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TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
O�A
This certifies that ............... �e—! ........
;� ; ...........................
has permission to perform . avrl ....................................
wiring in the building of .... .. .............................................................
at ...... t-�. .............. . North Andover, Mass.
Fee- ..... ...... Lic. No. -/ . . ...... J
';�� ............. ....... �/
..... ... ... ........
ELECTRICAL INSPECTOR 7 -
Check #
7227
1 10
RE
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N Commonwealth of Massachusetts Official Use Only
Department of Fire Services Permit No. - .�!2 .2 1
Occupancy and Fee Checked , -36—
kip BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07] (leaveblank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 52
J CMR 12.00
(PLEA SE FPJNT IN INK OR TYPE ALL INFORMA TION) Date: D7
City or Town of: NORTH ANDOVER To the Inspc&r of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location (Street & Number) C,2 6 (0 S 71�
Owner or Tenant JO&VM42 Telephone No. F91J, -?,TS 11711
Owner's Address —S.4n 12 ,
Is this permit in conjunction with a building permit? Yes No (Check Appropriate Box)
Purpose of Building Z ;L..,4 Utility Authorization No.
Existing Service Amps / / Volts Overhead 0 Undgrd 0 No. of Meters
New Service — Amps Volts Overhead Undgrd No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: Cr-emedw-at?- 7:2A�vstred szw.)�cH
J'AZ )?Acx &Own OZ -5E Mf'7-6/*L-rd�-, A,*I? .2 70 V
' RAIM10,4M
Completion nfthp fn1lowing, tablo m-1 h� 1-1 . —4 h th, 1--t— -I'Wi—
No. of Recessed Lu minaires
No. of Ceil.-Susp. (Paddle) Fans
�—y
No -Total
Ti-ansformers KVA
No. of Luminaire Outlets
No. of Hot Tubs
Generators KVA
No. of Luminaires
Above o In-
Swimming Pool grnd. Lgrnd. El
No. of Emergency Lighting
Battery Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
JNo. of Zones
No. of Switches
No. of Gas Burners
No. of D tection and
Initiatin2 Devices
No. of Ranges
No. of Air Cond. Total
Tons
No. of Alerting Devices
No. of Waste Disposers
Heat Pump
Totals:
Number.
1 11 . 1.
Tons
I KW
No. of Self -Contained
Detection/Alerting Devices
No. of Dishwashers
Space/Area Heating KW
Local El Mun'c'P!il 0 Other
Connection
No. of Dryers
Heating Appliances KW
Security Systems:*
No. of Devices or Equivalent
No. of Water
Heaters KW
No. of No. of
Signs Ballasts
Data Wiring:
No. of Devices or Equivalent
No. Hydromassage Bathtubs
No. of Motors Total HP
'I elecommunications Wiring:
No. of Devices or Equivalent
OTHER:
Attach additional detail �f desired, or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: &,? L, /0!2 Inspections to be requested in accordance with MEC Rule 10, and upon completion.
INSURANCE COOVERACE: 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 0 BOND [:1 OTHEREJ (Specify:)
Icertify, under thepains andpenalties ofperjury, thatthe information on this application is true andcomplete.
FIRM NAME: j&fpJe,/ LIC. NO.:/7pDpA
Licensee: Signature LIC. NO.:17-Aa a
(If applicable, enter "exempt - in the license number line.)
Bus. Tel. No.
Address: Pig ZTO *71 getw"Aig /y7J9 my4l Alt. Tel. No.1976 4 2 1 g:16 r, I
*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 E] owner's agent.
Owner/Agent
Signature Telephone No. FPERMIT FEE. $ e-,:,.
6
3 ,-) 7- a 7 ��
Ylg-6-f py� .
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Datel .... A� ... �.).7 .....
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ... )-'/ .......... f,
........... I ...........................................................
has permission to perform
..... .......................
wiring in the building of ....................
................................................................
at ......................... . North.,Amdover, Mass.
...........
Fee Lic. No/Am.4,.....�( .... :22z ................................
ELEcrRICAL INSPE
Check # :734
7213
9
No. of Recessed Luminaires No. of Ceill.-Susp. (Paddle) Fans No. of Total
Transformers KVA
No. of Luminaire Outlets No. of Hot Tubs Generators KVA
No. of Luminaires Swimming Pool Above o In- . of Emergency Lighting
Le grnd. grnd. Battery Units
No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS INo. of Zones
No. of Switches No. of Gas Burners No- of Detection and
4 — Initiating Devices
No. of Ranges No. of Air Cond. Total No. of Alerting Devices
Tons
No. of Waste Disposers Heat Pump Number. I Tons I KW.... of Self -Contained
Totals: I ... Detection/Alerting Devices
No. of Dishwashers Space/Area Heating KW LocaIE:1 Municippi El Other
Connection
No. of Dryers Heating Appliances KW Security Systems:*
No. of Devices or Equivalent
No. of Water KW No. of No. of Data Wiring:
Heaters Signs Ballasts No. of Devices or Equivalent
No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring:
No. of Devices or Eauivalent
IOTHER: I
Commonwealth of Massachusetts
Department of Fire Services
BOARD OF FIRE PREVENTION REGULATIONS
Official Use Only
Pen -nit No. Z�1_3
Occupancy and Fee Checked
I [Rev. 9/051 (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC� 527 CMR 12.00
(PLEA SE PPJNT IN INK OR TYPE ALL INFORMA TION) Date: C� 1113 017
City or Town of. NORTH ANDOVER To the In -spec r o 'res:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location (Street & Number) 0.2 to L, M &% 0 §J�,
Owner or Tenant 19� A 401=a _oR,4 L I V 1 Telephone No.911f,,�,Crs, s-7/1
Owner's Address 5,L"e,
Is this permit in conjunction with a building permit? Yes No UR (Check Appropriate Box)
Purpose of Building L
_/ 6km ;I— I -
Existing Service Amps Volts Overhead LJ
New Service Amps
Number of Feeders and Ampacity
Volts Overhead 1:1
Utility Authorization No.
Undgrd
Undgrd
No. of Meters
No. of Meters
Location and Nature of Proposed Electrical Work: . "61 /,.'!? hT,,,ry I
"LtJ e IT
Completion of the followinR table mav be waived bv the Inspector of Wires.
Attach additional detail �f desired, or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: 1.2 1 J-1 Inspections to be requested in accordance with M EC 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: INSURANCEN BOND [—] OTHER [_1 (Specify:)
I certify, under thepains andpenalties ofperjuty, that the information on this application is true and complete.
FIRM NAME: LIC. NO.: 170oa. A
Licensee: 5AI22 el Signature LIC. NO.: 119p
A
(If applicable, enter "exempt " in the license number line.) Bus. Tel. No.:
Address: Pl"W( 4=7 1�,-AnAN9! 424 i0oS6!2 Alt. Tel. No.:!774 -# 74 1
*Security System C;r�ira_ctor Lic'einse req�ired for thIs Work; -if applicable, enter the license number here:
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required by law. By my signature below, I hereby waive this requirement. I am the (check one) 0 owner E] owner's agent.
Owner/Agent
Signature Telephone No. FPERMIT FEE.
a
Datl�-37'�:2'9
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that r �4
.................................
has permission to perform ....... e .............
plumbing in the buildings of'/.�.,,
.............................
a t:�—'/' h� ............ , North Andover, Mass.
Fee�&,. Lic. No.
4-1-1 ............
PLUM,131W'INSPECTOR
Check #,O'�F2
64U 8
4
MASSACHUSETTS UNIFORM APPLICA
(Type or print)
NORTH ANDOVER, MASSACHUSETTS
Building Location d(Ol yba-g-j �-" y- 0%
(VO RrJ �) 'N -UE� Type of
New 1:1 Renovationm Replacement
FIXTURES
PERMIT TO DO PLUMBING
?/)q )0
Date
Permit #
Amount
Plans Submitted Yes No
. 11 1:1
(Print or type) Check one: Certificate
e-:�r'34'A ?IRMAA011- Corp.
Installing Company Name \
Address C'a ckw�-p Partner.
Businesslelephone q 4:;:- Firm/Co.
Name of Licensed Plumber: N Q Y\C�'
Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity Bond
Insurance Waiver: L the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Owner Agent
I hereby certify that all of the details and information I have sulbgautted (or entered) in above application are true and accurate to the
best of my knowledge and that all plumbing work and inrsation ed under Permit Issued for this application will be in
se
compliance with all pertinent provisions of the Massach, setts ing Code and Chapter 142 of the General Laws.
9
By: M—griature Of LICenseariumDer
Tvne ot Plumbing License
Title j ( I U-
City/Town ense lNumDer Master Journeyman
APPROVED (OFFICE USE ONLY
Location
No.
,�> I-
Date [I-J(Dj
T" TOWN OF NORTH ANDOVER
Certificate of Occupancy $
CHU Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
Building Inspector
V TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICAT12�*, TO CONSTRUCT I REPAIR, RENOVAT�; OR DEMOLISH A ONE OR TWO FAMILY DWELLING
'51
WO"'"', "W
NOW
01
WIN
BUILDING PERM[IT NUMBER. ISSUED: 1 —3 1
SIGNATURE: AA Ak(
Building Comnussioner/IRE�Etor of Buildings Date — — —
aMt-ILIVIN I-01LIZ JUNVUKTULAILWA
1.1 Property Address:
1.2 Assessors Map and Parcel Number:
Map Number Parcel Number
1.3 Zoning Information:
Zoning Di;—Uic—t Proposed Use
1.4 Property Dimensions:
Lot Area (sf) Frontage (ft)
1.6 WELDING SETBACKS (ft)
Front Yard .
Side Yard
Rear Yard
Required No—vide
Required Provided
Required Provided
1.7 Water Supply M.G.L.C.40. 54)
Public 0 private D zone
1.5. Flood Zone Juformation:
— Outside Flood Zone 0
1.8 SeweMe Disposal System:
municipal 0 On Site Disposal System D
SECTION 2 - PROPERTY OWNERSEE[P/AUTHORIZED AGENT
'TKwner o Record
-)1,A.j3,A,cA 50SfJS4*AN,,
Name (Print)
Address for Service
5E — t. r)
Signature
Telephone
2.2 Owner of Record:
Name Print
Address for Service:
Signature
Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
Licensed Construction Supervisor:
Address
Signature
Telephone
Not Applicable 0
License Number
Expiration Date
3.2 Registe.iod Home Improvement Contractor
Not Applicable 0
Company Name
Registration Number
Address
Expiration Date
Signature
Telephone
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SECTION 4 - WORKERS COMPENSATION (NLG.L C 152 § 25c(6)
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
Signed affidavit Attached Yes ....... 0 No ....... 0
�ECTION 5 DescriiDtion of Provosed Work (check an aDollcable)
New Construction 0 1 Existing Building 0 1 Repair(s) k I Alterations(s) 0 1 Addition 0
Accessory Bldg. 0 1 Demolition 0 1 Other 0 Specify
Description of Proposed Work:
V V
i /YT C) uo M4" C� wooac-q 6,4A" -f
. SRCTT01q 6 - RS9ATFD CONSTRUCTION COSTS I
Item Estimated Cost (Dollar) to be
Completed by permit applicant
`0 z --
0,Nt.,AkE
V
I Building 0V
(a) Building Permit Fee
Multiplier
2 Electrical
(b) Estimated Total Cost of
Construction
3 Plumbing
Building Permit fee (a) x (b)
4 Mechanical (HVAC)
5 Fire Protection
6 Total (1+2+3+4+5)
Check Niunber
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, aQ �er/A zed Agent of subject property
Hereby authorize to act on
"al', in all n1WAqs relative to work authorized by this building pennit application.
6 A-
&, //
JG2na—tur&'U bmrner' -' ' " ' - ' Date
I 'SECTION 7b OWNERIAUTHORIZED AGENT DECLARATION I
1, as Owner/Authon'zed 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
Print Name
of Owner/.
Date
NO. OF STORIES SIZE
BASENIENT OR SLAB ST ND
SIZE OF FLOOR TINMERS 1 2 3M
SPAN
DMENSIONS OF SILLS
DMENSIONS OF POSTS
DEMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CHINVEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
D. `Robert Nicetta
Building Commissioner
(978) 688-9545
'978) 688-9542 Fax
Please print
DATE -
JOB LOCATION C-.;)- (0
Number
"HOMEOWNER 71 OA�
Name
PRESENT MAILING ADDRESS
City Town
Building Department
27 Charfes Street ..
North Andover, MA. 0184,5
HOMEOW 4ER UCENSE EXEMPTION
vv� 4, � Aj
Street Address
It , t I . C(,) Y ;) \-0
q6 t_) C:)
Home Phone
State
Map lot
Oil
Work Phonsm'
Zip Code
The current exemption for "homeowners" was Qxtended to include owner -occupied dwellings
of two units or less and to allow such hibmteowners to engage an individual The hire who does
not possess a license, provided that the owner acts as supervisor. (State Building Code Section 108.3.5. 1 Y
DEFINITION OF HOMEWOWNER::
Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which
there is, or is intended to be, a . one or two family dwelling, attached or detached structures ac
cessory. to such use 'and/or farm structures. A person who constructs more than one . home in a
two-year period shall not beconsidered a homeowner.
The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other
Applicable codes, by-laws, rules and regulations,
The undersigned "homeowner" certiffes that h8/she understands the Town of No- Andover
Building Department minimum inspection procedures and requirements and that he/she �will
comply with said procedures -and requirements.
HOMEOWNER'S SIGNATURE
APPROVAL OF BUILDING OFFICIAL
f
C)+U
I
Town of North Andover
Building Department
27 Charles Stmet
North Andover, Massachusetts 0 1845
(978) 688-9545 Fax. (978) 688-9542
DEBRIS DISPOSAL FORM
0
0
Arm
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In accordance with the provisions. of MGL c 40 s 54, and a condition of
Building permit-# — the debris resulting from the work shall.be disposed
of in a properly licensed solid waste disposal facility as defined by MGL cl 1, sl 56a.
The debris will be disposed of in /at:
S, 2 0
Facility
Signature of Applicant
Date
NO ' TE: A demolition permit from the Town of.North Andover must be obtained for th"I
project through the Office of the Building Inspector. is
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Location (Aj "S I
No. Date
TOWN OF NORTH ANDOVER
�01
Certificate of Occupancy $
S Building/Frame Permit Fee $
6w4v
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # y(�2
7 7
Buildiri'g inspector
TOWN OF NORTH ANDOVER
I BUILDING DEPARTMENT
APPLICATION
BUELDING PERNUT NUNMER:
SIGNA
I SECTION I- SITE INFORMATION I
OR DEMOLISH A ONE OR TWO FAMILY DWELLING
DATE ISSUED:
//
of Buildines Date
1.1 Property Address:
C� (0 (0 A,4a On
1.2 Assessors Map and Parcel
C7 q&,,
Map Number
Number:
C)0'9�6
Parcel Number
NOar
1.3 Zoning Information:
Zoning Diai ict Proposed Use
2.2 Owner of Record:
1.4 Property Dimensions:
Lot Area (sf)
Fr-tage (ft)
1.6 BUILDING SETBACKS (ft)
Address for Service:
Signature Telephone
Front Yard
Side Yard
SECTION 3 - CONSTRUCTION SERVICES
Rear Yard
Required Provide Required
Provided
ReqWred
Provided
Not Applicable 0
1.7 Water Supply M.G.L.C.40. 54) 1.5.
Public 0 Private 0 Zone
Flood Zone Information:
Outside Flood Zone 0
1.9
Municipal
Sewerage Disposal System:
0 OnSiteDisposal System 0
SECTION 2 - PROPERTY OWNERSHM/AUTHORIZED AGENT
2.1 Owner of Record
Name (Print)
Address for Service
Signature Telephone
2.2 Owner of Record:
Name Print
Address for Service:
Signature Telephone
SECTION 3 - CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor:
Not Applicable 0
Licensed Constniction Supervisor:.
License Number
Address
Signature Telephone
Expiration Date
3.2 Registered Home Improvement Contractor
1(2
Not Applicable 0
7 -
Company Name,,
7 -
Registration Number
Add
Expiration D4e
Telephone
I SECTION 4 - WOREERS COMPENSATION (MG.L C 152 § 25c(6) I
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 ....... 0 No ....... 0
SECTION 5 Description o Proposed Work (check applicable)
New Construction 0
Existing Building 0
Repair(s) 0
Alterations(s) 0 1
Addition 0
Accessory Bldg. 0
Demolition 0
Other 0 Specify
Brief Description of Proposed Work:
SECTION 6 - ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost (Dollar) to be
Completed by permit applicant
1. Building
(a) Building Permit Fee
Multiplier
2 Electrical
(b) Estimated Total Cost of
Construction
3 Plumbing
Building Permit fee (a) x (b)
4 Mechanical (HVAC)
5 Fire Protection
6 Total (1+2+3+4+5) 0
Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUIELDING PERMIT
I, I 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 OWNER/AUTHORIZED AGENT DECLARATION
1, as Owner/Authorized Agent of subject
property
Hereby declare that the statements and information or(the foregoing application are true and accurate, to the best of my knowledge
and belief
Prijd!tame f .
2-!'e-6:fJ , t- –
Signature of Owner/A ent Date
I
NO. OF STORIES SIZE
BASENENT OR SLAB
SIZE OF FLOOR TITVMERS I ST 2ND 3RD
SPAN
DINENSIONS OF SILLS
DMIENSIONS OF POSTS
DINIENSIONS OF GrRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CHMNEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUUDING CONNECTED TO NATURAL GAS LINE
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N2 r4 -1 5 r 1. 41 - Date ...... ?11.71 ...
TOWN OF NORTH ANDOVER
0
0�
PERMIT FOR WIRING
0 Se T" f k 6 v, -t
Thiscertifies that .... T ......... .............................. . .................................
r 5rlhh�p
has permission to per . d ..... .... ... . .................
form ........ le— /��,
wiring in the building of ...... 1961c?.w ..... .................................
at ...... ..... JYI.!�:&-tAl� .... I ' ... - - ) N It Andover as
....... .............
... F :.!�O ... L
ee..:Z)
ic. No. ........ .............. X ........ .......
RICAL INSPECTOR
Check # ( 5
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
7BE COAMOWEALTH OFAUS-"alUSETIS Office Use only T
DZYMATAR�NTOFPUBLIC&4= Permit No. - r 3
A LY)ARDOFFD?EPREVEMONREGUA770AN527(M]2-00
Occupancy & Fees Checked
TI0NF0RPFJ?NflTT0FERF0RM==CA'L WORK
ALL WORK TO BE PERFORNED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 cmR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
Town of North Andover
The undersigned applies for a permit to perform the electrical work described below
Location (Street & Number)
Owner or Tenant
Owner's Address -1�3
AIAJ
/0
To the Inspector of Wires:
F7— PARCEL
z)at1,e4
Is this permit . in conjunction with a building permit: Yes= No F71 (Check Appropriate
zati
Purpose of Building on No.
Existing Service 900 Amps--;�(/O/ / 2o Volts Overhead r771 Underground No. of Meters
L ---J
New Service YOO Amps a Y01 / Z 0 Volts Overhead r -M Underground No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical WorkC lw&a e zoo w 777,11ce 1v llvo,4 77,-74 e, 9F 7 7q c, "IeIA-ld
7
No. of Lighting Outlets
No. of Hot Tubs
No. offransformers
Total
KVA
,No. of Lighting Fixtures
Swimming Pool Above
[7
Below r7
Generators
KVA
ground
around
No. of Receptacle Outicts
No. ofOil Burncrs
No. of Emergency Lighting Battery Units
No. of Switch Outlets
'2—
No. of Gas Bumcrs
rM- ALARNIS
No. of Zones
No. of Ranges
No. of Air Cond. 3 Total I? Xz-
Tons
No. of Detection and
No. of Disposals
No. of Heat Total Total
Pumps Tons
KW
Initiating Devices
No. of Sounding Devices
No. of Dishwashers
Space Area Heating KW
No. of Self Contained
Detection/Sounding Devices
Local Municip . al
r7
Other
No. of Dryars
Heating Devices KW
Connections
No. of Water Heaters KW
No. of No. of
a
Siam
Bailasis
No. Hydro Niassage Tubs
No. ofMotors
3'
Total HP
A
OTHER -
AM
I NO 11 "14, M
i . WC
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Telephone NAIA�Y��- �PERMITFEd' 7
Date. .
N2 i,,. -,z c.
,aORT#1
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
40,
ACHUS
This certifies that .... x� /7 ......................
has permission to perform ..... PC' ............
plumbing in the buildings of ... 1,�zl�.,� 7/ ..................
at. North Andover, Mass.
P ...........
Fee.��.-�. Lic. No..0 0 . ......
PLUMBING INS ECTOR
WHITE: Applicant CANARY: Building Dept, PINK: Treasurer
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DaPLUMMING
(Type or print)
NORTH ANDOVER, MASSACHUS= Date
,5� Owners Name c;E Perm --"—
Building it# 34=/,3
Amount
V
10
New 01--- RenovationEl Replacement 6--�Plans Submitted Yes El No
MTTTRES
Check one: Certificate
(Print or type) 51, 1-7"- /�a /) "r /� Corp.
Installing Company Name — 11
Ad 11-17 111'at, �?j 1:1 Pwtner.
11nd- I ----
Business Televhone 4 2 X- /11 9: [3Fkm/Co.
Name ofLicensed Plumber AIZ,41-�
Insurance Coverage: Indicate the typ urance coverage by checking tile appropriate bor-
Liability insurance policy ff �-� Other type of indemnity n Bond
igned, have been made aware that the licensee of this application does noi have any one of the above
insurance Waiver L the unders'
three misurance
Signanire Owner Agent D
I hereby cm&y 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 instdlations performed under Permit Issued for this application will be in
ach=S.n of the General Laws.
compliance vnth all pertinent provisions of the Mass !!!!:L
gj#e �awn,42
By- Z-apatum-orLicensW Tlumbar
T��e offlumbing License
Title / 0 C -L/
City/Town =Icense Nurnocr Master Er Journeyman 11
APPROVED (oma UsE ONLY
A
Location C7
No. - ") V (0 Date C--22�� -el-�
TOWN OF NORTH ANDOVER
0
Certificate of Occupancy $
Building/Frame Permit Fee $
14
Foundation Permit Fee $
Other Permit Fee $
Connection Fee $
Sewer
Water Connection Fee $
TOTAL $
�Tq A5
Building l6spector
02/26/98 10:32
25.00 PQID
Div. Public Works
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DEPARTMENT Of PUBLIC SAFETY
CONSTRUCTION SUPERYISOR LICENSE
Nuaber: Expires: Birthdate:
CS 012995 05/22/1998 05/22/1941
Restricted To: Do
R08ERT H STECCHI
11 STEYENS ROAD
PELHAM, NH 03076
W
'FOWN 01,'NOWHI ANDOVER
OFFICE OF
COMNILJNI'I'N'DEN'EI,01'Nil�-'N'I'AND SERVICES
30 SCHOOL STREET
NORTH ANDOVER, klASSACHUSETTS 01845
William J. Scott Teleplioii� (978) 688-9531
Direclor FAX (978) 688-9542
CONTROL CONSTRUCTION - SECTION 116.0 M.S.B.C.
CERTIFICATE OF ENGINEERING/ARCHITECTURE
BUILDING INSPECTOR
TOWN OF NORTH ANDOVER
120 MAI[N STREET
NORTH ANDOVER MA 0 1845
GENTLEMEN:
HEREBY CERTIFY THAT THE
BUILDING CONSTRUCTED AT
DOES CONFORM IN ALL RESPECTS TOTHE MASSACHUSETTS STATE BUILDING CODE AND
APPLICABLE FEDERAL REGUALTIONS FOR THE FOLLOWING:
AUTHORIZED SIGNATURE: a�g&
DATE:
REGISTRATION:
NOTE: ENGINEER "WET STAMP" MUST BE AFFIXED TO THIS FORM
BOARD OF APPEALS 688-9541 BUILDINGS688-9545 CONSERVATION688-9530 14EALTH688-9540
PLANNING 688-95' ) 5
146 MAIN ST. 1-20 MAIN ST. 30 SCHOOL, ST. 30 SCHOOL ST.
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Building lns6cVor
12 L; 730/98 16:26
25.00 PAID Div. Public Works
TOWN OF NORTH ANDOVER
0
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$
$
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$
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$
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fit TOTAL $
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25.00 PAID Div. Public Works
14
Lo"cation
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0 1-7
Date
TOWN OF NORTH ANDOVER
Building Inspector
Div. Public Works
Certificate of Occupancy
$
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$
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$
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$
Sewer Connection Fee
$
Water Connection Fee
$
TOTAL
$
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Div. Public Works
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ATENT FOR RENT, INC.
125 Commercial Circle, Dedham, MA 02026
Phone:(781) 326-6360 Fax:(781) 326-1656
RENTAL AGREEMENT
ATENT FOR RENT, INC. (ATENT) agrees to rent to (CUSTOMER): Kenneth W. Van Blarcorn
the following items at the quoted price on the reserved date of: Saturday October 3, 1998 Page 1
CUSTOMER: Kenneth W. Van Blarcom
Auctioneers & Appraisers
63 Eliot Street
Natick, MA 01760
508-6 53-7017
SITE: Field Hodges House
Order* 3478
Ordered or Revised on:
SetUP By. Friday, October 2, 1998
SetUp Time. Wed -Fri
266 Main St. TakeDown By, Tuesday, October 6, 1998
North Andover, 01845 TakeDown Time'. Mon-Tue
Method Of Payment
Event Auction FAX Cash
Vehicle Acc 5 0 - HoFw. Card
Surface: Grass Tax * Check
P.O.**
Quantity Description Unit Labor Unit Rental/Sales Item Total
1 40' x 80' white Victorian tent with white 800.00 800.00
sidewalls included.
1 Delivery and installation totalling 1,600.00. 800.00 800.00
Note: The tents will be adjoining. We will need
to bring 60' of rain gutters.
30' x 60' white frame tent with white 600.00 600.00
sidewalls included.
Delivery and installation totalling 1, 140.00. 540.00 540.00
Note: If you would like to go with two frame
tents, to keep the stake line out of the 30'x6O'
the price of the 40' x 80' frame tent is
2000.00.
Estimated Permit Costs: Permit 50.00, 175.00 175.00
filling fee 15.00, and a 3 hour running fee at
37.50 per hour.
Note: This is just an estimate. If I can do the
permit by mail it will be at a lower cost.
25 8' long tables, delivered and picked up folded 8.00 200.00
ACCEPTANCE SIGNED: I have read and I agree to the terms and conditions on both sides of this contract.
Atent For Rent, Representative Date
Customer — Date
TERMS AND CONDITIONS, ARE CONTINUED ON REVERSE SIDE OF PAGE
1. ACCEPTANCE TERMS - This purchase order constitutes the offer of ATENT FOR RENT, INC. (hereinafter "ATENT") to the CUSTOMER identified on the face
hereof and shall become a binding contract on the terms and conditions set forth herein when accepted by the ATENT. ATENT reserves the right to revoke
this order at any time prior to acceptance by CUSTOMER. Acceptance of this offer must be made on its exact terms
ATENT FOR RENT, INC.
125 Commercial Circle, Dedham, MA 02026
Phone:(781) 326-6360 Fax:(781) 326-1656
RENTAL AGREEMENT
ATENT FOR RENT, INC. (ATENT) agrees to rent to (CUSTOMER): Kenneth W. Van Blarcom
the following items at the quoted price on the reserved date of: Saturday October 3, 1998 Page 2
CUSTOMER: Kenneth W. Van Blarcom Order# 3478
and stacked
200 Blue Samsonite chairs. delivered and picked 1.00 200.00
up folded and stacked
Subtotal 3315.00
Nontaxable Amount 1515.00
Thmak you for volng ATanT for Rant, dac. Taxable Amount 1800.00
Thank you for your down payment of 1457.50, which Sales Tax 90.00
Total Order 3,405.00
we received on 09/19/98. Retain the yellow copy of Amount Paid 1457.50
the revised rental agreement as your receipt. We Balance Due 1,947.50
will bill you for the balance due, plus all contract Down Payment 1457.50
additions to be payable 30 days from the function Remainder of Bal. Due 1,947.50
date. We will call you on Tuesday September 29, Security Deposit
1998, to confirm a set up date. Mass sales tax is
not charged on the labor portion of eachinstaleld
item.
ACCEPTANCE SIGNED: I have read and I agree to the terms and conditions on both sides of this contract.
Atent For Rent, Representative Date
Customer Date
TERMS AND CONDITIONS, ARE CONTINUED ON FE—VERSE SIDE OF PAGE
1. ACCEPTANCE TERMS - This purchase order constitutes the offer of ATENT FOR RENT, INC. (hereinafter "ATENT") to the CUSTOMER identified on the face
hereof and shall become a binding contract on the terms and conditions set forth herein when accepted by the ATENT. ATENT reserves the right to revoke
this order at any time prior to acceptance by CUSTOMER. Acceptance of this offer must be made on its exact terms
f
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