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Home My WebLink AboutMiscellaneous - 222 MAIN STREET 4/30/2018 222 MAIN STREET / 2101041 000.0 d 1 r o Date//�7.4.3........./,.... ' e HORTM 1 3:;:_ r ��-• "�,� TOWN OF NORTH ANDOVER ' PERMIT FOR WIRING ,SSACMUS� This certifies that has permission to perform .......................................... wiring in the building of. . '.:.1..........N.. .........................�...................... at..!;X7 .l.!�.....5.1 ��................. . orth Andover,Mass. ....... .... A .Fee..:.�.�... Lic.No. l� S t= 1�i�c�� ELECTRICALINSPECTOR Check # 9 12 7 o ,18o1 Date P?Oplu. . . . TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING r This certifies that . . . . . . . . . . . . . . . . has permission to perform . plumbing in the buildings of. . �.��, , , , , , , , , , , , , , , , , , , , at . . �SQ,, , , , , . . . . ,North Andover, Mass. Feed . . Lic. No. . . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR Check# 5/0 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK \ pp N CITY �D 2TH t1 t,9 DOV Q2 MA DATE i t aLl I PERMIT# �� q�-wn \ w JOBSITE ADDRESS 9—aa ,MA 1 Or ')TaZET OWNER'S NAME CLIA I & IS U-T TA LU /y OWNER ADDRESS 21.2— Y J�XtQl S Fg&97 TE1297S-65a 1(J:FAX TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL PRINT CLEARLY NEW:❑ RENOVATION:❑ REPLACEMENT:, PLANS SUBMITTED: YES❑ NO❑ FIXTURES-1 FLOOR BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM n DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY _ ROOF DRAIN 1' SHOWER STALL SERVICE/MOP SINK TOILET URINAL 1 WASHING MACHINE CONNECTION a WATER HEATER ALL TYPES WATER PIPING OTHER INSURANCE COVERAGE: I have a current Iiabili insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YESX) NO ❑ - L IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 1jQ OTHER TYPE OF INDEMNITY ❑ BOND ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ❑ AGENT ❑ SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and ccurate o t e best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in pl ce hal rti ent provision of the Massachusetts Stale Plumbing Code and Ch pier 142 of the General Laws. SLUMBER'S NAME ,�h�`� 6'��t/ LICENSE# /0 F07 SINATURE AP D" JP❑ n L /►� /�I CORPORATION[01#3 j PARTNERSHIPS❑# LLC❑# OMPA AMF J 7 7 /> l�l�K ��(,S�� ADDRESS `!) ,ITY �S�r'1 STATE ZIP C TEL =AX CELL& 60t /- EMAIL � �j ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICEUSE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $� PERMIT# _____L'IL''►/ C' G/ - PLAN REVIEW NOTES /J-- Q :i t; s The Commonwealth of Massachusetts " Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/din Workers' Compensation Insurance Affidavit: Builders/Contractors/E lectricians/Plumbers A1!9licant Information Please Print I,e9iblV Name (Business/Organization/individual):f(/ I � � T��%�' (� r Address 0( � �'�-S ` ►� U& City/State/Zip: LSe a Phone#: 9'0 Are you an employer?Check the appropriate box: Type of project(required): I.L 'l am a employer with 4. ❑ I am a general contractor and 1 6. ❑New construction em to ees full and/or part-time).* have hired the sub-contractors p y ( p listed on the attached sheet.t E]Remodeling 2.❑ 1 am a sole proprietor or partner- ship and have no employees These sub-contractors have 8. E] Demolition working for me in any capacity. workers'comp.insurance. 9• ❑ Building addition [No workers'comp. insurance 5. ❑ We are a corporation and its 10.❑ Electrical repairs or additions required.] officers have exercised their right of exemption per MGL 11.❑ Plumbing repairs or additions 3.❑ l am a homeowner doing all work g p p myself.[No workers'comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.]t employees. [No workers' 1.3.0 Other comp.insurance required.] *Any applicant that checks box HI must also till out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name or the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: AG'o'-) IACrc- �Ias U !a4'r4-e- et. - -- Policy b or Self-ins. Lic.b: �� Sg'D �f 1 Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 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 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 certify under lite pains and enallies ofperjury that the information provided above is true and correct. .. S iprtature: Date: L Phone# (9 i ' Y2 I Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License 4 Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#l: CONINIONWEAL T H OF MASSACHUSETTS PLUMBERS AND GASFITTERS LICENSED AS A JOURNEYMAN PLUN E'ER ISSUES THE ABOVE LICENSE TO: STEPHEN G HDGAN . 109 BURROUGHS RD BRAINTREE MA 02184- 1517 19523 05/01/14 153824 li •' � µ y COMMONWEALTH OF MASSACHUSETTS P!..UMBERS AND GASFITTERS LICF-NSED AS A MASTER PLUMBER l ISSUES THE ABOVE LICENSE TOi STEPHUN G HOGAN I� 0.9 BU"ROUGHS RD ?N I .. MA 021.84-'1 B':AlNTR! E 10808 05/01/14 153825 , IN y to le r C y^• - 10 - . COMMONWEALTH OF MASSACHUSETTS PLUMBERS A'D'D GASFITTERS REGISTERED AS A PLUMBING CORP. ISSUES THE ABOVE LICENSE TO:` STEPHEN G HOGAN :PETRO HOLDINGS i IAC Im T09 BURROUGHS RD ?� BRAINTREE MA 02184 ' I 3403 05/01/14 1'Si�823 ' Commonwealth of MassachusettsFOccupancy Official Use Only Department of Fire Services Permit --9 BOARD OF FIRE PREVENTION REGULATIONS d Fee Checked(leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WOR All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMQ TION) Date:� �/ City or Town of: NORTH ANDOVER To the By this application the undersigned pector of Wires: gives notice of his ohintion to perform the ele electrical work described below. Location(Street&EAtm! Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with a building permit? y� Purpose of Building_ &A%% NO ❑ (Check Appropriate Boz) Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd D No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: > COMBIletion o the ollowin table may be waived by the Inspec, o Wires. No.of Recessed Luminaires 1- No.of Cel:Susg.(Paddle)Fans No.of Total . No.of Luminaire Outlets Transformers ISA No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ �_ o.o mergency g d• �d Bo. Units No.of Receptacle Outlets No.of Oil Burners FRE ALARMS No,of Zones No.of Switches No.of Gas Burners No.of Detection and No.of Ranges Initia Devices g No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers eat Pump Number Tons KW o.of Self-Containe Totals: '•--"-"..�-"'��- ...'.�'. Detection/Alerting Devices No,of Dishwashers Space/Area Healing KW Local❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems: o.of Water No.of No.of Devices or E uivalent Heaters KW No.of Data Wiring: Si s Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or E uivalent Estimated Value of Electrical Work: Attach additional detail if desired, or as required by the Inspector of Wires. Work to Start: 1 -r3^ (When required by municipal policy.) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: nless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability ' cc including"completed operation"coverage or its substantial equivalent The undersigned certifies that such cove a is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER I certify, ❑ (Specify:) under the pains and penalties of perjury, that the information on this application is true and complete- FIRM NAME: o Licensee: LIC.NO.: I aPP l:cable, enter 'exempt"in the license number line.) Signature LIC.NO.: (r Address: Bus.TeL No.: *Per M.G.L c. 147,s. 57-61,security work requires D Is,, Alt.Tel.No.: o. OWNER'S INSURANCE WAIVER: I am aware that the Department a dos not ehave the liability insuranccense: Lic.e coverage normally required by law. By my signature below,I hereby waive this requirement I am the(check one) ❑owner ❑ owner's a pmt Owner/Agent Signature Telephone No. PERMIT FEE. $q 1, ,/7- 0 � r 4'` The Commonwealth of Massachusetts y Department ofIndustrial Accidents Office ofInvestigations 600 Washington Street Boston, A"-02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'blv Name (Business/Organization/Individual): Address: y- City/State/Zip:�Q -�a� �, }� Phone#: 64 3 Are you an employer? Check the appropriate bog: Type of project(required): 1.❑A�ammployerI with 4. [❑ I am a general contractor and I ees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2. I am a sole proprietor or partner- listed on the attached sheet 7. ❑ Remodeling ship and have no employees These sub-contractors have 8. Demolition working for me 'many capacity. workers' comp. insurance. 9. ❑Building addition [No workers' comp. insurance 5• ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I I.[]Plumbing repairs or additions myself [No workers' comp. c. 152, §1(4),and we have no 12.[]Roof repairs insurance required.] t employees. [No workers' comp. incitran�required.] 13.[:] Other Any wpplicant that checks box#1 mus also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. lContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. Insurance Company Name: 6ta ie— Policy #or Self-ins. Lie.#: Expiration Date: o�Q IQ Job Site Address: A► 11 �' City/State/Zip: ,� �}� �rs �`�- i Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 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 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 cc, nde the pains MA enalties of perjury that the information provided above is true and correct, Signazure: /—� Date: ` Phone#: 6 [[60ther cial use only. Do not write in this area,to be completed by city or town official or Town: Permit/License# ng Authority(circle one): ard of Health 2. Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector act Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers toprovide 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 apartrnents 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 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 of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s), address(es)and phone number(s)along with their certificate(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' compensation 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 the 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 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 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 pemzit/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 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 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 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 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 usa call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accident. a� Office of Investigations 600 Washington.Street Reston, MA.02111 Tel. # 617-727-4900 eat 4:06 or 1-877-MASSAFE Fax# 617-72.7-7749 Revised 5-26-OS -" %mass.gov/cha ` Commonwealth of Massachusetts Official Use Only i Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/99] — � (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 V/ (PLEASE PRINT LV INK OR TYPE ALLL FO LIATION) Date: �'7, Q� City or Town of: h V e To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 6 014 n C� Owner or Tenant �YA 14 /1yary- u Ii' Telephone No. Owner's Address U S �. Is this permit in conjunction with a b ilding permit' . Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building J fL,(} Utility Authorization No. Existing Service_"Amps /v�VdVolts Overhead Undgrd❑ No.of deters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity ? bti Location and Nature of Proposed Electrical Work: Completion of the fol/''otivinsr table may be waived bcv the lnsDeeectror:or'TViren No.of Recessed Fixtures oz No.of Ceil.-Susp.(Paddle)Fans No.TransTotal Trsformers KVA I No.of Lighting Outlets INo.of Hot Tubs Generators KVA No.of Lighting FixturesSwimming Pool Above ❑ In- ❑ o.o me bbency Lighting gL rnd. grnd. Battery n'its No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. of Zones No.of Switches INo.of Gas Burners No If Detection Devices and No.of RangesNo.of Air Cond. TonsTotaNo.of Alerting Devices No.of Waste Disposers Heat Pump Nymber Tons KW' No.ofSelf-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No,of Drvers I Heating ApplianceshW Security Systems: No.of Devices or Equivalent No.of Water No.of Noof Heaters KW1. . Data Wiring: Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs INo.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of;p'ir-. 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: INSURANCEX BOND ❑ OTHER [I (Specify:) Estimated Value of Electrical Work: (When required by municipal policy.) (Expiration Date) Work to Start: Kl�)—b� Inspections to be requested in accordance with MEC Rule 10,and upon completio I certify,under the pains andpenalties of perjury,that the information on this application is true and complete FIRti1 NA�titE: U/yq R (r o7R i C o,,0 LIC.NO.: I Licensee: M l R k L bL q Signature (�r� LIC.NO.: C (!(applicable,enter-ev t"in i to license number line.) Bus.Tel. No.: `/79 3j--' 1—y t r-1Address: �.r (;u,(�y Lane Glor, l �lYjcZ c St ? ? Alt.Tel.No.:4'7 9-3c OWNER'S INSLRANC WAIVER: I am a are that the Licensee does not have the liability insurance coverase normally required by law. By my signature below,I herebv waive this requirement. I am the(check one)❑ owner ❑ owner's agent. Owner/Agent ,,. Signature Telephone No. PERMIT FEE: S�'o r--4 ,l: q7 6 .24 Sail(: Date X-(�?2�. . TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING SSACMUS� This certifies that . . . . !. '. . ..... . . . . . . . . . . . . . . ./. . . . . . . . . . . . . has permission to perform -' plumbing in the buildings of .-1'4�. at . . . . . ^'`' . . . . . . . . . .-. , North Andover, Mass. Fee . . . . . . . Lic. No.. . . . . . . . . . . . . . . . . . . . . . . . . . C� Plt91v181NG INSPECTOR Check !1 � 655J MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) Plass. Date__ City, Town _ Permit _ Building , y Owner 's AT: Location Z ZZ �'�f1/r7 Sr Name__ em, ��— — Type of Occupancy: 1� New ❑ Renovation �� Replacement ❑ Plans El V) Submitted: Yes ❑ No _Z 2 N fA Q Z x to J N O z = W w W x J N Q t1 F H a ¢ ¢ W Z N Q ¢ = O Z 3QF0 x►V' Q S ¢ Q Z ¢ n• 2 2�, <Z lJ ZN Y4 SWx W o C O W ¢ W ¢ JO , CJLFL 3LL S d = Y a O W LLZ Z O O W O U< a O J n o J o SUB—BSMT. BASEMENT 1ST FLOOR 2ND FLOOR I 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR (Prim or Type) r Check One: Certificate Installing Company Name h t' LLt❑ Corp. Address � ,/ El Partnership iDU• 4.1 �{� d/iaerz ❑ Firm/Company Business Telephone YV t.?7z l�/79 Name of Licensed Plumber or Gasfitter 1 hereby certify that all of the details and information 1 have submitted(or entered)in above application are true and accurate to the best of m knowledge and that all plumbing work and installations performed under Permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. I have informed the owner or his agent that I do not have liabilit%insurance including completed operations coverage. &gnerure of Owner,Allem 1 have a current liabiliq insurance polic}to include completed operations coverage. !!� a B� Signature of Licensed lumber Title Ci _ Town -of�� Type of Plumbing License I[�C4aster ❑ iourne.man APPROVED(OFFICE USE ONLY) License Number BELOW FOR OFFICE USE ONLY FINAL INSPECTIONS SKETCHES FEE PROGRESS INSPECTIONS NO. APPLICATION FOR PERMIT TO DO PLUMBING NAME&TYPE OF BUILDING LOCATION OF BUILDING PLUMBER PERMIT GRANTED f DATE PLUMBING INSPECTOR 3P/ 5 ' Date........1................. .. t�OR7M� ° , °.;•."° TOWN OF NORTH ANDOVER PERMIT FOR WIRING �o �sSACMU`�� This certifies that . .. . `J' dthas permission to perform 1 . /..... wiring in the building of........e.4 /... f.G./............................................... at........r ... .......` .(?.:�.'....... �. .................. rth Andover, ' s. Fee/ .... Lic.No//�..,f�@,,�.............. .. ....:1�'1�....1/..................... ELECTRICAL INSPECTOR Check # �) Permit No.utticiaruseVnly 3 ` ' �� et7n2�2�2zrr��.��tri�2�ss�Gr'�us��rs Occupancy&Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00 (Please Print in ink or type all information) Date -,JV-/'i3 �✓� To the Inspe r ofrWires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number ZZZ A,, Owner or Tenant Ownet's Address Is this permit in conjunction with a building perrm - Yes No ❑ (Check Appropriate Box) Purpose of Buildingy',t ��fa Utility Authorization No. Existing Service r " Amps Voits Overhead Undgrnd ❑ No.of Meters New Servicer ZD v Amps �� Voits Overhead Undgmd ❑ No.of Meters Number ofFeeders and Ampacity Location and Nature of Proposed Electrical Work Total No.of Lighting Outlets No.of Hot fuse No.of Transformers KVA Above ❑ In ❑ No.of Lighting Fixtures Swimming Pool grnd ❑ grnd ❑ Generators KVA No.of Emergency Lighting No.of Receptacles Outlets No.of Oil Burners Battery Units No.of Switch Outlets No of Gas Burners f FIRE ALARMS No.of Zone Total No.of Detection and No.of Ranges No of Air Cond Tons Initiating Devices Heat Total Total N%t of Di osal No. Pumps Tons KW No.of Sounding Devices No./of Self Contained N2.of Dishwashers / Space/Area Heating KW Detection/Sounding Devices ❑ Municipal ❑ Other N9.of Dryers Heating Devices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Bailases Wiring No.Hydro Massage Tuds No.of Motors Total HP OTHER: 6Esa OVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws rent Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES= NO = tt lid proof of same to the Office YES= NO = If you have checked YES please indicate�h coverage by checking the appropriate box E = BOND = OTHER =.(Please Specify) �J ( piration Date) Value of EI r' al Work$ Work to Start_ 7 Inspection Date Resquested Rough Final_ Signed under the Pe (ties of pe' �t �0 LIC.NO. FIRM NAME (� "ev Licensee �r (Signa ureLIC.NO. Address (G ( 1�v BAft Tel.No. OWNER'S INSURANCE WAIVER: I am aware th he Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws.And that my signature on this pehAlt application waives this requirement. Owner Agent (Please Check one) /� C Telephone No. PERMIT FEE $ (Signature of Owner or Agent) Date. 7 . ./�: `. � 04 ,ORT, tO•T TOWN OF NORTH ANDOVER , 3? �� •Oft A PERMIT FOR PLUMBING s a• •'a CHUS This certifies that . . .�. . . . . . .. . . . .�.t.. . . . . . . . . . . . . . . . . . . has permission to perform . . . . �.C�`. .`".F'. ` — . . . . . . . . . . . . . . . . . . plumbing in the buildings of . `. . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . 2. ?. 1. �' `��`' ¢. . . . . . . . . . . . . . . . North Andover, Mass. . . . . . . . . . . . . . Fee. C. . .: Lic. No. . . . . . . . . . ��' �� . . . . . . . /PLUMBING INSPECTOR Check # 52 .019 G3 = MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS c Date Building Location Permit# Amount Owner New Renovation Replacement 0 Plans Submitted Yes 13 No FIXTURES F Cr W x H P A A Smnivz BASEMENT 1ST HACM ` z"H" �M HOCR, 4IH FIOQ2 5M FIOOR 6THHOOR 7M HjOOR 8M ILOOR (Print or type) r Check o e: Certificate Installing Company Name �° / orp. Address JLI� ,� 1� �1` �� XV Partner. 7& Business Telephone Firm/Co. Name of Licensed Plumber: S' ��_��i✓/� Insurance Coverage: Indicate t�type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner13 Agentrl 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 tions performedu er Permit Is for this application will be in compliance with all pertinent provisions of the Massachu is State Plumbi C de C er 142 of the General Laws. . By i re o icense er Type of Plumbing License Title City/Town Eicense Nuinuer Master Journeyman ❑ APPROVED(OFFICE USE ONLY �7� Location o,� No. Date &0IVTPf TOWN OF NORTH ANDOVER 0 o- 9 s i ' Certificate of Occupancy $ • 'mob,,. ,'' • { x ��SJA�M�S<� Building/Frame Permit Fee $ 1 2, Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # le- 1 r'i 565 1 Building In for TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING rn BUILDING PERMIT NUMBER. DATE ISSUED. _ a SIGNATURE: /V \ AA .•� Building Commissioner/12i for of Buildings Date Z SECTION i-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Z z z VAo,%r �'Fft2� bbl 00 9 N IC�I" 'r 'vl�l A o`6b q5 Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided v 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: D Public ❑ Private ❑ Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record Cray oJ� A1\ ZZZ '�• �t - Name Address for Service: dna r Telepfione 2.2 Owner of Record: 3 Name Print Address for Service: O Z rn Signature Tele hone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ —s�phr k Mo rc.1�1 Oo g t �4 Licensed Construction Supervisor: O ib St n _wo.(_ N ^,t A pl B'; License Number Add ess ("{,t(',Q_ MR-'�pW �"\f'C l\ pz Zoo Sa�a I Expiration Da K S" nature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name rn to M6 J1Ipv\ �t• ^W$Q� ^,1 t`�`k c �� Registration Number C� 1 r Ad �Z r. 81 Z Expiration bate n Si ature ' Telephone v/ A ' SECTION 4-WORKERS COMPENSATION(NLG.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.......11 No.......❑ SECTION 5 Description of Proposed Work check au a Ucable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: Rwl>M kk tc 4� avid (P-60Lk '17- 1A SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by perniit applicant 1. Building (a) Building Permit Fee 56 1'?go Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a) x (b) 4 Mechanical(HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT ORCONTRACTOR APPLIES FOR BUILDING PERMIT I,,1 � ;C q AAA,� as Owner/Authorized Agent of subject property T Hereby authorize _� Gyro to act on ti My behalf,i11 matters relative to work authorized by this building permit application./ Signature of Wier Date ' y SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I> as Owner( of subject proy Her y declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief I., A. ��_ �. Pr i Name—`— S ature of Owne e Date -. i1iR 11. m 117717 . NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 ST2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS f IE IGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL,OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE North Andover Building Department f 1 Tel: X78-6$8-9: DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permil 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) Sig ature of Permit Applicant /L 0Z, Da#e NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name: Location: Clty Phone r"7 am a homeowner performing all work myself. ►► 111 am a sole proprietor and have no one working in any capacity 0 I am an employer providing workers'compensation for my employees working on this job. Company n-me: Address C) 'k 0 C L?o ti S •71tO LL Li , 1-(,4 O Phone -cl ) 3 6-Z-2-6, Inautance /-fi4 2 r017-/J , li '�Co k/L-- K N /co Zr C-gM Mf name: Address Clio: Phone#. Inst Co. 1 t=aitvre to secure coverage as required under section 25A or MGL 1552 can teat to-dofmpcsillon of criminal pend tles.or a fine up to s1',sm oo and/or one years'imprisonment as well as civil penalties in the form of a STOP 1NORK Of IMJ and arm of(a10Roo)a day against understand that a copy of this statement may be forwarded to the Office of investigations of the DIA for coverage verification I do herby certify nder the pains and penahes of perjury that the Wotmalron provided above is bue and-cornett / Signature Date �l!c/ -OZ Print name. A. /kO IT L 7;^ Phone Official use only do not write in this area to be completed by city or town official' E] Building Dept E] heck if immediate mesponse is required Building Dept 0 Licensing Board Contact person: Phone#t p Selectman's office Ej Health Department 0 Ofher 7,14 WORKMAN'S N'S COMPENSATION r 10 Moulton Street Georgetown,MA 01833 (978)352-2641 CSL##079425 MORETTI & SONS April 17,2002 Proposal for Kitchen Renovation for Craig and Darcie Nuttall 222 Main Street,N. Andover,MA Scope of work: Labor and materials for all of the following,with installation and location to be similar to the plan referenced in our meeting on April 14. 1. Removal of all interior finishes including cabinets,flooring,wall covering,and ceiling covering in kitchen,half bath and rear hallway. 2. Installation of beam to accommodate structural loading of rooms above. Beam location to be determined. We assume that the beam will be LVL engineered lumber. A steel beam or alternate material may be an additional charge. 3. Removal or exterior siding,trim and windows as required to receive new windows. Reframing of new openings and reframing of existing wall with plywood to match existing sheathing size. 4. Installation of windows per manufacturer specification.' Residing of house with factory primed cedar clapboards. 5. Removal of rear roofing over bump out,and replacement with rubber membrane roof to accommodate future second floor deck. Framing in walls and ceiling of bump out to accommodate structural load of future deck 6. Installation of two arched openings per plan,with plaster trim as required. 7. Framing of new half bath in rear entryway,along with closing in existing doorway from kitchen to porch,and installing new rear door. 8. Insulation of all exterior walls and interior walls where appropriate for sound deadening. 9. Blueboard all interior walls and cover with skim coat plaster. 10. Paint all new plaster with primer and two coats of finish paint. 11. Install trim around new windows and doorways. Install baseboard around all wall areas? 12. Install new door for half bath 4 1 We assume that the interior trim for the window arches will be supplied with windows. 2 Door/hardware allowance$500 3 Baseboard material allowance$2.50 per lineal foot 4 Door/hardware allowance$175 It 10 Moulton Street Georgetown MA 01833 (978)352-2641 CSL#079425 MORETTI & SONS 13. Install factory pre-fmished hardwood flooring throughout kitchen,rear hall and half bath as required.s 14. All trim and doors that are not pre-finished to receive either primer coat and two finish coats of paint,or stain coat and two coats of interior polycryiic, as preferred by customer. 15. Installation of all cabinets and appliances per final plan. Note,we assume that the built-ins labeled on the plan are supplied by the cabinet maker,not site built. 16. Installation of crown moulding around entire kitchen and cabinets. 17. Removal of built-in cabinet in family room, with intent of reusing it in the future. 18. Electrical Work: -Upgrade of service panel to 200A -Wiring to code in kitchen and bath, including exhaust fan in bath -Installation of 12 recessed lights -Installation of under-cabinet lighting in kitchen -Installation of all wiring required for kitchen appliances 19. Building permit fee for carpentry and electrical. Plumbing permit not included. General Specifications: 1. All debris will be cleaned up daily and placed either in on site dumpster,or taken off site for proper disposal. 2. While we expect some unforeseen structural and plan issues,change orders will be requested for significant issues beyond our control. Change orders will be accepted be the customer before the work is undertaken, and will be billed at time plus materials. Licensed Lead Carpenter rate $65.00/hr Carpenter Helper rate $45.00/hr Laborer rate $28.00/hr Materials will be billed at cost. 5 Flooring material allowance$6.00 per square foot. w. 10 Moulton Street Georgetown MA 01833 (978)352-2641 CSL#079425 MORETTI & SONS Not Included: Due to the intricacy of the project,the following are best estimates for the sub contractor work required on this project. These are not quotations and are not included in our pricing,but instead are guidelines for planning purposes. 1. Heating system upgrade $8,000-12,000 2. Plumbing required for kitchen/half bath,and upstairs bath $6,500 Pricing *Note that pricing is good faith estimate,and will be adjusted when final plans are ready. Total price: $56,880 Payment schedule: (may change as job conditions impact work schedule, i.e. weather conditions, supplier delays, etc.) $4,000 Deposit at contract signing $10,000 At start $9,000 When exterior is ready for windows $7,000 When interior is ready for wiring and plumbing $8,000 After rough inspection of carpentry,plumbing, electrical $8,000 After plaster is completed $5,000 After flooring is installed $5,880 At completion John C. Moretti r 4 . Craig Nuttall Darcie Nuttall 05/13/2002 07: 14PM THE HARTFORD PACE 2 OF 3 THE ACORD CERTIFICATE OF LIABILITY INSURANCE May 13 2002 Producer THIS CERTIFICATE IS ISSUED AS A MATTER OF 210705 INFORMATION ONLY AND CONFERS NO RIGHTS UPON Paychex Irkicormn THE CERTIFICATE HOLDER THIS CERTIFICATE The Hartford DOES NOT.AMEND,EXTEND ORALTERTHE COVERAGE 308 Farmington Avenue AFFORDED BY THE POLICIES BELOW. Farmington,CT 06032-1913 Insured Insurers Affording Coverage JOHN C MORETTI Insurer A: TWIN CITY FIRE INS.CO. DBA:MORETTI&SONS Insurer B: 85 SPOFFORD ST Insurer C: GEORGETOWN,MA Insurer D: 01833 Fax:9783522641 Insurer E: THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD 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 CONDHIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. General[lability Insurer. Limits Commercial General Lability Each Ocauience: $ Claims Made: Fire Damage(any one fire): $ Occur: Med Expense(any one person): $ Policy Number: Personal&Alv Liability $ Policy Effective Date: Genera]Aggregate: $ Policy Expire Date: Products-Comp/Op Ag,g: $ Genual Aggregate Limit Applies Per: Policy: Project: LOC: Amiomnobile[lability Insurer. Limits Any Auto: Comb Singe Limit(ea accident): $ All Owned Antos: Bodily]njury(Pem person): $ Scheduled Antos: Bodily Injruy(Per Accident): $ Hired Antos: Property Damage(Per Accident): $ Non Owned Autos: Policy Numlber: Policy Effective Date: Policy Expiration Date. Garage Liability Insurer. limits Any Auto: Auto Only-EA.Accideri: Policy Number: Other Than Auto Only: PolicyEffective-Date; EA-Accidert: $ Policy Expiration Date: Aggregate: $ Excess Liability Insurer. Limits Occurrence: Each Owurnewe: $ Claim Made: Aggregate: $ Deductible: Retention: $ Policy Number: Policy Effective Date: Policy ExpirationDate: Workers Compensation Imvrer.A Limits &Employers Liability WC Statutory Limits: X Other: Policy Number: 76WE KN 1002 E.L Each Accidert: $100,000.00 Policy Effective Date: 02-APR-02 E.L Disease-EA Employee: $100,000.00 Policy Expiration Date: 02-APR-03 E.L.Disease-Policy Limit: $500,000.00 Description of operatioms/locations/velicles/excl stom addedbv endorsers/special provisions: JOB:CARPENTRY WORK LOC:222 MAIN ST.NORTH ANDOVER,MA Certificate Holder Cancellation ATTN:BUILDING INSPECTOR Should any of the above described policies be canceled before the THE CITY OF NORTH ANDOVER expiration date thereof,the issuing insurer will endeavor to mail 10 days TOWN HALL written notice to the certificate]older named to the left,but failure to do NORTH ANDOVER,MA 01860 so shall impose no obligation or liability of any 16M upon the usurer,its agent or representatives. Reference Nrmber.0435-02APR02 AUTHORIZED REPRESENTATIVE: Pingree Insurance Fax:978-352-8078 Jun 11 '02 12:20 P.01 AC' 6/11/02 PAovuc:e„ THIS CERTIFICATE IS ISSUED ASA MATTER OF INFORMA i'ION UNLY ANI) CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERT'IFICATIL i DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED fly 'IHE N. Pingree Ins. Agy Inc. POLICIES BELOW. _ _ r__^...____..•{ 24 East !fain Street t Georgewn, MA 01833 COMPANIES AFFORDING COVERAGE j COMPANYA Interstate Fire & Casulty LETTER j COMPANY B I LE'(TEP INgVRF,n j MOrrettl & Sons COMPANY LETTER C 10 Moulton Street __..,....------......_ ....._..... j Georgetown, MA 01833 COMPANY D LETTER ! COMPANY E 1 LETTER 14A' tI:I ;+ ('!' :t!'r1'INIiURANCE LISTED BELOW HAVE BEEN ISSUED TV'1'HE INSURF:n NAMFI?AIM" I nn a+.h P(:E,II4 !'I 1'11('" I`,A: dill>i I('.:.':t.t_(ItIIJV,'iNT. rERMORCONDITIONOFANYCONTRACTOfIOThIPRpOCUlo1EN; wiIIII4 'a"r;`.!'Tr.',;+Irrl;rla". C;-;i1d'I(,;A'f(' -v!A'Y Cllr, 185tJF'.I)("+" '•: PZ41 AIN. THE INSURANCE AFFOPOED BY THE POLICIES 17)FSCWIBEO HFiEif'IA; Ip. Sl!)?-fl r;i ;r+ n; !p14• (i idN."r. i t'x,;f uf;117P;c;ANn L:QNr,)ITInh: r;f tat!;ri f'I:)LIi;11zS. t.0 10111'Op INSURANf.F POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION I IMIT$ LIN DATE(MMIDDIYY) DATE IMM/DD/YY) OFNFNAL LIAnILITV 11110.1 Y IN,II IHY UIX; A ...._x I':-Irt1''•lµ'll�I::Iy I• I''OI Im flOWLY IN,!tIFIV nril ;:I o'MI:,I:,'I'F'I-I;nrlOnc; CLP6222973 4/18J02 4/18/03 VPR(1PF.RIY1.)AMAi:c at .. .. I 1'ViUrlt'I'e 0AMA14F O '1........ .. 111NI)111'+I'('i1fN1) ... 4., " X 1,'XI'I1:':!1'!';B I:O(LAr•,fi HAl/,y,;) 500-00 •III R PO COMBINrp A(-,n , 11 I:II(tlpgl',.�":I)td I'I.F.11:tt,i,.i:r '. C�,✓<r'O fOM61N,'I)('�Ci; ......, I —............._...--_..,......... 5D INUI PI.N:11 It I i,(,)N I I IA( I I1);' I P[Ii:ONAI,INJUtry AilG o .. s ... !I1H1,1AI I PI)Illd l"if 1FFhl'V G)AM/0(.,� Ye iTmage ...,'IO�,DOII AUTOMOBILC I,IAAII,IT'Y ..__ ..—._ 60DILV INJURY I I At1,A'111` Pllr 119rl:nnl AI ti'::•I:r A 1'0, BODIl IT1., IlY L., fl^IU i.,i' Ip•', dJGIr."I'll ' �. At I O'.Wil I.,A'JIOS! ' 1'fl(JV{111 Y 1.........ti Ni'•.ti l' ;IMIan I BIWILY 11JAP1Y 6 P140PIERI'V pAMA61: :u COMIII('1k:0 I fIKC.G.SSLiA0ILIyr ArGIQF'11A1F 5 Il I I A r'AN:I!:AUIIELLA jj tiro 11,17 i>I'r, I IR(I:;: WUNXIiu'S CIIMVtNyA I IUN _. -1 _._.... j ._......._ . EACH ACr;I(1EN1 ANrI __.—,..._.---....._-. . .. .. - 01:EAST MA I(;' 111,1'I EMPLOVFIISLIABILITY •'------ , ULS F:AtiF--tnf;H FMHI:OV I'1' ,. D1;St,IOL't'IO H U, VaC(IA-(IONS,I,Qr'.AI If NSI ve HICLGS;SPE:CIAL ITEMS ' ! - • r • i Town of North Andover SHOULD ANY OF THE ABOVE DEr'.CNIBED North Andover, MA 01845 EXPIRATIONDATETHEREOF'. .1HE ISSUIN(} COMPAN` MAIL 1BAY5 WRITTEN NOTICE ATT: Building Dept. LEFT. BUT FAILURE TO MAIL SUCH NOTI(:F CSHAII Inn POS;! Ni? LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGI NI};(,:I,I•tlifl'FU';';t'JSA'I!•; AUTHORS PEPR NTATIv6 J 0" . 0 :. over 0 No. .............. 1,4100 C" LA O dover, Mass., b COCHIC HE WICK \- 0"�ATED C BOARD OF HEALTH Food/Kitchen PERMIT T Septic System BUILDING INSPECTOR tv 401 THIS CERTIFIES THAT......CP.......& ............................................. Foundation ..... .. ..... ...... ..... AI IV f . . . . . ... .... ....... has permission to erect.... on........ ...................... Rough 'K ......... A. Chimney . .44 ......., to be Occupied as......K. ....... ..................... ...................................... . ......................................... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Uws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 4DI PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations ions1jV1oid1s Is Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR tURough ...............IA-- Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Location No. Date �aRTM TOWN OF NORTH ANDOVER p Certificate of Occupancy $ Building/Frame Permit Fee $ ��b'••"''<� Foundation Permit Fee $ s1�C MUSE Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector Div. Public Works P c Location VVn CA ✓ No. Date HpRTh TOWN OF NORTH ANDOVER 3? •. 0 9 Certificate of Occupancy $ Building/Frame Permit Fee $ C� �'�b'•••°•'stn Foundation Permit Fee $ 'S CMUSt Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector ( � �30/98 10:21 25.00 PAID Div. Public Works 1)I:RMIT NO. (j�5 APPLICATION FOR PERMIT TO BUILD**"""NORT11 ANDOVIIR, MA AI(P NO• LDT.N(1• 2. REC(1RP OF O\1'NLItS111P DATE BOOK PAGE Vit,L SIIBBIC. torNo. I)( AIIUN PURPOSE(9:M III III NG OWNER'S tJM = NO.OfSI(AtIL'S <7 SIZE ()WNER'S ADDRE BASEMENT 02 SI.AB AR(I II 1 ECI'S NAME SIZE(1F FLOOR I IMBERS I 2 HD 3 RD 111111 DER'S N.AJ IE 1 5P.AN �1L DISI ANCE 10 NEAREST BUILDING DIMENSIONS OF SILLS III SIANCEIROM STREET DINIUNSIONS OF POS IS DIS I ANCE FRONT LOT LINES-SIDES REAR DIMENSIONS OF GIRDERS ARTA(FI.Ur FRONAGE IIEIGIfr(1 FOONI)AIION THICKNESS IS BUILDING NEW SIZE OF I(X)I INC, X IS BUILDING ADDI TION MA TERIAI.OF C111 r.INE Y IS BUILDING ALTERATION IS BUILDING ON S01.I1)(12 FII LED LAND %111 I.BUILDING CONFORM TO REQI IIREMEN IS OF CODE IS BUILDING C(NJNECI ED l O 1 OWN WAI ER BOARD OF APPEALS ACTION, IF ANY IS B1111.DING C(NJNECI ED 10 1 OWN SEWER IS BUII.DING CO NNEC I ED 1'0 NAI URAL GAS LINE INS I11('I'IONS 3. PROVE 11I1' INFORMAI ION LAND COSI ESI. BI IX;.COST PAGE I FII.I.mrSEmi NJS 1-3 ESI. BI IXi. Co stPLRSQ. Fl. ESI BI[Xi. Cost PLR R(X)fl EI.ECfRICKIETERSMUST BECNJOUTSIDE O BIM DING SEI'lICPERAIIINO. AFIACIIED(;ARAGESMI)STC(NJFMNIIOSIATEFIRE REG111.A'll(NJS a. APPROVED BY: PLANS MUST BE FILED ANI)APPROVED BY BIIII.DING INSPECr(ki 1111 .DING INSPE(I-011 DAIEr11'ill . _// 4 5Z7 1 — y – �Ul�– 79l/� V OWNERS llil b ,. t r C(NJ1R.lEI.N Al u _ 1998 SI(;NA Il (1 IRI: 'OWNER OR Alll 1 N 1121 Z1.)AGGNr (TN'fIR.I.IcH i ILLC.N 11:1: Ill RKII I CRANI EI) (/ O 19 X. Z. Boylan Masonry Proposal. J0..0. Sox 335 Salem , ..� Yz 03o,7 �3. 1800-8.¢I-8807 over 35 Years Experience _._. .. RQPOSAL SUBMITTED TO PHUIYE DATE: Dave Rutter 978/689-8072 /978/262-8770 July 30, 1998 ......,.... PHOT 222 Main St. QITY,STATE ANDZIP::CQDI'r ,! JOB:I.QOATION No.Andover, MA 01845. Same i CHITECT DATI<;O PLANS JOB PHONE' a ..i We hereby submit specifications and estimate for: f� Concrete Step Material and Labor: $ 1,200.00 Concrete Walk Material and Labor: $ 960.00 Customer is responsible for securing all permits prior to start of work PLEASE MAKE CHECKS PAYABLE To KENNETHL. BOYLAN [r; e ro o8Q hereb to fillnlsh triatertal and Iataor fete to P accordance With above s*if cations,for the sum of P . . .... ................ TWO THOUSAND ONE HUNDRED SIXTY DOLLARS dollars ($) 2,160.00 Payments to be made as follows: Payment to be arran ed ALL MATERIAL IS GUARANTEED TO BE As sPECIFim ALL WORK IS TO BE COMPLETED IN A WORKMANLIKE Authorized i MANNER ACCORDING TO STANDARD PRACTICES.ANY ALTERATION OR DEVIATION PROM ABOVE SPECIFICATIONS SFgoature i INVOLVING EXTRA COSTS WILL BE EXECUTED ONLY UPON WRITTEN ORDERS AND WILL BECOME AN Sl EXTRA CHARGE OVER AND BEYOND THE ESTIMATE. Note this proposal may be withdrawn by us if not accepted within days `Acceptance of 'Propoeal-the above price specifications and conditions are satisfactory and hereby accepted. You are authorized Signature to do work as specified. payment will be made as outlined above. Signature Date of Acceptance: �.►ORTjy Town of over L �. l No. * _ i . A dover, Mass., 19 9 LAKE COCHICHEWICK i�',•t�w '9 OW -r-Eo S E BOARD OF HEALTH Food/Kitchen PE.R T T Septic System IM IA so BUILDING INSPECTOR THIS CERTIFIES THAT.... .......• .. .......... .......... ...................................................... �� Foundation has permission to erect. ....�iNiings on .........j.J1.1..... .... .*.&........ '�' Rough to be occupied as........................................ �� t......��r�. ...... ... .. Chimney provided that the person accepting this permit shall in every restct conform to the terms oft application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INS CTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECT :7PER UNLESS CONSTRUCTION ST LRTS Rough ........................... Service.... .. . .. . ...B6 ING INSPECTORFinal -- - Occupancy Permit Required to Occupy Building GAS INPE TOR Display Conspicuous Place on the Premises — Do Not Remove Rough P Y in a Final No Lathing or Dry Wall To Be Done FIRE DEPAR ENT Until Inspected and Approved by the Building Inspector. Burner # Street No. `"�' Smoke Det Date. 1l. . . . . . . . . . . . L + TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACMUSE� This certifies that . . . . . . . . . i has permission to perform . . . . . . . . . . plumb; in the buildings of . .. .... . . . . . . . . . . . . . . . at.,. . . . . . . . . . . . . . . .. North Andover, Mass. Fee-9 . .Lic. No.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . D /1-/ PLUMBING INSPECTOR *Check # 6141 d `! •MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING ,i (Print or Type) z Mass. Date Iff d .Permit # 7(f/ f s Building Location--=,Q /9,11 n Owner's Name��c� ,I —�� Type of Occupancy Residential New ❑ Renovation ❑ Replacement 09 Plans Submitted: Yes❑ No ❑ FIXTURES 1 = to f to to to O Z h w b ♦- N J Z _ W W Y J N > V Q to _0 r :n Z to Q ¢ ¢ _ ~cc w Z G 2 H a O to W N (A 3: ~ Qcc W N = 0. O Q a C � i W L'L CC O ~ W Q to a Q J N a J z a = a LL . W = Q Y O Y S Y 0. O. !- Q Y .( W LL F V S a. f. to Z Y o Q p" Q Q S N to Q Q O Q OJ OJ 4 cc tr a Q O Q 3 Y J m N O a J 3 * 1- y LL O a O 4 ¢ W 3 3 RI SUB—BSMT. BASEMENT - IST FLOOR ASEMENT `iSTFLOOR 2ND FLOOR SRDFLOOR ' 4TH FLOOR STH FLOOR 6TH FLOOR ' 7TH FLOOR 8TH FLOOR Installing Company Name Heritage Htg. &Pig. Co. Inc.' Check one: Certificate Address 35 Pleasant Street IX Corporation 714 Stoneham; Ma 02180 ❑ Partnership Business Telephone 781 —43 8-77 76 (1 Firm/Co. ° Name of Licensed Plumber Gordon Switzer INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of Ch. 142. Yes ® No ❑ If you have checkedyes, please indicate the type coverage by checking the appropriate box. A liability insurance,policy Other type of Indemnity ❑ Bond ❑ , OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner ❑ Agent❑ Signature of Owner or Owner's 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 installations performed under the permit issued for this application will be in compliance with all . pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By, c/ 1 /? D i Title Sin re o cense Plumber Type of License:Master[g .Journeyman❑ City/Town 8322 4 APPRONED I S N License Number i ti BELOW FOR OFFICE USE ONLY FINAL INSPECTIONS SKETCHES _ _ PROGRESS INSPECTIONS FEE - NO. APPLICATION FOR PERMIT TO DO PLUMBING NAME&TYPE OF BUILDING LOCATION OF BUILDING M PLUMBER PERMIT GRANTED DATE 19 PLUMBING INSPECTOR .f M Location No. Date No�TM TOWN OF NORTH ANDOVER 3? ° • OL h 9 tea, _ • . Certificate of Occupancy $ Building/Frame Permit Fee $ sACHUs Foundation Permit Fee $ Other Permit Fee $ TOTAL $ eOV Check # /IP R 8 v 7 �'` Building Inspector,` TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING .O BUILDING PERMIT NUMBER Q`/�-- DATE ISSUED: � `7V I r SIGNATURE: -�- BugiM Colnlnisstoner of Buildin Date —23 Z SECTION 1-SITE INFORMATION o 1.1 Property Address: 1.2 As emors Map and Pared Number: � Map Number ParcelA'umber tSo�M A1.to,�.e. MA 1.3 Zoning hdermation: 1.4 Property Dim=iaos: Zonm Di3+id Proposed Use Let Area EMKIM ft I.6 WELDING SETBACKS ft Front Yard Side Yard Rear Yard Reqlaired Provide Required Provided ReqWred Provided 0 1.7 Water sopplyM.GJ.a+o. ser) M Frond Zone lntormni 1.e Sewerage DaPo,d Synem: Public 0 Primate 0 zMe onside Flood Zane 0 MMkW 0 on Site DhPad system (3 SECTION 2-PROPERTY OWNERSHiP1AUTIIORIZED AGENT Tn 2.1 Owner of Record Ce* 4 -I)AeuE 1407- aero M�tJ S ET N. �� ams(Print) Address far Service: i taro Telephone 2.2 Owner of Record: � Q Name Print Address for Service: z M a S' tune Tel e SECTION 3-CONSTRUCTION SERMCES 3.1 Licensed Construction Supervisor: Not Applicable 0 "10,A�s C. N109-ET-'1 p-+14aS p Licensed Construction Supervisor License Number „n Add ,—,t $ 20o b f 14 A 078)3Sz'5" Expiration Dite igns Telephone rw rw r� 3.2 Registered Home Improvement Contractor Not Applicable 0 Q Maes T� tau e, I oBSos Company Name M Registration Number Ir i MWW MA 00n r AddressF G) t re V ate SECTION 4-WORKERS COMPENSATION(M.G.L C 152 §2546) 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 build' it. Si ed affidavit Attached Yes.......V No.......0 SECTION 5 Descrizitlown of Proposed Workefxckk sa ble New Construction ❑ Existing Building 0 Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. 0 Demolition 0 Other 0 Specify Brief Description of Proposed Work R�t•v�' csT��c� Ziyy OT\trizjoJ -%Wrt: F66TKk SECTION 6-ESTIMATED CONSTRUCTION COSTS . Item Estimated Cost(Dollar)to be * <::r OFFICIAL:US14,NLY ` t ' - z 9 �': y_ Completed by applicant 1. Building (a) Building Permit Fee !;-Do O Mut' tier 2 Electrical 3 0 DD (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)x(b) 4 Mechanical AC 'Ord 5 Fire Protection 0 6 Total 1+2+3+4+5 / 1hio °~ Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, T CK 1�� V Q,rt I'L k AI � as Owmer/Authorized Agent of subject property Hereby authorize J MAA C Nk&�ET:\ to act on My behalf,'r all matters relative to :authorized by this building permit application. .-. � ? 1l2-/0< Si -ture of-Owner Date SECTION 7b OWNERIAUTHORIZED AGENT DECLARATION 1, �� 'k 10 o,4q AJ�j (Eas 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 Print Si lure of Owner/ARent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TRv1BERS Is[ 2Nu 3 RD SPAN DIMENSIONS OF•SHIS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHRANEY IS BUILDING ON SOI.IN OR FELLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE F NORTH TO" Of Andover 0 ......w No. qLdA/_!Aj� LA - over, Mass., COCKICMEWICK oRATED v ` BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THISCERTIFIES THAT......... ............................................................................. Foundation has permission to erect... ...................... ........... buildings on................................... •.. ............ ...................... Rough to be occupied a ............. .... . ... ... Chimney ..... ... ......................... .... ... . ............... . .......................... provided that the person accepting this permit shall In every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town,of North Andover. PLUMBING I&SPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION ST S ELECTRICAL INSPECTOR Rough ...... ........... ......... ....... Service BUILDING INSPECTOR Final Occupancy Permit Required to OccuPy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number:CS 079425 Birthdate: 08108/1971 Eiipires: 08108/2006 Tr.no: 1323:0 Restricted: 00 JOHN C MORETTI 4 CHANDLER RD BOXFORD, MA 01921 i Commissioner ' 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) S nature of Pe*#Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector i The Commonwealth of Massachusetts r ' Department of Industrial Accidents Office of Investigations M f4 600 Washington Street � ii�7u i ♦ ♦i mi i Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): Df-E poi SotJ S Address: A 'V-'0N't> City/State/Zip: ky,, b MA Phone#: Are you an employer?Check the appropriate box: Type of project(required): L,bj�1 am a employer with 4 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet. # Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.0 Roof repairs insurance required.]t employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information- Insurance N Insurance Company Name: wv�oin�, �os,)PA+ Policy#or Self-ins.Lic.#: UO of Expiration Date: 4 2.00(0 Job Site Address: 222 Mta S-i N. PCt 1l,NEA VA City/State/Zip: 0184S- Attach 18ySAttach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 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 violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certify der the p and p naldes of perjury that the information provided above is true and correct Signature: Date: Ztb S Phone#• 1-7 a 3S2` 50 6� Official use only. Do not write in this area,to be completed by city or town official, City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: ACORD. CERTIFICATE OF LIABILITY INSURANCE R076 04-11A72005 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION PRODUCER ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE PAyCHEX AGENCY, INC HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 210705 P: (877)287-1312 F: (877) 287-1315 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 3 08 FARMINGTON AVE INSURERS AFFORDING COVERAGE FARMINGTON CT 06032 ,NS(,RE„A:The Hartford Ins Grou INSURED INSURER B: MORRETTI & SONS INSURER C. INSURER D: 4 CHANDLER RD. ,NsuRERE: BOXFORD MA 01921 THSTANDING COVERAGES THE POLICY PERIOD THE ANY ROUIREMENTSTERM ORLCONDITION O ANY CONTRACT OR OTHER DOCUMENT WITH REESPECD TO THE INSURED NAMED ABOVE OTRTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES pESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CL IIMS.E cTLVE POUCVEMMATM Lwms Policy NUMBER DA V M TYPE OF INSURANCE EACH OCCURRENCE S GENERAL UARRITV FIRE DAMAGE(Any one fire) S COMMERCIAL GENERAL LIABILITY MED EXP(Arry one person) S CLAIMS MADE ❑OCCUR PERSONAL b ADV INJURY S GENERAL AGGREGATE S PRODUCTS-COMPIOP AGG S GEN'L AGGREGATE LIMIT APPLIES PER: PRO LOC POLICY COMBINED SINGLE LIMIT S AUTOMOWLE IIAORfTV (Ea accident) ANY AUTO BODILY INJURY $ ALL OWNED AUTOS (PEI person) SCHEDULED AUTOS BODILY INJURY S HIRED AUTOS (per acciden() NON-OWNED AUTOS PROPERTY DAMAGE S (Per accident) AUTO ONLY-EA ACCIDENT S GARAGE U4801fry EA ACC 5 OTHER THAN ANY AUTO AUTO ONLY: AGG S EACH OCCURRENCE S EXCESS UARILffy AGGREGATE S OCCUR CLAIMS MADE S S DEDUCTIBLE S RETENTIONS X WC STATU- OTW R IT WORXERS COMENS477ONAM A EMPLOYERS,IWRRlry 76 WEG KN 10 0 2 04/02/05 0 4/0 2/0 6 E.L.EACH ACCIDENT $100,000 E 1.DISEASE-EA EMPLOYEE $100-000 E.L.DISEASE-POLICY UMI T 5 5 0 0 O O O OTHER DESCRIPTION OE OPERATR)NS/LOCATIONSNEMCLESrEXU(MONS ADDED RVEWORSEMENrfSPECIA1 PROVISIONS Those usual to the Insured's Operations. CERTIFICATE HOLDER AMTM"1N5UREO:0SURERLET7ER- CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE BUILDING INSPECTOR EXPIRATION DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL TOWN OF BOXFORD 30 DAYS WRITTEN NOTICE 410 DAYS FOR NON-PAYMENT)TO THE CERTIFICATE HOLDER NAMED TO THE LEFT.BUT FAILURE TO DO SO SHALL IMPOSE NO ATTN: PAULA OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER.ITS AGENTS OR 7A SPOFFORD RD REPRESENTATIVES. BOXSFORD, MA 01921 AUr,Iomw REPRESENrA O ACORD CORPORATION 1988 ACORD 25-S(7197) -352-8078 Ma 5 '05 11:12 Pingree Insurance _ Fax:978 _ _ _ I ISSUE DATE: '.: s:,"• "PRODUCER: �I `SFSE ;"4Y IF+►xE ;!rc�.,., I THIS �`7TIFlw% ._`_i;Fl a! A aPI — )� ;rvcC'YR?IC;v ONL' -ti •;� >ERT:F:CASE HL?LJca.. TF:I$ CERT.,:CP -- I CONFERS 4U ila!- ON TN.E I DOES too AHEM, E.K.—PiD JT . •. !PROKUR NURSER I I POLICIES BEL.:;+. _ _ ------------ --------- C --- -----'---------_ ....__... ' ! CONPANIE5 AFFORDING COVERA6E INSURED: I COMPANY LETTER A - i I COMM LETTER 8 - = ::1aiuLE!l f`aNa COMPANY LETTER C :T.R fi i•'?= I COMPANY LETTER D . ! ! ICOMPRNY LETTER E : COVBRR6�5 ::. 7F .):7L' rfi LISTED BELOW BEEN ISSUED TE. '?'e T uAI�VE :I_.. I5 .D LZNIT Y TMA;? -•.FE t HAVE _ •.._::: : : .-:: :': CORDIf(LIN OF ANY G+;TRACT OR I?:'! =':__ �• _.. _ ! :!it):E:+�T`::, tti'1'II_'••`•S7ANii '.: �`?Y iiE�.l,•.•t'!i: :� - o!j ,� -- --- I cy _�R* _ :hSS-jpm&E PFFOADED B; THE POLICIES DE:C�:aci1 .BREI:i .� S.;Bj. ISSUED OR 1. :.- •N-'•� '. r; _ T1;;!v5 l'F 5krti 1;OLi � LIMITS £FKIWN !SAY HME BEEN REDUCED k" G+T:D :CO TYPE OF INSURANCE ;POLICY—mm (POLICY (POLICY ALL LIMITS IN THOUSANDS LTR IEFFECTIVE DATE:EXPIRATION DATE! I (GENERAL LIABILITY . !: •'_!�+E9 ►AL S hiERHL iNB�I',7' MfM.4�-489 1 4iI81@5 1 4/IAiNtS IPPQDI)CES-I.OI (OPS AGGREGATE : ,,diaa CL?.IMG MADE ' LINEg.1 6 CUIsIRPCTOR'ti -3C'. t ) 1 :EAI'=H E'CLIRREMt.E !F1;E' UAMr :Any onq fl--�; !l1EDICAL EX E��E (yey ons pe--s.-,R) i 5 --- -^- -----t----------------t- .------�-- -- - 'AUTOMOBILE LIABILITY I RV1 RLI:7 i I AGI'MRINEC SINGE '-!MIT i ! _ QOLY , ALL USO RU105 I i 1 11' : y.IUEY (per t•e!•;nri) � I I I I 1 ;BODILY INJURY (Per kewent) s SCHEDULED AUTOS ! f _u1k-�itVEli A111S I I 1 t GARAGE LIABILITY I I 1 Lu 1LY I1iI�RY f. P-OPERTY DAMAGE COmBINED $EXCESS LIABILITY =!roBRELLA FORM t EACH O CURRENLI 3 i t G;NER THAN UMBRELLA FOR-M. ! f------------------------ ---------- i WORKER'S COMPENSATION ! STATUTORY I I AND I 1 I s :EtyG�t aCCii�`;T% . ! I EMPLOYERS' LIABILITY LAL" E�F:YEL) I I t !OTHER ! I ! I 1 I I ' _--,....-----------------•'----------- ----------- ",-�_----__-_- DESCRIPTIONS OF OPERATIONS/LOCATIONS/VEHICLES/RESTRICTIONS/SPECIAL ITEMS ------------------------------------------------- _ -_....-------i :CERTWICATE HOLDER: ;CNCEUATION; SIIOIILD ANY OF THE ABOVE DESCRIBED POLICIES BE CRNCE-LED BEFORE THE ' '. OF BOXFORJ i EXPIRATION DATE THERE OF, THE ISMING COMPIMY WILL ENDEAVOR 'O MAIL Ie DAYS I WRITTEN NOTICE TO THE CERTIFICATE' n1LDER NrrMEL' TO THE L_F1, blit SIKH NOTICE SHALL IMPOSE NO OALIGATIM GR LIABILITY OF ANY KIIIC U�Ut: COtpPAXV ITS AGENTS OR REPRESENTATIVES. IAUTHORIIED REPRESENTATTIVE _ r 4 Chandler Road, Boxford,MA 01921 HIC# 108505 CSL#008147 SONS JOHN C.MORETTI RESIDENTIAL BUILDERS (978)352-5465 office EST. 1970 PROPOSAL Darcie and Craig Nuttall July 7, 2005 222 Main Street North Andover, MA 01845 Moretti and Sons Builders,herein after referred to as contractor, is pleased to present the following proposal for completion of your bathroom renovation. General Construction Notes: 1. Construction will follow all notes and specifications per the concept plan attached to this proposal and labeled"Nuttall Residence,Second Floor Bath Renovation". 2. Pricing is for all labor and materials to complete the specified tasks, and includes removal and proper disposal of all debris. The site will be vacuumed daily, and reasonable efforts will be made to consolidate building materials and equipment so as not to interfere with access to the home during non-working hours. 3. All subcontractors hired by the contractor will be registered and insured. Inquiries concerning any contractor can be directed to: Director, Home Improvement Contractor Registration One Ashburton Place Room 1301,Boston MA 02108 Tel: (617) 727-8598; 4. Owner understands and agrees that all communications concerning the job status, job changes,pricing,or any other job issues outlined in this contract will only be between the owner and Moretti and Sons principals or the designated Lead Carpenter assigned to the project. Contractor will not be held liable for any discussions or agreements made between owner and any other parties including contractor hired sub or specialty contractors, suppliers, or employees other than the Lead Carpenter assigned to the project. 5. Contractor is solely responsible for securing all labor,materials, subcontractor work and other related items included in the contract,and for scheduling, construction techniques and procedures, and the coordination of all trades and sequences hereunder. Owner, owner's agents or any other parties are prohibited from directing, or attempting to direct in any way, the progress of the work. They are also prohibited from securing labor,materials, subcontractors or other items that 1/4/ 4 Chandler Road,Boxford,MA 01921 HIC# 108505 CSL#008147 SON) JOHN C. MORETTI Rrc;1DE\H 1 BUILDERS (978)352-5465 office EST. 1970. substitute or supplant those included herein unless specifically authorized in writing by contractor. Construction Details: 1. The existing second floor bath will be demolished down to the framing including removal of the sub floor. A new 3/4"Advantech*sub floor will be installed,with additional framing as required to accommodate the new plumbing fixtures, wiring, and closet area. Replacement offailed framing members may constitute a change order. 2. All plumbing pipes and lines will be replaced with new and reworked to mate to the existing drain system. A new vent will be installed as required. The existing in-wall steam heater will remain. 3. The electrical wiring will be replaced with new, and fed with a new 20amp circuit from the main electrical panel. Currently 2 circuits in the panel remain available and we assume one of these can be used. Four recessed lights will be installed in the bath,with one in the shower area. An exhaust fan will be installed, as well as two sconces in the vanity area. The closet will not receive a separate light. 4. Blue board and smooth skim coat plaster will be installed on all walls(except tiled walls) and on the ceiling. The closet will have a sponge finish plaster. All plaster will be painted with primer,then the ceiling of the bath and the entire closet will be painted with white ceiling paint. The walls and trim in the bath will be painted per owner's choice,with two coats of pearl finish or bathroom paint. Only Benjamin Moore or California products will be used. The window sash and inside of the bathroom door will be primed and painted with two coats of trim color. The closet door will be pre-primed MDF,and will be painted with two coats of trim color. 5. Unless otherwise directed by the owner,the closet will contain five white melamine shelves located at 20", 36", 48", 60", and 72" heights. The bottom three shelves will be 16"deep,and the top two shelves will be 12"deep. i 6. The vanity and toilet will be removed during demolition and discarded. Every effort will be made to keep the shower installed and ready for use at the end of each work day,but this cannot be guaranteed until the rough plumbing has been replaced. Allowances: Our pricing includes the following allowances. Any deviation from the following will result in a credit or debit to the client's account, as appropriate. Please note that these allotments are for the materials or products only except where indicated. Labor to install 2/4 4 Chandler Road,Boxford,MA 01921 HIC# 108505 CSL#008147 1;T7 JOHN C. MORETTI i2t's�nrti'rte� Bt ai I): !tti (978)352-5465 office EST. 1970 is included separately in our price. These allotments are meant to be used as a guide in planning for budget needs. 1. Plumbing fixtures and accessories including sink,toilet, vanity, vanity top, shower valve, shower doors,tub, vanity faucet, soap dish, paper holder, towel bars, and mirror. $1,850.00 2. Tile for flooring and shower walls (including labor) $1,350.00 Exclusions from our proposal:(items NOT included in our price): 1. Building permit fees for building,wiring, and plumbing. 2. Work associated with prepping the 3rd floor for living space, i.e. plumbing, electrical, heat, etc. Change order policy: Without invalidating this agreement, owner may order extra work or change the existing contract by the use of a change order. A change may consist of additions, deletions, or modifications to the original contract work, with the contract sum and contract time being adjusted accordingly. Any change orders will be agreed to in writing prior to billing or crediting. Execution of any change order requires only one signature from each respective party. Verbal authorization will be accepted when time is of the essence, but will require signatures from both parties prior to billing. Execution of change orders is billed at an hourly rate of$60 per man hour for carpenters, with materials billed at cost plus 20%. Subcontractors change orders are billed at cost plus 20%. Owner understands a design/estimating and coordination fee of$60 dollars per hour will be incurred on the design, drafting and pricing of the change or additional work, whether the change is elected or not by the owner. Payment for change orders, where applicable, is due in full at the next progress payment. Schedule and Duration: Demolition can commence as soon as a building permit is issued, and coordination with ~ 4 Chandler Road, Boxford, MA 01921 HIC# 108505 • CSL#008147 JOHN C. MORETTI RF-Sf1 Vr1-%l,Bc'ir_nF!,'. (978)352-5465 office. EST.1970 subcontractors and owners schedules occurs. The anticipated duration of this project is 3 weeks of construction time. We request that the home be available to us Monday through Friday from lam to 4pm. Warranty: All workmanship is guaranteed for a minimum of one year from the time the Iinal payment is invoiced. Price and Payment Schedule: Total Price: $21,000 (twenty one thousand dollars) Deposit with contract signing $2,000 At start of demolition $6,000 After insulation inspection $8,000 At completion $5,000 Owner has read, understands, and agrees with the total payment schedule shown in this agreement. Owner will pay contractor the initial deposit, progress payments, and the final payment as per this agreement and without retention. Final payment of the entire contract price is due on the day of substantial completion of the work. If net amount due on progress payment is not paid within five business days,contractor reserves the right to stop work until the progress payment has been made, increased by a reasonable sum for the costs of shutdown,delays incurred,and startup. Right of Recission: Note: Massachusetts taw requires us to inform you that you may terminate any contract with us within 3 days of signing,and have all deposits returned to you. Please sign below for acceptance of proposal: Darc Nuttall (Owner) ;� Jo�C. Moretti\(Contractor) Craig" Nuttall (Owner) 4/ �� Add linen closet, and change to single vanity (5' length.) NOTES: V2 0 �5 1. Demo existing structure to framing. Ct) 5'-O01" 2. Install new plumbing and subfloor. 1 z'-o" 3. Install dedicated 20amp circuit for bath. `n 4. Install new Panasonic or Nutone fan and vent to outside, - x4 recessed lights including one in shower, and two wall N x O sconces for vanity area. - 5. Install new Americast tub and prep walls for wall tile. ro. Blue board and plaster walls and ceiling, with primer and two coats of latex finish, o 1, Tile floor and walls of shower, install sliding glass doors. Wood trim on window and doors to be painted, with profile to match existing. 1 114 = 1 FT NUTTAL RESIDENCE SECOND FLOOR 5ATH RENOVATION QQ Date.L!....cq..-"�/..... HORTM "° TOWN OF NORTH ANDOVER ' PERMIT FOR WIRING ,SSACMUS� This certifies that .. -:5- �e .......:. ,- ............................... _ has permission to per ... .............................. .a wiringin the building of................................................................................... •' at........a................................................:.................. .North Andover,Mass. Fee'....!.............. Lic.No./ .9 .�... ...y........................`. .....,.....I.... ........ ELECTRICAL INSPECTOR Q 716— Check # Commonwealth of Massachusetts Official Use Only i Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/991 (leave blank) At APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 J� (PLEASE PRINT IN INK OR TYPE ALL INF0 TION) Date: C:)d',- Qs City or Town of: �I i/e r To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) p'� _. f A& j Owner or Tenant CkA14 IfI d?T Telephone No. Owner's Address 0 g,:;, V,< Is this permit in conjunction wit�biilding permit? . Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building S utility Authorization No. Existing Service_"Amps /v� Volts Overhead� L'ndgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity 6'L� Location and Nature of Proposed Electrical Work: ,d, 1 �l Completion of the follotivin,table may be waived b_v the InsDecror o(TFiren No.of Recessed Fixtures No.of CeiL-Sus No.of Total p (Paddle)Fans Transformers KVA No.of Lighting Outlets INo.of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool Above ❑ ln- ❑ t o.o Emergency Lighting grnd. grnd. Battery Units No. of Receptacle Outlets f INo.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No.of Switches ,No.of Gas Burners Initiating Devices No.of RangesNo.of Air Cond. Tons l lNo.of Alerting Devices No.of Waste Disposers (Heat Pump \umber Tons KW' lNo.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ r�lunicipal ❑ Other Connection No.of Dryers (Heating Appliances KW Security Systems: No.of Devices or Equivalent No.of Waterh`�. No.of No.of Data Wiring: Heaters Signs Ballasts I No.of Devices or E uivalent No. Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wirins: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the htspecror of jVirer. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unies_ 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: 1NSURANCEX BOND ❑ OTHER ❑ (Specify:) Estimated Value oofElectrical lWWork: (When required by municipal policy.) (Expiration Date) Work to Start: K 1p?— aJ Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify,under the plains and penalties of perjury,that the information on this application is true and complete- FIRM omplete FIRM NAME: Ult/q e R L J e C-TR i C o e,,o LIC.NO.: Licensee: M/JR k j�A/a.0 Signature adt Aon LIC.NO.: (If applicable.enter"ecem t"in t7re license number linea Bus.Tel. No.: `/79 3.r-1 J—.q F 3 Address: �.� Alt.Tel.No.:57'9-3 a e r7 OWNER'S----RNC WAIVER: I am a are 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. PERA1IT FEE. S - tr'�