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Miscellaneous - 207 BEAR HILL ROAD 4/30/2018
N Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULA APPLICATION FOR PERMIT TO All work to be performed in accordance with the 14 (PLEASE PRINT IN INK OR TYPE ALL City or Town of Nbor By this application the undersignQ gives no Location (Street & Number) Owner or Tenant Owner's Address 0fficia1 uyq � Perm11-/it No. . NS Occupancy and Fee Checked r U (J [Rev, I IM) leave blank )ERFORM ELECTRICAL WORK achusetts Electrical Code (MEC). 527 CMR 12.00 Date: negp a- l % ZC gK— _ To the Inspector of Wires: neon to perform the electrical work described below. Telephone No. 9 -,y-. 2.5-8: 'a D this permit in conjunction with a building permit? Yes U No (Check Appropriate Boz) Purpose of Building Utility Authorization No. Existing Service Amps I Voice Overhead ❑ Undgrd ❑ No, of Meters New Service Amps t Volts Overhead ❑ Undgrd ❑ No, of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Comnledon ofthe followinv table may be waived by the lrunertnr nfWire c No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans °' ° ° Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above- rad. rnd. ❑ o. o mergency Lighting BatteryUnits No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o• o etectton as Initiatinz Devices No. of Ranges No. of Air Cond. Toad No. of Alerting Devices No. of Waste Disposers eat PumpIurn Totals:._._ Number. ons ......_....._....._ a ontatn Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal❑ Other Connection No. of Dryers Heating Appliances 1(W NSecurity Systems. or Equivalent aor water , Heaters o. o o. o Signs Ballasts Data Wiring: No. of Devices or E uivalent No. Hydromassage Bathtubs No. of Motors Total HP a ecommun cat ons mug: No. of Devices or E uivalent OTHER Attach additional detail if desired, or as required by the Inspector Of Pyres. INSURANCE COVERAGE: 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 eAtibited proof of same to the permit issuing office. CHECK ONE: INSURANCEBOND ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: (When required by municipal policy.) (Expiration Da(e) Work to Start`` 4-1-11- dS- Inspections to be requested in accordance with MEC Rule 10, and upon completion. I eerdfy, underpand penalties of perjury, that the information on this application is true and complete FIRM NAME:; �i�2 clzi LIC. NO.: �ceasee:Z%d�y�,gT�� Signature �-�x�.� vn=w!�!-. LiC. NO.: 7SC -- ,t� applicable, enter "exempt" in tJte license number Une.) Z- (5-7,9 OWNER' URAN E RIVER: 1 am aware that the Licensee oes not a►e ie ra t tty insurance coverage norma y roquirod by law. By my signature below, 1 hereby waive this requirement I am the (check one) ❑owner ❑ owner's agent. Owncr/Agent Date. TOWN OFNORTH NDOVER • - " PERMIT FO �i G NO=RTH t o 5 This certifies that .................... has permission for gas installation_. ���.7 .......... in the buildings of........................ . at I?A Vis!- ... .. !' 1 . , North Andover, Mass. Fee... Lic. No. !=? :"!n: 4. >'*!�`' .......... . GAS INS,P,ECTOR Check # 6324 C C Commonwealth of Massachusetts official Use Only Department of Fire Services Permit No. BOARD OF FIRE PREVENTION APPLICATION FOR P All work to be perfommd in ac (PLEASE PRINT IN INK OR TYPE ALL City or Town oh- 410/Z By this application. the undersigned gives not Location (Street & Number) ,2 D 7 or 3 TIONS Map &Parcel RMIT TO PERFORM ELECTRICAL 'ORK Massachusetts Electrical Code (MEC), 527 CMR 12.00 W Date:, 3 —305 sy- ,//E/2 To the Inspector of Fires: intention to perform the electrical work described below. Owner or Tenant PO H�3Eti/1JE T7— Telephone Owner's Address �l'O f30X // 7/Ll,4' Is this permit in conjunction with a building permit? Yes No ❑ Building Permit # Purpose of Building-Q116-lJr �¢.K/` y ,�/G,t! Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volta Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: tti/a No. of Recessed Fixtures ,,I No. of Cell.-Susp. (Paddle) Fans a NO. of Total Transformers KVA No. of Lighting Outlets %z No. of Hot Tuba Generators . KVA No. of Lighting FixturesSwimming o mergency g ng Pool ove ❑ n- El rnd. rnd. Battery Unita No. of Receptacle Outlets 30 No. of Off Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. of Detection an Initiating Devices No. of Ranker No. of Air Coad. p t, Tons No. of Alerting Devices No. of Waste Disposers Beat PUMp Totals: _um er_ omnia _ `"-" o. o e ont n Detection/Alerting Devices. No. of Dishwashers Space/Area Heating KW Local ❑ c p ❑Other Connection No. of Dryers o. o stem Heaters KW No. Hydromnassage Bathtubs GXE Heating Appliances KW o. Signs Baoh�laosts No. of Motors Tota! HP ecur ty yysstems: No. ofDevices or Equivalent Data Wh inQg: No. of )Devices or E uivalent a ecommu ca ons _ • ge ,i n..w;n -,swami aerau p MUM, or as required by the lnspector of Wires. INSURANCE COVERAGE: 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 BOND ❑ OTHER ❑ (Specify:) 9/1 7 Estimated Value of Electrical Work:(Expiration Date) (When required by municipal policy) Work to Start Inspections to be requested in accordance with MEC Rule 10, and upon completion. I caft under the pains and penaldes of perjury, that the information on this appUeadex is tate and complete: FARM NAME.CONTINO ELECTRIC -&LIC. NO.: A 1 1983 Licensee: _ LOUIS CONT INO Signature LIC. NO.E 2 8 8 8 Afapplimble, enter " exempt " to the license number Ihm) : Bus. Td. Nod 8 - 3 6 3-- 5 4 2 0 Address: 1 nnNnvanT nT? uiFcm x wgrTDV rrtA �19R5 Alt Tel.No.t OWNER'S INSURANCE WAIVER: I am aware that the Licensee doesnot have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement I am the (check one) 11 owner 0 owm.s agent Owner/Agent Signature Telephone No. PERMIT FEE: $ 6Y5^ °� c 0 Date. w ..... jao ,eye O TOWN OF NORT ANDOVER PERMIT FOR(GAS INSTALLATION This certifies that . .�..,,�..4.�.,._ ........................ has permission for gaffs in the buildings of ,!�,� -_- -,. %� ................ . at ..�-�- % - ... ,j North Andover, Mass. Fee '...... Lic. N�!r',�-.. •`:............ GAS '14 . ECTOR Check # /'V / 7 6213 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) 1Vej >T'J,a1r tt^ Mass. City, Town Building o —7 L tli AT: Location eG0'^ — P -JI , Date_ Permit Owner's Name kn^ L'netc; Type of Occupancy: New Renovation ❑ Replacement ❑ Plans Submitted Yes ❑ No ❑ (Print or Type) Check One: Certificate Installing Company Name TnlunePnd Oil rn Tnr® Corp. Address 27 Cherry Street ❑ Partnership Tian rorq � MA 01923 � ❑ Firm/ Company Business Telephone 979-777-0701 Name of Licensed Plumber or Gasfitter 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 State Gas Code and Chapter 142 of the General Laws. I have informed the owner or his agent that I do not have liability insurance including completed operations coverage. Signature of Owner; Agent I have a current liability insurance policy to include completed operations coverave. ❑ By Title City/ Town APPROVED (OFFICE USE ONLY) TYPE LICENSE: ❑ Plumber ® Gasfitter ❑ Master 0 Journeyman ............................ mom (Print or Type) Check One: Certificate Installing Company Name TnlunePnd Oil rn Tnr® Corp. Address 27 Cherry Street ❑ Partnership Tian rorq � MA 01923 � ❑ Firm/ Company Business Telephone 979-777-0701 Name of Licensed Plumber or Gasfitter 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 State Gas Code and Chapter 142 of the General Laws. I have informed the owner or his agent that I do not have liability insurance including completed operations coverage. Signature of Owner; Agent I have a current liability insurance policy to include completed operations coverave. ❑ By Title City/ Town APPROVED (OFFICE USE ONLY) Aignat f Licensed Plumber or Gasfitter License Number �� TYPE LICENSE: ❑ Plumber ® Gasfitter ❑ Master 0 Journeyman Aignat f Licensed Plumber or Gasfitter License Number �� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date L' Building Location �(j`7, , Uj Owners Name Permit #-a� "� Amount �_ .��•„S"� Type of Occupancy SJ(jaj:7d New Renovation Replacement Plans Submitted Yes No FIXTURES (Print or type)�/L Chec one: rrCe�cate Installing Company Name A CT4 PCS Pkin U #6fir, �k, Corp. li e I 11 Address 3 � I S ��i(1 In Partner. &OU'rye , 4A, - Business Telephone `� 7�i ](� �Lj�, Firm/Co. Name of Licensed Plumber: _ _A 4 %) o u f a t fres Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy © Other type of indemnity ❑ Bond E] Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner 11 Agent F1 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 wor I tallations performed under Permit Issued for this application will be in compliance with all pertinent provisions of tI< Mass u etts Sta lupi g C Chapt 142 of the General Laws. Q 42 By: Ina e riseCl Flumoer Type of Plumbin icense Title M 22— City/Town ense um er Master Journeyman .APPROVED(OFFICE USE ONLY -1 0 1:1 • .1 • .j • • .j • • • • III i il ------------------------- (Print or type)�/L Chec one: rrCe�cate Installing Company Name A CT4 PCS Pkin U #6fir, �k, Corp. li e I 11 Address 3 � I S ��i(1 In Partner. &OU'rye , 4A, - Business Telephone `� 7�i ](� �Lj�, Firm/Co. Name of Licensed Plumber: _ _A 4 %) o u f a t fres Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy © Other type of indemnity ❑ Bond E] Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner 11 Agent F1 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 wor I tallations performed under Permit Issued for this application will be in compliance with all pertinent provisions of tI< Mass u etts Sta lupi g C Chapt 142 of the General Laws. Q 42 By: Ina e riseCl Flumoer Type of Plumbin icense Title M 22— City/Town ense um er Master Journeyman .APPROVED(OFFICE USE ONLY -1 0 1:1 w Date..4.�'. Z- 0- ca S. NORTh pf TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ........ has permission for gas installation ... in the buildingsof... ! \..� w ... .................. . at .. d ®7 .. !�.4 .. .... , North Andover, Mass. Fee.... 5. vg Lic. No.. %.�?. Q ....... ��-t!...� .`'�; GAS'INSPECTOR _a Check # 5971 5252 MASSACHUSEIIS UNIFORM APPUCATON FOR PERNllT TO DO GAS FITTING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Locations I o-, ` Owner's Name New ❑ Renovation Replacement ❑ Date m — 076 "0 V Permit # �---� Amount $ eo r.J 1rw�cr Plans Submitted ❑ (Print or /� /'� C e one: Certificate Installing Company Name ( 1 6 � f � lie f Y✓ fi t Li Corp. Address S �'�� ❑ Partner. usmess a ep one —&A . �--^ 3 Firm/Co. Name of Licensed Plumber or Gas Fit of r (t Vk� a V f INSURANCE COVERAGE • Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 1:3No❑ If have checked es please indicate the type coverage by checking the appropriate box. youY—, ❑ Liability insurance policy —M Other type of indemnity ❑ Bond Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent 13 [ hereby certify that all of the details and in rmation I have submitted r entered in above applic n are true and accurate to the best of my knowledge and that all plumbing ork and installs ' ns pe ormed r Pe Iss o his application will be in compliance with all pertinent provisions of the R usetts St as -C Ater 1 of a General Laws. `%ED (OFFICE USE ONLY) Signature of L' ensed P1 mber Or Gas Fitter Plumber ❑ Gas Fitter License Numoer Master Iff Journeyman 6TH. FLOOR (Print or /� /'� C e one: Certificate Installing Company Name ( 1 6 � f � lie f Y✓ fi t Li Corp. Address S �'�� ❑ Partner. usmess a ep one —&A . �--^ 3 Firm/Co. Name of Licensed Plumber or Gas Fit of r (t Vk� a V f INSURANCE COVERAGE • Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 1:3No❑ If have checked es please indicate the type coverage by checking the appropriate box. youY—, ❑ Liability insurance policy —M Other type of indemnity ❑ Bond Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent 13 [ hereby certify that all of the details and in rmation I have submitted r entered in above applic n are true and accurate to the best of my knowledge and that all plumbing ork and installs ' ns pe ormed r Pe Iss o his application will be in compliance with all pertinent provisions of the R usetts St as -C Ater 1 of a General Laws. `%ED (OFFICE USE ONLY) Signature of L' ensed P1 mber Or Gas Fitter Plumber ❑ Gas Fitter License Numoer Master Iff Journeyman Location oh) c No. $ Date r TOWN OF NORTH ANDOVER . o Certificate of Occupancy $ s�cNusEt�' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ C-290 Check # I 768b - Building Inspector 9 � � TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING Fat BUILDING PERMIT NUMBER: DATE ISSUED: 'G C6AA'— - SIGNATURE: Buildin Commissioner/1for of Buildings Date SECTION 1- SITE INFORMATION - I . , • ° 1.1 Property Address: 2 Assessors Ma 1.ssessorp and Parcel Number: °207 SeAK .. . Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: S/, zoo �tcp Zoning District Proposed Use Lot Area (sf) Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided o� '►/- 6S' 30� 30� - 75' of 'r/- t�-'o' 1.7 Water S31ply M.G.L.C.40. § 54) 1.5. Flood Zone Information: / Zone Outside Flood �7/ 1.8 Sewelage Disposal System: ;; Zone Public Private ❑ Municipal' On Site Disposal System SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Ownerof Record 1\0NAj.0 &G-1.1N�'t'? $o VK(OC.E5 LANCI Name (Print) Address for Service: Signature Telephone 2.2 Owner of Record: 4 'B£?t{ A 4 N 'F w e:,r-r - to 64& kp G..£S 'LA i is N. Arlo w tv, . t Name Print Address for Service: 44 amps �976. ZSU 2ss'0 s . Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable Licensed Construction Supervisor: License Number Address Expiration Date Signature �` Telephone ,, 3.2 Registered Home Improvement Contractor Not Applicable Y 'ompany Name j Registration' Number Address Expiration Date Signature Telephone SECTION 4 - WORKERS COMPENSATION (RG.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 buildkg permit. Signed affidavit Attached Yes ....... V No ....... 0 SECTION 5 Description of Proposed Work check a Ucable New Construction ❑ Existing Building Repair(s) Alterations(s) Addition Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: erwO Vytlff cul APWVrl cµS Ar 6WrAA4e,6 Ato fe,Mt , C ie-*mM V✓144 4A 6 trE Aoo F5 . AL.?E v( `[wo &'010M5 AtW SA-Clf oN 2140 V"o-4 IQE AI r4 51 10 I N 4 # ICE A -A ct, ly)c -rf A to►R Tia -4m otd FrLe N't o �{-ov S E . Kc fi.A --C 14o0F. S6E M cm . IO14.o��✓ l N a s . SECTION 6 - FSTIMATRD C0NCTR1TrT7nN drncTc Item Estimated Cost (Dollar),to be Completed by permit applicant' OFFICIAL USE ONLY 1. Building 27SO © i (a) Building Permit Fee Multiplier SPAN 2 Electrical y� 'o 0 (b) Estimated Total Cost of Construction DIMENSIONS OF POSTS 3 Plumbing pEA?Jr4(A Q.Sr, O O Building Permit fee ca) x te> C�q go 4 Mechanical HVAC 5,60 5 Fire Protection 0 6 Total 1+2+3+4+5) IS BUILDING ON SOLID OR FILLED LAND 5 o L -t to Check Number ar,%,tiv11q iu vwiIr,tcAutnut(tLA11V1\ 1V 1fE l VMYLEIEU Wt1N1V OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property to act on Hereby authorize My behalf, in all matters relative to of Owner by this building permit application. Date DECLARATION 1 1, . ,as Owner/Authorized Agent of subject property . , 1 Hereby declare that the statements and information on the foregoing ion are true and accurate, to the best of my knowledge and belief Print Name Signature of Owner/Agent Date NO. OF STORIES 2, SIZE BASEMENT OR SLAB 3M1'f. SIZE OF FLOOR TIMBERS 1 Z x l0 2 Lx- tO 3 RD SPAN 6 y1w. DIMENSIONS OF SILLS Z IC DIMENSIONS OF POSTS 2 -oo 6 DIMENSIONS OF GIRDERS T^4fllf 111C t� HEIGHT OF FOUNDATION 461 THICKNESS Le, SIZE OF FOOTING gyp" 2o" X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND 5 o L -t to IS BUILDING CONNECTED TO NATURAL GAS LINE M 0 CA&J6—\ Name The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Afdavit ot-1 A 1-0 C -M H t:# / Please Print Location: ?,07 E H t %,� ''e,O City N • Aw cu-- 60, Phone # q78 . 0 I am a homeowner performing all work myself. I 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: K*t-1 N &Vf (1 t40 V tO vAt-, Address ��'x 2-11? City: N.o o v C�& r MA ©l 1 O Phone # `�% $ . 2-� a . 12-5--C-0 Insurance Co. HAMA F60WPoliot # d.raov r *0235'-6? Comnany name: Address City: Phone # Insurance Co. Policv # 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 $1,5oo.00 and/or one years' imprisonment.as .ural -as _civil,penafties in the farm 4-a_STOP WORK..ORDFR..and..a fined ($1413.00) .a clay .against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature r� Date Print name , `� i5 C -4N E'ft Phone # Official use only do not write in this area to be completed by city or town official' City or Town Permit/Ucensirtq Building Dept []Check if immediate response is required II Licensing Board p Selectman's Office Contact person. Phone #. Health Department Other Town of North Andover Building Department 27 Charles Street North Andover, MA. 01845 D. Robert Nicetta Building Commissioner (978) 688-9545 (978) 688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print. p DATE JOB LOCATION q,07 946AWd, 4 Number Street Address Map / lot "HOMEOWNER kot4 A caro 1 6,N ti e -r,< - Wt 2-6'$ 2srO Name Horne PRESENT MAILING ADDRESS %< ?A.40, c -C-1 c A WS N . Atw. ., 6oc, City Town -A State Work Phone The current exemption for "homedwners" was extended to include owner -occupied dwellings of two units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor: (State Building Code Section 108.3.5.1) DEFINITION OF HOMEWOWNER: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures ac- cessory to such use and/or farm structures. A person who constructs.more than onehome in a two-year period shall not be considered a homeowner. This undersigned "homeowner' assumes responsibility for compliance with the State Building Code and other Applicable codes, by-laws, rules and regulations, The undersigned "homeowner' certifies that he/she understands the Town of No. Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. -4 , HOMEOWNER'S SIGNATURE, APPROVAL OF BUILDING OFFICIAL Zip Code EMPLOYER: NOTICE OF ASSIGNMENT RONALD BENNETT P O BOX 2117 ANDOVER, MA 01810 The Waiver of Our Right to Recover from Others Endorsement is available on Pool policies. Contact your agent for details. COMBO I.D. 000023567 COVERAGE GROUP 0023567 STATUS OF EMPLOYER Individual Coverage under this assignment applies to Massachusetts operations only. For coverage outside of Massachusetts, contact the appropriate Pool or Plan for that state. AGENT MAZONSON LLC INSURANCE COMPANY: OR TWO CORPORATION WAY HARTFORD UNDERWRITERS INS CO PRODUCER: PEABODY, MA 01960 MS..MARTHA VAN METER P O BOX 4903 ORLANDO, FL 32802-4903 (800) 453-9843 AGENCY FEIN: 030447790 CLASSIFICATION OF OPERATION CLASS ESTIMATED RATE ESTIMATED CODE TOTAL ANNUAL PREMIUM' REMUNERATION -------------------------------------- --------------------------------------- CARPENTRY-DWELLINGS-3 STORIES OR LESS 5651 $0 9.93 $0 CARPENTRY -DETACHED PRIVATE RESIDENCES 5645 $5,000 9.93 $497 CARPENTRY-NOC 5403 $0 16.09 $0 EMPLOYERS LIABILITY 100/100/500 9845 LOSS CONSTANT 0032 $3 STANDARD PREMIUM $500 EXPENSE CONSTANT 0900 $264 TERRORISM CHARGE 9740 $2 ESTIMATED ANNUAL PREMIUM $766 DIA ASSESS. 4.9% OF STANDARD PREM. $25 EST. ANNUAL PREM. PLUS ASSESSMENT $791 INSTALLMENT BASIS: Annual DEPOSIT PREMIUM: $791 THIS IS NOT A BILL COMMENTS Coverage effective 12:01 AM on 08/30/04 DATE OF NOTICE: 08/30/04 PREPARED BY: Theresa Schofield EXT 542 * * VOLUNTARY DIRECT ASSIGNMENT * * LETTER ID: 611352 COPY: EMPLOYER The Workers' Compensation Rating and Inspection Bureau of Massachusetts 101 Arch Street - Boston, MA 02110 (617)439-9030 - FAX (617)439-6055 - www.wcribma.org Ronald Bennett, AIA Andover, Mass. OWNER:tb4L0'�.,tt�i/It11U�AIAI�YT OES REF. ADDRESS OF PRINCIPI.!* SUIL 09NG PLAF�REF.2317 247� 1dLG 1E'D� DAIS OF INSPECTION _�� ra� Y N. A--�1mVE=ef �A SCAt;E: T �SA� ,./or /8.4 DATE: September 9, 2004 The location of the principal structure as shown shall conform with the local zoning bylaws in effect at the time of permit application. Reference is made to certification of existing structure on attached Mortgage Plot Plan by EK Survey Inc. dated July 6, 2004 l 1Z No 904 ensTON q�h/OFMPc'' AtA /614. Jul 14 2004 10:18RM HP LRSERJET 3200 p.3 E K SURVEY INC ♦ HAVERHILL, MA Phone 97 1985 Fax 978Aeg.71WI . g i t MoiiTaAt;oR q p B�ft�A1JAi �yal rr' IDEE0 REF. &PSI/ PG. Z_ ADDRESS OF PRINCIPLE SUIt.OING PLAN REF. QIZ7 207 A#14 100, DATE-. OF INSPECTION s. �tl. A.t1mllE�y MR SCALE: V ■ 30' ,.,/or /8.4 $44 K R 04D 1404 T RU�Et CERTIFICATION TO: i'he locatl of the principle atructure/s This Mortgage Plot Plan was No. 361180 prepared specifically mortgage purpoeee only and It is not krtended or represented "f� f�CiSSts �� '^ local #Aj � yawa to effect when constructed to be a property line or land survey. This plan Is not to be used s�op� exp s� arid/ or Is exempt from violation enforcemnent to establish any of the property lines for any purpose. No action under Mass B.L. Title VII, Chap. 40A, Set. 7. responsibility is extended to the land owner or occupant : Subject bulkl6g to not in a Flood Hstard Aron. This certification Is hosed on the location of survey marker O Subject buMing Is In a Flood Hazard Area. of others. Flood Hazard determined from the FIRM m*# JOB f1 xyyyl Dom. 0 a �CIO< O d �0 20&Q cz 0 Q ZZ Z ZZQJ J JZOZZ NC7 c �2 _ QJCL a-��00rNcnCnC� _ �a0QC7C7QQ~F"00000 0 Q _0 i s E Z O O W 2i J J W W W W 0 0 0 w JLJLLL <wWJJ��UUU i cn cz Q WLL�O�Wr �w��LLLLLL Z Z W U U U Q o W O O � W Q Q Q 0 00oCw�i—"www 000LLLL<C CL NZ mLLW COU) A LL • a U U II II :Il � z ❑ 06 X00\.I[ zat=-0 UZ18(000 SIX3 0_ Hm W WwZOo odocx10 l 0 O L L,0 10: 0. 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Q1 ra L L L U U L p O p p "O N � L �+ r0 L L N C C C N O O Q) C- E -C �' — p O p O UUcn(f)C S N p C p p 0 i��wUY>ma�wUln X ra Z ra ra p a) Q) r0 a) — o, c W M Date ... ........... r TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ........ A ......................................... has permission to perform.. . .... wiring in the building of ..... /n ................................. 'at ....... �w . ..... . North Andover, Mass. Fee../?,.� ... ..... Lic. No.............. ... ( ................. ELEcrRI, AL INSPECIOR Check # 56T/ Date: - S yY TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ... 6? .41 .h. ... �........ l -C has permission to perform .... � k�' .�!." .............. plumbing in the buildings of ... .e ti . ............... . at . 2 P!..� r'!` .�' ` �. , North Andover, Mass. Fee.//- .... Lic. No.. f r�q (! . ....... ... 4 . ....... PLUMBING INSPECTOR Check # %` v 6424 I MASSACHUSETTS 19NIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Locatiory-A I Owners Name of New 0 Renovation 1 Replacement 0 VVV FIXTURES Date ^ 15— — 0 S- N Permit # L Amount y / - Plans Submitted Yes 0 No (Print or type) Check one: Certificate Installing Company Name ( %, o t _ A G, .114, d E] Corp. Address G 0 S.oj , r � � � Partner. usmess Telephone �Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Bond Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance I hereby certify that all of the details and i for best of my knowledge and that all plumbin w, compliance with all pertinent provisions of the By: Title City/Town APPROVED (OFFICE USE ONLY Owner 0 Agent ion I have bmitted (or entere in above ap do true and accurate to the and ins lata ns performed P t Is d f t ' application will be in iss usetts tate P od an er 1 f the General Laws. ;nature Or LlcenseQ Yl Dei Type of Plumbing icense 16,?o ense Numver Master z Journeyman ❑ f, Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. �6z 97 BOARD OF FIRE PREVENTION REG TIONS Map & Parcel r. APPLICATION FOR P RMIT TO PERFORM ELECTRICAL ORK All work to be perfonned.in accordance wi a Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT WINK OR TYPE ALL IN ORM TION Date: 3 --'?a o� City or Town of: ,10PT D E� To the Inspector of Fres: By this application the undersigned gives notice o or her intention to perform the electrical work described below. Location (Street &Number) 7 (� Owner or Tenant IX -1 Telephone Owner's Address PO /3DX aI17 /- X/7��//G & Is this permit in conjunction with a building permit? Yes No ❑ Building Permit # Purpose of Building S11/&L.E EA, ,4e& Y /,4 .W,57 Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Gti / /2 / hrl DA:: 142P17-1" T© i D /2C -ml- Completion of thefollowing table may be waived by the Inspector of Wires. No. of Recessed FixturesNo. d� of Ceil.-Susp. (Paddle) Fans a o. o Transformers of al KVA No. of Lighting Outlets 12 No. of Hot Tuba Generators .. KVA No. of Lighting Fixtures / ove Swimming Pool rnd. ❑ n- rnd. El No. omorgency Lighting Battery Unita No. of Receptacle Outlets 30 No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners NoZo7i3etection an Initiating Devices No. of Ranges No. of Air Cond. p Tons 1,JNo. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number I Tons I KWNo. oSelf-Contained Detecdon/Alertino Devices. No. of Dishwashers Space/Area Heating KW Local ❑c [3 Other Connection No. of Dryers Heating Appliances KW scar ty Systems: No. of Devices or Equivalent No. of Water KW Heaters o. o o. o signs Ballasts Data Whing: No. of Dgevices or Equivalent S No. Hydromassage Bathtubs (� '6 No. of Motors Total HP a ecommu ca ons No. of Devices or E uivalent S� Attach additional detail if desired, or as required by the Inspector of Fires. INSURANCE COVERAGE: 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 iu force, and has exhibited proof of same to die issuing office. CHECK ONE: INSURANCE a BOND 0 OTHER ❑ (Specify:) 9 /17 (ExPirari'onDa e) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties ofperjury, that the information on this application is true and complete FIRM NAMES C- LIC. NO.: A 1 1983 Licensee: LOUIS CONT I NO Signature 2^ LIC. NO.: E 2 8 7 8 8 (If applicable, enter "exempt " in the license number line.) L Bus. Tel. No.%7 8 - 3 6 3 - 5 4 2 0 Address: 1 nnNnVnn1 nu[n7FCT TLF_[nTRi_TRV_Pd1Z1 01985 Alt. Tel. No., 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) 0 owner 0 owner's agent Owner/Agent Signature Telephone No. PERMIT FEE. $ �5_ Date.................................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING l 7;/� This certifies that................................................................. has permission to perform�� /�!�1.�� �p wiring in the building of .................... a..... .. ...� ..f ...................... :North Andover, Mass. Fee ..`�,�!?� .V .. Lic. No. qZ�.......... ............... } ELECTRICAL INSPECTOR Check # J 56:9 Commonwealth of Massachusetts official us1 � Department of Fire Services permit No. BOARD OF FIRE PREVENTION REGULA ONS Occupancy and Fee Checked [Rev, I lil"] leave blank APPLICATION FOR PERMIT TO E�RFORNI ELECTRICAL WORK All work to be performed in accordance with the=us Electrical Code (NEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL IN RrNATI N) Date: Aojut 11, Z' City or Town oftTo the Inspector of Wires: By this application the undersigned -gives notice of his or lier intention to perform the electrical work described below. Location (Street & Number) 2 6'7 Owner or Tenant „Maly Owner's Address 2o'7 Telephone No. Is this permit in conjunction with a building permit? Yes Er— No (Check Appropriate Boa) Purpose of Building r.,�c. Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ Na of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Cy cc- ar L l colm 2z�� Completion olthe following table may be waived by the Inspector of Wires. Na of Recessed Fixtures No. of CeiL-Snip. (Paddle) Fans °' ° Vta Transformers KVA Na of Lighting Outlets No. of Hot Tubs Generators KVA Na of Lighting Futures Swimming Pool Above ❑ n- ❑ rnd. rnd. o. ° Emergency Lighting Bette Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS I No. of Zones' Na of Switches No. of Gas Burners No.o Detection Initiatin Devivi ces Na of Ranges Na of Air Coad. Toad No. of Alerting Devices Na of Waste Disposers eat Pump Totals:. I „ um er - ons _ _. a oMr-Contained DetectioNAlertin Devices Na of Dishwashers Space/Arca Heating KW Local ❑ unic pa El Other Connection Na of Dryers Headng Appliances )Wt SecuritySystems: Na of Devices or Equivalent No. of Water KWHeaters o. o a o Si s Ballasts Data Wiring: Na of Devices or Equivalent INa Hydromassage Bathtubs No. of Motors Total HP Telecommunications r triva No. of Devices or E uivatent OTHER: ,attach additional detail if desired, or as required by the hispector of Wires. INSURANCE COVERAGE: 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 EYlBOh'D ❑ OTHER ❑ (Specify:) Estimated Value of Electrical Work: (Expiration Date) (When required by municipal policy.) Work to Start:'. d6-- Inspections to be requested in accordance with MEC Rule 10, and upon completion. ! certify, under the painlr and penalties of perjury, that the information on this application is true and complete - FIRM NAME:LPA ; r1 �c SecsJ�czi LIC. NO. Licensee: Zd�,g--�Yr1/?,yl Signature 1� �1,�� LIC. NO. 7SC (IJ applicable, enter "exempt" ill fire license rrunrber line.) Bus. Tel. No. -29--98 2,8 d -2i Address: —"Te 61 e` c,- � Alt. Tel,Nv.:7gl SS3 /-i OWNERS INSURANCEWAIVER: I am aware that the Licenseeoe�C s not hme die liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. lam the (check one) ❑ owner ❑ owner's a ent. i Owner/Agent ---- �, �' r� � � � � � �. � � � � m �' a �o � I , � rs � ` a � } � 70 � D -+ � -' i l � H 'O,'1�. �.. a 1 o �� � ��� � .� � � � i � _ c < < � � � � a t � � � � l ---- �, �' r� �. 'VL ,� a 3 z o fV '� Qas �jso .r C-1 M O z � a a Qas o W �2 (% ° b .0 G w o°G w (� a°' w o4 w W rA 2 vii v vi �5 0 t:CS N C C=3 ` C N O �� ac eo ev ' m C C3 C.3 y< ` Ea' N :o~L t _ O: ?: ts C!� :L'' m C_ 0 CL cc m3}t N := c O "C O O v :EmaL. t --O 7: • L O co13 :• -01 H A� ix m cmrm oo : ca"N Z '� O •o a c O C C = m m 3 N � m o �� uj „ W � .vyi LU cm Vi a m� O3 Go CD S awm :IN NO K1 z z 0 U 0 78 4-1 m O CD z o. O y .0 C CD CM CO2 Q 32 y CD = CD CD 3.0 CD CDCL CL L a cma c o c ev 2 'p C CD CL � C CL C y is 0 Y♦ W W W W. W N Ak Location tea' n No. Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Q Check # 3 + �b t 17520 AW Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING :: 0,� BUILDING PERMIT NUMBER: (' _ DATE ISSUED: SIGNATURE: Building Commissionerfl2tktd6f Buildings Date SECTION i- SITE INFORMATION LI Property Address: 1.2 Assessors Map and Parcel Number: G Map Number Parcel Number 1.3 Zoning Information: _ _ _- Zonin District Proposed Use LA Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Re4qUired Provided Reqwred Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zane Outside Flood Zone ❑ Munici at ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record �oNA�-d ?EN4611( So G'Z�n4Cs c -o• E� t�. A+to«i� Name (Print) Address for Service n , 2S 8 vl'So Sign ture Telephone 2.2 Owner of Record: FE7t-F A • 3C—N ri >✓ TT � 8•�-to GES 1�.++£ , N. At-wo,r£t- N4me Print Address for Service: C)7B . ZS`b. ZS$'O Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable Licensed Construction Supervisor: License Number Address Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable a Company Name Registration Number I Address Expiration Date Signature Telephone Ma M SECTION 4 - WORKERS COMPENSATION (KG.L C 152 6 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work cher applicable New Construction ❑ Existing Building Repair(s) Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition Other ❑ Specify Brief Description of Proposed Work: A d!p Ct vTT6Q; l4iH✓ s&w N S You2S Tc> HOOSE ANO 9EQA%t, 1 NSEC,'f OAMA 4.E ov G-v4tP�NIG� ''['D 5t�lt�ri At�o -frG,{ r! AT NT dmcK. 4r1wE /G f t..Ac-E e0W_-rt— N 3" O fr %A)000 ,O Ec.K % 1� �, (� t`,�► 96 eAt & C-KAC-K- IN fov N iPA-V c N W">'LA. 1 N &At rC A 4E Ae0 (Or La>plG WAo, ANO <O( ACE, r1N%5H£5 114 6Yt5- rNt5I46V 135M'r. SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAUSI•<.E?N LY , 1. Building ©OO (a) Building Permit Fee Multiplier 2 Electrical O 00 r (b) Estimated Total Cost of Construction 3 PlumbinE O Building Permit fee (a) X (b) 4 Mechanical HVAC p� 5 Fire Protection 6 Total 1+2+3+4+5 O, O C O Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT CONTRACTOR APPLIES FOR BUILDING PERMIT /OR as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, 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 Print Name Signature of Owner /Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINIBERS 1 2No 3RD SPAN DRv1ENSIONS OF SILLS DIlvIENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHEVINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 10/ Town of North Andover Building Department 27 Charles Street North Andover, MA. 01845 D. Robert Nicetta Building Commissioner (978) 688-9545 (978) 688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print. DATE -7 O 01 JOB LOCATION 2-07 BC—AA, HI VL' foA-0 Number Street Address Ma / lot "HOMEOWNERN NN E'C'C / 7$ . 2S$ . 2530 g7$ . ZS$ Name Home Phone Work Phone © s PRESENT MAILING ADDRESS G� Al 4S LAM E City Town State Zip Code The current exemption for "homedwners" was extended to include owner -occupied dwellings of two units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor: (State Building Code Section 108.3.5.1) DEFINITION OF HOMEWOWNER: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures ac- cessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other Applicable codes, by-laws, rules and regulations, The undersigned "homeowner" certifies that he/she understands the Town. of No. Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATUR APPROVAL OF BUILDING OFFICIAL 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:,/� C, Ov rj �.5-r e72. J/ "O -r , %o 6lU o t406& -.c. -r (Location of Facility) NAS r Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector L32 0 F=4 ERS 01 * *4 6 z m m ca It 3 s cm A wl Q as. s � �O.r N W joo c is m o nc3ID m G :c,oc d iW y Z `O o 9-6 n •a cp CL c _ n Q o : I o c r N m w O Vi lC Z • y=,., WLu Cos m Z oc E o C.3 LU aca 5 _ a o = = o F- z 0n=..m F. CA CD Me 0 C O CD ccW- H 0 'o. H O cc C cc y 0 i 0 CL CO3 C O rm C O C CIO m 0 co 3� �D O Q,a c c �i iv .0 O Z s CD C. y C LLI UI U) W W I% W N v o U 6 'm c x � O � flo x W Go O J�� x c m d JOE w v ' c9� A a w c�4 T v U w rx w U w a°' w aG c w A ca 0 z cn v o v/i 01 * *4 6 z m m ca It 3 s cm A wl Q as. s � �O.r N W joo c is m o nc3ID m G :c,oc d iW y Z `O o 9-6 n •a cp CL c _ n Q o : I o c r N m w O Vi lC Z • y=,., WLu Cos m Z oc E o C.3 LU aca 5 _ a o = = o F- z 0n=..m F. CA CD Me 0 C O CD ccW- H 0 'o. H O cc C cc y 0 i 0 CL CO3 C O rm C O C CIO m 0 co 3� �D O Q,a c c �i iv .0 O Z s CD C. y C LLI UI U) W W I% W N v 3 6 'm c u 0 �11ti O � flo C y Go O J�� .a n c c m 01 * *4 6 z m m ca It 3 s cm A wl Q as. s � �O.r N W joo c is m o nc3ID m G :c,oc d iW y Z `O o 9-6 n •a cp CL c _ n Q o : I o c r N m w O Vi lC Z • y=,., WLu Cos m Z oc E o C.3 LU aca 5 _ a o = = o F- z 0n=..m F. CA CD Me 0 C O CD ccW- H 0 'o. H O cc C cc y 0 i 0 CL CO3 C O rm C O C CIO m 0 co 3� �D O Q,a c c �i iv .0 O Z s CD C. y C LLI UI U) W W I% W N 7 : u 0 �11ti flo H Go 2� 01 * *4 6 z m m ca It 3 s cm A wl Q as. s � �O.r N W joo c is m o nc3ID m G :c,oc d iW y Z `O o 9-6 n •a cp CL c _ n Q o : I o c r N m w O Vi lC Z • y=,., WLu Cos m Z oc E o C.3 LU aca 5 _ a o = = o F- z 0n=..m F. CA CD Me 0 C O CD ccW- H 0 'o. H O cc C cc y 0 i 0 CL CO3 C O rm C O C CIO m 0 co 3� �D O Q,a c c �i iv .0 O Z s CD C. y C LLI UI U) W W I% W N Date... &ORTH TOWN OF NORTH ANDOVER PERMIT FOR WIRING 4' - This certifies that ..... ry k�� ......... ...................................................... 0 ....... has permission to perform . ... .... ... wiring in the building of ............... Ra�y ....... ..................... at ... ip.P()f-..a ...........1..?.` ...-A .. ... .. t ................................ . NortI.Andover, Mass. Fee..... ...... Lic. No. ............. ............................. ELECTRICAL INSPECTOR Check# Z34 b.0 5379 THECOMMOAREAUHOFMASSACHUSMS Office Use only DEPARTBfEVT0FPUBIICS4FM Permit No. ^� BOAROOFFREPREVF. MONREGZII ATlONS527CMR12 Ob Occupancy &Fees Checked APPLICAHONFOR PERMIT TO P ORMELECTTMICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THESACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Mk$Date 7 Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical wort described below. Location (Street & Number) [�V�l U4-- OA V Owner or Tenant Ko M A, t-- o '(3 ;N N er-T Owner's Address 4 KQ a ✓ OK. Is this permit in conjunction with a building permit: Yes [Er No (Check Appropriate Box) Purpose of Building SIN GE FA -MIL-`( t+o-M E Utility Authorization No. Existing Service 'Ldp Amps 209V t ZO Volts Overhead Underground a No. of Meters New Service Amps' Volts Overhead Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work L t 4 HIN 4S EMEN -r c. -Et t� 1 N G No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures O Swimming Pool Above Below Generators KVA round 1:1round No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets 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 _ Othe No. of Dryers Heating Devices KW a Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP 06ER• VJ044<- 1R0 615 ?d*1 10A_ 160 gY ff*Ftl5 oLot tcK�. hlstnanoeCoverage Ptxaianttothelegtmetnalts�GalaalI.aws IhareaamentLiata7tyhmaarePblicyincl>amgCar Cowroricssti>btarrialec}rivalai YES NO Ibavasubniwdvandploofofsmmu) cOffm YES If)mha%echedcedYES,pleasei dc&thepAxofcDmrVby duJ&lgft b INSURANCEox BOND r7 OnJ R (P1ea9 *cify) Esli mted Vakr dBa=cal Wdk $ WodcmSW kq)ec6mD*Requbd Rough Fula] Signed un&rtTie analties cf perjury. FIRMNAME LioalseNo. Iioer>see Signaftm Li=W No BushnmTelNo. a Alt Tel M. OWNER'SINSURANCEWAIVER;IamawarethattheLio wdoesmthavethem uz=oDvw,WoritsalbsUldequivalentasregmedbyMassadxLgmCov alLaws andd army sgraltneon dwpeandappbcabm wa'rt's dl's mwMnalt. (Please check one) Owner AgenED t Telephone No. PERMIT FEE $ Signature or owner or Agent Location No. 4/4 Date O� NORT1y TOWN OF NORTH ANDOVER 3? •. O 7 F 9 Certificate of Occupancy $ CHU Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # C Pj �� 7 �' —Building Insp� Or TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR. RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUELDING PERMIT NUMBER:r / DATE ISSUED: Q D SIGNATURE: U Building Commissioner/In or of Buit-dings Date SECTION 1- SITE INFORMATION 1.1 Property Address: © 1.2 Assessors Map and Parcel Number: k J Map Number Parcel Number 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Area Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Re red Provided —+ 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Infomntion: Public ❑ Private ❑ Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System ❑ SECTION 2 -PROPERTY OWNERSHIP/AUTHORIZED AGENT "it;i; ii't:District: yea �,Jn 2.1 Owner of Record �>A©1� iso � N e�'� Name (Print) Address for Service : Signature Telephone 2.2 Owner of Record: Name Print Address for Service: I Signature Telephone SECSfjON 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address _ Signature Telephone Not Applicable License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable 0 tt Company Name Registration Number Address Expiration Date Signature _ Telephone 00 M 0 SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......❑ No ....... 0 SECTION 5 Description of Proposed Work check as A ucable New Construction ❑ Existing Building ❑ Repair(s) . 0 Alterations(s) OF I Addition ❑ Accessory Bldg. 0 Demolition 0 Other ❑ Specify Brief Description of Proposed Work: X Kc S 2,r I W..CTInN 6 - ReMMATRn CnNC7WTTrT1rnN rnCWC I Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICW. USE ONLY <; I . Building % 0Multiplier (a) Building Permit Fee 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x (b) C/ 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number ur,�,aavi� ra 1.11FX%tiV &Klux.MPLIlull 1V ISE l,V1V1rLE1hL wt xr4 OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT t as Owner/Authorized Agent of subject property r 6 Hereby authorize My behalf, in all matters relative to work authorized by this building pero mit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION to act on 1, ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are Lrue and accurate, to the best of my knowledge and belief Print Name of Owner/ Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1' 2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIlvIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY 1S BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 4- 88 F A 0 0,e( �C 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_ LW-4-/0?'i✓ti� PHONE G S' LOCATION: Assessors Map Number PARCEL'S SUBDIVISION LOT (S) STREET -:B-e-4 ST. NUMBER / TOR IAL USE ONLY**""**** AGENTS: DATE APPROVED DATE REJECTED TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS - SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE RovInd 9W7 Jm Cf Na RTh T.,OWN:OF NORTH ANDOVER � OFFICE OF p BUILDING DEPARTMENT 400 Osgood Street North Andover, Massachusetts 01845 D. Robert Nicetta, Building Commissioner HOMEOWNER LICENSE EXEMPTION Please print DATE: N—W-aS Telephone (978) 688-95454 Fax (978)688-9542 JOB LOCATION: 0,_ c7 7 9 eA'<- i - t Lt� te'Po Number Street Address Map/Lot HOMEOWNER KC)N Name �AGO �ct4Nev--( j7t d 2.S c6r 2S --a 41W Home Phone Work Phone PRESENT MAILING ADDRESS L16 a blit v C,6� L_A �4-e City Town State Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OF HOMEOWNER Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned "homeowner" assumes responsibility for compliances with the State Building Code and other Applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Ii4 MRI) OF, VITSLS 698-9541 CONSI:RV,\TION GRB 95:30 IIFALTIi 63k0540 PLANNING 699-9535 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) . Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector I C U C C� 0 0 00 N U E O c > U) �0O�a)rn C Q cn cz O EI c WW�— ctt —_ > m E0 = 0cn FECoLLU)000 U) N �+ Q (� Qz (n m z 0 70i d (z No Z o C CZ C C C� 0 00 N U c > �0O�a)rn O U- - W 0)a)— Q cn FL EI c WW�— E E 0 r 0 m i �— E0 FECoLLU)000 (A �+ N i N N N N 0 N LL c Ln � 0) (n cn cn cn cn cn cn Y O C 'cZ Q ami a0i �a'�/) LL �a'r) //a���i /�ami LL m m M� C. 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DECKRAIL SERIES, LAURELHURST STYLE (PANEL TRIM METHOD 'C') INSTALLED PER MFR'S RECOMMENDATIONS AND IN ACCORDANCE w/ ALL APPLICABLE CODES & STANDARDS (TYP.) HHHH HHF (2) 4x4 STRUCTURAL BRACES NOTCHED TO SUPPORT DOUBLE RIM JOIST ABOVE 0 6" 1' 2' 207 Bear Hill Road North Andover, MA BALCONY DETAIL 11 -Apr -05 (2) WELDED STEEL HANGERS FABRICATED FROM 5/16" STEEL ANGLE & 1/8" FLAT SIDE PLATES SECURED TO EXIST. 2x10 RIM JOIST w/ (2) 1/2" PLATED HIGH-GRADE STEEL THROUGH BOLTS — SECURE 44's w/ PIN CONNECTION USING (2) 1/4" BUTTON -HEAD THROUGH -BOLTS — COPPER CAP FLASHING UNDER SIDING AND OVER BRACES & STEEL HANGER (TYP.) _1ST FLOOR dk EXIST. 2x10 RIM JOIST @ 1 ST FLOOR LEVEL ALUM. FLASHING BEHIND LEDGER (TYP.) d Z_ COPPER FLASHING M UNDER DECKING 1x4 MAHOGANY DECKING INSTALLED (TYP.) OVER 2x8 JOISTS @ 12" OC. (TYP.) 1x4 MAHOGANY TRIM (TYP.) 2ND FLOOR 1x8 MAHOGANY FACIA (TYP.) DOUBLE 2x8 RIM JOISTS (TYP.) 3/8" PLATED LAG BOLTS (TYP.) 2x8 LEDGER BOLTED THROUGH EXIST. SHEATHING TO EXIST. 4'-42" 2x10 RIM JOIST w/ 3/8" PLATED MTL. LAG 1x4 MAHOGANY DECKING INSTALLED ON DIAGONAL UNDER 2x8 JOISTS w/ BOLTS STAGGERED 3/8" SPACE BETWEEN DECKING @ 16" OC. (TYP.) BOARDS ONLY WHEN USED AS SOFFIT FINISH ALUM. FLASHING BEHIND LEDGER (TYP.) (2) 4x4 STRUCTURAL BRACES NOTCHED TO SUPPORT DOUBLE RIM JOIST ABOVE 0 6" 1' 2' 207 Bear Hill Road North Andover, MA BALCONY DETAIL 11 -Apr -05 (2) WELDED STEEL HANGERS FABRICATED FROM 5/16" STEEL ANGLE & 1/8" FLAT SIDE PLATES SECURED TO EXIST. 2x10 RIM JOIST w/ (2) 1/2" PLATED HIGH-GRADE STEEL THROUGH BOLTS — SECURE 44's w/ PIN CONNECTION USING (2) 1/4" BUTTON -HEAD THROUGH -BOLTS — COPPER CAP FLASHING UNDER SIDING AND OVER BRACES & STEEL HANGER (TYP.) _1ST FLOOR dk EXIST. 2x10 RIM JOIST @ 1 ST FLOOR LEVEL ALUM. FLASHING BEHIND LEDGER (TYP.) . .. Woodway Deckrail Technical Data Sheet: Product Information Woodway Deckrail panels are made from precision molded 1 1/4" x 1 1/4" clear, kiln -dried Red Cedar or Mahogany. All panels are pre -assembled using mortise and tenon joinery secured with waterproof urethane adhesive. Panels are available in the five patterns shown below. All panel patterns are available in net lengths of 44 1/2", 66 1/2" and 92 1/2" to fit exactly 3 1/2" posts measured on 4', 6' or 8' centers. Panel patterns are also available in net panel heights of 30" and 36" suitable for finished rail heights of 36" and 42", respectively. Accessories Top Rail - Provides support and finished look; net 1 3/8" x 3 1/4" available in 6' and 8' lengths Sub Rail - Attaches top rail to deckrail panel; net 1 3/8" x 2 3/8" available in 6' and 8' lengths Bottom Rail - Finishing touch; net 1 3/8" x 3 1/4" available in 6' and 8' lengths Baluster (not shown) - Net 1 1/4" x 1 1/4" available in 36" height to match panel stock Post (not shown) - Net 3 1/2" x 3 1/2" x 60" Post Cap Top Rail Sub Rail Post Bottom 'Raid Panel Trimming Recommendations If post spacing is such that full panels do not fit the opening, the panels can easily be trimmed to fit. This can be accomplished in several ways. We recommend the following: 1 - If the panel length is less than 1 1/2" longer than the opening between posts, the panel can be trimmed equally on both ends with a 1/2" edge on both panel ends to fasten to posts. 2 - If the panel length is over 1 1/2" longer than the opening between posts, we recommend trimming the panel to the next full vertical 2" x 2" and then installing the panel centered between the posts. Verify that the distance between the posts and the nearest vertical 2" x 2" meets code spacing requirements. Stairways Because nearly every stairway is different, we do not manufacture pitched stairway panels. Instead, we offer 36" lengths of the same precision molded 1/4" square material used in our panels. These may be used as balusters set at the same spacing as the vertical members, or this material can be used to make a custom panel in a pattern to compliment the standard panels used elsewhere in the job. Building Codes The following references to Woodway Architectural Deckrail Series products and building codes are provided for the applicator as a general but incomplete guide to identifying issues of code adherence. It is not a substitute for a complete recitation of all relevant national and local codes. Please consult all relevant building codes prior to using Woodway Architectural Deckrail Series products. Height and Opening Size 1 - All of the panel styles comply with the requirement for a maximum opening size of less than 4" (CABO, Council of American Building Officials; BOCA, Building Officials Code Administrators.) Some building codes have a provision that prohibits any rail system that has a ladder effect. Interpretation of this requirement is apparently at the discretion of individual building inspectors. We would assume that all our patterns meet this requirement except Council Crest and Lair Hill. 2 - Building code height minimums for residential railing is 36", while commercial applications require a 42" height minimum (CABO, BOCA). Woodway Deckrail residential and commercial panels are 30" and 36" in height, respectively. When used in combination with Woodway top, sub, and bottom rail and a 3" toe space, finished rail heights of 36 7/16" and 42 7/16" will be achieved. Be sure to check all relevant building codes to ensure compliance. Woodway Deckrail Panels require a net addition of 6" through a combination of toe space and rails to meet code heights when not using Woodway rail accessories. Strength 1 - These products are intended for use by construction professionals. All strength claims are contingent upon proper installation and fastenings. Because of the many ways this product may be used, field variables beyond our control, and differences between various building codes, it is up to the designer and/or installer to be familiar with local codes and determine appropriate fastenings and other details of each installation. 2 - Panel strength: The panel is not designed to be used without top and bottom rails. Assuming the panel is securely fastened to an adequate top and bottom rail, any of the panels will easily meet the requirement of a 200 lbs. load applied over one square foot any place on the panel (CABO). 3 - Rail strength: Used as designed, our top cap and top sub rails combined with the panel itself will meet the requirement for a 200 lbs. horizontal point load anywhere on the rail at up to an 8' span between posts (Standard Building Code). Finishing We recommend applying a high quality stain or paint prior to installation of your Western Red Cedar Woodway Deckrail Panels. For generations Red Cedar has been the preferred material for external siding and outdoor applications due to its dimensional stability, rot resistance and superior finishing characteristics. Cedar will accept both water-based and oil-based finishes very well. Clear finishes will protect and enhance the natural cedar color but may need more frequent application to prevent the sun's natural silvering of the wood. A semi transparent stain in a cedar tone may also be used to retain the warm cedar color with less maintenance and is available in most major brands. Cedar also accepts an opaque stain or paint exceptionally well. For painting, we recommend a stain blocking solvent -based primer coat prior to applying the finish paint coat(s). rA R: ►� §51 El 4.4 Q E CD z O ca co CA .9 CD CD 0 CD Q cc a: V3 0 CO2 O C.3 cc cc CL CO2 O CD C. COD W CM C) CD co cc O CL. 0 CL cm< cc 10 C2 CO CD O. 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