HomeMy WebLinkAboutMiscellaneous - 19 TYLER ROAD 4/30/2018N
No
Date ..... 1.:�)I r/i/...
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that............5, � C' 1— l r t k . ( + �
...........................................................................
has permission to perform ......, c �! -'f ° r/ s ��' "• ` C �r• ,,,% (-
.............
t ..................................... /,-, . .
c-1
wiring in the building of........�.�:.:!......!....��.:.................................................
..........4 ................... �......................... , rth Andover, Mass.
Fee _(P ?:W Lic. No. �3.P �...... exC� �/�> �...
ELECTRICAL INS�P:T.O.R
C 1, If q5" I•/
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
office use an
ty J
Ui be LIImmuniuralt >zf gar m2tt Permit No.
` ?3k
3par mrra of 'Public —AmfY3g occupancy & Fee Checked
- BOARD OF FIRE PRE-ISTION REGULATIONS 527 C -IR 12.00 1 2M (heave blank)
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 OLt-/ f/ SS%
(XX or Town of NORTH ANDOVER To the Inspector of Wires:
The uderslgned applies for a permit to perform the e�cal 'Mork described be 0MAP
I
Location (Street & Number) 01
Owner or Tenant PARCEL
C'.vner's Address
Is this per -mit in ccnlur�ion with a building Permit: Yes _ No 1 77 (Check Appropriate Ecx)
P'.;rccse of 3utidirc_ {'► t Util" Autrorization No. /
Existing SerAce 90 Amos ticits Ll Ovemeac' Uncgmd I No. of Meters
New Service Gam/ Amos /L. ' Z40 t/efts Cverre_c Uncgrnc _ No. at Meters
i
Numcer af=eecers arc Amcac::y
,_ c,..,, sr!a Nat_... _.. _cosec=.ec*.-:c=i 'Icrx
No. - - �ucvets No. c. =s Total
_. _.y......g No. ct'ranstcrr..ers K.A
Accve— :n- — I
No. at L.cr::nc; . xtures Swimming Peat
grra. _ cmc. Ganeraters KVA
No. at Emergency u;gnnrg
NC. _t _-:ac:e Cutters No. at Cil Surners ; 3arery Units
No. at Sw,tcn Cuttets No. =r Sas _ufners I =tRE ALARMS No. at tines
.0 at I No. at Cetec::on arc
Ranges
No. a: Air,::Inc. ;cr.s intnaung Cavtces
No.=t "eat Total Total
.+ o. at �isaC5a15 p;; -=s Tcr.s KVJ I No. at Scuncmi; Cev ces
No. of Stitt Cantatnea
No. at C,snwasners - Scacetarea -,eating oetec oniscunetng Cevtces
I
4 Heac:rg Cev:ces KbV I _=cat — Muntc:=at —Cther
Na. at Criers Cannec:cn '
No. at No. at Law voltage
No. at :Vater jeaters KN ! Sicrs Satlasts I Winrc
No.-!vc.o.Massace ucs No. at Motors Plat »P
INSURANCE C:'VE=AGc. P•_rsuant :o one recutrements r assacnc.:secs ;enerai '-aws _ _
I nave a current L:ac tty Insurance Pcucy �nctuc:ng C /�tec Ccerauens :.average or ,ts suestannal aeutvaient. YES NC _
nave su=mtree -alt coot ct same to me Cttice. YES � NC - t— ,ave _ ea��Y�rES.:tease ,nateace :ne tyce of cover ge =y
crecxtng ^e aoor cnace cox.
INSURANCS. SCNo = O,: -'.E= = tPtease Sce�:�1
i airs an Cacei
surnatec Value at =Ac'ncal 'Norx 5
'Norx :o tar,
c J� lnscec::en Oate Aacuestzc: Rcut,r
7!ndl.
Y S gnea uneer :ne Pena at vertu 7�
ini\.t NAME �% UC. NO. r1�
L•censee Sigr.acure :C. N
let. No.
ACa(e:35 fG A7 It/ '� l Alt. .ei. No.
OWNER'S INSURANCc-- WAiVEF: I am are that tre Licensee cues not nave ms insurance coverage or its sugstanttai eautvalent as re-
eu.rea =v .Massacnusetts General Laws. anti :nag acy signature an :n:s =ermtt aconcauon waives erns reautrement. Cwnet-h/ Agent
(Please cnecx enel
eiecrcne No. �cRMIT FEc 5
Signature ct Owner cr agent'
Location (/
` No. "A/,q Date�--
NORTH TOWN OF NORTH ANDOVER
AL
a •
Certificate of Occupancy $
+dab+,-:� A`�• / ,Jy ,,.+�
cHust< Building/Frame Permit Fee $ '
Foundation Permit Fee $
Other Permit Fee $
} TOTAL $
Check # 9
fr
5;'B2
/ "Building Inspect
L. /
' TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
BUILDING PERMIT NUMBER:
DATE ISSUED: / _ 0 c;2 -
SIGNATURE:
SIGNATURE:
/'t /'L 1 -6 -4 -4 ---
Building Commissioner/12§REctor of Buildings Date
SECTION 1- SITE INFORMATION
1.1 erPrropertyy Address:
I t r1lL6t 'f?V
1.2 Assessors Map and Parcel Number:
b3,?- ob4
Map Number Parcel Number
J v 004V
1.3 Zoning Information:
Zoning District Proposed Use
1.4 Property Dimensions:
(t) 0-z = lDl
Lot Areas Frontage ft
1.6 BUILDING SETBACKS ft
Front Yard
Side Yard
Rear Yard
ReqWred Provide
Required Provided
Required Provided
1.7 Water Supply M.G.L.C.40. 54){
Public ❑ Private ❑ Zone
1.5. Flood Zone Information:
Outside Flood Zone 0
1.8 Sewerage Disposal System:
Municipal 0 On Site Disposal System 0
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record
Name (Print /
Address for Service
g� 3 350
Signature
Telephone
2.2 Owner of Record:
Name Print
Address for Service:
Signature
Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Co struction Supervisor:
Licensed Construction Supervisor:
Address
Signature
Telephone
Not Applicable ❑
License Number
Expiration Date
3.2 Registered Home Improvement Contractor
Not Applicable ❑
Company Name
Registration Number
Address
Expiration Date
Signature
Telephone
M
rn
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 ❑
Accessory Bldg. ❑
Existing Building X
Demolition ❑
Repair(s) ❑ Alterations(s) Addition
Other ❑ Specify, tL
1
Brief Description of Proposed Work:
r ���
SECTION 6 - ESTIMATED CONSTRUCTION COSTS
Item
Estimated Cost (Dollar) to be
Completed by permit applicant
OFFICIAL USE -ONLY
1. Building
I b b b
(a) Building Permit Fee
Multiplier
2 Electrical
5�b
(b) Estimated Total Cost of
Construction
3 Plumbing
Building Permit fee (a) X (b)
/
l �D i
4 Mechanical HVAC
pp
5 Fire Protection
6 Total 1+2+3+4+5
b b 0
Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, , 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 7b OWNER/AUTHORIZED AGENT DECLARATION
I, -t;&t-J TT s 45t 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 belice�f-�
Print Nam `
Si nat e 'Owner ent Date
NO. OF STORIES SIZE
BASEMENT O SLAB 1 — S}-towN (00 r rS
SIZE OF FLOOR TIMBERS 1 2 3RD
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
D`[v1ENSIONS OF GIRDERS
ILEIGHT OF FOUNDATION ' gpJ� �. W THICKNESS 2 'r
SIZE OF FOOTING It, X III
MATERIAL OF CHRVINEY Pwr Am t e rT t j -►G GNtmP!S is M>40N
IS BUILDING ON SOLID OR FILLED LAND t
IS BUILDING CONNECTED TO NATURAL GAS LINE fl b
MORTGAGE INSPECTION PLAN
NORTHERN ASSOCIATES INC.
401 SOUTH BROADWAY,LAWRENCE MA.01843-3522 TEL:(978� 837-3335 FAX:(978) 837-3336
MORTGAGOR: DANIEL*- L015 FRA5IER DEED REF: .5997/ 213
LOCATION: 19 TYLER STREET PLAN REF: 1780
CITY.5TATE: N ANDOVER, MA SCALE: 1 "=20'
DATE: 4/19/02 JOB #: 202.0341 1
i 13.Iq-'
GARAGE I.G. LOT 10
POOL 10,700 S.F.±
LOT 9
5TOKY _n
2 WOOD
#19
LOT I I
68.97' - 321
TYLER ROAD
CERTIFIED TO: . SUMMIT MORTGAGE
Flood hazard zone has been determined by scale
and is not necessarily accurate.Until definitive plans
are issued by BUD and/or a vertical control survey
is perjbrmedsprecise elevations cannot be determined.
NOTE: This mortgage Inspection was prepared
spsoijScatLyy Jbr monigape purpose only and
is ret to bs "Lied upon as a land or property
A,4,9,,�
.Y -(NA OFlc{,aSo
`''9O
This morL a s {run e
8 P pa tion was jph+vparvd {n acoordanoe
Ins ps tions with the can icol Sd d l e Air Mortgage Loan
Boaan
line auruey, cared frr "cotd{ng, preparing deed
dascriptI'... cr construction No corners we"
set Building location and offets a"
.��1
O JOHN GN
of
Reg{stratian of Pro,/Hssionat Eng{neara and Iarut
Sutrwyors 250 CUR 605.
appresimats lto located on ground and
J. !n
I farther state that in my projaastonal opinion that
an ahoum specifcally ,tar zoning determinalion
only and as nut to be used to sartablish pro
1 RU :S ALL -�
' r3 cn
#3V''7
the structure. shoum conlbrm with the local zoning horizontal
dimensforwl setbrwk cont—
at the time of construot{onor
are exempt —dor M..C.L W.
linea. The mnttsrs steam hereon are based only
client -furnished injbrmalton and may be subject
L ,,�,
provisions o J I0 -A Sec, r.
too j her cut -sales, takings, easements and rights
Ly
!q E-..$
10 Y. f'rope rly/Ilauso is not in Flood Ruaard.
J y, and other matters of "cord and prese>pttve
or other rights. Northern Asaociatee, Inc. assumes no
,
J Slli?y`"
� �v'W`aipN"v ,.
(� P, !'roporly/Roacse {s {n a FYond Hazrsrrl Arca.
0 S. Injbrmat{on is {nsufficent to determine Flood Nocard,
rcaponsib{llty h=Etn to tend Domer or occupant, p
aoospta no "sponsib {lily for damagaa re ling from said 4,I"1 `
Flood Rnzarrl determined jlem latsat Feda"t flood
2-5
"[fares by anyone other than the said mortgagee and its assigns 11
Irus .. Rate M... Aanet (/� ��1��T��
in connection with its proposed mortgage financing
to said mortgagor.
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The sunroom before demolition.
19 Tyler Road
This was disposed of by The Dumpster Depot.
Dan and Lois Frasier
19 Tyler Road
North Andover
Former location of sunroom.
New familv room to ao on same foundation.
e-b,.f;KWtI6
ridge vent 2x 2 4t4
.001".,-<' x10 rafters w/ 5/8 plywood
tar paper & asphalt shingles :�� :�
2x6 collar tie
R-38 insul. w/ proper vent
/ 8" drip edge & 3' ice & water
i'finsul. w/ 1/2" blue board
vapor barrier & vinyl siding
2x6 joists 16"o.c. w/ 3/4" plywood
«yP>
2x4 studs 16o_c_
w/ 1/2" cdx sheathing
x6pt sill w/ sill seal
existing slab foundation I
existing structure
w
z
room replacement
v\ ZA
LIVING AREA
220 sq ft
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rpRTM TOWN OF NORTH ANDOVER
0 ; p Certificate of Occupancy $ --- -
♦ o� ` a
Building/Frame Permit Fee $
R� ACMUS Foundation Permit Fee $
p Y Other Permit Fee y $
SEP Meer Connection Fee $ -
2 8 sv Water Connection Fee $
NO. Andover(; TOTAL $
t?i/OOH ,
b Building Inspector
4 Div. Public Works
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Suggested Affidavit for Home Improvement Contractor Permit Application
For Omce Use only NAME OF CITY/TOWN
Permit No. Y^� Ai,. A ao-e. r
Date
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
MGL c.142A requires that the "reconstruction, alteration, renovation, repair, modernization, conversion, inprovement, removal, demolition.
or construction of an addition to -any preexisting owner -occupied building containing at least one but not more than four dwelling units .... or
to structures which are adiacent to such residence or building" be done by registered contractors, with certain exceptions, along with other
requirements.
Type of Work: t cJ i/iX i,u W%, (�t,t`i Est. Cost_r9o�oGU
Address of
Owner Name:
Date of Permit Application: / J a
I hereby certify that:
Registration is not required for the following reason(s):
_Work excluded by law
_Job under $1,000
Building not owner -occupied
XOwner pulling own permit
_Other (specify)
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL
c. 142A.
Signed under penalties of perjury:
I hereby apply for a permit as the agent oTthwner:
05� y3o
Dae Contraciror Name Registration No.
OR:
Notwithstanding the above notice, I hereby apply for a permit as the owner of the above property:
aS �� c
Dat Owner Mfne
(508) 475-1787 FREE ESTIMATES
Quality ESTIMATE ' ti
Construction C Q
Date: / / 2
Estimate No.
T0: i ��\ t,tJ a
MARK PERLOWSKII I �� �-e +� I�- o ad
A)()rLdo o -c r
Carpentry
Decks 1„�,�c,,' �' 5 7 — �G 9b
Remodeling
Kitchens
Roofing
Additions Project: 13oyu w t v-\& W
Description:
Labor:
Q,C*M0.?a\ of W-1 (k Or lea.\\ I S�-e �-a LA C.- t i
Oc)Q"; , U-)* \ r-C)C)\,O , /97;ft, 4tv, '�Y'aw�e. C,.)+ 1r1� uJ
il.Uvci►� v�e� any mor- i�,,w �-Purl.) K\ Sa-ci(I (1�4,j
�vw U-`o.a; u�t�A {✓ 00-r (.t'I �cJ C1hd S(.t�rry!
Materials:
Gowu O.1 x 1q.w
—[' r vin C.t (,\Q i< 9-f-- T-0 r- C) -E (I u.; t r-cA C, w
SC.`C-etrJ
�� c C= T -o ►- rod C) 0
Total price: $ 2. 000, vc
Estimated Completion Date: ?Z3()
Terms of Payment: I -o i I . Try —CA+a r N UAR Iz.4i-0 ►1
This estimate is firm for days.
Mark Perlowski
1
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OFFICES OF:
APPEALS
BUILDING
C:ONSHIWATION
HEALTH
PLANNING
OF NORTNI
Town of
m
�•� NORTH ANDOVER
`.:: ::fir•. �e
UI V ISION ( W
PLANNING & COMMUNITY DEVELOPMENT
KAREN H.P. NELSON, DIREC"I-OR
r�
120 Main Street •
North Andover,
MiISS; WIInS( IIS () 1845
(617)( 685-4775
In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit
Number 'Z—SO is that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by MGL c 111, S
150A.
The debris will be disposed of in:
(Location of Facility)
Signature of Permit Applicant
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through the Office of the Building Inspector.
Z
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R Date. / - o - 0-.3\. ...................
4
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
^ This certifies that
IV
has permission for gas installation
w
in the buildings of. �"... ...... ...................
at ..... '.-�. .......'`�.......... , North Andover, Mass.
Feed -5 ..... 'Lic. No........... ....... (--e ,
/ GAS INSPEIC,70R//
Check #: ,/ U
4285
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASF=NG
(Print or Type)
�20Q�a ReiptPermit
LZ��
�6 MA Date `aLJ Building Location%/ :?5,/ s% Ownet'sName
�-
Map: Lot: Zone: Typecf0c=oancy
C
New Renovation ❑ Replacement ❑ Plans Submitted: Yes ❑ No ❑
Fee:
N
Y
W
47
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F-
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SUB - B SMT.
BASEMENT
1ST FLOOR
2ND FLOOR
3 R 0 FLOOR
4TH FLOOR
STH FLOOR
6TH FLOOR
7TH FLOOR
8TH FLOOR
I
I
11-H
Installing Company Name EASTERN PROPANE & OIL, INC.
Address 131 WATER ST DANVERS LMA 01923
Estimate valueof Wcrk:
Business Telephone 800-322-6628
Name of Licensed Plumber crGas Fitter 9CQ
Checkone: Certificate
Corporation
❑ Partnership
❑ Firm / Co.
INSURANCE COVERAGE:
I have a current Ii ' " insurance policy or its substantial equivalent which meets the requirements of MCL Ch. 142.
Yes No ❑
If you have checked Yes, please indicate the type coverage by checking the appropriate box.
t,
A liability insurance policy u_
---
A
I
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 an this permit application waives this requirement.
Checkone:
Owner Agenta
Signature of Owner or Ownels Agent
I hereby certify that all of the details and information I have submitted (ar entered) in above application are true and accurate to the best af
my knowledge and that all plumbing work and installations performed underthe permit issued for this application will be in compliance with
all pertinent provisions of the Massachusetts State Gas Cade and Chapter 142 ofa Gene Laws
By Type of license:! �
Plumber Signature of Licensed Plumber or Gas Fitter
Title Gastitter
Master License Number 14-13
City/Town iJaumeyman
APPROVED (OFF=ICE USE ONLY)
O
cn
71
m
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N
Location - -Q/ y�� fl, PC/
No. - f Date B,5?- o
`<I
MORTN TOWN OF NORTH ANDOVER
9
Certificate of Occupancy $
Building/Frame Permit Fee $
ncHus
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
P% Check #
1
175 19 Af
r/ Building Inspector
� 'ts
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REP RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
Tib! Swdm ihw
BUILDING PERMIT NUMBER: S DATE ISSUED:
SIGNATURE: C
Building Commissi ner/I for of Buildings Date
1.1 Property Address:
jj ��-
` n /�
�/ { 1"�
1.2 Assessors Map and Parcel Number:
Map Number Petrel Num
1.3 Zoning Information:
Zoning District Proposed Use
1.4 Property Dimensions:
Lot Area Fronts ft
1.6 BUILDING SETBACKS ft
Front Yard Side Yard
Rear Yard
R 'red Provide Required
Provided
R red Provided
1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information:
Public 0 Private 0 Zone Outside Flood Zone ❑
1.8 Sewerage Disposal System:
Municipal 0 On Site Disposal System 0
SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT
=11)
1.1 uwner of Kecora
Name (Print)
CI -79
Signature T'elephon'e ) '
2.2 Owner of Record:
I
M'h Aw e, N .A4rnyer
Addresr Service :
(p 6 - asDq
Name Print Address for Service:
Signature Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor: t ` Not Applicable ❑
1 V I
Licensed onstruction Supervisor:
(� M� (� License Number
a
s "1,,-. (C�i /t r r
` Q Expiration Date
eph e
ti
3.2 Registered Home Improvement Contractor Not Applicable ❑
1063 ? (D
Registration Number
b I I';) C�w
Expiration Date
R
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 ....... 0
SECTION 5 Description of Proposed Work check all a cable
New Construction ❑ 1 Existing Building ❑ 1 Repair(s) ❑ Alterations(s) ❑ Addition ❑
Accessory Bldg. ❑I Demolition ❑ I Other 1' Specify+ldl QYY1e rr4 f 11 i/lfiil(,(�S
Brief Description of Proposed Work:
SECTION 6 - RSTIMATF.D
U
Item
Estimated Cost (Dollar) to be
Completed b permit applicant
OFFICIAL. USE ONLY
1. Building
(a) Building Permit Fee
Multiplier
2 Electrical
(b) Estimated Total Cost of
Construction
3 Plumbing
Building Permit fee (a) x (b)
_
�j
4 Mechanical HVAC
5 Fire Protection
6 Total 1+2+3+4+5
Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, , 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 7b OWNER/AUTHORIZED AGENT DECLARATION
I,bztu •Qr S as Owner/Authorized Agent of subject
property J
Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge
and belief
''L -L4"
r�rs
PriLfame
Si ature 6f Owner/Agent Date ! `1
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TIMBERS 1Sr2 ND 3 RD
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DM ENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CHININEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
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Visit Our Showroom At:
354 N. Broadway
Salem, NH 03079
Weds. - Fri. 12 - 4
Sat. 9 - 12
Tel. (603) 898-2259
Fax (603) 898 - 2816
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VINYL SIDING
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Inc.
Proposal -Agreement
Famous Brand Names
Certainteed
Mastic
Alcoa
Andersen
Harvey
Therma-Tru
PROPOSAL MI
SAL SUBTTED TO PHONE DATE
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JOB NAME
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CITY, STATS 8 IP CODE JOB LOCATION
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We hereby propose to furbish all materials and labor necessary for the completion of the following products in accordance with the
specifications and drawings
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Total contract price is- _S jv 1 -7 -LI) h[�,,,4 � �la �2•� dollars ($
PAYMENTS TO BE MADE AS FOLLOWS::
ALL MATERIAL IS GUARANTEED TO BE AS SPECIFIED. ALL WORK TO BE COMPL6ED IN A AUTHORIZED
WORKMANLIKE MANNER ACCORDING TO SPECIFICATIONS PER STANDARD PRACTICES SIGNATURE
ANY ALTERATION OR DEVIATION FROM ABOVE SPECIFICATIONS INVOLVING EXTRA COST WILL
BE EXECUTED ONLY UPON WRITTEN ORDERS AND WILL BECOME AN EXTRA CHARGE
OVER AND ABOVE THE ESTIMATE.
ACCEPTANCE OF PROPOSAL- THE ABOVE PRICES, SPECIFICATIONS AND CONDRnONS
ARE SATISFACTORY AND ARE HEREBY ACCEPTED. YOU ARE AUTHORIZED TO DO THE WORK AS
SPECIFIED. PAYMENTS WILL BE MADE AS OUTLINED ABOVE.
CUSTOMER HAS THE RIGHT TO CANCEL THIS CONTRACT UP TO THREE (3) DAYS AFTER
DATE OF ACCEPTANCE
DATE OF ACCEPTANCE
SIGNATURE -�
SIGNATURE
FROM :
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PHONE NO. : 603 432 6096 Jul. 06 2004 04:16PM P1
ACQ£-DT; CERTIFICATE OF LIABILITY•INSURANCE CSRML
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THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
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HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
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Board of Building Regulations and Standards
HOME IMPROVEMENT CONTRACTOR
Registration: 100286
Expiration: 6/15/2006
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iType: Supplement Card
PELLERIN VINYL -SIDING
LYNN BROTHERS" i
354 N. Broadway i
Salem, NH 03079 Administrftor
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License or registration valid for individul use only
before the expiration date. If found return to:
Board of Building Regulations and Standards
One Ashburton Place Rm 1301
Boston, Ms. 02108
ric'Maud" -
Not valid without signature
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