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Miscellaneous - 215 OLD CART WAY 4/30/2018 (3)
N 1-60iltion. No. Date Check # ZT3 3 building Inspector TOWN OF NORTH ANDOVER Certificate of Occupancy $ A D I "us Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ZT3 3 building Inspector U ` TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONEtq OR TWO FAMILY DWELLING 24 BUILDING PERMIT NUMBER: r- DATE ISSUED: . oma SIGNATURE: Building Commis9l'oner/122CEtor of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 215 OLD CPtf-i WAI 1.2 Assessors Map and Parcel Number: q4� Mdp Number Parcel Num 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Area (sf) Frontage ft 1.6 BUILDING SETBACKS 00 Front Yard Side Yard Rear Yard Required Provide Required Provided Re red Provided 1.7 Water Supply M.G.L.C.40. 54) I.S. Flood Zone Information: Public ❑ Private ❑ IZone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record ERIL o LD w � p` Name (Print) Address for Service _s : a- 9-7 9-699-1 b5Z- lure Telephone 1 2.2 Owner of Record: Name Print Address for Service: Signature Tele hone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licenr,0 Construction Supervisor: J pfmEj V. 1)()"C,- Licensed Construction Supervisor: 8 C -T- / Ma��f C� !l�i�� 0'�y U Address j7 N 7 Signature Telephone Not Applicable ❑ C d License Number Z f VL. 12-oo Expiration Date 3.2 Registered Home Improvement Contractor DAMESy� �� „�� c , c A r�P. Not Applicable ❑ 1144%-7 Company Name K -Y,- C- T, f-1 f L, Ma 0 194 Registration Number C) I L " / p r Address L G _ �� 7! Expiration Date Signature Telephone SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Descri tion of Proposed Work (check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition ' ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: f'1A, s h o f� eA is hoi i^'.rd F/oo✓ o f Aou$e. M L a c r-ov�n� �00 MtQ 7L U.,,.d 6✓ h oYvIC 0 F�/Ct q ✓(� C�i Lr J q l�n+c.�� . �e �C, (Vp pav-4Pilon Weil c3„nd no ,,rfn) S Tr'vc f�vr'4111 �b 0()+-(1dc, o� nn ,, kousL• No IJG j'I,TaOM , SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost Dollar to be (Dollar) Completed by permit applicant x ()FFJ<CIA)�.1 JOE i3NLY N! L t v 1. Building(a) 15 00.Multi Building Permit Fee lier 2 Electrical _ 5� (b) Estimated Total Cost of Construction 3 Plumbing 000, Building Permit fee (e) X (b) ��-- / �% 4 Mechanical HVAC 5 Fire Protection o�ei. 6 Total 1+2+3+4+5 l 0 00 • Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, 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 OWNERIAUTHORIZED AGENT DECLARATION (t' 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 6m -L A C H� cKow�ra-1 { Print Nage Ct (h!l L I S 1 o) Y Signature of Owner/A e t Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR T VIBERS 1ST2 ND 3 RD SPAN DMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHDv NEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE r 'j I FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that allnecessary approval/ permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. APPLICANT E�iC CNECf-16WA PHONE 978.41-7652 �H- T 7? 74q -77/v_ ASSESSORS MAP NUMBER LOT NUM 3ER SUBDIVISION NUMBER OLD CANT VQA1 2I � STREET STREET NUMBER OFFICIAL USE ONLY ......................................................... .�a........... RECO;:J; NIDATIONS OF TOWN AGEN'T'S DATE APPROVED CONSERVATION ADMR41STRATOR DATE REJECTED COMMENTS DATE APPROVED TOWN PLANNER COMMENTS FOOD INSPE OR -HEALTH - HEALTH DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED_-�t�T/ > / DATE REJECTED COMMENTS f 10y� r�� � r7 cP ,` cs� a S w� Z k PUBLIC WORKS - SEWER / WATER CONNECTIONS DRIVEWAY PERMTr DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR - BOARD OF HEALTH January 22, 1993 120 MAIN STREET NORTH ANDOVER, MASS. 01845 Les Godin Merrimack Engineering Services, Inc. 66 Park Street Andover, MA 01810 Dear Les: AWP JAN 2 5 r TEL. 682-6483 Ext. 32 This is to confirm that at the Board of Health meeting held on January 21, 1993, the Board granted variances to North Andover regulations: 2.14-4, minimum design flow for single family dwellings, for Lots 1 and 18 Old Cart Way; 17.03, spacing between leach trenches for Lots 8, 10, 11, and 14 Old Cart Way; 4.18 distance to a catch basin for Lot 5 Old Cart Way; 4.14 to allow a twenty minute design rate. With these variances, all current lots on Old Cart Way have been approved, specifically, Lots 1, 2, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20 and 21. If you have any questions, please do not hesitate to call. Sincerely, v Sandy Starr Y I 2� 3 6 230 -% 134,49 L,4 :�t OL :S To T/YE rirZX ivsrre,0.e'A.vo TT% 7f/E BR,V,r T.s/gT /S C4C.4rEG VV Tf/E Car,fS 7Ae47'1rOates eaw aaew ,WZY rW-- Tom✓ OF,voZOmwa zead-11-r ,�6vI.P0/.K's SE-A4CA-X FEOA1 ST,PEETS f 407- C-EerzFY T•Y/S OA-eZZ/N6 4O44rE0 IAA 7,11e, F .PAG Fi[GOO 114T14E0 APEf:. 1%-Wdw" OSS/ F ► uN�TY /dlNCL o a �9 25-0,0-78 oa�ec o= JEFFREY HOWAN AL or 4..,v /vim_ f�.crr]o✓E� ��'l•4SS- O,Pgi�iV FO.P BEV 2�Z��nS Ot � SUP.v�LVOT FO.P Bovvo.Psi �'r� r Ario.�/- Bo�,vo-4.et� i.�fo,P,,s- �E��/�AGf' E.vGidEE.P/�6 SE.PviIES ATiO.t/ TA.t'E.S/ F,Po.17 Exrsri-uc ,eEco,Pos. � 6G �q.P,(� ,ST.rEET A.VODYE.� ifi•4S,S.4Gf/r/SETTS O/8/O Property Descriviliciri UNIFORM RESIDENTIAL APPRAISAL REPORT File No. CL271 Freddie Mac form 70 6.93 12 CH. PACE I OF 2 t anme mae roan I UU413 McCarthy Appraisal Services (617) 963-3239 Property Address 215 Old Cart Way City North Andover State MA Zip Code 01845 Leoaf DescHotion Essex CQUnL. L f Deeds Book 4503. County 1,;,S _y Regis- ry__c� --- a ge- Z!5 -k- -lax -Year 1998 R.E. Taxes _$ 5 Special Assessments $ N A -- ,B:. Borrower Eric Checkoway Current Same Occupant: Ix I Owner F] Tenant Vacant, Leasehold /Mo. Property rights appraised x I Fee simple Project Type I PUD I I condominium (H LIDNA only) HOA$ T.: N eighborhood/P role ct Name N/A Map Reference N-6 Census Tract 2531 Said Price $ Refinance Date of Sale N/A Loan charges/concessions to be paid by seller $ N/A ton, MA Lenfler/Client Monument MortZa e Co. Address 1050 Waltham Street: Lexina 02173 Appraiser McCarthy & Associates , Inc. Address 1594 Main Street #113: Weymouth, MA 02190 Location Urban x I Suburban L_] Rural Predominant Sin a family housint PRI E A E W Present land use % Land use change ... BU ill up -1 Over 75% Fx] 25-75% 0 Under 25% occupancy $(OOO) (yrs) One Family 90 Not Likely Likely .... Growth Rate Rapid EX I Stable D Slow [�x Owner 1007, 200 Low New 2-4 family In process Property values X Increasing Stable Declining Li Tenant 600 High 50 Multi -family To: ........ predominant Demand/supply X I -J Shortage El In balance E Over supply Lid Vacant (0-5%) Commercial 460 5 Marketing time I Under 3 mos. 1 -61110S. I Over 6 mos. vaca (over 5%) I nt Vacant 10 .... Note: Race and the racial composition of the neighborhood are not considered reliable appraisal [actors. Neighborhood boundaries and characteristics: The sub iect is bounded to the north b Sullivan Street- --to the south bv Old Cart Way to the east by _Q_ut_e_LL4_;__ to the west by Boston Street. G:: Factors that affect the marketability of the properties in the neighborhood (proximity to employment and amenities, employment stability, appeal to market, etc): Hi. B*.The subiect is located in a subdivision of newer single family homes. The subject neighborhood R:%consist r)rimarilv of colonial and contemporary stvle 'ngs maintained in &g_Qd__QKe -nditi-Q-11--R-0-ute 114 is located nearby Drovidi- g access to employment�—Q-enter.�;---shpp-pi-ng.---- c --o — n .0 .facilities and all area amenities. The market alDDeal and appearance of the neighborhood is .--considered wood overall. Market conditions in the subject neighborhood (including support for the above conclusions related to the trend of property values, demand/supply, and marketing time such as data on competitive properties for sale in the neighborhood, description of the prevalence of sales and financing concessions, etc.): ,.......The economic base for the area is expected —e- to remain stable for the near future. The real _ .::::::estate market has experienced an increase in prices over the past 24 months with a E;teady ....:UlMbEer of buvers and a shortage of available properties according to local brokers. .... brokers are Lincrease in sales prices over the past twelve months. This data is -orligg-an -rep ....m.suot)orted by local -trade publications. See additional comments... Project Information for PLIDs (It applicable) -- Is the developer/builder in control of the Home Owners' Association (HOA)? 1-1 Yes Li No U. Approximate total number of units in the subject project N/A Approximate total number of units for sale in the subject project N/A Describe common elements and recreational facilities: N/A Dimensions 150'+/- Frontage Topography At Grade/Mainly Level Size 1.54 Acres /Average ___ Site area 1.5.4 Acres Corner Lot L❑Yes Ex]No Specific zoning classification and description Residential (R2) I Acre Shape -Irregular o El Legal nonconforming (1](andlalhered use) Illegal Zoning compliance [x Legal No zoning Drainage Appears Adequate Highest & best use as improved: Present use Other use (explain) N/A View Neighborhood Trees Utilities Public Other Off-site Improvements Type Public Private Landscaping Typical of ther (Za A� Street Paved Electricity Lx] 0 Driveway Surface Paved E:�: Gas Curb/Gutter Granite I -XI D Apparent easements None Noted Water Sidewalk Paved x FEMA Special Flood Hazard Area Yes No El Dx S anitary sewer Ll Septic Streetlights Standard Lx] FEMA Zone Zone C Map Date 6/02 Starlit sewer xI Rca1e FEMA Map no. X: _Alley___ Comments (apparent adverse dasements, encroachments, special assessments, slide areas, illegal or legal nonconforming zoning, use, etc.): The . subject_ is located on a typical size lot for the neighborhood. Private septic is typical of the area,-•_ no seepage noted. There were no apparent adverse easements or encroachments noted. GENERAL DESCRIPTION EXTERIOR DESCRIPTION FOUNDATION BASEMENT INSULATION No. of Units 1 Foundation Concrete Slab N/A Area Sq. Ft. 1372 Roof -Ay-g- x No. of Stories 2 Exterior Walls Clapboard Crawl Space N/A % Finished 0% Gelling Avg. .n... Type (Det./Att.) Detached Roof Surface Asphalt Shing Basement Full (100%) Ceiling Floor Joist Walls _AV x Design (Style) Colonial Gutters & Dwnspts. Aluminium Sump Pump None Noted Walls Concrete Floor -Avz- LxJ .C::: Existing/Proposed N/A Window Type DblH_ng/Caserpit Dampness None Noted Floor Concrete None .R t::; Age (Yrs.) 3 Storm/Screens Combination Settlement None Noted Outside Entry Walkout Unknown - T.:: Effective Age (Yrs.) New- Manufactured House No I Infestation None Noted I Adequacy Tvt) X ROOMS Foyer Living Dining Kitchen Den Family Rm. Rec. Rm. Bedrooms I Baths Laundry Other Area Sq. Ft. Basement 1,372 " 9 Levell 1 1 .5 HkUDS 1,372 . f� Level 2 4 2 1.49 R.. are Feet of Gross Living Area Finished area above grade contains: 8 Rooms; 4 Bedroom(s); 2 .5 Bath(s); 2Square Sq SURFACES Mate rials/Condition HEATING KITCHEN EOUIP. ATTIC AMENITIES CAR STORAGE: Floors Har_dwdRCarpt/Good Type FHW Refrigerator ❑ None ❑ Fireplace(s) # 1 X None El Walls Plaster/Good Fuel Oil Range/Oven Stairs x H Patio N/A Garage of cars Trim/Finish Wood/Good Condition Good Disposal ❑ Ll Drop Stair Deck Side X Attached Bath Floor Ceramic/Good Dishwasher Lx:lScuttle 1:1 Porch 2 XFloor Detached COOLING Bath Wainscot Ceramic/Good Central Air Fan/Hood UDoors XJ 1: Fence N/A Built-in 2 Standard /Go-od,01her None Microwave Heated Pool N/A Carport Condition Goo —1 Good Washer/Dryer Finished Driveway 2+ Additional features (special energy efficient Items, etc.): See additional comments .... Condition of the Improvements, depreciation (physical, functional, and external), repairs needed, quality of construction, etc.: The sub iect's_ V. improvements were considered to be in good condition. There were no physical. functional or ':external inadequacies noted at the time of inspection. Any depreciation can be attributed to T normal wear and tear. Physical depreciation is calculated by the age/life method. Adverse environmental conditions (such as, but not limited to, hazardous wastes, toxic substances, etc.) present In the improvements, on the site, or In the Immediate vicinity of [lie subject property.: nime late vie The durinp, inspection. See additional comments.... Freddie Mac form 70 6.93 12 CH. PACE I OF 2 t anme mae roan I UU413 McCarthy Appraisal Services (617) 963-3239 BOARD OF BUILDING REGIJLATION%:-' License: CONSTRUCTION SUPERVISOR' Number:- CS 060726 BirthdateF --0212211 Expires: 02/22,/2001 Tr. no: 7608 Restricted7o: . 00 JAMES V DOUCETTE PO BOX. 23 -e-lmr� `,'MANCHESTER',WA 01944 Administrator v W V- T .4; Til,44ikc CO m C m 0 m CA — m CA o CD C9 Z y CL O �� d .-F O CZ = y CD M O CD v CD o CC CL CT c % d CD CCD o CD mw P. C CD CD CL C) y O Cg I v H O CD CD Z o CD 0 CD C SP -0, d 2 O �• N Or N d O m .O VA Igo m C7 o y C2 06 C2 3 m Z �� HCOD -4 ,. =r CL CDo m y o y o gym' m _ 0 CD O's a O m �o n O N C' ? �• �. N CL =r !^ m O N c / CO C O O ny W. o m ® _t r"y• ai � CL Q '' ^^ C VJO O d 1I- ►•�i..ssL N O1 CCD CL N ,� O jm m IZ. n m N CDA o �o o z a ` m o =Cp �. C - JL C/j CA CD •.• =r o CDBei _: O / C) �o ►d n c CDc y 0 9 c c � w � tv y 5 � ° x w � z w � ° x r H z � pd ° x 00 C) :vn g 0 °p 0 C7 C) cp c ° °� o o W v 4 a -A 'Al S. le ir" O\ Cd �9 1, �H a � U al a� z E Os '� ��\GO co � • O cc -0 O v IIO " O v LL. U)0 p O U C O w O C —co O C a w tu .0 CO cn V) ui� C�2 elm p z �p�cs Zoo .2z cc* to M O m C ti. O m4. —;.o �.' CO a u0i m La g6Ec i E4 o co o cm m m c � N 3 �} C m t4!- N W : m O N m ; =yL,, O !� N act d C t m O -t v Z ev U fs p O.O H m x m 0. - cc ID .—Wi® W C _ � coo . O.t O c oI CD C'n p.0'.� c _ c C, N III co O CD J Q � o z E Q J� co � � O 0 Q O v O d �a Q a c O CO) c O O O c z co O Z C-) CO) C 2. 03,� im- co — au CO) •F w C/) d CO2 m m z O co L O CD V co Q o �''Coo CDL 0 Q R CL O d �a c 00 c O O Q CD Z C3 O CD Z C-) CO) C 2. 03,� Cc d CO2 C3 z z ,f D. Robert Nicetta, Building Commissioner TO: Sue Ducette FAX : 978526-1616 DATE: February 10, 2005 TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 400 Osgood St North Andover, Massachusetts 01845 FROM: Building Department — Jeannine TEL: 978-688-9545 FAX 978-688-9542 Certificate of Occupancy as requested Telephone (978) 688-95454 Fax (978)688-9542 BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 QIP Fax K1220xi Log for NORTH ANDOVER .9786889542 Feb 10 2005 9:47am Last Transaction Date Time Type Identification Duration Pages Result Feb 10 9:46am Fax Sent 819785261616 0:47 3 OK Location 7?- I'S�" OLD (UaT u)Aq No. '7, -Z 6 Date I. 731- ^ ! t3 TOWN OF NORTH ANDOVER' Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector Div. Public Works Location '�"A��- GU) Q(2 --C No. 55 24�� Date M TOWN OF NORTH ANDOVER Certificate of Occupancy $ Buildir)g/Frame Permit Fee $ Foundation Permit Fee $ 100 Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL a? $ . -Buildina InSDector 7 3 Div. Public Works Location No. TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ 1,077-50 39, TOTAL $ ins e t .,-j PAT,.-, 8422 D)y�P,4611c Works PER'lfIT NO.y APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP a-40/b'7I ZONE l LOT NO. SUB DIV. LOT NO. I® 2 RECORD OF OWNERSHIP DATE BOOK ;PAGE — LOCATION`.- 20 ___ _a.L0- .CA e -r_ _ + ` 'A\/ PURPOSE OF BUILDING S' / NG�� �j'�iJ �(�V OWNER'S NAME .,/) ,^ /C14 W �ZL �� NO. OF STORIES SIZE 3 yXy CJ / CS '7 �'7.i., .7c�VlJ fr- OWNER'S ADDRESS //�' , v _ BASEMENT OR SLAB �� 7 - ARCHITECT'S NAME ARCHITECT'S SIZE OF FLOOR TIMBERS IST i7`/�yy 2ND /o V 3RD _2 j BUILDER'S NAME ��'Y!^ ID ./� t. --L CJ SPAN DISTANCE TO NEAREST BUILDING / /tir'4- DIMENSIONS OF SILLS DISTANCE FROM STREET t 5 Q " POSTS DISTANCE FROM LOT LINES - SIDES 30 '�'" REAR j(ap -i- GIRDERS 'L/ ]� �l AREA OF LOT �' S' iA S `'^1 FRONTAGE/ t 1 l HEIGHT OF FOUNDATION C1 THICKNESS j O f IS BUILDING NEW � SIZE OF FOOTING /S j/Q� %`� X IS BUILDING ADDITION MATERIAL OF CHIMNEY W 0 00 IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE Y� 5 i IS BUILDING CONNECTED TO TOWN WATER / v��O BOARD (1W APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE N INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST ' Lj O f OfS� SEE BOTH SIDES RKfus A -W EST. BLDG. COST jO.a41. ;E � bCTZZ: .� PAGE 1 FILL OUT SECTIONS 1 - 3 �i�i MAR} � b� EST. BLDG. COST PER SQ. FT. MSKW 3-i;Z EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 rV11�� " (L/ ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING SEPTIC PERMIT NO. 414 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED d Y� E OF OWNER OR AUTHORIZED AGENT F E E S� o PERMIT FOR FOUNDATION ONLY PERMIT GRANTED`- REGULATED BY PARA. 114.8-S. B.C. 19 �34- DATE AFEE PAID t� BUILDING OWNER TEL. # L/ 17 © CONTR. TEL. a 5A Y%-/ 4-- CONTR. LIC. M. Cid 7V H.I.C.# / / NOV 31994 PERMIT FOR FRAME/BUILDING I 7b`i�p �-W,Z - DATE: FEE PAID:7 e (B +2.,Z BUILDING RECORD OCCYANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA - APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. MULTI. FAMILY CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE - _V1 - 3 1 2 13 CONCRETE BL K. INE BRICK OR STONE HARDW D PIERS PLASTER DRY WALL UNFIN. 3 BASEMENT y AREA FULL FIN. B M T AREA '/4 FIN. ATTIC AREA NO BMT_ FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS Y 9 FLOORS CLAPBOARDS 2 3 DROP SIDING CONCRETE WOOD SHINGLES V TARTH ASPHALT SIDING- HARDW D ASBESTOS SIDING COMtACN VERT. SIDING ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR 12 BRICK ON FRAME 2W CONC. OR CINDER BLK. TIL111-16 3r STONE ON MASONRY WIRING JM Alin SUPERIOR P ADEQUATE NONE STONE ON FRAME 5 ROOF 10 PLUMBING GABLE I -dip I BATH J3 FIX.) GAMBREL MANSARD TOILET RM. (2 FIX.) �7_ LAT SHED VATER CLOSET ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO 6 FRAMING HEATING 11Z PIPELESS FURNACE E, C WOOD JOIST OVORCED HOT AIR FURN. U TA 'U TIMBER BMS. OSTEAM 10, _L#O�XOT W'T'R 0 STEEL RMSPWIPCOLS. R VAPOR WOOD RAFTERS _jo/ AIR CONDITION) NG RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS AS 010� Oil B'M'T 2 d ELECTRIC Inrd NO HEATING C� O. z o CA cd :o =pH Z v : o ; S2 a-oZ = gm J moL� * Rom s O m 4- �z O O. `{ id VQp Co cm t Ny . Jmm CD cm3 C ED O J Jr m . H C O m aC.3 H O ' A �o c /t C y Q !►1 - p, C L m O � � � Z ►Cclo H m ya m C Q o C4mt 3 H DCO2 H mco om~ W O +' C •93 R �O C .r W uiE v � v y o- m5Cm co " 2 d N t H O i N C O R m C: cm m 0 cm c �C N m L O Z co co N O J Z E a co z CLLU 0 CL O O W CO CM C:) z w I cm Q ISU Q SMM W y_ •E M�Oy� WO z LU CD CD CD w x O 0 .CD0 !d O d �Q ca .�.. w O fr C43 J J z v .0 Z s z H LL V C r�Cf)�J c crW � a a w acz F -- w 2 v v � Z_ Z � W Z W CL w 4) ° a°' U w w°' ii cu a°' cn W u) cn o CA cd :o =pH Z v : o ; S2 a-oZ = gm J moL� * Rom s O m 4- �z O O. `{ id VQp Co cm t Ny . Jmm CD cm3 C ED O J Jr m . H C O m aC.3 H O ' A �o c /t C y Q !►1 - p, C L m O � � � Z ►Cclo H m ya m C Q o C4mt 3 H DCO2 H mco om~ W O +' C •93 R �O C .r W uiE v � v y o- m5Cm co " 2 d N t H O i N C O R m C: cm m 0 cm c �C N m L O Z co co N O J Z E co z CLLU CL O y >- CO CM C:) z w I cm Q ISU Q SMM W y_ •E M�Oy� WO z LU CD CD CD co O 0 .CD0 !d O d �Q ca .�.. O fr C43 J J z v .0 Z s z H LL V C crW cc F -- "a CO) � Z_ Z � W Z W CL C/� FORM U — LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction does not relieve the applicant and/or r� Town of North Andover, Massachusetts Fo►m 011M 2 o. ,.00•x. BOARD OF HEALTH —fi L 19-9j._____ DESIGN APPROVAL FOR SOIL ABSORPTION SEWAGE DISPOSAL SYSTEM Applicant_ r� �av� �nSk' Test No. Site Location Reference Plans and Specs. C..�ir�' Inr�o✓� .� j !n eCX l trLQ. ENGINEER DESIGN i DATE Permission is granted for an individual soil absorption sewage disposal system to be installed in accordance with regulations of Board of Health. Fee CHAIRMAN, BOARD Of HEALTH Site System Permit No. 4,el 7-ig/.-),C X33 • �2 ,� � 5 �. �/�' 1 EASE,r�fuT _� GVE7LAupS EASGin!°NT ' ' Z .V"COV cE,cT�FY rb ryE rirZZ �L or -V; BAN.r T.s�gT T,YEG�►'EGG/.NG /S LOCATE- ON Ti+/E GOT i!S S.4l�i!'•v ANO Ti4G4T?OG�3 eawl-aelff. 1,A1 !Y/TN r/1E rGwi.✓ OF .vo. A.vOovE,t° ZON/.vG ,�E6!/LAr.G.tiS ST�PEG7S � LOT GivES. "' � /O /%moo ✓E� ,/�J�S`S. �V fT ��'! .PL'r6rleO/.fit+ .SETEi/CiC.S' f•CO.fI . s FIj,�TyC•C LE.�T/FY T.yiIT T�/J O.Y'CLL/NB �s.�/OT ��A�� f�� GOGgTEp /,V T.f�E F .PAG FiCGbO ffi�T4�0 APE. ►. ,Syew�v oiv ASN 2SQO98 ODBC cyG GE,eALD `YE'L C,S/ DATE- 61-03 JEFFREY S. 'rFSS� l►�0 SUP.V��¢ .4r�ov r,4,rE,y feor� E'xisr�.vc .Pero,Pos. 6G �.4.P,E� .ST.�'EET A,vODYE.F, �1.4S.S,4Gf/l/SE77S O/8/O r x :1 cr ON w uj O z. o w° a cit p U ] C ° C w° ao' v C U CIS�'. w �O-! 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Q .-U at m a a sfn i {� O o ¢ w pp s` w G� N a o JAN 10 ' 95 10::E4 F-PC41 aF' P'IAHCHE'=;TER PAH f' Corporation 12/13/1.,994 .11:48 F'AGE . 001 3eorgia - PaCI lc p.0. BOX 4370/Manchester Nei 0310$/603-627-3881 GP FASTBeam (c) 1990-4 GEOkGIA-PACIFIC CORPORATION v 4.09115 Project HARVEY Location : THE WESTBROOK Mark 1 . Description : NEW EAVE ROOF HEADER Units Mark 0" Spacing Usage Roof (Beam) Rep -Stns. : NO Slope: 0.00/12 Max Defl: LL = L/ 240 TL = L/ 180 + 18- 0- 0 + nts E!:�--� a 5.50" ■ 5.50" O.A. length = 18- 4- 0 (Span is horizontal dimension to centerlines) project Design Loads: Roof: rive- 35.00 psf, Dead- 15.00 paf L=�'e* Dead Load(T) Live Load(L) ca^nd DOL Loeativr- incr. - gtar`s Ends Add, Info. u Sha a 3�Start mind IStart 35.0 psf 15% 1 0.00 12.00 42.0' s_c. 1 Span Carried 50.0 psf 0 0 0.00 18.00 22-0' s -e. 2 Span carried 10.0 psf 35.0 psf 1585 0 0.00 16.00 5.01 s.C- 3 Span Carried 50,0 psf from 'left end when roan# is 0, otherwise., from left. end of the specified span -Dimensions (feet), measured Support 1 2 Max R'n (lbs) 10740 6540 Min R'n (lbs) 3915 2655 550 $i 3.72 2.27 Fcp = P Min Brg(inch) Value Span# x Group A11oW Ratio Design (lbs) 10440 1 0- 3 41 14086 0.74 V M (ft -lbs) 43969 1 7-11 41 45238 0.90 0.97 0.77 L/313 D-LL(inch) 0.69 1 9- 0 41 0 41 1.20 0.92 L/196 D-TL(inch) 1.10 1 9- USE: GP 2.0 4tmlMcCauseyOLumberps Master Plank LVLK2 Co. NOTES ional 1. Designed in accordance with theNat bearingclecativncneareetocachocndoof the�memberonCont nuo-asclaterle alsvPPort req irals edor cforReports.2. Provide lateral support compression edge. not been verified by Georgia-Facific Engineered Lumber Technical gery ces- 3. Load-- have been input by the user and have 4. Design valid for dry use only. 5. Bearing length based on design material; support material capacity shall be verified (by othces). 6. Roof Ueagc= install with minimum 1/4:12 slope for adequate drainag2- 7, Verify that load is applied at top or equally from both sides - g, Nail p'-ie2 together with 15d nails a 12" 0/c alone top and bottom edges and the --center. Nail from alternate faces. 2" from edges, 9, Company, product or brand names re need arc trademarks or registered trademaxKs of their respective owners- -441 JAN 10 '95 10:35 FPC.M GP t,1AHC:HESTEF' PIH Georgia - Pacific Corporation 12/13/1994 11:38 P.O, BOX 4370/Manchester NH 03108/603-627-3881 GP FASTSeam (c) 1990-4 GEORGIA -PACIFIC CORPORATION v 4.09115 PAGE.00 Project HARVEY Location : THE WESTBROOK Units : 1 Mark 2 Description : ROOF BEAM TO CARRY 1 ®St. 5550.0 lbs Usage : Roof (Beam) Rep.Strs. : Na Spacing 0.0" Slope: 0.00/12 Max Defl: LL = L/ 360 TL = L/ 240 1350.0 lbs + 12- 0- 0 + nts 0 L7__� 0 5.50" N 5.50" �D1menCions (feet), measured from left O.A. length = 12- 4- 0 (Span is horizontal dimension to centerlines) project Deign Loads. P.oef: Live- 35.00 psf, Dead- 15.00 psf USE: GP MPLANK2 2.0 11.88 (1.75xI1:88) 3 plies (Depth & plies forced by user) Master Plank LVL tm McCausey Lumber Co. NOTES i. Designed in accordance with National Design Specifications for wood construction and applicable Approval* or Research Reports. 2. Provide lateral support at the be?ring location nearest each end of the membct. continuous lateral support rerquired for compression edge. 3. Loads have been input by the user and have not bcen verified by Georgia-Pacific Engineered lumber Technical Scrrices. a. Design vali5 for dry u9,-, only. S. Bearing length based on design material; support material capacity shall be verified (by others) 6. Roof usage: install with minimum 1/9:12 slope for adequate drainage. 7, vcrify that load is applied at top or egn-'ly from both sides. 8. Nail plies together with 16d nails a 12* v/c along top and bottcm r..dges. Nail from alternate faces, 2" Prom edges. 9, company, product or brand names rcfeeenced are trademarks or registered trademarks of their respective owners. } * TOTAL F• 3E . 002 :*;::f: Live.Dead Load(T) w�End Live Load (L) 98tart eEnd AOL I00c3tion* Incr. S Stars Ends A Info. Sha 1 Concentrated ®St. 5550.0 lbs 3865.0 lbs 15t 1 5.00 2 concentrated 1350.0 lbs 0 C 5.00 �D1menCions (feet), measured from left end when span# is 0, otherwise., from left end of the specified span Support 1 2 Max R'n (lbs) 3450 3450 Min R'n (lbs) 1508 1508 Min Brg(inch) 1.50 1.50 Fcp - 550 psi Design Value .Span# x Group Allow Ratio V (lbs) 3450 1 6- 0 42 11951 0.29 M (ft -lbs) 20700 1 6- 0 41 33148 0.62 D-LL(inch) 0.19 1 6- 0 41 0.40 0.47 L/772 D-TL(inch) 0.33 1 6- 0 41 0.60 0.55 L/435 USE: GP MPLANK2 2.0 11.88 (1.75xI1:88) 3 plies (Depth & plies forced by user) Master Plank LVL tm McCausey Lumber Co. NOTES i. Designed in accordance with National Design Specifications for wood construction and applicable Approval* or Research Reports. 2. Provide lateral support at the be?ring location nearest each end of the membct. continuous lateral support rerquired for compression edge. 3. Loads have been input by the user and have not bcen verified by Georgia-Pacific Engineered lumber Technical Scrrices. a. Design vali5 for dry u9,-, only. S. Bearing length based on design material; support material capacity shall be verified (by others) 6. Roof usage: install with minimum 1/9:12 slope for adequate drainage. 7, vcrify that load is applied at top or egn-'ly from both sides. 8. Nail plies together with 16d nails a 12* v/c along top and bottcm r..dges. Nail from alternate faces, 2" Prom edges. 9, company, product or brand names rcfeeenced are trademarks or registered trademarks of their respective owners. } * TOTAL F• 3E . 002 :*;::f: 0, Date ...... . 0 G) .................... ...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...... .............. ................................ ............................. has permission to perform .......... ................ I ....... . ...... ; .......... .......... wiring in the building of ............. . ............................... at ..... North Andover, Mass. .............................................. ............... Fee..................... Lic. No'....,----'. ............ ..................... I ... e ......... ELECTRICAL INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 1kQ •\IRV(-UIVIMU1VWP,4LJ,H '14 MAa1i4(.IYUJC11,N UruceuseOnly DEPARTAfiDVT0FPUB1IC&4FM Permit No. c:) TL/F BOARD 0FMEPREVEW0NREGUL4T10AS527CMR12.00 -2 U1A1Occupancy &Fees Checked PPUCATION FOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date o' i I— (PLEASE of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 4R ) 5 01-D GA WL r® Owner or Tenant 446:(,r Q W Owner's Address Is this permit in conjunction with a building permit: Yes � No (Check Appropriate Box) Purpose of Building -enD yR T /0/} 01'= 1Q 1571 ti(,,.- A Tfl (I Utility Authorization No. Existing Service _ Amps/ Volts Overhead M Underground No. of Meters New Service Amps /� Volts Overhead r7 Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA �� groundg1:1round 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. pf Ranges f,. 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 IV. of Dishwashers Space Area Heating KW 1 ' No. of Self Contained Detection/Sounding Devices Local� Muniectio Connections Other No. of Dryers '. Heating Devices KW No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER lt-a nceCamrar- Iha,,eaomftLiaWhmm=Pohcymdud gCanp,�e�'�Coveagailssksutiale4ivalait YES ® NO Itmes bnadvakiptoofofsameID&Oliim YES U NO If}ouha%edle WYES,pkmmdi*the4WofwmaWbydrdcrgthe INSURANCE = BOND [D OTHER M WodciDSw 3 '",f _p 1 Signed underM Realties ofpajtay. FIRMNAME InspectimD&RaTlestod ftffiesy) bpiraticn Date Estir x d VahtecfE6&ical Wait $ RoLlgI "ICU I CC ML Final Witt C A CL 1C A �, S�rZ-vl�� � Lioa�seNa L;oa t9ee ! " 1 A UL (r-A\.iT VA I -C rZ signatul �/ tGc'L!(f.".' \ d�L��tG LloawNo e oZ c� g I -�~ BisirlesTeLNa Ams � MILL � t Ak Tel Na OWNER'SINSURANCEWAIVER;IamaWmdxtt cLj=wdmW tenua=wvmWa-gssxtarWeo�valatasmgmWbyM=xhme GnrAlaws aadtlratmygg�c,thispatn$Wphca6a,um*.Csft nab (Please check one) Owner a Agent Telephone No. PERMIT FEE $ 7-2-/'09 Date........................... VC ..... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ............................................................ ................. has permission to perform ............................................................................... wiring in the building of ....... ic .................................... .t.- ................. I North Andover, Mass. Fee.3$�� Lic. No. ............ K� ........ Check ff / ( ELECTRICAL INSPECii)R / 8960 Only Parmit No. S BOARD OF FIRE PREVENT101 REGULA rioNs OtxzJpaartCy 0-d Fft axm*w _Aiewsblank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK A; I work to be performed i'l O=YdaM I th ftM 2WX %a1W-S ElWH od e f, M EC), 527 CM R 12.00 e (PLEASE PPJ NT IN INK OR TWE ALS �NFOFVAATION) Dates City or Town of:Z, _ To ft. I nqmdor of \M res 09- eorm the aleancal work deaMbed r.4 ow. By thisqo;i!cWjoeitoundwagn6dgive;noL,' vi i4 nrrfi:)n to Perf Location (Strad & Numba) 101d C -2411-7-6x ALf. Owner or Tenant JZ t_g; e- Taleph"Nol Owner'sAddreas-I--- Isthisp4rmit in conjunction with a building permit? �46 No (Check Approix! ate Sm) Purpossof Utility Authorization No. Exit'ingSarvire 7407/ AmPs .0,.ol VO brats Overh wd Undgrd N'ju §Kvice Amps it Vols Over h wd Undgrd L7_ No. of hitters Number of Feeder s and Arnpacity L ocation ape Nature of Propmed Electrical Wark Ale "U 0"Snp of chs fUlowinfitadfarrav hawMvw4huthalr6rWinr r4VMt= ,7,7/6 No. of ReoedeW Luminaires No. d Ceii. - Swp- (Padoi a) Fans ITrjosforrrms KVA No, of L uminair e Outlets No. of Hot'rubs Generators KVA No. of LvmInairas swi I ng pw. Ate tqr nd. 0nd. jjnd .X wgwcy terl Units jNo. of Rewtade Outlets INo, of Switches Np of No. of WasterAspows !No. of Oishwashers No. of Oil Burners No, I Gas Burner s _'r0r8T___ T___Ranges tic. of Pjv;. Tons Spacdovet Heating K V f FIRE j Of Zones 1966 dectionwo— No, of Alerting Devion No� of Sal L oW Other INo. of Dryers 176- -5a K W Heaters No. Hydromagsage Bathtubs Heatim. Appliances I KW 0. son$ — E'allasts No. of Molars I otaii HP �OWNTY 4941TWI No. of vicnor Equivalent Data Wiring: No. of Diwica or �Rulval I)t Waffiryons OTHER. Attest' a dtiarW dftl if desired, or so required by the I rwpWor of Wraa Estimated Value of EJ e1ri Cd Work: (WhMr(;pulredbYnvnidpA policy.) Work to Start: -7m-� 1 -<) C 2quaded in wmrdarewith MEC Rule 10, "upon completion. "69t - I— of d 0*1 OW work may i fflue I NSURANCERC 1RAGE: Unlewwived by the owner, no per, 1*nit for ft perfornwve w unless the liceneas provides proof d I i OU lity inwfor" irldwing " oomplel ed opwabW wvor its %A*sntJ al equi vol ON, The uncier3igned owtifi w that sich coverage is in fo=axd has ftNbiu d proof of sort to ft perrni t IsOng office CHECK ONE, I NSURANCE � BOND C] 01 -HER L) (4 sify:4701.0, Aeotee.-O �V- 5--,0 V—/0 I owfify, under thepains and penalties t1lat the I nform ifion on this 901cation is true and 0onplate. FIRM NAME: LIC. NO.: L icenses 319natur ed L I C. NO,: (If aoicW It pr kg;;A i the 11mrse, rKrrto lirol Bus Td, No.: RI Address k S�p_. ad ee-Ayff-Juem &1t...Tqj.No.: Yz Per M.G.L. a 147, & 57-61, simmity, work requi ra Depstrmnt of "ic, Safety"S Licarm Urd-Rd, OWNER'S I N'&JRANCE WAI : I am aware that the License edoes not have the ligbilihi Ing rm%na re*iaw ,%TW Y her47Vwe1v*#isrfAqulrrrmt. I amthe(dv*a*C] owrwr 0awner3eoant, __._ Tdophona No, I PERM required by law. By my a! "w* bal ow, Owner/Agent Signature _ i k The Commonwealth ofMassachusetts Department of industrial Accidents W ce of Investigations . 600 NCashington Street Boston, Meq 02111 c ? www_nuus.gov/dia . Workers' Compensation lwkraince Affidavit: Builder's/Contractors&lectrician;s/piambers Wiicant I`nforrrtatinn Name (Business/Organizafion/lndividual): Address: 0 6 Aer re l City/State/Zip:_ l,2ly► )7171-. (2/ %D 0 Ar / G Phone Are you an employer? Cheak.the appropriate box: I I am a employer with 4. ❑ T am a general contractor and I employees (full and/or part-time).* 2. ❑ I am .a.sole proprietor or have hired the stns -contractors listed partner- ship and have no employees' ori the attached sheet S These su&contractors have working for me in any capacity. [No workers' comp. insurance workers' comp. insurance. 5. ❑ We are a corporation and its required.] 3. ❑ I am a homeowner doing officershave exercised their all work right of exemption per MGL myseI£ [No -workers' comp, c, 152, § 1(4),'and we have no insurance required.] .t employees. [No workers' comp. insurance required_1 Type of project (regni*: 6. ❑ Naw construction . 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition I0.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs I3.❑ .Other 'E+nY applicant that checks borl01 must also fill out the section below showingtheir workers' 'Doerr l t iiomeownety who submit this aindavit ind•c titin theyare loin all work pensation policy information rllmohed an additional shear rho end than h� outside conmwtm must submit a new affidavit indicating such. -- ;Conoacmrs first check this box must' , wirr� the name ofthe sub- comrmtons and their workers' cemF. peric} iltimns60n. I arc aA earpioyer filar is prnvidnig:workers' compensation irisurXwe or information. f m1' employees; Below is the policy andjoh site Insurance Company Name: / V U /-, i I. t. - Policy # or Self -ins. Lie. #: Expiration Date: Job Site Address: City/ Wa/Zip: Attach a copy of the workers'compensation policy declaration page (showing the policy number and expiration date). Failure m secure coverage as required under Section 25A of MGL C. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the farm of a STOP WORK ORDER and a fine of up to 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby ceriify under to acrd pen 'es ofPerjury that the information provided above is true and correct d Df cial use Ditty. Do not write in this area, to be completed 4 C' or town oar raL City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2 Bnilding Department 3. City/Tewu Clerk 4. Electrical Inspector S. Plumbing inspector 6. Other Contact Person: Phone #: Information a nd I111structions Massachusetts General Laws chapter 152 requires all emp Ioyers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "..:every person in the service of another under any contract of hire, express or implied, oral or written." '.r I An employer is defined as "an individual, partnership, association, corporation or other Iega1 entity, or any two or more of the%regoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, asmciatioin or other legal entity, employing employees. ' However the owner- of a dwelling house having not more than three apace-imerits and who resides therein, or the occupant of the dwelling house of another who employs persons to do maisace, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states treat "every state ow -local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or *e construct buildings in the commonwealth for any applicant who has not produced acceptable evidence.of compliance with the insurance 'covera„Qe required." Additionally, MGL chapter 152, §25C(7) states "Neither the commarnwealth nor any of it political subdivisions shall enter into any contract for the performance of public work- Lentil -acceptable evidence of compliance with the insurmce require wds of this chapter have bene presented to the coTTftacting authority." Applicants Please fill out the workers' compensation, affidavit compLa✓tely, by checking the boxes that apply to your situation and, if necessary, supply sub-cantractor(s) name(s), address(es): acrd phone number(s) along with their certificates) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not requiredito cant' workers' cci---mpensafion insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage.. Also be sure to sign and -date, the affidavit. The affidavit should be: returned to the city ar town that the .application for the perzreit or License is being requested, notthe Department of industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the nurribe r listed below. Self-insured companies shouid enter their self-insur n=t license number on the'approprinte Zine. City or Town Officials Please be sure that the affidavit is completer and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in they event the Office of Investigations has to contact you regarding the applicz t. Please be sure to fill in the permittlicense number which v►-iII be used as a reference number. In addition, an applicant that must submit multiple pe rmittliconse applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town)." A copy of -the affidavit that has been officially stamped or marked by the city or town may be provided to the appiicent as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. When a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.) said person is NOT.required to completo this affidaviL The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number. The Commonwealth of Massachusetts Department of industrial Accidents Office of Iavestaggations 600 Washington Street Gaston, IviA £12111 TeL # 617-7274900 6Kt 406 or 1-977-MASSAFE Fax # 61 7-727-77491 Revised 5-26-45 www.mass.govldia i COMMONWEALTH OF MASSACHUSETTS OF ELECTRICIANS i REGISTERED MASTER ELECTRICIAN �. ISSUES THIS LICENSE TO j -TALBOT ELECTRIC INC { KEVIN;S TALBOT_] 134 OCEAN AVE WEST Jj SALEM MA 01970-2919 17458 A 07/31/10 303® i STATE OF MAINE g DEPT OF PROFESSIONAL 8 FINANCIAL REGULATION ELECTRICIANS, EXAMINING BOARD LICENSE # MS60018791 KEVIN S. TALBOT MASTER ELECTRICIAN ISSUED Mar 01, 2007 EXPIRE S Feb 28, 2009 9 82 0 (?- '� , / 0 Date.................................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING Thiscertifies that ............................................................................................. has permission to perform ......... 5- ........ ......... -eAC 19 wiring in the building of ........... ( ... ................ ct-1:!W ................................. at ... North Andover, Mass. Fee .... L/ Az�— .,5— '. Lic. No . ............. ............... . .......... ...... Check# ?3 z �Q /� Uk `/t��n,eachuir( Official Usc Only -- (,,.onvnvnii•ra a • . Pcrmit No. 3 Z 2eper"ni o�Jus �ervitrl Occupancy and Fee Checked 7 BOARD OF FIRE' PREVENTION REGULATIONS Rev. 1/07) (;cave blank) �\ APP.LICATiON FOR. PERMIT TO PERFORM ELECTRICAL WORK \ All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 1' (PLEASE PR rYT IN fjV K OR TYPE ALL IXFORATATIOAt) 'Date: % ©(— C City or Town ot': /� , f�rdl.�l) `�i� To the Inspector of Wires: �\ By this application the undersigned eives notice of his or her intention to perform the electrical work described below. Location (Street 8: Number) % C4r^-P LQ 144 Owner or Tenant IC, ��^W p 02"Telephone No7g'�� O:vner's Address Is this permit in conjunction with a building permit? Yes ❑ No ® (Check .,kppropriate Box) Purpose of Building Utility Authorization No. Existing Service , Amps / Volts Overhead ❑ Undgrd ❑ IN6. of Meters New Service Amps / Volts Overhead ❑ tJridbrd U No. of Iyicicrs Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: III, Completion of the following table may be waned bv.the lnsaecror o! lFires. No. of Recessed Luminaires \o. of Cei1.=Susp. (Paddle) Fans N. of Total ITroansformers KVA No. of Luminaire Outlets No'of Hot Tubs -Above Generators F`•VA No. of Luminaires In- Iswimming Pool orad. ❑ ^rnd. ❑ t o. of mergcncv Lighting Battery Units �'o. of Receptacle Outlets INo. of Oil Burners FIRE ALARMS .INo. of Zones No. of Sw'itchcs �No. of Gas Burners No. of Defection and Initiating Devices No. of Ranges 'No. of Air Cond. . otal Tons No. of Alerting Devices -Self 11'0. of \Vaste Disposers P Heat Pump Totals plumber lc�" o. o? -Contained Detection/Alerting Devices _ons No. of DishYiashers 5 ace/Area Heating W P o IC Local .-Municipalonolo ❑Other � Connection No. Of Dryers ry Heating Appliances KeySecurity Systems" No. of Devices or E uivalent fro. of Watero. Heaters IAV I o o. o Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. ofNlotors Total HP =`t""'•, t:ntcairons :.ming: No. of Devices or E uivalent OTHER: a� -� 4trach odditionor u rj detadesires, or os regmrea oy the rnspcuur uj .r„ Estimated Value of Electrical Work: (When required by municipal Policy.) Work to Start: 'ASA _P Inspections to be requested in accordance with NEC Rule 10, and upon completion_ INSURANCE COVERAGE: Unlcss 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 (NE: INSURANCE 2 BOND ❑ OTHER ❑ (Specify:) Self Insured I certify, under the pains and penalties of pzrjury, that the in rmotion on this application is true and complete. FIRM NAME: P -DT Security Services LIC. NO.: Licensee: Mark A. Brophy Si�nAtlrrF �� C LIC. NO.: C-95 (lf, pplicob/e, enter "exempt -in rhe license nitmber !erre.;) Bus. Tel. ,`lo.:, 6 O 3 -594--5b: Address: 18 Clir•ton Drive Hopis NHAlt. Tel. No.: "Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. 0 0953 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 aryl the (check one) (] owner 1) owner's asent. Om,ner/Agent PERMITFEE.- 8� Signature � _ _ __ _ _ _ Telephone i'Yo.' b - ''//�,• (i'c. nr ner•. n.a•r•r: /iir r!. (l :..irri: u.;•!ra 1 . r 7j DEPART -HENT OF PUBLIC SAFETY ^.A'. -REGISTERED SYSTEM CONTRACTOR.;:..• Number: SS CO C !]:•53 •. ISSUES THE ABOVELICENSc TO. 1 j ExpIcas: 02:07i 'I, . n rA;DT. SECURIT-Y, SERVICES, -rIIIC :'. �:/Tr. no: I�.'. htAR =A BROPHY .SR I i� ', S -License: :+DT SECURITt' SER'.!ICE 410; UNIVERSITY.'AVE - :.r.a ;w tJARK ?. r POPHY SR :>',GIESTW.QOD hi A`:02.090-231:1..{, �11NiORs-ST - _ aJORav000, t•,IA 020:21- ..,. -.. 45 C 07/31/13 ':'. 849174 ' Cannrnision.r 4 ---------' ----'-----' '--- Fold. Than Oelacn Along All Pedomdona , Date.?-41#?.4f. To OF NORTH ANDOVER PERMIT FOR L I /�_ PLUMBING This certifies that ....................... has permission to perform . c;27W .).rzeee�-. plumbing in the buildings of '--eg ..... C 11.q ......... at ............... North Andover, Mass. Fee Lic. No .......... ........ PLUMBI . N . G . INSPECT . 0 . R... .Check ff v MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS /�Uld C < ,�.,.// Date Building Location oZ 1,0 4('f Owners Name � L" �-�l ���� Permit # Amount Type of Occupancy New Renovation Replacement Plans Submitted Yes ❑ No ❑ (Print or type) C � . r Installing Company Name �Tn Address Check one: ❑ Corp. P r. OAIwwS ( M/4 o1�12 3 Business Telephone 6'/Fir:Co. Name of Licensed Plumber: Insurance Coverage: Indicate the e type of insurance coverage by checking the appropriate box: Liability insurance policy ja Other type of indemnity ❑ Bond Fol Certificate 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 ❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing w stallations performed under Permit Issued for this application will be in compliance with all pertinent provisions o e Massac i s Stag Pluming Cd Chap kr 14,2 of the General Laws. By: MEN a re o cense um er ype of�.g-License Title City/Town ense uMaster Journeyman ❑ APPROVED (o�tcg USE orrt.Y • -��---------------------- (Print or type) C � . r Installing Company Name �Tn Address Check one: ❑ Corp. P r. OAIwwS ( M/4 o1�12 3 Business Telephone 6'/Fir:Co. Name of Licensed Plumber: Insurance Coverage: Indicate the e type of insurance coverage by checking the appropriate box: Liability insurance policy ja Other type of indemnity ❑ Bond Fol Certificate 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 ❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing w stallations performed under Permit Issued for this application will be in compliance with all pertinent provisions o e Massac i s Stag Pluming Cd Chap kr 14,2 of the General Laws. By: MEN a re o cense um er ype of�.g-License Title City/Town ense uMaster Journeyman ❑ APPROVED (o�tcg USE orrt.Y The Commonwealth of Massachusetts vt*4. Department of Industrial Accidents Office of Investigations I 600 Nrizshington Street Boston, MA #2111 Compensation Inskrance www nwss gov/dia . Affidavit. Baiiders/Contractors/Eieetrician;s/piumbers Ai PWorkers' licant Information Please prutt La�bty Name (Business/organiration/Individual): sof--o NVQ V1t—.S f'!�c Address: City/.5tate/Zip: l�,�t'AAJA ,5 . AIW of yz-3 Phone #.- : Am Are you an employer? Check the appropriate box: 1. ❑ I a employer with 4.Type of Protect (requires: ❑ I am s general contractor�71d ployees (full and/or part-time).* have hired the stub-eonha6 ❑ New construction 2. I atn.a.sole proprietor. or partner- listed on the attached sheT• ❑ Remodeling ship and have no employees workingfor me These sub -contractors have 8 ❑ Demolmon . .in � ��Ty• [No workers' comp. insurance workers, comp. insurance. 9• Building 5. ❑ We are a corporation and its ❑ addition required.] 3. ❑ I am a homeowner doing officers have Exercised their 10.E Electrical repairs oradditions all work myseIi [Nowarkert' cotutP• right of exemption per MGL I I.Q Plumbing repairs or additions c. i52, § 1(4), and we have no insurance. aired .t �l j 12.E Roof repairs .employees. [No workers' comp. insurastce required.] 13 -El -Other - 'Airy ttppiicant tluu checks bo>L # l must also fi[I out the section below showing their worked' compensation policy information t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors tnust'submit a new affidavit indicating �Cotttrttctors that check this box must attacher! an additional shoot showing• tete name of the sub -contractors and their wottmrs' comp, peiic; ii6tiq Such. such 1 ant an Employer thin is provrdutg:workers information. compensadon insurance for my. en3ployeesc below is the policy and job site Insurance Company Name - Policy # or Self -ins. Lie. #: Expiration Date: Job Site Address: City/Statezip. Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration daie� Failure to secure coverage as required under Section 25A of MGL c. 152 can }ead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well E s civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby c der the p ns�jand pen Si tur•e: � � of p rjury firm` the infnrnration provided above is true anerrorrcet � � (. Date: 9:�e -il?&7 -/,Yz3 Of,rJCial use MJ*. Do not write iR dt& area, m be compiet ed by city or town. official City or Town: Permit/License # Issuing Authority (circle one): L Board of Health 2 Snildiag Department 3. City/Tovvu Clerk 4. Electri 6. Other cal Inspector 5. Plumbing Inspector Contact Person: Phone #: Information a nd Instructions Massachusetts General Laws chapter 152 requires all emp 3 overs to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, - express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the'foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. 'However the owner -of a dwelling house having not more than three apaxtin.ents and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or *o construct buildings in the commonwealth for any applicant who has not produced acceptable evidence.of compliance with the insurance 'coverage required" Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the perfannanco of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presmited to the cori*acting authority." Applicants Please fill out the workers' compensation affidavit compie✓tely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), addresses) arnd phone number(s) along with their mrtificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' cornpensation insurance. If -an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage.. Also be sure to sign and date the affidavit The affidavit should be returned to the city or town that the .application for the permit or license is being requested, not'tiie Department of Industrial Accidents. Should you have any .questions regarding the taw or if you are squired to obtain a workers' compensation policy, please -.call the Department at the nurxiber listed below. Self-ip—v Lred m --t ;es shoLId ent-tfivr self insurance -license number on the'appropriate tine. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/license number which will be used as a reference number. in addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy'infonnation (if necessary) and under "Job Site Address" the appiieant should write "all locations in (city or town)." A copy of'the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a iicense or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit ThP Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number. The Commonwealth of Massachusetts Department of IndmstrW Accidents Mee of Investabations 600 Washington Stireet Boston, MA 02111 TeL # 617-727-4900 ext 406 or 1-977-MASSAFE Revised 5-26-05 Fax # 617-727-7749 VAMmem.gov/dia I gs� Pu�LT- tLEVATIoA1s TOP of Fou140AT10" 19/.3 9 /NV'><"PVC SCK 40 cO I= NO SEPTIC TANK MANNOL67: Jif 't •, t r r' a7 /0' FROM 50'T'IC TANK 11 „ rr rr r, /NLLEr 7V it It /88.e (' It ►, r, rr rr d ourteT F1Tohl , ►r rr = 18&.57 it r. t. r rr rt e� X12 %?' Fl esto 168.4• % Ir rt tr rr tr ImEr TO j>�eox /Be. 3e Ir rr rr . rr �► A% 0 /TLfj!' Hedy r. a 68.2 1 END of TRENCH of /88.08 v to 2= /615.05 N „BM 1/V F b o -0 215 -r -F 4 = lee. dd Cn r Pont r /1 It rr It rl I I I 3 = X68.20 I rr L a IOU/L01NG .COR&I tr ^ 11 r/Q rr /3391 rrC, rr riD a / SEPTIC TANK MANNOL67: W6tLANt>� LOT 9 d/STie /BUTIO�IJ CS OX - 4.1 ' -- 531 ENS CAP TieEAlCly 3 %' 38.5' if r, r, 46' — rr CD ' rr L a AS BUILT PLAN OF SUBSURFACE DISPOSAL. SYSTEM .LOCATED IN N O RT F-1 A HOOVER AS PREPARED FOR_ GeRRRe E. WELcK� ANG. DATE: MAY , 1995 SCALE: j " _ 4 MAY L "3 1995 MERRIMACK •ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS • LAND SURVEYORS to PLANNERS: 66 PARK STREET • ANDOVER, MASSACHUSETTS 0181'0 0 TEL. (COO) 475-3535, 373.3721 0 eD6E OF / W6tLANt>� LOT 9 01 LOT c CD 1500 6ALLO" v SEPTIC TANK `1" BK N „BM 1/V F b o -0 215 -r -F Cn r Pont r G _r,3 rAm"flv j Oit • s oo , _. \,eV A Y AS BUILT PLAN OF SUBSURFACE DISPOSAL. SYSTEM .LOCATED IN N O RT F-1 A HOOVER AS PREPARED FOR_ GeRRRe E. WELcK� ANG. DATE: MAY , 1995 SCALE: j " _ 4 MAY L "3 1995 MERRIMACK •ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS • LAND SURVEYORS to PLANNERS: 66 PARK STREET • ANDOVER, MASSACHUSETTS 0181'0 0 TEL. (COO) 475-3535, 373.3721 0 Date........................... ....... %ORTH TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING SA U Thiscertifies that ............ I .................................................................................... has permission to perform ........................................................... ................... wiringin the building of ......................................................... ......................... at .............................. ...................... : ........................... . North Andover, Mass. Fee..................... Lic. No . ............. ............................................................... ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File Pftase eee o.theh side Office Uae Oniy r �� Die Comynoinvecllth of Massachusetts we -14 No. 1 tJ ®epartment of hiblic Safety I/9p �,��,, pe.h't M .ankl BOARD OF FIRS PREVENTION REGMATIONS 527 CMR 1200 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WOR AD work to be Performed In accordance with the Dtassachusetts Electrical Code. 527 CDIR 12:00 (PLEASE PRINT IN DIK OR TYPE ALL IIiFORHATIOH) Date �Vf,��G�� � lcl�ff City or Town of 4fleA,f/f /jN/�/�` To the Inspector of Aires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) -7-/3- aG/) O%:ner or Tenant Owner's Address t,�f y G�%!/%'G%� ST`/IizT ,vG A/%y/Zsy Is this permit in conjunction With a building permit: Yes ® No ❑ (Che ppropr a1 w Purpose of Building 1117— /4r1vr /f Utility Authorization Existing Service- limps _ / Volts Overhead 11. Undgrd [JIto. of Heters New Servicev, _ Volts Overhead ❑ . Undgr2 ® No. of Metes Number of Feeders and AWpacity- Location and Nature of Proposed Electrical Work 1"/jiff /��Y /li/�i.. /��iH/Or Ito. of Lighting Outlets �t Ito. of Hot Tubs Ito. of Iransformers TKVAI Ito. of Lighting Fixtures SwimmingPAbove In -' grnd. ❑ grnd. ❑ Generators KVA No. of Receptacle Outlets / Z ®. Ito. of Oil Burners � No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE MARKS No. of Zones NI of Detection and Ynitiating Devices Ito. of Sounding Devices No. of Set( ContainedW Detection/Sounding Devices Local ❑ Hunicipal❑Other Connection of Ranges talNo. Ito. of Air Cond. Tons No. of Disposals No. of pumps TTons Total No. of Dishwashers Space/Area Heating K Ito. of Dryers Heating Devices KW No. of Water Heaters KV No, of Ito. of Signs Ballasts Low Voltage Hiring No. Hydro Hassage Tubs Ito. of Hotors Total NP OMER: INSURANCE COVERAGE: Pursuant to the requirements of Hassachusetts General Laws I have a current Liabilit Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES( NO [ I have submitted valid proof of same to this office. YES[A No ❑ Ii you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE BOND ❑ OTHER ❑ (Please Specify) . xp rat on atei' Estimated Value of Electrical Work S Work to Start Inspection Date Requested: RoughwjLG e-*" Final Signed under the penalties of perjury: LIC. 10.��c��� Licensee SignatureLIC. NO. Address�� %�st��..f js,rr /Cj L -ii6G �ilzSl: </���Bus. Tel. No. Alt. Tel. No. OWNER'S INSURANCE WAIVER-. I am aware that the Licensee does not have the insurance coverage or Its su btantI;1 equivalent as required by Massachusetts General Laws, ani-Rhhat my signature on this permit appliction waives this requirement. Owner Agent (Please check one) V'' Telephone Ito. PERIIIT FEE 8 Signature of Owner or gent