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Miscellaneous - 22 FULLER ROAD 4/30/2018 (2)
r Date .... /./*—.��-/�*Y`` ..... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ............ & ........ E.�. ........ L ............ 771zz . ......................................... has permission to perfonn 4-( ............. ;!!n./ ................... wiring in the building of ....... , ....................................................................... at . ................ North Andover, Mass. Fie .......... Lic. No. 1.72,394 .............. 0�1 EL=Zz.... ......................... *& Ec"To r r heck # 1 P- p Commonwealth of Massachusetts Official use Only Department of Fire Services "No' Z pa BOARD OF FIRE PREVENTION REGULATIONS Oev. 9//0ncy and Fee Checked ] eave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), S 7 CMR 12.00 (PLEASE PRINT RV INK OR TYPE ALL NFORMATIOI9 Date: /I D 1 City or Town of: A)t 41Gftcy' To the Inspector bf Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Owner or Tenant Owner's Address Telephone No. Is this permit in conjunction with a bu � permit? Yes No ❑ (Check Appropriate Box) Purpose of Building J // Utility Authorization No. Existing Service ps 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: f'-to-fr- z'i y ,r ihe Completion ofthe followine table may be waived by the Inspector of Wires. No. of Recessed Luminaires �. No. of Ceil.-Susp. (Paddle) Fans r o Transformers ata KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool d Above 11nn d, ❑ Batte Units Emergency g No. of Receptacle Outlets Z No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners ction and o. Initiating DevicesNo. of Ranges No. of Air Cond. Ton No. of Alerting Devices N& of Waste Disposers mp Totals: um r _ __.___ ons - _ o. o antes ined Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Muni Leval ❑ Col neclion ❑ Other No. of Dryers Heating Appliances KW st Security No. of Devices or Equivalent No. of Water KW Heaters o. o o. of Signs Ballasts Data Wig: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP a #commun ca onsWiring: No. of Deices or Equivalent OTHER: Attach additional detail if desired or as required by the Inspector of Wires. Flstimated Value of EI9cftW Work: (When required by municipal policy.) Work to Start: 1111111Z1 Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides 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 ® BOND ❑ OTHER ❑ (Specify:) 1 cera fy, under the pains and penalties of perjury, that the informadon on this application is true and complete FIRM NAME: LIC. NO.: 172 -IRA Licensee: Richard J. Arel Signature -&&!L --',,z LIC. NO.: 27514E (IfaMicable, enter "exempt" in the license number line.) Tel. No.; 978-372-1601 Address: Alt. Tel. No.: 1Q7R-1Q9-21 7 *Security System Confis&i License required for this work; if applicable, enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) [] owner owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE. $ ' The Commonwealth of Massachusetts Department o f lndustr iql Accidints Office Oflnvestlgations 604 Washington Street Boston, MA. 02111 www.rnass.govIdia Worker$, Compensation Insurance Affidavit: Buffders/Contrav Address: 7n3 verrbi) OYV 043 11,46 Phone #: � %k" J9 7z -v M O . Are ou an employer? Check the appropriate box: 'Type of project (required): 1. �I ara a employex with 4• ❑ I am a general contractor and I 6. ❑ Now construction employees (full and/or pax- time) * 2. 1 1 am a sole proprietor or partner- have hired the sub -contractors listed on the attached sheet. t 7• emodeiing ship and1ave no -employees. working forme in any capacity. These sub -contractors have workers' comp. insurance. 8. ❑ Demolition 9. F] Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] 3E]x am a homeowner doing all work officers have exercised.their right of exemption per MOL 11. ❑ Plumbing repairs or additions myself. [No workers' comp. c.152, §1(4), and we have no 12.QRoofrepairs insurancere ed. ] employees. (No workers' 13F] Other comp. insurance required.] 'Any applicant that checks box#I must also fill outthe section below showingtheir Workers' compensationpolxcy imtormation. i Homeowners who sabmitthis affidavit iad1catingthey 2're doing allworlt and then hire outside contractors must submit anew affidavit indicating such. TContractors that check thisbox. must attached an additional sheet showing the name of the sub -contractors and their workers' comp, policy information. I am an emyloyer that is providing workers' compensation insurance for my employees Below is the policy arid job site information. 1 /- Insurance Company Ell Policy ## or Self ins. Lic. #: //d C,41 L� 3 z 7 Expiration. Date: 3 (el -S J'ob Site Address: Z% ry /� C� QkI lw(City%State/Zip: /J� Attach a copy o#tie workers' compensationpolicy declaration page (showing the policy number and expiration date), liailu to secure coverage as requiredunder Section 25.A. ofMGL o.152 can lead to the imposition of criminal penalties of a fine up to $1,50 0.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER. and a fine of up to $250.00 a day against the vioXator. Be advised that a copy of this statementmay be forwarded to the Office. of Investigations of the DIA for insurance coverage verification. I do hereby cert curt r tlieiiains and p aloes ofperjury Mat the information provided ahoy is�u%e/anti correct. - -�- - /If/.��Lfti Z i�1 ,/ nnfw // // Phone #: a7Y- _�d Z; -V ZZO Official use olt1y. Do not write in tliis area, to be completed by city or town official. City or Town: Permit/License 0 Issuing Authority (circle ane): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other - Contact Pers Phone #: Information. and Instrncti®ns Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is dei7md as "...every person tri the service of another under any coriixact ofhire; express or implied, oral or written." An employer is defined as "an individual, partnership, associafion, corporation ox other Iegal entity, or any two or more of the Foregoing engaged in a joint enterprise, and including the legal representatives of a• deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides Therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to bean employer.,, MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced -acceptable evidence of compliance with the insurance coverage required " Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofpublic work until acceptable evidence of compliance with the insurance requirements of this chapter have beenpresentedto the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your sitaation and, if necessary, supply sub -contractors) name(s), address(es) andphone number(s) along with their ceitiixcate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, arenotrequiredto carry workers: compensation. insurance. If anLL CorLLPdoeshave employees, apolicy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for contiimation of insurance coverage. .Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that tb e application for the permit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain, a workers' compensationpolicy, please call the Department at the number listed below Self-insured companies should enter their self-insurance, license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete andprinted 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 is 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 tov )" A copy of the affidavit that has b een. officially stamped or marked by the city or town may b e provided to the applicant as proof that a valid of idavitis on file for future permits or licenses..A, new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or,peimit not related to any business or commercial venture (i.e. a dog license orpermit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: `1;he Co onwoalth of 11- Metts Plv-a imut offxidusWal .Accidonts MAN ofTAvesti94am 6b Washi on S ree Bosion� M- A, 02111 Tei, # 617-7-27-4900 ext 406 ox 1-877,SAM Revised 5-26-05 Fax# 617"727'7749 WWW-Mass,govfdia October 17, 2014 Town of North Andover Attn: Building Inspector 120 Main Street North Andover, MA 01845 Re: Property Address: 159 Forest St, North Andover, Ma 01845 Policy Number: H3221231014313 Liberty Mutual Insurance New England Region Central Property Unit 75 Sylvan Street Danvers, MA 01923 Tel: (800)566-0323 Underwriting Company: Liberty Mutual Fire Insurance Company Claim Number: 030543280-0001 Date of Loss: 9/6/2014 Attn: Town/City Official Pursuant to M.G.L. c. 139, � 3B, please be aware that a homeowners insurance claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or causes the condition of a building or other structure to render Mass. General Laws, Ch. 143, 5 6 applicable. You are required to notify Liberty Mutual by certified mail in accordance with Mass. General Laws Ch. 175, 599, if you intend to initiate proceedings designed to perfect a lien pursuant to Mass. General Laws, Ch. 139, 5 3A & B, or Mass. General Laws, Ch. 143, 5 9, or Mass. General Laws, Ch. 111, 5 127B. This letter should not be construed as a waiver or estoppel of any of the terms, conditions or defenses afforded by the policy or applicable law. Please direct your notice to the attention of the undersigned and include a reference to the above captioned property address, policy number, claim number, and date of loss. Sincerely, Liberty Mutual Support Liberty Mutual Insurance New England Region Central Property Unit 1-800-566-0323 Date........... V ..................... 7 TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING This certifies that ................ ....... ..................... ....................... has permission to perform ... / zlem' wiring in the building of ...... S. T .. .............................................. I ... ........ ..... . North Andover, Mass. at....,. 42..Az&.. UE.e.. 6� ........... Lic. No..,.1052-0A ................ ELECMICAL INSPECr OR 3Y 0 7—� Check # 7197 M. Commonwealth of Massachusetts Official Use Onll Permit No. < F Department of Fire Services Occupancy and Fee Checked r BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/051 leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT ININK OR TYPE ALL INFORMATION) Date: 2 ,Z 0 -7 City or Town of. NORTH ANDOVER To the Inspect r ofWires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) �� 1011Cr !—C. X'p0 Owner or Tenant iaj; l mac, S -,i' --1�0 r-1 Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building C�-N �C2 1(t ne, Utility Authorization No. Existing Service Amps / Volts Over ❑ 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: Completion of the following table may be waived by the Insvector of Wires. No. of Recessed LuminairesNo. �� of Ceil: Susp. (Paddle) Fans No. o Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires SwimmingAbove In- Pool rnd. [:]rnd. ❑ o. o mergency Lighting Battery Units No. of Receptacle Outlets 0 No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pum Totals Number Tons KW No. o elf -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances g pp KN' Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: D C7 Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: _ 0� `— When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such &yrage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE OND ❑ OTHER ❑ (Specify:) I certify, under the airs and penalties of perjury, that the information on this application is true and complete. FIRM NAME: i�- _ LIC. NO.:� Licensee: Vz- Q>; Cc r run Signatur LIC. NO.: �3 502 (I(applicable,�nter "�xempt" in hg license number line.) Bus. Tel. No.: �/ _ 7 Address: I Upf- ly yke �& A .�� vft/f �/1�3 p�y�1 Alt. Tel. No.: O *Security System Contractor License required for this work; if applicable, enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent PERMIT FEE: $ Signature Telephone No. Date.................. t&ORTH TOWN OF NORTH ANDOVER, PERMIT FOR GAS INSTALLATION 'V SACH This certif ies that ......................... has permission for gas installation ... t4 ................... n in the buildings of Alee�.� F.( . ....................... at .................. North Andover, Mass. Fee.� f�, ..... Lic. No. .... .... . S INSPECYOR Check # 2 6808 P' MASSACHUSES UNIFORM APPLICATON FOR PERMU TO DO GAS (Type or print) ` G NORTH ANDOVER, MASSACHUSETTS Date Building Lo gations 1 (lLL�% l2� Permit # Y Owner's Name Amount S / O New1:1Renovation 1:1 U/ Plans Submitted Name of Licensed Plumber or Gas Fitter 0FjI INSURANCE COVERAGE �a w , U Z ° e o z , ra C y, s � �, w �.,, Q U j z = e z a W QQ W 5 Q w U SUB -BASEM ENT A BASEM ENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR. BTH. FLOOR. (Print or type) Nance— -< /tLL,4 Address � AV : S` Name of Licensed Plumber or Gas Fitter 0FjI INSURANCE COVERAGE �a w , U ° e o z z Chffg ale: Certi c I s ling Company rp. 0 Partner. Firm/Co. I have a current liability Insurance poli r it's substantial equivalent Check one Lf you have checked vesYes No , please ' Cate the type coverage by checking the appropriate box. Liability in policy Other type of indemnity p 13 Bond Owner's Insurance Waiver13 : l.am aware that the licensee does not the Insurance coverage required by Chapter ) 42 of the Mass. Genera) Laws, and that my signature on this permit application waives this requirement. Signature of Owner or Owner's Agent Check one: I hereby certify that all of the details and information 1 have submitted (or entered) in � Agenapplication 13 e � best of my knowledge and that all plumbing work and installations p rf a under Permit Issued for this compliance with all pertinent provisions of the Massachusetts State, d accurate to the ° and Chapter .142 of the General Laws. on will be in By: Signatur o� -p Title ED Plumb City/Town., Gas Fitter 0 Master APPROVED (OFFICE USE ONLY) Journeyman 1 sed -Plumber Or Gas Fitter icense hum er �� 0 Date. . V...... TOWN OF NORTH ANDOVER 0 PERMIT FOR PLUMBING SACHUS This certifies that ... el;4. �� ........................ has permission to perform ... 77 ....................... plumbing in the buildings of ... t'�. ............... at. . J. �'. F' .( .( . . . . / � . J . . . . . . . . . . N or th Andover, Mass. Fee.2 9, Lic. No..0 ........ �L... ......... UMBING INS�ECTOR Check # )-?6c, ), r MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS // q �-Fu�LC-12 � �� Date Building Location Owners Name /�1/-S��2Soti- Permit # ES Type of Occupancy New 1:1 Renovation 1:1 Replacement Plans Submitted YesNo ❑ al Kly IM9 My i / J • .J .J .r • i EM -1 ice` I ---.--..------..---�-.--- • MN i r • ������������� (Print or type) Check one: ertificate Installing Company Name GAL1AJ by AL +A7-6 ❑ Corp. Address ❑ Partner. O(3UL ❑ Business Telephone 7 Firm/Co. Name of Licensed Plumber: -Te-FF Insurance Coverage: Indicate the 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 Signature Owner 11 Agent ri 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 ins lati s performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massa ch a at P Code and Chapter 142 of the General Laws. By: Ig • cense er Title yp o Plumbing License — City/ icense um er Master �/ Journeyman ❑ APPRORO VED (OFFICE usE oNLY -1% Date ............. TOWN & NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ... ... .. ................................. has permission to perform ...... .............................. I plumbing in the buildings of i .1 ........... Not-th Andover, Mass. Fee�� ..... Lic. No75��4�?. . Check # PLUMBING,JN4P/IEC�T*0'R* 7251 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date 3 -07 Building Location �`'t Ile D ` Owners Name it !E� `eY�GYI Permit #y /1 e Amount 9x `'— Type of Occupancy New Renovation E] Replacement 031�- Plans Submitted Yes No FIXTURES (Print or type) Check one: Certificate Installing Company Name 1L Corp. Addressy Gf 6CD a S' 441e1✓/ / 1/ O ` 17 g E]Partner. Business Telephone11 Firm/Co. Name of Licensed Plumber. Insurance Coverage: Indicate the type insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity 11 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 Signature IOwner 11 Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and instal ations ormed under Permit Issued for this application will be in compliance with all pertinent provisions of the MaspQh 142 of the General Laws. ByIgnalUreOILICenSeQPIUMDer Type of Plumbing License Title — / City/Town LicenseNumoer Master ❑ Journeyman ' APPROVED (OFFICE USE ONLY 1_I /- / - -C , Date. � ....... ........... 0 '. TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION k j / - , � , " , - This certifies that . . !�.- . i.,. . . . .,I? z ............................ has permission for gas installation ............. in the buildings of ... > /I I, ...................................... at ............ North Andover, Mass. Fee. ... Lic. No. .......... .......................... GAS INSPECTOR Check # MEN MASSACHUSETTS ni IFORM APPLICATON FOR PERMIT TO DOG 4S F=C, ✓Type or print) NORTH ANDOVER, MASSACHUSETTS Date l 9 Building Locations C rt)`f e 1fr Permitg— Dl-) Amount S Owner'siName New ❑/ Renovation ❑ Replacement ❑ Plans Submitted ❑ (Print or type) Name Check one: Certificate Installing Company ❑ Corp. Address �—u l , UX-rb),Z-4- ❑ Partner. iness Telephone Name of Licensed Plumber or Gas Fitter ��� J2o, )-d- (P z -L- tee, Q' Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes E3— 'NO F7 If you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver: ( am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the ivlass. General Laws, and that my signature on this permit application waives this requirement. Sitznature of Owner or Owner's Agent Check one: Owner ❑ Agent ❑ I herebv certifv that all of the details and information I have submitted (or entered) in above appiicanon are true and accurate to the best of my knowledge and that all plumbing work and inst ations pertormed under Permit Issued For this application will be in compliance with all pertinent provisions ofthe :Massa us s Stas;ode an�)Chapter 1422 0 e Generaws. City/Town APPROVED ioFPic;-- us�!)Ni,y) Sienature of Licens6d Plumber Or Gas Fitter Plumber EQ 3 ❑ Gas Fitter )cense wumoer ��laster ❑ Journeyman '.r f (Print or type) Name Check one: Certificate Installing Company ❑ Corp. Address �—u l , UX-rb),Z-4- ❑ Partner. iness Telephone Name of Licensed Plumber or Gas Fitter ��� J2o, )-d- (P z -L- tee, Q' Firm/Co. INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes E3— 'NO F7 If you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver: ( am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the ivlass. General Laws, and that my signature on this permit application waives this requirement. Sitznature of Owner or Owner's Agent Check one: Owner ❑ Agent ❑ I herebv certifv that all of the details and information I have submitted (or entered) in above appiicanon are true and accurate to the best of my knowledge and that all plumbing work and inst ations pertormed under Permit Issued For this application will be in compliance with all pertinent provisions ofthe :Massa us s Stas;ode an�)Chapter 1422 0 e Generaws. City/Town APPROVED ioFPic;-- us�!)Ni,y) Sienature of Licens6d Plumber Or Gas Fitter Plumber EQ 3 ❑ Gas Fitter )cense wumoer ��laster ❑ Journeyman "'N2 2U77 Date ...... r177 i TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING ..... ................................................................. This certifies that ....... E.�J.A X- 17 if C- t(,, , - C- -T,-, C, has permission to perform ..... 1�C).l?.rnAL ........................................................ wiring in the building of ..... Al. ............................................. at ........................... ............................................... North Andover.,Mass. Fee..J.L.�O ... Lic. NoAqb . ..... ...... ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 14t &Jnutuuur> aJ0 of fflttsuttl:lpirftu i➢tpurtmcut of Public :-9,ufctg BOARD OF FIRE PREVENTION REGULATIONS 521 CMR 12:00 Office Use Only Permit No. Occupancy A Fee Checked 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Z),,� ,7 / City or Town of__ A L, /0 f)U,0li To the Inspector of Wires: The udersigned applies for a permit to perform the/electrical work described below. Location (Street & Number)I4%`� Owner or Tenant %%fi' S'(/ � Owner's Address�- Is this permit in conjunction with a building 'permit: Yes E4-*' No ❑ (Check Appropriate Box) Purpose of Building /01-0 -//(4 Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrnd ❑ New Service Amps —J Volts Overhead ❑ Uri:4grnd ❑ � Number of Feeders and Ampacity Location and Nature of Proposedl Electrical Work 6_1 C f, X.cn i-1- o i' C 6 ✓a.� fry r� .3%n � / r.�1 No. of Meters No. of Meters .4 No. of Lightirfg Outlets No. of Hot Tubs No. of Transformers Total No. of Lighting Fixtures yKVA Swimming Pool Above ❑ In- ❑ cl grnd. grnd. Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. -0f -Detection and No. of Ranges No. of Air Cond. Total tons Initiating Devices No. of Disposals' No.of Heat Total Total Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices Local Municipal ❑ Other ❑ No. of Dryers Heating Devices KW Connection No. of No. of Low Voltage No. of Water, Heaters KW Signs Ballasts Wiring No. Hydro !Massage Tubs No. of Motors Total HP OTHER:' INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Completed Operations Coverage or Its substantial, equivalent. YES Er NO ❑ 1 have submitted,valid proof of same to the Office. YES ❑ NO ❑ 11 you have checked YES, please Indicate the type of coverage by checking the appropriate box. - INSURANCE )0 BOND ❑ OTHER d" (Please Specify) (Expiration Date) Estimated Value of Electrical Work $ Work to Start Inspection Date Requested: Rough Final Signed under the Penalties of erjury: FIRM NAME Budd E�ectric Inc Licensee V in c en a..n e r 8 T' LIC. NO. 2O (Q F,, �zCo Address24 Col ate lir' N AndpVpr M � Bus.Tei No,SQFi-�7�i-qq�5 r �.-Q—�-9-L- Att. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the Insurance coverage or Its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE $—I& t6_ (Signature of Owner or Agent) r x•6565 N22U36 Date ..... Z'u TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ......... P'l ................................. has permission to perform ....... . ....... .................................... wiring in the building of ........ /7&,7 ......................................... atp ....... ....... ........................... ,�, North Andover, Mass. Lic.No./ /�*: ...... ........ ALiNSPECTOR C�' WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 011e TMH 1011wettltli of :ffluggadiuietto i1irparttnettt of public 1 tnfrtg BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Office Use OnIyG%'_C�f?j Permit No. K�V Occupancy A Fee Checked 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date City or Town of D A-,UAD(1� To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) _ a .1-:22 k a-) Owner or Tenant ��� Y- / M Z L'/Z.-©1U Owner's Address Is this permit in conjunction with a building permit: Yes No No ❑ (Check Appropriate Box) Purpose of Building 10WA11 Al / (n Utility Authorization No. Existing Service Amps —J Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Ur C'tgrnd ❑ No. of Meters Number of Feeders and Ampacity 41-ocation and Nature of Proposed Electrical Wk k' P 0J -&J 1 n ( 0 fJ��— .S'Cc� /�-1 ✓YI !n _G--- Poo / �� (J n � �"� i t No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above In- ❑ ❑ _ grnd. grnd. Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and No. of Ranges No. of Air Cond. Total tons Initiating Devices No. of Disposals `'` "Heat -"" Total Total No.of Pumps Tons KW No. of Sounding Devices No. of Self Contained 5 No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices Local Municipal EJ Other ❑ No. of Dryers. Heating Devices KW Connection No, of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES fir NO ❑ 1 have submitted.valld proof of same to the Office. YES ❑ NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box.' INSURANCE X7 BOND ❑ OTHER E ' (Please SDecifv) - Estimated Value of Electrical Work $ Work to Start Signed 'under the Penalties of erjury: FIRM NAME. BUdd of Licensee Vincent B. Iaa.n d e r Inspection Date Requested: Tnc Rough Final (Expiration Date) e LIC. NO. 12014 F - - - - L 4 —LIC. NO. ? .3 68 Address24 a Col tN Andw(�r Ma 01845 Bus. Tel.No5A-975-4455 g e Pr -r Alt. %I. No. OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) fl o. �w (Signature of Owner or Agent) Telephone NPERMIT FEE $ I-- x-6565 Location No. Date 12 -- TOWN OF NORTH ANDOVER Certificate Occupancy of $ CHU Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #,,22�1c�- 3 5 u 6 Building lng&tor o C O O, U yr en. . urts. O O V C7 V U 7_ Z U o o..° ^ O U W y v7 r C O p O w O OF O G O O O < G7 t9• A A e U U U ,G i - - U (j U tCj p W Z w w w U w C U V - - z z z C z U U z z z n n o w 19 O O b F c, z O- O U O U O U .a W in W - t°"i h .r A - Z U z 0,•, a F O U "b T' 9 k• (` y a C ,dzj o C O O, U yr en. . urts. O O V C7 V U 7_ Z U o o..° ^ O U W y v7 r C O p O w O OF O G O O O < G7 t9• A A e U U U ,G i U (j U tCj p W w w w U C U Q iO 'y z z z C z U U z z z n n w 19 O O b F c, z O- O U O U O U .a W in W W t°"i h .r o C O O, U yr en. . urts. O O V C7 V U 7_ Z U o o..° ^ O U W y v7 r C O p O <' � y = G L W N < G7 t9• A A e U z 0,•, a F O U "b T' 9 cn r z z W O O U Z� v' NLJ.v, a C o a ri c v Z-, C cn 'U O U U W W U 7_ Z U o o..° ^ It - I -LA. FORM U - LOT REL=EASE 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 WiLLIIt1avi M► ASfE7256d LOCATION: Assessor's Map Number O 6 5 - SUBDIVISION PHONE 0178 - SS -7 `P75'b PARCEL 007, LOT (S) STREET 22Z fru L L e -m ST. NUMBER 22 **rte,-tet**�OFFIC3AL USE ONLY***** R MMENDATIO OF TOWN AGENTS: '—a A') L1Z, CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS 'V� Q`�5 "yllr\ �U�� a� GB�J✓�i�I TOWN PLANNER COMMENTS FOOD 1NSP TOR -HEALTH PECTO DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED COMMENTS All /<-"- 2_z> If r PUBLIC WORKS - SEVVER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR Revised 9\97 jm DATE s Pt C_ A 11!24/99 WED 19:38 R X FO001 TEL: (508) 475-1474 FAX: (508) 475-5451 BATES®N ENTERPRISES, INC. Excavating -Water & Sewer Lines -Septic Systems & Pumping Sewice 111 Argi Ila Road Andover, Mass. 01810 TO: sq.� - FAX A(qg) DATA PAGES: l . INCUMING CMR swkw FROAk TODD 8ATESON SUBJECT:S-�Ccv� J� COdIIUTAE�ITS� i /w.0 3 W�Ir .14 IN z sr'Y 400' No.sa ,aEL K Map �Lp.ovn�► Nit lA ie+ STP JtL uuu IN W. a f 7 X �IJL L E'er Ra, a,,ysEM�,ivT i I 3 3oZ-oo 1 ` 1 1 LoT :='This pian was.rtot. pre�are-drot�_ an Instrument survey. Offsets and distances shown should nci be -used to establish property lines. This plan Is Intended for mortgage. purposes only... - 1.c ertify.that the structure shown on this Plan �&E - In conformance with the zoning setbacks. In -effect at the time. of construction. ce*-.that.the parcel shown is evo7- Iocated;wtthin'a flood hazard area' as depicted ion FEMA. Flood .Insurance Rate Maps for Community No: ssGe 9� LOCATION: y SCALE: i•'=¢a' DATE: 6-6-87 REGISTRY - TITLE REFERENCE:4WO64 Paz PLAN REFERENCE: w.wa. a/:2a3 v • COREY & DONAHUE. INC. EnOneers Z Surveyors IDS Cambridge Rnad, WahnM NIA 01801 n ','ura: t: .y i .: ..V� s +� ' h ctrl;„ � .c^'U+j'L}r }:{t,��'�� ,b f;.6� "� "! �• t5 - � a t -z �,y t ai x :°t- r `•. r, 'y 1 t `+ J, -*?1 - Y v�w"�r h 1. t'�x.'`� ; 1 spCi 1.. nib,.. f. `� ' ^k:.t-.i��'-7-•��Z x'J' ', �c-j {`3 ` • F r Y -. T '�x' �� 3 jY3'}' a A 4, w � � a � y • �•ij"'���y+ ��r CIA,, e A i izt— To J,�L�%,�0��z�'•��y�f �Y xK tL� �/.���� �f :,. C 4, x, t r,"'�Tfa "i ''`-`fi ,p b��r{i Sc �F'�a- ri :f k< .j 1 ..', ' r�+°�titf "�r.-�r��'c_:i• r v 'jai r+ay, ..,'.:. r • �k' J x i a �A:z •iii r•>..ww/'y?.-�ifr.�ti .h,: ! f 't+'�"C'f' {c �`• i vT 'C +. v ,��q�'LaM Yf4..T: f � *• N � $ yyh' : .��J -•+-�Z�"r Y� `V� at ``L� ±am o Y. .J,+ a r r{. v '. � T aRi` � 3 d /a -..1 i a '✓ . 1'� h �'' a ".� e°.iJ�a •y��i W 3'ti ��. � � r • ' ik r �� 3 7 ��.�%I t ��Ky s r .i,}r4ih nJ t .� A.�A.s rl���.���� �•.'!'!'M,rr���i'4i1-:I;,'?'i��t, - a. _ .. i�'..����-. r. /` - I-' �Y..?r3� ...,,112_ b�K�'� � "','ill a�I, tr• aF +'3{4ll ..sem•• fid` T--: c PRE fr\g`�t,�p i� y.i, 'f z� t L 7 t :ns'^' 04 A -;.� .ri Y, �'°t, ,F t r.r y. 6 yj :, ...fS- t �,; t y ��� } �t,�,, yt n'!/ :✓ >; '1 fFi" t . ,ts. f: .: �,c .: �•s ,a,u:. , cf, :v„+; AL,,j,;t1+l,.?i iKn'�� •s fi.., y) s<i�jj•N 1"i'�+'�d•t. a �F.�?! S A ..,.�„ K.. � .. le-,, ..e•,� A ... . A CORD .�......:: u:•x•.r\»\\v�\�..w +:oxo\\�\c'r',\�2<'•.':'x'r::::3:\����'h PRODUCER (603)893-9450 FA _akeside Insurance Agency, Inc. 88 Stiles Road Salem, NH 03079 INSURED Andrews Gunite Co Inc 6 Republic Rd N Billerica, MA 01862 ■ �.� •DATE •MMID:. r 1 D/rn:: ■ :+; MENEVIN .. \ v. ,ti 1 r ,:• + •� . .,:+. v .. 10/04/f999 ...>O:. •gym. •... f/Jr ., (603) 893-9480 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY CNA Insurance Companies Ext A 1 COMPANY B COMPANY C COMPANY D INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COTYPE OF INSURANCE POLICY NUMBER i POLICY EFFECTIVE : POLICY EXPIRATION: LIMITS LTR DATE (MMIDMIQ DATE (MMIDONY) GENERAL LIABILITY : GENERAL AGGREGATE S 2,000,000 X COMMERCIAL GENERAL LIA131 TIY ..................................................................................... : PRODUCTS-COMP/OP AGG $ 1,000,000 CLAIMS MADE X : OCCUR : A .`......•. .•••••. 174087794 PERSONAL & ADV INJURY S :03/01/1999: 03/01/2000: - ................................. 19000,000 OWNER'S & CONTRACTOR'S PROT ; : EACH OCCURRENCE = 1,000,000 X.. CUSS A99 limit FIREDAMAGE(Anyonefire) s 000 per project :.............. ...:... MED EXP (Any one Wson) ...................50 .............. $ 5.000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS A X SCHEDULED AUTOS SAP1082055940 X HIRED AUTOS X NON-OWNEDAUTOS ............................................................ . COMBINED SINGLE LIMIT $ 1,000,000 BODILY INJURY S :(Per Person) 03/01/1999 03/01/2000 BODILY INJURY S (Per accident PROPERTY DAMAGE S GARAGE LIABILITY AUTO ONLY - EA ACCIDENT S ...............................................:::::::.::::::::::::::.::.::::::.:::. ANY AUTO OTHER THAN AUTO ONLY: ::S :::::.............. EACH ACCIDENT ............... ............................................................::....................................................................................... AGGREGATE: $ EXCESS LIABILITY EACH OCCURRENCE $ 2,000,000 :.................................................................................... A X UMB7tELLA FORM 174087827 03/01/1999: 03/01/2000: AGGREGATE $ 2,000,000 OTHER THAN UMBRELLA FORM S WORKERS COMPENSATION AND TORY LIMITS ER ::::::::::::::`•:%:%i:? ::;:s:: EMPLOYERS' LIABILITY EL EACH ACCIDENT 5..........1.t.000 A-20530275 03/01/1999: 03/01/2000 ••••••............•.........••••• ' THE PROPRIETOR/ a INCL : : EL DISEASE - POLICY LIMIT S 1,000,000 PARTNERS/EXECUTIVE OFFICERS ARE EXCL EL DISEASE - EA EMPLOYEE $ 1.000.000 OTHER ring work to be performed by insured SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WALL ENDEAVOR TO MAIL XX_ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. 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ATI pw•1 FOlF:L7�i1J1 SiY?Cl':.�v= WILL =al A•.t A•O Gs ATC �T.A%ICR AO � \ • ' �7 ar.•s oc'o.ct O.o i I -At AS r: IY. CAC w G vC f.A♦ Nf•Tl %I%gcF VALVC r'..I.LL •t wla••\� O. 1 t vI Ir t wL,Yt •.� �•�R •wwG Jf• Cwc AR Ce••C. Lo+[W � ExOA) . i' SO,*- wALL S'cCTIOM 1 iGL1Fd ^Ptlr, I ll?•I' 1Jl'H: F USPa - y • • f • •tAn 67 fMit Q its -L -tan • � •��tl NI /N.t CIMAiC •Att"i («AT.ORO• + r_~t: i a eh: y� �nwt d �'•G Clitr• wi wwtcy t vI Ir t wL,Yt •.� �•�R •wwG Jf• Cwc AR Ce••C. Lo+[W � ExOA) . i' SO,*- wALL S'cCTIOM 1 iGL1Fd ^Ptlr, I ll?•I' 1Jl'H: F USPa - Cl) m m C/) 0 m Q 10 C � O � Z7 O � z� CL 0 � O t�. �• y �'•� O C.) c c CD CD O Cr d O co o CD co 00 � O y. CD Q O H tC C � o CO) O CD z co � o CD CD dc co C ; al o m = � C• flf� O Q CO) O E , - y =1 t m �! Z CA W q*-� O O' - L2 cc,,, � �m N T dw 1 ? m.► m CO)d „_� CO) CD 0 1: ® o m : m n > o� o C O O L O_ l7 O m I C y t :• I ' ^ to C �G J G Vc=c, CD ? ' o m c c a1. m m Oma' = V x N w= FA, Q CL CA C -CD -- :E m : y N CD su 1 1 COD o � =m o� to 0 O a o Z O C3: �► CD CD: z �1: H CD = m CD r =CD _ A a� o� C2 _ 7 y 0 0 c ° rD d z w G oc DO n w C oc CdGQ w C GO w C C r o M rt g x eb O o y 0 0 c Location r U Z Z No. li L' Date Check # 1 165Z5 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Building Inspector, 11, c - G - v I. C z c - G - v I. The Commonwealth of Massachusetts Department of Industrial..,9ccidents Office of investiaations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Blame Please Print E:1 rel I am a D.cmewner per7crming all work myself. am a sole proprietor and have no one + orkina in any cGpadty I am an employer providing workers' compensation or my employees working on this job. Ccmoanv name K f Address / City' ��I�LQ.w Phone T 1--1-36 - /of E",//� Co. VU 6J (,A�"�� Policv # D� ' a&S Comcanv name I Insurance Co. Policv # Failure to secure coverage as recuired under Section 25A or MGL 152 can lead to the imposition or criminal penalties of a fine up to 51,500.00 and/or one years' imprisonment as we!I as civil penalties in the form of a STCP WORK ORDEFR and a rine of (5100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby cert fy upis�pr the pains and penalties of perjury that the information provided above is true and correct. Signature Print name 6q Date U' Phonen Official use eniy do not write in this area to be comoleteci by cry crcv✓n ct iiciai City or Town Permit/Lcensinc ❑Check if immediate response is required Contact person: rnurie Budding Dept Licensing Board ❑ Selectman's Office ❑ Health Department ❑ Other i/ r 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) lkdjt,��� Signature of Permit Applicant . "',&-IF? Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector Meyer Construction, Inc. 22 Waltham Street Woburn, MA 01801 T: 781-938-6957 Home Improvement Contractor License #115234 CONTRACT To: Mr. & Mrs. Masterson Date: October 14, 1999 22 Fuller Road North Andover, MA Home: 978-557-5750 Meyer Construction hereby proposes to furnish the materials and perform the labor necessary for the completion of a sunroom on existing porch at 22 Fuller Road. All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications submitted for above work and completed in a substantial workmanlike manner for the sum of $24,000.00 Contract Documents: a. Contract b. Design drawings C. Specifications d. Local building codes Specifications: • Footings, excavations per drawings • Framing add to existing to meet codes • Demo & dispose of rubbish • Exterior to match existing • Glass Andersen casement and awning style per drawings • Door is light glass per drawing • Two (2) Velux 306 skylights • Electrical to meet code • Tile floor TBD with allowance for tile at $3.50 per sq. ft. • Trim interior windows with birch match to existing kitchen • Walls & ceiling drywall and paint • Glass block replace existing window and door to bath and laundry • Repair all landscape (note: no shrubs) loam and grass Page 2 - Owner to carry fire and other necessary insurance upon above work. Workmen's Compensation and Public Liability Insurance on above work to be taken out by Meyer Construction, Inc. Payment All work specified in this contract will be completed for the sum of Thirty -Three Thousand Two Hundred Fifty Dollars ($24,00.00) with payments to be made as follows: 10% deposit at signing of contract 2400.00 20% on glass order 4800.00 20% on framing 4800.00 20% after glass installed 4800.00 20% on finish trim 4800.00 10% final 2400.00 Changes to contract 1. Changes and extra charges are to be paid when change order is signed. 2. Contractor will not be responsible for any unforseen conditions pertaining to the site work in the excavation process. Any changes will be negotiated with the architect, owner and contractor and performed under a change order. See attached agreement. UWe the undersigned agree to all terms and card& ti ns of this contr ct. kAIY Meyer Meyer Construction, Inc. Print Date: REM/k D:\Meyer Construction\Contracts\MastersonContract.doc r �� lyti �C��`l� �GfL L �,�' Rh• N I 1 1 � /SOK 111 'l This This plan was not prepared -from an Instrument survey. Offsets and distances shown should not be used to establish property lines. This plan is Intended for mortgage• purposes only. I certify that the structure shown on this Plan ;"xlzi . in conformance, with the zoning setbacks In effect at the time of construction. 1 certify that the parcel shown is located within o flood hazard area as depicted ,on FEMA Flood Insurance Rate Maps for Community No:15if",, s' - 1 Job No. OF MA cy 1 � E Lam MORTGAGE LOAN INSPECTION LOCATION: zZ -&b evj- SCALE: �o ' DATE: -Z — REGISTRY: A, Ct ` Com` TITLE REFERENCE: 2' PLAN REFERENCE; _ - COREY & DONAHUE, INC. Engineers IL SWCYGIrs ln$ CnmbrJd$e Itorksl, WObnrn. MA 01901 Tod Wd6S:Z 666T 02'^oN 6ZVVSZ6 6Z6 : 'oN dNOHd .::U0SaE1$dw::: : woad 1 � Z OF MA cy 1 � E Lam MORTGAGE LOAN INSPECTION LOCATION: zZ -&b evj- SCALE: �o ' DATE: -Z — REGISTRY: A, Ct ` Com` TITLE REFERENCE: 2' PLAN REFERENCE; _ - COREY & DONAHUE, INC. Engineers IL SWCYGIrs ln$ CnmbrJd$e Itorksl, WObnrn. 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