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Miscellaneous - 2350 TURNPIKE STREET 4/30/2018 (4)
0 ` The Commonwealth of Massachusetts Office Use Onlyr � 1 -- Department of Public Safety Gccupancy S Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 1200 3/90 (leave blank)lLl3 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CM,R I2:00 (PLEASE PRINT IN INK OR TYPE ALL INFOF.MATION) Date City or Town of LAN C JELL To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 23 Oc mer or Tenant O•.mer's Address Is this permit in conjunction with a building permit: Yes ❑ No (Check Appropriate Box) Purpose of Building _jgZ j*y C/ /���., p Utility Authorization 140. Existing Service /6 _Q Amps 0� 1jd Volts Overhead EJUndgrd No. of Meters_ New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work —5, 2 ()&&/11 r /^i�M .��a .-�ir A /%. .✓ `/ 9 /_ n ifsfn XrT w !' � � � i� � .. �// / /.. �L No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures No. Swim:nin PAbove In - grnd. ❑ grnd. ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners INo. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARIMS No. of Zones No. of Detection and No. of Ranges g Total No. of Air Cond. tons Initiating Devices No. of Sounding Devices No. of Self Contained Detection/Sounding Devices Local ❑ Municipal ❑ Other No. of Disposals No, of Real Total Total Pumps Tons KW No. of Dishwashers Space/Area Heating KW No. of Dryers y Heating Devices KW g Connec`i.on No. of Water Heaters KW No, of No. of Signs Ballasts Low Voltage Wirine No. Hydro Massage Tubs No. of Motors ITotal HP �I _ OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES ❑ NO [] I have submitted valid proof of same to this office. YES ❑ NO If you have checked YES, please indicate the type of coverage by checking the appropriate box. BOND ❑ OTHER F-1(PleaseSpecify) INSURANCE V Estimated Value of Electrical Work $ �oa o Work to Start_ & � Inspection Date Requested: Rough Signed under the penalties of perjury: FIRM NAME Licensee Signat ktxpiratt.on Late) Final LIC. NO. LIC. NO. Address Bus. Tel. No. Alt. Tel. No.��S2 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PEFL`IIT FEE" S � (Signature of Owner or Agent Date.............................. r TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ......... ......................... has permission to perform 61.n.4wz4,.ce.W ........................................ -:: wiring in the building of ........ CU ........ --41 North Andover, Mass. Fee/00 ............ Lic. No.&3-749 ......................................................... ELECTRICAL INSPECTOR Al, )r WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Office Use Only q13 014r Lfum 111uEFIfth of Ainr2 l #mitts Permit No. 3C�1IIi'=zrit of f 1 hHC �fETg Occupancy A Fee Checked �) BOARD OF FIRE PREVENTION REGULATIONS 527 VIR 12:00 3t�o (leave blank) /2J3 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts EIectrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date (XX or Town of NORTH NDOVFR To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. i Location (Street & Number) Owner or Tenant /�� Owner's Address z Is this permit in coniunctian with a building permit: Yes _ Na (Check Appropriate Box) Purccse of Suildina Utility Authorization No. Existing Service A4dUAmos jL96 j Z-7 `lairs Overhead _ Unacrnd ��✓ c Vcits Overhead Unc,rra (- New er�ice Amos _J — No. of Meters z No. of Meters Numcer of Feeders arc Amcactty Lccaticn and Nature of Prceosee Eec:rCal 1.11er>< a _ No. at -:gn,:ng Cutters No. a' Hct '.Cs No. of Transformers KVA I above.— In - No. of L:cnnng Fixtures I Swimming =cal grna. — crnc. _ I Generators KVA No. at Emergency Lighting No. of Receotacie Outtets No. at Oil =urners ; Battery Units No. of Switch Outlets No. of Ranges No. of Discosats No. of Cisnwasners - No. of Dryers Total No. of '.Vater Heaters No. or Gas :urners Tota[tons No. cl Air Canc. Heat Total Total iNo.of iourr.cs Tons KV11 i ScaceiArea Heating KV Heat:nc Devices KIN No. at No. of t(N Signs Ballasts No. of Motors Total Ho FIRE ALARMS No. of Zones No. of Detection ane Initiating Davices No. at Sounding Devices No. of Seit Containea Oetec:ianiSounaing Devices Local - Mun[c:cal Other Connect:cn Law voltage Wir:nc •eeuirements at .Ltassacnusens ;enera[ Laws — — ic:ucing Ccrno:etee Ocerations Coverage or its suostantial eeuivatent. YES — NO — flits. YES = NO _ If you nave cnecxea YES. -tease inaicate :rte type of coverage cy (Rease Scec:!y) i,ec%on Date Racuestec Rcugn Final (Exciration Oatei / LIC. NO. Signature / LIC. NO. Sus. 791. No. .6-63. % ZZ Alt. Tet. No. `at the L:censee noes not nave the insurance coverage or its suostantial eautvaie t as e- at my signature an ^:s permit ac-ticatian waives this reeturement. Owner Agent 7eiecnone No. PERMIT FEE 5 Y�j7 C.4. Date .......... �. �.a..3. 3 "sa 713 t NORTH � "0o� TOWN OF NORTH ANDOVER 12 * y PERMIT FOR WIRING CHU This certifies that ... ../....4...........\.........� k'�-..... .......................... has permission to perform ..... d. ..... ..................K�4r�.c......../ wiring in the building of . ..L at ..... Z3 -D ..... t"MSL, ... ... �.............. . North Andover, Mases moi^ Fee...�Q. .......... Lic. NoL—P.3..%/j ............................................................... ELECTRICAL INSPECTOR Uk 1 � S WHITE: Applicant CANARY: Building Dept. PINK: Treasurer ;1 .4 Y Date ... �3-... O/... TOWN OF NORTH ANDOVER PERMIT FOR WIRING d This certifies that ............!_................. ............................................ has permission to perform .... .`5." u c � pAN!- ( 1C�c �ocA� td . .......................................................... wiring in the building of ....F.�A wi q LA L' UA 4( .......................................................... V,( - at ..... 3.S..t7.....V.r'....�•.�.`..- .................... . North Andover, Mass. Fee...5...... Lic.No. �..ao....... ��.: JA. 1�ELECTRICAL INS Check # 5175 ?WE 69 XA V*4V---_e 4 POO& S40ty BOARD OF FIRE PREVENTION REGULA APPLICATION FOR PERMIT TO PE All work to be performed in accordance with the Masi (Please Print in ink or type all information) Town of The undersigned applies for a permit to perform the electrical work des Location (Street & Number Owner of Owner's Official Use /Only Permit No. 9.577s � Occupancy & Fee Checked✓ f CMR 12:00 11 ELECTRICAL WORK Electrical Code 527 CMR 112:00 Date / ' ;�A, e To the InspeGt6r of :fares: Is this permit in conjunction with a Purpose of Building permit Yes 0 No 0 (Check Appropriate Box) Existing Service © U Amps 2ZG %l0 Voits Overhead 0 Utility Authorization No. % ✓ �2� Undgmd 0 No. of Meters New Service / © el Amps. 0 Volts Overhead 0 Undgmd 0 No. of Meters T � Number of Feeders and Ampacity `� S7/�l / G U, i3 �'e,2 fi, r /CO ""1C Location and Nature of Proposed Electrical Work INSURANCE COVERAGE. Pursuant to the requiremenSts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO - e su valid proof of same to the Office YES = NO - If you have checked YES please indicate the type of coverage by checking the appropriate box. INSU - BOND . OTHER - (Please Specify) (Expiration Date) Estimated Value of. Electrical Work$ 7 d Q el Work to Start Inspection Date Resquested Rough Final Signed under the Penalties of perjury: FIRM NAME / LIC. NO. lycensee / Glt/�e U2� Sig ure t LIC. NO. P Bus. Tel No.� Address �lf.t'i7 , /� 7�ri~fl Aft Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE $ (Signature of Owner or Agent) Total No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA Above 0 in 0 No. of Lighting Fixtures Swimminq Pool gmd 0 gmd 0 Generators INA No. of Emergency Lighting No. of Receptacles Outlets No. of Oil Burners Battery Units No. of Switch Outlets No of Gas Bumers FIRE ALARMS No. cf Zone No. of Detection and Total No. of Ranges No'of Air Cond Tons Initiating Devices Heat Total Total No. of Diposal No. Pumps Tons KW No. of Sounding Devices NoJ of Self Contained _ No. of Dishwashers Space/Area Heating KW DeteeborlSounding Devices 0 Municipal 0 Other 1 No. 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 INSURANCE COVERAGE. Pursuant to the requiremenSts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO - e su valid proof of same to the Office YES = NO - If you have checked YES please indicate the type of coverage by checking the appropriate box. INSU - BOND . OTHER - (Please Specify) (Expiration Date) Estimated Value of. Electrical Work$ 7 d Q el Work to Start Inspection Date Resquested Rough Final Signed under the Penalties of perjury: FIRM NAME / LIC. NO. lycensee / Glt/�e U2� Sig ure t LIC. NO. P Bus. Tel No.� Address �lf.t'i7 , /� 7�ri~fl Aft Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE $ (Signature of Owner or Agent) Name: Location: City Phone am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing_ workers' compensation for my employees working on this job. Company name: - Address City Phone #: Insurance Co Policy # Company name: Address Citi Phone #. Insurance Co Policv # r Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. f l I do herby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name Phone # Official use only do not write in this area to be completed by city or town official' Ej Building Dept I]Check if immediate response is required Building Dept 0 Licensing Board p Selectman's Office Contact person: Phone #--E] Health Department 0 Other FORM WORKMAN'S COMPENSATION F 16. TOWN OF NOS " ANDOVER PERMIT FOR GAS INSTALLATION This certifies that . ;�:. ? 14-A.' - has permission for gas installation,–pl in the buildings of at ..! ....S i' .... , North Andover, Mass. Fee 5 .-.. Lic. No........... ..................... GAS INSPECTOR Check # l�J 55,7 a Is MASSAM SETTS UNIFORM APH ICATON FOR PERNIlT TO DO GAS F TNG (Type or print) Date a.-' 04 NORTH ANDOVER, MASSACHUSETTS Building Locations _ "23So Permit # Amount $ Owner's Name � Ao� - New Renovation ❑ Replacement ❑ Plans Submitted 11 (Print or type)V G y(_�e Ch k one: Certificate Installing Company Name /�� Corp. Address Q Partner. 1 N Cil � Business Te ep one 2�1 07;;2 S'�5- c Firm/Co. Name of Licensed Plumber or Gas Fitter�c �i�i� CDrWi (YGIT1ri'/ INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 13 No O If you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy P Other type of indemnity 0 Bond 13 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: Signature of Owner or Owner's Agent Owner 13 Agent E] -.7 ,,.,.111y L, — L— U, Wl,a unu ,iuuunauvu I uavc suMnnueu for enterea) in above application are true and accurate to the best of my knowledge and that all plumbing work and inAlations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massae uset State C, .ode nd Chapter 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) !Signature of Plumber Gas Fitter Master Journeyman SCd'PJLmlber Or Ga. Fitter �SoS% icenseLNumber 9 x 4 'e a o 9 iz n FW. C a z z W w w a F z z F z F ¢ z x F E;- W �• O O , z W o F z x o 3 a a a a U > SUB-BASEM ENT B A S E M ENT 1ST. FLOOR 2ND. FLOOR 3RD. F L O O R 4T 1I. FLOOR 5 T H. F L O O R 6TH. FLOOR 7 T H. F L O O R 8 T H. F L O O R (Print or type)V G y(_�e Ch k one: Certificate Installing Company Name /�� Corp. Address Q Partner. 1 N Cil � Business Te ep one 2�1 07;;2 S'�5- c Firm/Co. Name of Licensed Plumber or Gas Fitter�c �i�i� CDrWi (YGIT1ri'/ INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes 13 No O If you have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy P Other type of indemnity 0 Bond 13 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: Signature of Owner or Owner's Agent Owner 13 Agent E] -.7 ,,.,.111y L, — L— U, Wl,a unu ,iuuunauvu I uavc suMnnueu for enterea) in above application are true and accurate to the best of my knowledge and that all plumbing work and inAlations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massae uset State C, .ode nd Chapter 142 of the General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) !Signature of Plumber Gas Fitter Master Journeyman SCd'PJLmlber Or Ga. Fitter �SoS% icenseLNumber ... .......a .. �. ._ ...� _ — .._•.fid ST,I i'r r wr.,. �+...rg .. M1.s.Myi-n_ h .Y'3+.,. — w.[ M+.vER'V. .V, f VR Y l46'..FiM •. .Y%.. O111 Use Orth '7 'CY ur aXHar' .. _ .-.._ � •.-. w 1" � . w ht c':ummunu�l i�h of SIBS _PetmiE No. -� _ _ aritanrt of Fuhlft *ufdq _ _ y "occupancy Fee Checked _ 3190 (leave blas ) BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12.00 -- --. _. ` APPLICATION ..FOR -PERMIT 70—PERFORM ELECTRICAL WORK �`1= All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12 00 "- (PLEASE PRINT IN INK OR TYPE ALL`INFORNIATION) �' rt+ 'Date- CM Date-CM or Town of NORTH ANDOVER � `"-_To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below.. Z Location (Street & Number) Owner or Tenant M i?Q ( � Owner's Address Sri .i"%� 11V1 to t >• Owen Is this permit in conjunction with a building permit: Yes !� No C (Check Appropriate Box) Puroose of Building V � r-1-Vivu I-' Utility Authorization No. Existing Service Amos _1 Volts Overhead Q Undgrnd ' r No. of Meters New Service Amps _J Volts Overhead fi Undgrnd : f No. of Meters Number of Feeders and Ampacity z Location and Nature of Proposed Elect ?cai WcrK. I e c At ac- VLI _Total • No. of Lignting Outiets i No. of Hct as I No. of Transformers KVA No. of Lighting Fixtures i Swimming Pcoi gfbt'Ce_ gma r Generators KVA No. of Emergency Lighting No. of Receetacte Outlets I No. of Oil cumers Battery Units No. of Switch Outlets I NO_ at Gas Burners FIRE ALARMS No. of Zones I � Total No. of Detection ana - No. of Ranges I No. of Air Cerc. tons Initiating Devices t� No. of Oisoosals I No.of Heat oral Total Purn=s ons KW i No. of Bouncing Devices No. of Self Contained No. of Oishwasners ScaceiArea Heating KW Detect:oniSouneing Devices : _ No. of Dryers ! Hearing Devices KW — Municicai Local _ Connecnon Other ` y No. cit _ _ . No. of _ I Low vCttage �— d Wirinc 7"' 1 (` No. of Water Heaters KW Signs 9ailas s P - No. Hycro Massage was No. of Motors Total HP OTHER: ' INSURANCE COVERAGE: Pursuant to the reeuirements of Massac'usets general Laws YES iX NO = I .= 1 have a current Liaeiiity Insurance Policy inclucing Cam=:etea Cceratiens Coverage or its suostantial equivaient. have suomittee valid proof of same to the Office. YES NO :9 It you have- checxea YES. =lease indicate the type of coverage by . .� checking the approonate Cox. ~=(Please G INSURANCE— BOND = OTHER S erfy) _ _(Exciration Dater Estimated Value of E?e txicai Work S O fJ O ._:. !. /) ____ - Work to Starter .. e.--_ "ecuon Date Aecues:ec ,�, ougn• lAJ I I C4 I 1 nal . J Signed unser xteoneiric of perjury: C ' FIRM NAME VS 4 a V t t° UC. NO. — _ Licensee W O -KI Signature � LIC. NO. 1729,2 : �r�1 ![�� p ftft d 1) A� AA 3 P C tp' � t'7i ' r"� 2' ✓! [Y (7Y1 Y" l Cl Bus. Tel. No. Alt. Tel. !Vo. Address (-a "Y' ( t�'P'Vt _ _,0 OWNER'S INSURANCE WAIVER: 1 am aware that the licensee noes not have trio insurance coverage or its suostantial equivalent as re• : quires by Massacnusetts General Laws. ane mat my signature on tits permit application 'waives this reouirement. Owner - . Agent__ . (Please cnecx onel _ Teteonone No. PERMIT FE= S y ' (Signature of Owner or Agerm :•3005 Date .....�.� ! .' 611 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ................. ................. has permission to perform .. ..,,k,,rC... ... .. .. .............................. wiring in the building of .............. �!J�................ 1 at 23.57J........1-a�L.... .... ................ , North Andover, Mass. SSW Fee...3 . ......... Lic. No.1............................................................. �� iL� ELECTRICAL INSPECTOR /"'' �- 10109/96 11.51 35.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Date ... �........ �:... Z� TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that y.! ^..`'... .............................. . ,,,has permission for gas installation .............................. in the buildings of- ti .' ...= ..': .... .......-. ... ...... . -41 {� 1� i t ........ c '.. ,North Andover, Mass. Fee.. .. . Lic. No........... /. {1 t ............ GAS INSPECTOR Check# i 1 �' n MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) C�P��_, Mass. Da e3�_19 Permit # PIC' Building Location .3, �/n/v / Owner',s Named 4 G/! �Pay T Type of Occupancy_L Olrr°fvC%eor —'C, IM New ❑ Renovation ❑ Replacement 1Z Plans Submitted: Yes❑ No Installing Company Business Telephone - ��� Name of Ucensed Plumber or Gas Fitter 9 Check one: Corporation ❑ Partnership ❑ Firm/Co. �����■111111111111111111111.: Installing Company Business Telephone - ��� Name of Ucensed Plumber or Gas Fitter 9 Certificate C INSURANCE COVERAGE: I have a cu er�t liability insurance No policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes Jf you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy tn 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 Gas Code and Chapter 142 of the General s. BY T of License: Plumber Signature of Licens2ed lumber or �rFa tter Title sfitter Master License Number it 7 s City/Town Journeyman O I ONL Check one: Corporation ❑ Partnership ❑ Firm/Co. Certificate C INSURANCE COVERAGE: I have a cu er�t liability insurance No policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes Jf you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy tn 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 Gas Code and Chapter 142 of the General s. BY T of License: Plumber Signature of Licens2ed lumber or �rFa tter Title sfitter Master License Number it 7 s City/Town Journeyman O I ONL r Location = Date N°RTS TOWN OF NORTH ANDOVER O�t�ao ra1'y p Certificate of Occupancy $ v� 1i° ; Building/Frame Permit Fee $ ?,34- #: yes',^°•'��� Foundation Permit Fee s�CHuse $ cc Other Permit Fee $ C] Sewer Connection Fee $ Water Connection Fee $ TOTAL $ �✓ r 3 -1u' Ch --� Building Inspector Div. 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S v CO) O wCD Z O CD 0 CD Flo cn cn l J 0 cn a 7 O —• y O Q y = =1 O m o m Cli ra CDo. 0 3 O y Co -Pm y '71 O Q n r Q C CD -4o m y p y N O Ac ? CD J �•1 7 7 m CA a coO�O O .19 O d CA CC2) CD CD l„ J 1 E m : M C_ dg _y O. Q Vnl m ,••► m N • cn ? H • O IA O WCD t e o� to o � : D► -� '�► Q c+i o H 3 :� G 2 � „•„ . :. t Cl CDCD CD O OCLI O � Cl) :� 0 CO3 O i O CD t o rn p p C) O 71 O N, pip, tSJ G M rr) tl Z fD ]- ��si pC b _ 011 x go QM • 11 R 0 c II-Vl5 1JJb 11:22AM FRUM BHD"MIDDLETON 180023AO988 t OFFICE OF BUILDING INSPECUR -TOWN -OF NORTH ANDOVER n -''"`' '� s CONSTRUCTIOri CONTROL *1 SKI• �. . t PROJECT NUMBER: NOV B .i9.,5 PROJECT TITLEt Bicknell Huston Distributors Inc. PROJECT LOCATION: Building C d 2350 Turnpike St. No. Andover MA NAME OF BUILDINCs rNAIURE OF YROJECT3 Fire Detection and Alarm System Installation IN ACCORDANCE WITH SECTION 127:0 OF THE HASSACHUSEITS STATE BUILDING CODE" 1, -Maurice M. Pilette, P.E. Registration No. 36346 BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECT HEREBY CERTIFY THAT 1. RAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICA- TIONS CONCER`iING: ENTIRE PROJECT C= ARCHITECIURAL= STRUCTURAL r---1 MECIUUIICAL EZD FIRE PROTECTIONS X ELECTRICAL = OTHER (specify)= FOR THE ABOVE NAMED PROJECT A11D THAI', TO THE BEST OF HY Y-NOWLEDCE, SUC11 PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE"APPLICABLE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE yR4CTICES.- .AND APPLICABLE LAWS AND ORDINANCES FOR IRE PROPOSED USE AND OCCL'DAPCY. .1 FURTHER CERTIFY THAT I SHALL PERFOR'f THE NECESSARY PRCFESSICNAL SERVICES Al=D BE ".PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETEP11111E THAT THE WCR.X IS PRCCEEDING Iii ACCORDANCZ WITH TEiE DOCUMEVIS APPROVED. FOR TILE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPSCIFIED IN .SECTION 227.2.2: I. Qev2ev of shcp drs"s, samples end o_her S.: -:31s of t`'4 c=nLyactax as reQuired by the ccnSc_-=.lcn c=tract docu=ts as submitted fc: LWIldi g pwait, end appromal for conformance to the design cencepte 2. Review and approval of the gualit7 c--nt of proce_,aes for all Cade -required ccnuvlled materials. 3. Special 8tchitectural or engineerirsj g-:esSi=-.al.inspecticn of critical c°tr+persen_ Lien ca is requiring eonuvlled mterials ar c --M sMticn spe-ilie3 in t_tie actepc : Bring practice erandards listed in Appendix B. - t�� PURSUANT TO SECTION 127.2.31 I SHALL SUBMIT WCCKLY , A PRR %�ITii PERTINENT COMMENTS TO TETE NORTH AN='Yt;it BUILDING IN UR UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS T .'.COMPLETION AND READINESS OF THE PROJECT FOR OCCUPAl7CY. SI 1 SUBSCRIB Am, TO BEFORE HE THIS 5th DAY OFNovember J9 96 IdUTARY P�/!' MY COMMISSION EXrIRES July 10, 2003 OFFICE `OF BUILDING INSPECTOR , •'4 �.� -TOWN -OF NOR71*11 AND -�- CONSTRUCTION CONTROL PROJECT NUZIBERt b 4 PROJECT TITLEt B ckneli Huston Distributors Inc. PROJECT LOCATION: Building C ri 2350 Turnpike St. No. Andover MA' NAME OF BUILDING: NATURE OF PROJEC13 Fire Detection and Alarm System Installation IN ACCORDANCE WITH SECTION 127.0 OF THE HASSACHUSETTS STATE BUILDING CODE, 1, -Maurice M. Pilette, P.E. Registration No. 36346 BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECT HEREBY CERTIFY THAT I.11AVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLAITS, COMPUTATIONS AND SPECIFICA- TIONS CONCERNING: ENTIRE PROJECT_ Z ARCHITECTURAL r 7 STRUCTURAL (Z MECHANICAL [�] IFIRE PROTECTIONX ELECTRICAL Q OTHER (specifp)Q FOR THE ABOVE NAMED PROJECT AND T1tAT, TO THE REST OF MY K.tOHLECCE, SUCII PLAt1S, COMPUTATIONS AND S2ECIFICATIONS MEET THS'APPLICABLE PROVIS10r1S OF THE HnSSACHUSETTs STAIE BUILDING CODE, ALL ACCEPTABLE FR�cZICEs. .AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY.- 1 FURTHER CERTIFY THAT I SHALL PERFOR14 THE NECESSARY PROFESSICNAL SERVICES AND BE PRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETF-PJ111IE 11LAT THE UCR.K IS PROCEED" I1; A.CCORDAI+CE WITH TETE DOCUME11T5 APPROVED. FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOUIIIG AS SPS=IED 1.4 .SECTIO11 127.2.2 r 1. view of shcp ckauings, samples end o.1e- s•,:b•?t_als of tSe ccnc_•actQr as required by the cmLsczuc:icn c=tract documnu as submdttsd fc, L.:ildi,S permit, and al for co�forrnance to the design c=cspt. 2. Review and approval of the quality c.--nttel pzoce-y.cex for all code-ccquired centzvlled mterials. 3. Special architectural or engineering F=!essicnal.inspecticn of critical cons t-wticn carrperr�cs requiring controlled materials cr c_-ztrvctirn s p•s=1.Eied in Ltie actepce<d.: ineriiig.�Pzactica standards listed in Appendix B. PURSUANT TO SECTION 127.2.3, 1 SHALL SUBMIT WE'EKLY' 1N EKLY � ` A PR li ItEORT: TOG' R .y NITH PERTINENT COMMENTS TO THE NOIt•,LH ANU:;YER. BUILDING INS! SUR UPON COMPLETION OF THE I:ORK, I SHALL SUBMIT A FINAL REPORT AS T .E\�S T1�FA ,COMPLETION "D READINESS OF THE PROJECT FOR OCCUPA27CY. j . S1 t SUBSCRIBE ANA UI 1 :ICO BEFORE HE THIS 5th DAY pFNovember /4 96 NUTARX P BL7.Sr: t1Y COMMISSIOti EXrIRES July 10, 2003 .1.11AM J. SCOTT Director Town of North Andover OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES 146 Main Street North Andover, Massachusetts 01845 oo✓. IS ISS( - i3 k km -1-Z- - H Los 7-,p .0 1D, s r 1•�v2RY A 1..7o Vt�� nfA vi8�� C•S.�*os iVl2 3 I C �21w��� � ••• Car � 1(�� �'i s � r�-G�' 13 -� ti cigCL w���l STc.� ��g o "'!� Faq o (=r=- LC w�-rL(— s s o�,� C ;A, J)w 4t *'A- *q-2-/-7 C3 Gr i . '�3 2u iu a R `3s °1 C✓s+-Tc:s� SNC , To 077�1�Z w�a2k 73 !3c' �c72 Fn rTl•, 61> l Jl �'T i L `� u i Lrp, F- 12--k 3:!T w, L L .�.-e A c7� t.� /-t �1u !'.z� i L Z)I )u 4- PtTL �n.� 11 SCC" Z`3S U 6-0 . BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEAUM 688-9540 PUNNING 688-9535 FORM U - VERIFICATION FORM ' INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ************* ***Applicant fills out this section****************** APPLICANT: du5Jo Phnner6i6,k) -�Q- - Mry� LOCATION: Assessor's Map Number Parcel C Subdivision • Lots) Street X350 eW`c K� O( �� �oXvQWySt. Number z35� ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Conservation Administrator Comments Town Planner Comments Food Inspector -Health Septic Inspector -Health Comments Public Works - sewer/water connections - driveway pe it Fire Department Received by Building Inspector OCT 2 8 1990 Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Date V . R Lf a 0 c a C C a V I c u a P"405 397 066 US Post4-$ervice Rfceipt for Gertmea man No&nsurance coverage Provided. Do not use for International Mail See reverse Sent to J�t4 Str &N umber 3 bZ� l Post Office, State, & ZIP Code Postage $ Certified Fee Special Delivery Fee Restricted Delivery Fee Return Receipt Showing to Whom & Date Delivered Return Receipt Stowing to Whom, Date, & Addressee's Address TOTAL Postage & Fees 1 $ Postmark or Date Town of North Andover OFFICE OF 14ITY DEVELOPMENT AND SERVICES 146 Main Street North Andover, Massachusetts 01845 Fab Tech Inc. 2350 Turnpike Street North Andover, MA 01845 To Whom It May Concern: February 28, 1997 You are hereby ordered to cease and desist all work at 2350 Turnpike Street location immediately. The following is a list of violations: 1. Blocked egress/access from building 2. Inadequate ventilation (BOCA Mechanical Code) 3. Exit signs inoperable 4. Entry door is locked and dead bolted from outside building. Yours truly, D. Robert Nicetta, Building Commissioner N/g <,, w clew 'iec r BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 f Office Use Only viii: Tommumealth of star4alm Permit No. Je:VM-tMrnt Df JIu131"tt _%fYtg Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 C &1R 12:003190 peave bank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Q*or Town of NORTH ANDOVER To the Inspect r of ires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) Owner or Tenant Owner's Addressr— IS this permit in conjunction with a building permit: Yes _ No Cum (Check Appro x) Purpose of Building Existing Service Amos _J Volts New Service Amps Voits Utility Authorization No. Overhead '_ Undgrnd No. of Meters Overhead _ Uncgrnd r No. of Meters Numcer of Feeoers ana Amoacity Lccaticn and Nature of Prcoosea Mectricat 'Norx -2�20� /ALC �cIO 1211-W Z: /127 DRI-74E"y H No. of Transformers o `a No. of Lighting Outlets � No. at ',:bs KJA A No. of Lighting Fixtures i Swimming Peci g...rae- arra. _ I Generators KVA No. of Emergency Lighting No. of Receptacle Cutlets I No. of Cil Burners Battery Units No. of Switch Outlets ; No. of Gas Burners FIRE ALARMS No. of Zones Tota[ No. of Detection ana No. c'. Air Colic. No. of Ranges I tons Initiating Devices No.of Heat Teta) Total No. of Disposals Pures ;Ons !CW No. of Sounding Devices No. Contained No. of Dishwashers � SpaceiArea Heat:ra !(1.•J Detea ctiontion /Sounding Devices JI Mun[cioat No. of Orvers Healing Devices KW LOCat Connection _Other No. at No. of Low Voltage No. of Water Heaters KW ! Signs Bailasts Wiring No. Hyaro Massage .ubs No. of Motors —,ora; HP 07HER: INSURANCE CCVERAGE. Pursuant to the requirements of Massacnusers general Laws I have a current Liaoiiity Insurance Policy inducing C^ c:etec Operations Coverage or its substantial eeuivaient.�F_S::NOnave suomitte° valid proof of same to the Otfic . • ES = NO = If you nave cnecxea YES. please mtlicate thoverage by checxing the appropriate box. INSURANCE — BOND — — OTHER = lPlease Scec:t•+f — (Exairation Date) Esnmatea Value of E!ectncat WorK S , �� Worx to Start 41 / � zq,h Insoec:.on Oate Racuestec: Rough (O Fnai irf)GL C`�1G Signed uneer the Penalties of perjury: FIRM NAME LIC. NO. Licensee 4&6 �LL �PQ% Signature�11 LIC. NO. Bus. .el. No../�/7-_2 7.9 Atldress Alt. Tei. No. OWNERS INSURANCE WAIVER: I am aware that the Licensee aces not have the insurance coverage or its suostantial eeuivaient as re- ouirea by Massachusetts General Laws. ana that my sig/nature on tt::s permit application waives this requirement. Ownp[� Agent (P!ease cnecx one) C ' �G T�/[��/S^d I tj eieonone No. PERMIT FEES ' iSionature of Owner or Agetxi x•6EE5 Date ..... 584 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...... C�L- .. .... VS has permission to perform . wiring in the building of ... ...... ... ............... JJ . ......... .. ....... B(.%.e-,North Andover, Mass. Fee ..... 7S. Lic. No. �'-d�4:� ............................................................... ELECTRICAL INSPECTOR 75.04 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer cec .�- � aL w u x CERTIFICATE OF USE & OCCUPANCY Town of North, Andover Building Permit Number-5, umber_5, 9 6 Date3 v 9 THIS CERTIFIES THAT THE BUILDING LOCATED ON MAY BE OCCUPIED AS IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO 14 ADDRESS _ I ding pector -0 A a rA rA co C� O O y 'J Sc "" cc CL Cmt C 6 •CD O CL Q- : 0 m cl 0 0 In H E m m CIE 0 • y H u�� t • � Z . y m zip to m mo aC2 m = O cm o ccc: z 'o tca o.� Z O moo vi H m�m =3 "C = m : N $ vi o o o s w =o ZE2 c +- � -C—O2 at cc = Z C.3 m C. 0) g y a 4DCD ca cm f- S. i 0 CD L O V Z a O y v � CD cm C C CA G 'M c h mm O O co O O G O L m O _ a � cm Q C CD C O co go C Z 5 C.3 h � C C � C c CLCOD 0 0 Q t O O `- 1) N M e I. aoi Job Jr (h Q7,,,],, � 0.4 C., Fj � \ CS (� •, h � C ,3 w c9i w° ° U w a°' w w w c3i c�° rs'a c C� O O y 'J Sc "" cc CL Cmt C 6 •CD O CL Q- : 0 m cl 0 0 In H E m m CIE 0 • y H u�� t • � Z . y m zip to m mo aC2 m = O cm o ccc: z 'o tca o.� Z O moo vi H m�m =3 "C = m : N $ vi o o o s w =o ZE2 c +- � -C—O2 at cc = Z C.3 m C. 0) g y a 4DCD ca cm f- S. i 0 CD L O V Z a O y v � CD cm C C CA G 'M c h mm O O co O O G O L m O _ a � cm Q C CD C O co go C Z 5 C.3 h � C C � C c CLCOD 0 0 Q t Date.. .... . NOFTM TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ... 1p 46 .... ............ has permission for gas installation :%' !! . t . �?'i�.. �!�! {G . . u in the buildings of .. �1j ryn P.... /�",.'m. C"'l ! ": MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) e AT: bia., 4-jolek , Mass. City, Town Building O �S Locatio ! _ t�fnT. i ,P Date Permit # Owner's r Name ��C(-fY1L tLlml,�n� Type of Occupancy: New ❑ Renovation C" Replacement ❑ - Plans Submitted Yes ❑ No ❑ krruu yr type) '' Check One: Certificate Installing Company Name k) d P ni�IriC R7 Corp. Address Business Telephone L 4!! Q Partnership U Q ❑ Firm/ Company Name of Licensed Plumber or Gasfitter 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 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 liability insurance including completed operations coverage. Sipatum of Owlw/Agent I have a current liability insurance ooliev, to include completed nnamtions coverage. fl TYPE LICENSE: ❑ Plumber Signature of Licensed Plumber or Gasfitter Gasfitter c� ❑ Master / o ? l ❑ Journeyman License Number By Title City/ Town APPROVED mmm use ONLY FORM 1243 A" en 11. V.\I M 7020 I F V W1 I m����e■■��e�■�■ase■■������■��■ cm MEN krruu yr type) '' Check One: Certificate Installing Company Name k) d P ni�IriC R7 Corp. Address Business Telephone L 4!! Q Partnership U Q ❑ Firm/ Company Name of Licensed Plumber or Gasfitter 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 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 liability insurance including completed operations coverage. Sipatum of Owlw/Agent I have a current liability insurance ooliev, to include completed nnamtions coverage. fl TYPE LICENSE: ❑ Plumber Signature of Licensed Plumber or Gasfitter Gasfitter c� ❑ Master / o ? l ❑ Journeyman License Number By Title City/ Town APPROVED mmm use ONLY FORM 1243 A" en 11. V.\I M 7020 M*pw Q i IUnn eityxip - - 4m & T,'hipm I I dq94 Ar.110710''e 2c bb tw I. I.Arn a'64-10-'rw am &Vner�Lcontu �-ajjd.j. 4� t"". �i�e.sv�ts contractors Lam a ao proprietor: or partmr-, . the atWhec:sheet: ship and have no employees Wotlti ,g for nit ki O rS 1,04DI .5. ETW prat e�pres-wrp aon and its,, officers have exercised ami m & homeowner 46 i1work, ' , irg,la right of exemption myself. INO-workers' 1521"0(ftj . IIA. V*O no b,=a= muted:]T emo Gyms -t No VOW �mctqrsthat ,ditck this; Typ-94-projoct (required): I [3Remordeling R.EJ IBuading;addition IIE] Aodf repairs BE Inman employer ih mtsurancoj . br)7y,:4fflW loyeas. Belaw, WhepaUcy and job &t information. .Insuranto'bompariy:iqiime;—Nla.41 0 naul Infe-re4nio- in -z CA 1Ajrunnj~c 1.., cm,-, .policy #,or SafAns-uc.. #:: UIP -V-d.14 3003SDh EvimfionDaip"... A La I / to T& -Site C"i Attach cagy Oftjjt *.4orUr s' coffipe mai.404 will mElieW 15� can lead e mpositioftf o cnmm penalfifs of a fine:*Wtos,l,$60,00ail&lbrone-dear �� oniftentmmellas, f. uppris ofd to 414 p -$�56,0 tA y-*i'nd vialatot : Be 9&he.0 OW A SPYof ft -,# ffiobt #y:6: -de f ifiv'04ufbos,of the OIA f 40% m -age . tf QrW en ;440* I dolerebyn&9*1,&epmAtdpen�pe.ofpe.-jury&&*e:ip#'or)ft4*Onprodded above t':sl.tie :and:correct. Lai Officiatus,camly. Do not m*e InIkisarea, to4evompleted,'by.vit , r. n — y 0 &W OfficiaL city -o f Taw"N.-Ir rip. A Pease # I-Ssuing Authority ptdrkO IOSPOOW S. PIUM-bb.j. Inspettor 6-- Other. ODutact.Person: Phone 4- Y-1 PERMIT NO.: UNIT NO.:_ o. O Town of ,�,s=,<��s�''• NORTH ANDOVER BUILDING PERMIT INSPECTION REPORT f\ 7 —PROJECT: `�,5�� rC� R h �� Ii ( St•INSPECTION DATE: o FLOOR: WING: BUILDING NO.: Fo, L e C -T,Spcc REMARKS: ttfj . U Sf- r?,,�//G.I ��I�r fr(� `✓� X°S iln'P ✓1 ti'ld('e r, T'„�� Framing - Other: f' C.o21 cut J h 4S Date: Date: �— JG c �e , , F 1, �f c R Gam . Jt. S P. E0 •Y2 G ( �� t' ��tc �1�1 �Jy (CA-iz*o,\ 5• Date: Date: Inspector Inspector Inspector Electrical - rough - Plumbing and/or gas - rough - Other: Date: Date: rl 6 P R rA '0 OX —to C 0 NN;z� //, � �' 7” Excavation - depth and soil conditions Framing - Other: f' C.o21 cut J h 4S Date: Date: Date: Inspector Inspector Inspector Footings and foundations and drains - Insulation - Other: Date: Date: Date: Inspector Inspector Inspector Electrical - rough - Plumbing and/or gas - rough - Other: Date: Date: Date: Inspector Inspector Inspector Electrical - final Plumbing and/or gas - final Other: Date: Date: Date: Inspector Inspector Inspector Fire Dept - oil burner, tank, stove, smoke detectors Final inspection Certificate of Use and Occupancy Date: Date: Date: —Cof 0# Inspector Inspector Inspector corm #Wt) Action cress, use -mm ✓9(o lie, \ Office Use Cnly u�JP LAITIIIIIITI11IPc� I IIf gimiar#EEtt Permit No. 'Be>r aril int Df Vuhi(t —EiinfEIIl Occupancy &lee Checke� 2M (leave blank) 1 l BOARD OF FIRE PREVENTION REGULATIONS 527 C'dA 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Eiectricai Code, -27 CMR 12:44 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date %0' 2 T" 9 � QM or Town of NORTH ANDOVER To the Inspector of. wires: The udersigned applies for a permit to perform the electrical wcrk de crib low. Location (Street & Numbe� Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes (Check Appropriate Box) Purpcse of Suildinc ©� IC46 Utility Authorization No. Existing Service Amps —J - Vcits Overread Undgrnd r Na. of Meters Ne -.,v ServiceAmos �J Vaits Overrleac Uncgrnd (� No. of tiieters Numcer of Feeders and Amcacity %% l Lccatjen and Nature at Pr000sea c-lectric ai .'Icrx 'to cat No. of L:gnang Outlets i No. c`. -ct %,=S i' Ng. of Transformers KVA Above—In- — { No. of Lighting Fixtures �L%. i Swimming Col grnc. crnc. ! Generators KVA No. of Emergency Lighting No. at Cil Surners _- j Battery Units OTHER: INSURANCE COVEPAGE: pursuant to the reau+rem.ents at %1assacn1-se,-s general Laws - - I have a current Liao0ity Insurance Paticy including Careered Operations Coverage or ;ts suostanaal equivalent. YES NC - have suominea valid proof of same to the Office. YcS rt(7 - It ycu nave cnecxea YES. please indicate the type of coverage Cy checxtng the aoprP1411le Cox. INSURANCE V BCNO = OTHER = (Pease Scec:fy) tExpiratton Oatei sttmatea Value at E!ec:rtcal Work 5 ..�t C Final �=• t worx :o Start - Ir -C/ J. Inscec::on Oate �acues:ec: Rougn (/ Signed under the Penalties at perjuryf� J 2 / 3 Y FinM NAME o1a e2 C o t..J v� tic. NO. 14S a Q2s{5�✓ Signature UC. NO. --q — L:censee LS b y r3 a Z r' �' i �l t� Sus. TaI. No. Address M 5� l e- I ke 1.a3 awl �i�ee C ws Alt. Tel. No. OwNEP'S INSURANCE WAIVER: I am aware trial '_!Censea noes not nave the insurance coverage or its suostannal eautvaleflit eni cation varves this reoutrement. Owner e cutrea ay Massachusetts General Laws. and that my signature on :r::s 2ermtc aoptt9 (P!ease cnecx one) -e+ecngne No, PERMIT FEE S (Signature of Owner Cr Agentl 1 1 FIFE ALARMS No. of Zones No of Sw+tcn Outlets No. or Gas Bunters _ Total No. of Cerection and No. of ?angel I No. of Air Cara. tons Initiating Zav+ces Heat Tata+ No.at dtat KW No. at Sounding Devices No. of pisoosais ?a -as Tons No -of Saif Contained </ Oetect:ontSounCing Oev+ces No. at Cisnwasners - ! SoaceiArea rearing _ KW — Muntc:oal — Other Local No. of Owers I Heatcnc Oevices _ Cannec•ton No. or No. of Law Vcltage No. I / of `Nater Heaters / tCW II Sicns Badass Winnc — •-..-,- AA—.. . Tuns ! No. of Motors Total HP l OTHER: INSURANCE COVEPAGE: pursuant to the reau+rem.ents at %1assacn1-se,-s general Laws - - I have a current Liao0ity Insurance Paticy including Careered Operations Coverage or ;ts suostanaal equivalent. YES NC - have suominea valid proof of same to the Office. YcS rt(7 - It ycu nave cnecxea YES. please indicate the type of coverage Cy checxtng the aoprP1411le Cox. INSURANCE V BCNO = OTHER = (Pease Scec:fy) tExpiratton Oatei sttmatea Value at E!ec:rtcal Work 5 ..�t C Final �=• t worx :o Start - Ir -C/ J. Inscec::on Oate �acues:ec: Rougn (/ Signed under the Penalties at perjuryf� J 2 / 3 Y FinM NAME o1a e2 C o t..J v� tic. NO. 14S a Q2s{5�✓ Signature UC. NO. --q — L:censee LS b y r3 a Z r' �' i �l t� Sus. TaI. No. Address M 5� l e- I ke 1.a3 awl �i�ee C ws Alt. Tel. No. OwNEP'S INSURANCE WAIVER: I am aware trial '_!Censea noes not nave the insurance coverage or its suostannal eautvaleflit eni cation varves this reoutrement. Owner e cutrea ay Massachusetts General Laws. and that my signature on :r::s 2ermtc aoptt9 (P!ease cnecx one) -e+ecngne No, PERMIT FEE S (Signature of Owner Cr Agentl F Date .....� y13 - 551 TOWN OF NORTH ANDOVER Mow PERMIT FOR WIRING This certifies that.. ....... ,G' .......... ,��..�,.c a'r---- ............. has permission to perform -r ...... . ........... wirin the b ' ding of ...1,7. ,. Z?.......�1.. at ..... . . ........ .... ,North Andover, Mass. Fee. Lic. l............................................................. ELECTRICALINSPECTOR L/ '&'2- S WHITE: Applicant CANARY: Bj0MJ%ejS*ll PINK:MaKer PAID &. SSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO UO GASFITTIN - (Print or Type) NORTH ANDOVER , Mass. Date 11;'WG 1 f3uilding Location ; /� �- r Owners New 77 Ren vation Replacement IT]"' Plal Permit # r' r Name s Submitted D Type) Business Name of Check one: Certificate Q Corp. Partner. Firm/Co. \ Y • 1 MEMO Emommus mmommommom ME MEME son • • • • ��■■■■■■■.■om■MERME■ (1 • �■�■■■■■MOMEME Z■■■■■EN■R■ a ■■��■no mo■■■ 0 monsoon Ma 0 EMENESEENEEN MINES Type) Business Name of Check one: Certificate Q Corp. Partner. Firm/Co. Telephone: ?� E— Licensed Plumber or Gas Fitter b h k -n the Insurance Coverage: Indicate the type of insurance coverage y c ec l g appropriate box: Liability insurance policy U Other type of indemnityE] Bond 0 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 coverages. Signature of owner/agent of property Owner 0 Agent El I hereby certify that all of the devils and information 1 have submitted (or entered) in above application are true and accurate to the best of MY knowledge and flat all plumbing work and installations performed underPermit itteed fo: this application will -be In compliance with all P=tlnenf provisions of tho hLssachusetts Slate Gas Cude and Cluapter 141 of tho Genera! Laws. By Title City/Town: APPROVED (OFFICE USE ONLY) TYPE LICENSE: Plumber Ga s f itter- Master Journeyman Signature of�censed p�G fitter License -Number Q Location -2 3 S D No. �� oZ Date 3 N0*y" TOWN OF NORTH ANDOVER 0�.•o .•'��.0 i • pL 9 Certificate of Occupancy $ Building/Frame Permit Fee $ VSs...... sE Foundation Permit Fee $ Other Permit Fee obi $ �f�y�U� TOTAL $ Check # 656 �`^-- Building Inspector t Date.... ................. TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ....... �........................... has permission for gas installation .<.' ...�...................... in.,the buildings of ........................................... at , North Andover, Mass. Fie.:.`...... Lic. No..,<...'. .......................... GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING J- 77777' BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Apy Building CommissionedI for of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 235-0 , eN®,er --'�7- 1.2 Assessors Map and Parcel Number: . o C- c� Map Number Parcel Number 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Area (sf) Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Recmired Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: Public ❑ Private ❑ Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record n 4'LI%lyiF l'�il�'///Uf�Ti/V(� 2 75-6 1y�NRK& ?--r> N, /7NUa v C< Name (Print) Address for Service % 8 = %zs- Signature Telephone 2.2 Owner of Record: -:q-og'c d�� i r A I A 2 �dr e w< <cQ jy + Name Print Address for Service: 9 Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: D� / EMTi 1>74101e Lo z47b.V �i9mES �}rST Licensed Construction Supervisor: 6 AL -A,,,, -E l�akinnbiv , ^4 a 7Y P Address Sig lure Telephone Not Applicable ❑ etd$ O M License Number s- zy-as Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable Com -;.any Name Registration Number Address Expiration Date Signature Telephone 00 M Z O 1 V 1 Qj d O Z M 90 O r v M r r Z 0 SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 § 2506) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) V Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: PVS`MLL 610 GvO'r L70AMCC14L 64pF lvrrW 12E6*„ f 81Cn0 SOF-r nF 6x,MM& cPAn, a ef Qoo.4 INSTq« 1V E1 JNfc LA-noN AND EPP1%-, Goic 5ti5-nF�_ SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to he Completed by permit applicant OFFICIAL USE ONLY 1. Building -79,006 (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction /7 ! e 000 / 3 Plumbing Building Permit fee (a) x (b) P'.r � 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 D Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, , as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNEER/AUTHORIZED AGENT DECLARATION 1, z,- J c S 4537— as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief y� ( Q(/J� ✓ / �- iLr Print Name a "7-2i_d? Si nat of Owner/A Ient Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TU413ERS 1 ST 2 ND3 RD SPAN DIWNSIONS OF SR.,LS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS FIEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BIJII DING CONNECTED TO NATURAL GAS LINE w o t` iL �578s #k. 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 properly licensed solid waste disposal facility as defined by MGL Chapter 111, S 150 A. The debris will be disposed of in: E. L, �/A�'�EY �/ASrE IBESr4o�e , AA (Location of Facility) Signature of Permit Applicant 7 -ZR- 03 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector C.F.NTTMARK Roof Svstems I WL Attn: Mr. Eric DiGrazia LOCATION: 2350 Turnpike Street, North Andover MA 01845 SUBJECT: Building A - 8,160 SgFt ROOF SYSTEM: Conduct safety briefing / Install necessary safety equipment Remove existing roofing and insulation and dispose of properly Remove & replace deteriorated steel decking at an additional $5.35 per SgFt Install 33" rigid, closed cell polyisocyanurate insulation Install CENTB4ARK FULLY ADHERED 60 mil EPDM ROOF SYSTEM Flash 180 SgFt of walls with CENTIMARK approved detalling Install a new surface for the flashings at 50 LuFt of tie-in to the gable end wall of metal building Raise the height of the skylight curbs with new pressure treated lumber Flash all curbs, stacks, skylights etc. with CENTIMARK approved detailing Install and flash four (4) new pitch pockets, fill and crown with pourable sealer Install new protective pad at roof entrance point Install 160 LnFt of new pressure treated wood nailer to receive apron gutter Install 160 LnFt of new .040 aluminum custom apron gutter with a kynar finish Install 212 LnFt of new .040 aluminum custom metal edge with a kynar finish Install four (4) new downspouts with all necessary outlets, endcaps, offsets & straps Clean up and remove all job related debris TOTAL (INVESTMENT: $64,621 .� WARRANTY: 20 years complete system warranty OPTIONAL PRICING: Install 219 LnFt of gutter with necessary downspouts. outlets, endcaps, offsets & straps Done in conjunction with roofing prof . Add - $3,792 Done separately to roofing project: $6,142 PRICE FIRM UNTIL: July 15, 2003 ,. David Pineo - Branch Manager 6 Avenue E ♦ Hopkinton. MA 01748 $88-523-2187 ♦ 508-435-0999 ♦ Fax 508-435-0110 Nationwide ♦ 1-800-558-4100 ♦ www cmdwari-com R: f C.F.NTTMARK Roof Svstems I WL Attn: Mr. Eric DiGrazia LOCATION: 2350 Turnpike Street, North Andover MA 01845 SUBJECT: Building A - 8,160 SgFt ROOF SYSTEM: Conduct safety briefing / Install necessary safety equipment Remove existing roofing and insulation and dispose of properly Remove & replace deteriorated steel decking at an additional $5.35 per SgFt Install 33" rigid, closed cell polyisocyanurate insulation Install CENTB4ARK FULLY ADHERED 60 mil EPDM ROOF SYSTEM Flash 180 SgFt of walls with CENTIMARK approved detalling Install a new surface for the flashings at 50 LuFt of tie-in to the gable end wall of metal building Raise the height of the skylight curbs with new pressure treated lumber Flash all curbs, stacks, skylights etc. with CENTIMARK approved detailing Install and flash four (4) new pitch pockets, fill and crown with pourable sealer Install new protective pad at roof entrance point Install 160 LnFt of new pressure treated wood nailer to receive apron gutter Install 160 LnFt of new .040 aluminum custom apron gutter with a kynar finish Install 212 LnFt of new .040 aluminum custom metal edge with a kynar finish Install four (4) new downspouts with all necessary outlets, endcaps, offsets & straps Clean up and remove all job related debris TOTAL (INVESTMENT: $64,621 .� WARRANTY: 20 years complete system warranty OPTIONAL PRICING: Install 219 LnFt of gutter with necessary downspouts. outlets, endcaps, offsets & straps Done in conjunction with roofing prof . Add - $3,792 Done separately to roofing project: $6,142 PRICE FIRM UNTIL: July 15, 2003 ,. David Pineo - Branch Manager 6 Avenue E ♦ Hopkinton. MA 01748 $88-523-2187 ♦ 508-435-0999 ♦ Fax 508-435-0110 Nationwide ♦ 1-800-558-4100 ♦ www cmdwari-com ACORD.a, « �c sn :x,-s:e: :a•a:a •^ra..: y. z DATE(MMIDD/YY).. PRODUCER r' 's 04/30/03 ' Aon Risk Services, Inc. of Pennsylvania THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO Dominion Tower, 1 Oth Floor RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES 625 Avenue NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED burgh Pittsburgh PA 15222-3110 BY THE POUCIES BELOW COMPANIES AFFORDING COVERAGE COMPANY PHONE - (412) 594-7500 FAX - 4125629606- A Continental Casualty Company INSURED Centimark Corporation COMPANY Transportation Insurance Co. 12 Grandview Circle Canonsburg PA 15317 USA COMPANY American Casualty Co. of Reading PA COMPANY _. W eY:-1 v.�.riS:... .:� i:•. :,.. c;'P W'6 Alii � �`�. '.: �' ..•. '- :•4" :•.-_i•+i4�../{�Je [.iL'.if ::Zw-R . _•1;2 .''t}t :t'I�i THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE'BEEN ISSUED TO THE iNSUREO NAMED ABOVE FOR THE POLICY PERIOD INDICATED. N07VNITHSTANDING ANY REQUIREMENT, TERM OR CONDfiON 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 CONDMONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. � TYPE OF INSURANCE POLICY NUMBFdt POUCYEFFECTMPOUCY E WRATTO DATEM/D DIM DATE (MMIDDNV) LadITS A GENERAL LtAORM GL251940534 05/01/03 05/01104 GENERAL AGGREGATE $2,000.000 X COMMERCIAL GENERAL LIABILITY PRODUCTS -cowioPAGG $4,000,000 :�.`. CLAIMS MADEQ OCCUR PERSONAL 8 ADV INJURY $1.000.000 OWNERS&CONTRACTORS PROT EACH OCCURRENCE $1,000,000 X AGGREGATE UIMITS FIRE DAMAGE(Any one fire) $100,000 APPLY PER PROJECT MED EXP (Anv one person) $25,000 A AUTOMOBILE LU►BB I7Y BUA251940548 05/01/03 05101/04 X ANYAUTO COMBINED SINGLE LIMIT $1,000,000 ALL OWNED AUTOS 8001LY INJURY SCHEDULED AUTOS (P«>>�I HBIED AUTOS BODILY INJURY NON4)WNEDAUTOS (Par U PROPERTY DAMAGE GARAGE LIABILITY AUTO ONLY -EAACCIDENT ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGAT EXCESS LUU31L EACH OCCURRENCE UMBRELLA FO FORM AGGREGATE OTHER THAN UMBRELLA FORM 0SM1104 WORKER'S COMPENSATION AND WC251940503 05/01/03 EMPLOYERS' LIABILITY (AOS Exdud bV � EL EACH ACCIDENT $1,000,000 B THE PROPRIETOR/ PARTNERSIEXECUTNE X INCL WC251940498 05/01/03 05/01/04 EL DISEASE-POLICY LIMIT $1.000,000 OFFICERS ARE EXCL (AZ, NJ, OR, WI) EL DISEASE-FA EMPLOYEE $1.000,000 DESCRIPTION OF OPERATIONS/LOCA ITEMS Other Worker's Compensation-For Information Purposes Only-Not Provided by Aon Risk Services, Inc. of PA: AZ State Fund #167763-�; OH Self Insured #20005105; WA Risk #804.219-00 4; WV Risk #79002151-101; NY State Fund #1320206-4 ND Acct #1224476, ,,•ii •�tinr• SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVORTO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE ,AC'�T;R-.2.56 �, •�H.:]�'i.�•i: ':. - .>.J./' ]�..�,_ - v..`.•e i,%i .- _ _ lit y r } k1TION 9HB Certificate NO: 570006009658 . . _14n1d ar_Idnnfit•,sr i 2003/JUL/28/MON 11;16 AM P. 001/001 � wmisaymwsrstiemwm I CENTIMARB BENEFITS DEPARTMENT INTEROFFICE MEMORANDUM 1 TO: GRZEGORZ.GRYGORIEW, 2 DORCHESTER STREET, WORCESTER, MA 01610 FROM: JOANNE t t KARE r_r BENEM REPRESENTATIVE SCM ECT: VArvr t OF OOVJMA,GE FORM DATE 07/02/03 CG WAIVER OF MEDICAL COVERAGE We have received your request to waive participation its. our medical/dental/prescription plan. Our plan is governed by the IRS guidelines for a Section 125 benefit plan. As such, there are very specific guidelines for when an employee may enter the plan and when an employee may leave the plan: just con4Aeting-xwaiver iii an "non-opew-enrolimee timef =e wUl not satisfy the --IRS guidelines. We need a letter from your wife's employer/benefits administrator stating that she has coverage for her family and the effective date of that coverage. If this enrollment is the result of a recent open -enrollment timeframe or if this is the first time she can make an elemon to participate in the benefit plans, this infotnaation should also be stated in the letter. After we review the information received, we will make a determination as to whether or not this information satisfies the IRS requirements• If we cannot process your request, you will be able to make the change in April 20N during our open enrollment period. The effective date for that change will be May 1, 2004. Feel fxee to contact me if you have any questions on this process. .jrl Cf) m m C/) 0 m O CO) 'O CDZ cD o CL r d CD CL 3INCO .p O O p a� c� � d CD O .... CD cc CD CO) 'O CD n O C2 y d O CO) C' c O C CO) n CD 0 rt CD CD a F CD N2 �71- O CCD CD0 < OD -0 c -4 Q _n N Cr m H y — C2 m C7 ?'O C.0 .d -r O H T Fn - CD � O m y y 3E�m C --I CD o: �-C O so �, go o= O N. C.) C7 w m:s r a ao�= CrJ `o oEr mcn CD 0 CD �,y:• % S l J n o' may: *, Q H O ?:(.%. :�. zff C f0 f. C/)c: �`W � a Uj a co, � c 7 .pop O to m o: : cn � z o ^ — C2 �C=* C/) p� co,� Z W : r _ O m = c tTI: z M. 0 0 0 9 y H O W � n rA H O ]-a- r c� Z O GO O c CL °CD r 0 z O (D v cn p p n A. o� O o 'cn� m H 0 9 O C CD