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Miscellaneous - 20 SAMUEL WAY 4/30/2018
I �t i 1 } =I- s R ,40RTN\ Date.....y. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ......c;,n�!/d/,+ has permission to perform............ l f !L..... =✓ �...................... wiring in the building of .... L"' i.1��Q?'m........................................... at ...... ...5� W .... + glfr....................... . No h Andover, Mass. .E a I . Fee . �%S'�'� ....... Lic. No.St's r �� ..:........�.. �l ..... ............. ELECTRICALINSPECTOR 4 . - Check # 87"12 �-� Commonwealth of Massachusetts Official Use Only Permit No. % 1, Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Occupancy 1/ and Fee Checked cave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the MassachusaM Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: I/'- Z /-- 9 City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work desenbed below. Location (Street & Number) Z Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with a building permit? - Yes No ❑ (Cheek Appropriate Boz) Purpose of Bw7ding" f/ l Utslity Asthorization No. Existing Service Amps / Volts Overhead ❑ Ua dgrd ❑ Na. of Meters New w Service Amps / Volta Overhead ❑ Und Sid ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: No. of Recessed Luminaires No. of Luminaire Outlets No. of LununjGres; No. of Receptacle Outlets No. of Switches No. of Ranges C:ompie ion of the No. of Ceil.-Susp. (Paddle) Fans No. of Hot Tubs Swimming Pool Anodve ED o. of Oil Burners of Gas Burners No. of Air Cond. No. of Waste Disposers Heat ramp Totals: — olat r No. of Dishwashers Space/Area Heating Conn tion KW No. of Dryers Heating Appliances ICV o. o ater Heaters' °' ° o. o No. of Devices oraivateat S Ballasts No. Hydromassage Bathtubs No. of Motors Total HP OTHER:v ,tdnz tabkr be waived the No. o Total Transformers KVA Generators KVA o. o easy ❑. ��K��. TT_v_ ALARMS INe. of Zones o. of Alerbag Devices o. of beet-Contain� eteetion/AlerEia Devxes rani '� ❑ -- OthQ Conn tion Nof Devices or Eruivalent it: wiring: No. of Devices oraivateat aommunsca6ona No. of Devices nr Fn Estimated Value of Electrical Wo '1 (Whtrack additional detail if desired, or as required by 1111 A pecsor of Wires. Rork to Start ti-2/1/-� Y/ �`%�1,� y municipal ) rryuired by m a1 policy INSURANCE COInspecti0� 1O be requested in accordance with MEC Rule 10, and upon completion. VERAGE: Unless waived e i the the licensee provides proof of liabilityowner, o permit for the performance of electrical work may issue unless insurance ncluding °`conmpleted operation" coverage or its substantial equivalent The undersigned certifies that such co v a is in force, and has exhibited proof of same to the CHECK ONE: INSURANCE permit issuing office. I certify, under the BOND ❑ OTHER ❑ (SPecrfy:) FIRM NAME: S✓asRs an penahies ofperjury, that the information on this application is true and complete �f Af LIC. NO.: gySG Licensee:!//V"t it S' (If applicable, enter exempt in the license number Line.) 8 e h LIC. NO.: .2 2 V 7,/� Address: / C hJ ST. L )W,PE.V� /l' Bus. TeL No.: - - t'Tf- *Pcr M.G.L c. 147, s. 57-61, security work Alt:. TeL No.: OWNER'S INSURANCE W requires Department o Public Safety "S" License: Lic. No. RIVER: I am aware that the Licensee does not have the liability ;n.��n..,� coverage normally required .g law. By my signature below, I hereby waive this requirearent I am the (check one) owner owner's Owner/Agent ❑ ent Signature Telephone No. PERMIT FEE: S The Common wealth of MdssackwdIS ' Department of Industrial Accidents Of lee of Invesdgations 600 Washattgton Sired Boston, MA 02111 r , w►vw.massgov/dila . Workers' Compensation Ins6rance Affidavit: Bullers/Contraetora/Eiectricimi&T embers m6csnt Information /� �Q PkMM Print Legbly Naaie (Business/Orgaeirafiom4ndMdnel): JJ ���y� /7`/i /,( P�'3/t' f Alww % Address: .2- City/State/Zip: .-City/.State/Zip: L.Au rer►16z4 Phone #:. 9W -,i42 -4,Y71 Are von an employer? Cbeek.tbe appropriate box: Type of project (r'egoir*: am a employer with % 4. ❑ I un a general corftotor and I 6. 20f4ew construction employees (full and/or part-time).* 2. ❑ I am .a sole proprietor or partner- have hired the yrs Iisted an the attached sheet t 7. ❑ Remodeling ship and have no employees These sub -contractors have S. ❑ Demolition working for me in any capacity, [No workars' comp. insurance workers' comp. insurance. 5. ❑ We are a corporation and its 9. ❑ Building addition required ] offices have exercised dick !Q.� ❑ or additions 3. ❑ i am a homeowner doing all work right of exemption per MGL 11.0 Plumbing mpairs or additions myself [No•workes' comp. c. 1.52, § 1(4), and we have no 12. Roof ❑ insurance required.] t employees. [No workers' 13.[] Other comp. issuu anc a required.] ,,,.r .Pp„wum na oxna tat I t trust lila tat out the aural heiow showing their worker' companettion polity otfomtation, 1 Haneownen who mbmit this affWtvit mdioting aroy ate doing i o work end thm him omide —Mam n ants anbmit a new affidavit irdkw* AMC jCarrtratetors ttuet cheek this box num-Imbed an additioaai shearshowmg- the none ofdw sub-cunaacMa mad Blair wortxt=' cess poFiey irt5xsatioA. / am an eirrployer ilea is ptaoW&V:workers' mWensaadon insurmce for nV eaVio9em Belox, if �.��,. �W site information Inmuartce Company Name: Gra n , f,� _q'Ot/-t Policy # or Setf-ins. Lie. L 3S9 S9- Expiration Date: S-- /0 — 9 Job Site Address: Z e) Sez,,a 6Lf_ ::' City/State/rip: a/ ep y 3 - Attach tt copy of the workert' rnatpaasatioa.-policy dechtration page (showing the policy Number MW expiration date} Faihse to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to S I,500.00 and/or one-year imprisonment, as well as civil pan dries in the form of a MP 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 Of&x of Investigations of the DIA for insurance coverage verification. 1 do hereby cerMjy lender th a�peRalties of perprry that me infortaaam pnoWAL-d above to aw and Correa Phone #: (,0 Y 7 c� Officia! else only. Do not write in this area, to be eonpletad by City or town ojj%iaL City or Town: PermitUcense # Issuing Authority (circle. one): L Board of Health ? 80" 09 Department 3. City/Towu Clerk 4. Electrical Iaspecter 5. Plumbing inspector 6. Other Contact Person: Phone #: Date... NORTH ' TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ................ ............ d ...... .............. ................ has permission to perform ....... .................... 4 ............................. wiring in thebuilding of ....... ..... ......... ......... . . at,40 North Andover, Mass. .................................... ................ ....... Lic. No, Fee.701...— -47 ............ . ........ ............. .... ..... LECTRICAL INSPE Check # /e 96 8697 0 Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS U19-` Official Use Only Permit No. 07 Occupancy and Fee Checked [Rev. 9/051 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (Xtrof 7 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: �09 City or Town of: /�fd r) log �2 To the Inspe Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) FAQ SA C O U UJAY Owner oi- Ten +t QC, a a s �� Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes Y I No U (Check Appropriate tsox) Purpose of Building ' LL►1J�'9- Utility Authorization No. Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd Existing Service Amps / Volts New Service 2_00 Amps 3Q /2-40 Volts No. of Meters No. of Meters �— Number of Feeders and Ampacity _ I - Z,03 AMP Location and Nature of Proposed Electrical Work: IAS 1 ZE ALIELta S i13G LE rA m i y E)W L.L ,1 AJ& Com letion of the following table may be waived by the Inspector of Wires. AttaCn aaaltlonai aetaii ly aeslrea, or u5 reyuueu uy Lite —y—ay. i .. •. < Estimated Value of El ctrical Work: (When required by municipal policy.) Work to Start: Ll 0 Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE CON RAGE: 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 cove;age is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) ' I certify, under the pains andpenalties of perjury, that the information on this application is true and complete. FIRM NAM E: Interstate Electrical Servi5js rpor.at4 LIC.N .:A-5217 Licensee: Pasquale A. Alibrandi Signature L4 (If applicabl rater "exe : i" in the license number line.) Bus. Tel. No.: 9 7 8-667-52 0 0 Address: �� Tregie Cove Rd., N. Billerica, MA 01862 Tel. No.: *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 PERMIT FEE: r Signature Telephone No. No. of Total No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans Transformers KVA No. of Luminaire Outlets T No. of Hot Tubs Generators KVA No. of Luminaires qt Above In- Swimming Pool rnd. grnd. o. o mergency ig ting Battery Units No. of Receptacle Outlets No. of Oil Burners IFIRE ALARMS No. of Zones j No. of Detection and No. of Switches No. of Gas Burners / Initiating Devices No. of Ranges / ) Total No. of Air Cond. / Tons INo. of Alerting Devices Heat Pump I.Number I Tons ............ KWINo. .................... .......... of Self -Contained No. of Waste Disposers Totals: (Detection/Alerting Devices No. of Dishwashers S ace/Area Heating KW P b Local Municipal E] Other Connection Heating Appliances KW Security Systems:* No. of Dryers No. of Devices or E quivalent No. of Water KW No. of No. of Data Wiring: Heaters ' Signs Ballasts No. of Devices or Equivalent Telecommunications Wiring: No. Hydromassage Bathtubs No. of Motors Total HP No. of Devices or E uivalent OTHER: AttaCn aaaltlonai aetaii ly aeslrea, or u5 reyuueu uy Lite —y—ay. i .. •. < Estimated Value of El ctrical Work: (When required by municipal policy.) Work to Start: Ll 0 Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE CON RAGE: 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 cove;age is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) ' I certify, under the pains andpenalties of perjury, that the information on this application is true and complete. FIRM NAM E: Interstate Electrical Servi5js rpor.at4 LIC.N .:A-5217 Licensee: Pasquale A. Alibrandi Signature L4 (If applicabl rater "exe : i" in the license number line.) Bus. Tel. No.: 9 7 8-667-52 0 0 Address: �� Tregie Cove Rd., N. Billerica, MA 01862 Tel. No.: *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 PERMIT FEE: r Signature Telephone No. i Fmi E Y t NOIYTIt a f then � s4C1Y1� CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 484 Date: August 3, 2009 THIS CERTIFIES THAT THE BUILDING LOCATED ON 20 Samuel WR MAY BE OCCUPIED AS Sinele Family Dwelling IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Edgewood Retirement Community 16 Samuel Way North Andover MA 01845 wilding Inspector APPLICATION FOR CERTIFICATE OF OCCUPANCYANSPECTION Building Permit # � ADDRESS/LOCATION OF PROPERTY:-.. Map Parcel Lot Number SUBDIVISION�[1tli DATE REQUESTED FILED/READY FOR INSPECTION CLOSING DATE ON PROPERTY: FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN -OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE- INSPECTION FEE OF TWENTY DOLLARS $20.00) WILL RF nI4AR(ZFn W naF eTof 11"n 10c DOES NOT MEET ALL APPLICABLE CODES. D f ermi t Issued to: Address SIGNED - CONSERVATION PLANNING DPW - WATER METER SEWER/WATER CONNECTION NOTE DPW MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUPANCYANSPECTION REQUEST DPW X)MA 47nAA.A Signature File: Application for OC form revised Jan 2007 a W M Cd i•� U c c @ c o � c ` N O c �c O V CL M o ev @ c 0 CD H = E Q CF :.s c. N E c o� •��� :moo cmc O m 3 c @ _ m �= c �1 Q @ O C-2 mac > o p 0 i o, ca z H O .c>Z • � c � o Q i @ca c eN d � ev C LU E oc� G) @ p @ c N2 a @- Oz _ cc N .= F = 2 as 19 O U 0 0 • e.a 0 O O .S v Z co C. O y ® C CO OM CO2 O ,O O ® — y O �O coco CD 0 CD CD CD® L M ® Q K: CM< O e� cc -� .= OCA �O+ O CD CL C.� COD O C CL CODis W G N U) W W LU LU V' 0 'U' o U. coo. v`� C/) 0U) m G W G ° LI! cn w° w U ° ij. ° cn ° cn U) U) c c @ c o � c ` N O c �c O V CL M o ev @ c 0 CD H = E Q CF :.s c. N E c o� •��� :moo cmc O m 3 c @ _ m �= c �1 Q @ O C-2 mac > o p 0 i o, ca z H O .c>Z • � c � o Q i @ca c eN d � ev C LU E oc� G) @ p @ c N2 a @- Oz _ cc N .= F = 2 as 19 O U 0 0 • e.a 0 O O .S v Z co C. O y ® C CO OM CO2 O ,O O ® — y O �O coco CD 0 CD CD CD® L M ® Q K: CM< O e� cc -� .= OCA �O+ O CD CL C.� COD O C CL CODis W G N U) W W LU LU V' .-J Project Number_ Project Title: Project Location: Scope of Project: Registered Architectural and Engineering Services Construction Control Affidavit DSA Project #0706.00 Edgewood Retirement Community Cottages #20 Samuel Way, North Andover, MA 01845 22 Individual Cottages In accordance with Section 116.0 of the Massachusetts State Building Code I, Allen Dewing Jr., MA Registration #4301 being a registered professional engineer/architect, hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project 1� Architectural Structural Mechanical Fire Protection Electrical Other (Specify) For the above named project and that, to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code. All acceptable engineering practices and all applicable laws for the proposed project. I further certify that I shall perform the necessary professional services and be present on the construction site on a regular basis to determine that the work is proceeding in accordance with the documents approved for the building permit and shall be responsible for the following as specified in Section 116.2. 1. Review for conformance to the design concept, shop drawings, samples, and other submittals, which are submitted by the contractor in accordance with requirements of the construction documents. 2. Review and approval of the quality control procedures for all code -required materials. 3. Be present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine, in general, if the work is being performed in a manner consistent with the construction documents. Upon completion of the Work, I shall submit a final report as to the satisfactory completion and readiness of the project for occupancy. 'PA-b"M �-� v No. 4301 CONCORD, UA 4 a OFM Dewing J F:\DSA Project Files\Edgewood 0706\05. Project Word Documents\a. Correspondence and Transmittals\vi. Misc Registered Engineering Services Structural Construction Control Affidavit at Completion of Structural Work Project Number_ DSA Project #0706.00 Project Title: Edgewood Retirement Community Cottages Project Location: #20 Samuel Way, North Andover, MA 01845 Scope of Project: Wood Framed Cottage with Concrete Basement and Foundations In accordance with Section 116.0 of the Massachusetts State Building Code, I, Geoffrey S. Conway, MA #32753 being a registered professional engineer (structural), hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project Mechanical Other (Specify) Architectural Fire Protection XX Structural Electrical For the above named project and that, to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable laws for the proposed project. I further certify that I have performed the necessary professional services and have been present on the construction site on a regular basis to determine that the work -is proceeding in accordance with the documents approved for the building permit and have been responsible for the following as specified in Section 116.2. 1. Review for conformance to the design concept, shop drawings, samples, and other submittals, which are submitted by the contractor in accordance with requirements of the .construction documents. 2. Review and approval of the quality control procedures for all code -required materials. 3. Been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine, in general, that the work has been performed in a manner consistent with the construction documents. e7� �p�.�Ft OF ggqssqc Geoff re onway, P.E. pale �o GEOFFREY �N g S. CONWAY V "4 STRUCTURAL ; No.32753 ti O - GIST F�SIONA EAG Date... . NORTH Of 1.y oTOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ............... .has'permission for gas installation ......... in the buildings of c ................ .:.......... at .. .. f/?e ! .1, �' cam. A?!.... . , North Andover, Mass. Fee.,/4�G ';�Lic. No.,/?.`!. ?. �_ ....... GAS INSPECTOR Check # t/3 % 6818 oCZ W W Y F N 2 1.. O = f m= O b J} ~ O Z f Z p p� W j �C p� 0 1- 7 W lu W m O ~ IL IqW- G� W (A QQV Wca . Z 40 _ I- u+ = u. _ W Z O tWQ- iQ= O Z -J n IL = w W W O 0}C WQ oC W W m> O Z O W Z W Q F 0 0 G u. 0 O== g o d l` >>> O c Installing.Company Business of Licensed PlumberiGas Frtbe -- 1 have a current Nabi insurance policy or Ns substantial equivalentwhich mesrs the requirements of MGL Ch. 142 Yes ® Nn ❑. If you have checked )C% please indicate the type of coverage by checking the appropdate box below A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'SdNSURANCE WAIVER: i arrr aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives thla requirement. Check One Only -- -_,-- - Owner ❑ Agent ❑ By checking lift box p;1 hereby certify that alt of the detatft and hftnrratlon i have submitted (or enlereM nWdit thI9aWNcatlon aretrue and accurate to the best of my Knowte fte and that all plumbing worts enol irniallations performed under the permit issued for this applica ton will be in eompltance with all Pertinent provklon of the Massmhusetts Stale Plumbing CoO6 arrd—Chapter 142 of the General Laws. Gas Filter Tine Mases S" nature of) �s#ed ft�u, m6% _ F10 APPROVEDAP�(OFFICE tisE ONLY) ❑�n Licence Num 1 T MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING City/Town:14© r +h A), c�rr�� Imo, MA. Date• (O1s' n Permw Building Location: d f� YYl i<i �{ Owners Name:l.dna la �� T a i�e.IR c i? `� Type of Occupancy: Commettial ❑ Educational ❑ Industrial ❑ Institutional ❑ Residential ❑-*- New: E2""" Alteration: ❑ Renovation: ❑ Replacement: ❑ Plans Submitted: Yes ❑ No ❑ oCZ W W Y F N 2 1.. O = f m= O b J} ~ O Z f Z p p� W j �C p� 0 1- 7 W lu W m O ~ IL IqW- G� W (A QQV Wca . Z 40 _ I- u+ = u. _ W Z O tWQ- iQ= O Z -J n IL = w W W O 0}C WQ oC W W m> O Z O W Z W Q F 0 0 G u. 0 O== g o d l` >>> O c Installing.Company Business of Licensed PlumberiGas Frtbe -- 1 have a current Nabi insurance policy or Ns substantial equivalentwhich mesrs the requirements of MGL Ch. 142 Yes ® Nn ❑. If you have checked )C% please indicate the type of coverage by checking the appropdate box below A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'SdNSURANCE WAIVER: i arrr aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives thla requirement. Check One Only -- -_,-- - Owner ❑ Agent ❑ By checking lift box p;1 hereby certify that alt of the detatft and hftnrratlon i have submitted (or enlereM nWdit thI9aWNcatlon aretrue and accurate to the best of my Knowte fte and that all plumbing worts enol irniallations performed under the permit issued for this applica ton will be in eompltance with all Pertinent provklon of the Massmhusetts Stale Plumbing CoO6 arrd—Chapter 142 of the General Laws. Gas Filter Tine Mases S" nature of) �s#ed ft�u, m6% _ F10 APPROVEDAP�(OFFICE tisE ONLY) ❑�n Licence Num 1 T Registered Engineering Services Structural Construction Control Affidavit at Completion of Structural Work Project Number; DSA Project #0706.00 Project Title: Edgewood Retirement Community Cottages Project Location: #20 Samuel Way, North Andover, MA 01845 Scope of Project: Wood Framed Cottage with Concrete Basement and Foundations In accordance with Section 116.0 of the Massachusetts State Building Code, 1, Geoffrey S. Conway, MA #32753 being a registered professional engineer (structural), hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project Mechanical Other (Specify) Architectural Fire Protection XX Structural Electrical For the above named project and that, to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable laws for the proposed project. I further certify that I have performed the necessary professional services and have been present on the construction site on a regular basis to determine that the work is proceeding in accordance with the documents approved for the building permit and have been responsible for the following as specified in Section 116.2. 1. Review for conformance to the design concept, shop drawings, samples, and other submittals, which are submitted by the contractor in accordance with requirements of the construction documents. 2. Review and approval of the quality control procedures for all code -required materials. 3. Been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine, in general, that the work has been performed in a manner consistent with the construction documents. -41%% DFS A 7IL c�� Geoffre onway, P.E. DateT� GEOFFREY �N S. CONWAY 0 STRUCTURAL No -32753 ® y IS7Eµ��� FSS�ONAL EN Registered Engineering Services Structural Construction Control Affidavit at Completion of Structural Work Project Number: DSA Project #0706.00 Project Title: Edgewood Retirement Community Cottages Project Location: #32 Samuel Way, North Andover, MA 01845 Scope of Project: Wood Framed Cottage with Concrete Basement and Foundations In accordance with Section 116.0 of the Massachusetts State Building Code, I, Geoffrey S. Conway, MA #32753 being a registered professional engineer (structural), hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project Mechanical Other (Specify) Architectural Fire Protection XX Structural Electrical For the above named project and that, to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable laws for the proposed project. I further certify that I have performed the necessary professional services and have been present on the construction site on a regular basis to determine that the work is proceeding in accordance with the documents approved for the building permit and have been responsible for the following as specified in Section 116.2. 1. Review for conformance to the design concept, shop drawings, samples, and other submittals, which are submitted by the contractor in accordance with requirements of the construction documents. 2. Review and approval of the quality control procedures for all code -required materials. 3. Been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine, in general, that the work has been performed in a manner consistent with the construction documents. N OF MgsS9 o` GEOFFREY yG Geoffrey ay, P.E. Date f S. CONWAY O STRUCTURAL .y C3 No.32753 ti Aflo�FGISTE����' FSS/0NAL I.,a Registered Engineering Services Structural Construction Control Affidavit at Completion of Structural Work Project Number_ DSA Project #0706.00 Project Title: Edgewood Retirement Community Cottages Project Location: #36 Samuel Way, North Andover, MA 01845 Scope of Project: Wood Framed Cottage with Concrete Basement and Foundations In accordance with Section 116.0 of the Massachusetts State Building Code, I, Geoffrey S. Conway, MA #32753 being a registered professional engineer (structural), hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project Architectural XX Structural Mechanical Fire Protection Electrical Other (Specify) For the above named project and that, to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable laws for the proposed project. I further certify that I have performed the necessary professional services and have been present on the construction site on a regular basis to determine that the work is proceeding in accordance with the documents approved for the building permit and have been responsible for the following as specified in Section 116.2. 1. Review for conformance to the design concept, shop drawings, samples, and other submittals, which are submitted by the contractor in accordance with requirements of the construction documents. 2. Review and approval of the quality control procedures for all code -required materials. 3. Been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine, in general, that the work has been performed in a manner consistent with the construction documents. 4 OF ,�3' 9G� Geoffrey �. way, P.E. Date �� GEOFFREY 9N S. CONWAY STRUCTURAL No.32753 y 90- .o F I ONA1. �a Registered Engineering Services Structural Construction Control Affidavit at Completion of Structural Work Project Number_ DSA Project #0706.00 Project Title: Edgewood Retirement Community Cottages Project Location: #41 Caroline Way, North Andover, MA 01845 Scope of Project: Wood Framed Cottage with Concrete Basement and Foundations In accordance with Section 116.0 of the Massachusetts State Building Code, I, Geoffrey S. Conway, MA #32753 being a registered professional engineer (structural), hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project Architectural XX Structural Mechanical Fire Protection Electrical Other (Specify) For the above named project and that, to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable laws for the proposed project. I further certify that I have performed the necessary professional services and have been present on the construction site on a regular basis to determine that the work is proceeding in accordance with the documents approved for the building permit and have been responsible for the following as specified in Section 116.2. 1. Review for conformance to the design concept, shop drawings, samples, and other submittals, which are submitted by the contractor in accordance with requirements of the construction documents. 2. Review and approval of the quality control procedures for all code -required materials. 3. Been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine, in general, that the work has been performed in a manner consistent with the construction documents. H OFMAssgo o Geoffrey yN GEOFFREY way, P.E. Date _v S. CONWAY VSTRUCTURAL No.32753 CO) O hoc G/STEL ��� .o F S�ONAL EN Registered Engineering Services Structural Construction Control Affidavit at Completion of Structural Work Project Number_ DSA Project #0706.00 Project Title: Edgewood Retirement Community Cottages Project Location: #49 Caroline Way, North Andover, MA 01845 Scope of Project: Wood Framed Cottage with Concrete Basement and Foundations In accordance with Section 116.0 of the Massachusetts State Building Code, I, Geoffrey S. Conway, MA #32753 being a registered professional engineer (structural), hereby certify that I have prepared or directly supervised the preparation of all design plans, computations and specifications concerning: Entire Project Mechanical Other (Specify) Architectural Fire Protection XX Structural Electrical For the above named project and that, to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable laws for the proposed project. I further certify that I have performed the necessary professional services and have been present on the construction site on a regular basis to determine that the work is proceeding in accordance with the documents approved for the building permit and have been responsible for the following as specified in Section 116.2. 1. Review for conformance to the design concept, shop drawings, samples, and other submittals, which are submitted by the contractor in accordance with requirements of the construction documents. 2. Review and approval of the quality control procedures for all code -required materials. 3. Been present at intervals appropriate to the stage of construction to become generally familiar with the progress and quality of the work and to determine, in general, that the work has been performed in a manner consistent with the construction documents. li7i t%� OFMgssgc o� GEOFFREY yG Geoffrey S. ay, P.E. Date f S. CONWAY STRUCTURAL y No.32753 ® ti Ago FSS ONA �N �� Date.F 1.. . .....:�� TOWN OF NORTH ANDOVER ° PERMIT FOR PLUMBING a, • ,SSACMUSE� - - .This certifies that .......... . •f has permission .to perform ......✓1 ... 't!�' ........ plumbing in the buildings of .. ;`. r!!� ... �� Y dT.. . J i t =. at .... . d ........... , North, Andover,,iMass: . Fee c ff- Lic. No: -? .�. ............. ............ PLUMBING INSPECTOR Check 8065 � MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING /) / Cityrrown: &20,(+ rd bde-f , MA. Date: ,5/ d� Permit# QIdJ 1 A — Building Location: o20 5o o cye-( LA-)Qy, Owners Name: t6 Wne,VA Cora, 00 Type of Occupancy: Commercial ❑ Educational Q Industrial[] Institutional ❑ Residential o z New: ❑ Alteration: ❑ Renovation: ❑ Replacement: ❑ Plans Submitted: Yes ❑ No ❑ FIXTURES z z Z in �, O � in W Z Z ~ Y NLu Z Z Q Q W Z O m W W U)i Y w F eat a N pC a W G O 0 0. u. W h J J? at 3 Q . W V a H= s Orn 3 z a v_, 9 o a 0 *- a� g ®_ a Y i� F H a a s a W a m m 0 0 W = Y ..I v! to 3 3 0 SUB BSMT. BASEMENT I IbT FLOOR 1 1 2 FLOOR 3 FLOOR C FLOOR 5 FLOOR 6T" -FLOOR 7 Z FLOOR 411 8 FLOOR 1 1 1 1 1 Check One Only Certificate # Installing Company Name Manstietd Plumbing&Heatin:g,lnc_ 2561-C I$ Corporation Address: 36 Jackman St ..._ . cityrrownGeorgetov+rn:.. ❑ Partnership Business Tel: (978}352-5493`_ - Fax (978}352=541::f1_. - ❑Firm/Comparry Name of Licensed PlumberTi hothy J. Manstiel INSURANCE COVERAGE: I have a current liabilityinsurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142 Yes No ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy ❑ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: l am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Aaent 1 hereby certify that all of the details and Information I have submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations 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 ofjhe General Laws. . BY Trte Type of License. Citytrown I'� ur yman I License Number. 13437 APPROVED (OFFICE USE ONLY)