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HomeMy WebLinkAboutMiscellaneous - 267 BOXFORD STREET 4/30/2018 (2)Ova 6,- m v TOWN OF NORTH ANDOVER 0 PERMIT FOR PLUMBING 40 This certifies that ... //� e� .................. has permission to perform ... r r .................... plumbing in the buildings of ... f"* at .... ?. e�. .) ..... P ( / 1, .�. ........... . . North Andover, Mass. Fee..�� ..... Lic. No.. A '?.1 ... ........ PLUMBING INSPECTOR Check # 11 1 � � 5441 -?-(- 7 -- MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) ("79) /aj&�L�M ass. Date Permit# (r6's Narne Building Location")V-06 Bn—x TypeofOccupancy Residential New Renovation D Replacement L4 Plans Submitted: Yes El No El FIXTURES Installing Company Narne Ile r i tag e Htg.&Plg. Co. Inc. Address __3_5_-JUe as a n t 'S t r e e t --Stonehain, Ma 02180 Business Telephone .j81 Name of Licensed Plumber Gordon Switzer Check one: EX Corporation Partnership F] Firm/Co. Certificate 714 INSURANCE COVERAGE: I have a current liability insuiance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes N- No [] If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability Insurance policy M Other type of indemnity 1.1 Bond El 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 0 Agent El e or Uivnsr or 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 311 pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 ol the General Laws. By si66�fwe A�ofUc,,kd IPI inb—or (Z:) Title Type of Licunse� Master Journeyman 0 City/Town— APPROVED TOWIMLJSE—Ur�[-Y) License Numbor-8-3.2 2 Z W Z Y., H 0 W U) U Uj Ix P tn Z o -j -It rr Z 0 Z 49 W 4- j P W W V) NC LL 49 Z ' '0 0 D CC Lt U) 1AJ CC cr Uj Ul LU o C3 _j 5d (n 0. C: 0 rr Z C3 LL W LL �A �-o V) V) Dtn'-Z000�—W�--06 < P 0 -1 j LL X M 0 < a) 4-J SUR—BSIAT. BASEMEtIT IST FLOOR 2 U D FLOOR 3 11 D F LO 0 T1 4TH FLOOR 5TH FLOOR 6TIi FLOOR M1 FLOOR 8TH FLOOR Installing Company Narne Ile r i tag e Htg.&Plg. Co. Inc. Address __3_5_-JUe as a n t 'S t r e e t --Stonehain, Ma 02180 Business Telephone .j81 Name of Licensed Plumber Gordon Switzer Check one: EX Corporation Partnership F] Firm/Co. Certificate 714 INSURANCE COVERAGE: I have a current liability insuiance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes N- No [] If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability Insurance policy M Other type of indemnity 1.1 Bond El 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 0 Agent El e or Uivnsr or 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 311 pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 ol the General Laws. By si66�fwe A�ofUc,,kd IPI inb—or (Z:) Title Type of Licunse� Master Journeyman 0 City/Town— APPROVED TOWIMLJSE—Ur�[-Y) License Numbor-8-3.2 2 z 0 w V3 m w u i: U. 0 cc 0 LL. w M 0 z 0 p u w z W V) w cc 0 0 cn w 0 z 0 z Z Lt. I w L&I U. (s z 0 z 0 cl 0 it w IL cc 0 w z 0 D m U. 0 w Q. w z LL 0 0 0) m rell -e— / 5'-- :�9 6 Date.................................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ........... 1110k woe'6 &-- 7 — ............................... . ........ / .. ................ has permission to perform ... /� wiring in the building of ........ A013 ....... ................. at ....... . _Z(P.7 ...... ....... 1,21) ........ . North Andover, Mass. Fee ... 3 Lic. No. ��7Y!. 4-.14 ........... IfIlls �-C;i; Check# qz-07 6860 Commonwealth of Massachusetts Official Use Only Permit No. 49'& 0 Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/05] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be perfonried in accordance with the Massachusetts Electrical Code (MPC), 5 7 CMR 12.00 (PLEASE PPJNT IN INK OR TYPE ALL INFORMA TION) Date: XaG City or Town of: Al. &rj,�24, e r To the Inspectorlof Wires: By this application the undersigned giv6s notice of his- or her intention to perform the electrical work described below. Location (Street& Number) 2-(6-7 6 a X.); (-.4 S -7t -- Owner or Tenant Owner's Address Is this permit in con ' junction with a building permit? Yes Purpose of Building Telephone No. No El (Check Appropriate Box) Utility Authorization No. Existing Service2fa-0 Amps /fJ—/236Volts OverheadF-1 Undgrdf� New Service . Amps I Volts Overhead [:] Undgrd F-1 Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: No. of Meters No. of Meters Completion of the following ble may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above Ei I n- grnd. grnd. El . of Emergency Lighting Battery Units No. of Receptacle Outlets _3 No. of Oil Burners FIRE ALARMSTNo. of Zones No. of Switches No. of Gas Burners No. of Detect I Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: J.N7uiii��.r I Tons IRT77 No. of Self -Contained iDetection/AlWing Devices No. of Dishwashers Space/Area Heating KW M ' W1 E] Other LocalEl Counnn'ect ion No. of Dryers Heating Appliances KW Security SVstems:* No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: I No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: �;- /—/ 41 /6 / Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COV`ER9GE: 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. CHECKONE: INSURANCE g]—BONDE] OTHER [] (Specify:) I certify, under lite pin and penalties ofperjuty, that the information on this application is true and complete. FIRM NAME: wos;,7110 LIC. NO.: Al2- V Licensee: Signature LIC. NO.:C-2-7ilY- (If applicable, enter "exempt in the license numb r line. A Bus. Tel. No..9,7,C- S�jtj-- It Address: V S� Ae-,Z;%bJ:t, 49" - 4) (1) c C� Alt. Tel. No.: *Security System Contractor License required for this Aork; 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)E] owner [I owner's agent. Owner/Agent Signature Telephone No._ PERMIT FEE. $ 01 lK I Location No. Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # (��q . 9 3'11 Building Inspector Permit NO: 2D Date Issued: TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION DateReceived I IMPORTANT: ADDlicant must comDlete all items on this Da2e I LOCA PROP] MAP NO PARCEL: TYPE AND USE OF BUILDING Print ZONING DISTRICT: HISTORIC DIRTRICT VF.q F1 TYPE OF IMPROVEMENT— PROPOSED USE Residential Non- Residential 0 New Building 11 Addition 4AIteration 6 One family 0 Two or more family No. of units: 0 Industrial >(Repair, replacement 0 Demolition 0 Assessory Bldg [I Commercial Moving (relocation) El Other 11 Others: t0 o Foundation only I)ESCRIPTION OF WORKTO BE P OY�NER: N ( d r -AM I'L� 12�2m --IZ-r, I Identification Please Type or Print Y) Phone: Q-1 V49%)" Address: --2(o 5�f�zi> CONTRACTOR Name: Address: Phone: Supervisor's Construction License: Exp. Date: Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: —Reg. No FEE SCHEDULE. BULDING PERMIT. $12.00f;ER$1000.00 OF THE TOTAL ESTIMATED COST BASED 0 $125.00PERS.F. Total Project Cost:$ - C. xl2.00=FEE:$ Check No.: Receipt No.: Page I of 4 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits • Building Permit Application • Workers Comp Affidavit Lj Photo Copy Of H.I.C. And/Or C.S.L. Licenses • Copy of Contract • Floor Plan Or Proposed Interior Work Addition Or Decks o Building Permit Application ca Surveyed Plot Plan Li Workers Comp Affidavit • Photo Copy of H.I.C. And C.S.L. Licenses • Copy Of Contract • Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) • Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) Lj Building Permit Application • Certified Proposed Plot Plan • Photo of H.I.C. And C.S.L. Licenses • Workers Comp Affidavit • Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) Li Copy of Contract o Mass check Energy Compliance Report In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application DGe: INSPECTIONAL SERVICES DEPARTMENT:RPFORM05 Noe 4 nf4 TYPE OF SEWERAGE DISPOSAL Tanning/Massage/Body Art Swimming Pools El Public Sewer F Well Tobacco Sales Food Packaging/Sales El Private Permanent Dumpster on Site El (septic tank, etc. Electric Meter location to project IN 01E: Persons contractm"g with unreg do not have access to the guarantyfund Signature of Agent/Owne " L7 Signature of contractor Plans Submitted El Plans Waived 11 Certified Plot Plan El Stamped Plans F1 THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED PLANNING & DEVELOPMENT 11 COMMENTS CONSERVATION COMMENTS DATE APPROVED F11 E]Water Shed Special Permit El Site Plan Special Permit 11 Other DATE REJECTED 11 HEALTH El COMMENTS Zoning Board of Appeals: Variance, Petition N Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: DATE APPROVED in] DATE REJECTED DATE APPROVED Comments Comments I Water & Sewer connection/Sii!nature & Date Drivew Permit Temp Dumpster on site ye *Y \ \ 0_ Fire Department signature/dater- T, 4 Building Setback (ft. Front Yard -7 Provi �d Dimension Number of Stories:_ Total land area, sq. ft.: Side lard, Rear Yard Pro quired Provides JRe uired Provided Total square feet of floor area, based on Exterior dimensions. (A m m m m 4 m m co m co EP m B7 CO) CD C) Z co E; 0 '0. Pilo, CL E 5 CO) 32000 C* CD CL cr =r "C CD P.* Sr CD 0 CD w w a CP COO) CD CL CIO CD S- CA CD z CD CD 0 O'k C/) C/) n 0 z C/) I 11 rn : Cf) 2 0 z C/) -C tog lR a = --4 c 10 0 cr CA RE M. cc, 10 CO) Eggs 0 n cc Q* CL C.) m cop . r- = z Er's. col 0 -*a Lo'. Zn - CO) CD M CD 2>4 7R co ac a Z:S. C.) 0 Ll Ino L cc =r 0 a Cos 0 CD CL, CD CA w CR=r: cr w CL CA CD CIO 0 --I CD CD C, c CD FW co a: C.) C2 cl 0 CO) 0 -0 0 CD CD a: CD N 0 CD tie. CL'O C-) col 0 *Raw&.* mmi 0 z M "X PO 0 CA co Poo r- tTl :3 EL P:j 0 tz :J x - r- r- GO tz C/) CD a a. C/) al 0 CL 0 z 0=3 0 411 Gerald A. Brown Inspector of Buildings Please 12rint DATE:— C* TOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 1600 Osgood Street Building 20, Suite 2-64 North Andover, Massachusetts 0 1845 HOMEOWNER LICENSE EXEMPTION Telephone (978) 688-9545 Fax (978) 688-9542 JOB LOCATION: Number Street Address Map/Lot HOMEOWNER f0-0mv, § q_7 g Home Phone Work Phone PRESENT MAILING ADDRESS .9):t& City Town State Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor). State Building (Code Section 108.3.5. 1) DEFINITION OF HOMEOWNER 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 structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned "homeowner" assumes responsibility for compliances with the State Building Code and other Applicable codes, by-laws, rules and regulations. The undersigned "homeowner" certifies that he/she understands the of North Andover Building Department minimum inspection procedures and/r quiremcnts and t he/she wi mply with said procedures and requirements. A I/ rt. I Co HOMEOWNERS SIGNATURE I IA I AX -Yv,A V V - - - —V V APPROVAL OF BUILDING OFFICIAL Revised 10.2005 Fonn Homeowners Exemption BOARD OF APPEALS 688-9541 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688- 9535 I 60'10 Date ..... ...... .... ... ...... .. .. TOWN OF NORTH ANDOVER At PERMIT FOR WIRING This certifies that .1Q)T //:� ... 3- A�Zr ............... has permission to perform ....... 57p-.C- *,�524...0.1 ............ 7 wiring in the building of ....... 41PAIF"r .......... ................ at ....... a.4 ... 7 ... 6?,KF�e,6 ...... 5.!f ............. . North Andover, Mass. 00 ..... Fee..v ..... Lic. No..1.53.�.Y . ............ ELEMICAL INSPECTOi Check# 00,57 -7zl 7Z V Commonwealth of Massachusetts Official Use. nly Permit No. Department of Fire Services Occupancy and Ofchecked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/99] ave blank) APPLICATION FOR PERMIT TO PERFORM ELECWCAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CJY12.00 AV (PLEASE PREW TN TNK OR T YPE IrZ�:�f D City or Town of- To the Inspector of Wires: By this application the undersiAngives notice of* or hei, intention to perform the electrical work described below. ,!!�;g / /7, Location (Street & Nwher) Owner or Tenant Telephone N Owner's Address -,F16 Is this permit in conjunction with a building permit? Purpose of Building Existing Service Amps Volts New Service Amps Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of Security system ._'Yes -NO Utility, OverheadO Overhead El - P�:V (Check Appropriate Box) .uthorization No. UndgrdF_1 No. of Meters UndgrdE:l No. of Meters C'nmnlptin" �fth, f�71­i­ fhla —­ A, -;—d A,, il,. No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Above o In- Swimming Pool grnd. grnd. No. of Emergency Lighting Battery Units - No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS INo. of Zones No. of Switches No. of Gas Burners No. o� rid Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Number Tons KW No. of Self -Contained Totals: Detection/AIerting Devices No. of Dishwashers Sphe . e/Area Heating KW Local F1 Municipal [I Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent,45- 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 Felecommunications Wiring: No. of Devices or Equivalent OTHER - Attach additional detail it desired, or as required 6 ' v the Inspector oJ Wires. 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 [I BONDEI OTHER El (Specify:) (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under thepains andpenalties ofperjury, that the information on this application is true and complete. FIRM NAME: ADT Se"r-ity Services 18 r' I iiq+An py- Hnj I i q LLLL LIC. NO.: 1 Licensee: John S. Bassett Signature 4A LIC. NO.: 1533C (If applicable, enter "exempt" in the license number line) Bus. Tel. No.: 603 594 59 8 Address: I/ Alt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Licl6see does not have the liability insuiance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) [] owner El owner's agent. Owner/Agent Signature Telephone No. FEE: Sx�, M Commonwealth of Mas'sachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Offi ial,.Use Only /7 Permit No. 7 - Occupancy and Fee Checked [Rev. 11/991 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CN 1200 (PLEASE PR11VT 11V 17VK OR TYPE AV J� Z.RM,�TION) Date: __1 __1 /7- e!5 City or Town of- d0)J_Vt_, To the Inspector of Wires: By this application the undersignECTgives notice o ' or he intention to perf the elect *cal work described below. Location (Street & NuMber) 12 2 Owner or Tenant Owner's Address Telephone Is this permit in conjunction with a building permit? .'Yes'. [I No tjP (Check Appropriate Box) Purpose of Building U . tility kuthorization 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: —Installation of Security system h 77-4-- -L1_ ___ L - __ - - I , , , 1 -1. ��A No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above o In- grnd. Und. 0. of Emergency L-ig iing Battery Units - No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS ! o. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number I. I Ton I No. of Self -Contained Detection/Alerting Devices No. of Dishwashers S I pace/Area Heating KW Local E3Municipal [I Other Connection No. of Dryers Heating Appliances KW — -5.0T Security Systems: No. of Devices or Equi alent No. of Water Heaters KW N No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Uelecommuii—cations Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required ky the Inspector o * / Wires. 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 El OTHERE] (Specify) Estimated Value of Electrical Work: M, Lqr - (When required by municipal policy.) (Expiration Date) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under thepains andpenalties ofperjury, that the information on this application is true and complete. FIRM NAME: A.0T Sa"r-ity Servires 18 r3iiAtAn ng- Hol ] 1,z LIUL LIC. NO.: I Licensee: John S. Bassett Signature LIC. NO.: 1533C (Ifapplicable, enter "exempt" in the license number line.) Bus. Tel. No.: 603 594 5928 Address: Alt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Lic'Qfisee 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 11 owner's agent. Owner/Agent Signature Telephone No.— PERMIT FEE: S j N4 PV I" .Z)cation 7 N o. 0? Date f TOWN OF NORTH ANDOVER 0 Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee Other Permit Fee Sewer Connection Fee $ Water Connection �Fee $ ---------- TOTAL op C-) OL- Buildin6'lnspector A/W—� ao--� I c%-00 PAID 7346 Div. Public Works PER'liff NO. -14 APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. I/P/AGM I MAP 4-40. 4 LOT NO. 12 RECORD OF OWNERSHIP IDATE BOOK ;PAGE ZONE SUB DIV. LOT NO. I F - v LOCATION �' 6 7 r,�O',e 1�c PURPOSE OF BUILDING OWNER'S . NAME -ro lby I- A kll� z -le #4wA6z 6w w - OF STORIES SIZE OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME Yz L&IJL'44-4 SIZE OF FLOOR TIMBERS IST 2ND 3RD 8 U I L D E R - S N A M E "#,,SPAN DIMENSIONS OF SILLS DISTANCE TO NEAREST BUILDING 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 yx MATER:AL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF fO6E IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS SEE BOTH SIDES PAGE I FILL OUT SECTIONS 1 3 PAGE 2 FILL OUT SECTIONS 1 12 --A ELECTRIC METEPS, MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR D E F A. SIGNATU F E E IZED PERMIT GRANTED 19 73 Offl,!ER TEL, #- CONTR.TEL.# CONTR. LIC. #--52A-g6o M4 3 PROPERTY INFORMATION LAND COST EST. SLOG. COST % , 00 EST. BLDG. COST PER 96/ FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF IIIELECTMEN �Z-4U&ILDINS INSPECTOR ol;/- BUILDING RECORD OCCUPANCY 12 SINGLE FAMILY ;ORIES S— S "' MULTI. FAMILL::�— — �l F I'C ES — APARTMENTS CONSTRUCTION 2 FOUNDATION CONCRETE 8 INTERIOR FINISH PINE HAROW 0 PLASTER DRY —VVALL a 1 2 13 CONCRETE BL K. BRICK OR STONE PIERS 3 BASEMENT AREA FULL FIN. B M T AREA '/' 1/1 1/1 ATTIC AREA t!O 8 M T -FIN. FIRE PLACES HEAD ROOM KITCHEN -MODERN 4 WALLS 9 FLOORS CLAPBOARDS CONCRETE --EAPTH 7— HARDNIJ D COMIACN TILE B 1 2 3 DROP SIDING WOOD SHIN ES GL ASPHALT SIDING ASBESTOS SIDING VERT. SIDING STUCCO ON mkSONRY STUCCO ON FRAME BRICK ON W-A—SONRY ATTIC STRS. & FLOOR BRICK ON FRAME CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR POOR jl-�DEQUATE NONE 5 ROOF 710 PLUMBING GABLE GAMBREL I A HIP B TH (3 FIX.) MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET ASPHALT SHINGLES LAVATORY WOOD SHINCES KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL_ STALL SHOWER ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COILS. STEAM STEEL EMS. & COLS. HOT W T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T G UNIT HEATERS 7 NO. OF ROOMS AS OIL B'M'T 2 1 lo 1 3 nrd 11 ELECTRIC NO HEATING THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. ot um -0 FORM U — LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdictic-n 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: -q(3 li" Z,4k11Y'_ V10 &Vlllc- Z-��a Phone LOCATION: Assessor's Mar) Number Subdivis4l.on Parcel Lot (s 1) -7 S treet St. Nu-,,=er '�L !�- / Use only************************ RECOMMENDATIONS OF TOWN AGENTS: Cons ervaz ion Administrator Cc=en4.,,-,= Town Planner C o-mrn e n t s Fco' 1nsr_eC:-_or-;-ealth SemzLc Insrec-=-Hea-ItIn Cc=en,:= Pu_' -_--_4c Wcr.*-Is - sewer/water connect -;:.ons - driveway pernit Fire Demartment Received by Building Insmector Date Ancroved Date Re-iectad J Date Approved Date Re-jec--ed Data Approved Date Re'� ec,:ed Date Approved /17 Date Rejeczed JUN ;,:FAffTMENT Date S, y f, 4 ��ee_� ELEVATIONS TAKEN AT TOP OF PIPE DWELLING ELEV.: TANK IN: m -j?' TANK OUT: IS5.61 tA_�_ D -BOX IN: 15 15 1/0 5 .\ N D -BOX OUT: I q -5 END OF DISTRIBUTION LINE A: B: C: D: A AS -BUILT SEWAGE DISPOSAL SYSTEM PLAN IN AS PREPARED FOR THIS IS TO CONFIRM THAT I HAVE INSPECTED THE CONSTRUCTION OF THE SAID DISPOSAL SYSTEM LOCATED ON LOT elf - THE S SPECIFIED IN THE D S ATIONS DATED P L AAA Y cmmt4UA SSOC., INC. J. RDSAI I NO. 654 DATE MARCHIONDA & ASSOC., INC. ENGINEERING AND PLANNING CONSULTANTS 62 MONTVALE AVE., SUITE I STONEHAM, MA. 02180 (617) 438-6121 SCALE: ilo' DATE: 7 10 q[ M & A FILE No.: COMMONWEALTH DEPARTMENT OF PUBLIC SAF OF ONE ASHBOATON PLAC ETY E MASSACHUSETTS BOSTON, MA 02108 LICENSE C I AUTION EXPIRATION DATE CONSTR. SUPERVISOR FOR PROTECTION AGAINST - 04/20/1994: EFFECTIVE DATE LIC -NO. FIESTRICTIONS..':.'' THEFT, PUT RIGHT THUMB 06/30/1993- 008828 :':-.PRINT IN APPROPRIATE NONE 685-1 BOX ON LICENSE, VAL.J LANZA 34 BI-XBY BLASTING OPERATORS 'L2151 Y :SS A 022�4'6. 6424 IREVERE"MA Z MUST INCLUDE PHOTO. PHOTO (BU�STING �OPR ON�L PAID oo NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY STAMPED - OR - SIGNATURE OF THE CC)MMISSIONER HEIGHT: DOB: JUN .9 1993 04 / 20 119 51 THIS DOCUMENT MUST BE 7;(. SIGN . 14AME IN F IGQURE LINE TURE OF LICENSEE ..CARRIEDON THE PERSON OF THE HOLDER WHEN EN-- GAGEDINTHISOCCUPATION. SSIONER OTHERS - RIGHT THUMB PRINT HOME IMPROVEMWt T ACTOR 7 on Registrati RPORATION Type � PRIVAtE*:'CO­ EXPira V/02/��-N tion New England Cuiidm besign, In Val Lanza 5 Billerica Paf;'�,_fol BilleriCA ADMIN161HA1011 Billerica MA Or�21'. A DEPAF"�NT OF PUBLIC SAFETY COMMONWEALTH 60MMONWEALTH AVE. i1olo. ECK,OR MONEY ORDER OF BOSTON, MASS. 02215 ENCLOSE CH MASSACHUSETTS FOR REQUIRED FEE, LICENSE SUPERVISOR CONSTR. BLE TO N'DA E PykTt MRAID EXPI, t T 97. LIC -NO. r6 ', ,COMMISSIONER OF PUBLIC SAFETY" EFFECTIVE DATE RESTRItTIONS 006/30/1991, 008828 SH). 'NONE, %PNI ?EAPA J LANZA 'VAL ST t) OFV I INCREAS-E '34 B I XEB 'M A 2151 PLEASE NO T SS 0 022-36-6424 R.EVER 0 so 1989 FEE, E ftCTIVE. FEB. PHOTO (BLASTING OPR ONLY) 100. 00 NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY OF THE COMMISSIONER HEIGHT: STAMPED - OR SIGNATURE LICENSE STUB�� DOB: D NOT 04/20/1W I -r SIGN NAME IN FULL -ABOVE SIGNATURE LI N E --f LICENSEE _ATURE OF THIS DOCUME�NT BE MUST CARRIED ON T HIERSON THE HOLDER W EN ENGAG- OmmISSIONER PRINT ED IN THIS OCCUPATION. 1s4 OTHERS - RIGHT THUMB uor, X. "R Qk �r it tv. 1, t T, 'IASV 0, 1 < r -z Jmw N fj G, a, < m " L4 M M Lj w 3< ro 41 Ln to C') G m -pl. z 7' )'In r, m NEW ENGLAND CUSTOM DESIGN, INC. FIVE BILLERICA PARK * 101 BILLERICA AVENUE NORTH BILLERICA, MASSACHUSETTS 01862 (508)667-3600 Home Improvement Contract Registration No. 102467 RESIDENTIAL HOME IMPROVEMENT AGREEMENT This is a legally binding contract Make sure you read this agreement and understand it before signing it Do not sign this contract if there are any blank spaces. NOTICE: All home improvement contractors and subcontractors, unless specifically exempted by Massachusetts Law, must be registered with the Commonwealth of Massachusetts. All inquiries about registration should be directed to: DIRECTOR- HOME IMPROVEMENT CONTRACTOR REGISTRATION ONE ASHBURTON PLACE, ROOM 1301 BOSTON, MASSACHUSETTS 02108 TELEPHONE (617)727-8598 This Agreement is made on 19 9 el by and between New England Custom Design, Inc. (hereinafter, "Contractor") and owner -77 o&� �iqk7X( (hereinafter, "Owner"), of City / Town /-�, 19 & �).d Ve /< State. z0cL Zip e),2 -W 5� hone Billing Address (if different): job Address ("The Pren-tises"). 2 z�o Xz77, V. XA.ID,,) o:2 New England Custom Design, Inc. Salesperson V/1 4vi-y?4 A. DETAILED DESCRIPTION OF THE WORK TO BE PERFORMED. The Contractor agrees to perform in a good and workmanlike manner all work detailed below. Such work consists of the following. 'E( -01'e 0 F u, � a 8 L? c, C -r rj/-- f 'I I-0 C 0 le C/ CA -f 15111-V PC, e2 13 j 0" /0 i011� 7a r 7�� 14 X /1 f', -OL,&"j S-L4oz, /-/C- d) C,-, 41e 6-,L C2 t,::� /I R LZ 2 I-Tf I o Le S'7Cn,,4 e, �-r Alt Lo s r a r- e1n,,-,)s eW,- 7e( �," cy e- -7 —?ql O_r �14 1-0 F? laa P-1 I"'- C (LIlLsi -71-� 00� k" 0 V 'j- r �-J A,� IP S:::p e-1 r- (-Z� r V-C� S, rl I z I O—Z 12—// �`7 1E L,,- 6P 4�1)- �e TotalContract Price $ ................ 0 ..... .............................................................................. Payment Schedule $ ......... ..... ................ S/ ................................................................................................ oo ? ................................... .............. ......... ...... at, ........ 0 Cf $ ........ 1.�20.0 .................... . .............. .................................. i5,22��J.h ..... . ............................. $ ....... 4,::�W ..................... ................ ........ ......... . $ ............................................... BALAN.C.E..DUE.UPON..COMPLETI.ON..O.F..WOR.K ............................ ............... .. .. ......... ............ ....................... ...... .. .. .......... ... RIGHT TO CANCEL The Owner may cancel this agreement if it has been signed by the Owner at a place other than the address of the Contractor which may be his main office or branch thereof, provided that the Owner notifies the Contractor in writing at his main office or branch by ordinary mail posted, by telegram sent or by delivery, not later that n-ddnight of the third business day following the signing of this agreement. See attached Notice of Cancellation. A cancellation fee representing 30% of the contract price will be in effect if cancellation is requested after the legally allotted time has elapsed. A ON HOM W NOT SIGN THIS CONTRACT IF THERE ARE ANY K SPACES. W Owner's ignature l5ate' NeN� Englan�,6�t�o Date (9 0 er's Signature 'Date -V C') C) 21-1 cf) m C) m C2 CO) S7 CO) Cl) 10 0 CD 0 CA El' D CL 0 n) CL CO) CD 0 CD CL cr "C C=Dl CD 0 CD w El CD ra CD EL- cv co) S.0 cc CD a - CO) 10 CD CD CD 0 n 0 2� n 0 �-i Cl) CD =r CD um 0 cc CD (M CO) -0 CD 9 FW ft -4 CRO CO C) Ms. C013 ki CD !2. C-3 14 Omni —&C CD - =r = = C42 > = 0 C2. Oro, CD CO CA 0 co CL. gCD -3 Wo 01 C2. cr S, C.,Dc co CA 0 :E co G*,Q omjl� t CO TO C2 C2 VAX 01) g r CD cm o Eta CD < gS3 kk CO) CD q Im ft CL C22 C', CD C2 CL o C/) CA cr Ce m PL dc CD 0 5: =CD 0 C) CO2 0 — CIS coi 0 C2. -CD -1 m P =r= CO) =r CL CL 5 m CD —. 0) CD CO) CO2 =CD: CD ft -4 CRO CO C) Ms. C013 ki CD !2. C-3 14 Omni —&C CD - =r = = C42 > = 0 C2. Oro, CD CO CA 0 co CL. gCD -3 Wo 01 C2. cr S, C.,Dc co CA 0 :E co G*,Q omjl� t CO TO C2 C2 VAX 01) g r CD cm o Eta CD < gS3 kk CO) CD q Im ft CL C22 C', CD C2 CL o C/) m PL Ix C) 0 Cl) C/) 0 rL W W CD A A ­ - I FORM U - LOT RELEASE FORM (r-.')% INSTRUCTIONS, This form is used to verify that all necessary approvals/perrnits, ft Boards and 2--partments, having jurl Ict,on have been obtained. This does n ot relift the applicant and/or landowner from compliance with any applicable or requirenlients. "**APPLICANT FILLS OUT THIS SECTION*V*****"**"**," ,4 L A./ Z, -/APPLICANT M�kli_ZW&�_,4AIo (2v&7 -e,._7 1), 4 -Al 4 PHONE 1"10CATION: Aswswes Map Number 10�,A VSUBDIVISION_ -8,A --- - - -M.— PARCEL__j, �STREET 7 /51 LOT (S) _IL A --- Mow---- ST. NUMBER-2zi 7 "**A - -OFFICIAL USE 11ENDATIONS OF TOWN AGENTS: ATION ADMINIST_I�T_OR COMMENT4_ —VUtflD /I ( �7 TnW1j 01 ALjLt=rj C^Ar% DATE AP_PROV�D DATE REJECTED- - ( I DATE APPROVED DATE REJECTED -------------- .NTS "Pu I WWIMAL I H R -HEALTH DATE APPROVED DATE REJECTED DATE APPROVEI)--------------- DATE REJECTED COMMENTS PU13LIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT L,,ZFIRE DEPARTMENT- 0 C4 ;k —;7z RECEIVED BY BUILDING INSPECTOR -7- nATC Isd 16A, az� Office* Use Only Permit Nq—a- �-2!— �cp ­ _k Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK AJI work to be performed in accordance with the Massachusetts Eectrical Code 527 CMR 12:00 (Please Print in ink or type all information) Town of North Andover Date s-//2-/ or To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number pcso,!�:f Owner or Tenant AI V Lo Owner's Aoddress Is this pen -nit in conjunction with a building permit Yes C�' No [I (Check Appropriate Box) Purpose of Buildin 6a�q C.e a,, -7d I-Glnd-1 JXt7—) Utility Authortmdon No. [Existing Service —Amps —Voits Overhead C1 Undgmd 0 No. of Meters New Service _Amps__________Yort5 Overhead C3 Undgmd C1 No. of Meters.— Number of Feeders and Ampacity Location and Nature of Proposed Eectncal Work OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a cu.. en Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO have submitted valid proof of same to the Office YES = NO = if you have chec�ed YES please indicW type of coverage by checking the appropriate box INSURANCE = BOND = OTHER = (Please Specify) 7-:4 (Expiration Date) Estimated Value of Electrical Work$ Work to Start Inspection Date Resquested L"'t Rough ali Cl (4/(—Flnal Signed underthe Penalties of perfury, FIRM NAME LIC. N10,­­­� 9RXtrS1F/rAAV17&W LIC. NO. Bus TelNo. Address /s, :5," I'a fl4e- 60 6�w, Alt"Tal. No. OWNER'S INSURANCE WAJVER: I am aware that thdkicanses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Uw5. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No, PERMIT FEE $—E -SL (Signature of Owner or Agent) Total No. of Ught8nq Outlets No. of Hot fuse No, of Transformers KVA Above C: In M No. of Lighting Fixtures Swimming Pool gmd C: gmd C Generators KVA No. of Emergency Ugnting No. of Receat3des Outlets No. of Oil Bumers Battery Units No. of Switch Outlets No of Gas Burners FIREALARMS No.ofZone No. of Detection and Total No. of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No. of Oio6sai No. lumas Tons KW No. of Sounding Devices Nod of Self Contained No. �of Dishwashers SoacetArea Heating KW oetecdoruSounding Devices C: Municipal C2 Other No. of Orvers Heating Oevicas KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Baflases Wiring No. Hvdro Massage Tuds No. of Wtors Total HP I OTHER: INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a cu.. en Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO have submitted valid proof of same to the Office YES = NO = if you have chec�ed YES please indicW type of coverage by checking the appropriate box INSURANCE = BOND = OTHER = (Please Specify) 7-:4 (Expiration Date) Estimated Value of Electrical Work$ Work to Start Inspection Date Resquested L"'t Rough ali Cl (4/(—Flnal Signed underthe Penalties of perfury, FIRM NAME LIC. N10,­­­� 9RXtrS1F/rAAV17&W LIC. NO. Bus TelNo. Address /s, :5," I'a fl4e- 60 6�w, Alt"Tal. No. OWNER'S INSURANCE WAJVER: I am aware that thdkicanses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Uw5. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No, PERMIT FEE $—E -SL (Signature of Owner or Agent) N2 ],,2 6 * . a 0, - .4 Date.. TOWN OF NORTH ANDOVER PERMIT FOR WIRING Ar This certifies that ................... .............. . ........................................ has permission to perform ...................... ( .. ...... ............... ................................ wiring in the building of .............. / * �- —.-I .... ; .................................................... -e4 . .............. at .... ... ..... .. ............. . North Andover, Mass. Fee..... Yr. Lic. No . ............. ............................................................... ELECTNICAL INSPECTOR ()5/12/98 12:20 85- 00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer r12 rr% eD n PK*k a V �r 4 6_v� z eb M& APW mo sZ 0 tv FA fb -0 Ck. fo CL M rn A IV WC M7 to ryl ;o c. IT, ZZ 0:6 IV 'Am rl rr) eD IVD r— Dt> CL n '-, - T .... _. �..: . e .. _> . - I'- . . . I ' . IT- �%' 'N CA cl� qmpdkmozK Prn �4* m P6_ m �7 0 lkjt�W N� "041M X Orr V) D -n -n- 7! Ej, t 'ca C: IM T tv 01 i".4 kj. . r IA 'Pic- cn Prn �4* m P6_ m �7 0 lkjt�W N� "041M X Orr V) D -n -n- 7! Ej, t 'ca C: IM T tv 01 i".4 kj. . r IA 'Pic- Building permit Number 237 Date JULY 30, i991 THIS CERTIFIES THAT THE BUILDING LOCATED ON 267 BOXFORD STREKI__(LO� MAy BE OCCUPIED As .. . ........ SI'' F F,!1,jjA1.LY--.D..UE'LL1 IN ACCORDANCE SSACHUSETTS STATE BUILDING CODE AND SUCH WITH THE PROVISIONS OF THE MA OTHER REGULATIONS AS MAY APPLY - CERTIFICATE ISSUED TO FLINTLOCK, INC �—ox 5-31 r MA Kth dOver Ma ADDRESS An SACHU5 uilding Inspector Location No. Date 40RTOI TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ 3 $ I (,-U A W Foundation Permit Fee Other Perm ift%e� & $ Sewer,2onpection Fee $ Water Connection Fee $ TOTAL $ 3 Buiiaing Inspector Div. Public Works Location f No. Date TOWN OF NORTH ANDOVER *!. �. .- " '6'V aiingd0i Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ CHU Other Permit Fee $ Sewer Connection Fee $ A IVA I �' �, ". #" :2, 1 Water Connection Fee $ /V//�- TOTAL $ /uu 9-16- Buildin spector M10. Arx'i)m cxl!cdoy Div. Public Works PF,inirit N& -21*111 APPLICATION FOR PERMIT TO BUILD —NORTH ANDOVER, MASS. 1�ezzlv / e a, V/ PAGE I MAP'iq LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK "PAGE I ZONE I<J �UB.DIV..LOT NO. LOCATION PURPOSE . OF BUILDING OWNER'S NAMI-F- NO. OF STORIES OWNER'S ADDRESS z�z BASEMENT OR ARCHITECT'S NAME BUILDER'S NAME Xllwlzl� z2L,��&Z- 2ND 3RD SIZE OF FLOOR TIMBERS I Sjn8XI SPAN - DISTANCE TO NEAREST BUILDING DISTANCE FROM STREET DIMENSIONS OF SILLS POSTS DISTANCE FROM LOT LINES - SIDES 7 REAR f et",IV � J GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICK EBB IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATER:AL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE �Ief IS BUILDING CONNECTED TO TOWN WATER VKW - BOARD OF APPEALS ACTION. IF ANY meg IS BUILDING CONNECTED TO TOWN SEWER If%o, IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS OUNDATION ONLY SEE BOTH SIDES L.�:,ILDSYPARIAHAC- PAGE I FILL OUT SECTIONS I - 3 4 arD PAGE 2 FILL OUT SECTIONS I - 12 ML __ J FEE PAR 02 &-v -- ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUJT BE FILED AND APPROVED BY BUILDING INSPECTOR DATE F1'!:E'D-/Wx& "Ake SIGNA'9UWr OF OW F E El )v PERMIT GRANTED JUA)C 4 / &I^ PERilhfT FOR MOUNDING DRATI E: - FEE PAP... , CI. BLDG, PERMIT FEE I ESS FDA FEE_� FRAME PERMIT 8 2-7 0 3 3 PROPERTY INFORMATION LAND C06T EST. BLDG. Cost --- EST. BLDG. COST PER -SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN SUILDIWO �INSPECTOR 'NV-ld 10-ld S3:)V"-id3?1 SIHI'a3socimm3cins *013 'S3VVH SiN3YVl"dV -VE) 'S3H:)H0d HIIAA 'SONiauna =10 SNOISN3WIa L:)VX3 aNV S3NI-1 JLO'l A S3DIA40 miwvi ainw WOMA :3::)NVJLSIC3 aNV.LO-1 AOSNOISN3WIC LDVX3 MOHS.LsnW N01103S SIHI 31dois kIIWVA 31 A0NV'.c'Jn3Z)0 7 01033V OW(mns 0NIIV3H ON —1 Pic I /--1 45! F—puz I . I.W.0 :)INID313 e^— 110 SVO SWOOV 40 'ON 4 SN31V3H ilNn 9.I.H iNVIaVd ONINOUIGNOD 81V NOdVA NO d.I.N\ IOH WV31S SbRJVd GOOM -SlO:) v -swa 13TIS- 'SIOD 7 Swg m3swil 'NRnA dIV IOH 03:)80A 3DVNdnj SS313did islor (loom 9NlIV3H L L DNIWVVJ 9 OGV0 3111 dooll 3111 Shnim NS30OW 0NIAOOd 110d d3MOHS IIVIS 13AV80 7 MVI E)NIBWf)ld ON 3ivls NNIS N3H:)11>1 S30NIHS GOOM kdOlVAV1 S310NIHS IIVHdSV 13SOID dRVM C13HS —�li3bgWVS IV Ij VI A I*XIA Z) WN 131101 (INVSNVVV C) HIV13 dIH 319VO 319VE) Wswnid OL locra C; LNON 31 nway. I doo, dOlb3dns ONIHIM 3WVdJ NO 3NOiS AdNOSVW NO 3NOIS 'A19 N3GNI:) NO ':)NO:) 3WVdJ NO )131dg dooli 7 Sdis DIIIV kdNOSVW NO )ID189 _71 I —IHdSV NOWWOD 3WVdJ NO onnis kMNOSVW NO o:)Dnis ONICIIS Id3A, 0 IGIS SOIS39sv ONIGIS IIVHdSV G,ti\(JdVH H16V3 S310NIHS GOOM 3ANDNO5- 17,—SGdVOUdVl:) ONIGIS dONG SHOOIJ 6 Sllvm N3HDIDI NdMOW WOOd GV3H S3:)Vld 3dl I.W 9 ON V3�V DIIIV N14 I/c 1/1 V3dV I.W.9 'NIII iinA V387V IN3W3SVQ —Z —Z NIJNn 11WA A60 631SVId Sd3ld (I.M(JNVH 3NOIS NO >1:)Idg �Nld . )1.19 313dDNO:) 3i3�DNO:) HSINId VOIMNI 8�p NOIiVGNnoi Z NOuon HISN00 'NV-ld 10-ld S3:)V"-id3?1 SIHI'a3socimm3cins *013 'S3VVH SiN3YVl"dV -VE) 'S3H:)H0d HIIAA 'SONiauna =10 SNOISN3WIa L:)VX3 aNV S3NI-1 JLO'l A S3DIA40 miwvi ainw WOMA :3::)NVJLSIC3 aNV.LO-1 AOSNOISN3WIC LDVX3 MOHS.LsnW N01103S SIHI 31dois kIIWVA 31 A0NV'.c'Jn3Z)0 7 01033V OW(mns FORM U 10 TOWN OF NORTH ANDOVER LOT RELEASE FORM SUBD`IVISION AS!ESSORS MAP :S Ze SUBDIVISION LOT(S) z� PERMANENT ADDRESS (A8SIGNED BY D.P.W.) STREET APPLICANT PHONE f -g - DATE OF APPLICATION TOWN USE BELOW THIS LINE PL-A.NNfG BOARD A _ -h I AM DATE APPROVED ZJvS TOtteVtA-NNER, DATE REJECTED CONSERVATION COMMISSION CONSERVATION ADMIN. DATE APPROVED DATE REJECTED BOARD OF HEALTH - DATE APPROVED EALTR SAN TARIAN'---- DATE REJECTED DEPARTMENT OF PUBLIC WORKS DRIVEWAY PER111T E!Ajxj�4 SEWER/WATER CONNECTIONS ."2 1" d' FIRE RECEIVED BY BUILDING INSPECTION DATE This form shall be signed by the agents of the Planning and Ilealth Boards, the Co'nservation Commission prior to the issuance of any building permits f6r the subject lot. This form shall not releive the applicant from the compliance of any applicable Town requirement or Bylaw. Any.aPpeal shall be filed With d a -t,,-, s after the of "iVthis Notice in tile Office 0 the Clerk. YOWn 0 A 1L7TV C U5 "VTVw'4' TOWN OF NORTH ANDOVER MASSACHUSETTS BOARD QF APPEALS NOTICE OF DECISION 30 Anthony & Frances Szelest June 26, 1990 Date............................ PefiVion No.. . . . 110-. 8 9 ........... May 1, 1990 Date of Hearing. J-une. 12,. 19-90 ... June 25, 1990 Petition of .... Anthony . & Frances S . zelest ............................................... ....... ....... ...... Premises affected Lots. 4.,.6,9,10. and .11. Boxford. Str.eet ................................ Referring to the above petition for a variation from the requirements of the . Section. A..2,.. Paragr.4p.h.j thr.0 .8 of. the, Zoning. Bylaw ................................................. so as to permit construction. of. single. f amily. res.idences. on .10. lots in. a 12. lot sub-Aivision ............................................................................. After a public hearing given on the above date, the Board of Appeals voted to GRAN.T ..... the Variance ... as -requested ........ and hereby authorize the Building Inspector to issue a permit to Anthony - Frances. Sze.lest, - F.l.intlock-,. -Inc ............................... Signep .......... Walter Soule, Clerk .......................................... Raymond Vivenzio Antia, 01-Co-n-n'o'*r* Louis. Rissin ........................ ................................. Board of Appeals AVA oa pop eb m POOL eD CL FM M cr (70 0 :2 eb ov OR 1--rj m rn .71 C) m 11-1 co C= ; r7 =r -- -2z m U) U) 0 0 z 0 m E. X m CL (A 0 m C) C:: m A= < M m CL -0 m CI el cr cr m CL la CL rri ft to > V [A Al V ro 0 -4 Ob �t wk�- ft ft S. : : 0: ol 0 a) -n m -" (D M m ii 0 m 3 c 0 CD 0 0 :) :r 0 0 c Cc M (a c CD m =r (D cc 0$ 0 CD > > (A z a m 2 C) C) (A lu — — 0 m m z z F) (A -4 *0 m m 0 m > 0 0 0 m CA 41;-o "%%b *7hk 0 44 (D pi T6 m wm� THIS PLAN IS INTENDED FOR ZONING PURPOSES ONLY. IT WAS COMPILED FROM EXISTING PLANS AND RECORDS WITH BUILDING LOCATIONS CONFIRMED - IN THE FIELD. IT SHOULD NOT BE USED FOR PROPERTY LINE DETERMIN— ATION. THE BUILDING IS NOT LOCATED IN AN ESTABLISHED FLOOD HAZARD AREA. ZONING: REQUIRED SETBACKS: FRONT: '30 SIDE: so REAR: 30 CERTIFIED PLOT PLAN IN NOZT44 Ajv0v&7<AA AS PREPARED FOR PAyE zmm M & A FILE No.: 351-C>l WE HEREBY CERTIFY THAT WE HAVE EXAMINED THE PREMISES AND THAT ALL EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED AS SHOWN. ALL BUILDINGS SHOWN CONFORM TO THE,��LAWS OF THE MUNICIPALITY WHEN C PAUL MARCHIONDA No. 30015 1 T, w Av� dak/ ,Aa,P_E. f)ATE ' MARCHIONDA & ASSOC., INC. ENGINEERING AND PLANNING CONSULTANTS 80 MAPLE STREET STONEHAM, MA. 02180 (617) 438-6121 SCALE: 1"= q0' DATE: 6- JZ -9 I �Ocation --,-7 6, No. Date TOWN OF NORTH ANDOVER 0 Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Q4 us Other Permit Fee $ Se%Wer Connection Fee $ Water Connection Fee $ ��4 TOTAL $ N2 iM4 Building Inspector" Div. Public Works Location Date No. TOWN OF NORTH ANDOVERcE 0 4L % Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ 4 Water Connection Fee $ TOTAL $ Building Inspector Div. Public Works Le 0 C M. 0 z > c 4 x 0 >M a zm 4 > 0 > > m m 0 r r 0 0 c c n n j -4 0 0 z z $A Lq w z (A c 0 z Ul 9 T M 0 "a m 0 z � Z� z m 0 z 0 Ap z a 0 m g > * r r ; ; ; , c > A > 0 ; _ > a ; _ a ; _ > 0 > - x 0 * z - 0 :E z m r 0 > N 0 Z 0 P 6 - z 6 z o z o m r z n m z n m z n m n -4 0 m 0 r o Z 0 0 I m 0 I 0 z > z r z 0 z )PI r z p Pn 0 z -4 m " > a - :1 0 r 0 m A m > m m > 1 m A 0 0 > 0 0 z r m m 0 -4 0 z > z < m zo ZI ) 0 0" k A NS !j n 0 In m 0 Z �� > IN. il r r r Z r 0 o MO m z a n z a n z a n 0 0 0 'q n o -4 0 0 m m > 0 m 0 z Z 0 Z Z 0 Z Z z 0 z c z a - c F 0 0 0 -q m nnna, A m m -4 m m -4 m F 0 z > -q0"-qlr-im 0 Z M w 0 0 61 z 0 0 0 -4 0 z > 0 -4 0 -4 0 a A 0 -1 0 m T r r - 0 z C > Z z A 'fN r M > M z W r i m x -f x FA 00 Qk 0 7, � Z� z m 0 z 0 Ap z a 0 m HOME IMPROVEMENI- '.-,ONTROCI-ORS REG]"I'R(I I Board of Builclino Regulations ancl Stail(-k-t'l Room 1301 one A-shbLirt,(.;n Place Boston, Mal.-!.:z;ac hu set ts 02100 HOME IMPROVEMEN'r CON'1-F-',A.(-.'1-0R Registration 102467 ir-xpii-ation 07/02/'),*i I'ype - PRIVA'1"E CoR,.PoR(-)-1'-10N. NEW ENGLAND CUSI'OM DESIGN, INC. Val Lanza 10i Billerica Ave Bld 5 N. Billerica MA 01822 R�!�tricted To: 00 OEPARTMENT Of PUBLIC SAFETY 8 None CONSTRUCTION SUPERVISOR LICENSE Number; Expires: Birthdate: A Masonry only C s .058828 041H11998 I & 2 family HOM -ent edition of OP Restricted To: 00 ;a; lure to possess a curi 4.a;sachusetts state 86ilding Code i!! cause for revocation of this license. �F4)dJJW'A 4011 VAL J LANZA 34 BIXBY ST REVERE, KA 02151 51988 it - ell 'L, / . .. FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/per" frcrm Boards and 2--partments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requireffwnts. APPLICANT FILLS OUT THIS SECTION VA L Z'A Z-4 PLICANT M��kl J'P164-,4,V,0 C- AP PHONE 099� t'LOCATION: Asseswes Map Number J 0 A PARCEL__j_ VSUBDIVISION LOT (S) �STREET ST. NUMBER 7 IIENDATIONS OE TOWN AGENTS: - , A 4 ( i � A � TION ADMINISMATOR COMMENTS VUWO_Alf� '7 USE ONLY��",__**_ -IM DATE APPROVED - --,fj to DATE REJECTED— T__T - i I A TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED DATE REJECTED TH COMMENTS DATE APPROVED DATE REJECTED PUBLIC WORKS - SEWERiWATER CONNECTIONS DRIVEWAY PERMIT I 1 ,""'FIRE DEPARTMENT V�� a /�X /-/' '? RECEIVED BY BUILDING INSPECTOR DATE s GLORAL- REGISTERED LAND SURVEYOR 0 REGISTERED PROFESSIONAL ENG -ER 24 VERNON S r. -1ELD, MA. 0/880 r- 246-9345 6-9338 WAKEF (p. - 40'�" '-J v (D 13 LOT I IA 949135±SF I Hoc k y sT- w S9 0 1')4 ol 0 X//� SIGNATURE DATE — -------------- 0 ALb A. MANO 1307 7 PLOT PLAN IN r NORTH ANDOVER, MASS. w I" OWNED BY SCALE I"t. 60' . DATE 3-19-98 w 0. i PRODUCER CERTIFICATE OF I-N---S-*--*---------'---'--'"-----------'I URANCE f.,DATE (MM/DD/YY) KILG�DRE INSURANCE GROUP 33 C�INTENNIAL DR PEAB:-)DY, MA 01960 (978,',; 531-655_Q____FAX: i§U_FlffD__ � NEW ENGLAND CUSTOM DESIGN, INC. t226 LOWELL STREET UNIT B4 -A WILMINGTON,MA 01887 __T_HI`SI�Ehfl�_lCAjt- -is ONLY AND CONFERS Is S bt b_4§ -4-M A�ftt Fi- NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICI ES BELOW. COMPANIES AFFORDING COVERAGE COMPANY A _ COMMERCIAL UNION COS. COMPANY B SAFETY INSURANCE COMPANY C _ TRAVELERS INSURANCE COMPANY D _iHIS IS ­TO' CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE 13EEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFIC ATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE A;:FORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY 14AVE BEEN REDUCED BY PAID CLAIMS. Y EFFIE IVE 'POEXP �RATIYON CT LICY I Y) (MM/ /Y POLIC CO LTR IYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIV POLICY EXPIRATION DATE (MrvVDD/YY DATE (MM/DD/YY) LIMITS LGENER f L LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADE [X OCCUR A —OWNER'S & CONT P�OT RENEWAL OF FBLP04167 0 1 AUTOMOBILE LIABILITY Al\ . AJITO AL, OWNED AUTOS �X_ SCIEDULED AUTOS B HIFILD AUTOS 62853 I-) NON OWNED AUTOS T6 2 8 5.3 _�ARAGE I �li BILITY I ANN AL 10 EXCESS 1, Z' IiLITY M' U IIIE -1 A�FO�RM - 0 M r.3 OTH HAN UM13RELLA FOF�M WORKER "'PE..AT'O. A.. E Loy . E RS LIABILITY C THE PROP -"',I[ TOR/ PARTNERS E,O�CUTIVE 1_� INCL 12 6 3X3 7 2 6 OFFICERS ARE: EXCL EVIDENC."�'.'. OF INSURANCE JR I I ACORD 25-S (3/_q GENERAL AGGREGATE PROD UCTS-COMP/OP AGG PERSONAL & ADV INJURY /99 M/14/98 �03/14 EACH OCCURRENCE I FIRE DAMAGE (Any one fire) M M '.P ED EXP lAny one person) COMBINED SINGLE LIMIT BODII-Y INJURY (Per person) ll_0_0'_0_0_0___ I 104/05/97 104/05/98 BODILYINJURY 1 250,000 04/05/98 04/05/99 (Per accident) f $ ! 50_0_,_0_0__0____ PROPERTY DAMAGE $ 10 AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY- EACHACCIDENT I$ AGGREGATE $ EACH OCCURRENCE $ LB 0D'Ly If Per accd PROPi AGGREGATE $ $ X STATUTORY LIMITS EACH ACCIDENT 1$1 00 103/14/98 03/14/9 DISEASE 9 POLICY LIMIT 1$50 - 0' 0_00__ DISEASE -EACH EM LOYE -1 r) r% r% t P E Sl r) () CANCELLAT­l0__N'---------� SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO 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 KIND UPON THE COMPANY, ITS AGENTS On REPRESENTATIVES. AUTHOR I * ZED R�_PRi.jENT__A__T_lV_E_ Cc-- @ ACORD CORPORATION 1993 cl CO) CO) CD St z CA CD 0 '0. 06 0 =r CL S. COP) t= CD CD CL icr %IC M CD P-41. -0 =r -1 -1 CD 0 CD CO) CD CA Cc CD S- tp ca C* CD z C2 CD CD gr -4 CD CD C, CD 0 n m z .* C = =r= CO3 0 CA =r CL CL m =r ', =r so CO) CD 0 0 W 0 r a CD . -% a Go CD 0 Z CWJ LOS. 0 j CD =F (a cco CL U2 'CCD C D rA '" C') -o co 0 CD CL fA 0 m — w C3 i4* cr Z .6 EL CL ca co IE CA rl*-- 'A SCD RU CA 71� U2 C') C-2 iD =r ft 0 0: 0 Ca z C.) Go CD- M tp S=A CD lu CR lu c CD �q 0 z t3i M 0 9� 0 a CL 0* C/) �4' I )mq 0 41i CD ol TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date Received Date Issued: (0 IN IMPORTANT: Applicant must complete all items on this page LOCATION Print. PROPERTY OWNER npj_ t— g I , . _; --"- . Print Old -Structure MAP NO: PARCEL ZONING DISTRICT: Historic District Machine Shop Villa yes no yes no ves no TYPE OF IMPROVEMENT PROPOSED USE Reside -*9f Non- Residential 0 New Building e family El Addition El Two or more family El Industrial 0 Al ion No. of units: El Commercial R'Aepair, replacement El Assessory Bldg 0 Others: [I Demolition 0 Other El Septic 1 11 Well, 0 'Floodplaih 0 1 We t1a I ncl� 0 Waterth edibisirict El Watef/Sewer : � �191, RIPTION OF WORK T0,1if- FEaORIVILL), 1�9 0 0/75y_ /T:L� /i:� 00 T LL '01N\/L 5�:(Dt C C_: -:!3 OWNER: Name I a 0 L) e- R_ '7 _jUgntification Please Type or Print Clearly) Q b 0 N 1-0/ Address: V CONTRACT -OR NaffiO: Address: zs�a z, -e D__ Supervisor's Construction License: Exp. bate: Home Improvement License: Exp. Pate:, -7 ARCH ITECT/ENGI NEER Phone: Address: Reg. No. �A� -1 IW\_ 0.-3 -Z;S-_-007&Y FEE SCHEDULE: BULDING PEROPT. $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COSTBASED ON $125.00 PER S.F. 2 St: (00 Total Project Co FEE: $ Check No.: Receipt No.: 2 - NOTE: Persons contracting with unregistered contractors do not have access to the guarantyfund Plans Submitted 1] Plans Waived 11 Certified Plot Plan [I Stamped Plans 11 Building Department �-Thefoh'-jw1ng*iv-a*]i'stof the r6�ujfed forms to be.filled out'for the appropriate permit to, be obtained. Roofh�g, Siding, Interior Rehabilitation Permits B,uilding Permit Application Workers Comp Affidavit Photo Copy Of H. 1. C. And/0'r G. S. L. Licenses Copy of Contract Floor Plan Or Proposed Interior Work Engineering Affidavits for E . ngineered products NOTE: All dumpster. permits require sign off from Fire prior to issuance of Bldg Permit Addition Or Decks Lj Building Permit Application • Certified Surveyed Plot Plan • Workers Comp Affidavit E3 Photo Copy of H.I.C. And C.S.L. Licenses • Copy Of Contract • Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) • Mass check Energy Compliance Report (if Applicable) • Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) Ej Building Permit Application L3 Certified Proposed Plot Plan • Photo of H.I.C. And C.S.L. Licenses • Workers Comp Affidavit • Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) • Copy of Contract • Mass check Energy Compliance Report • Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp tfie,decision from the Board of Appeals that the apt).?al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submAted with the building application Doc: Doc.Building Permit Revised 2012 Location2-Q;:,I J S44A+ No. C, I (� (P Date TOWN OF NORTH ANDOVER Certificate of Occupancy Building/Frame Permit Fee $ E!� I 2,0D Foundation Permit Fee $- Other Permit Fee $- TOTAL $ Check # 2'/ 679 BuildAg Inspector ..Plans Subm itted 'Plans-Waive'd-11.2; ..'.,--.Certified Plot Plan Stamped Plans' F1 TYP ?R-0F­;.SEWE-RAGE_DlSP_0SAL Public Sewer Tanning/Massage/Body Art Swimming Pools 0 Well Tobacco.Sales Food Packaging/Sales El Private.�(,sep'tic ta*, ete.- rmaiidnt DUmpster Gn�site El THE- FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM -.-,.--DATE REJECTED.--_. DATEA PPROVED PLANNING & DEVELOPMENT' D COMMENTS -CONSERVATION Reviewed on Si6nature COMMENTS HEALTH COMMENTS Reviewed on Signature - Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Conservation Decision: Comme ..Comments Water & Sewer Con nection1Signature & Date Driveway Permit DPW Tow;! Engineer: Si Located 384 Osgood Street :.FIRE 'Dump, steroh site . no A re do-aft—merl A-N--,-% e d44 COIVIMEN'TS`� --Dimenston Number of Stories: Total square feet of floor area, based on Exterior dimensions. -Total land -area,, sq. ft.* -ELECTRICAL: Movement of Meter, location-, rriast or service drop requires approval of '.Electrical Inspector -Yes No DANGERZONE LITERATURE: Yes No MGL-Chapter166. Section 21 A �F and G min.$100-$1000 fine NOTES and DATA — (For clepartment use I El Notified for pickup - Date Doc.Building Permit Revised 2010 CA a CID 0 z r -l -L o CD CL CL > cc 0 0 CD CL cr CD 0 CD CL 0 S' = CO CD CO) a CD 0 V.-lpL 0 7 0 0 U) a F r_ 0 r_ U) -0 Q) 0 CD 0 CD CD U) 0 z 0 POOL X CD a 0 CD in - a z r— m Cl) U) 0 0 z Cl) cn C) cn: m 0 0 -0 m m m cn 0 z Cl) 0 0 m -11, zr -4 0 " 0 2) 0 cr cn cn CD 0- 0 CD CD 0 -% 0 CL 0 m o =r -0 cn 0 —0- 0 Fn =r CD 0) cin) (n 0 CD M - CD m 0 r (n -L 11) CD OR �O=i 0 0) 0 0 CD o o< cm .5 CD z o 0 CD > = CL 0 0 CL < CD CD U) 2) CD CD CD C.) 2) h to CD CD in "0 CD cn 0 =r >CD CD WS: r.L OOOMW C,2 -0 0, 0 Ln 3 0 27 rD Ln -- m rD z 03 M Z M -n. 5 �o 0 r- (M > Ln rD ;o 0 c m r- M rn RL ;o 0 C r - c rn 0 L rD ;)o 0 r- m 0 C: cu 0 D 2 z C, z m 0 (n (D _0 L�� r) LA 3 -n 0 0 CL 03 0 0 m > 6S ,q CS # 022680 HIC# 103358 � Propiosol === A. J. Walsh & Sons 55 Pleasant Street .North Andover, MA 01845 of - pages 978-688-6737 or 1-866-AJWALSH Proposal Submitted To Job Name Job Job Locationji Address Date —17Z�olf Plans A -- Phone # Ojr- I Fax # Architect We hereby submit specifications and estimates for M 11 /-�) ,, 4 V C. 11 ->46440 -7 or We propose hereb(to fumish material and labor complete in accordance With the above specifications for the sum of: 010 $ Dollars with payments to be made as follows: OJV t2 �- LI)O, L40 0 Any alteration or deviation from above specifications involving extra cost will be Respectfully executed only'upon written order, and will become an extra charge over and Wes, accidents, or delays ab theestim' a. All Agreements contingent upon ate submitted ove beyond our c6hirol. Note — this proposal may be withdrawn by us R not accepted within _ 4days. 2cceptance of Prop ' oo The above prices, specifications and conditions are satisfactory and are --- �aignature hereby accepted. You are authorized to do the work as specified. Payments will be made as outlined above Date of Acceptance — --- ?/.? / /Z Y— Signature I- LV I J I L . I/-, 1%VVVV Lit I t.V lll%JVI%rl]VVL I CERTIFICATE OF LIA THIS CERTIFICATE 13 13SUED AS A MATTER OF INFORMATION ONLI ,#ERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEN OF -LOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTIT�. REPRESENTATIVE OR PRODUCER. AND THE CERTIFICATE HOLDER. , MPORTAINT: If the certificate holder Is an ADDITIONAL INSURED, the he terms and conditions Of the Policy. certain policies may require an a ;ertIfIcate holder In lieu of such endorsement(s). )bUrFR 00775 - 001 orso & Jankowski Insurance Agency Inc 8 Mass Ave Suite ims )rth Andover, mA ams )RED thurWalah J Walsh &Sons Pleasant stmet )rth Andover, MA 01845 )VERAGES CERTIFICATE NUMBER: - HIS IS TO CERTIFY T14AT THE POLICIES OF JNSURANCI IDICATED. NOTWITMSTANDINQ ANY REQUIF.Emrr'l 1, It: ERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE I XCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS IVV. LVIU I- - I ) kBILITY INSURANCE DATE(MMIDDIMY) 1 1210412013 r AND CONFERS NO RIGHTS UPON THE CERTIOICATE HOLDER. THIS EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES rE A COhTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED POIICY(185) MUSt be endorsed, If SUBROGATION1 18 WAIVED, subject to ridorsement. A statement on this certificatis does not confer rights to the RAeCT FX8.1o. EXH! - (07!).682.5175 No.1 (976)794-0313 101680: INSUR VERAGE ,Nsugffg A. A.I.M. Mutual insurance Company 33758 INAURCR a i INSUSER Q - INSURERD! LibIGURER E 6 1 1 I INSURPR F - 45 INSURED NAMED ABOVE FOR THE POLICY PERIOD t OTHER DOCUMENT WITH RESPECT TO WHICH THI$ )ESCRIBED HEREIN 18 SUBJECT TO ALL THE TERMS, r-LAIM-A TYPE OF INSURANCE OFENERAL LIABILITY COMMERCAL OENERAL LIABILITY CLAIMS-MADP 17 OCCUR VOW POLICY NUMBER MA—MUMN ARM LIMITS E�CH OCCURRENCE DAMAGE ED PAEMISSS Ilia Q=LMM91 MED EXP (Arty one peraon) PER13ONAL & AQV INJURY 3 GENFRAL AGGREGATE 41 MENPL AGGR4GATE UmIT APPLIES PER: RO 10 ::J-0LJCy F—Wi [ C PRODUCTS - COMPIO;k AGG $ AUTOMOBILE. LIABILITY ANYAUTO ALL 0 SC EDULED S AUTOS AUTOS HIRS "':S NON-OVMEO D AU qAUTOS COMBINED (Fa n=1de BODILY INJURY (Per poldon) S BODILY INJURY (Per wmenk) S PROPERTY DAMAGE UMARELLA LIAB EXCESS LIA-8 OCCUR CLAIMS woe EACH OCCURRENCE AGGREGATE OED RETENVON S YIN 9�10 TAI�WPA� PIM -MbWECLfrfVEFN (Mandalmy In NH) 91RA!90-955RATIONS bei. MIA AWC-400-7014648-2013A 1111412013 -T 1111412014 X E.L EACH ACCIDENT 100,000.00 F -L DISEASE - F.A EMPLOY�� 100,000.00 IL DISEASE -POLICY LIMIT 8 600,000.00 'RIPTION OF OPERATIONS I LOCATIONSI VEHICLES (Anieh Acoao 101, AdC11IIoA41 Romarks SchadLdt, If more 4pace In required) in Of North Andover ) Osgood Street :h Andover. MA 01846 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES OE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. NOTICE VALL BE DELIVERED IN ACCORDANCE MTH THU POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ORD 25 (2010/05) The AGORD naMe and logo are registered marks ;�i66WD' TZ ss Regulation Consumer Affair, &.gu,i- Office of —M OME IMPROVEMENT CONTRACTOR -201 R,egistration: 103358 Type: Xpiration: 7/7/2014 Private COrporati( A. J. WALSH & SONS,INC. Arthur Walsh,Jr. 55 Pleasant St N Andover, MA 01845 UnderSeCretal.3, Massachusetts .. Department of Pubkc. Safety Board of Building Regulations and Standards Construction SuperviNor �_icense: CS -022680 ARTHUR J WALSH JR 159A WAVERLY-RD N ANDOVER AM 01845 06/09/20 Office of Investigations 600 Was1iington Street Boston, JVA 02111 wwMinassgovIdia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Pluinb . ers plicant Information Please Print Legibil lie (Busiiiess/Orgariization/Individual): iress: 16� 0- W ft e -k L //State/Zip:_,�.() . "p 0 1) ­ep f 'V)— Phone#: ,;Vo �mployer? Check the appropriate box: 0 I �ama employer with 4. E] I am a general contractor and I employees (Rill and/or part-time).* have hired the sub -contractors I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub -contractors have working for rne in any capacity. employees and have workers' [INo workers' comp. insurance comp. insurance.! required.] I am a homeowner doing all work myself [No workers' comp. insurance required.] T We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comi). insurance reauired.1 --z� 73 Type of project (required): 6. E] New Construction 7. E-R-emodeling 8. F -I Demolition 9. n Building addition 10.n Electrical repairs or additions ILEI Plumbing repairs or additions 12.[] Roof repairs 13.0 Other )1icant that checks box #1 must also fill out the section below showing the:ir workers' compensation policy information. wners �vho submit this Widavit indicating they are doiiig all work and then hire outside contractors must submit a new affidavit indicating such. tors that check this box must attached an additional sheet sh - owing die name of the sub -contractors -and state whether or not those entities have .s. If the sub -contractors have employees, they must provide their workers' comp. policy number. i employer that isproviding workers' compensation insurancefor my employees. Below is the policy andjoh site qtion. ce Company Name-_ Mai WAL /A G 0 V or Self -ins. Lie. 4: -7 0 ly(e - C> D Expiration Date: ---/Z— /4/ �Address:,),,(,-7 eoy, City/State/Zip: jVO /1-1V /0 41-Jele /4*74 a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a to $1,500.00 and/or one-year imprisonment, as well ascivil penalties in the form of a STOP WORK ORDER and a fine � $2SO.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of ,ations of the DIA for insurance coverage verification. PebY cerdi"derthepains andpenalties ofperju'Y that the information provided above is true andCOMOCI, A . . . I MR. M 4al use only. Do not write in this area, to be completed by city or town official or Town: Permit/License # 41112 ng Authority (circle one): )ard of Health 7. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 'her Phone 4 - act A-.r.Ron- MASSACHUSETTS HOME IMPROVEMENT CONTRACT This form. satisfici-all basic:roquirements ofthe states Home ImPlOvernentContmettir Law (MGL chapter 142A), lint doei not iriclude siandkYd language to protect homeowners. Seek.legal advice ifn h, ecessary. Any person planning ome pp ' ints sho4d: b M*m* ticopy 0 rovern 0 Massachubeftconsumer.guide to home,improvethent" before agreeing to any work on yourresidince, you may obtain -a freecopy by'calling the Office ofConsumcr Affairs and Business,Regulation!s Consulner Information Hotline at617-9734787 or 1#888*283.3.751. Homeowner Information Contractor Information Name ;Mpany Naoi. Street Address (do not use.a Post Office, Box address) Z671)1�09 �;mitractorl Name 5w p -w Own -,F4,7 D �;T Cityfrown side Zip Code Business Address (mast include a streetarl") 1/41/0 )91V10 6 10 e R_ /w/T Daytime Ph e Ev * cn4ftonti. Ntyn own State�/ Zip Code Mailing Addross (It different bom above) 3usiness Phone Sederal Employer ID or S.S. Number L.. ftq� ual m" h" i� The Contractor agrees to . d . o the following work for the Homeo*ner- W1 Me Wro 0 com I Required Permits - The following building p ermits are required and will be secured by the contractor as the'liomeouter's stgcnt� (Owners who',secure. . their own permits wiH be excl��ed.,.fromthe�Guar.antyFiind'provisionsof MGL chapter 142A.) Total Contract Price and Proposed Start and Cprerpletl' on-Sibeelate - The following schedule will be adhered todfiless. circumstances beyondthe coritractriesi control arise when contractor will begin contractied work. when ..contractid -work willbesubstandidly rompletrA PcH�Xm We wGrX, n11111411 Me Material and labor specified above for the.total sum -. "(,OWL -V 4 of M Payments will be made according to the Mowing schedule: upon,signing contract (notto, exceed 0 of the total.exintract price gr the costaf Spec ial order whichever is. greater) S 00by / or upon corn�lction of $J608,00 by / or upon completion of s 7 A upon completion of the contract (Law forbids denumelitig full payment until.contract is cc th party!s. satisfaction) no following matmial/equipment must be special paid for ordered before the contracted work*izLs in order �_,7 to meet Elie completion s&edule.(**) to be.paid for mance charges (**) Law requires tbat any deposit or down -payment required by the contractor before work begins may NOTES: (0) including all f noVexceed The greater of (a) one-third ofthe total ormtract: price or (b) the actual cost of any special equipment or custom made material which must be special ordered in advance to race the completion wbedule. Express Warranty -Is an exyress warranty hing:provided by the toretractor*9 No Ys! terms 21 1111BI, =2.,�eo to tbuollrjrp� Subcontractors The contractor agrees to be solely responsible for cd*lction of the work &a ad iegardles ons;ofany thiid parly/subcontramr utilized by the contractor. Ile contractor further agrees to be solely responsible for all payments to all subcontractors-f6i matrrialsandla rund . ent Contract Acceptance - Upon signing, this document becomes a binding c contract WWI not imply that any lien or other security intercstlas been ontract under law. Unless otherwise noted within this document the carefully before signing this contract placed on the residence. Reviaw.the following cautions and notices 0 Don'tbepressured into sighingthe contract. Taketimeto readaindfully unticestandit, -Ask-eluestions ifist-&Iiiiijisimelear. Make sure the contmamha&a valid Home ]in - Reiristration Ile Wv; requires most home improvement contractors and subcontractors to be registered with the Director ofHome Improvement Contrite Regi tion. you may u .One Ashburton Place, Room 1301.,.Boston, -MA 02 108 orby. calling 617-727-3200 or registration by writing to the Director it tdir Itim inquire abo t contractor 1-800-223-0933. • Does the contractor have insurance? Check to ScOth.11t Your.coutractor is properly insured. • Know your rights and responsibilities. Read the ImportainfInformation an the ireverse side ofthis 116 'copy of the Consumer Guide to the Home hhProvement Contractor Law. rin and get a You may cancel this agreement if it has been Signed at a Pl&c& Other than the C011131IL161's normal place oftnisineas provided you notify the contractor in writing at his/her main offlic or branch office by ordinary mail POStCA by telegram sent or by delivery, not later than midnight ofthe. thiid business day following.the signing ofthis agreement. . See the-auched notice of cancellation form for an explanation of.this right DO NOT ST r.N 7741.R rnN'rD A f -r TV q�rrvirs im A " " A — — . - — __ � __ - - - - Twoideatice copies �rbecon,19WRACIS400i Onscopy.ftuldplothe COW WMW be kept by ft coaftlaFter. �HOmcownc S Ignature '2_ Contractor or S i Store gn Date �Datc Contractor Arbitrdii6ns The Home Impovement-Contractor Law:provitips.-homeowners with4he-right'-to-initiate an arbitration action (as an ion' alterrui ve ' Wbourtacti - �ihhi.w.havea-. 'with a contractor. Thesame iig'hfis m Lok' automatically afforded toa Contractor,. lt�wevei_fi� contricW would haveAp resolve any,tiftputi �cVshe.has.witb a homeowner m' courtul fless. �oth parties agree to the optionall clause provided below.. This clause m6uldgive & contractor the. satlle.rfght 16 arbitiaiion As is afforded to the homeowner. -by the Home Improvement Contractor Law. i The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute - concerning this contract, the contractor may submit the dispute to aprivaie arbitration firm which hag been Approved by the S ffi f Consumet Affairstrid Business Regulation andihe consur I ner shall be required 1;,cre, oFfhthe ecuti ce 0 to sl mitt c i itrati provided In -Massachusetts General LawsyMpter 142X Hqy(eojW;er`i; Sigrulture Contractor's Signaturi TIOPM I The signatures of the parties above apply only to the agreement of the parties to alternative dispute resolution "ated by the contractor..::.,The�:homeDwner.may initiate altenc.Ativedispute resolution even where this sectipAis not tpnArAt6lvsiLyn�diw'.th6nmties,.,..- Homeowner's Rights A homeownees rights w . A *O­Aboe.-Improvement Contractor Law (MGL chapter 142A) and other consumer protection laws (i.e. MOL c6p� 9Sk) may not be waived in any way, ev6 by agm=ent: However, homeowners may be excluded from certain rights if the contractor they choose is not properly registered as prescribed by law. Homeowneq who secure their.own building permits are automatically excluded from all Guaranty Fund provisions of the Home Improvement Contractor Law. The -contractor is responsible -for completing the work as described, in a anner Homeowners may be entitled to other specifir. legal rights if the contractor guarantees, timely andmorkmanlikem, r. or provides . an. express . warranty for workmanship oir materials. In addition toguarantees.�or warranties provided by th ' e contractor, all goods sold in Massachusetts carry an implied warranty of merchantability And fitness -for a particular purpose. An enumeration of other matters on which.the homeowner and contractor lawfully agree may be Added to the. terms of the contract as long as they do not restrict a homeowner's basic consumer rights. If you have questions. about your c . onsurner/homeowner rights, contact the Consumer Information Hotline (listed �elow). Execution of Contract The contract must be executed in "gicate and should not be signed until a copy of all exhibits and referenced documents have been attached. Parties are also advised not t6 sip the document until all blank sections have been filled in or marked as void, deleted, or not applicable. One original signed copy of the c�ontract with attachments is to be given to the owner and the other kept by.. the contractor. Any modification. to the gfiginal*o6niract must be in writing and agreed to by both parties. Contracted m;ork may not begin until both parties have received a fully executed copy of the contract and the three day recission period has expired. Accelerated Payments A contractor mpy not demand payments in advanceof the dates specified on the payment schedule in cases where the homeowner deems him/herself to be financially insecure. However, in instances wherta contractor deems him/herself to be financially insecure, the contractor may require that the. balance of funds not yet due be placed in a j oiij� escrow account as a prerequisite to. continuing the contracted work. Withdrawal of funds from said account would require the signatures of both parties. Additional Information If you have general questions ormeedadditional information about the Home Improvement Contractor Law or other consumer "A Consumer Guide to the Home.Improverrient Contractor Law, contact: Cqnsumer-Information Hotline Office -of Consumer Affairs and Business Regulation 10 Park Plaza, Room 5170, Boston, MA 02116 (617) 973-8787 or 1-(888) 283,1757 If you want to verify thelegistration of a contractor or if you havequesti6ns or need. -additional inftirmation specificahy about the contractor registration component of the Home Improvement ContractorLaw, contact: Director of Rome Improvement Contractor Registration, Bureau of Building Regulations and Standards One Ashburton Place, Room 1301, Boston, MA 02108 4-800-223-0933 (617) 727-3200:or For assistance With informal mediati tin: of diisputes or to- register f,ormal complaints against alyas j-dift, Co ee0bimplaint'Settion: Office of the Attorney General (617) 727-8400 AND/OR Better Business Bureau (508) 652-4800 (508) 755-2�48 (413) 734-3114