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Miscellaneous - 223 CHESTNUT STREET 4/30/2018
X223 CHESTNUT STREET 21010600000.0 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance-with the provisions of M.G.L.c.143,§3L,the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.01 c. 166,§32,an electrical permit shall be issued to the person,firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall-be limited as to the time ofongoing construction activity,and maybe_deemed_by.the.Inspector_ofWires abandoned_and_invalidsf lie—.. ._ or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or-the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008 and extending through August 15,2012. v Mule 8—Permit/Date Closed: Z., ***Note:Reapply for new permi�'� 0 Permit Extension Act—Permit/Date Closed: L4-- ' 3 - Date................................ NORTH TOWN OF NORTH ANDOVER p PERMIT FOR WIRING b ,r.o ,SSAC14US� �CR/51rnov This certifies that f `-&t T . ............................Q................. has permission to perform ............... DDr wiringin the building of................................................................................... �LL — 5,7- at........................... ''7 ?7`/1/l.J. S orth Andover,Mass. r_.' :�i RFee.... .�J........ ic.No.6.z.7!k ............... � �. u ELECTRICAL INSPECTOR � -'Check # .10772 07l2 _ Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. /0772- Occupancy 0772-.Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (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 IN INK OR TYPE ALL INFORMATION) Date: City or Town of. NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) A' Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction vyi,tb a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building_ Utility Authorization No. Existing Service Amps Zo/ 2 &Volts Overhead ❑ Undgrd [El"' No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity a Location and Nature of Proposed Electrical Work: Completion o the ollowin table ma be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above E] In- ❑ o.o Emergency Lighting rnd. rnd. Batter Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches l( No.of Gas Burners No.of Detection and Initiatin Devices No.of Ranges No.of Air Cond. Total Tons g No.of Alerting Devices No.of Waste Disposers Heat Pump Number TonsNo.ofSelf-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other 1 Connection No.of Dryers Heating Appliances KW Security ystems: No.of Devices or Equivalent No.o Water No.of No.of Heaters KW Ballasts Data Wiring: / Signs No.of Devices or E uivalent " No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications irmg• No.of Devices or Equivalent (Q OTHER: ;2 AJ,e6 j Attach additional detail if desired, or as req;ir-edig the Insldctor of Wires. Estimated Value of Electri al Work: (When required by municipal policy.) Work to Start: Z Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO GE: 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:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: ow EC zr:nL J LIC.NO.: 6s22 IVAO Licensee: D4VP ",4q)=J-Gyl Signatur LIC.NO.: (If applicable, enter " empt"in the license number line Bus.Tel.No.: — 6 7 Address: /V14 (13/0 t, Alt.Tel.No.: LQ3-36! -Cy,3a *Per M.G.L c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑ owner's agent. Owner/Agent PERMIT FEE. $ Signature Telephone No. 9302 Date. . 1. . . . . . . . ,.ORT1y TOWN OF NORTH ANDOVER so Is PERMIT FOR PLUMBING 49 SSACHUS� D This certifies that . J. !.�!!�a,45 S Gjr ..J S has permission to perform��^` �. �?'�. .�. . . . . . . . . . . . . . . . . plumbing in the buildings of .�U!� . . . . . . . .�`P S at. ro. PS tiv� . . . . . . . . . . . . . . . North Andover/ ass. Fee'i Z�. . . .Lic. NoISJ4?�. . . PLUMBINNSPECTOR Check # io33 A V MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY MA DATE 12 12 j PERMIT# lf JOBSITE ADDRESS OWNER'S NAME POWNER ADDRESS TEL IFAX TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL[� PRINT CLEARLY NEW:a RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO[—] FIXTURES Z 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 i DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM '—_ DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER i FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK _ LAVATORY ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES ! WATER PIPING OTHER - r _ - — -- -- , INSURANCE COVERAGE: I have a current liabili insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES❑ NO ❑ IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW 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 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 tru 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 com i with Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME I Nicholas Sawas LICENSE# SIGNATURE MPO JP CORPORATION❑# PARTNERSHIP[]#O LLC❑#0 COMPANY NAME I Nicholas Sawas Plumbing and Heating ADDRESS I P.O.Box 623 CITY Methuen STATE MA ZIP 01844 TEL 9788043303 FAX I j CELL 19788043303 1 EMAIL savvasplg@gmail.com c_ s* ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No .oe/111Z11-',z11 Xll?lle— THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# � /`��� �r PLAN REVIEW NOTES /�/ e Lliel The Commonwealth of Massachusetts - Department of Inlustrigl Accidents al Office of Investigations 600 Washington Street .Foston,MA 02111 www.mass gov1dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le0b . r Name(Business/Organization/Individual): i, Cid (f v �; 4 Address: 15 QVe&1,; '6i-- ��14 City/State/Zip: T1'``� , ��C) Phone#• Are you an employer?Check the appropriate box: Type of project(required): 1.(D I am a employer with _ 4• ❑ 1 am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.x �• ❑Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for mein any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 10.❑BuEle dingtricarepairs or additions required.] officers have exercised their 3111 am a homeowner doing all work right of exemption per MGL 11. lumbing repairs or additions myself.[No workers'comp. c.152,§1(4),and we have no 12.❑Roof repairs insurance required.]t employees.[No workers' .13.❑Other comp,insurance required.] *Any applicant that checks box#1 must also fill outthe section below showing their workers'compensation policy information. I Homeowners who submit this affidavit indicating they ire doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that checkthis box must attached an additional sheet showing the name of the sub-contractors and their workers'camp.policy information. I am an employer that ispYoviding workers'compensation insurance for my employees Below is the policy and job site information. Insurance Company Name:. Policy#or Self-ins.Lic.#: 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 a ' edunder Section 25A of MGL c.152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 a or one= ear imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a ay against e violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations,c6the DIA fo insurance coverage verification. I do here ay cer . u e e pai a penalties ofperjury flint the information provided a ove is t ue and correct. - Si afore`: / Date: > 2 Phone#: 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract ofhire,• 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 j oint 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 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 ofpublic 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-contractors)name(s),address(es)and phone numbers)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 fox 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 permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy 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. Anew affidavit must be filled out each year.Where a homeowner 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 us a call. The Department's address,telephone and fax number: The Comra.onwalth of Mossachvsetts - Department of Wdustrial Accidents Office of Investigations 600 Washingtoa Street Boston,MA,021 It Tel,#61.7-727,4900 ext 406 or 1-877 ATASS.AFE Revised 5-26-05 Fay,#617;,727-7749 www.mass..gov/dia N ( Omneonuiea[th o�t!/a�sachuda� Official Use Only e(JaParfinenE o/n. C� �� Permit No._ f U / Y 3 l_tiro J Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (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 t� (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: / _ ti_ / j G Town of: W_ q"p V6 R To the Inspector of Wires: S By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Owner or Tenant Telephone No. Owner's Address Q�q/yyj Is this permit in conjunction with a buildi g permit? Yes ❑ No [?? (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts lIZZA- verhead ❑ 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: _ D IQ Completion of the ollowin table be waived by the Ins ctor of Wires. y No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets 3 No.of Hot Tubs Generators KVA No.of Luminaire3 Swimming Pool Above ElIn- ❑ o.o Emergency g rnd. d. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners o.o etecbon an InitiatingDevicesNo.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers eat Pump I Number ITonsIKWo.0Self-Contained Totals: _ Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ unicipal ❑ � Connection Oth No.of Dryers Heating Appliances KW SecuritySystemDevices or Equivalent Heaters KW Si No.of Water No.o No.of s Ballasts Data Wiring: No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Device or E uivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: e.— IS-11 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:) I certify,under thepains and penalties ofperjury,that the information on this application is true and complete FIRM NAME: !L t` LIC.NO.: " Licensee: Signature LIC.NO.: _ (lf applicable,enter"exempt"in the license number line.) Bus.Tel.No.; Address: // f�i191�/.aQ. Obi, �( C2 'Af_��_ Alt.Tel.No.: Per M.G.L.c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ Date.. f NORTH TOWN OF NORTH ANDOVER PERMIT FOR WIRING SACHUS This certifies that ......... ..../!.../......... .f. .......... .`....................:......... has permission to perform .................. // /: ') 1...� ...... ............................................ wiring //, (,Iq `l ng in the building of................................................................................... at...... `. ...C. LL ... J�.. ............. .. .North Andoxe �M�fee...3 .iQ.01. Lic.No...l..J...... ................. ... ............. .......... ELECTRICAL INS CTOR Check # �J u? - Department of Fwe Services Permit No. 3 r BOARD OF FIRE PRE/E"ON REGULATIONS O=pamyandF=ChcclCed . 1U99J. mramk APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All aoti to be performed inaccotdaace with tete IrLimchtrscsts Electrical COL 527 CIvQt 12.W (PLEASE PRINT ININKOR TYP IIYFa TION)' Date: City or Town of .' To the Inspe for df Fires. By this application the undersigned gives no ' his or her invention to Pedbrnt the eletxricai wodc described below. Location (Street&Number) Owner or Tenant Telephone N Owner's Address Is this permit in conjunction Kith a building permit? Yes ❑ No (Cheri:Appropriate Boz) Purpose of Building Utility Authorization No. Existing Scrice Amps / Volts Overhead❑ Undbrd❑� No.of 141cicrs New Serice Amps t Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Amoacity Location and Nature of Proposed Electrical Work Comotedon oft/re fol/moittz table mar be uuived by die h=eror of Frim. No. of Recessed Fixtures No.of Cal-Susp.(Paddle)Fans No.of Total I Transformers KVA No.of Lighting Outlets No.of Hot Tubs (Generators KVA I b No.of Lighting Fixtures $trimming pool Above ❑ in- ❑ i o.ot lime,encu tgnung d. rnd. (Battery Units I No. of Receptacle Outlets No.of Oil Burners FIRE Al-ARtllS No.of Zones No. of Switches No.of Gas Burners_ No.of Detection and Initiating Devices No. of Ranges No.of Air Cond. t - Torsi No.of Alerting Detiiccs No. of Waste Disposers HcIEPUMP Number ons lINV No.of 'cif- ontaincd Totals: Detection/Alerting Dc ices No.of Dishwashers SpaedArea Heating KNVLocal ❑ Dlunicipal ❑ Other Connection r No. of Dryers Heating AppliancesK-tiV Security systems: I No. o crit r KIM No.of.Devices or E uivalen °`° o.of Heaters Data%ring: I o Sienna Ballasts Na.of De-vices or Equivalent No.Hydromassage Bathtubs No.of ldotor's Total HP ITclecommunicatiorts Wiring: I OTHER: No.of Devices or Eouivalent • I 41tadi additional detail iifdesired,or as required by the Inspector of hires. INSURANCE COVERAGE: Unless waived by the owner,no permit for the perfortuance of electrical work rnay issue unless lie 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 e.,ittbited proof of same to the permit issuing office. --CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify;) - Estimated Value of Electri Work: $ ( tpuation Date) (When required by municipal policy.) Work to Start Inspections to be requested in accordance with NEC Ride 10,and upon completion. I certify,under the pui s and penalties of perjury,that the information on this application is true and complete: FIRri1 NAME: ADT Security Services 111 Morse Street,Noyjro ,iVIA 02062 LIC.NO.: 1533C Licensee: John S.Bassett Signatu LIC.NO.: 1$33C (7f applicable, utter"exempt"pr the licertse number Gne.) Address: Bus.TeL No.: 181-278-11-,' Ait.TcL No.: OWNER'S INSURANCE WAIVER: I am atvam dint the Licensee does not have die liability insurance coverage nor,mily required by law. By my si,nature below,I h=by Nvaivc this requirement. I am the(check one)C1owner C3owner's aa-- Owncr/Agent Signature Telephone No. [P:ERbI1T FEE: Stij 0 Date...J .y. .... NORTIi • `°;•�"� TOWN OF NORTH ANDOVER O A PERMIT FOR WIRING SACMUSE� This certifies that ....L....F.. t ........ - ............................................................ has permission toperform ... v< < F a wiring in the building of .. �--)) ......................... ......................................................... at.....A d.......C......�.�.�.f...................��,North Andov , FeeS. :�P Lic. . ELECTRICALINSPECCOR 7y 7 Check N � (fammonweallk of M] ijacleuaelfs Official Use Only 2eparinhenl o`J`ire Servicee Pernut No. BOARD OF FIRE PREVENTION REGULATIONS [ROccupancy and Fee Checked ev. 1 1/99] !leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(POEC),527 CMR 12.00 (PLE'ASE PRINT IN INK OR TYPE.,ILL IN/.'OR;bL!PION) Date: City or l'own of: N6/zTI) J9n�l(>OVCTo the Inspector of lGires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 3D 3, Ch jalu j1 S--� Owner or Tenant LRC>G-51'clephone No. 7 - -•8a7S- Owner's Address rjyzh: -gg Is this permit in conjunction with a building permit' Yes ❑ No (Check Appropriate Bos) Purpose of Building; 571% k yh Utility Authorization No. (0-15 Existing Service ^,60 t\nhps Q/ Volts Overhead Undg;rd [:] No.uCt�Ieters _� New Service atm Amps /34J/aIP Vol ls Overhead a'- Undgrd ❑ No. of iVleters Number of Feeders and Ampacity p6Yj /4 y-1� Luz z Location and Nature of Proposed Electrical Work: CV) SfAVIC I eY-z- Ke— 1Ue C1 �Fo--A tCRO Completion of the fo olving table ma,be n•aived v the Ins ecto•or{fires. No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans No.o1 Total Transformers IiVA No.of Lighting Outlets No.of Ilot Tubs Generators KN'A No. of Lighting Fixtures Swinuuing Pool Above ❑ In E] No.o Emergency Lighting rnd. rnd. Batte •Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones of Detection and No.of Switches No.of Gas Burners No. Initiating Devices Tot F No. of Ranges No.of Air Cond. Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Nm uber Tons KW No. of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Heating ace/Area S Municipal Space/Area g KW Local Connection El Other Heating Appliances KW Security Systems: No.of Dryers No.of Devices or Equivalent No. of Water KW No.of No.of Data Wiring: Heaters Sights Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total IIP Telecommunications Wiring: No.of Devices or E uivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. INSURAi'NCE COVE1tAGE: 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 ❑ 0.1.1-IER ❑ (Specify:) 6tfi✓'ZS�'�LL<✓tt/ (Expiration ate) Estimate of Electrical Work: (When required by municipal policy.) Work t Start: drj G Inspections to be requested in accordance with iVIEC Rule 10,and upon completion. I certifj•, under the pains antl penalties of petj►uy'that the information on this application is trite and complete. F1101 NANIE: 7�Z1CH \ S��U�`� LIC.NO.: yo'4 Licensee: e t� �- Sig;natme LIC.NO.: d le-' (Ienterapplicable enter " .rem � pt"ii ne license numberline.) �II G Bus.Tel.No.: 7-�oZ (/x-'36 Address: � �� 7 '�oP-LO � T1t 1 � Alt.Tel.No.. 279 - OWNER'S INSURANCE WAIVER: I art aware that the Licensee does not have the liability insurance coverage normally required by law. By nhy signature below,I hereby waive this requirement. I am the(check one) ❑owner ❑ o cr's zwent. Owner/Agent Signature Telephone No. PERMIT Y : S r v PLEASE FILL OUT BACK SIDE TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: O Date Received,-..1--IL— Date Issued: EWORTANT:Applicant must complete all items on this page LOCATION e, t Ut Ce Ct P mt PROPERTY OWNER aJ' eh n Wr co A'e"s Print MAP NO: 2j0 PARCEL: 140 ZONING DISTRICT: R 3 Historic District yes Machine Shop Village yes djp� TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family El Addition ❑Two or more family ❑ Industrial ❑Alteration No. of units: ❑ Commercial 'Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑Other Efl Septic Dwell FloodpTaiii U Wetlands ` ® yVatershedyDistrict . - DESCRIPTION OF WORK TO BE PERFORMED: kdentification Please Tyjte or rint Clearly) OWNER: Name: �ar + Tenn c f (_a eS Phone: Address: C hz5�N U� ST CONTRACTOR Name: C� y (� �,N� �0 N Phone: ��S�3`Q � � p Address: L oN OC/�Ff' /V ' 0363 b Supervisor's Construction License: Exp. Date: — 2. i �4�¢ 4-2(�,t)3 Home Improvement License: Exp. Date: � ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ 2 dDP Gc� FEE: $ Check No.: Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund S'_gnature of_'Agen _ n Signature of.,to rtracorffj �-C Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits o Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Flo or/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (if Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products 40TE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit n all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals hat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording lust be submitted with the building application Doc: Doc.Building Permit Revised 2008mi Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/MassageBody Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on (�o [* Si nature l0� ` I COMMENTS /V� � �p � I-VI, (pp -�4 I I HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments j Conservation Decision: Comments Water& Sewer Connection/Signature&Date Driveway Permit ! DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date Doc:.Building Permit Revised 2008 Location -22.2J ��11�5 f).7 t� No. e5C24— Date NORTH TOWN OF NORTH ANDOVER f �ti Certificate of Occupancy $ isNUS Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 0 33 L 2 L;. r , Building Inspector NORTH And T® of _ over 0 No. 6 9& - �,o - AKE o dover, Mass., COCHICMEWICK C %S RATED U BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..........M*P�.4.................C.. ... .... �...... ......................................................................... Foundation has permission to erect........................................ buildings on -0 ......C.� !VT........,. .a..... Rough A. to be occupied as...... ...........~.......!470........ ... ............. ....... .......................... Chimney provided that the person accepting this permit shall in every respect cohform to he 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 INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS $ ELECTRICAL INSPECTOR UNLESS CONSTRUC ST TS Rough .............. .. ....................... ......................... ............................................ .. BUILDING INSPECTOR Service 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 30DE Smoke Det. r t The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/JElectricians/Plumbers Applicant Information ,, 7 Please Print Le ibl Name(Business/Organization/Individual): r� V d t"'' ( �Uo!eAddress: ) ? City/State/Zip: n co/i"V . D 3 d Phone#: ©3 l �J C& Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction INP (full and/or part-time).* have hired the sub-contractors 2.�am a sole proprietor or partner- listed on the attached sheet. E]Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. g. ❑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 11.0 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' q ] 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. lain an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic. C, Expiration Date: 2 (P�Z Job Site Address: l 2 st o ul ^ A liJo /State/Zip: 1&!L05: _ 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 ofthis statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. X do hereby c e the pains andpen hies ofperjury that the information provided above is true and correct. Signature: Date: t'r Phone#: r,d a 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 CIerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Persoia: Phone#: V212011 12:30 PH FRO14: Fax TO: +1 (603) 437-6134 PAGE: 002 OF 003 AC40 CERTIFICATE OF LIABILITY INSURANCE106/02/20D"°A `M D11 -4 11 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Obre Insurance Agency,Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE YHOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1 E Commons Drive Unit 27 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Londonderry NH 03053 INSURERS AFFORDING COVERAGE NAIC# INSURED Af Watson General Contracting mm.FERA: PEERLESS INSURANCE COMPANY 3 Edgemont St IWAS ERB: INSLRERC_ Derry NH 03038 INSU ERI_ IN ERE COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED T OTHE INSURED NAMEDABOVE FOR THE POLICYPERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECTTO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SU8JECTTOALLTHETERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSRODT.4 TYPE QF INSURANErPOLICYNUMBER POLICYEFFECTIVE POUCYEXPIRATION LIMITS I TR DATE IMWDDrYYYYJ GENERAL LIABILITY EACH OCCILIZENCE S 1,000,000 A X CCWAER0ALG3ERALupsuTY GL8257537 03/0612011 03/0612012 WAGETLOR39ED a 5100,00 TI Cwnls NRDE I OCCUR MED EXP «� _16,000 PERSCMLSADVINJLW 51,000,000 m109RALAGSREGATE s2,000,000 GEIJLAGGREG4TEUMTAPPLIESPER PRCDUCTS-CCNPJCPAGG s2,000,000 POJCY PRCI EJ LOC AUTOMOBILE LIABILITY OOMNED SINGLE UMT ANY AUTO (Eaaccident) 5 ALL OWNED AUTOS BODILY INJURY SCFEDLED AUTOS (Pet f>*wN 5 L HRED AUTOS BODILY INJLRY NONLOWNEDAUTOS (Peracciderd) S PROPERTY DAMAGE S (Per acddeM GARAGE LIABILITY AUTO ONLY-EA ACCIDENT S ANYAUr0 OTFERTFIAN EAACC S AUTO CN.Y: AGG S EXCESS I UMBRELLA LIABTLrrY EACH OC.CLEZIENCE S OCCUR CLAIMSNME AGG ECATE S Is D-L)t1CABLE S RETENTION S 5 WORKERS COMPENSATION X WC STATICIT(IRYISIVEMI AND EMPLOYERS'LIABILITY A ANYPRMETORFARTNE7fF.XECURVE YWC 9384376 03/06/2011 03/0612012 ELEACHACCIDENr S100.000 CFRCER/MEMBE2 EXCUD�? (Mandatory In NH) EL DISEASE-EA EWLOYEEI s 100,000 ffYes,descubeu der SPECIALPROVISIONSbeimv ELDISEAS-t-POLICY UMT s A OTHER DESCRIPTION OF OPERATIONSI LOCATIONS i VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT!SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION Town of North Andover DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN 223 Chestnut Street NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,its AGENTS OR REPRESENTATNES_ = Ra, North Andover, MA Au HORnaPsaurATIVE � rTP> Leo 00 ACORD 23(2009101) O 1988-2009 ACORD dORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SBDH (FND) MONTEIRO WAY SBDH IR (FND) / (FND) / N/F STANLEY L. FLING & SHIRLEY FUNG J N14'49'22"W 120.00' i Lv Z CEM. r N/F Q CONC. I SWIMMING I HOWARD & MICHELE J PAD I POOL I w o I o NACHAMIE 0 04 _. � r — I/ 5RWIDEED of w N DECK u J Z Q 38.01' Id w I 42.69 w JS v I BIT. CONC.I Om Z Q _ SUN w PAVEMENTI Qo I ROOM — -� m Z 17f9' 2 STORY 28.82' Z < > I W.F.D. U 37.66' #223 26.98' 0o w z I w w N/F �` m I I T A JAMES J. THOMAS & �-.. AREA=31,412 S.F. ANDREA M. THOMAS I 3 ` =0.7211 AC. a o� I6; I w 91 Lo LA►� I l � o I z I N I o I I � m I � I I I � S21'42'05"E 125.00' CHESTNUT STREET NOTES PLAN OF LAND I. SITE IS SHOWN ON TOWN OF NORTH ANDOVER IN \ ASSESSORS MAP #210 LOT #140. SEE E.N.D.R.D. NORTH ANDOVER, MASSACHUSETTS BOOK #4970 PAGE #171 FOR SITE DEED. DRAWN FOR 3.1 2. SITE IS R-3 ZONE REQUIRES 30' FRONT 20' SIDE MARK D. CORDES & JENNIFER CORDES AND 30' REAR YARD SETBACKS. 0 223 CHESTNUT STREET NORTH ANDOVER, MA I� r\ 4, t SCALE: 1"=40' DATE: JUNE 2, 2011 x 0 20 40 80 120 0) 0 V SFr: MERRIMACK ENGINEERING SERVICES ,�;If.„ is 86 PARK STREET " 6/2/11 ANDOVER, IMAS'SACHUSETIS 01810 / STEPHEN E ST N KI, R.L.S. DATE PROA` (878) 476-3666 FAZ: (878) 47'6-1448 EMAIL• A&MUNG®AOL COSI ^ Office f�o4cmerzA rs Business egu ati HOME IMPROVEMENT CONTRACTOR Registration: 118848 Type: ; Expiration: 4/28/2013 DBA A.' . 'ATSON GEN,CONTRACTING ARTHUR WATSON 3 EDGEMONT ST DERRY,NH 03038 _ Undersecretary Massachusetts- Department of Public Safety Board of Building Regulations and Stand.:;cls , 'Construction Supervisor License License: CS 63168 Restricted to: 1G ARTHUR F WATSON 3 EDGEMONT ST DERRY, NH 03038 Expiration: 2/12/2012 . Co Tr#: 16906 \ N -------------- TI — -----------------------------------J of k� --------- - - -- ll / / I , I I mx \ I ov c =m v I V \ I X0 \ I \\ I \ I A f v v-Z` 5`C��I-9 ryfl'C //� 1Ylassachusets IIoie YA1,'�r��•ement' Sample Canr`act This Form satisfies all basic requirements of the states Dame imprtivement•Contractor Law ' langtLnge to protect homeowners. Seek legal advice Ifnecessar , Ap (MGL chapter IA2A),but does not'include standard ivlassachusetts consumer guide to home improvement"before a y' y Person planning home improvements should first obtain s co " P 1111Y Office of Consumer Affairs and Business Regulation's Consumer IttfOgimtrt n Hork o t your esia 67 or 1-888-2.83-3757.free;copy by cilli g the . Homeowner Information - Contractoi Information Streel.Address(de not use a Post Office Box address) Contractor!Salesperson/Ownerl`]sme ��� State Zip Code usiness Addre (must include aa-street address) vie: 4r5 �� sT Daytime Phone Evening Phone :ityrZ;rry�_ Q2 /S�t&O Zip Cod/e� Mailitig Address(Il diffee%rrent from above) r `;/� V usiaess Phone ederal Em 1 erID laategaYreoutatman>tomd�_ P oY orS.S.Numbar 0 3 prowmeotwetractarsluvet Home ruov®cot coatncloraeg,Numbe• &xPpl date aid�eyiatuatian numdcr The Contractor agrees fo do the'following worl:for the Homeo nert �C m e m a r o comp e e sped /.2 anne, eoRs LU o e on /�J�r tC{�..`'i C.h (�� ' v 0�./�L� ��Gt >'✓ /' � ace ' Regtiired.Eermits-The followin�•'•bnildingpermits aro required Proposed Start and Completions Schedule-The following schedule will and��yyill be secured by the contractor as the homeowner's agent, be adhered to (OvJners who secure their own permits win be unless circumstances beyond r's the contractocontrol arise excIpded from the Guarant3i Fund provisions'df • ' ' ' MGL chapter 142A.)' ' r Date when contactor will begin contracted work -23 when contracted work will be substantially completed. Total Contract Pi•ice'and Payment Schedule The Contractor agrees to perform the wort;:,furnish the material and labor specified above for the total sum of Payalebts will be made according to the following schedule: v—Z-460. upon signing'contract(riot to exceed 1/3 of tbe'tata]contract price or the cost of's acral order items,whichever is greater) $ 0 DD by or upon completion-of j ('1C e, SJ&000 by JG2_/ ��-or upon completion of ('q ; Q0 upon 777completion of the contract (Law forbids demanding full paymentuntil contract is completmd to both party's satisfaction) The fallowing material/equipment must be special S Ordered before the contracted wail:ttegins in order S to be paid for t to meet the completion schedule,('►*) to be paid for NOTES:(*)Including all finance ch not exceed theme(**)Taw requires that any deposit or down-payment required by the contractor before wort;bogies may greater of(a)ane-third of the totid contract price or P Which must bo special ordered in advance to Meet the completion schedule.(b)the acetal cost of any special e i meat or Custom made material ress a an _ sane resswarru' berg rovided tate con actor'? Subc6niractors-;'lienoniractor agrees to be solely responsible for coiiopdetion of rho work described regardless of the actions of any third ell terms of the warren must be attic ed o the cantrnet paity{subcontractor utilized by the contractor, The contractor further bgraeg to be solely for allPayments eter a s and labor under this•a cement ll Contract Acceptance-Upon signing,this documentbecomes aBinding contract under law. Unless otherwisoted wifltin subcontractors for ca carefully shall not imply that any lien or other security interesthas been placed on the residence, Review the following oautions sed notice carefully before signing this contract this document,the ' • Don't be pressured into signing c •s • , fining the contract Takc time to read and fully understand it Ask questions if something is unclear. Cvialce sure the contractor has a valid Rome i subconhsctars to be Tel with the Director ofHame I iprovcment Contractor Registration You may inquire about c to rove ant Co ctorR.eoistrntion The law requires most home improvement contractors and ;-200- registration by,wridngto the Director at One Ashburton Place,Room 1301,$ostg MA 02]08 orb calling inquire 1:800-223-0933. � contractor • Does the contractor have insurance? Chccic tp see that your contractor is properly insured, y g 727"3200 or Know your rights and responsibilities. Head the Important Infornladolo on the reverse side ofthis form and get a copy of the Consumer Guide to the AomaImprovement Contractor Law, You may cancel this agreement if it has been signed at a place OtKi r•than the contmotort,no contractor in writing at his/her main office or branch office by Ordinary mail' rite third business day f.1. signing ofthis agreement See the attached of an ellatlon form obusiness,provided you notify the Posted,by telegram sent or by deljdery,not later than midnight of the ��NOT SrGN THIS CONTRACT ''T' ran explanation Of this right we Identical copies ofthe•confxactmust be completed and sjaned.one capyahould o two Y 13L,t N d thb hoineown¢The otherco R SPACES should be rapt by the contractor: Romeo Aer's tgna re ; j; Contractor's Signttture , Date ••� / / • Date ..r Contractor Arbitration The Home Improvement Contractor Law provides homeowners with.-' tlte right to initiate an arbitration action(as an. alternative to-court action)-if they have a disputdwith a contractor. The same right is not automatically affordei to a' contractor,however. The contractor would have to resolve any dispute he/she has with a homeowner in court unless both parties agree to the optional clause provided below. This clause would give the contractor the same right to arbitration as is afforded to the h6meowner by the Home Iinprovement Contractor Law. '• The contractor and the homeowner hereby mutually agreeiii.advance that in'the event the contractor has a dispute concerning this-contract,tile e contractor may submit the dispute to a private arbitration firms which has been apprpved.by the Secretary,of the-Executive Office-of Consumer Affairs and Business Regulation and the consumer shall.be required to submit to such arbitration•as provided In Massachusetts General Laws,chapter 142A, Homeowner's Signature Contractor's Signature NOTICE:The signatures of the parties above apply only to the agreement of the parties.to alternative dispute resolution initiated by the contractor. The homeowner may initiate alternative dispute resolution even where this section is not separately signed by the parties. - Homeowner's Rights '.A homeowner's rights vender the Home Improvement Contractor Law(7v1GL chapter 142A)and other consumer protection laws'(i.e.IYIGL chapter 93A).may not be waived in any way,.even by agreement: However;homeowners 4may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law. 0meowziers who secure their own building permits are'automatically excluded from all Guarantypund provisions o£ 'thd Home Improvement Contractor Law. The contractor is responsible for completing the work as described,in a timely and workmanlike manner. Homeowners may be entitled'to other specific legal rights if the contractor guarantees or provides an express warranty for worlunanship or materials. In addition to guarantees or warranties provided,by the contractor,all goods sold in Massachusetts carry an implied warranty of merchantability and fitness for a particdlar purpose; An enumeration of other matters-on which the homeowner and contractor lawfully agree may be adde�to the term§of the contract as Icing as they do not restrict a homeowner's basic consumer rights. If you have questions about your cansum&r/homeowner rights,contact the Consumer Information Hotline(listed below). Execution of Contract U The contract must be executed in du licdte and should notbe signed until-a copy of all exhibits and referenced documents have been,attached. Parties Are-also advised not to sign the document until all'blank sections have been filled.in or marked as void, deleted,or not applicable. One original signed copy of the contract with attachments'is to* • ,be given to the owner'and the other kept by the contractor. Any modification to the original contract must be in writing and agreed to by both parties. Contracted work may not begin witil both parties have received a fully executed copy at the contract,.and the three day recission period has expired. Accelerated Piiyiments A contractor may not demand payments in advance of the dates specified on the payment schedule in cases v;here the homeowner deems him/herself to be fuiancially insecure. 'However,-in,instances where a contractor deems I*nIlierself -to be financially insecure,the contractor may require that the balance of funds not yet due be placed id a joint escrow account as a pretequisite to continuing the contracted worlr-, Withdrawal of fimds from.said accounbwould require the signatures ofbottiparties. Additional Information If you have general questions or need additional information about the Home Improvement Contractor Law or other consumer rights,or°lf you wish to obtain a free copy.,of .A Consumer Guide to the RomeImprovement Confxa�tior Law,"contact: Cdnsumer Information Hotline ` Office of Consumer A ff.mrs and Business'RegulatioiL .10 Park PIaza,Room 5170,Boston,.MA 02116 (617)973-8787'or 1(8.88)2833757 Ifyou want to verify the registration of a contractor or if you about the contractor registration component of the Home Iinprtoveavem nt nstr0acneed additional infalmatilon sp' Cally Contractor Law,contact: Direct6t of Home ImprovementContractorRegistration Bureau of Building Regulations and Standards f One Ashburton Place,Room.1301,Boston,MA 02108 ' (617)727-3200 or 1-800-223-0933. For assistance with informal mediation of disputes or to register formal complaints against a business,call: Consumer Complaint Section Office of the A,ttorhey General i (617)727-8400 AND/OR -Better Business Buteau (508)652-4800 ` .(508)7�5-2548 (413)734-3114 01 Li3 Date... ...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING sib" a ,SSACH This certifies that ......./,)......Ce."Sel.........../Z ................. . ...../........................ has permission to perform ... . .........'.f. .//..'-/v...:........... wiring in the building of........ ............................ .......................... at...?.Z.3...... North Andover,M ......... Lic.Noits—fe? ...... /.&LEcrmcAL INS R Check 4,