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Miscellaneous - 190 BRIDGES LANE 4/30/2018 (2)
I 190 BRIDGES LANE � -- --- - f_ - J/ 2101104._ D�0084'0000.0 Date. ,/.Q11.-? .`1... .... j ,4ORTIy o= �` TOWN OF NORTH ANDOVER ' PERMIT FOR GAS INSTALLATION � s 1 �9SS,q SES This certifies that . U�'�. £!� . . . . . .! �. . . . . . . has permission for gas installation If, in the buildings of .4%cx. . f/ . . . . . . . . . . . . . . . . . . . . . at . ./Ik .47,CA, 4��. . . . . . . . . ., North ndover, Mass. Fee A, . Lic. . . . . . . . . . • r GAS INSPECTOR t, Check# �,?D%Sz� 7844 x -.MASSACHUSETTS.�� ORN APPLICATION F0R PERMIT70-00 GASFITTING ^� (Print or Type) 14 Mass. Date 7 _ �� - � J� .20 Permit# building L-ocatLon Owner's Name ✓1cj C U. !JC Type of Occupancy New l Renovation W Replacement ❑ Plans Submitted Yes ❑ No ❑ a a: Lu Cf) V (,6CO Cl)co ar to a` O � (f) _ F F- W w L= O U m >_ = in z o w � I'_ >- Z z o � ¢ °° w I.- w W O E W wO z z E- O > w cc Z < Ma_ � wQW ~ Wt- 2 C0 U L- Z -� L'- Z w w > u_ U J W z ¢ w =' Q a[ t- i– >- W m z O Z w O L– w w > Cr w � z Q a: ¢ Q O O w a` O w F F- M x O C4 = w o O U a_ > o a_ t– O SUB-BSMT. BASEMENT 1ST FLOOR 1 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR i 6TH FLOOR 7TH FLOOR i 8TH FLOOR Installing Company Name l`h '� �" D�1i:n'3�E F,e, s _._-Check one: i Cert�f,icate _ . Address y AS -RI 11Partn tion Corpo hip Business Telephone ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter yF J INSURANCE COVERAGE: have a curve Lability insurance policy or its substantial equivalent which meets the requirements of MGL Ch 142. Yes ly No ❑ If you have checked yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy EK Other type of indemnity ❑ Bond ❑ OWNERS INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass.General Laws and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's A ent Owner ❑ Agent ❑ I hereby certify that all of the details and information 1 have submitted (or entered) in above application are true and accurate to the best-of my knowledge and that-all plumbing work and installations performed under the permit issued for this application will be,in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By_ -T of.License __ .. __ ._... ... _ Plumber Title 0-2'assie er Signature of Licensed Plumber or Gas Fitter { { tErMa CL -/town O Joumeyman License;,Numberci= APPROVED OFFICE USE ONLY) i y Date.<)A7A1. .... .. . . J ,kORTM Of ° '^.�'�'O TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION �,SS�CMUSEt This certifies that . .eft�.1.`n" .64q A!?- . . . . . . . . has permission for gas installation . 614A4. in the buildings ofd� at . . . . . . . . , North Andover, Mass. Fee., . Lic. No.. � . . . . /7/ `? Fee.,,Z,.� . . . . u GAS INSPECTOR Check# 7839 3d.0 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) NORTH ANDOVER ,Mass. Date OCT. 13, 2011 permit# Building Location 190 BRIDGES LN. Owner's Name ERIC PAULIK Owner Tel# 978-975-5223 Type of Occupancy RESIDENTIAL New a Renovation F-1 Replacement❑ Plan Submitted: Ye[]No[] FIXTURES W W F O' U W `n 7 � w `� ° o o � � x � 9 J z a ' z z o H a m W ' W o oo W F W W x H w cti > d Wz S z ww W A Z ~ W =� Q~ Z OA z O z uUu77 O � Q Q > a A d a d 4 O O W O w 0 M . O C7 = W. . 5 . 3 A 0 a U x > A a Fw 0 u. SUB-BSMT BASEMENT 1ST FLOOR 2"D FLOOR 3RD FLOOR 4T"FLOOR 5T"FLOOR 6T"FLOOR i 7T"FLOOR Ftt -1-+F- F-H 8T"FLOOR Eastern Propane & Oil Inc Installing Company Name P � Check one: Certificate Address 131 Water Street Corporation Danvers, MA 01923 Partnership Business Telephone# 800-322-6628 Firm/Co. Name of Licensed Plumber or Gas Fitter JOHN MARSHALL INSURANCE COVERAGE: I have a cur liabilityinsurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. P Y q q Yes ✓ No ❑ If you have c ecked ygs,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: Owner 13 Agent C3Signature of Owner or Owner's Agent I hereby certify that all of a de ails and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all biwork and installations performed under the permit issued f application will be in compliance with all ertinent vi ' ns o t sa usetts State Gas Code and Chapter 142 of the Gee I aws By Type f License: Y lumber Signnsed Plumber or Gas Fitter Title Gatu f Lice Gas fitter •-Master License Number City/Town •-Journeyman APPROVED(OFFICE USE ONLY) Aug. ?2. 2010 9: 36AN No. 3(196 P. 2 Taw Commonwealtk of Massachusetts .-Department of Industrial Accidents oflee 0J ,Fnvestigm ons 600 Washington Street Foston,AL� 62111 - - wwW.-/ltfl:45.b Br it€ 'v`o kers'-Compensatitm.- nsurAnee. davit, build-73le.onractorslElectrieians/Pita�bers Applicant Information - Plisse P�imt"�eeabit r / Name ($uainesafOtganizetimdlndivim�al); Address ✓v 1�� -> City/ste teZip: /� �/ S i` phone#: Are you an%employer?Check the appropri®te:box: Type of p,roject.(t'equlred): 1 19 1 am•a employerwith :7� 4: 0 I am z;general coatrartor and I 6. ❑Ncw construction employees(frill and/or part-time).* have hired the sub-contractors I am a sole proprieto 'o*partner- listed on theattkhed sheet 7. Q Remodeling N .. ship and have no:eatoloyees These sub-contraetor-s.have 8. [:Demolition working'for me in any capacity. workers' comp.insurat>ie. 9, 0 Building addition [No workers' comp.insuran..e 5. ].We are a corporation and its F required:] officers have exercised their 1D,7..]ecttical.repairs or additions' 3:.0 I am a homem mei doing a3t work. ,right of exemption per MGL I.I:�Piumbmo repairs or additions. myself. [No`.worker'crimp c.152 §1.(4),_and we have no 1Z:(]P.00 .repairs insurance required.]t. erttvloyees. [No wor?rers' an Dther r�f ��� comp.insurance required_] ::Az*,Vplic %bat ebecks boa#1-m= fill wz tna=ion'belov sbowinZ d=i roods'. oapolLy kntamssdon..: 1 Hnmeoww=who Submit this 311=vh iadicadttg they am doin;aU Wm3;and thea hi=odd-coms:sotots==tshmtt%MW affidavit ho=ming 2Con==o:s twat chert^this boa mom w=hzdb addiUM21 acct showing the of the.sub comsA=a2d theirwccmp.pct iw ado on F am an employer that is prm ding workers'eompeptsadvir ir. e fpr my empioyees Below is lh e.pahey.an d job site Mir, afiaFL Insurance Company Name: j Policy t or Set;-ins,Lac.n:_.l .C _ Datc_ Job Site Addr-.,ss: Qct(✓ d9C-S l.w . ✓ :C.400, Gity/5ia&Z*4 nj.+ 14v�[.�.WQ./. G 1 $SIS '. paw ( wig po'�number.�nd e_ !ration ate e�ttach;a copy.af::the�oEi�P� tuntge�tt.aa�:�►iicy dec �va. .:tee,rho_ . the Ia Failure to s;cure..coverage.es regaimd under Section 25A.of MGL.c.152 can lead to the impo6tian:of trim i penalties of a _ fine up_ta S 1,500.QO z nd/or.one-year impdsontn Wit,as well as civil penalties in.the form of a STOP WOK ORDM wr_.e.fine•,. of up to 5250-00 a day against the.violatar..Be advised that a copy:of this statmnent may be forwarded to the Office of Investigations of the DIA fDr-it incc coverage verification r do hereby-cerdfy undrr:the patns and p {perjr7-3 nformadonprvvidedabvK.ts true acrd carred Da Phone (}U-af use only.Do not tvrzie ir,this area,to becatnplered by city.or town offklal - City or t.oym PArIillf2lCpBSe '� -_ lssuing Authority(circle one): 1.Board of Healtb 2.Building Department 3.Cttyllown Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: j , Date..... 'i ORTp TOWN OF NORTH ANDOVER PERMIT FOR WIRING 7SS,gCNUSEt This certifies that .... ........................... has permission to perform .........<<..dd ........... Oiring in the building of .f a'� .... :?.%���'°S at............4.77)...a�r..w-f;...... ............/I. ,North Andover,Mas Fee...Yd.(�!� . Lic.NO ................f'..:... ELECTRICAL INSPECTOR Check # __� L� 4447 THECOMMOAIRE LTHOFIVIASSACHUSETTS Office Us only DEPARTNIEM0FPU&1CS4FHY Permit No. BOARDOFF7REPREVEN'T70NREGUTAT70NS527Ct1M12 G10 Occupancy&Fees Checked APPLICA77ONFOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) 110 'R,(-.Aalt-s LY-,t,N� Owner or Tenant P. I L— , Owner's Address Is this permit in conjunction with a building permit: Yes[-_—_] No (Check Appropriate Box) Purpose of Building �� ©W!V►.�. Utility Authorization No. Existing Service Amps� Volts O erhead Underground No.of Meters New Service Amps / Volts Overhead ED Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical WorkR►'� 1Z^G+tSS�'f� , gu.1 �G�r1�`! Z LVIHV�-S No.of Lighting Outlets l / No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA d round round No.of Reciptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pum s. Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal Other Connections No.of Water Heaters KW No.of No.of i Si ns Bailasis No.Hydro Massage Tubs No.of Motors Total HP i� OTHER- k1SL==CovtrdF-FUIS<IanttDftmW mr>entso WbMdmsettsGardLaws lbaNeaamfflLd3kkmo=Pbkymck&igCon4)leeOvaahmComragporitswbstuMegralat YES NO IbawsubrntltodvandproofofsametDtheOffce YES If}cuhawdeda�dYES,plea9eic lcaethetypeofoDNaawby cllelgthe box WSURANCEC BOND'M OTHER M (PaseSpeciy) c Fxpi�alIk>E Fstnn dVak eofEbc(icalWak$ waktoSlatt hW0cfionDateRegtlested Rough whny 14-14 Final Sigrrdutxlx'&I of FIRMNAW In+411e t't �F\K.i�•r�i.��. Li=WNo. Li ee o b•< ys",\,k- ST No E- 95 3 3 p Tel No. 477793" ddressA1tTel No. 926•$1$• y56oa OWNER'SINSURAMMWAIVfl2IamawacethattheLmwdoesnothavetheirasura)oecovUageori at)stantolepvalentasmgmedbyNb%xhusetsGui2dIaws and thatmysignatureonorispmntapplicationwaim sorisIegkenial (Please check one) Owner M Agent ��J w rJf I Telephone No. —PERMIT FEE$ (,,✓J (, f/ Signature of ner or Agent U' The Commonwealth of Massachusetts d Department of Industrial Accidents Office of investigations Boston, Mass. 02111 1b y Workers'Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity 0 I am an employer providing workers'compensation for my employees working on this job. Company name: Address r_ City: Phone# Insurance.Co. Policv# 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 h andfor one years'imprisorvnent-as weU_as_evil.penattiesiinlbelnrm-dA-STOP]OOW-0RDFR.and_a fine-f_(,$1110.DD)AAayagainstme. t understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I I do hereby certify under Me pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name Pbone.# Official use only do not write in this area to be completed by city or town official' City or Town •;' PermitAicensigg 13 Building Dept Check d immediate response is required Licensing Board M1 p Selectman's Office Contact person: Phone#: �' `'Health Department Other AORT" TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING SACHU Thiscertifies that ............................................................................................. has permission to perform .......:7..................................... ring in the building of........ ...................................... ,it... ............ ......North Andover,Mass. Fee ......... Lic.No.............. ...... .................. . �' ELECTRICAL INspwrm Check # 4999 Official Use Only Permit No. Dyiant ?»ufillc Sadd� Occupancy&Fee CheL`k BOARD OF FIRE PREVENTION REGULATIONS 52 MR 12:00 APPLICATION FOR PERMIT TO PER OIM ELECTRICAL WORK All work to be performed in accordance with the Massac u Electrical Code 527 CMR 12:00 (Please Print in ink or type all inform " /ation) Date 2 4-01/ To the Inspector of itiires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number I7D `1'0 1 E6 L. J Owner or Tenant Al?Vc . Owner's Address Is this permit in conjunction with a building permit Yes No 0 (Check Appropriate Box) e Purpose of Building \ i Utility Authorization No. Existing Service Amps lofts Overhead 0 Undgmd 0 No.of Meters i New Service Amps Volts Overhead 0 Undgmd 0 No.of Meters Numg)r of Feeders and Ampacity, Location and Nature of Proceed Electrical Work HAMIX ILI A 1 i ty�L Al �l�lfr�s Total No.of Lighting Outlets No.of Hot fuse No.of Transformers KVA Above 0 In 0 No.of Lighting Frdures Swimming Pool gmd 0 gmd 0 Generators KVA No.of Emergency Lighting No.of Receptacles Outlets No.of Oil Burners Battery Units No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone Total No.of Detection and —No. f Ranges No of Air Cond Tons Initiating Devices Heat Total Total No.,2fDiposal No. Pumps Tons KW No.of Sounding Devices —� NoJ of Self Contained No.of Dishwashers Space/Area Heating KW Detection/Sounding Devices 0 Municipal 0 Other No.of Dryers Heating_Devices. KW. Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Bailases Wiring No.Hydro Massage Tuds 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 ilp substantial equivalent YES=NO = have submitted valid proof of same to the Office YES= NO a If u have checked se indicate the of a by checking the appropriate box. INSURANCE _ BOND a OTHER (Please Specify) 1 m 0 Estimated Value of.Electrical Work$ 3ood (Exatio Date) Work to Start Inspection Date Resquested W&LL Rough Final Signed under the Penalties of PertM r �FIRM R7te—+} G ` LIC.NO. 06 Licensee lab h•A*r 1NIW,V - $i __ _ LIC.NO_ena �� ��T+C� &k Bus.Tel No. /76" 6 • 7 - 9 ad) 7 Address V Q Alt Tel.No. S � 3_ OWNERS INSURANCE WAIVER: 1 am aware that the Licenses d not have the insurance coverage or its substantial equivalent as required by Massachusett General Laws.And that my signature on this permit application w Ives this requirement. Owner Agent (Please Check one) !� S� V Telephone No. PERMIT FEE $ (Signature of Owner or Agent) The Commonwealth of Massachusetts = Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 n`s Workers'Compensation Insurance Affidavit Please Print Name: Location: City Phone am a homeowner performing all work myself. ,f FI 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. r Company name, t Address City Phone# Insurance Co. Policv# Company name: Address 1 City Phone#: (y 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. .l do herby certify under the pains and penalties of penury that the information provided above is true and carer t Signature Date Print name Phone# Official use only do not write in this area to be completed by city or town official' E] Building Dept ❑Check if immediate response is required Building Dept E] Licensing Board Selectman's Office P Phone#:" 'Health Department Contact person: - Other FORM WORKMAN'S COMPENSATION I E .I. . Pfg9,i3ai 7i} ac14 6 CERTIFICATE OF USE & OCCUPANCY TOWN F NORTH Building Permit Number -7� Date THIS CERTIFIES THAT THE BUILDING LOCATED ON /016? / G- S L A rV MAY BE OCCUPIED AS A'Ly �� �idy�►r �`t u/ l�r v q 'f C3A-- 3 — --Z b t;� / 0A,9 /2 IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO Building Inspector ORTH Tol"M Of No. 4 5 1 gg -A+ _ =_o over, Mass., Y O LAKE "C ME WICK � AoRArE� BOARD OF HEALTH PERM .IT T DFood/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT A *-..Y P -c/ :..4A N A a.�'Ait. s �/ ��// ............................................. Foundation :�U'� has permission to s�..�....1 �.....� 1..r..... buildings on ... ..q........ �� ��.S Rough to be occupied as W * /�A G I"O !N p1 4� ! �'� Chimney 1a1............ . .............. ................................................mss.............. provided that the person accepting this permit shall in every respect conform to the terms of the application on file i Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, eration and Construction o ✓�J�L Buildings in the Town of North Andover. a i( $��v s PLUMBING INSPECTOR y A e VIOLATION of the Zoning or Build!n Regulations Voids this Permit. Rough (T 0W 5 -C-:5 It?-- -9 a Final j I P I EXPIRES N. 6 MONTHS ELECTRICAL INSPECTOR LESS CONSTRU=ON STARTS Rough C '.... .....................:............................. ervice L0060" - S BUILDING INSPECTOR -.f Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEP NT Burner Street No. J=S E REV E R Smoke Det. SE SIDE T, l" fi Location F. No. Date / .23 &ti Vr. Th TOWN OF NORTH ANDOVER Of NOR1 f' 9 Certificate of Occupancy $ Building/Frame/Frame Permit Fee $ sACHUSE 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ��►17024 Building Inspector t TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVAT5 OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: y5 -a / - off W SIGNATURE: Building Commissioner/I for of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: ILogT) (Q jq- Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Fronts e ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide RegWred 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 p Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIPIAUTHORMD AGENT M 2.1 Owner of Record S /Cc(Print) Address for Service: Signature Telephone 2.2 Owner of Record: n Name Print Address for Service: M Signature Telephone M SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ cerlsed Construction Supervisor: -j— 4Y4 License Number Address`/� 7c;7, Expiration ate v nature Telephone N 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name J 3 J yoC M / ,0 _ /u/.4. V, P�� � Registration Number ssr AddreJ v 7Wy�� Expi tion D Sin a Telephone, f 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 buildig permit. Signed affidavit Attached Yes.......WK 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: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be g OFFICIAL;USE ONLY , z Completed by permit a licant } 1. Building (a) Building Permit Fee ��- 0 Multiplier 2 Electrical n / (b) Estimated Total Cost of 7 Construction 3 Plumbin Q. Building Permit fee(e)X (b) 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 BUII.DINING",PERMIT &7 Y �rr�P+l� as Owner/Authorized Agent of subject property Hereby authorize ESN—< C %LG-49 to act on My behalf,in all matters Ytive work authorized by this building permit application. -Signature of Owner Date 6G / SECTION 7b OWNER/AUTH D AGENT DECLARATION f 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 I Print Name Signature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TDvMERS 1 2ND 3RD SPAN DR%4ENSIONS OF SILLS DIMENSIONS OF POSTS DIWNSIONS 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 _ The Commonwealth of Massachusetts is rA b Department of Industrial Accidents Office of Investigations ,a Boston, Mass. 02911 Workers'Compensation.Insurance Affidavif Name Please Print Name: rl ' Location: City Phone # I am a homeowner performing all work myself i am a sole proprietor and have no one vuorking in any capacity �l am an employer providing workers°compensation fix my employees woWng on this job. Company name: Address -11,O6 B��h a ��,� ��� �"��1� 01��0 c' Insurance Co. n Poli # L2 Companv name: Address: Phan&* Insurance.Co. POW;# Cy Fal ure to segue coverage as required:under SeWon 2M or MGL 152 cmJeadto the k1on cfpern�.s of a�tEhe upt�.s anwor one years'bnprfsorw=t,-w,-eee&as a copy of this stat ��79P understand that enent �� �a niay be forwarded to the Office of Irons of the DIA for cavern&moi►. d0 hereby CerW WXLr•the pains and pena/6ies of pedWY dist ft beam fiM p oVided above is true and cored Signature Date Print name Ph Me 4 Official use only do not write in this area to be completed by dty or town dficW CAY ng . t OCheck I immediate response is.regured p SeledrYlar Contact person: Phone# Health Del. Other 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: (Location of Facility) f II 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 Cardillo Construction Company 206 Nahant Street Wakefield, MA 01880 Office 781-246-2272 Cell 617-548-0811 Proposal Alex Parnes 190 Bridges Ln. North Andover, MA Basement- Hang new blueboard and veneer plaster all basement walls $ 4,200.00 Replace suspended ceiling grid and tile 1,750.00 Replace carpeting and stair runner 1,650.00 Hang new blueboard and veneer plaster all basement walls 1,350.00 Basement total $ 8,950.00 First Floor- Hang new blueboard and veneer plaster affected first floor walls $ 3,250.00 Replace all oak flooring on first floor 6,300.00 Replace oak stair treads to second floor 900.00 Replace trim on first floor-affected doors, frames, casing, baseboard 4,250.00 Replace all exterior wall insulation w/vapor barrier 850.00 First floor total $15,550.00 Second floor- Hang new blueboard and veneer plaster affected x second floor ceilings and exterior wails $ 6,150.00 Replace all exterior wall insulation w/vapor barrier, ceiling insulation 2,900.00 Second floor total $ 9,050.00 Garage- , Replace garage ceiling and insulation $ 2,800.00 Replace overhead doors and garage door openers 2.950.00 Basement total $ 5,750.00 Cardillo Construction Company 206 Nahant Street Wakefield, MA 01880 Office 781-246-2272 Cell 617-548-0811 Proposal Miscellaneous electrical- Remove, inspect, and reinstall all ceiling fixtures and smoke detectors $ 925.00 Permit Fees- $ 1.000.00 Total $41,225.00 Thank you, enneth P. Cardillo y Accepted:__ -<-.....-,ti..r.......,...-.,...._..-.r-..--.f...,....i—.Y.-...y-,:.e•...:.... .. -Y...... � � ...�..r'+.�.-..�..r..f-7r,...,r�..`..-1 �„[`....-w z, Date. . . ./. A t. . . HORYPI TOWN OF NORTH ANDOVER c? a�, .,...�• °� PERMIT FOR PLUMBING - ,SSACl/USE� _ This certifies that ,`:,.. . . . . . . . . . G:'I A1'. ... . . . . . ,�' . . . . . has permission to perform I�_ f,: l�l . . . . !. . . plumbing in the build'n' of . . �i. . . . . . . . . . . , . , at.!.%. . . : . . . . . . . . �... . . . North/Andover, Mass. Feet Lic. No. PLUMBING INSPECTOR tJ }: Check #7. 6367 i MASS CHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING ' . (,rint or Type) Zo.ey].d 1&rVass. Date Permit # ' Building Loc-a7tion Z 2d r •c� Owner's NameET 1/11, / Type of Occupancy Residential New ❑ Renovation ❑ Replacement IN Plans Submitted: Yes❑ No ❑ FIXTURES z Ln �i N N W O Z N W Y J N >- O Z W F- W cc = 2 N z W Z 2 ` d i-' -4 Cr _j 7n V Z a: m N W > 1- N .� p Q (// W O r W Q N O Q J Ncc J Z O O LL W Z Q S 3 O Z S X a. Q H a Y Q W LL '41 i� r > H O W a. D N ►' Z O O 0 x W O U 3 Y m N o o a 0 a J ., a cc a a a 0 a S 1 3 r- 0 U. a 3 ¢ a) 3 3 SUB—BSMT. BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR STK FLOORETT Installing Company Name Heritage Htg. &Plg. Co. Inc Check one: Certificate Address 35 Pleasant Street EXCorporation 714 Stoneham, Ma 02180 .1 Partnership Business Telephone 781 —438-7776 (1 Firm/Co. Name of Licensed Plumber Gordon Switzer � • INSURANCE COVERAGE: _ have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes ® No ❑ . . If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability Insurance policy L 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: Owner ❑ Agent ❑ Signature of Owner or Owner's 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 Stale Plumbing Code and Chapter 42 of the General Laws. By Si o consed Plumber 1 Title Type of License:Master[ Journeyman❑ City/Town i 8 3 2 2, L APPROVE6(Ol IC USE ONLY) License Number I 71 a'I . ,i '/Z"Watts 9D bfp on water line to water bo titer I BELOW FOR OFFICE USE ONLY FINAL INSPECTIONS SKETCHES PROGRESS INSPECTIONS FEE — NO. APPLICATION FOR PERMIT TO DO PLUMBING NAME do TYPE OF BUILDING LOCATION OF BUILDING PLUMBER PERMIT GRANTED DATE _19 PLUMBING INSPECTOR r' Date.... 94� `. . i pORTM TOWN OF NORTH ANDOVER p PERMIT FOR WIRING SSAcMus� 7 This certifies that ... t. ! .. /� ........:� '.... ..f.. /..... ..... ..... has permission to perform .... .... ... . . . . .................... ...... /....... wiring'n the b ilding o /.......... / ..................................................... at./ ��jj ...f/... 1 aL.:..�� ........-- ..........���......... ,North Andover,Mass. ,Illy Fee_ ,/.. . Lic Nd .... y'-Y �! �G! .....,.... �..... �"........ ELECTRICAL INSPECTOR Check # i .'A R— I A a 10 it I;n.U� Occupancy:)n,.l Fee Cheqcd c, � BOARID OF FIRE PREVE-NTION RFGU1..AT1C_NNS (Rev I I/qqj i lcav, blli APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK A It wmlit to lie perloro wJ in ac.L ot dzmc c 0, oic s•.iiomsci tis [lorif icil Cotic(,\I 7 CN IR 12 flo W1-1:-JSE 1'/?/irVT IN INK 011 f'YPk,'ALL INT O, A'iV.?J,i! City or TONVII of: (�I- To 0ic ln.sIwciov o)' IP,jj (,.S, llicni:cm it) pci Iorm the c1ccil ic3l Nvor�' described below. By (Ills APPIK"M Oil (lives lio," r Loc:wtm (Street & iNimil)cv) Owner or 'Ycnisil iion�No, Owner's Utlress IN this viermi( iii coiijuitoimiperm i Y NoI (check ,\pprnjlri3ito I'm prise Of LJli1Hy1/'1Km,., i7fliuii No. E05fillo Set vitt' 0�C I ll C'A L1 0 o, u( elers A ;;;,tit ON C010.1d EJ Uol)grd 0 NMNO. Number of Y,(,.tders mid Amp.icil.v Locltiolilarts Nature of PtDI)OSod Fiedricni Work: - INO. or Rece'l.led Fixtill,cs Nq.of(.CIL-Susp (1'adkj1c) Falls 1 0. KVA No, of t.1gilring 01,I)el.S IND, at I lul Tuhs cncrafars KVA Above of Lighiijig Fixlw-i.s SIN immilt Poul j D - o lu of Recepllcle Outlets ()it 13"'ne"s ------ 0 Al /LR JS No. of sivilchei —o of c,�� ef—I —0rue—te c I FO-1 x I n,I _jt'_10a1 iqjij)Q vlet$ INV. of Rnnges Nrl, of Air (.oud. T DF1.1 Tong No. of Alerflog Deoccs No. of VV- Nm% I �Ors— av�� 40 n m No. of Disliwashers _q Spnce0req 111lopi -- ------------- 1, 1 01her )iv vsm No. of Dryers Acnlinp APDl13111C(15 i� )IS, IN'0:0 I"De N-i C, i�!_rk I 1 0 I)lt^ Wiring: No.of Devices or Erri"IV0011t No. "I'dromalsige 0.1111(ubs JIN0. of Molors Toial cfecon)MU'lloliom 'f1' 11g, OTHM: Vdemi/if desired,or as rogifireft by tile filspecli.;ir of Wires. I NS(j R..-kN C F Co N,-E jt,\G j:: Unless waived by the 0 NN liel. 110 perm t for the PCrF()rmjjjcc 0 tile lic ensec Prov idt's Proor o(I tabilic y i i1sur 101c r. i1w 'c or 1P le led f decrrical work nt;3y issuc utilm Und0signird oemifics 1h.11 $11c cQvcf,'-qc 01[ its Sub�(anfial rquivolcm, Thc Cllr- bK 9,NF.- iNMSSIR UK-DOND _j\NIC r 7 I I IA e of Elcc(I I C31 Wo I Lcillo!rckl by mm)I crpjj poll,) (EN,picition D.vc) Wotk to Still hl5pc'(1(oi1s it)be it I ceviirr+ 1 "' f."I""c' %s 10, and lipon Loripletion. nit 1\,.�INN u l�ro r fruemij comp/r/o 1z LJC. n/:.at ^;,l<N',4 Irl a rhe ft' 11 Sla It A111. T 0 WIN i`, \NCE \dA 0t:,( Ill;' illsw$Once c0%cr.qlk: normally j by In 1,c bolu\". I heicby 1111" rr. Jill(11� ". - m,rIA ge i oiw) D 11,N1 I Ic 0\�tic 17's IVIC,1111, ORTH T0VMOf Andover No- 451 - _ - _a / .ago 91 ower, Mass LAKE COCMICNEWICK ATED pCl) BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....lv.v.e7AY cl e it /0DN !.e A P.ap&.,q s has permission to ee M....�..... .....�! r buildings on A*#* do a ss "04t Rough .. ............ .............................................................. to be occupied as W *M e /�A G �I"O i !moi p� p�� w�+�+f /f� Chimney ..................... 1 .............................��'....................................... ...... .............. .�... provided that the person accepting this permit shall in every respect conform to the terms of the application on file i Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, eration and Construction o Buildings in the Town of North Andover. o y y�� �s PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS of LESSCONSTRUCTION STARTS Rough 6,,.,-...................... ......................A� �............ BUILDING INSPECTOR Sem Final Occupan g Permit Required t® ®cc O Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises Do Not Remove Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner FIRE DEPARTMENT ` Street No. SEE REVERSE SIDE Smoke Det.