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HomeMy WebLinkAboutMiscellaneous - 194 BOSTON STREET 4/30/2018 194 BOSTON STREET 210l107.B-0063-0000.0 - 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance-with the provisions of M.G.L.c.143,§3L,the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166,§32,an electrical permit shall be issued to the person,firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall-be limited as to the time of.ongoing construction activity,and may be.deemed-by.the Jnspector_of-Wires abandoned-and.invalidaf-he—_. ._ or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this putpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 1 IZ29 8 and extending through August 15,2012. le 8—Permit/Date Closed: --_l ***Note:Reapply for new permgl(, 11 Permit Extension Act—Permit/Date Closed: // Date.......l....... .'.� .... t - � NORTM °�,�``°;•�'"° TOWN OF NORTH ANDOVER f p PERMIT FOR WIRING ,SSACMUS� This certifies that .......... ........���-��...................................... has permission to perform .....,��=��v T C wiring in the building of............. ....................................... at.... .................................................................. . ....North Andover,Mass. d Fee..%. —� T c.No.,�Y.7 � ..... f ............ _ ELECTRICALINSPEC{OR Check li 93 ► 3 Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No.— I , BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT W AW OR TYPE ALL X'0k7kL4TION) Date:. City or Town of: NORTH ANDOVER Wr_ By this application the undersigned gives notice of his or her intention to perform the ele electrical wpector ork idescribed below. Location(Street&Number) ( q H 305-roki ST Owner or Tenant Vl'� p�T/./ / + I- - Owner's Address 2U W Telephone No.12L-15?6,53 /3►'rL� Is this permit in conjunctian with a building permit? ,.. Yes No (Check Appropriate Bog) Purpose of Building �e S 1 p �;�-j A� � Existing Service //v Jy Amps )3.t) lay 4 Volts Utih Authorization No. Overhead Undgrd No.of Meters New Service cjOO AmpsJz� / d.{u Volts Overhead Undgrd No.of Meters Number of Feeders and.Ampacity f Location and Nature of Proposed Electrical Work: Com letion of thELoLlowing table may be waived b the Inspector of Wires. No.of Recessed Luminaires J a No,of CeiL.-Susp.(Paddle)Fans No.of Transformers Total , No.of Luminaire Outlets No.of Hot Tubs KVA Generators KVA No,of Luminaires Swimming Pool Above ❑ �_ o.o mergency No.of Receptacle Outlets d Batt Units g j(� No.of Oil Butaers )^ �S No.of Switches No.ofZones No.of Gas Burners 0.of Detection and No.of RangesInitis • Devices Co No.of Air Total Con d. Tons No.of Alerting Devices No.of Waste Disposers eat Pump amber ons KW o.of elC - ontained Ttals: __ f o _. No,of DishwashersDeteetion/Alertin Devices Space/Area Heating KW Local❑ Municipal i Connection ❑ Other No.of Dryers Heating Appliances Securi S stems:* + KW tY ms: No.of Water y KW No.of o of No.of Devices or E uivalent Heaters Si s Ballasts Data Wiring: No.Hydromassage Bathtubs No.of Devices or Equivalent g No.of Motors Total HP Telecommunications Wiring; OTHER: No,of Devices - E uivalent Estimated Value of Electrical Work: Attach additional detail if desired,or as required by the(When required by municipal policy.) Inspector of Wires. Work to Start 'Ll3 r 10 (When to be requested in accordance with MEC Rule 10,and upon completion ' INSURANCE COVERAGE: Unless waived by the owner,no the licensee provides proof of liabiIi permit for the performance of electrical work may issue unless undersigned certifies that such cov liability insurance in forcle including has exhibited d peted roof of same to the permit issuiperation"coverage or its nno equivalent The CHECK ONE: INS URANCE OND ❑ OAR S e. I certify,under the pains and penalties o ❑ (Specify:) . fP�lury,that the information on this application is true and complete FIRM NAME: Licensee: L- 11 1 T L LIC.NO.: �3r3�'J+G Signature �� (If applicable, enter exempt"in the license number line.) LIC.NO.: �a Y Address: LU t-G f S7_ �C:�J Ul Bus.Tel.No.:-7 -1!�1 ala 3 *Per M.G.L c. I47,s. 57-61,security work requires D Alt Tel.No.: OWNER'S INSURANCE W epartrnent of Public afety"S"License: Lic.No. An'ER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one) ❑owner [I owner's agent Owner/Agent Signature Telephone No.----. PERMIT FEE.,S' Q �z P(Ij e4hl-Z C44- �L F Y The CommonWea&h of Af,7srachusetts kj l Department of fndustriid Accide d, ! Q Ice o f Invesg ti ations aaa i/ 60Q N�ashington Street Boston, MA 02111 f�t WtM.jrjaSS.&0V1dla Workers' Compensation Insuranee Affidavit. Bailders/Contra.ctors/Eiectricians/piambers A ficant Information Please Print Legibly Name (Bitsmess/0wir.a4on/Individual): Address: City/State/Zip: Phone#: . FE9/1 employer?Check the appropriate box: employer with 4, Type of project(requires: ❑ I am ageneral contractor and I ees(full and/orpart-time).* have hired the sub-contractors 6 LI New construction ole proprietor or partner. Iisted on the attached sheet i 7. ❑Remodeling d have no employees These sub-•contractors have g for me in any capacity. workers, comp.insurance. ' Dernoiitionrkers'comp.insurance 5. ❑ We are a corponrfion and iLs9• ❑Building addition ]III officers have exercised their l0•❑Electrical repairs or 3.❑ I am a homeowner doing all work right of exemption per MGL 1 l.❑Plumbing additions R1Ysel£[No-workers'comp. c g repairs or additions 2, §1(4)'and we have no 12 Roof insurance required.].t ❑ repairs .employees. [R(o wor}cts:s' comp• insurance.require.&J 13.❑Other '�}epp[icert tivlt Cheeica bo>#l must also fi[1 out the station below showin ;Amy who submit this affidavit indicating they are loin a0 B their workers'bompensation policy information. 4conmwtors that chcak this box must N° and than him outside contractors must submit a new affidavit indicreting such attaoirad an additional sheet showing the trt'me of the sub. cottctrnF a� _ wirup. f on an employer that is m ' ut ,rt ,inihrrnaiion. information �°,f> g:warkers compensation u7suranceformy,employees: Below is theo P hry mad job site . Insurance Company Name: ' Policy#or Self-ins. Lie.#: Expiration Date: Job Site Address: Attach acopy of the workers' eom City/State/Zip: pensation policy declaration pag Failure to see(showing the policy number and expiration date)• cure coverage as required.under Section 25A of MGL c.152 can lead to the fine up to $1,500.00 and/or one-year imprisonment,as well as civil penalties m the form imposition of criminal D Penalties of a Of up to$250.00 a day against the violator. Be advised that a copy of thif a STOP WORK ORDER �a fine investigations of the DIA for insurance coverage verification. s statement may forwarded to the office I do hereby cetfify under the pains and penalties ofpcorury j*at the informationrov ' P rded above is true and COMM Date: Phone#: Of, ficial use only. Do not write in this area,to he completed or Y city town official City or Town; Permit/License# Issuing Authority(circle one): 1. Board of Health 2 Building Department 3.City/Towta Clerk 4.Electrical Inspector 5. Pinmbiag Itespector 6.Other Contact Person: Phone# Date. .`.�. '. .�.J i f pOR7M,1 TOWN OF NORTH ANDOVER ~I PERMIT FOR PLUMBING ,SSACMUS� This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission to perform . . . . 4. t ;���. :-:` plumbing in the buildings of . .' �L� �`k'!`.' . ./�` %!t?.: . ..�.. . . . . . . at.��`► . . .�; f .!?�!! . . . . . . . . . . . . . . . North Andover, Mass. Fee.62Lic. No.jL,—). y . . . . . . . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR Check #f 8661 J y; MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING (Type or print) Date A /0 NORTH ANDOVER.,MASSACH SETTS +r Building Locations --.—.— Z�` ,S fi Permit# -mount$ Owner's Name '„�p� New1 1 Renovation ❑ Replacement Plans Submitted ❑ zWz � pc4 � 0 U Z�z w Zzz¢ F W W 44 p W U m �' $ C W z 0 > W Z cz < Q O O W w� O C' m o m w 3 c U a U x > c a p SUB -BASEM ENT BASEM ENT IST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR -6T H . FLOOR 7TH . FLOOR STH . FLOOR (Print or type Check one: Certificate Installing Company Name h4k i �-j C, Corp. Address Aa4� E] Partner. Business Telephone _ OTirm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check o I have a current liability Insurance policy or it's substantial equivalent. Yes ff NoQ If you have checked yes,please mokate the type coverage by checking appropriate box. Liability insurance olicY Other type of indemnityEl 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 Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts Stat YPAAe and Chapter 4 General Laws. By: Signature of Licensed Plumber Or Gas Fitter Title ©Plumber i.0 City/Tovm ❑ Gas Fitter License Number Erm- aster APPROVED(OFFICE USE ONLY) ❑ Journeyman The Commonwealth of Massachusetts Department o f Industrial Accidents Office of Investigations 600 Washington Street Boston, AfA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leqbiv Name(Business/Organiza6on/Individual): Address: City/State/Zip: Phone#: Are you an employer?Check the appropriate boa: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor etor or partner- listed on the attached ached sheet 7. ❑Remodeling ship and have no employees These sub-contractors have 8. EJ Demolition working for me in any capacity. workers comp.insurance. [No workers' comp. insurance 5. 9 ❑Building addition p ❑ We are a corporation and its required.] officers have exercised their 10.0 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4);and we have no 12, Roof repairs insurance required.] t employees_ [No workers' ❑ . comp.insurance required.] 13.7 Other *'zay applicant that checks box#i must also fill out the secaur below s'-wi 7 eir wcrt a s'compea;ation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers' comp. policy lic information I am an employer that is providing workerscompensation insurance for my employees. Below is the policy and job site information. Insurance Company Name- Policy#or Self-ins.Lic.#. Expiration Date: Job Site Address-City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing theolic number an P Y d expiration date). Failure to secure coverage as required under Section 2 q SA of MGL c. 152 can Lead to the imposition of cnmmal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct Signature: Date.: Phone#: Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation orother legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of cox npliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants . r Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of i insurance. Limited Liability Companies (LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. 'If an LLC or LLP does have employees,a policy is required Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be retuned to the city or town that the application for the permit or license is being:-ques+.ed,not the Depararrient of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"aE locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would Like to thea..you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. # 617-72.7-4900 ext 406 or 1-877-NIASSAFE Revised 5-26-05 Fax#617-727-7749 www.mass._eov/dia Date.4D. �S. .'.. .I.�.. OF NORTH try o? D TOWN OF NORTH A VER 41. �a - . PERMIT FOR GAS INSTALLATION 9 - � 0 SACHUSEt This certifies that . . .Y. �. . . . . . . . . . has permission for,gas installation in the buildings of/ !!'.I.�'i .4 ",j. . . . . . . . . . . at . . . . . . . . ., North Andover, Mass. Fee. .5? . . Lic. No.:�.�.4�7. . . . . . . . . . . . . . . . . . . . . . . . ... . GAS INSPECTOR Check# Z 7214 r r MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS �( Building Location < Date J- /Permit# Owner Amount Owner New Renovation Replacement ❑ Plans Submitted Yes No FIXTURES &1S1+1VII�T1 IST ELOCR 2%ELOM 3M ELOM �>QOQt 6iM NJ" 7IM E[OM gm Rom (Print type) �Y 7 f ` Check one: Certificate InstallingCompName l ( A' Corp. Address ��`� Partner. Business Telephone aFirm/Co. Name of Licensed Plumber: vJ i Z_:-T ala Insurance Coverage: Indicate the U=of insurance coverage by checking the appropriate box: Liability insurance policy Q Other type of indemnity n Bond Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above threeinsurance Owns' Agent I hereby certify all of the details and information I have submittedor ( entered)in above application are pp true and accurate to the best of my knowledge and that all plumbing work and installations perfo ed under permit Issued for tb;s application will be in compliance with all P ent visions of the Pim Massachusetts sachusetts State PAi e an�Cha By: eQeneral Laws. ignature or EicensecypFuLZIM—n Title Type of Plumbing License City/Town icenseumtwr�— Master Journeyman APPROVED(OFFICE USE ONLY ❑ ... _ � .. t ,. n . '..': 1 i .. _.... t The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.nzass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip: Dy a� C() Q (� n Phone#: 70- Q� /- / 9 / Are you an employer?Check the ap ropriate,box: 1.❑ I am a employer with 4. ❑ I am a general contractor and I Type of project(required): employees(full and/or part-time).* have hired the sub-contractors ti' New construction 2. I am a sole proprietor or partner- listed on the attached sheet t 7• Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. ' insurance 5. 9. ❑Building addition [No workers' comp. i p ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11- Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.] t- employees. [No workers' comp.ins I3.❑ Other p urance required-]`..ny applicant that checks box#: must also rill out the section belor. shcs•ag worker-!co;;�Ywsation Policy info mation. r Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workerscompensation insurance for my employees. Belot is the policy andJob siteinformation. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to sec M' GL coverage as required under Section 25A of MGL c. 15 2 can lead t I� fine u _ o the imposition of criminal penalties of a p to$1,500.00 and/or one-year imprisonment,as well as civil penalties inthe form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. 7do eby der the pains a s o, perjury that the information provided above is true and correct re: �/ _ / _IfD Date.: Phone#: Fonly. Do not write in this area, to be completed by city or town offciaLn: Permit/License# hority(circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector 5.Piumbing Inspector 6. Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers',compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer, or the receiver or trustee of an individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary, supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of 1 insurance. Limited Liability Companies(LLC) or Limited Liability Partnerships(LLP)with no employees other than the members or partners,.are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be-„turned to the city or town that the application for the permit or license is being reques*. d,not the Departs ant of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary) and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Wasl'tinngton Street Boston,MA 02111 Tel. # 617-72.7-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass..govfdia Date 9/ o//Z- NORTH TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that C .P-� has permission to perform�P .�,1!�u.� rP plumbing in the buildings of .30(-J. 4'e PO ,-i . . . . . . . . . . . . . . . . . at. . ` . . . . . . .. . 5:�?. . . . . ..e Q ., ort /CTOR ass. Fee�5- . . .Lic. No3Z1(3U. . . r�(a. . . . . . . PLUMBINGINS Check x t Z 8414 ji N�& r � MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY Q MA DATE f PERMIT# JOBSITE ADDRESS LLZY s� OWNER'S NAME 0 etc) POWNER ADDRESS 25Zn TELT— 11FAX TYPE OR OCCUPANCY TYPE COMMERCIAL® EDUCATIONAL ® RESIDENTIAL PRINT CLEARLY NEW: Z RENOVATION:® REPLACEMENT: PLANS SUBMITTED: YES® NO® FIXTURES 7 FLOOR— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB __�J ( ( 1 CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM { DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR l AREA DRAIN J _ I _I I ,_____J •__ i INTERCEPTOR INTERIOR �� � _ ------- KITCHEN SINK _I LAVATORY ROOF DRAIN SHOWER STALL SERVICE/MOP SINK1I TOILET URINAL I WASHING MACHINE CONNECTION _ WATER HEATER ALL TYPES _( I WATER PIPING OTHER INSURANCE COVERAGE: have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES 0 NO Eli IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE OF INDEMNITY 0 BOND OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts eneral lw �nd that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER 0 AGENT 0 SI AT E F OWNER OR AGENT I hereby fy that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME : _S �—IILICENSE# t' l00.1 SIGNATURE MPD JP CORPORATION D# PARTNERSHIP# I LLC COMPANY NAME 4VIL1�• j ADDRESS 4j/ eCy S ` CITY ear! STATE ZIP C-) TEL 7 0 FAX �� CELL IL - ��11 EMAIL ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes 4;;0z . 4 THIS APPLICATION SERVES AS THE PERMIT �f 71 FEE: $ PERMIT# PLAN REVIEW NOTES a ry The Commonwealth of Massachusetts Department of IndustriglAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/clia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'b . / ' Name(Business/Organization[fadividual): hfl5r �Q e!1 d/`!A1;1 A Address:`_ Xtlf-selq ►5�- City/State/Zip:_ 5Gle M I'JA 1 d 157a Phone M (c17$) 30-L/- 7a7Q Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I a employer with 4. ❑ I am a general contractor and I 6. ❑New construction imployees(full and/or -time).* have hired sub-contractors 2. I am a sole proprietor or partner- listed on the attached sheet.x 7• E]Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working forme in any capacity. workers'comp.insurance. . g, El BI addition [No workers'comp.insurance 5. ❑ We area corporation and its required.] officers have exercised their 10.[J Electrical repairs or additions 3.❑I am a homeowner doing all work right of exemption per MGL 11.[]Plumbing.repairs or additions myself.[No workers'comp. c.152,§1(4),and we have no 12.❑Roof repairs insurance required.]► employees.[No workers' comp.msurancerequired.] 13.❑other 'Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. T Homeowners who submitthis affidavit indicating they gre doing all work and then hire outside contractors must submit anew affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy andjob site information. Insurance Company Name% Policy 0 or Self-ins.Lie.k Expiration Date: lob Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A ofMGL c.152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance co erage verification. .Ido hereby cer er tl p s an na i ofperjury that the information provided above is true and correct. - Si ature: Date: <P ao f Phone k FOther only. Do not write in this area,to be completed by city or town official. n:. Permit/License 0 use (circle one): I. Health 2.Building Department 3.CitylTown CIerk 4.Electrical Inspector 5.Plumbing Inspector son: Phone#: Information and Instructi®�rn� Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,• express or implied,oral or.written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the Insurance coverage required" Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)andphone numbers)along with their certificates)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. Han LLC or LLP does have employees,a policy is required. Do advised that this affidavit maybe submitted to the Department of Industrial Accidents fox confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(ifnecessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. Anew affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number.- Tho umber:`aha Common moalth o iassaoliv.:setts Dop.aftentofJndustdal,, coldoats Woe of juestigatitons 600 WashiVoa Street Boston,M&02111 TeJ,,#6x7-727-4900 ext406 or 1-877:WASSAFF, Revised 5-26-05 `ay,#617"727-7749 WWW.Mass,Lxevfdia 6/21/2012 Rick Danforth Plumbing Inspector Town of North Andover 1600 Osgood Street North Andover, MA 01845 Site:Addition at 194 Boston Street North Andover, MA Mr Danforth, This letter is to confirm that we want to change the licensed plumber of record from Matty's Plumbing and Heating to Chris Stanchfield Plumbing.There was a disagreement on charges with Matty's Plumbing. Please feel free to contact me directly at 978-806-1662 if you have any questions. Thank ou, Matt Goodrow O O CLQ' i , .9.�qll toOk y °� ep A,. ���5 Q�`fi J�a���i.��4. �o• vis 4 0cll � G� A �q VC i �� i i ,\ � / \ / ,` � �` � � � � / .,� . . � \ r .\\ % MASS'ACHUSETT,S' _ DRIVER'S= 4. LICENSE�- - r uSA OF MA �sa ONE�v79Z503�G� a 3 co ' 0 .29.197 15 SF70.M§.•1 11: -- .E 5� e 1 NURSERY STREEF. s N SALEM;MA 01970 3 G /f,', ��� S w os•x:o,1 R�v07•iS20QD ��`� . Commonwealth of Ma usetts Division of Regis Board of Plumbi CHRIST IEL a 60 LIBE ` APT 3 W DANVER c" a z Joumeyma PL32100-J 05101/2012 004019 Expiration Date.. Serial No. License No. , Date... N2 2477 ... ... 45;' TOWN OF NORTH ANDOVER 0 I- A- 1100,18k. 'A PERMIT FOR WIRING 40 1 Thiscertifies that ..... . ... ..................................................................... has permission to perform ......A-41................................................................ wiring in the building of.... .................................... at/...9111........ ...........................41--� . A................... .North Andover,Mass. Fee—.-b................ Lic.N0/7Ttk..>.. ......................................................... t// ELECTRICAL INSPECTOR Check #Za--� WHITE: Applicant CANARY: Building Dept. PINK:Treasurer IC1 E E/LY1LY1(JYVYI 1fl"rLYIf1-" dl1r—l13 vruceuseonty � DEPARTMNVT0FPUBLICS4FM Permit No. BOARD 0FMEPREVEAW0NREGUL4T10NS5270fR 121X1 ' Occupancy&Fees Checked ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 o (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date �02� 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) �L� Aa C/©telsT Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes No ® (Check Appropriate Box) Purpose of Building /,{JS/Lffce Utility Authorization No. Existing Service Amps / Volts Overhead Underground ® No.of Meters New Service Amps / Volts Overhead ® Underground r7 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work ✓' rr _ pp No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA ground 13 ground No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Wtiating Devices J 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 Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER s Irr;lrxreCaaage Ptasua4bthetegtmana�tsofdntGer�alLaws I ea=utLiHityk&arcePb yutdudngCarrpkte Cueawcritsabslati apiva YES ® NO Iharesthno�dvandpoofofsatmtotheOffo,-YES ® Ifyu hawchcdW YES,please h&&thetMxcfcowraEp by chmkingtbe MiTriMbcx INSURANCE BOND OTHER ® ftweSpacffy) E#ationDale valueofIIatr WorkiDSiat © Ir�ectionDaleRoWe>led Ra�I w/ ee>/% F Work$ Sigred ut�'�ie of FIRM NAME /c'r c � hl� G /ez:;-G7'`r�is is Al Li MNTQ t�swan Lio=l b aw,essTdNa --?ML—3 5�'3 AiTe1Na OWNER'S 11,0 VCEWANER;-lamawaretbatheLiome Cott thei t tr9ss egrivalt asragmedby C alLaws aod�mysigr�hsetxrihisp�rriithis lagtt�nag. (Please check one) Owner Agent ® d� Telephone No. PERMIT FEE�� Location No. '" Date TOWN OF NORTH ANDOVER a Certificate of Occupancy $ Building/Frame Permit Fee $ 4 �&S.CMSE` Foundation Permit Fee $ f r , FF $ Sewer Connection Fee $ Waster fttiection Fee $ TOTAL $ Building Inspector Div. Public Works Location 'ty os Gam+ S a` No. _35g Date ,YOR7h TOWN OF NORTH ANDOVER p�tt�ao ,•,�O p Certificate of Occupancy $ 41 Building/Frame Permit Fee $ e c►+uE�� Foundation Permit Fee $ s� s Other Permit Fee $ � Sewer Connection Fee $ �Tater Connection Fee $ 41 $ a v r 2 � X999 Building Inspector Y f p Div. Public Works PERMIT`1N0. 1:M APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP J0. 1 LOT NO. 2 RECORD OF OWNERSHIP iDATE IBOOK PAGE — ZONE SUB DIV. LOT NO. ` EC-EAT / PURPOSE OF BUILDING OWNER' AME Q NO. OF STORIES SIZE � /� �X Z7' 7 CL s OWN 'S ADDRESS S BASEMENT OR SLAB / �-V A ITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME 'T1 13 Q 7'1 7 7-- SPAN --- DISTANCE TO NEAREST BUILDING S DIMENSIONS OF SILLS DISTANCE FROM STREET /� / POSTS DISTANCE FROM LOT LINES-SIDES .1 REAR 3(5)/} " " GIRDERS "'TTT AREA',OF LOT / `7 G fe FRONTAGE`Jw`�jjti * HEIGHT OF FOUNDATION THICKNESS / i > JCJ IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION ,�/n MATERIAL OF CHIMNEY �» IS BUILDING ALTERATION y� S IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER Tem BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER fA 162 IS BUILDING CONNECTED TO NATURAL GAS LINE \ �. INSTRUCTIONS 3 PROPERTY INFORMATION 1 LAND COST SEE BOTH SIDES /1/"@�K/ �L- • 'T�, j EST. BLDG. COST / mss UIUc EST. BLDG. COST PER 8Q. FT. PAGE t FILL OUT SECTIONS 1 - 3 ! �C r PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT R T NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FIYED V / -IO ` BOARD OF HEALTH . SIG TU OF OWNER ORA KIZED AGENT QWbIER TO it GOD ,3ip F E E CONTR.TEL.# CONTR.LIC. Z PLANNING BOARD PERMIT GRANTED l 19 BOARD OF SELECTMEN BUILDING INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY I STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 3 112 I3 CONCRETE BL K. PINE BRICK OR STONE HARDW D _ PI� PLASTER _ DRY WALL _ _ UNFIN-77-71 . 3 BASEMENT AREA F`LL FIN. B M AREA _ FIN. ATTIC AREA _ NO BMT FIRE PLACES _ HEAD JOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARD\ND _ ASBESTOS SIDING _ COMMON VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR I_ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR POOR ADEQUATE ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH (3 FIX.) _ GAMBREL MANSARD TOILET RM. )2 FIX.) _ FLAT I SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T s2nd I_ ELECTRIC 1st li3rd NO HEATING b r 1, Conomo Point Road, Essex a., Mass. 01929 8/15/91 , For: constuction (. footings, frame, roof- ) of wrap around porch at s 194 Boston St. , ..=A?%1over. Dimensions; length, 20'x 27 ' width 7 . ,. - height at eaves, approx.- 7'6" Work. shall consist of: a) Poured sono tube footings approx. 6`9" o.c. e/e-✓e'�O I b) 4"x6" x 8' P.T. . posts c)'Dbl. 2"x 8;' joist. carriers"`P.T. S C,/ tic d) 2"x 8" P.T. foists, 16" o.c. e) Dbl. 2`"x8" K.D. rafter header lag 6e)/74ed O f) 2'x 6" K.D. rafters, 16" o.c. ' g) �2, C.D.X. sheathing }- 5��,, h) 20 year asphalt shingles, at.,5 2" to the weather i) 2" x 4" ceiling joists, 16" o.c. j) All necessary aluminum flashing Total cost of Work to be completed: $3755 F 6, Price is quoted upon following conditions; 1) Existing house sill to be in good condition, able to support joist band. 2) House sheathing to be in good condition. All work necessary to correct existing structural faults shall be charged at $20 per man hour. No painting, staining or finishing of woodwork/ shingles is included in quote. Work to be done consecutively, barring inclement weather. Payment schedule; $1500 ,:i at commencement of work $10.00 at completion of framing $Balance at completion of work to customer's satisfaction. Derek Brown, Mass. Lic. # 043972 J� CONSERVATION.—_ SINAL SEWERMATE- R_ _ _FINAL NORTIy ANNING FINAL Town 6 veer ILIO. 358 ° •__ „ .. _,,.. DRIVEWAY ENVY PERMIT er, Mass., lqus / Co. 1941 C HEWICK SS BOARD OF HEALTH PERM .IT T, LU THIS CERTIFIES THAT...............Tm.y.......Fq.2.rUt.(........................................ BUILDING INSPECTOR has permission to er"t ... 4 ........ buildings on Rough to be occupied as........ ®4 :L: `.. .UIJ.[.4�N..�',...�R: �.!:�.�.....!Zi�jK .27/...^ iTIc. Chimney Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Rough Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough Service Final .......... .. ... ... . ..... ........................... BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Burner No Lathing to Be Done Until Inspected and Approved by STREET K,.', Det. Building Inspector 4 I I Q n I % •N n BARN i I i 1`RN. OWER. A/14 OF1 33178 1 ff SS►O�p , Suave°� �OST•4N Sr'`�� r ' - i AMERICAN SURVEYING COMPANY r—A. f3apmlcx 135 Beaver Street Waltham, SIA. 02154 (817) 883-8477 REGIST0110 LAND SURVEYOK O HEREBY CERTIFY THAT TH6 ♦i [� SOVE "T"GEEP/NSPEC ION a e Inspection Plan rV M9! CDR" IN __L . _ ONNECTION WITH A NEW DATE 1 1 •2•f5° R[;CORDgD ATs^� County REOISTAY OF UEE08 IN BOOKoi9 PAGE asz ORTGAG,E AND IS NOT INTENDED CLIEN�E • M PLAN REFERENCE: ��� �' ,,`020 SOAN AP R REPRESENTED TO BE A LAND J.O. 0 D DRAWN AS PER TO WW?51�-��TAX ASSES R PROPERTY LINE SURVEY. NOADDRESS: 49015 8 ORNERSWERESET.ITgANNOTBE THE LOCATION OF THE ORIGINAL iSED FOR ESTABLISHIN(!-FL`•NCE, DWELLING AS SHOWN HEREON IS IN BORROWER:w r-*R�Zr!. -_ IEDOE OR BUILDING LINES. O COMPLIANCE WITH THE LOCAL APPLIC• IESPONSIBILITY 18 EXTEND D ABLE ZONING, BYLAWS IN EFFECT SUBJECT DWELLING LIES IN FLOOD ZONE lEREIN TO THS`LAND OWNER OR WHEN CONSTRUCTED.WITH RESPECT AS SHOWN ON FLoOD.IN8URANCE PROD FL IN RAN E =UPANT.IV IS NOT INTENDED TO To HORI�OtVTAL DIMENSIONAL AE- RATE MAP IE RECORDED, QUIREMENTS, UNLESS OTHERWISt: CO�AMUNITY +� 2F.n�9 SHOWN HEREON. DATED: IE I ► /z 8� SGA AC-At -- a N M a - ,N ti SA,t �c,srxr �Nev �Rk arvcu. A/9rt t OF C.A. 3 178 1 ^•�'"""""'""_"w fEss+ SURv�+ ,BOSr'ON AMERICAN SURVEYING COMPANY c-,A. $t/. ,Vxx 135 Beaver Street Waltham, MA, 02154 (617) 883-8477 REOIST15AED LAND BURVEYOR, T THE ROVE RL ORTWE INBY CERTIFY 6 ECTION �pp r1/ W M7'6- C404,1` FOR Mortgage Inspection flan '4NNECTION WITH A NEW DATE 11 •2 f5� FItCORDED AT 4FSS�—Eour� `CREGISTRY OF DEEDS IN BOOKloi9 PAGE 45"- JN Z �ORTGAGE AND 18 NOT INTENDED CLIENTlTE • o 9 PLAN REFERENCE: P[.W f X020 A REPRESENTED TO BE A LAND J.O. d ADRAWN ASDDRESS: PER TO Q�s>x► 5 AQ��Eib`dA� �R PROPERTY LINE SURVEY. NO THE LOCATION OF THE ORIGINAL IORNER8WERE SET.ITGANNO—TBe DWELLING AS SHOWN HEREON IS INBORROWER; gR4 44 ISED FOR E9TAALISHINO FENCE. COMPLIANCE WITH THE LOCALAPPLIC• IEWE OR BUILDING LINES. NO ABLE ZONING BYLAWS IN EFFECT SUBJECT DWELLING LIES IN FLOOD SONE IESPONSIBILrrY IB EXTENDED WHEN CONSTRUCTED,WITH RESPECT AS SHOWN ON FLOOD.INSURANCS PROD FL INSURANCE ►EAEIN TO THE"LAND OWNER OR ti9I1ONTAL DIMENSIONAL FIE. RATE MAP 0010 e I)WUPANT.IT 19 140T INYEND5D TO "p 'IE FIECORDED. TO TO (E l;NTB, UNLESS OTHERWISt: COMMUNITY SHOWN HEREON. DATED: 1• I S _��. SRH ROF,l1 TPP).-f'F.A I.in i rnn �•r �.- _ __ _. - - - - - August 29; 1991 - In the excavation of the footings for the porch performed on thisday, the building inspector has informed me that some of the footings_do not extend the required 4.0 feet below the surface. He has also notified- - - me of my options. After inspection of the excavation site I accept the depths that were reached because either ,(1) a footing does reach the required 4.0 foot depth or (2) the footing was atleast 3.0 feet deep and-based - on solid rock which appears to be ledge. S - AV _ UZ4 \ _ .. _, +�1 � � 1 1