HomeMy WebLinkAboutMiscellaneous - 233 MASSACHUSETTS AVENUE 4/30/2018 233 MASSACHUSETTS AVENUE
210/011.0-0023-0000.0
10266 Date.....
TOWN OF NORTH ANDOVER
0
PERMIT FOR WIRING
CHU
�.......This certifies that ................................. . ...........................
has permission to perform .............\51.. . ...........
wiring in the building of.........ej.c..m.'....J
at........... 4.3.........M
North Andover,Mass.
-,Fee..... . ........
ELECMCAL INSPECTOR
Check #
2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance with the provisions of M.G.L.c.143,§3L,the f
permit application forth 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.G.L c. 166,§32,an �-
electrical permit shall be issued to.1 11
person,firm or corporation stated on the permit application. Such entity shall be responsible for the
notification of completion of the work as rekuired in M.G.L.c.143,§3L. '"Irl
Permits shall-be limited as to the time of ongoing construction activity,and may be-deemed-by the7nspeetior_of_Wires abandoned.and.invalid_if he—_. ._
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
puipose 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 bxtends,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.
J["�Rf ule 8-Permit/Date Closed/2- 3 ` ***Dote:Reapply for new permit
0 Permit Extension Act-Permit/Date Closed:
Commonwealth of Massachusetts Official Use Only
Permit No. 2. 9
Department of Fire Services
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev. 1/071 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) ,�13 e loqv
Owner or Tenant Ad" Telephone No.
Owner's Address d A W
Is this permit in conjunction with a building permit? Yes r5T No ❑ (Check Appropriate Box)
Purpose of Building 11411f Utility Authorization No.
Existing Service Amps Volts Overhead ❑ Undgrd ❑ No.of Meters
New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
Completion of the ollowing table may be waived by the Inspector o 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 SwimmingAbove In-- o.o mergency Lighting
Pool rnd ❑ ❑
rd. BatteryUn►ts
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones
No.of Switches No.of Gas Burners No.of Detection and
Initiatinz Devices
d
No.of Ranges No.of Air Cond. Tons No.of Alerting Devices
No.of Waste Disposers Heat Pum Number Tons KW No.of Self-Contained
Totals Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other
Connection
No.of Dryers Heating Appliances KW Security No.of DSyevices or Equivalent
stems:*
No.of Water KW No.of No.of Data Wiring:
Heaters Si ns Ballasts
No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.of Devices or Equivalent
OTHER:
Ot
Attach additional detail if desired, or as required by the Inspector of Wires.
Estimated Value of Electrical Work: y (When required by municipal policy.)
Work to Start: J_7A& 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 andpenalties of perjury,that the information on this application is true and complete.
FIRM NAME: /%01111 LIC.NO.: V/
Licensee: oN �o�� Signature 9
g 1 LIC.NO.:
(If applicable, nter "exempt"in the li nse n tuber line) Bus.Tel.No.
Address: rQ eak 6 Sg �/v a,�r�7-� 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 El owner's
Owner/Agent PERMIT FEE. $
Signature Telephone No.
a
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
ky 600 Washington Street
Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information / Please Print Legibly
Name (Business/Organization/Individual): I /V
Address: a 3 wve 12-71)
City/State/Zip: 5A�e M /v tf 6-,36n Phone #:
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
employees(full and/or part-time).* have hired the sub-contractors ❑
2.❑ I am a sole proprietor or partner- listed on the attached sheet. 1 7• ❑ 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.❑ 1 am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions
myself. [No workers' comp. c. 152, §](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 out the section below showing their workers'compensation policy information.
I 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 Company Name:
Policy#or Self-ins.Lic.#: Expiration Date:
Job Site Address: -233 A&55 �Ve 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 er the pain and p allies of perjury that the information provided above istrue and correct.
Signature: Date:
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#:
Location
No. Date
KORTM TOWN OF NORTH ANDOVER
Certificate of Occupancy $
+ ilding/Frame Permit Fee $
�
ssACHU < oundation Permit Fee $
� 7�a
�PerFee $
ertohnec`tion Fee $
��w
Water onnection Fee $
Building Inspector
�'W
Div. Public Works
PERMIT NO. J APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAG i
MAP 4,40. I LOT NO. 2 RECORD OF OWNERSHIP iDATE BOOK 'PAGE —
ZONE _ SUB DIV. LOT NO.
LOCATION 033 6c,,Z PURPOSE OF BUILDING
OWNER'S NAME i-a> cz,{ /� Q NO. OF STORIES SIZE
OWNER'S ADDRESS 1_33 VA _ rim Ike BASEMENT OR SLAB PJC�� `y
ARCHITECT'S NAME +�"lG( SIZE OF FLOOR TIMBERS IST /V�&-2ND 3RD
BUILDER'S NAME 1homCLSaIV1'Lo SPAN j�L.�:ST K
DISTANCE TO NEAREST BUILDING �J ,7 rt DIMENSIONS OF SILLS a �O +��v��,,
r15 /�
DISTANCE FROM STREET " POSTS G L I+ J
DISTANCE FROM LOT LINES-SIDES .?�x REAR .'?f�Q� GIRDERS fJy
AREA OF LOT u FRONTAGES J HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW SIZE OF FOOTING X
IS BUILDING ADDITION MATERIAL OF CHIMNEY
IS BUILDING ALTERATION ?qS IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE f IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION. IF ANY J IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS
3 PROPERTY INFORMATION
'p
eco u��� _ / LAND COST
SEE BOTH SIDES y� EST. BLDG. COST ✓
PAGE I FILL OUT SECTIONS I - 3 � O� EST. BLDG. COST PER SQ. FT.
PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM
SEPTIC PERMIT.NO.
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILLED AND APPROVED BY BUILDING INSPECTOR
DATE FII E Q
BOARD OF HEALTH
'S GNATURE OF OWN AUTHORIZED AGENT
FEE 10
OWNER TEL# 441 PLANNING BOARD
PERMIT GRANTED CONTR.TEL#121��7��
' a*/;=.0 y 19 q CONTR.LIC.# O
BOARD OF SELECTMEN
BUILDING INSPECTOR
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA-
APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
CONSTRUCTION
2 FOUNDATION _ 8 INTERIOR FINISH
CONCRETE _ _ 3 1 2 13
CONCRETE BL'K. PINE
BRICK OR STONE HARDW'D
PIERS PLASTER
_ DRY WALL
"y UNFIN.
3 BASEMENT
AREA FULL' FIN. B'M'TAREA _
' FIN. ATTIC AREA _
NO B M FIRE PLACES _
HEAD ROOM MODERN KITCHEN
4 WALLS I 9 FLOORS
CLAPBOARDS B 1 2 3
DROP SIDING CONCRETE �_
WOOD SHINGLES EARTH
ASPHALT SIDING HARDII✓'D X�5T1 -'TR(/c.TvR'x
ASBESTOS SIDING _ COMMON
VERT. SIDING ASPH. TILE
STUCCO ON MASONRY _
STUCCO ON FRAME I �v(Ild
BRICK ON MASONRY ATTIC STRS. & FLOOR I_
BRICK ON FRAME r
CONC. OR CINDER BLK.
STONE ON MASONRY WIRING
STONE ON FRAME
SUPERIOR I I POOR
ADEQUATE NONE
5 ROOF 11 10 PLUMBING
GABLE I HIP BATH 13 FIX.) _
GAMBRELMANSARD TOILET RM. (2 FIX.)
FLAT SHED WATER CLOSET _
ASPHALT SHINGLES LAVATORY
WOOD SHINGES KITCHEN SINK
SLATE NO PLUMBING
TAR & GRAVEL STALL SHOWER _
ROLL ROOFING MODERN FIXTURES
TILE FLOOR
TILE DADO
6 FRAMING I 11 HEATING
WOOD JOIST PIPELESS FURNACE
_ FORCED HOT AIR FURN.
TIMBER BMS. &COLS. _ STEAM
STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR
WOOD RAFTERS _ AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS
GAS
7 NO. OF ROOMS OIL
B'M'T2nd _ ELECTRIC
1st 13rd NO HEATING
A
y .
f
` ,. • ..
COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY
OF 1010 COMMONWEALTH AVE. °.
BOSTON i
MASSACHUSETTS ,MASS.02215
LICENSE
EXPIRATION DATE CONSTR. SUPERVISOR
01 /31 /1994
RESTRICTIONS a EFFECTIVE DATE LIC-NO, of
6
NONE ' 0210111991 055417
_(.
c
c�
i r +
THOMAS D ZAHORUIKO ml • i �, - `"�
24
00
SS b 032-46-0456 HAVERHIL. LNMAP8
L018
1DR
1830
} PHOTO(BLASTING OPRNLY - I.,• '
o > FEE:
0. 00 I.
HEIGHT: NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY
STAMPED OR SIGNATURE OF THE COMMISSIONER
DOB:
04/05/1960 D
THIS DOCUMENT MUST BE
CARRIED ON THE PERSON OF ,IGIjATUIf OF LICENSEE
THE HOLDER WHEN ENGAG 4 7 .i
OTHERS RIGHT THUMB PRINT ED IN THIS OCCUPATION " MI$$IONER I'
V '
200M-2-8781429 , 7
.n+. ,,,• _.- ..ii• a IIS'. }
I,-f u k h• <x7
1 1
7 4
1.
_ ( :w,:'�.�tk.��r.�is. a'! #'a=.:.r4�-h •-1...,:,x.1.,. �.�3�:�..•A,.:�
EWE R/IAVATIER_ _ ®r-1, CONSERVATiO
N0RTH
own of
No. Q 6 O
over
K • dVlass.
AC h HE w� erJ
OR PRS .
SS
194
PER
i
BOARD OF HEALTH
MIT T
: THIS CERTIFIES THAT.
6Clo �
has permission to erect W. , ...... buildings a?.473. .�� ...............
...•..•.•..• BUILDING INSPECTOR
on
to be occupied as ZAW-oa .! v... � . e�. �'"" Rough
eii+ Chimney
provided that the person accepting this permit shall in every respect conform to the terms of thea lication.on .••.•. Final
PP file in
this office,and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of PLUMBING INSPECTOR
Buildings in the Town of North Andover. Rough
VIOLATION of the Zoning or Building Regulations Voids this Permit. Final
PERMIT EXPIRES IN 6 MONTHS
UNLESS CONST ION STA ELECTRICAL INSPECTOR
RTS Rough
w
Service
Final
. .. ... ..................
.......
BUILDING INSPECTOR
Occupancy Permit .Required to Occupy Building Rough GAS INSPECTOR
Display in a Conspicuous Place on the Premises Final
Do Not Remove FIRE DEPT.
No Lathing to Be Done Until Inspected and A pproved bBurner
y
_Building 1nC1 ",rfw% r Smoke Det.
.--.-�-_�-r--•'-moi'�-- N-^�-i"-�-_�^--..�_-_�. � --�1 -_� ."_-�. i�-•--+•---�' — t-^-•'rte-•4------- .-- Y I {•---r--
- + - -- t t + t i-- + �'�---� } t' i-•--j----- t' 1 �•--t� I - i - •tom�
i
Yom+----�-�r-'---•F�-'r•--}�+ �'- -[-�-�-�� •h--T T-�----'j'---"� ! r--�-}r-�; 1- " r
I I I I •--- -.L-
� ' I
}
;a ss due
I
l -
-
I
T I '
I
44-- -Y.—t—
-
1
I
Location
No. Date /
N0RT#1 TOWN OF NORTH ANDOVER
o? o
Certificate of Occupancy $
Building/Frame Permit Fee $
,SSACMUSE� / Foundation Permit Fee $
a ether Permit Fee $ >_0
Sewer Connection Fee $
Water Connection Fee $
V KTAL $
t U 19� Building Inspector
Div. Public Works
PE&11IT NO. 66 ` APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. APAGE 1
MAP KJO. LOT NO. 2 RECORD OF OWNERSHIP DATE BOOK iPAGE
ZONE g I SUB DIV. LOT NO. �—
LOCATION Ave ri.�, PURPOSE OF BUILDING '
, efi
OWNER'S NAME L e. NO. OF STORIES SIZE
OWNER'S ADDRESS �_ s— BASEMENT OR SLAB
A�1caSSS
ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST `( C� 3RD
BUILDER'S NAMESPAN 4
T'hmr• ,
DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS
DISTANCE FROM STREET POSTS
DISTANCE FROM LOT LINES—SIDES REAR GIRDERS
AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW SIZE OF FOOTING X
IS BUILDING ADDITION(/ /v J MATERIAL OF CHIMNEY
IS BUILDING ALTERATION /!I' lJ IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION. IF ANY l� IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS
3 PROPERTY INFORMATION
LAND COST
SEE BOTH SIDES
EST. BLDG. COST
PAGE 1 FILL OUT SECTIONS 1 - 3
EST. BLDG. COST PER SQ. FT.
PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
e
DATE FIL D 4,
BOARD OF HEALTH
S GNATURE OF NER OR AUTHORIZED AGENT
Owner Tel #
FEE
Contr. Te 1 #1573_176
PLANNING BOARD
PERMIT GRANTED Contr .. LiC #
os�yr�
19 (71
BOARD OF SELECTMEN
F �
BUILDING INSPECTOR
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY StORIEs I THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES, GA-
APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
CONSTRUCTION
2 FOUNDATION 8 INTERIOR FINISH
CONCRETE _ B I 2 13
CONCRETE BL'K. PINE
BRICK OR STONE HARDW D
PIERS PLASTER
_ DRY WALL
UNFIN.
BASEMENT
AREA FULL FIN. B'M'T' AREA _
'/, 1/2 1/1 FIN. ATTIC AREA _
Nd BM'T FIRE PLACES _
HEAD ROOM _ MODERN KITCHEN _
4 WALLS 9 FLOORS
CLAPBOARDS B 1 2 3
DROP SIDING CONCRETE �_
WOOD SHINGLES EARTH
ASPHALT SIDING HARDW'D
ASBESTOS SIDING _ COMIACN
VERT. SIDING ASPH. TILE _
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY ATTIC STIRS. & FLOOR _
BRICK ON FRAME
CONC. OR CINDER BLK.
STONE ON MASONRY WIRING
STONE ON FRAME _
SUPERIOR I� POOR
ADEQUATE NONE
5 ROOF 10 PLUMBING
GABLE HIP BATH 13 FIX.) =
GAMBRELMANSARD TOILET RM. (2 FIX.)
FATI A SHED WATER CLOSET _
ASPHALT SHINGLES LAVATORY
WOOD SHINGES KITCHEN SINK _
SLATE NO PLUMBING _
TAR & GRAVEL STALL SHOWER _
ROLL ROOFING MODERN FIXTURES _
TILE FLOOR
TILE DADO
6 FRAMING I 11 HEATING
WOOD JOIST PIPELESS FURNACE
_ FORCED HOT AIR FURN.
TIMBER BMS. &COLS. _ STEAM
STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR
WOOD RAFTERS _ AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS
7 NO. OF ROOMS GAS
OIL
B'M'T 2nd _ ELECTRIC
1st 3rdNONO HEATING
i ..
NORTH
o%-wn 0%h'
6 0 W C;F ndu _
L
0 ,r ' .aTV%
46 ?_19
WICK , P -
.
SS r
` -I BOARD OF HEALTH
PERMIT T 0
THIS CERTIFIES THAT. .. . 'e4 Ar. ....
BUILDING INSPECTOR
has permission toe i . �wlmAn •• •.•••••• Rough
� � � .•• � � s Chimney
to be occupied as.. ♦.�, 6_40.44t. •• •• AZ Final
provided that the person accepting this permit shall in every respect conform to the terms of the application on file in
PLUMBING INSPECTOR
this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Rough
Buildings in the Town of North Andover. Final
VIOLATION of the Zoning or Building Regulations Voids this Permit.
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONST R ORTS Rough
N STA
Service
Final
.............. .... . .......4P....... ..............
BUILDING INSPECTOR
GAS INSPECTOR
Occupancy Permit Required to Occupy Building Rough
Final
Display in a Conspicuous Place on the Premises
FIRE DEPT.
Do Not Remove Burner
No Lathing to Be Done Until Inspected and Approved by Smoke Det.
Building Inspector
i
Specifications: xepair rare oamaye
Demolition/waste removal:
+ remove hardwood strips, save/reuse or replace if needed
1' remove floorboards through 2 spans, as required
cM,M„cr remove header at fireplace, as required
remove basement carpets
remove basement ceiling tiles in fireplace room
4 remove false facade and mantel on main level fireplace
remove lower level fireplace mantel
remove misc. debris or waste from basement level
04%
NwH cas `a Structural/mechanical repairs:
replace headers per above removal
`M replace subfloor per above removal
a4u frame around gas boiler, new frame walls in work area
insulate new walls if exterior
rick over fireplace on main level
frame and drywall/finish new wall over fireplace, min. 211
ay4 VW41I.$ clearance to chimney
kf r0a.4N drywall new walls, ceiling in lower fireplace room,
y�-. p,��„q,, o�ts;�r,..;s►� 5/8" firecode in boiler room
tape and finish drywall
drywall repair in bedroom closet near chimney
**electric repair and upgrading by others**
Finish and Trim:
hardwood floor strips replace in living room- sand and finish
re-install all trim removed in the process
painting- drywall primer plus finish coat of choice
3 ' hinged louver door on boiler room
MAIN LEVEL basement flooring by others or additional
re-install any facilities removed during repairs
baseboard trim for new walls
— —— Replaoa be.4�..r �borboarQS�
(a,"clea to c4:rv%*,e,7�
�O Go. mel �. �tr+oar �wK} tp c{��s1n��la�9c� }o Fra�n�
SASEN%EVYT LEVEL
J�GJOSK� KESi�uCE
073 3 N\c,spps Ave
f `✓ rrl.•.
n
♦ r4
NY tali,FE YI 1 7 I
COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY
OF 1010 COMMONWEALTH AVE.
MASSACHUSETTS BOSTON,MASS.02215
} `
CONSTRUCTION SUPERVISOR
LICENSE
)S
EXPIRATION DATE 01/31/94 v rsl, r .
RESTRICTIONS >02/01/91 EFFECTIVEgo DATE LIC-NO.
0 055417
L, O
I
i Thomas D. Zahoruiko
24 Woodland Park Drive
iaverhill
' � , MA 01830
PHOTO(BLASTING OPR ONLY) FEE: $150.00
HEIGHT' NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY
STAMPED -OR-SIGNATURE OF THE COMMISSIONER A
I, I DOB: �f
a THIS DOCUMENT MUST BE - -
CARRIED ON THE PERSON OF - ppp I���+++NATURE OF LICENSEE
1 f THE HOLDER WHEN ENGAG- /nv /j
•; OTHERS-RIGHT THUMB PRINT ED IN THIS OCCUPATION. �i0/ -�''^ ♦% / ^ ISSIONER
I