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Miscellaneous - 20 KITTREDGE ROAD 4/30/2018
Date. C1,— / (.`d. G ............... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that A...... �)..4 E has permission to perform wiring in the building of ....... (&.,1.........,,t? .�.d... v..Yv ............................... at ................. ki'................................................ . North Andover, Mass. Fee ..Q,..5 ... Lic. No...... ................. ELEcrRicAL INSPINSPECTORCheck # 60 9Y 3 I . 7 J I k Commonwealth of Massachusetts Department of Fire Services =I BOARD OF FIRE PREVENTION REGULATIONS Official Usee Only ,.Permit No. U 2� Occupancy and Fee Checked [Rev. 9/05) leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 2.7 CMR 12.00 (PLEASE PRINT IN INK OR :TYPE ALL INFORMATION) Date: 5 • of — O Ci �orTo�,vn of: lU �Je-�— To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) Owner or Tenant t,,) , i Owner's Address 0 elephone No. 971121jJ--CJ37 Is this permit in conjunction with a building permit? Yes ❑ No t9 (Check Appropriate Box) Purpose of Building I Utility Authorization No. Existing Service Amps / Volts Overhead ❑ ur:dgr" ❑ Na, e; Meters New Service Amps / Volts Overhead ❑ •Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of Security and or Fire alarm systems Completialof die following table may be waived by the Inspector of 6Vires. No, of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA 1 No. of Luminaires Above In- Swimming Pool rnd. ❑ rnd. ❑ o. o mergency Lighting Batter TJnits No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No,,of Zones No. oi'Switches No. of Gas Burners No. of Detection and Initiating Devices _ No. of Ranges No. of Air Cond. Tonal No. of Alerting Devices No. of Waste Disposers Heat Pump 1�'umer Tens ._-- K1a/ .___-w__ No. of Self-Coniained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Loca[ ❑ MunicipalConnectioir ❑Other — No. of Dryers y Heating Appliances 1(W Security Systems: '-- �d'y� No: of Devices or Equivalent Devic No. of Water r{W ' 1 lo. of No. of Data Wiring: I Heaters Signs Ballasts _ No. of Dvices or Eeuivalent No. Hydromassage Bathtubs iNo. of Motors' Tota[ HP Y�i 1 etecomcur cations Wiring. No. of Devices or E uivalznt� OTHER: �_� Attach additional detail if desired, or as required by the Inspector of {Vires. Estimated Value of Electrical Work: 574 (When required by municipal policy.) Work to Start: p4�tq inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proofof liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE E BOND ❑ OTHER ❑ (Specify:) I certify, antler the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: ADT Security Services, [tic. LIC. NO.: 1533 C Licensee: Kenny Wong Signature rte;, LIC. NO.: 5966D (if applicable, enter "exempt" in the license number linea Bus. Tel. No.: 603-594-5900 Address lg Clinton Drive Hollis N.H. 03049 Alt. Tel. No.: 603-594-5930 *Security System Contractor License required for this work; if applicable; enter the 'license number here: SS CC 001975 OWNER'S INSURANCE WAIVER: 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 ❑ owner's agent. Owner/Agent FPE71?1V11T FF.E: $ yJr ptnature Telephone No. I Date - � �- ...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that . ---n '4 ..;r .................. ............. — ............................. has permission to perform .... k,. 4 k. -I, ......................................... .......... ......................................... wiring in the building of ........... ..... atc2o ..... ...... ....................... North Andover, Mass. ... .. . . ..... Fee.S� . . ....... Lic. No.3,.Y/dP ................. EL PM�ICALIiN�S Check # N Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 'I �� •7 —cnr Occupancy and Fee Checked •=�`J BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/05] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 5/7 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: //a, "G City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notic of his or her intention to perform the electrical work described below. Location (Street & Number) X20 ,�%f recfz Qd Owner or Tenant Owner's Address Save z -rn Is this permit in conjunction with a building permit? Purpose of Building Existing Service 0200 Amps / Volts New Service Amps / Volts Telephone No. Yes 4�— No ❑ (Check Appropriate Box) Utility Authorization No. Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd ❑ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: No. of Meters No. of Meters Completion of the following table may be waived by the Ins ector of Wires. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets 3 No. of Hot Tubs Generators KVA No. of Luminaires Above In- Swimming Pool rnd. grnd. 0 o. o mergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: I Number I Tons KW No. o Self --Contained Detection/Alerting Devices No. of Dishwashers / Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of El ctrical Work: (When required by municipal policy.) Work to Start: s// ,27 06 Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE CO ERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Q—SOND ❑ OTHER ❑ (Specify:) I certify, under the pains andpenalties of perjury, that the information on this application is true and complete. FIRM NAME: LIC. NO.: Licensee:/0 Signature 7-17a-- /.5.LIC. NO.: 534,Z0E (Ifapplicable, enter "exempt "1 in the license number line.) 1/ Bus. Tel. No.:, 0O-LLXL S -P3 Address: % Uw I kft 4 Q& 1 -, le -11' /1��1r — Alt. Tel. No.: �77-P--.26J--e ?-P/ *Security System Contractor License required for this work; if applicable, enter the license number here: OWNER'S INSURANCE WAIVER: 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $,—;Z6— Date.... ......... TF/ 3? �` TOWN OF NORTH ANDOVER FO P i PERMIT FOR GAS INSTALLATION This certifies that .. 1 .=.:� ............ has permission for gas installation .......... in the buildings of ........................... at e../.. ! j''i{!t:" �'� '• • • ..:.. • • • North Andover, Mass. Fee.;.? .7... Lic. No........... .......... . GAS IPE• TOR Check # MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS MING (Type or print) Date NORTH ANDOVER, MASSACHUSETTS Building Locations Owner's Name New ❑ Renovation Replacement ❑ Permit # 13 i Amount $�',- Plans Submitted (Print or type) 11 ( Check one: Certificate Installing Company Name t 1 I Corp. Addre n r Partner. Busme Te ep one � Firm/Co. Name of Licensed Plumber or Gas Fitters INSURANCE COVERAGE Check one: t have a current liability Insurance policy or it's substantial equivalent. Yes 1:1 Non If you have checked yes, please i icate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity 1:1 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 13 Agent 1 I hereby certity that all of the details and intormation 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 Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusett Gas Co a 42 of the General Laws. By:Signature of Licensed Plumber Or Gas Fitter Title Plumber /-) Z64 �_ Title City/Town Gas F'Lter License tNumoer aster APPROVED (OFFICE USE ONLY) Journeyman __Clam :41, S 1 1 (Print or type) 11 ( Check one: Certificate Installing Company Name t 1 I Corp. Addre n r Partner. Busme Te ep one � Firm/Co. Name of Licensed Plumber or Gas Fitters INSURANCE COVERAGE Check one: t have a current liability Insurance policy or it's substantial equivalent. Yes 1:1 Non If you have checked yes, please i icate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity 1:1 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 13 Agent 1 I hereby certity that all of the details and intormation 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 Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusett Gas Co a 42 of the General Laws. By:Signature of Licensed Plumber Or Gas Fitter Title Plumber /-) Z64 �_ Title City/Town Gas F'Lter License tNumoer aster APPROVED (OFFICE USE ONLY) Journeyman __Clam :41, S 1 Location ' A, " No. Date ~ 40RT" TOWN OF NORTH ANDOVER 3?O�,t `'o ,•,SOL ` Certificate Occupancy $ of CNUSE<� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # - ' / Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: � �-D -a SIGNATURE: Building Commission er/I for of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: a6 X/7xi0(0c 1.2 Assessors Map and Parcel Number: . 661 — // Map Number Parcel Number A), /4/U1V(f6-1Z. 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided R red Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: Public ❑ Private ❑ Zone Outside Flood Zone 0 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record STE V ti 4,?, k /Tn//-% E Name (Print) Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3,1 Licensed Construction Supervisor: J663yz ,Z),g9 CA -1 1,9?A-1-e7-11U Li ensed Construction Supervisor: /I �1"�� M��E J �/ �Ai�iJ Address 4eyAP4-JS -3 63 Signa Telephone Not Applicable ❑ License Number Expiration Date 3.2 Registered Home Improvement Contractor LL Not Applicable ❑ Company Name j� Z,)`u ��A p Registration Number 7?) /2,/,& 1r, 6 Expiration Date i nature Tele hone SECTION 4 - WORKERS COMPENSATION (XG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes ...... X No ....... ❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) X Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant , . OF'ICJAL, USE QNLY ' ; 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (@) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATI N TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUII.DING PERMIT I, 7D AZ4ieA.) as Owner/Authorized Agent of subject property Hereby authorize to act on M If, in all matters relative to work authorized by this building permit application. na o Owner Date ION 7b OWNETRJAUTHORIZED AGENT DECLARATION 1, Z�� �--" mimnit--� 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 �j,�� I/ /`74<67jV Pri ame Siglifitur6 ofjAer/A ent NO. OF STORIES Date SIZE BASEMENT OR SLAB SIZE OF FLOOR TINMERS iST 2 ND 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIIVMEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print Name: Dg1-tou MM W4 - Location: City N ' %moo o V EA In*- Phone F7am a homeowner performing all work myself. fi�;71 am a sole proprietor and have no one working in any capacity aI am an employer providing workers' compensation for my employees working on this job. Company name: Address City: Phone #: Insurance Co. Policy # Company name: Address City Phone #: Insurance Co. POlicy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the 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. I do herby certify under the pains and penalties of iSig erint that the information provided above is true and correct Date Phone # �&,30 Official use only do not write in this area to be completed by city or town official' ❑Check if immediate response is required Building Dept Contact person: Phone FORM WORKMAN'S COMPENSATION ❑ Building Dept ❑ Licensing Board ❑ Selectman's Office ❑ Health Department ❑ Other 1� _ r FORM - U - LOT RELEASE FORM f INSTRUCTIONS: This form is used to verify that all -necessary approval / permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. APPLICANT PHONE ASSESSORS MAP NUMBER LOT NUMBER SUBDIVISION LOT NUMBER STREET /� ��%Z/®� STREET NUMBER OFFICIAL USE ONLY RECON M ENDATIONS OF TOWN AGENTS ,.■ .....�..............................................-.y...... ........ f \ DATE APPROVED 7 2 0d CO SERVATION ADMINISTRATOR DATE REJECTED DATE APPROVED T R ' DATE REJECTED FOOD INSPECTOR - HEALTH SEPTIC INSPECTOR - HEALTH COMMENTS PUBLIC WORKS - SEWER / WATER CONNECTIONS L DRIVEWAY PERMIT FIRE DEPARTMENT COMMENTS DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED RECEIVED BY BUILDING INSPECTOR DATE 0 iu��+� R SkacQ m m m 0 m .... COO) 'O CD O O CO) "0. O CA d n CD O CD CD y. CD CO) 0 O CD O CCD I �I Cr] O z cn C O GO �.cr m 0 S CA o yc�aCL 0 m Z CD 0. CD H T =r d ,,,► a C ffin C O y O y N 0 Cm m > OmCA m t0 .00 0 O D1 0 C7 W � O D c Er ='o d ay C .., co . ` CD CL CD Ce N g: H � d cr c C =` . W n CL CA :E c m V J y N .Z X O CD g cCA � CO O m z �CaD D y N z "0 CD Wim: o X5 CD: _'W O CD: W � m CL=' CA • MO m o.o ►z-3 �. o a , rD r' n 7� °� y 3 x a. 0 ai y � �� o x I H 0 ORTGAGOR: STEPHEN & KBLL ;Y B sRNARD JCATION. 20 KITTRIDGE RD ITY, STATE: NANDOVER, MA )ATE: 1112198 I L07'43 &,P* / LOT 41 a 6.1529 sf ± /3D LOT 42 e 3S.S'•-_/- n r# 20 R=60.00' r __ in AAf R=30.00' L=27, 40' KITTRIDGF. RD Cr# pTjrIt D 7'U: PALLADIAN _ j1t i iioriiv Yj fA iwrtgaa+.lnapactlon wa• prap.red ip•cltltsk W'10r Yrortgaga purposai.only and ttl Of AP 1s nolttdlb+l til1Ild Upon its a land or property flhd;tdttlrl►i Urrd, (br taaordIngl praparinq lord dsselibllbnrl�,br bbdatruetlon: iia corners were CARMEN $red ,tltllldlhq°fbbiltlon hod pttratr are apprbrlYl�tU)i?iboralid on the around. and 11 TA arasrhoUiilipabltleilfit for.tehihq datakathation ehI Andjtd,Mt=totbe ll•ad to aatablish propert No:.1846 o ,71nNsa !hr`Ya!!i1� h,.ahown hateon are bailedon ellahttltutMirhlid=lhlbnetlon and may be du Fd OIaYEP .160 .'ts�ttltlhaT btilhrrlra laklhge� aasabants and rIis ttare of tacord and prosorlptiva 0 Nd( 1110 etFYril(*jhj�bthjr_m ir(88htr> llbrtharn havoclatas, Inc. _ ua�aa no owner or bcaupsnt, C <ttipenrlblfltgxhitalb to the land iie tasponalblllty for draagaa reaultlnq from Pot""'and said L/ its assigns ft b 'anyone other than flu said mortgages 07th its peopcead mortgage tlnenelnq to amid mortgagor. 111 bbnMatfon DEED RBF: BK 3195 PG 350. PLAN REF: #9085 JOB fl: 9815000. SCALE: 1 "=80' yb� h LOT 40 tA.0 rt� S Nt4, w.�1 .%I Thinyr mtgege lnslluctlun was pleperod !n accordance with the Technical Istendardn Ins* Mortgage Loan herylntrbtlbnaofal�ofesalonnited by er�gtneurhesanlera of Land 8u1•veyore 25e 01111.6115. I Its $lets thnt 111 ay prolesslonnl 11111111011 that the streotures ahuwn ebulora with the Incnl'zoning horizontal dlaanalonal $etbnck requirements at the time of eonstruetlon 1 are exempt under provision$ of M.C.L. CII. 4e -A Sao. 7. W10-11property/douse Is not In a Flood Ilazerd.• r32:property/house is lit a Flood Hazard Aron. p ]:I11formation In Inallfticlellt to determine Flood Ilazerd. Flood hazard determined tr N l to rl if mg F od .Insurance It*!tintsl-a11el Date tom__ Zone A Date., .................. %` jl�TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that .............'�.'..r !......... . has permission for gas installation .. ........................ . in the buildings of .......................................... at ............ '....... ................... North Andover, Mass. Fee......... Lic. No......: . Check # I GAS INSPECTOR MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DU t;A,rt t (Print or Type) �i/p , /�,r�,e�01'�''>it1 MA Date / 20� Receipt# � 'fin ��`,d%`/�•`,/W- A41 _ OwneesNam$',f-l/G Building Location - Lot Zone: Type of Occupancy_S'i Map: - New mK--- Renovation ❑ Replacement ❑ Plans Submitted: Yes ❑ No ❑C (5 .001 Fee: v7 "' Y W � y � rn ¢ O�- w w J N ¢ W O F- U m = = Qs o w a Q¢ Y Z c O F z F ¢ © w W O d ¢ W \ N ¢ C7 W U Q W — ?7 W ~ Q ¢ OF c > f,. w _ W W fn N Z Q ¢ Z C7 W w (� U7 ¢ a F- 2 -.1H Z F W w 0> 7L O F- w O H w Z Q W Q [L ~ Y N m 2 Z S y Q W 7 S W z Z Q 5 Q Q Q O W - 0 W ¢ s O v= a 3 c O v¢> c a O SUB-BSMT. BASEMENT 1ST FLOOR ' 2ND FLOOR 2 R 0 FLOOR 4TH FLOOR STH FLOOR 7 I IA 5TH FLOOR 7TH FLOOR STH FLOOR Installing Company Name EASTERN PROPANE & OIL, INC. Checkone: Certificate Address 131 MATER ST DANVERS uA 01923 Corporation Estimate Value of Work: ❑ Partnership Business Telephone 800-322-6628 ❑ Firm/Co. NamPnf i irsansxf Plumber or Gas Fitter INSURANCE COVERAGE: I have a current Ii ility insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes Zr No ❑ If you have checked ves, please indicate the type coverage by checking the appropriate box. A liability insurance policy !D-- 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. Checkone: Owner❑ Agent❑ Signature of Owner or Owners Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and ac: urate to the best of 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 Code and Chapter 142 of the L �% s By Type of License: �' Plumber Signature of Licensed Plumber or Gas Fitter City /Town APPROVED (OFFICE USE ONLY) Gasfitter Master License Number Journeyman T m m cn z m n Fri N r: O O m m y z N m n O z .A No 5�,3 'r Date.......... 25 ,/�/!� TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ....... .. Q........... �...............�i�r C 1.....`..................... 1P has permission to perform ........��. F...:..4. ............................................... wiring in the building of ..... a `? at. �...�................�:....�... ..........k.�................Nocth Mdover,as.. y. Fee.. ? (�.:.� v.... Lic. No. / �. ;31�.....�,,� Vic....../..........; ELECTRICAL INSPECTOR Check # J� WHITE: Applicant CANARY: Building Dept. PINK: Treasurer AAAA/ %- lllAtft%,rL YY, � AMARA VA IIA(74.1:� %( Af%-JLMJA lU "--- -- -.1 /� DEPARTMENTOFPUBIdC&I `'1'�' Permit No. 01,S V 3 BOARD OF FIRE PR EVENTIONREGUL4 TIOA S 527 CMR 12.00 Occupancy &Fees Checked PAPPUCATION 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 'S . Z • 00 Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. r Location (Street & Number) 20 K t'T1Z%.0Gt; R 0 Owner or Tenant 57eJ E g cRhlAeo Owner's Address Zb K 1TR%OGC Is this permit in conjunction with a building permit: Yes [No ® (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps/ Volts Overhead Underground ® No. of Meters New Service Amps Volts Overhead ® Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work M404 A-no,� O -q 2sAIZ ZOOM 04 K 005e , pglr+a O - MASTgtt No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Qo Swimming Pool Above Below Generators KVA ground ground No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. ofSwitch Outlets Z No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local® Municipal Other No. of Dryers Heating Devices KW Connections ® No. of Water Heaters KW No. of No. of Si gns Bailasis No. Hydro Massage Tubs No. of Motors Total HP 'OTHER- EMO e7(15'1-11-I(o C.�IIZIA v -t- er-iASTAII — AaD b per -C. t \cvxTS 1 A.0 irnlrareCa,crage Lam -- IhawatacertLiabtkk POI ymdudutgCmVkte� ' CovmWcritsakgatafc4mela:t YES NO IhaNeahni&dvaWpoofofsarmlothe0ffiu-- YES M NO j�� Ifj uha%eduiWYES,pl mmdc*thetypeofwyuarby tgthe �J IN�x E ff BOND F-1 CfII-1PR ® omespe* E#aticnDlk 5---eC:� WciktoSW 'A • k• OC, _ ,D*Fz, a Signed ur&7a Nnalties ofpajtay. FIRM NAME S A CC& C . Lit ff= :!E -q -Q 5 AccA Eshm&dvah>e ;eal Werk $ plaigh 1-2-0(73 Fatal �..1��1 CA.\.L L+=wNia %!5053 A Lio=No .3 (0009 E h2sTd % G03 • 1635 3? -1 -4- (.3 ? -+Z63 3QREny y►<< P 14 V AiTdM r20r03810 OWNER'SINSURANCEWAIVER;Iama%=hattheLx=d9gnota mgtzrdbyMasdas&Card Laws and�mystsernthspe�ronwai�esthistec�raa�t, gra' (Please check one) Owner ® Agent ❑r d Telephone No, PERMIT FEE $ 3,� • d or N2 Date ..... 7.1.1 . . .. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...... A.q..(Aa�Lk? ........... I ...... . ............... has permission to perform ........ ...... ....... wiringin the building of .... ........................... tv , "S"", at.....0...... . L..Jj..t11J . . ... ........ North AndovTr,,;Aass. ..... ........... Fee ,� L.,.(1)... Lic. No. ,-fll�3 ... ALINSPECTOR EL C 'A t4 ffl 08/23/59 13:28 35-00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 71T-1 I© F�THOF L4- Office Use only MAP AEPARMD'YT0FPUBLIC&1MY Permit No. -7� OFFIREPREVE ONREGULA OM 27CVR J2.00 Occupancy &Fees Checked �PARZEL PERAIIT TO PERFORm a CTRiCAL 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 Z" p' y Town of North Andover To the Inspector of Wires: The undersigned applies for; Location (Street & Number) Owner or Tenant �' �—� ,� e A/ 2 /Z f1/j,4/Y/i Owner's Address Is this permit in conjunction with a building permit: Yes r7r No F7 (Check Appropriate Box) Purpose of Building S fi✓! kn In / N/ 7 49 Utility Authorization No. Existing Service Amps6 Volts Overhead Undereround �— No. of Meters Ney Service Amps / Volts Overhead Underground No. of Meters Number of Feeders and Ampaciry r. Location and Nature of Proposed Electrical Work �S &V M/ L No. of Lighting Outlets No. of Hot Tubs , No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA ground eroumd No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units N0. 01 Switch OIrICiS No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cord. Total - Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumos Tons KW hosting Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW 4y No. of SeifContained i� Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW Connections hb. f Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs I No. of Motors Total HP OTHER hawaarreritLkbitf 1.0 ••r •t :i .. • :r& ••:.r• . Co:.:orqs• •.•N sal :c 1 ••1► F NU s • ,•..e. Ea •.r •�:. - .: •• ci •S •9-2. FRM NANfE/ L .: r, BsnessTeLNo. •r :a %' ! i 15Z� 1 ri 1 rte. • OWNER'S A = drt te IN C •:. • •tITM1r M :� • t\ A M N • 1 ib t :. KA•6 .:1\ (Please c"leck • Owner 11 �/'� �5�� J�C� Location _�� J No. a Date S ,b . NORTH ca TOWN OF NORTH ANDOVE14 O�"1O ,a,�•C • a Owd op O?• 9 Certificate of Occupancy $ Building/Frame Permit Fee $ • ; , �'�s'•'•° '�� s�cMust Foundation Permit Fee $ ' Other Permit Fee ?oA $ Sewer Connection Fee $ r Water Connection Fee $co L �` -AS TOTAL $ "� ;1,4- 3�3 — Building Inspector Building Div. Public Works M Y z k. M■ 2 ❑ C\ w U c .v C w v Z fir`( I ` y O _Q ❑ w ° F i G1 U O O O U U Vd O A O z -x -x ❑ a A ❑ w w Z n y ❑ F Z a W n 4 C C Z Z ❑ �Z � z F w p c w d r`, h^�1 N a Z CO to to ❑ ❑ ❑ v1 O � z 0 a Z C 1 (. a V \ � Z z CN in� CL F w Z Z � z � w w a z w Z ;a 'V 3 w ❑ ❑ a ?❑ z n a ti F Ua y c F U U U r O w V C� C7 Z _ z w z Z z o Z zz z v ti n m Y z k. M■ F z W 2 ❑ C\ w U c .v C w v Z fir`( I ` y O _Q ❑ w ° F i G1 U O O O U U F z W 2 ❑ C\ _O F c .v C w v Z fir`( I ` y O _Q ❑ w ° F i G1 ? z' w U w a w a Ln S day .t,y�,� •srJ aha .a� r 'X-..�. h .fb S. r �a U 4- t - IIi rl Q i LL fu LU < (j Ei N��'•. 1,L zcz ¢{it3 M'E'p' � O �!+��f. ` � E 1 J i cc t! uj x; jex rJ cL LLI V � U' •. 73, � If I L l V f•+ Q �i Z j - L L Q W. Q r , Ext: INSURED Andrews Gunite Co Inc 6 Republic Rd N Billerica, MA 01862 "'i;:?c:: •`::;': :`;:;Yi;>:;;! DATE(MNVDD/YY) .. , .... <;::..:<•::....:::..,:,:,;.>:::>:, 1999 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANY CNA Insurance Companies A COMPANY B COMPANY C COMPANY D INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION:: M/LIMITS LTR DATE (MM/DD/YY) DATE (MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ 2,000,000 X COMMERCIAL GENERAL LIABILITY : .................................................................................... PRODUCTS -COMP/OP AGG $ 1,000,000 CLAIMS MADE X OCCUR : PERSONAL & ADV INJURY $ OOO.000 A 174087794 03/01/1999 O3/Ol/2000 .......1, A ....... 120530275 OWNER'S & CONTRACTOR'S PROT :'EACH OCCURRENCE $ 1,000,000 : EL DISEASE - POLICY LIMIT S 1,000,000 FIRE DAMAGE (Any one fire) S 50,000 OFFICERS ARE: EXCL MED EXP (Any one person) $ 5,000 AUTOMOBILE LIABILITY ... COMBINED SINGLE LIMIT $ ANY AUTO 1,000,000 ALL OWNED AUTOS 'BODILY INJURY $ X SCHEDULED AUTOS : (Per person) A SAP1082055940 03/01/1999 03/01/2000 X HIRED AUTOS BODILY INJURY $ X NON -OWNED AUTOS (Per accident) ...... .....................................................: PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S ......................................................... :;;;:;;:4;::;;i:i:i:;:::;:;::Yi:G;S;i:� ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT S ............................................................::...................................................................................... AGGREGATE S EXCESS LIABILITY EACH OCCURRENCE :. S 2, 000, 000 A X UMBRELLA FORM 174087827 ..................................................................................... 03/01/1999 03/01/2000: AGGREGATE . $ 2,000,000 OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND TORY LIMITS . ER :::: :::::::::::::: EMPLOYERS' LIABILITY EL EACH ACCIDENT 5:; 1,000,000 A ....... 120530275 03/01/1999 03/01/2000................................................................ THE PROPRIETOR/ INCL : EL DISEASE - POLICY LIMIT S 1,000,000 PARTNERSIEXECUTIVE OFFICERS ARE: EXCL EL DISEASE - EA EMPLOYEE S 1,000,000 OTHER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTA VES. FOR INFORMATION ONLY p I • �I •• • 1 •0 1 0 •? 0 � •QI '' '1Y 31rA 11111 1 1in ' j' , lJ r J < •I rri I'�' 40 all N U, 1 U •� t r u uv d X 3 • s u 0 11 111 Iv" 0 �C 1 • ivolo�l a 1 7 1 I C di F < ► N1 la ••10„'.a J 0l S tYoj • ► O ♦ •a «Q ,. O I J < 0 < j b q� fttLo • 01 3: u O IC I j� Y T f-26 VI VI 1 y I F 1 K• q' I'r. 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O I J 0 < j =o 1,01 1 IC! fttLo a 01 3: Y T f-26 VI VI a��is J I'r. in M I `2 Q <v U4 U 1 L°<' .it r / • Ov � r�,• a -.j a4tl i Sri fcu 70 Zr t • o• y • N iC 1111 1. <i tib Vrl 1, 1 JLO •.> J w� (I '}I J J !j) t) 1 1 r n i 0 v I J y J a O J k .A4CJ )1 O _ •. Y rl (� � � /• N of • r J < •I rri I'�' t • ry–. 3 • !j) t) 1 1 r n i 0 v I J y J a O J k WON .A4CJ U • b O _ •. Y rl (� � � /• N of • r J < 1 • t .SMI � J 3 • ) ' • U1•" . v U ylM.n • 7 o •. Y y di F < ► N1 la ••10„'.a J 0l S tYoj oaUg; O 141 O I J 0 < j =o 1,01 1 IC! fttLo a 01 3: Y 11~ f-26 VI VI a��is I'r. in M `2 Q <v U4 U 1 L°<' .it U ` 'Y6A Y u a4tl Sri fcu 70 t • o• y • N iC 1111 1. <i tib Vrl WON .A4CJ U • b .z � V rl (� � � /• N of • r J 1 • .SMI � J ° • U1•" . v U o •. 0 1• r � ••10„'.a J a S tYoj ) (Q 0 O a j =o 1,01 1 11~ f-26 -J d"d ' all. J r • t • o• y • Vrl 1, 1 ) i •.> • 3 �• w� (I '}I J J 1701 ~',Q =t0'•� (i C.1 WON v • tj <ris 1� �F<2J 1 ulv� J L<'•I • t •ew r •rfr • Y� iyr • g N .A4CJ U • b .z � V rl (� � � /• N of • J 1 , v • tj <ris 1� �F<2J 1 ulv� J L<'•I • t •ew r •rfr • Y� iyr • g N a � t •1 r J • .° •J « a J « 1 L 1 t ( V J ,1•i U (• '. z ••. IJ a. Q 1 :"(� •J Oi � �7 0 a ) C J O IL a W m U • b .z � V u 4 La a ,� a � t •1 r J • .° •J « a J « 1 L 1 t ( V J ,1•i U (• '. z ••. IJ a. Q 1 :"(� •J Oi � �7 0 a ) C J O IL a W FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION***************�''`***** APPLICANT /�_109�-o PHONE g �J &,�r3 l �S LOCATION: Assessor's Map Number. SUBDIVISION STREETS PARCEL LOT (S) ST. NUMBER *****************************************OFFICIAL USE ONLY********************* - - _ RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED 21 (VI DATE REJECTED COMMENTS { �'� �W � TOWA PLANNER DATE APPROVED & o DATE REJECTED COMMENTS epi a"'t FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH COMMENTS 0�(, 60-,O ) DATE APPROVED DATE REJECTED_ PUBLIC WORKS - SEWERIWATER CONNECTIONS. DRIVEWAY PERMIT FIRE DEPARTMENT _ RECEIVED BY BUILDING INSPECTOR ,' , �D "T� - '• Revised 9197 jm i ` JUN 9 P9 C/) m C m m 0 m v. P d d y n CD n z y CD O �_ a r c� ?a d =• .yam� D� = O O v CD C. O MCD CDo CD mm 9 C O 0 CD CL O_ y to CD I S v W O CD CD zo o CDCD0 0 177 C C �' p _ O -• go O CTN C O < m fl W »m h m n Cfl n =C2 m Z N• m .r. C � � =r -C O� .-► .O•► CD N T =r CD a ? Cv y CD O O N p 0-, C =r CD CD > > D 2 it OO N O m:7 a >o= 0 � �co CL :� Cfl O =r =rC CD CD c t om: • CL llb t � CD O DJ N N C d CT C C O� .W CZ N / ' CD cc =r rCD -4b CD CD CD � CO) = CD 0 ter" o CD CD µms:• a3 •� � 7 "CW N o ` Er Oco r Y ' ate• ono O Cv C O o=: r a a O ora p 7 2 O � C C �' p _ O -• go O CTN C O < m fl W »m h m n Cfl n =C2 m Z N• m .r. C � � =r -C O� .-► .O•► CD N T =r CD a ? Cv y CD O O N p 0-, C =r CD CD > > D 2 it OO N O m:7 a >o= 0 � �co CL :� Cfl O =r =rC CD CD c t om: • CL llb t � CD O DJ N N C d CT C C O� .W CZ N / ' CD cc =r rCD -4b CD CD CD � CO) = CD 0 ter" o CD CD µms:• a3 •� � 7 "CW N o ` Er Oco r Y ' ate• ono O Cv C O o=: LIN z y 0 0 c z 7 °—' O ora cn "C� 7 2 O � � c 7 °� O z O O r z rD C ITI x LIN z y 0 0 c NORTHERN ASSOCIATES, ES, INU- 342 N. MAIN STREET ANDOVER MA 0,8.10 TEL: (978) 474-4410 FAX.' (978) 474-5067 fORTGAGOR: STEPHEN & KELLEY B sRNARD ,OCA TION., 20 KITTRIDGE RD 'ITT, STATE: NANDOVER, MA )ATE: 1112198 '-. LO7' 43 a IAT 42 % LOT 41 ' 6.1529 sf + /3D # 20 DEED REF: BK 3195 PG 350 PLAN REF: #9085 JOB It: 9815000, SCALE: 1 11=80' b� bh LOT 40 R=60.00' x L.,=30.00' R=30.00' 121 �3' L=27.40' KITTRIDGF, RD- 7 � �. C91?,PIRIED TO: PALLADIAN .. t"i Int eelloH Yat prepared thla wc1•lysge (nm{+octiao wns ptepntod !n accordance , lit)TEl "4111 set, q p ttl ,,• with the Tochnicnt titnndanln ►m tlartumet s tit ipecltlisill��fbr W. 691. purposes on catty end OF ^M,y`t+ IIIN{+eCllallN ns' adopted by the IlNtxrehuretts aaerd of it notittl'4 allied Upon as a land or property peglntlatlan of proresNlnnal rnglneurs atoll Land 11hi,iYtwi{i1lUiid Ibr reeordlnq, prsperinq deed p ButVeynrs do cnn 111115i ll t1e corners were CARMEN 1 further elate that in wy prolesslonnl opinlon that sitd=t htlldlhy lbeitlon ind.ettittr an the structures shuwn eonlorw with the focal' soninq horltontel apptbltlMitily;lecitid kin the ground end ESTA dimensional antitank requlrewatots at the time or construction + -ate ilwskhkNl+sblfloilly for tohlnq dstermthstlon are exempt under provlslolls or R.G.L. cat. 40-A see. 7. en1� ind•itd Act to be kited to establish propert .� N0. 1846 �. 11Mtt "fhi•Mttt&tb shown hereon ore beeed bat q 9 to o roperty/ifouse is not In a Flood Ilezerd.• clliht 10miihid: nfermstlogn end any be subjeot ird�O /titfPt� Kolproperty/Ilouse 1s !n a Flood Itazard Arcs. .te./kktthit,bkit�Nlat takln dw eisnents end rights CI7,lnforlmetlon Is insuttfclent to determine efeMi�j+i J, litllfwteeiitteri of ttcord and prescriptive NdIIRMO Flood rmserd. er'6t is+t ihiii•;iforthern Asseelitesw lnc..maauwes no e rNpek111blllty•hitsln to the land owner or bcoupmntw ((,l� �C Flood tlezerd detirmined [r 1 tpsod aaeepti !ic-ttspentlblllty for dtuages resulting from amid l.nsurence Ra a Ito panel O 7 reiltne by tnyens other then ti+e said mortgagee and its eealgns r�=_ �5 Lnno !n conneot on with !ta pro{+oead mortgage finenelnyto said mortgagor. nate Date .... / 1 .r ° TOWN OF NORTH ANDOVER I. p PERMIT FOR WIRING This certifies that has permission to perform- ...: lli-ILZI.�. o wiring in the building of .1...•�r�.vl.� �`;�.. 1. t..��........ : X:�..... ,North Andover, Mass. FmA... Lic. No . ... .. ............................................................ �n ELECTRICAL INSPECTOR Official Use Only Permit No. Dy Kt �uElie Sa6cty Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527,9M7 12:00 (Please Print in ink or type all information) / Date ?o the L^^sp�or of :'ices: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number��� Owner or Tenant C��� 25, Owner's Address Is this permit in conjunction with a building permit Yes No 0 (Check Appropriate Box) Purpose of Building o-> lixX--,T? 14L--- Utility Authorization No. Existing Service Amps Voits New Service Amps Voits Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Overhead 0 . Undgmd 0 No. of Meters Overhead 0 Undgmd 0 No. of Meters OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO - have submitted valid proof of same to the Office YES = NO a If you have checked YES please indicate the type of coverage by checking the appropriate box. INSURANCE - BOND - OTHER - (Please Specify) (Expiration Date) Estimated Value gf le rica Work$ �/ Work to Start Li Inspection Date Resquested_ _ Q_ Rough v Final Le/1 LL nAw— Signed r the Pttof perjury: NAME Jo 02—e!:z 2 ?�� e -0!!:h. 4 A LIC. NO. LIC. NO. 010y I R �. I Bus. Tel No % Address ( FMW-:,ST Alt TeI. No. C�;' OWNER'S INSURANCE WAIVER: I am aware that the icenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws_ And that my signature on this permit application waives This requirement. Owner bent (Please Check one) L Telephone No. PERMIT FEE $. (Signature of Owner or Agent) Total No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA Above 0 In a No. of Lighting Fixtures Swimminq Pool gmd 0 gmd 0 Generators KVA No. of Emergency Lighting No. of Receptacles Outlets No. of Oil Burners Battery Units No. of Switch Outlets No of Gas Burners FIRE ALARMS No. of Zone No. of Detection and Total No. of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No. of Diposal No. Pumps Tons KW No. of Sounding Devices Nol of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices 0 Municipal 0 Other No. of Dryers Heating Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Bailases Wiring No. Hydrz. Massage Tuds I No. of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO - have submitted valid proof of same to the Office YES = NO a If you have checked YES please indicate the type of coverage by checking the appropriate box. INSURANCE - BOND - OTHER - (Please Specify) (Expiration Date) Estimated Value gf le rica Work$ �/ Work to Start Li Inspection Date Resquested_ _ Q_ Rough v Final Le/1 LL nAw— Signed r the Pttof perjury: NAME Jo 02—e!:z 2 ?�� e -0!!:h. 4 A LIC. NO. LIC. NO. 010y I R �. I Bus. Tel No % Address ( FMW-:,ST Alt TeI. No. C�;' OWNER'S INSURANCE WAIVER: I am aware that the icenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws_ And that my signature on this permit application waives This requirement. Owner bent (Please Check one) L Telephone No. PERMIT FEE $. (Signature of Owner or Agent) Name: Location: City Phone am a homeowner performing all work myself. F -1I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Company name: Address City Phone #: Insurance Co. Policy # Company name: Address City: Phone #: Insurance Co. Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 andlor 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. I do herby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name Phone # Official use only do not write in this area to be completed by city or town official' F1 Building Dept ❑Check if immediate response is required Building Dept p Licensing Board p Selectman's Office Contact person: Phone #: F1 Health Department 0 Other FORM WORKMAN'S COMPENSATION t' Date /-/. - 7 iJ TOWN OF NORTH ANDOVER . 0 PERMIT FOR PLUMBING ,SSACHUS� This certifies that A-7: .... .. . has permission to perform ..? ;?..................... . plumbing in the buildings of .. at :' . %� .��� ........... North Andover, Mass. C FeeW.4..... Lic. No.......... . r,, :� ............. PLUMBING SPECTOR Check 5; 7? T type or p NOR Building r MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING w New Renovation Replacement Plans Submitted (Print or type) Chec one: Certificate Installing Company Nam Corp. Addres Partner. Business Telephone l ElFirm/Co. Name of Licensed Plumber: X1 ov Insurance Coverage: In ' to t type of insurance coverage by checking the appropriate box: ❑ Liability insurance policy Other type of indemnity 1-3 Bond Insurance Waiver: I, the undersigned, have been mdde aware that the licensee of this application does not have any one of the above three insurance Signature Owner I hereby certify that all of the details and information I have submitted (or entered) best of my knowledge and that all plumbing work and Inst ons performed compliance with all pertinent provision _ tate Plumb"n By: a re icen Type of lumbinfLicense Title City/Town �� m e� Master APPROVED (OFFICE USE ONLY Agent rl ,-above application are true and accurate to the Pe�Issued for this application will be in L � hamer 142 ,afohe General Laws. ❑ Journeyman • `9 I m.m..m.-mmmmmmmm-m--mmmmm ME (Print or type) Chec one: Certificate Installing Company Nam Corp. Addres Partner. Business Telephone l ElFirm/Co. Name of Licensed Plumber: X1 ov Insurance Coverage: In ' to t type of insurance coverage by checking the appropriate box: ❑ Liability insurance policy Other type of indemnity 1-3 Bond Insurance Waiver: I, the undersigned, have been mdde aware that the licensee of this application does not have any one of the above three insurance Signature Owner I hereby certify that all of the details and information I have submitted (or entered) best of my knowledge and that all plumbing work and Inst ons performed compliance with all pertinent provision _ tate Plumb"n By: a re icen Type of lumbinfLicense Title City/Town �� m e� Master APPROVED (OFFICE USE ONLY Agent rl ,-above application are true and accurate to the Pe�Issued for this application will be in L � hamer 142 ,afohe General Laws. ❑ Journeyman Location L No. le!� U Date %off S. TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ JACMUSE Foundation Permit Fee $ Other Permit Fee $ TOTAL oe Check # 17 15= Building Inspec r� TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING -7777777777, 77 -77 BUILDING PERMIT NUMBER: DATE ISSUED: r % r SIGNATURE: Cts' Buil3n—g Commissioner/Ifor of Buildings Date SECTION I- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 20 KlMAO 9E eqb� F Map Number Parcel umber 1.3 Zoning hiformation: 1.4 Property Dimensions: -/ /7eJOE/urill- Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided RecMired Provided 1.7 Water S ty M.G.L.C.40. 54) 1.5. Flood Zone Information: Zone Outside Flood Zone 11 1.8 Sewerage Disposal System: Municipal On Site Disposal System 0 Public Private 0 (bJ/ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes NO 2`1 Owner of Record STEV t% SE2N010 IC ITzP Name (Print) Address for llService: �— V Signa a Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Tele hone SECTION 3 - CONSTRUCTION SERVICES .1 Licensed Construction Supervisor: Not Applicable ❑ DaRROU M,4��ti0 Licensed Construction Supervisor: leso� aye License Number yy 144010 ` f RUG E `T— M�1�AI /V J�19_/�,,_�3=o�3/J7152005" Address Z- 33 10 tS� Expiration Date a�ture Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ .D)WWAi mggrz4k) /a y q� Company Name Registration Number %j/ /7 20u / 0 _ / �L_ &77p��Ti /'E y MOM WV V Address . 77F� 6 �S3W7 Expiration Date �jfr72- SV Si natu Telephone v 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 Descri tion 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: z3onauim 11\,fr& /VE&) Fmlt6 AIEL Alo a � SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by 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) 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 1, , as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, �il�//(N ,as Owner/A onzed A e f 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 D>4"n! %+&r//%o e Y -o/-6 Si atur o caner A en Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS iST2 ND3 RD SPAN 5M ENSIONS OF SILLS DINIENSIONS OF POSTS DINIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Name Name: The Commonwealth of Massachusetts Department of Industrial Accidents Office of /nvestigatkins Boston, Mass. 021T I Worke& Compensation .insufawe Affidavit Please Print Location: 7,60 city /U • 41-10d Ve-A Phone # �7 P- 947 o QI am a homeowner performing all work myself. t'. I am a sole proprietor and have no one worlting in any capacity . I am an employer providing warkere compensation for my employees worlang on this job. Company name: Address f✓itre:. insurance Co. Poliev* .=„ Ad+d ews . Fa to secure coverage as requiredundw setoon 25A or fit_ 15.2 czWwd t&the i VodIw d anWer oneyewe knprisnrrrumLas_vaLas:-?T understand Drat a copy of ibis statement ma r be forwarded to the Office of Imresft2& s cf Um DK �P� �P�� o�fperjrrry8imt Gheirdarmetiarsproviid�edaboveisLveandcarrecL Print Offidar use only do not write in this area to be completed by city or lawn dficiar .#- 9ZL-1�Oz-��bv 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) Sigrvfiture, of Permit Applicant -aim y ate NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector �m �__ DM Construction Building with the QUALITY and Character of yesteryear. 44 Addison Ave Ext. Methuen, MA 01844 (978) 685-3037 Estimate Submitted To: r Steve Bernard i 20 Kitridge Rd N. Andover, MA 01841 We hereby purpose to famish the materials indicated and perform the labor necessary for the completion of: Bathroom remodel.(See specifications sheet) All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications submitted for above work and completion in a substantial workmanlike manner for the sum of Eleven thousand dollars -$11000.00 Payments to be made as follows: $3000.00 when work begins. Remaining payments as work progress. Respectfully submitted: Darren Martino, Any alteration or deviation from the above specifications involving extra costs will be executed only upon written order, and will become an extra charge over and above the estimate. All agreements contingent upon accidents, or delays beyond our control. Note -This proposal may be withdrawn if not accepted within 10 days. Proposal Date 12/12/03 ACCEPTANCE OF PROPOSAL The above prices, specifications, and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payments will be made as outlined above. Date: Signature: I/ Bernard Bathroom Remodel Specifications Sheet Scope of work: Renovation of main bath on second f oor. Permits- The cost of the all permits required, including building, electrical, and plumbing is included in this estimate. Demolition- The bathroom will be completely gutted to the studs. DM Construction is responsible for the removal of all debris generated. Framing -Existing linen closet in bathroom will have the door removed and the opening closed Off. Insulation -Exterior walls will be insulated as necessary. Drywall-Blueboard will be installed with a plaster skim coat. Painting -Walls and trim to be primed and receive two coats of finish. Finish -Installation of new window trim, door trim, and baseboard. Plumbing -Demolition of any plumbing deemed necessary. Removal of existing plumbing fixtures. Provisions for new sinklfaucet, toilet, tub, and shower valve. All new fixtures to installed at current locations. Installation of all new plumbing fixtures. This estimate does not include an allowance for any plumbing fixtures. Electrical -Demolition of old wiring and fixtures as deemed necessary. Wire bathroom as necessary. Install new light fixtures. This estimate does not include an allowance for any light fixtures. Tile -Install new underlayment on f oor. Installation of the f oor. Installation of tile on three walls above tub. The cost of the tile is covered under an allowance. Installation is based on standard tile installation. Miscellaneous Installation of new shower door. Installation of all accessories(towel bars, toilet paper holders, etc) Installation of vanity and hardware. This estimate does not include changing the existing door entering the bathroom. This estimate does not include changing the existing window in the bathroom. Bernard Bathroom Remodel Allowances The following allowances are included in this estimate. The allowances exist to cover the purchase of materials only, unless otherwise specified. Any amount in excess of an allowance will incur extra cost. Any amount less than the allowance will warrant a credit. Upon completion of the project any extra cost or credits will be issued. Countertop -$750.00 This allowance includes the cost of the countertop and its associated template and installation cost. Tile -$800.00 This allowance covers the cost of all the and grout. Note: Not included in this estimate are any allowances for plumbing fixtures, electrical fixtures(including fanlight/heat), cabinetry, accessories, or a shower door. m m x m m X CA v m y C S d •0 O CD O Z CO) CLO n• r c � � c PL y aCc -0 c o CD Q� O � dCD CDo CD c CD co). CD CO CO) cc C=D 9 l cn 2 o� O cn O O Z 0 O O m O 1 C12 O. to CO coC 0 C, 0 CL Vl ... y O CT y EL- O<o 1 y a man m e� C,* m dC a = O 81 01- y ..� ..a o T =' C L �► 0 rte CD CD y O O O ?m ® _ O C O� O O : •�► O y. C09 , Cp H n � C, ,.... o CO � m y ' d 1 CD vl d y CL d c w a �CCD cc CD y N Q CD m 4: � co.. C.) Ero: �.: CO O � 3 � O • Wim: C CD: ;w CA CD o CD dd: ='o o. 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O m D >> ' 2S0 m 2 _ 0 C:tT1 00 A 3 W 0 ° ; S+1 A CA tTt N O m > O n G� r r' z z ri*0 isZ o 3 -VA +O D � m yCm !1 m N .0 mm vo D �xC om H C �p m D< 0 O cr I; r m o o X022 OC R1 NO z W O N O <y f N r .y1 r s� l m N m `6' � m F D fTi ti` � •�.- r; W O to n N , o Z D v m 4c Sxn ? o O ni O p 0 m z� c M r�►y.. h' '' z O 2 j O -in 00 z M m m m m t• n�` h1__t 0 O D O 7c m K zm D M►� M O z n � °r° o 3 z -+ m > m m z 1 m m %0m oD m = n O m m m m •p b cn D { O r y m. !'� N m m 0 0 C { m Y FORM U - IAT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out, this section***************** APPLICANT: 1'lr fii'(l�; 9,1V �P.Si/ Phone CFJ_ C/l0 LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) Street _o'Z D �i'ii ��c%Q �� St. Number .20 ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Conservation Administrator Comments Town Planner Comments Food Inspector -Health Septic Inspector -Health Comments Public Works - sewer/water connections - driveway permi Fire Departmenty" Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Received by Building Inspector Date T Z r v. CO) 'v C � 'v O CD C7 Z CO) d0 n� r� ? 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