall remain a lawn and landscaped area. The contractor is Friel Construction. The site is located the Watershed District, an overlay protection zone. Given all of the above, it is our opinion that the scope of work for this phase of work on the exterior of the existing dwelling shall have no impact upon the adjacent wetlands on properties. We have enclosed site information such as Zoning Map and Assessors Map for your review. Please contact our office should you have any questions or comments. Very truly yours, MERRIMACK ENGINEERING SERVICES Obert C. Daley, P.E. Civil Engineer cd Enclosure cc: Mr. Frank Connearney, Friel Construction 0 E co 0 d Z O O y y .co L- CL 0D C O Q V Q CL CO) 0 .7= COD C O V O V Q CO) C GD QM C CD O .0 m m 'G C c CLCA 3 Lli 0 U) Cl)LLI Ir W Ccw U) w a c� or- c o u2 to oa x U co a w" a 00to o aG G w' a 0 U u w chi ii U to w w w w ° cn cn co 0 d Z O O y y .co L- CL 0D C O Q V Q CL CO) 0 .7= COD C O V O V Q CO) C GD QM C CD O .0 m m 'G C c CLCA 3 Lli 0 U) Cl)LLI Ir W Ccw U) m c �cv � vi O � c N r.+ C O \: OU • d C m C e � w O � I m CS yr y ck� �.IEc Vo m - c0 o om,.. Q L` m c� E O yV m 3 v' z Q7 : O \ y c Q C ' o v.•: E m �E, 9 m oCD S Q cm CD c ((v (0:.E- :.E- c o a. s m o V 02 m C p d cm C Q : y m C m z,,, p O S ~ m y � N r0+ CD Eco mu" o Lw m 0ya - g M0 211 y=o O S �=4-a�m> A co 0 d Z O O y y .co L- CL 0D C O Q V Q CL CO) 0 .7= COD C O V O V Q CO) C GD QM C CD O .0 m m 'G C c CLCA 3 Lli 0 U) Cl)LLI Ir W Ccw U) This certifies that ...... .. .................... has permission for gas installation ............ in the buildings of ...... .......................... at ./'�I/gbrth Andover, Mass, --��.Fee ... Lic. No\-�V.... GAS INSPECT Check # 7 4250 Date Of 4, . 6 .+ � TOWN OF NORTH ANDOVER 0 PERMIT FOR GAS INSTALLATION CHUS This certifies that ...... .. .................... has permission for gas installation ............ in the buildings of ...... .......................... at ./'�I/gbrth Andover, Mass, --��.Fee ... Lic. No\-�V.... GAS INSPECT Check # 7 4250 G MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) nj�gz� ,RVAA\3*,fj— , Mass. Date 20 oa, Permit # Building Location I`4iepc ` AjA ft:t� Owner's Nafne it ICH Telephone 271 L&L6:pg3 Type of ccupancy +46 M— New f9L Renovation EI Replacement 11 Plans Submitted: Yes M NoZ1 Installing Company Name EnergyUSA, Inc. Check one: Certificate Address 500 Myles Standish Blvd. X❑ Corporation 115C Tauton, MA 02780 F1 Partnership Business Telephone 1:1 Firm/Co. Name of Licensed Plumber or Gasfitter William Kent Corson INSURANCE COVERAGE: EnergyUSA has a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL Ch. 142. Yes X❑ No ❑ ,If you have checked yes, please indicate the type of coverage by checking the appropriate box. liability insurance policy X❑ Other type of indemnity M Bond IOWNER'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: Owner n Agent F1 ignature of Owner or Owner's I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Code and Chapter 142 of the General Laws. Type of License: By F] Plumber Title X❑ Gasfitter City/Town XO Master APPROVED (OFFICE USE ONLY) Miourneyman Signature of Licensed Plumber or Gasfitter License Number 3707 1 � • 0 u r Installing Company Name EnergyUSA, Inc. Check one: Certificate Address 500 Myles Standish Blvd. X❑ Corporation 115C Tauton, MA 02780 F1 Partnership Business Telephone 1:1 Firm/Co. Name of Licensed Plumber or Gasfitter William Kent Corson INSURANCE COVERAGE: EnergyUSA has a current liability insurance policy or its substantial equivalent, which meets the requirements of MGL Ch. 142. Yes X❑ No ❑ ,If you have checked yes, please indicate the type of coverage by checking the appropriate box. liability insurance policy X❑ Other type of indemnity M Bond IOWNER'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: Owner n Agent F1 ignature of Owner or Owner's I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Code and Chapter 142 of the General Laws. Type of License: By F] Plumber Title X❑ Gasfitter City/Town XO Master APPROVED (OFFICE USE ONLY) Miourneyman Signature of Licensed Plumber or Gasfitter License Number 3707 J z O w W D w U LL W O w O U. O J W m z O I -- C.) U W d z_ N U) W w 0 O w CL w U F- W Y z O 1- U W a z_ J Q z LL W W U. 1 O z J_ m LL O W a F - ca w Q z 0 _z J D m W O z O a U O J w H Q O O w w m 3 J IL O z U f JCTIONS: S'' /— /6Z -c, qi1 • 96 7X,7Jk- CW d6ACX &- ,e- ,� 'S %�L(.'�1 %Q e /ftle<' 7a Ilo(jse, S�ru�' , �¢L-So A/ i "5 ie PoxI'll, ezy o?o Q)C-- S'i / G /7'r 0/n �it%� QI%/OAC / / ! /l • C'v�tl7k q 7a� G�1��L .S Gm of IFY IN DETAIL, DIRECTIONS TO LOCATION WITH A MAP. DIAGRAM OF HOUSE OR BUILDING AND DRIVEWAY, FROM N STREET. BE SURE TO SHOW TANK LOCATION. W � E T S 1 .leas L�n1� WHITE - SERVICE MAN'S COPY 4 12/99 9�9S �./N& YELLOW - OFFICE COPY (Cf,�.)c,6-- PINK - SALESMAN'S COPY /.1.215 Date .://.. /j.. (. L....... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ............................... J� G has permission to perform .... .:......:......���......................................... wiring in the building;of ....� ✓� ; ............................................. •�`N�o'.a %....n.r �orth Andover Mass. Fee.......... Lic. ........................... ELECTRIC AL INSPECTOR Check # Z' THECOMMONWEA,LTHOFM4SS4CHUSEM office Use only DEPARMHATOFPUBIICS4MY C F 2 rs BOARDOFFIREPREVENT7p1VRE4SUM0NS527CttIRl2.� Permit No. Occupancy &Fees Checked Al'PLICATIONFOR 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 � Owner or Tenant Owner's Address IS this permit In CL Uuuuurg pullirlu Purpose of Building Existing Service Amps i / Volts New Service Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work t i,) No. of Lighting Outlets No. of Lighting Fixtures No. of Receptacle Outlets No. of Switch Outl is No. of Ranges t No. of Disposals No. of Dishwashers No. of Dryers No. of Water Heaters No. Hydro Massage Tubs r es u No " (Check Appropriate Box) © No. of Hot Tubs 0� Swimming Pool Above Q� round No. of Oil Burners 1 KW No. of Gas Burners Utility Authorization No. Overhead LIQ Underground L__j No. of Meters / Overhead Im Underground M No. of Meters f - No. of Air Cond. Total Tons No. of Heat Total _ Pumps Tons Space Area Heating Heating Devices No. of No. of Signs Bailasis No. of Motors Total HP ' No. of Transformers Total KVA Below Generators KVA ground No. of Emergency Lighting Battery Units FIRE ALARMS Total No. of Detection and !:I Initiating Devices No. of Sounding Devices No. of Self Contained Detection/Sounding Devices KW Ial Municipal Connections No. of Zones IDOther��� i [nswmceCOvsagtw Ptz tot6etegtmerria>asOfMassadx�eftsGenaallaws [haw awHaiLiabilityk ancelblicymddTCofr]p ComageorilsakA3l alegtuvakm YES ,NO ubmiwdvalidp000fsammheOffxp- YE © Irciarghe box �.IfyuhawdlcYESpaTidrtyeofo oWW NCE BOND MIER E:] ftmY)ci-��j –w — , � /,,, 7, Volkto Start k1- \ 7 - d 'L Estimated Value ofF�l Wolk $ 1Da�Rt�d Rough igncdunder'&Pbiahiesof Final Il2MNAME 2 1 L Ii=wNo. ioenaee Qigrrahate Lice ws ,b �' S Bi>SincssTel. No. at u t\ WI`IFR'SINSURANCE W Ah Tei No. � F 1 q 3 ` 71 S" AWEII IamawatethattheLiccmdoesnothavetheinsutatmcovera,0coritSsubstantialagurvab tas required dthatmysigaattmcnthispemmapphcaWnwaiveslhisttt�raIt by lu�ttsGet�aalLaws 'lease check one) Owner Agent Telephone No. PERMIT FEE $ Igna re o wner or gen -3565 Date.Z..C'b ...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING TPiscertifies that ............................................................................................. /)", 11� 'e , , /00 Y ' has permission to perform ........... I ....................................................... wiring in the building of ...... ................................................ at ....../.. 22.. ..... North Andover, Mass. ot) . .......... Fee ---"Z5 .............. Lic. No . ............. `.......:../0:...... .. ........... ................. ELECTRICAL INSPECTOR Check # Official Use Only Permit No. '30 '/ 6 mJ 057 A D0411t---t 4;D -P& Shy Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00 (Pleasr� Print in ink or type all information) 8 Town of North Andover The undersigned applies for a permit to perform the electrical work described below. yQ I nr�tinn rClroo# R Ni imhor % / ? 4--r-P A-4 R01: A 20n F'L Owner or Tenant R V IZ S G L Owner's Address SA E Date D Q L Ilk of To the Inspector of Wires: Is this permit in conjunction with a building permit Yes Ar No ❑ (Check Appropriate Box) Purpose of Building zP-S,d e t\ C e_ Utility Authorization No Existiiog Service Amps d Voits Overhead ❑ Undgmd W., New Service Amps Voits Overhead ❑ Undgmd ❑ Numt:6r of Feeders and Ampacity Location and Nature of Proposed Electrical Work 7C ezr L fJ 'qyrN s6e;o No. of Meters _ / No. of Meters OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a Current Liability Insurance Policy including Completed Operations Coverage or its substantial equivale YE - NO = have submitted v lid proof of same to the Office YES= NO = If you have checked YES please indicate the type of coverage by checking the appropriate box. INSURANCE f'BOND = OTHER = (Please Specify) (Expiration Date) Estimated Value of Electrical Work$i aGclo . eo Work to Start Inspection Date Resquested Rough Final Signed under the Pen (ties of,,ppgqryuryq _A / r I _ - FIRM NAME /Y1s' l'30 S /'. 'PGfT ICA- I S�s�#Ms� CIPA O4# LIC. NO. J� L NO.i;64 4-7 Bus. Tel No 7�si_ 3� y ` A // Address 6 y t AA J%40 k :jr ,'� /nN )'l Alt Tel. No. % l - br if 2— OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMITTEE S(=;" (Signature of Owner or Agent) Total----------- - --- No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA Above ❑ In ❑ Ptd. of Lighting Fixtures Swimming Pool grnd ❑ grnd ❑ Generators KVA No. of Emergency Lighting N5 of Receptacles Outlets No. of Oil Burners Battery Units N&f Switch Outlets No of Gas Burners FIRE ALARMS No. of Zone No. of Detection and Total No. of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No. of Dip sal No. Pumps Tons KW No. of Sounding Devices No./ of Self Contained No. of Dishwashers Space rea Heatin KW Detection/Sounding Devices ❑ Municipal ❑ Other No. of Dryers Heating Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW I Signs Bailases Wiring No. Hydro Massage Tuds I No. of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a Current Liability Insurance Policy including Completed Operations Coverage or its substantial equivale YE - NO = have submitted v lid proof of same to the Office YES= NO = If you have checked YES please indicate the type of coverage by checking the appropriate box. INSURANCE f'BOND = OTHER = (Please Specify) (Expiration Date) Estimated Value of Electrical Work$i aGclo . eo Work to Start Inspection Date Resquested Rough Final Signed under the Pen (ties of,,ppgqryuryq _A / r I _ - FIRM NAME /Y1s' l'30 S /'. 'PGfT ICA- I S�s�#Ms� CIPA O4# LIC. NO. J� L NO.i;64 4-7 Bus. Tel No 7�si_ 3� y ` A // Address 6 y t AA J%40 k :jr ,'� /nN )'l Alt Tel. No. % l - br if 2— OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMITTEE S(=;" (Signature of Owner or Agent) 1, T -D T 'Q iX.J a VTVr, ST. �j c �_q 7�� ��; ^2"-- T n t w n 1! O STO IV YIA- - ^ t -- Tr LL.617-a92-50 SAX. 6i?_p?3<7l��iG _ :rps.1gMITTAL SHEET PROM: - yo: Joc Conneamey (..��.. A.... Wit.------ DATS: COMPANY: October 282002 !Own OI ivinw i,avver ' TOTAT. NO. OF PAGES INCLUDING COVER: FAX NUMM' 1-978-688-9542 51*:DrRS pt3F8RRNCE NUMBER: pHONC NUMBER. vtSuA AEFER' 1CII z4UM88R: RE: temnation of electrical contractor © URGENT ❑ FOR REVIEW t] PLEASE COMMENT CS PLBASE REPLY ❑ ?DACE RP•.CYCI.E NOTESICOMMENTS: 6 Mt. DeCdla r please be advised that F.CM. NH is terminating Metro Boston Elec. Sezvices with the existing contract The new contractor of record Z be Tatnagna and Depietro - M*e Tarrlagna w l be in to v e a new permit for the project at 177 Great Pond Rd Please contact me if there anY questions at the .foiiowiag office 1-617-492-5000 ext. 12 oz 617-282-0405 cell. Thank yp14 Joe Connearney Location 0 Cory po -vo ecl N.o. 3 �' Date °�' ' v/ c Ma�T� TOWN OF NORTH ANDOVER 41 � 9 Certificate of Occupancy $ Building/Frame Permit Fee $ 3 SACHUS ` Foundation Permit Fee $ Other Permit Fee $ • TOTAL $ 3 Check # rAS __�_ ,i 5 .' f_ G /!i .��LQ•w� Building Inspector 0 - f ' TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING 7 BUILDING PERMIT NUMBER: ?3a DATE ISSUED:` SIGNATURE: Building Commissioner/Ikspecibr of Buildings Date SECTION i- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 3-? (� i 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 I Provide Required I Provided Required Provided •1.5. Flood Zone Information: 1.8 Sewerage Disposal System: 1.7 Water SupplyM.G.L.C.40. § 54) Public 0 Private ❑ Zone Outside Flood Zone ❑ Municipal 0 On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record ljl)7,; Name (Print) Address for Service 2.2 Owner of Record: Name Print Address for Service: SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: jhr �./ S� �1t✓J/5x � Address Ir 07 -d1; -51t& Sign re Telephone 3.2 Registered Home Improvement Contractor Company Name Address Not Applicable ❑ ��Z� 7 License Number i6 -o3 Expiration Date Not Applicable ❑ Registration Number Expiration Date 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 emit. Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: R6 o % 1C/ -P -7o VT 7- I?Ce 14e el IaD4 71, A Pl% J/i7e✓GG /2741f2 f -;X,. -L ,�f .,1 ,f F� SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed bypermit applicant �`; O TCIA'', USE p1�TI,Y ;' ., } •• 1. Building � 60a (a) Building Permit Fee Multiplier 2 Electrical �D9 (b) Estimated Total Cost of Construction 3 Plumbing S o oo ' o Building Permit fee (a) X (b) ` 4 Mechanical (HVAC) 5 Fire Protection 6 Total 1+2+3+4+5) 'Yli Ov0•-SJ Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR APPLIES FOR BUILDING PERMIT CONTRACTOR I, as Owner/Authorized Agent of subject property Hereby authorize_ /—i Cy .mss to act on 'ive authorized by this building permit application. , My behalf, nurt _ _ Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name Si ature of Owner/Agent Date ' NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIIvMERS 1 ST 2 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS 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 '?f • Tete ��'ammanwea�N �f . Ili/ BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number. CS 062017 Birthdate: 04116/1967 Expires: 04/16/2003 Tr. no: 9178 Restricted To: 00 FRANCIS L CONNEARNEY 15 EMERALD STREET MEDFORD, MA 02155 Administrator r ' (CE 1CIFliC'ATE OF LIABILITY INSURANCE DATEIMMIDDIYY) 12/05/2001 '., 81)� 324-4118 FAX 0781)324-7189 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE ,jallion Insurance Agencies, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR /Exchange StreetALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW Box 367 INSURERS AFFORDING COVERAGE 'Malden, MA 02148 5 Kelly Lann Atkinson, Nil 0381-L INSURERA; Quaker Special RiSk INSURER B! Boston Insurance Services Inc INSURER C: _. INSURER 0: _ INSURER t' __ THE POLICIES OF INSURnNCE US EU dtLUVV rvAve mach IzQUry I vAY BE ISSUE O , �� ,,.�.,n� . -- •- -- - • - • • • • - ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE M 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. - A B TYPE OF INS r:: POLICY NUMBER GENERALLIABILnY �— PPGL T� COMMERCIAL GENE SAL LIASIL TY CLAIMS MADE ❑ OC(UR GEMLAGGREGATE LIMII APPLIES FER- -I POLICY JECT L'>C AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTO: HIRED AUTOS NON -OWNED AUTO i GARAGE LIABILITY ANY AUTO EXCESS LIABILITY OCCUR E CLAIMS Mf DE DEDUCTIBLE RETENTION 16 WORKERS COMPENSAT ON AND EMPLOYERS' LIABILITY A001TICNAL INSURED: INSURER LETTER: Dr. Erhitl 177 Creat fond Rd N.Andover, MA 01345 ,) 2 UMITS EACH OCCURRENCE $ 1, 000 FIRE DAMAGE (Arty one fire) $ so MED EXP (Any one oetson) $ S PERSONAL & ADV INJURY S 1.000 GENERAL AGGREGATE s 2,000 PRODUCTS-COMPIOPAGG is - 1,000 COMBINED SINGLE LIMIT I S (Es secident) BODILY INJURY $ (PerOerson) BODILY INJURY S (Per soddent) PROPERTY DAMAGE S (Per accident) AUTO ONLY - EA ACCIDENT S OTHER THAN EA ACC S AUTO ONLY: ACG S EACH OCCURRENCE $ AGGREGATE S -45 S 11/14/2001 11/14/ZOOZ ITORY LIMITS ER E.L. EACH ACCIDENT S 100,0 E.L. DISEASE - EA EMPLOYEE S 10010 EL, DISEASE - POLICY LIMIT S 500,0 SHOULD ANY OF THE ABOVE DESCRI@Eb POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLOER NAMED TO THE LEFT, OUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE CO(AANY, ITS AGVP� 9,R REPRkSENTATIVES. JHil =AX: C617)8,'5-7866 North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. The debris will be disposed of in: /i&S 11oa-iz ;10,. 6� (Location of Facility) Signature of P Applicant /,)-/�-r-�x Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 42119 Workers' Compensation Insurance Affidavit Please Print Location: Bps- i city �6 i9s -h "--Phone �r�- L�S;� ` 1D am a homeowner performing all work myself. 01 am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Company name: 4 Address Ci _� /�v�¢ �� l-� �i - Phone # � �li 2 Insurance Co. Policy # 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 farm 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, I do herby certify under the pains and penareies of Sionature . the information provided above is true and correct %i —/ j—W 7 Print name Phone # �17- Official use only do not write in this area to be completed by city or town official' ❑ Building Dept ❑Check if immediate response is required Building Dept ❑ licensing Board ❑ Selectman's Office Contact person: Phone #. ❑ Health Department ❑ O#iter FORM WORKMAN'S COMPENSATfOP: m m m 0 m CO) CD CL� Z CD O O CL n� -C .� o o p CL cr CD o cCCD CL C2 O tG CD CO) CD O 71 v. SO d 0 CA C�� O y d CD 0 CD CD y H 0 CD O CCD c c a = o =hoa y a0�m m y CAC2an T Z .0c N N �a�� m 0012 r� ccr _ o �mC41 a > omo� � U2 = � n0 o H, � ' _m H w S :� a~'=r,t m o CD _ a NCA � O p� r* L/-1 CL H Wm CD CA y • CA CD .�-►rt N O O .+ *� 0 o z CD c„ O COD 3 0 zD CD C=D CCO2) WE. D O c� CA O �; qC a S VJ 0' G 0 �^ Y O (b y� :! w 0 by "71 N r Q T ra. Z3 r (9 O a. x O � P 0 c - W�, - - �, 0,A -J 4 \ � � A �'z In �s;\ n � m r nOn�96bi� i / Lei # 4 _2� !1 1A Z --- �+------------'� k0 .'T VCO) \ s -?3 9 N)NOZ --- .2 IV. 4 'lk ci cz 10 0 1 ` � tsj V) 2W 23 126 Ur 199 GVOX J-2 GNOd sd Ire I-)gq 209' 177ny 00 C4 Aro-Y, C7