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Home My WebLink AboutMiscellaneous - 29 HEATH ROAD 4/30/2018 (2)S 09845 Date TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING �his certi,fies that ....... ................. has permission to perform ...... ......... plumbing in the buildings of ...... at. ...... Fee,30 e Lie. No... Check # / gc) .......... (:"�Ij i PU ......... ........ /,-Nort Andover ass. PLUMBING INSPECTOR 4 -46 =� =�'� P TYPE OR PRINT CLEARLY MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY MA DATE 3 PERMIT# JOBSITE ADDRESS OWNER'S NAME OWNER ADDRESS TELE _____.__J.IFAX __j OCCUPANCYTYPE CO C71- Ell EDUCATIONAL EQ RESIDENTIAL NEW: M-1 RENOVATION: REPLACEMENT: Ell PLANS SUBMITTED: YES NOD FIXTURES I FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OIL/SAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/ AREA DRAIN INTERCEPTOR (INTERIORF ------- KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL --J SERVICE MOP SINK TOILET URINAL -------- -- WASHING MACHINE CONNECTION J I WATER HEATER ALL TYPES WKfER PIPING --bTHER ..... . ..... INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY In/ OTHER TYPE OF INDEMNITY Ell BOND El MINK OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER El AGENT 0 SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and and that all plumbing work and installations performed under the permit issued for this application will ein rof, Massachusetts State Plumbing Code and apter 142 of the General Laws. PLUMBER'S NAME [-,I LICENSE # M P D ip a,-' SIGNATURE CORPORATION Fj# PARTNERSHIP Pi #[::=LLC U� COMPANY NAME [E ADDRESS CITY STATE ZIP TEL FAX CELL EMAIL of my knowledge 13slon of the .7 1 �- ,,� rz-s-,-4 o,4 .-S It �.p &J 6 ' \1 � 41 or 0 0 *4 F-4 u w 44 0 El z 0 LU a_ u LLI 0 < uj cn LLI 0 LU 0 z 0 L) ::i a. a. < Lii LLI LL- ey 0-.4 N u w The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov1dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Name (Business/Organization/Individual): e Address:_,L4. City/State/Zip: m-e 4--- 4: & 2 � 7e�� Are you an employer? Check the appropriate box: I - 11 with 4. El I am a general contractor and I �amployer �0 ployees (full and/or part-time).* have hired the sub -contractors 2. 1 am a sole proprietor or partner- listed on the attached sheet. I ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. El We are a corporation and its required.] 3. 1 am a homeowner doing all work officers have exercised their right of exemption per MGL myself. [No workers' comp. c. 152, § 1 (4), and we have no insurance required.] t employees. [No workers' comp. insurance reauired.] Type of project (required): 6. E] New construction 7. El Remodeling 8. El Demolition 9. El Building addition 10 -El Electrical repairs or additions 11 - 0 Plumbing repairs or additions 12.0 Roof repairs 13 -El Other *Any applicant that checks box #I must also fill out the section below showing their workers' compensation I policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-c'ontractors and their workers' comp. policy information. f am an employer that isproviding workers'compensation insurancefor my employees. Below is thepolicy andjoh site fnformation. Insurance Company Name: :1olicy # or Self -ins. Lic. #: lob Site Address: Expiration Date: City/State/Zip: kttach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Wlure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine if up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of nvestigations of the DIA for insurance coverage verification. doherelyc * undqr iepa' and o erjury that the information provided above is true and i nature: I If - Date: -:� —1 � -'/ Official use only. Do not write in this area, to be completed by city or town official City or Town: Permit[License # Issuing Authority (circle one): L Board of Health 2. Building Department 3. City/ToWn Clerk 6. Other Contact Person: 4. Electrical Inspector 5. Plumbing Inspector Phone #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLQ or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the pen -nit or license is being requested, not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in _(city or town)." A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax # 617-727-7749 www.mass,gov/dia i Division of Professional Licensure: License Search The Official Website of the Office of Consumer Affairs and Business Regulation (OCABR) Division of Professional Licensure Mass.GovHome StateAgencies A-Z-ropics Home ) Division of Professional Licensure ) Check A Professional License By the Division of Professional Licensure LICENSEE Name:RICHARD COWER PLAINSTON, NH Licensing Board: PLUMBERS Et GASFITTERS License Type: JOURNEYMAN PLUMBER License Number: 20349 Status: CURRENT Expiration Date: 5/1/2014 Issue Date: 1/3/1986 Exam Date: School: This web site disp[ays disciplinary actions dating back to 1993. This license has had no disciplinary actions taken during this time. The page above has been generated by the Division of Professional Licensure web server on Monday, March 18, 2013 at 9:14:46 AM. 0 2007-2011 Commonwealth of Massachusetts Page 1 of I Mass.Gov ONLINE SERVICES Check a License Locate a licensed Professional Onhne Address Change Con tact the Agency More... REFERENCES & RELATED INFO Disclaimer Regarding Website License Searches Enforcement Process Glossary Glossary of License Status Codes More. Site Policies Contact Us http://license.reg.state.ma.uslpubLiclpubLicenseQ.asp?board—code=PL&type—Class=—J&li... 3/18/2013 RTH 0 0 This certifies that Date..-- ................................ TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,0 ................ ............... 4 .......... 9 Ilk has permission to perform wiring in the building.of ..... ....................... ttzt" I .... Ak& -1 - k't,; - North Andoyer, Mass. 91 ,.Fee .................... Lic. No.,� ....... ................ ..... ... .. ELECTRICAL INSPECTOR Check # 5614 IRE CUMMUIVVYLAL,111 UP'AZ4M4(,H(/3EI IN Office Use only DEPAiM1VU0FPUB1JCW= Permit No. /z/ ON EM 7*UM�3n7aR12WO Occupancy & Fees�Che'cked REV MEP AMOFF B0 I APPUCAHON FOR PERVff TO PEUORM EU=C1U WORK PRIN ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE YASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 .(PLEASE T IN INK OR TYPE ALL INFORMATION) Date d%& Town of North Andover To the Inspector of Wires: Ile undersigned applies for a permit to perform the electrical wo, d low. Location (Street & Number) 1)19 Owner or Tenant e- q U) K) Owner's Address —50_rV7 -e-- is this permit in conjunction with a building permit: Yes No F-1 (Check Appropriate Box) Purpose of Building ISN' CN R u— \ / \- \ ^ Utility Authorization No. Existing Service Amps Volts Overhead Underground M No. of Meters New Service Amps Volts Overhead Underground ED No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work vooc-\�� I �N CYIYXISA��- No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA S7 ground [D ground M No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. T0 -t a I Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding *Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW F-1 Connections L --J No. of Water Heaters KW` No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP VXI-J-e- SKY�- VIQS A Jnsurar=CoWrJW- lbaW,a=utiLtkbsLra=Pokywlu&gCmVk�eCpmh=Cc)Ntr4perAsWXmtWmpvaht YES ED NO ED ItowiubrriwdvabdpoofofsamiDdrOffiM YES Y)ajhaNedrdadYBpk=hxicaiede�WofoDma�pby chadcingthe box 1:1 ET P4SURANCE BOND OI11ER M fta�eSpeffy) EViratiml)& EmmatedValirofE1BMxalWcdc $ wcdctostart hpedimD&Rapesbd Rao Firial signed uridcrTrFtAescfpqw FIRM 2 , , cc LicelM si, Licerw1% c`4 Busin=TeLl%. �� ot4 arddmtffr (Please �heck one) Owner 1:3 Agent M signature of Owner or Agent AIL Td NoL abWnWaPvulmtasmqmWbyMamdmgZG=xWLa%s Telephone No. PERMIT FEE $ I JAAL;f t-WIMULAL V y yl;dmj�A Al 1JI, ir L3LV1%,"UarJ1JL3 uiie omy DEPARTAIENTOMBLICS4FM LPe rmui t No. /Z/ BOAMOFFREPREVEMONREGULAHONSM7aR]2-M ancy Occupancy & Fees Checked APPLICATIONFORPERVffTOPERFORMELECMCALWOI?K ,/J ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat&_ Town of North Andover To the Inspector of Wires: Ile undersigned applies for a permit to perform the electrical work des low. Location (Street & Number) �)19 Ntc(,&A Owner or Tenant Mlv-e q u) in Owner's Address t) C,,-vY7 -e, Is this permit in conjunction with a building permit: Yes 10 No (Check Appropriate Box) Purpose of Building CS N 4-\ ck ZLAJ� Utility Authorization No. Existing Service Amps Volts Overhead 0 Underground No. of Meters New Service Amps-/ Volts Overhead Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Voor,-�,-\ I V 77; I I I No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA ST ground 1:1 gro No. of Receptacle Outlets JS7 No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and 9f Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW 1:1 Connections No. of Water Heaters KW No. of No. o Signs Bailasis .No. Hydro Massage Tubs No. of Motors Total HP 11TWIP-1 I(-. —$,;,I =1 1E.M Xdvafidpwofofs=iotheOfficP_ YS 10L gat . YES 13 NO M Y3uuhaNedmdzdYES,pkmhicalethel�pofaNmgby cc_ L=WNo Btri=TdNa -?-L-1L-1--7471_ ,-:;L 1__UA�J JRANMWAMa�lamaw=dUtheL=wdmsnothm meonftpwr*RTkahmwa�esftM#W01 one) Owner 0 Agent AJLTdNo. 53 RksmUqmifftasmqzWbyM2MdXMMCaUWUWS Telephone No. PERMIT FEE $ A I As -;I rAtzlv rrz;H�11 LIA, jVAtJJLVJJ-"UJZ 11,3 vul" use oruy DEPARTAIEWOMBLICS4MY [Per-aut No. --.� /Z/ BOAMOFFREPREVEMONRBgJL4UONSR7aMl2VO O.,.pan.y — 0 Occupancy & Fe�es Checked APPLICATIONFOR PERMU TO PERFORM ELE=CAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date OV16)5 Town of North Andover To the Inspector of Wires: lie undersigned applies for a permit to perform the electrical work des below. Location (Street & Number) 919 kltcl-&A Owner or Tenant Mlv-e--- qu"/) Owner's Address 'ba-ry7t, Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building 1�� Nr\ cN Q- Utility Authorization No. Existing Service Amps I Volts Overhead M Underground No. of Meters New Service Amps Volts Overhead M Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work v\ No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above 1:1 Below Generators KVA ground ground No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. To -t a I Tons No. of Detection and No. of Disposals No. of Heat Total Total Fumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW E] Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP Z111 -d -e- S�(Y�VlqS, rUUUILIUUr.RXfMMHM(XlVkWRUIJS=Uff=LaM ilybst1X=R&yi1ri&VCcffF-1* CbyemFcritsmb&dWequivai= YES NO F1 1p110Qf0fS=lDIheOffi= YES If3cuhawcheclod YES, pimm (betyWcfaAaWby rr FT BOM r7 0711M prm-**) B#rafimD& kq)ecfimD*Req Raigh Eslxm&dVakrdE1mftJcalWc& $ Fula! cc- q�) , '�? 1�� Liam% sigr� Liompj6 L /N i r -N - r, Busir=TdNb. -)R') -�s--44LI-7(oC—1 I k -c-( �UA\J JRANCEWAIVEP,IarnawmdxtttL-Licamdomnothavi jecnftpmnftffkabmwai%esMmWje= one) Owner 1:1 Agent Ajaem Rbu]WqmlatasmpWbyMamdxNftGffoWLavvs Telephone No. PERMIT FEE $ M I I SECTibN 2 - PROPERTY OWNERSEEIP/AUTHORIZED AGENT Ulstrict: Yp:S I Owner of Record TOWN OF NORTHA 4DOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT RENOVATE, OR DEMOLI H A ONE OR TWO FAMILY DWELLING o: 7, 77777 BUILDING PERM NUNIBER: 3 ATE ISSUED: C/ SIGNATURE: /a /N Building ColnmissioneE�Wto Date LWto of Buildin -)k SECTION I- SITE INFORMATION i.i PropertyAddress: lei, 1.2 Assessors Map and Parcel Number: 0 --OP 15' Map Number Parcel Number Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 1.3 Zoning Information: Zoning 5ii—V�c—t Proposed Use 3.1 Licensed Construction Supervisor: .1.4 Property Dimensions: Lot Area (sf) Frontage (It) 1.6 WELDING SETBACKS (ft) Front Yard Side Yard Rear Yard Required Provide Required Provided Reqaired Provided -3 --t 0 � � l,. --)� ND 11. 6 1.7 Water ly, NCGL.C.40. 54) fic —r Private 0 1.5. Flood Zone Inforontion: 1.8 S Disposal System: Zone Outside Flood Zone muu�cipal 570 On Site Disposal System I SECTibN 2 - PROPERTY OWNERSEEIP/AUTHORIZED AGENT Ulstrict: Yp:S I Owner of Record 'Vi�e (Print Address for Service: 0 (215L 9 -!5 3 -12 Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable 0 Licensed Construction SupeNiso 0'7 3 0' License Number �ddress t, b S- 33 5— �A Expiration Date S i gn,"Wre Telephone 3.2 Registered Home Improvement Contractor Not. Applicable 0 -ompany Name Registration Numb�r &A kAAdadaress Expiration Date Signature Telephone OU M X z 0 M 0 z M 90 0 0 M z 0 SECTION 4 - WORKERS COMPENSATION (MG.L C 152 § 25c(6) . Workers Compensation Insurance affidavit must becompleted and submitted with this in the denial of the issuance of the.builgling permit. Signed affidavit Attached Yes ....... 75�,, No ....... 0 SECTION 5 Description o Proposed Work (check aff appUcabie to provide this affidavit will result New Construcuon U Existing Building 0 Repair(s) 0 Alterations(s) 0 Addition Accessory Bldg. 0 Demolition 0 Other 0 Specify Brief Description of Proposed Work: '2 t I. SRCTTON 6 - RqTTMAT3?.n rnN.QT1D1TrTMV t1neVe I J Item Estimated Cost (Dollar) to be t1 . a 0M V L -Completed. by pennit applicant I Building (a) Building Permit Fee Multiplier i 2 Electrical (b) Estimated Total Co t of Construction .3 Plumbing Building Permit fee (a) x" (b) 4 Mechanical (HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) 1 Check Number ClVd�TInV'Y. nU7PJV'D A TVVI"J�%"Tm A JV'" VV XIM11 OWNERS AGENT OR CONTRACTOR APPLIEES FOR BUnDING PERNHT as Owner/A.uthorized Agent of subject property AW��Utl'0 to act on JAmatters relative to work authbriz6tty this building permit application. Signature of' er Date SECTION 7b OWNERIAUTHORIZED AGENT DECLARATION property as Owner/Authorized Agent of subject Hereby declare that the statements and informatio n� on the foregoing application are Lrue and a�curate, to the best of my know and belief i ledge of Owner/, Date NO. OF STORIES __ _ _ k SIZE BASEIVENT OR SLAB LA. SIZE OF FLOOR TRvIBERS 194� SPAN 1W# DINIENSIONS OF SILLS DINIENSIONS OF POSTS DMIENSIONS OF GIRDERS a FlEIGHT OF FOUNDATION SIZE OF FOOTING MATERIAL OF CHRANEY IS BUILDING ON SOLM OR FILLED LAND S P IS BUILDING CONNECTED TO NATURAL ��LJNE_j, THICKNESS L t X -_7 -A -14�- &Z/ 6 - //— 17—tolle PLAN OF LAND IN NORTHANDOVER, MASS. PREPARED FOR ELIZABETH QUINN SCALE. I"= 20' DATE.,8)2012004 SEE ASSESSORS MAP 60'A, PARCEL 15. 1011212004 THE ZONING DISTRICT IS R3. Soott L. Giles P. L. S. IProposal No. 451A Curran Construction Co., Inc. Shoot. No. 1 8 Stone Post Road Salem, N.H. 03079 (508) 686-2917 Date MARCH 16, 1994 (603) 894-690? Proposal Submitted To Work To Be Performed At Name MR. & MRS. DONALD BENNETT Street- 29 HEATH ROAD Stree Ci -- - SAME State Date of Plans City NO. ANDOVER, MA. 01845 State Archhect— Telephone Number 508-682-5117 We hereby propose to furnish all the materials and perform all the labor necessary for the completion of pgnVTpF AppTjoN AND RFMOVATE-REAR OF HOUSE IN ACCORDANCE WITH . pATgp pErF.MRER 1993 AND CURRAN CONSTRUCTION CO. pT,ANq gy gTT,T, T.F F ING SPECUTCATIONS DATFD MARCH 1-6, 1994, All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifications submitted for above work and completed In a substantial workmanlike manner for the sum of Dollars($ 55, 300. 00 with payments to be made as'follows; $7,300.00 UP -ON ACCEPTANCE, $5,000 FOUNDATION COMPLETE, $45,000 FRAMING COMPLETE WITH WINDOWS, $10,000 PLASTER COMPLETE, $5,000 HARDWOOD FLOORS COMPLETE AND $3,000 UPON COMPLETION. Any alteration or deviation from above specifications Involving extra costs, will be executed only upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary Insurance upon above work. Workmen's Compensation and Public Liability Insurance on above work to be taken out by Curran Construction Co., Inc. Curra �?t - C I ic uctio RespeZc fly . � �111ttd Per Z& Note — This proposal may be withdrawn by us if not accepted within /0 days. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified. Payment will be made as outlined above. Accepted Signature L Date Signatur FORK U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: odno -Phone 6 , S�// 7 LOCATION: Assessor's Map Number ZG66 Parcel Subdivision Lot (s) St. Number Street 20 W_V� ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: 'x�Date Approved Conservation�Administrator Date Rejected Comments �; /-��Ao �,, &Z Town Planner Comments Food Inspector -Health Septic Inspector -Health Comments Public Works - sewer/water connections - driveway permit 1'�Fire Department Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Received by Building Inspector Date Location No. Date d ri5 5 TOWN OF NORTH ANDOVER, Certif icate ' of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee Sewer Connection Fee $ Water Connection Fee $ TOTAL s Zi 2 2,, Building Inspector Div. 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