HomeMy WebLinkAboutMiscellaneous - 278 HILLSIDE ROAD 4/30/2018C)
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TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
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This certifies that ........... i
has permission for gas installation 1�12*044.lf �401. 14k
in the buildings of ... wme. Ae,
................
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at ... ........ North And er,,/Mass.
Fee..?f� v?!? Lic. No..,7�o�.
GASINSPECTOR
Check#
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INORTE AN-DOV-= AIASSAC��
BdI&3=-,L0Cad0nS Peankfu
Amount S
-X0 t 1JA1, , �lf e �-/ - OwnLes Name
/I
New -Raa�oa r-1 RepInment PIws Submitted
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SS
Tckpllow
-- 177-Y r" Y5-- T 5-v�
141anwaMcmsed Plumber or Gw Mier r-2/aMisu
WSURANCE COVERAGE � Check Mw
Ihaws curr=IiabWIwuraacapdIIqy aries subs=&j equivaleaL Yes MI W-om
Ifymbmchecked-vs-pleweindicauthetypecovaa,.,ebychwidpg-theappropn-mabc>x
Iiabfiftyhsaamce policy -E] �OthparWeeofjnderanfty rl - Boad [3 -
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Y-ass-Gmw&]Liws�andtbatnudgnaftmcmtbispmmitapplicadmvr&vestftrequkament
Checko=
Siggastare of Ovma or Ownes Aggemt . owner
r hmbyca*tbataUd�hedeWUsandliffimaadanihavesubmiftd(ermft-ed) in above awlicatioriamtrie and acem-atato the
best afmylm� andtha all ub3mbmgwcak2ndush�wspmffimiedunderPM=Lme fmriNs aplicatianTnill be m
compliawavA& afl paitinm9providons of1haI&9sad:msdts Smw-Gas Ca&jaqA ChapterIA12 of1he Canad Laws.
SI_gnatura or-Licansed Plumbw Or Gas Fraer
PImber A V <33
cm Ht& License Nunter
(Off ME USE CM -D Jameyman
AMR
4S -UB -B A SE W B NT -
ASEMENT
ST- TLOOR
A
D. FLOOR
I
RD. FLOOR
4� T H. FLOOR
STH- FL.O 0 R
:6TH- FLOOR
7TH. FLOOR
8TH. FLOOR
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ire,, Al ---I
SS
Tckpllow
-- 177-Y r" Y5-- T 5-v�
141anwaMcmsed Plumber or Gw Mier r-2/aMisu
WSURANCE COVERAGE � Check Mw
Ihaws curr=IiabWIwuraacapdIIqy aries subs=&j equivaleaL Yes MI W-om
Ifymbmchecked-vs-pleweindicauthetypecovaa,.,ebychwidpg-theappropn-mabc>x
Iiabfiftyhsaamce policy -E] �OthparWeeofjnderanfty rl - Boad [3 -
OwzweshsarancaWdver. 1 mn avramfkatthealicensw dow not havathchwimace caveragereq*ed by ChaWw 14�2- OfThe
Y-ass-Gmw&]Liws�andtbatnudgnaftmcmtbispmmitapplicadmvr&vestftrequkament
Checko=
Siggastare of Ovma or Ownes Aggemt . owner
r hmbyca*tbataUd�hedeWUsandliffimaadanihavesubmiftd(ermft-ed) in above awlicatioriamtrie and acem-atato the
best afmylm� andtha all ub3mbmgwcak2ndush�wspmffimiedunderPM=Lme fmriNs aplicatianTnill be m
compliawavA& afl paitinm9providons of1haI&9sad:msdts Smw-Gas Ca&jaqA ChapterIA12 of1he Canad Laws.
SI_gnatura or-Licansed Plumbw Or Gas Fraer
PImber A V <33
cm Ht& License Nunter
(Off ME USE CM -D Jameyman
MASSACHUSETTS UN]TO`RM APPLIC-kTION FOR PERTaT TO DO PLUMBING
C.-Lype or print)
NORTRANDOVEP, MASSACHUSEM
Date
B,&di.,, 1-:16-D. AIISMZ77 A-4 0,,,,� jT.,JeAjIVA1C- 4L
pennit.
TYP Amomt
e ofo i!Fai/v
vmw [3 Rmowdm r-1
F&
(Rha or type)
Instamg COE
0 � ��o x
Addr= 1 -0
9262
Phw Submifted yes 0
This certifies that
slim
D a t: e . ., �/? w Ap-r.
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
........... .
...........
has permission to perform . . / - - ......
plumbing in the buildings of .. 7-.
5 -9�em�e ........
at ... rth Andover, Mass.
/C 1� 44 ......
Lic. No.. 4 ...... /2 .....
PLUMBING INSPECTOR
Check #
LJ FirwCo.
Name or-LicamudPbmber
Tnsurmim Coven
am
UakfthIsIlrempolky M WzMZI=c0vMMPbydwkmgthe-4j�-- b=
M Otbart�"ofkdeznnfty ri BmLd ri
101mWAR-1yar L the wdadga4 bm bm ma& awamtaihe HaweD Offt 2PPRe2fim does nd haveany one afthe bbove
ihmhMmmize
ow=
Agent
Ihmby=ffytbatauaflhedm&*mdbhmamjbmsWmftd(or=und)iLab.
bmtafmykaawle* Pe&M mularpemut
sm4ft�411plumbingym&and kswja&w ed , -in
.1�:Fbr INS appncadm wM be
SwePhqbia md O�� 14� of te Cmjrd laws.
BY: =0=77 mew -
Cr
Type offfhmtbing
jq#q . - - - - - - I ye -,732
CiWTOVM-
R,OVED mmm.um ony
Date.....................
..\Ol\
4* 'L TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that ...........................................
. /' - ! , Z2
has permission for gas installation ............. ...........
in the buildings of ....... .................
at ................... I North Andover, Mass.
'4o' .....
Fee.�,5. . Lic. No..
... ................ A ............
GAS INSPECTOR
Check#- -, /
31,- 0
MAP
4ASSAC.PSMSIZUARM-a2� ICATON FOR PERNUT TO DO GAS F=G
or print) Date 0
1-1 UK I rl AIN IJV V L II., IVIAZZ-iAk- tl UO V- L L0
-1 -7 LJ - //
Building Locations 2 � " V C, 1%1,/
-TO IA A.IAJ 1C Al 44 5 C�e Owner's Name
New F� Renovation F� Replacement 19 - Plans Submitted 1:1
Permit 9
Amount S
(Print or type Check one: Certificate Installing Company
1.9 CIA1 orp.
Iddress — 0 - 15j9A, 57A
&'qAV,f eejey- /11 4�1 99,
ness
.21 — * 5-0
Name ofLicensed Plumber or Gas Fitter
F� Parmer.
F] Fir-m/Co.
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes R1 No
If you have checked ves please indicate the type coverage by checking the appropriate box.
Liability insurance policy Other type of indemnity Bond
Owner's Insurance Waiver- I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the
Mass. General Laws, and that my signature on this permit application waives this requirement.
Check one:
S 1 Qnature of Owner or Owner2 s A gent Owner 7 A2ent M
I hereby certify that all of the details and information I have submitted (or entered) in above annfication are true and accurate to the
best of my knowledge and that all plumbing work and installations perfort-ned under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws.
11-� / �ov
By:
Title
Ciry/Town
APPROVED (OFFICE IJSE ONLY)
Signature of L' censed Plumber Or Gas Fitter
P I umber c -y 73
Gas Fitter License Numoer
ilvlaster
f7
,51 Joumeyman
;C --j
Date.
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING.
Nz� 7 14",-7 ---�
This certifies that ................. ........
has permission to perform ...........................
plumbing in the buildings of
-7f
at. .=� .................................. North Andover, Mass.
LrIn'
Fee A. Lie. No ...............
UMtBleG INSPECTOR
Check # AV
5628
MASSACHUSETTS UNIFORM APPLICATION FOR�PE�R TO DO PLUMBING
(Type or print)
NORTH ANDOVER, MASSACHUSETTS Date
Building Location 7 �I/J/5i/)if R/).OwnersName '-To4"kJ-e- M*J-6C-f Permit # 6-0,9?
f Amount —11�r
TypeofOccupancy 0"Ieffrov 1,:::�
New Renovation Replacement 0 Plans Submitted Yes E] No
FIXTURES
(Print or type) Check one: Certificate
Installing Company Name ri Corp.
Address 0,0- /3 o X -5- 7.)— ri Partner.
e Pq t-lle -r -- c c 4-1 4. o/,P
Business Telephone �? 7 X 570 2- - 9 47�O V Firm/Co.
Name of Licensed Plumber: '46�r- //0 't .4,
Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy MY Other type of indemnity 1-1 Bond El
Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Owner Agent
I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts State V7bing Code and Chapter 142 of the General Laws.
By: Signalure of Eicensea riumuer
Type of Plumbing License
Title
City/Town License Numoer Master Journeyman
APPROVED (OFFICE USE ONLY
Location -ns 47� t ks i De
No. Date
,&OR of
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
4:
*A?.o -
S US
I Cc) —
Foundation Permit Fee $
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL $
4��firing inspector
150.00 PAID
8838
Div. Public Works
Z7,*
Location
No. 4=1
Date
ANDOVEA
,AORTpq
TOWN OF NORTH
0
41
Certificate of Occupancy $
4L
Building/Frame Permit Fee $
HU
Foundation Permit Fee $
0
Other Permit Fee $
CU
t
10—
1
Sewer Connection Fee s
A2—W, 42
510
water Connection Fee $
lo77,
20
TOTAL s
40 go 644&
Ildli
Inspectoh
�,B
1,000-00 PAID
8939
1 - - - biv- Pdb1,!Cworks-
Locationi
No. Date
TOWN OF NORTH ANDOVER
Certificate of Occupancy
$
Building/Frame Permit Fee
$
Foundation Permit Fee
$
Other Permit Fee
$
Sewer Connection Fee
$
Water Connection Fee
$
TOTAL 40 $ S,3(" -
r -,Y- i;�A '-L�lding Inspector
836.00 PAID
3 6 r39 Div. Public Works
PER.AlT NO. 4-7-)
—tl APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS.
11 PAGE I
MAP 4-40.
LOT NO. ?-
SUB DIV. LOT NO. 5 Ct%tto– -b Y
2 RECORD OF OWNERSHIP IDATE
�1-1
BOOK PAGE
—
LCOCATION -A4 J
7% ",xu tm
PURPOSE OF BUILDING
/--Q-
6�'
NER'S NAME
Co'^4
NO. OF STORIES 2
- z—
ow NER'S J%DDRESS -733
4vy ck
.
BASEMENT OR SLAB
UZI 1 1
ARCHITECT'S NAME
Ta..' z
fZE OF FLOOR TIMBERS IST Z,*</o 2ND 2 -1. 13RIJ
BUILDER'S NAME
SPAN
DISTANCE TO NEAREST BUILDING
DIMENSIONS OF SILLS 1.4
POSTS G
DISTANCE FROM STREET
DISTANCE FROM LOT LINES - SIDES
REAR
GIRDERS. '5 -
AREA OF LOT 6'o 0 0 FRONTAGE -7
HEIGHT OF FOUNDATION
THICKNESS it
IS BUILDING NEW
SIZE OF FOOTING /01'
x �z 2- It
IS BUILDING ADDITION
"ovo
MATER:AL OF CHIMNEY
xv
IS BUILDING ALTERATION
Is BUILDING ON (�-,6 R FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE
IS BUILDING CONNECTED TO TOWN WATER
Y -e
BOARD OF APPEALS ACTION. IF ANY 'V
IS BUILDING CONNECTED TO TOWN SEWER
V -e,5
IS BUILDING CONNECTED TO NATURAL GAS LINE Ye s
INSTRUCTIONS
SEE BOTH SIDES
PAGE I FILL OUT SECTIONS I - 3
PERMIT FOR FOUNDATION ONLY
REGULATED BY PARA. 114.8-S. B.C.
PAGE 2 FILL OUT SECTIONS I - 12
DATE SIZ77) kFEE PAID I cx–
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING I Ir
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
DATE FILED
3 PROPERTY INFORMATION
LAND COST 2-jc) c)(:3
EST. BLDG. COST i:fi:�
EST. BLDG. COST PER SQ. FT. -tV,,q
EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
4 APPROVED BY
lNeracTopt
SIGNATURE OF 0 NER OR AUTHORIZED AGENT
F E E
S
F;ERMIT GRANTEE) c�o PERMIT FOR FRAME/BUILDING
cul z Ft t�- D PAID-S3G
If ATE: I L%.,l tr-F
I v
OWNER TEL.# 7
CONTR. TEL. # –7
1.3
CONTR. LIC. #
;-I H.I.C.#
Sp 2 61Wl- mon-paw In s- - 2 z �Q swoulow. 1 4 ef:l'zl czo-n.lz
= MA FU - q— t2a- Ess.3 3.
ME "m ffm $ al c- . sss�
BUILDING RECORD
OCCUPANCY 12
�!NGLE FAMILY S-ORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
MULTI. FAMIL LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES, GA -
APARTMENTS RAGES. ETC. SUPERIMPOSED. THiS REPLACES PLOT PLAN.
CONSTRUCTION
Ir
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lal um
2 FOUNDATION
8 INTERIOR FINISH
CONCRETE — -
PINE
a
1
2
13
-
CONCRETE BL K.
BRICK OR STONE
HARDW D
PIERS
PLASTER
DRY WALL
UNFIN.
3 BASEMENT
AREA FULL
FIN, B M T� AREA
1/1 1/2 IA
FIN. ATTIC AREA
tLO B M -T
FIRE PLACES
HEAD ROOM
MODERN KITCHEN
4 WALLS
9 FLOORS
CLAPBOARDS
B
1
2 3
DROP SIDING
CONCRETE
EARTH
WOOD SHINGLES
ASPHALT SIDING
ASBESTOS SIDING
VERT. SIDING
HARDW'D
COMMGN
ASPH. TILE
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK qN MASONRY
BRICK ON FRAME
ATTIC STRS. 8
CONC. OR CINDER ELK.
WIRING
STONE ON MASONRY
STONE ON FRAME
SUPERIOR POOR
EQUATE NONE
5 ROOF
10 PLUMBING
GABLE
I*mQ
HIP
BATH (3 FIX.)
AMBREL
MANSARD
TOILET RM. (2 FIX.)
FLAT
SHED
WATER CLOSET
ASPHALT SHINGLES
LAVATORY
WOOD SHINGES
KITCHEN SINK
SLATE
NO PLUMBING
TAR & GRAVEL_
STALL SHOWER
ROLL ROOFING
MODERN FIXTURES
TILE FLOOR
TILE DADO
6 FRAMING
11 HEATING
WOOD JOIST
PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER EMS. & COLS.
STEAM
STEEL BMS. &.COLS.
HOT W'T'R OR VAPOR
WOOD RAFTERS
AIR CONDITIONING
RADIANT H'T G
UNIT HEATERS
AS
7 NO. OF ROOMS
OIL
B'M*T 2�d
Ist 3rd
ELECTRIC
NO HEATING
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FORM U - LOT RELEASE FOR14
INSTRUCTIONS: This form is used to verify that all necessary
approvals/permits from Boards and Departments having jurisdiction
have been obtained. This does not relieve the applicant and/or
landowner from compliance with any applicable local or state law,
regulations or requirements.
****************Applicant fills out this section*****************
APPLIC2UIT: K-eo-Hb (6 Phone 61C-7- 02-2-
V
LOCATION: AsSessor's Mau Number
00,
S ubd -4v i s 4L on -011d
S-%reet
Parcel
Lot (s) 75�
St. Nu-L'ber 7-78
Use Only*******************w****
REC ONS OF TOWN AGENTS:
Date Ancroved
CoXservazion Ad=-4,-1is'[-'rar-cr Date Rejected
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Received b Build-Jng Insz;ec-tor
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Location c9 ZfAZe�A-,� Pe-��
No. Date
A
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
�Ts Building/Frame Permit Fee $
CH
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check #
6
Building Insp r
Aug.30 05 12:24p NORTH nNDOVER 978GO09542
TOWN OF NORTH ANDOVER
]BUILDING DEPARTMENT
-Lt-P-PLICATION To CoNsTRUCr XPAIR, RFNO"AT �L OR DEMOusif A ONE OR TWO FAWLYDWELLING
.. .. .. . . . ..
. ........
BUILDING PEK\11T NUMBER:
DATE 1' SSUED:
JJU,1u,,% t-omrmssionevingDo.-tor of Buildin
SECTION i- ;1TF —INFOR
MATION
FrOPWY Address:
1.2
AaP and P3rx!
Map Nurnbcr
I Zoning LrLfvqn3Z'0�w:
14 'Icp-tyi)irmnsions�
Uw
Lot Arw
Front Yard — Side Yard —
=Reawired Provide Reqwred Provided
1.7w. S:�
ly st� Z.�
Ci
LC 40 L'one
Publig 0 Priv.t� r, 7ma
SECTIGN 'z - FKQPER'y 0"EKSHIP/AUTHORUED AG
2.1 Owner of Retord�
W.mc, (Print) Address for Senice:
Tr1cphone.
.2 Owner of RccoTT
Nams Print
3.1 Licensed Construction —Superyiso—r:
Liccn3cd Con siruction Supervisor -
Address
Signature
rc ephone
3.2 Rcgisr Me Irnpro em t Cbntractor
e-
ompanyName
±r
tA
10
Addiess for Service:
Number
Rear Yard
1.1 'Sew",
mmlicipal 00 Site Disposal Sysam 0
''— "uL- Te-' —No_.
Of I I
Not Applicable-
Liccnsc Number
ExPiradon Date
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E -7p -ti-n Date
d,
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SEMON 4 - WORKERS COWMATION (XC -L C 152 § 2506) 1
Workers Comptrsation ;n ?1TidavNqm,,,st be -�kwnpleted and submittic;d wit�, this application. Failorc ri�, prwidc this affida-vir vril-7-1
I s -it
New construcliao 0 Existimg Building 0 Repair(s) Altcralioris(-s) 0 Addition 0
'iccessoTy I
Bldg. 10 Demolition 17, 11 Spocify
SECTION 6 - RSTIMATRn C'nKqTRVC'T1n-v rnQTQ
item
Cost —�T)011u)to be
Ccritpleted b� Penlut Mb"alt
OFFICIAL USE ONLY
I Buildin g
(a) Miding Permit Fee
Multiplier
2 Flcctrical
(b) E�Iimated Total Cost of
Constructioti
3 Plumbing
Railding Permit fee
4 Meclumical r 1 IVAC)
5 Fire Protectiun —i
6 Tota) (1+2+1+4�
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nug 30 05 12:25p NORTH nNDOVER 978GO09542 p.4
NORTH ANDOVER BUILDING DEpARTMENT
Tel: 918-698-9545
IDEBRIS DispOSAL FORM
y1sion of MGL c 40 S 54, a condition of Building Permit
in accordance with the Pro I *As work sW be
at: 470�7H � ' ' t, is that the debris resulting m
disposed of in a Property liceLqed soild waste disposal facility as defined by MGL
c 11, S 150 A.
Also, note permits are required under FiM Prevention laws Chapter 148 SectiOn
10A.
Tjw debris win be disposed of in:
(L4kafion of Facirq)
-91��ttwe of -ficant
,remiit A&
Fire Departinent Sign off-
Dwnpster Pelmit I -A)
/ - al
Date
Aug,30 05 12:24p NORTH nNDOVER 9766689542 p.3
Departmeng of jrndU&fFWAWjdejjtj
offl" of InFewsmions
600 Wilahinron Shwt
B090M.MA 02111
9 WKW.M43&g0V1d(k
� Workers' Compensation Insurance Affidavit: BuJidtn/Coutractors/ElectridanOluvaberI
A V_&__ -J__
Name
)Ad&ess:
city/state/zip:_ &JO _77
_�Z - �6 Phcme fL 7V
-1 ---- -------- 22i7_1)_1 __ ___
Are yaqn employer? Cbeck the- apprupriate bcm:
I. e '13M a employa with
4- 0 1 aM & gmenj COMMCM, and I
cnipioymi (fun and/or pan -d")..
have hired ft sub-cantracols
2.[3 1 am a sole ptaprictor Or partner-
listed on the attached sbeeL t
ship and have w avloyea
Thme sub-contractm hm
woriting fDT me in any cqmiry.
WGTkC=' COMP. &VUMce.
[No worken, comp. itmum"
5- 0 We Be & COTPOration and ito
requirail
Officeu hVV9 exercised their
I C3 I am a homeowner doing x12 work
rigbt of exemption per mGL
myself [No workers' env,
c. 132, j 1(4)� and we Mve no
insurance required.] t
employees. [No worken,
com.
Type at Project (reqsdred)-
6. []New cowmwdm
7. Remodeft
B. Demolition
9 Cj Building addition
10. 0 Electrical mpairs or additions
I I - F-1 PhLmbkg Tepairs or additiou
12.C] Roof repai
13106thff &,/1 1 0 Jeb_)_5
GWWMS MW watm, oompon"Ses PACY iVED.. 11dw
Offt 40mg RU wOd "d 11M bn Qvft& caah,�
Hal. WMS wbo 061* Us afrAnk Zz" �Mw
&Cantiecom dMcbw&*6b=rmadtmcbW=sd&dwAjA MUV $UbKMt 2 MW Off3dWb k1diV4fftiqg Xftk
mW dww*al dw =M OM FA0QwFUW2m and *Aftr WO&We IV poficy bXorrnakw
I am an empidyer that hprpWdjaS jwAepS I C009MU"fen
InfopmWISM bunrafteef4waye"PlOYM Below Is dkepWky Al"Job ifte
Insmace Company Nzme: , KC Krok
f I' IV, �- t'rj'A
Policy N or Self-im.Lic. A PP T__77
Expiradoz Date:
Job Site Address: City/stawrLip:
Attacb a copy of the workers' compensation polky declarstion page (AhOwigg the PON
CY RUMIber and expiration date).
Failun to sewt coverage as reqt" under Section 25A of MGL c. 152 cim lead to The inIPOSifion of critabW penalties of a
fine up to S),500.00 audlor one-year Imprisonment, U w911 as C" penalties in *4 form Of 3 STOP WORK ORDER jmd a fte
of up to $250.00 a day 2g2iWt the Vi0bla. Be advised that a copy of this Statement may be ibmwded tO ibc Office of
Investigations of the DIA for imurmce coverage vVificatiolL
I do hereby " M18409, the nNim OWPeRaht" ofPc#ury thar dw jxyam&j(*xprm4,kd
abo" 6 ow Mod
siguavy: V -� —,4 5 —C --p
- r's L
v
rW,§
e. At. NOW Ithg1b6d SMh, jin� Mr
M"""S F""Oie
4r
rraw" ATAM
�o vp� to lueMsh at III dnu me ,nid nuanvortrip to install fic tAoift jotoqow at
0'.* 1, 1 AS 4f"IOI no At" 0ow 06. Md
Uwt style: Tau Units:
aft N
VfInd
mishmap
Onibia .4ung; Unih
—7 WW Irl, -en,"'i.
—ft by "AW.",
Pidljf* Orkile
Hopper "a;
Total
Price. (> P)'c2
------
Glirdan WinWwq:
3-111,111— -.4"m Hie!
wHh (j(4#r
EVedo. T)MI Projilctiln llrack&vi, Y IN
l7wry
Das
Upon Dellmiry:
St.—
Silding Gissi, Dllbaw
SwEnce Due
UpOn F;M
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,iv A v mPlavilm Wost- UP, f ftmPk4lor ol if* vook if You W m. rnake M—te wrie" �hfiy am ow, ttion t -A may inannanawy lift wark. ft may c'nootio to not
nart Warr. Again lint!) "vatotin, (a With o'Dialyratenhafili W) "I 6wilm, biltint-ic tie rIvrianting psymois. if tione It, any *q:pwp arm* oup k% jhe rMc4,jjrjp
klyth dAwy c�lail cutomaticativ fty! OKI it*Oftfif 'Jaubstaraw va,,vialten.
rhe'rafeldflAo win beqln an or so: = t,,, qrno.uk it is to-vismood 7yyou Ltvt tft
.1—irg "Duld m8l I'MOV cmarRv rill AIRmINTAC cAYIDI"M 0916 etdrvOi abovic rualarnarli Innil linaneing; inctAritOorl, wailthae,
,K�as or athof labor disrulollfirl!"I Of rNktaidala; vote at Woc. NN. -
VA rk-mlint Val " cAffV VV40"M 0 - a 1111516114ditan Will PL4& lJobilay IftwrA4c6 if, tKe av�At of 14W�Dcv.l Om,ow,
(OU WAY CANC91- THIP A0FIEP;!M Ir tr WAS WIN ZdAllim IPY A FAFITY THEPIEMA? A N-AOlk OrHM TI -AN AN ADDRFOR OF rHe $0-t.I.Fe vj"ICH fAAY se 1415
,AAIN QPrICE OR 12,01ANCH rrIV: �OFI ff"O'ADED YOU NOTIFY THE gii1itF;N, INFITING Air �qj$
lr�LEGRAPJ B" OR BY MAIN OM, CIE 09 FIRANCH BY OMNAPY VAL kg� Vt. 9Y
DELM: te. NCII LArtP 7HM MIDNIGHT 07 71191TWIT) 2USIMM IAY FOLLOMt4GTHE 9104M OF"AoMEEMEW,
JY GIGNING EELOWYQU ArK)1'%VUr*LV
— _ Z TWAT Vbtf ChfM THr A8011E f"ROPMPITY A&M N- YQ%J AMFE -MALL OF TWC TEWa OF QgWRACT, *JCLVD-
_NQ THE AMMONA1.MftM0 JL:�tATE_.:) ON TM F&JOWSIM joir jj*lj p
WPY 10 TPIS W"ACt AND I WQ COMPLETM COPIEs OF TijF "Ckl� '�OU ALSO Ae"O"CM T�I- YOU HAVE RECENITi A PLLLY COMFLETM..
. NarOE Cr CAf0tr'J_jkMN. AND TW YOU WAVC OM 6PALLY INPOPLinw
k)CA1YC5L 0 OF Yo�[P Plji-IT
DO NOT AM Tk'Q CONTRACT F THERE AAC ANV ULANK BOAGIM
-4 WITN'929 WHFIREOF I it In th. later .1 fgR45t4. L.—
&if
lig-1 __ 26 21�' /_7 , 2'ze�
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OWNGA
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407110E OF CANWLLAI ION
___OA7V (OF TRAN&ACTIONJ
YOU MAY CANCEL ANT PROPEATY TRADC-L' IN, ANY PAYMEM MADE ITY YOU UNDER THE CONTRACT OP 9
ING PEOMPT BY THr ;!LLI�fl Of YCAM CANDMIATION NOTICE, AN13 ANY SECUIAED JNT RUSINIM DAYS FOLLOW -
AND ANY NIPOOTIABLE INSMMENr Fxt;cuTED BY YOU VVILL EM RETUANOwnNiN jo , ALL,
THE TRANSACTION VAI 1. or; OAN=.,..vD. MOST AA15INQ OUT OP
TO C-ANCIFL. THIS TPAII `,ACTIOK MAIL OR DELIVEA A StUNIED AND DAM dOPY Oj� *1419 CANCELLAITON N6TI0F
OR ANY 01 -HER WRIT71: N NOTICE, Oft SEND A rELEORAM 10 NraW ENGLAND sAAMw IN11, 1301 ORAFTON SMECt
WORCESTER, MA 0,, CC, JOT �ATIEIR THAN MIDNIGHT or:
DAI-P fMLr14PAY`,'; 0
HEREBY CANCEL THIS T IANUCMN.
DArt
(*INN' L. COPY YFLIJ7A ILCTOMER'S COPY PINK -01210E copy (71MAMPOD-CUMPAEPa cary
Tift; 7:37 AM To:
PA&AS @
WV4-003 0
A ORD- CERTIFICATE OF:
PRQm;C,ER IA I ITY INSURANCE I
tne if
"V^ a %;Ompony, Inc.
one Goodwin Square
148riford, CT 06103-4306
BWSM76M
ma"ontl Energy systena Inc
NOW England Sash Inc
1331 Grafton Street
Worcester, MA 01WX,,=S
THE POLICIES
.... --MU% I Ail
F'Rmu VQMFZM NO RIGHM UPO-h -7iiec'EFMFICATE
HOLDEFL TWO CERTIFICATE DOES MOT A 'C
ALTER THP MummAng Amp -RM BVTj4MEEpN0DU,fiCX,,rEND OR
BELOW
INSURERS AFmarimun ^^,�—E
NAJC
rNSURES k NIA AlAslanaof 01.L W -
a
'1� MQUIREMEWT, TERM OR co�-E- -- --Q Q=m ROVEDTO THE WSURED NAMEDABOVE FOR THE POLICy M
DITION OF ANY CONTRACT OR OTHER 100 WDICATED. NO----�
1114" INSURANCEAFFORDW SYTHE POWES OOCUMWWrTH RMPECTTO V4j" 7H TWITHSTANDING
POL ArC I lu� 113 CERTIFICATE MAY BE tMED OR
EUJDMRI WD HEREN IS SU SJ ECT TO ALL THE TERM% 01=51ONS A1Vb CONDITIONs OF SUCH
MAY HAVE SE84 R CED By PAID CLA;Ms.
LD ANY (99 T4E AA30VE DESCRWD po I LICSES BE CANCELLED BEFORE THE-6)(PIRATION
rAMOF, THE ISSLxma INWJRER WILL ENDEAVOR TO MAIL III DAYSWWMN
E To rAe cERnF"79 HOLDER NAMED TO THE LEFT, SW FALURETO 00 80 SMALL
3E NO 00-MATION OR UAINUTY OF ANY IGNO UPON TME WWMR, ITS ACIINTS OR
ON 1989
JAP 0 ACORD CORPORATI
ACORD 25 (2W/05) 1 at 2 #334040
NUMBER
GENEWUANurf
LIWTS
C04MERaAL QEN-0-)-A—L UASILIrY
NOE $
CLAWS MADE 0OOCUR
-11-1�
Itu
I
DEXP, am t
p ADV ANARY $
GENIL AOW�EQATE UMU AppUES pER
GENEFIALA001EGATE 9
POLICY LOC
PQQWCT8 - =POP AGO
ALITOMOSILg L"XM
MY AUTO
COM81NEDONOWUhMT
ALL OMED AUTOS
a
80fQULED WTO$
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par P -M)
NONIOWNEDAUTOO
INA)RY
r. -L'-dert)
-----------
GE
GARAGE WABILM
MY AUTO
EMT& SA ACC 9
AUTO
IL A03 6
O(CEMMOREUAUABILITY
EACH 00CURREWX 6
OCCUR CLAIMS MADE
0
AOAMWE
DEDUCTIBLE
11 RETENTION I
A woRKERs comPeNSATION AW
WCAPPLICATION 04/29/06
04/2WM
x I TIM I I LMT, 10.T.H-
EMPLOYERS' IJAWLITY
1�6� AQRZNT JIM=
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L62MSE - EA EMPLOYEE 61W.2m
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OFSOWTION OF OPEMATIONS /LOCATIONG /VEHIOLIS I EXCLUMOM3 A00EVOY ENOORSEMEW 1 SPECIAL PRWUQ"
LD ANY (99 T4E AA30VE DESCRWD po I LICSES BE CANCELLED BEFORE THE-6)(PIRATION
rAMOF, THE ISSLxma INWJRER WILL ENDEAVOR TO MAIL III DAYSWWMN
E To rAe cERnF"79 HOLDER NAMED TO THE LEFT, SW FALURETO 00 80 SMALL
3E NO 00-MATION OR UAINUTY OF ANY IGNO UPON TME WWMR, ITS ACIINTS OR
ON 1989
JAP 0 ACORD CORPORATI
ACORD 25 (2W/05) 1 at 2 #334040
us n, lRdivid a Y
Board of Building 140801100 "it itstandardi Llcenwbr rilgiStrAdOn vA" for" 91 use 0 1
bgforc ti�4,, ,Ipitltion date. if found return to:
HOW IMPROVEMENT CONTRACTOR Board of ijuilding Regulations and Standards
010614"flon' 04098 One Amhbul,1011 Place RM 1301
Raltm N1 A.
Mtpirat.lort: M312006
NEVY E �JGLAN D SA§H, -INC
RICH POUPOU.-O'"'.
1331 Graftv) Street
Worcester, MA 01604 Administrator Not valid without signature
S
I
SCHUCO
USA
VINYL FRAME TRIPLE GLAZE
KRYPTON FILLED * LOW E2
CRNA 4000
CNr. T FERFOR ANCE RATINGS
W --
U;— Factor (U.SJI—P) Wr Heat Gain C-ufficlent
0.21 0.30
UDITIONAL PERFORMANCE RATINGS
Visible' Tringniiiiance
0.40
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C! WItmam NFAC 109S are detwMad for g fived W &f #p.vjm"mjrftj Co"11045 and a
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