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HomeMy WebLinkAboutMiscellaneous - 300 WILLOW STREET 4/30/2018I Date .... .......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ................................................................ has permission to perform e. wiring in the buildingPep, of ,,,.,,.,,,.,h` ..North Andover, Mass. at . j lld�j g . 6 .. , ...✓,0 ........ �0 ....................... . ............................. Fee 77, Lic. No/�_�S ..... � . . .............................. . ................................................... ELECTRICAL INSPECTOR c Check - 6,17 871 -5 6,2 6 Commonwealth of Massachusetts OfficialUse Only Department of Fire Services Permit No. !7 ( , 1 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC)/,'527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: F//O A, City or Town of. NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 00 No. of CeilSusp. (Paddle) Fans : 61 VS, No. of Luminaire Outlets Owner or Tenant Generators KVA Telephone No. Above ❑ In- ❑ Swimming Pool g rnd. rnd. Owner's Address i h Q QQQJJJ Is this permit in conjunction with a building permit? Yes No ❑ . (Check Appropriate Box) 4� Purpose of Building [ "O 6 & a Utility Authorization No. No. of Gas Burners Existing Service Amps / Volts verhead ❑ Undgrd ❑ No. of Meters No. of Alerting Devices New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Tons ` Number of Feeders and Ampacity No. of Self -Contained No. of Waste Disposers P Totals: and Nature of Proposed Electrical Work: Completion of the followingtable inay be waived b the Inspector of Wires. No. of Recessed Luminaires No. of CeilSusp. (Paddle) Fans : o. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Above ❑ In- ❑ Swimming Pool g rnd. rnd. o. oUnits Emergency ig ing Batter Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS I No. of Zones No. of Detection and No. of Switches No. of Gas Burners D Devices No. of Ranges No. of Air Cond. Tons Tota No. of Alerting Devices Heat Pump Number Tons KW No. of Self -Contained No. of Waste Disposers P Totals: Detection/Alerting Devices No. of Dishwashers S ace/Area Heating KW P g Local ❑ Mun►cipal ❑ Other Connection No. of Dryers Y Heating Appliances KW ecNo. Systems: No. of Devices or Equivalent No. of Water KW No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of wires. Estimated Value of Electrical Work: 410,d dd • 0y (When required by municipal policy.) Work to Start: p Ao Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 15- BOND ❑OTHER ❑ (Specify:) I certify, under th is andpenalties of perjury, that the information on this app lica ' is true and complete. FIRM NAME: n r 41r1e6rT LIC. NO.: Licensee: %Y/ip /rnb/LE Signatu e LIC. NO.: (If applicable, enter "exe pt" in the license num&r line.) Bus. Tel. No.: Address: �0 5� c 0 >< d 0 . �! �' Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security w rk requires Department of Public Safety "S License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner - ❑ owner's a ent. Owner/Agent PERMIT FEE: $ Signature Telephone No. A/w z, - 3 -/ The Commonwealth of Massachusetts Department oflndustrialAccidents Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 s•v www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): Address: 65 Avco Road, Unit F Citv/State/Zip: Haverhill, MA 01835 Amore Electric Inc. Phone #: 978-372-5877 Are you an employer? Check the appropriate box: 1. ❑■ I 'am a employer with 19 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub -contractors have working for me in any capacity. employees and have workers' [No workers' comp. insurance comp. insurance.1 required.] 5. ❑ We are a corporation and its 3. ❑ I am a homeowner doing all work officers have exercised their myself. [No workers' comp. right of exemption per MGL insurance required.] t c. 152, §1(4); and we have no employees. [No workers' insurance requirea. I I I Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.9 Electrical repairs or additions 11. ❑ Plumbing repairs or additions 12.❑ Roof repairs 13. ❑ Other *Any applicant that checks box #1 must also fill out the section below showing their workers' compensation 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. $Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Associated Industries of MA Mutual Insurance Company Policy # or Self -ins. Lic. #: WMZ 8005862012015 Job Site Address: 300 Willow Street Expiration Date: 06/15/2016 City/State/Zip: North Andover, MA 01845 Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine 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 of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and�'enalties of perjury that the information provided above is true and correct. �,� h, 0 0 ✓S ,- � nntP.03/10/16 Phone # 978372587 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): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone 0 lir z -7" uml z co z CO) CL W W CL ZE E Z c LLw - CL S C CD 0 ca CIL .v U) V cc C cc CL O — o mm 0 z d G O `o a cQ o Q � C Cc O zCD N C o Gcc a G G J = 12 0 mEU. t v c 01 ya L% LU z z 9 m o n }�E IL z Z IL m z J9La G W J W u yZ �o G G z t o S E L d .: y G Y. o -7" uml z co z CO) CL W W CL ZE E Z c LLw - CL S C CD 0 ca CIL .v U) V cc C cc CL O — o mm 0 z d G O `o a cQ o Q � C Cc O zCD N C cc OISI I O m z a � m �` lL O o m C € LL z LL $ a E m O 3 m �o� ti 3coLLS° INsPt:CTIONS SERVICES LOG DATE: ADDRESSAj, i f; I �{ 1 I?�c�/� INSPECTED BY: NAME PECTION: -•-� �/ 7,,, �{ � FAIL OTHER PHONE C TION NOTE[ INSPECTION. COMMENTS: PERMIT# OFFICE NOTE: 11� INSPECTION REQUEST: ESC/FOOTING FOUNDATION FRAME ROUGHFINAL OTHER TIME IN: TIME OUT: ADDRESS NAME. PHONE PERMIT # OFFICE NOTE: t INSPECTION REQUEST: ESCIFODTING FOUNDATION FRAME ROUGH FINAL OTHER INSPECTED BY.• DATE OF INSPECTION: PASS FAIL OTHER CORRECTION NOTE/ INSPECTION COMMENTS: TIME IN: TIME OUT: 'ADDRESS INSPECTED BY: NAME DATE OF INSPECTION: PASS FAIL OTHER PHONE CORRECTION NOTE! INSPECTION COMMENTS:' PERMIT # OFFICE NOTE: INSPECTION REQUEST: ESCIFOOTING FOUNDATION FRAME ROUGH FINAL OTHER TIME IN: TIME OUT: ADDRESS NAME PHONE PERMIT# OFFICE NOTE: INSPECTION REQUEST: ESCIFOOTING FOUNDATION FRAME . ROUGH FINAL OTHER )LDDRESS TAME 'HONE ERM1T # OFFICE NOTE: 1SPECTION REQUEST: ESC/FOOTING FOUNDATION FRAME SOUGH FINAL OTHER NSPECTED BY.• DATE OF INSPECTION: PASS FAIL OTHER CORRECTION NOTEI INSPECTION COMMENTS: TIME IN: TIME OUT: INSPECTED BY: DATE OF INSPECTION: PASS FAIL OTHER CORRECTION NOTE[ INSPECTION COMMENTS: TIME IN: TIME OUT: 4 WH C� W a O 7 O go N N 3 N O 00 O V1 M 00 3 N o Q. M 0.l 7 O O � Q M N O w U O r a. v1 0 0 .-y N v U M � aw �O �a �z � 0 � 0� 0 Z o> H oz� U W � O G O iti Q U� C 7 � tina- aU+ ro a z� O W E- WO a U � W W o p� U y p W � U w �a W P. fYl w�aU 0 w O N �wz o w�ar� 3 N o Q. M 0.l 7 U O U O r .-y N � a � aw �O o o � 0 � 0� 0 H oz� G O iti Q � a W �O z� W E- zWz a U � W W o p� U y p N W P. fYl GAS INSPECTION TESTED INSPECTOR.,.. NAME STREET ST. NO. LOT NO. U� I ■ - TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION _� •` MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY ^_ iliOiQfR�I�OV�fL- � MA DATE PERMIT # lT JOBSITEADDRESSLlfl — m OWNER'S NAME r�[KCIfN(� CCI'r2 I OWNER ADDRESS TEFAX TYPE OR PRINT OCCUPANCY TYPE COMMERCIAL EDUCATIONAL ® RESIDENTIAL CLEARLY NEW:.-..-. RENOVATION: REPLACEMENT PLANS SUBMITTED: YES Q NO.� APPLIANCES 7 FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 1 14 BOILER ' BOOSTER CONVERSION BURNER COOK STOVE_ - DIRECT VENT HEATER ---- DRYER (_..... _..I FIREPLACE FRYOLATOR-- FURNACE--- - GENERATOR I GRILLE—I__-�-� INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT _ ._ _- 1 _ _ — _� is -. L OVEN POOL HEATER ROOM/ SPACE HEATER ROOF TOP UNIT _ TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER i — — INSURANCE COVERAGE have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES.4NO[�� I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY � OTHER TYPE INDEMNITY ® BOND] 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 [j AGENT O SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information 1 have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent p v' 'on of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME LICENSE SIGNATURE MP 9 MGF 0E JP Ej JGF LPGI Ell CORPORATION -U# PARTNERSHIP D# _-__ _ ( LLC E]# COMPANY NAME:C, f) —4 _ — ADDRESS tl LS CITY _ _ _ STATE ZIP TEL -(gyp FAX _ _� CELL1__ EMAIL NtrAcM41 it H O z z w a O W o ❑ z O y ❑ w �- F- W LU °z W w Cl) W > a o w W CO 0 a a, a U J E., a a � a U) ui x w F LL H z z 0 H U a c�7 0 Clx The Commonwealth of Massachusetts . F Department of IndustrialAccidents < •Wa ds� . X Congress Street, Suite 100 Boston, MA. 02114-2017 ;r www mass.gov/dia °gym Svv -Workers' Compensation Insurance Affidavit: Builders/Contxactoxs/Electricians/3'lwm ers. TO BE PILED WITH THE PERMHT]NG AVI'HOI2ITY. Name (Business/Or'ganization/fndividual): Address: 06FLJ City/State/Zip: A )-7 Are you an employer? Check &e ap ropriate box: employees (fiill and/or part-time).* l I am a employer withL-41 y 2. ❑ I am a sole proprietor or partnership and have no employees working for me in any capacity. [No workers' comp. insurance required.] 3.❑ I am a homeowner doing all work myself [No workers' comp. insurance required.] t 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. 1 will ensure that all contractors either have workers' compensation insurance or are sole proprietors with no, employees. 5.❑I am a general contracfo i and I have hired the sub -contractors listed on the attached sheet. These sub -contractors have employees and have workers' comp. insurance.t 6. 1 We are a corporation and its. officers have exercised their right of exemption per MGL c. 152 §im andWe have iio employees: [No workers' comp. insurance required.] Type of project (required): 7. [] N6*,dOnstrdctlon 8. [] Remodeliiig 9. ❑ Demolition 10 ❑ Building addition 11.❑ Electrical repairs or additions 0 -Plumbing repairs or additions 13U Rb6f repairs 14;rM Other A-70 R0 GBC &-4cw- *Any applicant that cheoks box A wrist also fill out the section below showing their workers' compensation policy information. Homeowners who submit this;aftidabit 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 c the sub -contractors and state whether or not those entities have employees. If the sub -contractors have employees, they must provide their workers' comp. policy number. ' compensation insurance for my employees. Below is the policy and job site X am an employer that is providing workers information. Insurance Company Name: 'KC•'' WC49-Q C�� Expiration Date: Policy # or Self ins. Lie. #: p lob Site Address: X06 �� 11uAe,.1 S� City/State/Zip __A/ Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under MGL e. 152, §25A is a criminal violation punishable by a fine up to $1,500.00 and/or one-year imprisonment, as well as civil p nalaiebe forwarded to theffi e of fmve tig00 a d Ons of the DIA. for insurance day against the violator. A copy of this statementm y coverage verification. Ido hereby certify UI de t e�ains Menalties ofperjury that the information provided above i/s true and. correct. -S 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): i 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Phone Contact 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 hl�re, 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 enierpri'se, and including the legal representatives of a deceased employer, or the receiver'6x 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 ofthe 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 b6 deemed to be an employer." MGL chapter 152, §25C(6) also. states that "every state or local Iicensing 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('1) 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 Pleasb fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub=contractors) name(s), address(es) and phone numbers) along with their certificates) of insurance. Limited Liability Companies (LLC) 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 maybe 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 permit or license is being requested, not the Department of IudustrialAccidents. Should you have any questions regarding the law or if you are required to obtain a vSorkers' 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 thai 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 burn leaves etc.) said person is NOT required to complete this affidavit. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston, MA 02114-2017 Tel. # 617-727-4900 ext. 7406 or 1-877-MASSAFE Fax ## 61.7-727-7749 Revised 02-23-15 wwwmass.gov/dia n PLUMB AN U I.SSUES, _THE FOLL FEti I STERED AS A JAMES I MORRI L4 CQC MECtiAlIEQL `SERVICES IiSt/`tr '^2 39 FRA STOWN "RD I EL:O:iH 03.047 4205 �„ a 3 Z - Date... e�';��`�-,"! ~�oL TOWN OF NORTH ANDOVER p PERMIT FOR WIRING This certifies that X. .. ..� ..� ............ ................................................. has permission to forms i.. .:....: ................................................. ....... wiring in the building of .. ... ............ at .... .. r r! �' ,North Ando r, Mass .......1.r�,�.......... 5.."" "... 2 Fee ../z r ......... Lic. No.�. Z5.... / ��...... T. � .... ., .. 7................. EilcmicA - - S5 �4TOR Check # /3 a ,� -Urz massactrusetts Electrical Code Amendments 527 CMR12.00 § Rule 8: Jn accordance-with the provisions of M.G.L. c.143, §.3L, the a permit application form to provide notice of installation of wiring shall be uniforin throughout the Commonwealth, and applications shall be filed on the prescribed form. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166, § 32, an electrical permit shall be issued to the person, fum or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L. c. 143, § 3L. t Permits shallbc limited as to the time of ongoing construction. activity, jnd maybe deemed bythe.Inspectorof_Wires abandoned.and.invalidafle—. or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or the installing entity stated on thq permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of the Acts of 2012. The purpose of this act is to promote job;growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain-permits -and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effect or existence" during the qualifying period beginning on August 15, 2008_and extending'through August 15, 2012. ule 8--Permit/Date Closed: ** Note: Reapply for new permi ❑ Permit Extension Act — Permi at Closed: a (.ommonwealttt. o f )Va99ac4ajetb 2.partnwnt o� ire Jervicee „-. BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Pen -nit No. 1 Occupancy and Fee Checked [Rev. 1/071 (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK A!' Naork to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 <PL L-A SE PRI.N T . Citi• or I By this application Location (Stregt & Owner or Tenant ON%'ner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ Purpose of Building Ezistin" Service _ CNV Service (Check Appropriate Bos) Utility Authorization No. Amps i Volts Overhead ❑ Undgrd ❑ Amps / Volts Overhead ❑ Undgrd ❑ b .Number of Feeders and Ampacity I.ation and Nature of Proposed Electrical Work: =e No. of Meters No. of Meters Completion ofthe %ollowino table nray be x-aived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil: Susp. (Paddle) Fans No. of Total Transformers YVA No. 'of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Above In- Swimming Pool grnd. ❑ rnd. ❑ o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Sv. itches No. of Gas Burners 1'o. of Detection an Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pum \umber Tons KW ......... No. of Self -Contained Totals: Detection/Alerting Devices No. of Dish�%ashers Space/Area Heating KW Local 0 Municipal ❑ Other Connection No. of llrN ers Heating Appliances KW Security SNo. of Dystems:* evices or Equivalent No. of 'VN aterK`�,. No. of No. of Data Wiring: Heaters Sivns Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: •1 Attach additional detail if desired. or as required by the Inspector of Wires. r�stimated \ alue o Electri al \k'ork: (When required by municipal policy.) ork to Start: ` Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSUR•kNCE C VER. E: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liabilit} 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. C'JF(—h O\E: INTSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certift, under the pains curd penalties ofpetjury, that the information on this application is true and complete. FIRM N:��IE: �'► — LIC. NO.: Licensee: c, �� t c Signature IC. NO.: 17s (ff op,plicab/e. enter `eye tt " in the licef se na rube .li 7e. ,2t / r y Bus. Tel. No.. :lddress:,� [ �r, � it . L�i hwl Lit ,&q of If L` I2 Alt. Tel. \'o. "Per \1.6.1_. r. 147, s. 57-61, security work requires Departfnent of Public Safety "S" License: Lic. No. OWNER'S INSUR=ANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally tequircd b., law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. 01yner'Agent Signature Telephone No. PERMIT FEE: $ _�-- - Date. Il...................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .... . ........ .. ..................... has permission to perform ...... eq................... / ....... ....... wiring in the building of ..... ............... ................ ........................... at ... . . ............... ......... North ;Ander, as/s' .. ... ....... .... ... .. ...... M Fee..., ................ Lic. No. . ..................... ELECTR-I'C' A-L-I'N-S ECTOR Check# :2,0' -Ye 2----7- 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance -with the provisions of M.G.L. c. 143, § 3L, the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed on the prescribed,forin. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166, § 32, an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L. c. 143, § 3L. Permits shall -be limited as to the time of ongoing construction activity, znd may be_deemed_by-the Inspector -of Wires abandoned_and_invalid_ifhe—_ .. _ or she has determined that the authorized work has not commenced or has not progressed during the preceding 12 -month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or -the installing entity stated on the permit application. . ❑ The Permit Extension Act was created by Section 173 of Chanter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of the Acts of 2012. The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effect or existence" during the qualifying period beginning on August 15, 2008 and extending"through August 15, 2012. Rule 8 — Permit/Date Closed: Note: Reapply for new permitf%� 0 Permit Extension Act —Permrt/Date Closed: n `yy (emmonwealM o f Ma-mac4ubetb Uepavtmzn� o��ire �evvices U9, BOARD OF FIRE PREVENTION REGULATIONS t, �t a Official Use Only Permit No. d Occupancy and Fee Checked [Rev. 1/07] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to he performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR T. PE ALL I F TION) Date: % J A,4 1\1 City or Town of- To the Inspector of Wires: By this application the undersigne gives no ace of his or her intention to erform the electrical work described below. \\ Location (Street & Nuyuber) �����L�UJ f -� � � � `1` h ► `� Owner or Tenant Telephone No. Owner's Address Is this permit in conjunct n with a building permit? Yes ❑ No � (Check Appropriate Box) Purnose of Building �Mk.1S a�C 1 -A -N Utility Authorization No.. Existing Service New Service Amps / Volts Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed No. of Recessed Luminaires No. of Luminaire Outlets No. of Luminaires No. of Receptacle Outlets No. of Switches No. of Ranges No. of Waste Disposers Overhead ❑ Undgrd ❑ No. of Meters Overhead ❑ . Undgrd ❑ No. of Meters Electrical Work•����1j, �r`l\ Completion o the ollowin table ma be waived b the Ins ector o Wil No. of Total rners Susp. (Paddle) Fans Transformers KVA Tubs Generators KVA Above In- o. o mergency �g ung Pool rnd. rnd. ❑ Batte Units urners FIRE ALARMS No. of Zones o. of Detection and Burners Initiatin Devices TotalNo. of Alertin Devices Cond. Tons g No. of Dishwashers Space/Area Heating KW No. of Dryers Heating Appliances KW No. of Water No. of No. of Heaters KW Si ns Ballasts No. Hydromassage Bathtubs No. of Motors Total HP Mumctpat El Other Local ❑ Cnnnprfinn N of Devices or OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of lectrical Work: J (When required by municipal policy.) Work to Start: S \ Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete FIRM NAME- b��`: D�`ti LIC. NO.: \ Licensee: Signature LIC. NO.. 'i '� � � - (If applicable, enter "exe " in the licens number ine.)� Bus. Tel. No. \ Alt. Tel. No.: Address: *Per M.G.L. c. 147, s. 57-61, security workrequires Dep rtment of Public Safety "S" License: Lie. No. OWNER'S INSURANCE WAIVER: Iam aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one ❑owner ❑ owner's a ent. b4^ Owner/Agent Telephone No. PERMIT FEE: $ Signature S. Date.... '7117//y /. ........................ TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION . This certifies that.---, ......................................................................... has permission for gas installation .. .................................. in the buildings of ........... ..t.... ....... .. + �..5............................ . at.....�•-:��.,��.......��.�.. . ............. North Andover, Mass. Fee ./P..�...... Lic. No. 151 2'.... GASINSPECTOR Check # �7 f 9414 •` MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY Al y) QG�c�---� MA DATE r PERMIT JOBSITE ADDRESS= � - OWNER'S NAME r � �N 6—j--1 GOWNER _T ADDRESS W , TEL _ FAX I TYPE OR PRINT OCCUPANCY TYPE COMMERCIAL, EDUCATIONAL ® RESIDENTIAL CLEARLY NEW:[! . RENOVATION: © REPLACEMENT: PLANS SUBMITTED: YES D NO; APPLIANCES 7 FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER I -a 1 .._ .. l _. f 1 _ _ .. .-_... , 1 _ _ - BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER. - FIREPLACE FRYOLATOR FURNACE -i s- ! —s_ i GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS WAKEUP AIR UNIT OVEN POOL HEATER —NO—OM/ SPACE HEATER I ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHER T ...... — - l - 1-11L _ - - --- -�- _ INSURANCE COVERAGE 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES NO El IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Pf OTHER TYPE INDEMNITY E] BOND 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 II AGENT SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information I have submitted or entered regarding this 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 complian with II Pertinen ion of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME GS �"�dvQi_L_(1�_ _ LICENSE # SIGNATURE MP0 MGF 0 JP ® JGF Q LPGI ©CORPORATION,0# off' PARTNERSHI #= LLC ®#= COMPANY NAME: '- ADDRESS � r J - __. CITY STATE ZIP ]TEL^ FAX '"O CELL _ EMAIL_ P H Z O H U W 'A on O �E W } � W OH a Z w � � w aco w L LU w c a a a a 0cc J H °- a a C w x w 1- LL H O H U a a P The Commonwealth of Massachusetts - Department ofIndustrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Uf www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information PIease Print Legibly Name (Business/Organization/Individual): Ch!r= Address: lc 0 cSr, lf3 City/State/Zip: N 0�' Phone#: Are you an employer? Check l -appropriate box: 1. I am a employer witf4tj 4. ❑ I am a general contractor and I employees (full and/or part-time).* have ]fired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. t ship and'have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] i employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11. ❑ Plumbing repairs or additions 12.❑ Roof repairs 13.Lo Other k'rUP S *Any applicant that checks box#1 must also fill out the section below showing their workers' compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then.hire outside contractors must submit anew affidavit indicating such. tContractors that checkthis box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that 1s providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance CompanyName:.2G�,1-ts Policy # or Self -ins. Lie. #: WC -At 7 i,3 091, Expiration Date: Job Site Address:_ VJ�C� [/�<U.�A% `City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine 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 of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby certtfyun4kribepains angXeM1Ves of perjury that the information provided above is trFe and correct. RM"Nalm Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # rl11-'► l) Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other - - - Contact Person: Phone Informati®n 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 ofpublic 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 (LLC) 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 permit 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 burn 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 Comm nwealth of Mossachusetls Department ofludustrial .Accidents Qfflee of Investigations 600 Wasbington Stzeet Basten, MA. 02111. Tel, # 61.7-727-4900 ext 406 or 1-877r,MASSAFE Revised 5-26-05 Fax # 617-727-7749 wwW.x>„tass,goVaa COMMONWEALTH OF MAS SACHIETTS Date. �..z- ........ . TOWN OF NORTH ANDOVER MOO x 41 PERMIT FOR GAS INSTALLATION °SACHUSt / f j r- This certifies that ........ -. ...... has permission for gas installation '. `. 4) 0 � . Tom. �^A . in the buildings of . -)oo ".ve --n?- L: , ��P � n �• to at .. do. . ���! d?>! ............. . North/Andover, Mass. Fee. /n'.�'.. Lic. Nog��-Z.'...-.• • ............ . GA INSPECTOR Check # 8313 MAS A USETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK - CITY Andover 11 MA DATE 9/4/2012 PERMIT# JOBSITE ADDRESS 300 Willow Street North Andover Ma. OWNER'S NAME 355 Middlesex Ave. Wilmington Ma. 01887 GOWNER ADDRESS 355 Middlesex Ave. Wilmington Ma. 01887 TE 617-242-0365 FAX TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL ® RESIDENTIAL® PRINT CLEARLY NEW: ® RENOVATION: ® REPLACEMENT: PLANS SUBMITTED: YESE] NOE] APPLIANCES Z FLOORS— BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER ® ® ©O D© D DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE ®®®® INFRARED HEATER ® © I LABORATORY COCKS MAKEUP AIR UNIT © ® t OVEN©®® POOL HEATER _ ROOM / SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER �® OTHER0 INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES E] NO I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ETI OTHER TYPE INDEMNITY ® BOND O 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 ® AGENT 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 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 c mpli nce with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUM BER-GASFITTER NAME FJohn J. Mullane LICENSE # 9552 NATURE MP 0 MGF © JP ❑—J JGF ® LPGI ® CORPORATION ®# PARTNERSHIP©# LLC [D#� COMPANY NAME] Mullane Plumbing & Heating 'ADDRESS 62 Putnam Street 02143j TEL 617-628-3239 CITY Somerville STATE Ma ZIP -71 FAX 617-623-0203 CELL 617-293-0067 EMAILmullaneplumbing@gmail.com w F O z o w w . J, CT � N >' C ❑ a z � � w � F F a O V W ?# z 3 v' a w s C w a w w Q W N W d' a a � U x J F � d Q � c W 2 W F LL rA F O z z 0 F u W a cn x x 0 a The Commonwealth of Massachusetts fn Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (B, Address: City/State/Zip: Phone #: Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. I am a sole proprietor or partner- listed on the attached sheet. t ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ 1 am a homeowner doing all work 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 required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ lectrical repairs or additions l 1.Ylumbing repairs or additions 12.❑ Roof repairs 13.❑ Other *Any applicant that checks box # 1 must also fill out the section below showing their workers' compensation policy information. I 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 -contractors and their workers' comp. policy information. 1 am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lie. #: Expiration Date: lob Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a Lme 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 )f 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. ! do hereby certify under the painsfqndpenalties of perjury that the information provided above is true and correct. >ignature: A% Date: `711?. - 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): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: 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 -contractors) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) 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 permit 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 burn 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 r 89bl 3 Date. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that .. (A �... A 1. has permission to perform plumbing in the buildings of ..'�tv' �... ...... . at ... (�.Ca .. a !�... s ......... ,Northnwer, ass. . • L. . PLUMBING INSPECTOR Check # INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YeNo ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. s, A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does 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 Si nature of Owner or Owner's A ent Owner ❑ Agent ❑ 1 hereby certify that all of the details and information 1 have submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and chat all plu,Tibing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 94< of the General Laws. By L License: Title ber Signatur f Licensed Plumber City/Town r APPROVED OFFICE USE ONLY)eyman License tuber: _ %�0 19 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING , rBuilding MA. Date:h -� Permit# tion:�(/�%j ��'j Commercial 11 OwnersName:pancy: Educational ❑ Industrial ❑ Institutional ❑ Residential ❑ New: ❑ Alteration: ❑ Renovation:X Replacement: ❑ Plans Submitted: Yes ❑ No OT FIXTURES z n: DEDICATED z Z SYSTEMS z W Y0 to W zLn Cn a w z f- be `^ z 7' Q V) Ln 0 w C7LU cc: z y z Q o� W y H W OD (n LL' C' F a y a z o W o 'n h = z(n W W z a Q 4' LU v x a N LL x a Uj a I'd3 0 o UIL vO m z h W a F3W- a BSMT. z g 0 N 33 N a 3W a 3•SUB BASEMENT IST FLOOR 2ND FLOOR 3" FLOOR 4TH FLOOR ST" FLOOR e FLOOR 7' FLOOR 8r" FLOOR Installing Company Name: O's J- Check One Only Certificate # Address: C / `� -n City/Town: �� &Corporation ( 0 C ,� State: El Partnership Business Tel:� 3 r tCP�4°' Fax: 3 -r�,3 Name of Licensed Plumber: � /� 1�X7LA ❑ Firm/Company INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YeNo ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. s, A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does 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 Si nature of Owner or Owner's A ent Owner ❑ Agent ❑ 1 hereby certify that all of the details and information 1 have submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and chat all plu,Tibing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 94< of the General Laws. By L License: Title ber Signatur f Licensed Plumber City/Town r APPROVED OFFICE USE ONLY)eyman License tuber: _ %�0 19 N tLLd-' • m Ln W O. o tn.9 WLLJ N Ljj Z LL,, j- J - m .Ix. J. Q = W CW. •_ 0,.; Q N .._� , 6 W w ~ = .ar C '�s J E ZNN le z Enter construction cost for fee cal North Andover Fee Calculation Construction Cost $ 95,000.00 Building Fee $ 1,140.00 Plumbing Fee $ 142.50 Gas Fee 100 comm. $ 100.00 Electrical Fee $ 142.50 Total fees collected $ 1,525.00 C of O 200 300 willow st 7' l 4 J Date .:7.—A7>.7. ti A ..... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that ...................... has permission for gas installation in the buildings of .� � -- .. .N �.. •............ . at .. Cw.. "., l�?w ..S K ....... • North Andover, Mass. Fee. :yP . Lic. No. i � d ?... ....0 -t !-. GAS INSPECTOR Check # r) Q� 1 11 GIv-r ICCI+ MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING City/Town: d AZ% W Cf�— , MA. Date:—"7.119 /// Permit# Building Location:_tSeo Wl"x,j Owners Name: �� % C7 C61 7-C—rte, Type of Occupancy: Commercial Educational ❑ Industrial ❑ Institutional ❑ Residential ❑ U New: ❑ Alteration: ❑ Renovation: ❑ Replacement:X Plans Submitted: Yes ❑ No GIv-r ICCI+ INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes [ No ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. 1 A 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Signature of Owner or Owner's Agent Owner El Agent El By checking this box ❑; I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and 7- ........,W ' .............y ., a„- ,,,�,a„a„�„� perrormea unaertne permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Tye of License: By Plumber Gas Fitter (2 Title Signature Licensed PI r/Gas Fitter ['Master City/Town LJJourneyman License ber: ' I APPROVED OFFICE USE ONLY ❑ LP Installer WQ U C6 2 Z 2 N N W = w W m Z H Q W Z J} U V) W F Z O 0� N w w W m o Q a W W R o O wco X W a W W W Z ag to = w W t— o LL Z W 5�IX W y J F- F- O Z J :7 LL 1- = W F.W. W W U 0: o t=i z z O a W F>>> O SUB BSMT. BASEMENT 1 FLOOR 2 Nu FLOOR 3 RD FLOOR 4 FLOOR 5 FLOOR 6 TH FLOOR 7 FLOOR 8 T R FLOOR Installing Company Name: Check One Only Certificate # i 4Corporation �� � Address: �S Cit y/Town: State: ❑ Partnership Business Tel: Fax:(6 6* -V i %L ,3 1 ❑ Firm/Company Name of Licensed Plumber/Gas Fitter: a INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes [ No ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. 1 A 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Signature of Owner or Owner's Agent Owner El Agent El By checking this box ❑; I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and 7- ........,W ' .............y ., a„- ,,,�,a„a„�„� perrormea unaertne permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Tye of License: By Plumber Gas Fitter (2 Title Signature Licensed PI r/Gas Fitter ['Master City/Town LJJourneyman License ber: ' I APPROVED OFFICE USE ONLY ❑ LP Installer ra I The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 600 Washington Street t Boston, MA. 02111 �„ 5Y• www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezilbly Name (Business/Organization/Individual): c Address: 6 City/State/Zip: ,1\,Vj:�t U -Y ' t Phone #: Are you an employer? Check the appropriate box: I V I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2. ❑ I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] i employees. [No workers' comp. insurance required.] '"" b 6 % Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.0 Plumbing repairs or additions 12. ❑ Roof repairs 13.R Other *Any applicant that checks box 41 must also fill out the section below showing their workers' compensation 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. #Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance forin y e loyees. Below is the policy and job site in l le D 3'f Insurance Company Name: � 1 Policy # or Self -ins. Lic. #: W 3 o`?,6p Expiration Date: 141— � � / nf r& j I —0' —d -ofd_ Job Site Address: �� (, J \ L LG V i S ( City/State/Zip:Evi Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine 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 of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance, coverage verification. Ido hereby certif under thep(a/iinsr dpenaId ofperjury that the information provided above is true and correct. Q7[Tl'19{'11YP• � .%n / 1 ti l/ -nom+o - 1 It Y /l °► 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): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: L��j STONECLEAVE ROAD BOXFORD P 0 BOX 198 BOXFORD 3 STONECLEAVE ROAD BOXFORD IECLEAVE RD REAR 1465 BOXFORD 27 FOSS ROAD NORTH ANDOVER 19 FOSS ROAD NORTH ANDOVER 11 FOSS ROAD NORTH ANDOVER 12 FOSS ROAD NORTH ANDOVER 20 FOSS ROAD NORTH ANDOVER 28 FOSS ROAD NORTH ANDOVER 36 FOSS ROAD NORTH ANDOVER 745 FOSTER STREET NORTH ANDOVER 734 FOSTER STREET NORTH ANDOVER 720 FOSTER STREET NORTH ANDOVER 706 FOSTER STREET NORTH ANDOVER FOSTER STREET NORTH ANDOVER IqC; LNSHIRE DRIVE 7 FO:.TER STREET 40 SYLV IN ROAD 300 FOSTE R STREET 544 FORE f STREET 554FOSTEfi"STREET 400 FOSTERS . 546 FOSTER STREET BRADFORD NORTH ANDOVER WALTHAM NORTH ANDOVER NORTH ANDOVER NORTH ANDOVER NORTH ANDOVER NORTH ANDOVER 6 FOSTER STREET PALOMINO DRIVE r458FOSTER STREET 0 FOSTER STREET NORTH ANDOVER NORTH ANDOVER NORTH ANDOVER 9t'ORTH ANDOVER STREET NOFc. 4 ANDOVER TER STREETNORTH ANDOVER TER STREET NORTH ANDOVER M352TER TER STREET NORTH ANDOVER TER STREET NORTH ANDOVER TER STREET NORTH ANDOVER 497 FOSTER STREET NORTH ANDOVER 40 SYLVIN ROAD WALTHAM 40 SYLVIN ROAD WALTHAM 9,754 Date ....... l�% TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ... ..... . ........ ......................... has permission to perform ........ ......................... wiring in the building of . . ...... .......................... at ....... -,.0 .. ............................. North Andover, Mass. Fee.. No. ......... Check # eis— (fommonwaald o` Massachadelfa official Use Only Permit No. 1JeParinranl o`..tira �arvicae Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11199] (leave blank) APPLICATION FOR P'ERM1T TO PERFORM ELECTRICAL WORK All work to he performed in accordance with the Mussachuselts Electrical Code (MEC), 527 CNIR 12.00 (PLEASE PRINT IN INK OR TYPE ALL itYl•ORjVf,-l770/V llatc; City or 'Town of: At b A -U DO v eK To the Inspector of I- res: By this application the undersigned •gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 3 �v w t L Owner or Tenant C 4-ktv 'u 6 z i-!> (A L 01 Arc; (2-0 / v Telephone No. c/7T-6 S 7 -73&0 Owner's Address 3 � /tet topLC- St`s Avg i l�t�nr�iuL/�>y, A4 O> 2-rg - Is this permit in conjunction with a buildin; permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts' Ovenccad ❑ Undgrd ❑ No. of Meters New Servicc Amps / Vohs Overhead ❑ Undgrd ❑ No. of Meters. Number of Feeders and Ampacity ` Location and Nature of Proposed Electrical Work: Completion o%the jolluiviug table niav be waived by the lirmpr/nr of IVirer No. of Recessed Fixtures No. of Cei.l: Susp. (Paddle) Fans traof nsformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Sivimmhtg Pool Above [I n- E] rnd. rnd. No. OTEInergency Lighting. Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARINIS No. of Zones No. of Switches No. of Gas Burners of Detection and ` o. Initiating DevicesTot No. of Ranges No. of Air Cond. Tons No -.of Alerting Devices No. of Waste llis users p f cat Furnp Totals: .i um er I -ons � o. Of e ontauic Detection/Alertin Devices No. of, Dishivasliers Space/Area Heating K8V Local ❑ mnctpa ❑Other .Connection No. of Dryers Heating Appliances 1(W SecuritySystems: No. of Devices or Equivalent . No. ofWater KW Heaters o. o r o. of Si -ns Ballasts Data 3Viriug: No. of Devices or E uivalent No. HN•dromassage Bathtubs No. oftllotors Total I1P a ecommunications•irtiig: No. of Devices or E uivalent OTHER: Attach additional derail ifdesired, or as required by the Inspector of fires. INSURANCE COVEfUkGE: 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: INSUI-ANCE ❑ BOND ❑ 0.17•IER ❑ (Specify:) (Expiration Date) Estimated Value of Electrical Work:* (When required by municipal policy.) Work to Start: Inspections to be requested ui accordance with MEC Rule 10, and upon completion. I certify, tinder the pains nod penalties of peijury, ural the inforiira^r oil this nppl is true and Complete. FIILII NAIVE: Ahvrn.C% 4�- Licensee: A -N y- (fo >u V p- #41 Me Sign ur (If applicable. enter •'e.vempt " in the license ruauber line.) Address: uiT A&yEnik OiVNER'S INSURANCE WAIVE,R: I am aware that the Licensee doe, required by laa•. By my signature below, I hereby waive this requircmcnl OwncrlAbcnt Si"naturc 'Telephone No. i LIC. NO.: NO.: R / 5 3-7 5 Bus. Tel. No.:.g78-37a--SB77 5� Alt. Tel, No.: not have the liability insurance coverage normally I am the (cheek onc) ❑ owner ❑ owncr's agent. P.iiRi111T FEF:: S /lss�,�Q� Ani I 4k Date......................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ........... "") ........... 6.::— ............. c - has permission to perform ........ .... ......0 ...................f'"..... v ................... / !�� .................... wiring in the building of ...... . ........... at ...... 340 .0 ... IV./. (-. L.O.L4J ......... 51 ................. -,-�North Andover, Mass. ...... .. .... . .. ... .. ...... ......... Fee ./Y"4a. Lic. No.IS"T7-� . ......... ................ ......... .. ...... ... ...... ....... CC ELECTRICAL INSPECT , R Check # -7,S-67 Commonwealth of Massachusetts Department of Fire Services A BOARD OF FIRE PREVENTION REGULATIONS r Official Use Only Permit No. % D6 Z Occupancy and Fee Checked [Rev. 11/99] (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of: No //iV p o v Ex To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) '3 Uy U✓ I c t o t-, 5 i ( c t/ E2 s t -,i- T t -a 1-/ Owner or Tenant C lf�v w &-L- (5,,,l (-,D/ti v `� / ti `- Telephone No. S f - -G 5 - 73vo Owner's Address 3 % 5 Al 10 PI1 SFy /,u & cw, M N DI V� 7 Is this permit in conjunction with a building permit? Yes ❑,; No ❑- (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters No. of Meters Number of Feeders and Ampacity y�- Location and Nature of Proposed Electrical Work:�%f����j Cmmnletinn of the following table may be waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil:P• (Paddle) SusFans of TransTotal Trsformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool rnd. Above ❑ In- rnd. ❑ o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection andInitiating Devices No. of Ranges Tot No. of Air Cond. ons No. of Alerting Devices No. of Waste Dis osers P Heat Pump Totals: Number Tons KW No. of Self -Contained Detection/Alertin2 Devices No. of Dishwashers Space/Area Heating KW S P g Local 1:1Municipal ❑Other Connection No. of Dryers Y Heating Appliances KW Security Systems: 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: No. of Devices or Equivalent OTHER: Attach additional detail it desired, oras required by the inspector oj rvires. 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 ❑ OTHER ❑ (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 the pains and penalties of perjury, that the information on thisapion is true and complete. FIRM NAME: JA.,orLE love- 1-� 111 LIC. NO.: Licensee: A9-kJ�-7vy I710ri F Signatu NO•: 1-/ s }-7 S" (Ifapplicable, enter "exempt" in the license number line.) Bus. Tel. No.• % 7e SB 77 Address: to 5 Poe -v at n ,� ti r-, /I,* v K l ! / t C /�-i 14 0 / 3 Alt. Tel. No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent rPERMIT FEE: $ Signature Telephone No. i W. 09 2, 1 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATIONt �1_�� r.. Permit No. Date Received .. r3. L__�e Issued: Lc� ORTANT: A licant must complete all items on this naize LOCATION • --300 GAJ!/ -d Print PROPERTY OWNER Print MAP NO:'�a5 01. PARCEL:06a"7 ZONING DISTRICT: Historic District yes 3UO X 0,)301 4 c Machine Shop Village yes g TYPE OF IMPROVEMENT PROPOSED USE Residential ❑ New Building 0 One family !WN,ondential ❑ Addition ❑ Two or more familyrial 'Alteration No. ofunits: ercial 0 Repair, replacement 0 Assessorjr Bldg s: 0 Demolition ❑ Other DESCRIPTION OF WORK TO BE PERFORMED: (Identification Please Type or Pr• t Clearly) OWNER: Name: gDC6 t,[ 5 0.o Phone /`r'7�'-�s7 7sadXiv� Address: -- CONTRACTOR Name: C'ZW,, W_ -z "Vyj4,151y6 110L Phone:/c /iddress: 26:3-7J7,*al�'y7 Supervisor's Construction License: CS'-�'9�7e Exp. Date: 13ome Improvement License: Exp. Date: ' NRCHITECT/ENGINEER JosgeMlf beW11,9v. Phone: 7'?a6 __K " -sex �� kddress: ItJ�[.M �� ���rJ v, &4 a .q9q Reg. No. 1.3dE17 FEE SCHEDULE: BULDING PERMIT.• $92.00 PER $9000.00 OF THE TOTAL ESTIMATED COST BASED ON $925.00 PER S.F. 'otal Project Cost: FEE: $ I�Y� :- -%�Z /d Yl b :husk No.: Receipt No.: TOTE: Persons ontracting Vith unregistered contractors do not have access to th e" &-�IaA '*� fund 75'5 Date /..Z.? //..U..... . of �` TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION ,Sg^CNUSEt -`' This certifies that ... . ...... //�?1... Z ............ has permission for gas installation ..... ....� I.! .' . j... . in the buildings of ... . X ...0 t fz................. at -U-t North Andover, Mass. Fee. 0 T... Lic. No. J.2 P .`1.1.=. ........... GASINSPECTOR Check# 2 0 i f -3 FIXTURES MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING lugCity/Town: _A !$IJ hod MA. Date: /9( t Permit# By Plumber Building Location: 3-z2 M u a1 ,,% _ Owners Name: �� _ Title Type of Occupancy: Commercial Educational ❑ Industrial ❑ Institutional ❑ Residential ❑ Signature oicensed Plumber/Gas Fitter New: ❑ Alteration: Renovation: ❑ Replacement: ❑ Plans Submitted: Yes ❑ No ❑ FIXTURES INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes No ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy V 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Aaent By checking this box ❑; I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. co Ty e of License: By Plumber Title Gas Fitter Signature oicensed Plumber/Gas Fitter City/Town Master Journeyman rn S—A ! ter: ❑ LP Installer Z W Y H V7 �V Q co L) D W O W W U U) H O = W W Z I— ~ Z J °m } W Z U) O m w w r° -n > W L o ~ a a w �° = x u' W U)U W W W Z W WH a _ Z W >- W W N J Q ~ Q m W O Z O ~ H N W i H Z W = 0 0 0 LL 0 x x 0 a Q a W H>>> O SUB BSMT. BASEMENT 1 FLOOR 2 FLOOR -r 3 FLOOR 4 TH FLOOR 5 FLOOR 6 FLOOR 7 FLOOR -i 'FLOOR Check One Only Certificate # Installing Company Name: (.� Corporation L C� 1 Address: City/Townl State: �� ❑ Partnership Business Tel: �lr Fax: ❑ Firm/Company Name of Licensed Plumber/Gas Fitter:m1Aalc�-, INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes No ❑ If you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A liability insurance policy V 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Aaent By checking this box ❑; I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Ty e of License: By Plumber Title Gas Fitter Signature oicensed Plumber/Gas Fitter City/Town Master Journeyman License Nu S—A ! ter: ❑ LP Installer APPROVED OFFICE USE ONLY Date .....-/D .. /Q.. oTOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION s a Oq •' .• ty �9SSACMUSE� \ This certifies that ..�:� 62(V.... pke... L LG. has permission for gas installation Poor to, — 4945 in the buildings of ... Z- ....... at . �3 0© R.'LtOw:.S! ; , ...So.T, North Andover, Mass. Fee. 1.Z'..... Lic. Nol 2-.,:13.o .. ....................... A'1 GAS INSPECTOR Check # 3 U/ t r` MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTING (Type or print) Date- �. NORTH ANDOVER, MASSACHUSELTTS Building Locations 3© 0W Ile,- ST!'- f so��• Permit # Amount $ C NAY, Q(A Cl�r Plans Submitted Owner's Name New❑ Renovation ❑ Replacement ❑ (Print or type)/ Check one: Certificate Installing Company Name Osb o r+�e Q V�\ ha `L V ❑ Corp Address Abbot V e C *b VG E1 Partner. 0 usmess Telephone q 75 q 9 ®Firm/Co. Name of Licensed Plumber or Gas Fitter.�� OsbQ /M INSURANCE COVERAGE ChecEff;� I have a current liability Insurance policy or it's substantial equivalent. Yes No If you have checked Les, please in ate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnityBond { Owner's Insurance Waiver: I am aware that the.licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner 0 Agent I IIv, y LCI IIIy ulal aII W Inn uelaiis ana miormanon 1 nave suomltteo (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. e IAPPROVED (OFFICE USE ONLY) ignature of Licensed Plumber Or Gas Fitter. Plumber a V Gas Fittericense um er Master Journeyman &O' U zW C x .4. dd � z z F . GW W U W �, rn W FFC fY, 0 a W QL C7 F z H d x F W C C W W F x cx W x v 0.01 z O 0> Z p F o' a 3 c 0 c a F o SUB -BASEMENT BASEM ENT 1ST. FLOOR 2ND. FLOOR - 3RD. -FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR 8.TH. FLOOR EiL (Print or type)/ Check one: Certificate Installing Company Name Osb o r+�e Q V�\ ha `L V ❑ Corp Address Abbot V e C *b VG E1 Partner. 0 usmess Telephone q 75 q 9 ®Firm/Co. Name of Licensed Plumber or Gas Fitter.�� OsbQ /M INSURANCE COVERAGE ChecEff;� I have a current liability Insurance policy or it's substantial equivalent. Yes No If you have checked Les, please in ate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnityBond { Owner's Insurance Waiver: I am aware that the.licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner 0 Agent I IIv, y LCI IIIy ulal aII W Inn uelaiis ana miormanon 1 nave suomltteo (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. e IAPPROVED (OFFICE USE ONLY) ignature of Licensed Plumber Or Gas Fitter. Plumber a V Gas Fittericense um er Master Journeyman ";:;w The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Name (Business/Organization/Individual): Address: City/State/Zip:_ ffr1LJ Q v -C _r 1vw1t, VIV Phone #: g7If y 757 o 111 Are you an employer? Check the appropriate box: 1. I am a employer with _ 4. ❑ I am a general contractor and I employees (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 working for me in any capacity. [No workers' comp. insurance required.] 3. ❑ I am a homeowner doing all work myself [No workers' comp. insurance required.] t These sub -contractors have workers' comp. insurance. ❑ 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' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10. ❑ Electrical repairs or additions 11. ❑ Plumbing repairs or additions 12.❑ Roof repairs e 13.[Other / 64s -re­.:,a� ;,+i=-�.:.:. ver. r, i m=-' it:so 110 Cu: the section bei0w sh twino 'rein workers! ' compensation 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. $Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. I _ n I ­_ Insurance Company Name:_ H -j2 or '"l Policy # or Self -ins. Lic. #: 11 Expiration Date: _+• 10 to Job Site Address: 1��d 1�1%4k4ws�^. .yv City/State/Zip: /N' PKJQVtk Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine 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 of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under he pins andpenalties ofperjury that the information provided above is true and correct Si ature: 0416Date:{�� d ( ) 0,SnyNo 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): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: 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.anothdr.who employs persons to do rpaintenRc6; 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." a` MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a IiieiiseiDr, per t'to bpera' 4a business or to ,construct buildings in the cotumonwealth 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 insuranceP 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 (LLC) 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 fol confirmation'of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be retuned to the city or town that the application for the persxiit or license is being requ-sten, not the Deparcment 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 mthe permittlicense 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;submir 6136 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 F "' Department of Industrial Accidents Office of Investigations 60:0 Washington Street Boston, MA 02111 Tel. # 617-72.7-4900 ext 4;06 or 1-877-MASSAFE Fax # 617-72.7-7749 Revised 5-26-05 w m,-rnass..gov/dia h Date.. A/............ TOWN OF NORTH ANDOVER p PERMIT FOR WIRING This certifies that has permission to wiring in the built ...........��...................................... .North Andover, Mass. Fee.. 7- !�.......... Lic. No Ca........................ ........................................ ELECTRICAL INSPECTOR Check # al- P 5142 Commonwealth of Department of E BOARD OF FIRE PREVEN' APPLICATION FOR All work to be performed in a (PLEASE PRINT IN INK OM�Lb City or Town of: By this application the undersigned gives rJJQtJi1 Location (Street & Nt ber) n--'V�A Owner or Tenant Owner's Address assaehusetts Official Use Only T� �f/ e Services Permit No. Occupancy and Fee Checked )N REGULATIONS [Rev. 11/99] leave blank MIT TO PERFORM ELECTRICAL WORK :e with the Massachusetts Electrical Code (MEC), 527 QMR 12.90 ZMATION) Date: VYX �, To the Inspector of M6: � or her intentign to perform the electrical work described below. Telephone Is this permit in conjunction with'a building permit? Yes. ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization 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 Comnletion of the following table may he waived by the In mprtnr of Wirpc 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 ❑ In- ❑ Swimming Pool rnd. rnd. o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o Detection and No. Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting in Devices No. of Waste Disposers Heat Pump Number Tons KW No. of Self -Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances g pp Kms' Security Systems: No. of Devices or Equivalent No. of Water Kms, No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent Na. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of 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 ❑ OTHER ❑ (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 the ains ndpenalties of per, jury, that the information on this application is true and complete. FIRM NAME: LIC. NO.: I r, 3(` Licensee: John S. Bassett Signature LIC. NO.: 1533C (If applicable, 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 Lid, see 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 ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ , 4162 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies tha';—Y�a_� t ................................ .... ..... ..... ..... 34... has permission to perform .7.40.1 ........ wiringin the building of ........................................................ .... zz�� A�2� ........ : ........ . North Andover, Mass. Fee .SGS i:'...... Lic. - �)' d-- - — ........................ ......... . . ........ .... .. ..... . LEc rR ICAL INSPECTOR Check # 92/ - TBE COMMONWF4LTHOFMASSACHUSE17S . Office Use only DEPARTMENNI'0FPUX1CS4FE7Y BOAROOFFIREPMEEVHONRWMHONS527C ]2.W Permit No. Occupancy & Fees Checked v APPUCA 770N FOR PERMIT TO PERFORM ELECTRICAL 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 Ld LZ 6 v .Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street � Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes C1No (Check Appropriate Box) Purpose of Building Utility Authorization No. _ Existing Service pmp =Volts Overhead Underground New Service AmpsVolts Overhead Underground Im Number of Feeders and Ampacity g_. -3O Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Lighting Fixtures No. of Receptacle Outlets No. of Switch Outlets Y No. of Ranges No. of Dispisal� s No. of Dishwashers No. of Dryers No. of Meters No. of Meters No. of Hot Tubs No. of Transformers Total VAI A Swimming Pool Above r1 Below No. of Oil Burners -.11 tu,s ----ra,icy iagnung tsattery Units No. of Gas Burners No. of Air Cond. Total FIRE ALARMS No. of Heat Total Pumps Tons Space Area Heating Heating Devices No. of Water Heaters KW No. of Massage . a/-' STfz(.C.. l #J G No. of Motors n� 1� v.►�t v �c�c`tti bZ� �.! No. of Bailasis rotal HP 1 otalNo. of Detection and KW Initiating Devices KW No. of Sounding Devices No. of Self Contained Kms' Detection/Sounding Devices LocalMunicipal D Connections KVA No. of Zones ED Other nsum=Covage. P1nu IIDtheitx wm)ff>tso WbMdWsett Co aalLam haveaa.InaltLiate7ilyhmuarrepblicy Comp Coageorns&b lWnala1 YES NO ha Ig validpo?4 sametotheoflxa YES � lf3uthawd�edodYES,Pleascuxbc drtArOfw by VSURANCE BOND OTHD2 (PleaseSpeafy) EVirafim Date GALL Es6rn&d Vak eofl�c�a1 Wotk $$ hD Rougjl FRtal !RMNAME /4r e `LU-)� � / IL _ LicawNO 3 Z z1K, 3 Bt>srmTel.No. ( J/) 5�-�-, — t-t:/y!>CiICN //yt F P/ Ah Tel NO.. JVNERSINSURANCE WANER;Iamawatedmtdelkemdoes nothave-the unsuanoecovetageoritsst tantialegtrivale>tastegttitadbYMassacln tsGalaalLaws 3thatmysigmmOonthisl�mMVphcationwaivzsthisregttitea imt. lease check one). Owner Agent Igna ure ocanTelephone No. PERMIT FEE �A96 er or gen .5a ,�6L\ •W......�. • 1 %A jourvt;1M rMrrLi.#A i iun r%jn rlartmr i I v uv r&.v+mrurrw Print or Typal NORTH ANDOVER, , Mass. Date Buliding Permit * - location Owner's Name New ❑ Renovatlon Replacement ❑ Plans Submitted: Yea ❑ No. ❑ FIXTURE$ ......... — Check one Certificate Installing Company Name . /% c /-/o.���yC ,,�i L� Com. _w.._ 16 7 C - --- Address Via. - �� S� 7 - ❑ Partnership - /�/%..._. ❑.Firm/Co._ Business Telephone CrDk" '6x ..Name of Ucensed Plumber INSURANCE COVERAGE: ChacK I have a current liability Insurance Icyor No substantial equivalent Yea No,C] It you have checked ease fcate he t y". W type coverage by checking the appropriate_ box A liability Insurance "`poley Other _ ce _ type d Indemnity ❑ Bond OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the-insuranca coverage -required by Chapter 142 of the Mass. General Laws, and-that_my signature on this permit appllcatlon :waives thla:,requlrement..:- F: Check one:- ... _._ Owner p: - _Agrnt, p --.�,� iture of Owner or Owners Ment m ( hereby cerilty that aM ofthedetails and Informatlon.l.haveywAxrAted for entered) In above appkatkm are.true and-.aacwate.lo a be _ .1h_ diol fl?y:, f- knowledge and that all plumbing vrork and installations pertormad under the permM laswd log Ws appkatlon will -ba in oornpAancevrilh aH perilneni provisions of the Massachusetts Stale Plumbk-q Code and Chapter 142 of lbs General Laws. gY ,a....� 7 s,. Tule SigSignature Lkense Number 2S 2a--- Ar'1 LIVED (OFFICE USE ONLY) Type of �a^�^q lJa^ve Master ®/ Journeyman ❑ r V 19 s <" M �Jr Z M t N aL s~• SZt ~ N i Q 4 s .j ~'I N Z N 1-tl s�r N 1! < M all K _ s r O D S 0et e) !< y O s, _ a O at ' L r<, A J Is O tilX J 44 �.. •a-tie—veMT. BASKMIKMT IST FLOOR -12110 FLOOR >1R0 FLOOR 41THFLOOR _ sTH FLOOR OTH PLOON. : - F'TR FLOOR sTHFLOOR — Check one Certificate Installing Company Name . /% c /-/o.���yC ,,�i L� Com. _w.._ 16 7 C - --- Address Via. - �� S� 7 - ❑ Partnership - /�/%..._. ❑.Firm/Co._ Business Telephone CrDk" '6x ..Name of Ucensed Plumber INSURANCE COVERAGE: ChacK I have a current liability Insurance Icyor No substantial equivalent Yea No,C] It you have checked ease fcate he t y". W type coverage by checking the appropriate_ box A liability Insurance "`poley Other _ ce _ type d Indemnity ❑ Bond OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the-insuranca coverage -required by Chapter 142 of the Mass. General Laws, and-that_my signature on this permit appllcatlon :waives thla:,requlrement..:- F: Check one:- ... _._ Owner p: - _Agrnt, p --.�,� iture of Owner or Owners Ment m ( hereby cerilty that aM ofthedetails and Informatlon.l.haveywAxrAted for entered) In above appkatkm are.true and-.aacwate.lo a be _ .1h_ diol fl?y:, f- knowledge and that all plumbing vrork and installations pertormad under the permM laswd log Ws appkatlon will -ba in oornpAancevrilh aH perilneni provisions of the Massachusetts Stale Plumbk-q Code and Chapter 142 of lbs General Laws. gY ,a....� 7 s,. Tule SigSignature Lkense Number 2S 2a--- Ar'1 LIVED (OFFICE USE ONLY) Type of �a^�^q lJa^ve Master ®/ Journeyman ❑ 1 s� Date .3.:. f �: N2 2851 H�R7M �'<.�•_� •'�o TOWN OF NORTH ANDOVER ° p PERMIT FOR PLUMBING 1SSACMUSfct This certifies that .. :- .. .... � ........ .......... has permission to perform ....I�!y.° `! ............ . plumbing in the buildings of ... 1(. C' .. h xr !Z ...... ,2 at ..30.4?....t ? C a: - : ? :k" ...... North Andover, Mass. k.. Fee Lic. No.. . .. .................. ..... . PLUMBING INSPECTOR 03/18/% 11:49 125.00 PAID WHITE: Applicant. CANARY: Building Dept... PINK: Treasurer ..t GOLD File r MA- SACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTIN(3 '�•� (Print or Type) NORTH ANDOVER Mass. Date , A=3 building Location c�c:a,�itlrl%�,t1 c�'7� Permit # Owners Name )&r/5 e. °i New Renovation Replacement Plans Submitted �] FIXTIIR! c (Print or Type) Check one: Certificate ' Installing Company Name �,� c'c��wlc.g C ��or a? P • %t� Address Partner. F-1 Firm/Co. t Business Telephone: 6�y- Name of Licensed Plumber or Gas Fitter \%4 -r zA7 XI' Insurance Coverage: Indicate the type of i.isurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Q Bond Insurance Waiver: I, the undersigned, have been rnade aware that the licensee of this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner Ll Agent n 1 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 al! plumbing work and tnstaUations pctfomud under f ermit itsued lo.- this application will be to compliance with aA peiUnrnt provisions of tho Massachusetts State Gas Code and C6aptet 142 of the Genual Laws. M Title City/Town: APPROVED (OFFICE USE ONLY) YPE LICENSE: Licensed Plumber Plumber S' � ature of Master Plumber or Gasfitter Journeyman - License Number w tri m N oc to as cr p v nC� U x N F' cc i tri H �t 10 w N to F x to 1s -e a: z 7 Q t - LU d tc N M t3 N w f- d w x W O F- O 0 0 W > f- `t N W W W x V w x aW a7 . d a a t Q t- W x C11 cc z 4 w cc W f, w yr am ? — �' a -j i-- z ,tu > C W J z Q M o ra d O O w > _ o w H a z o c� Y u. to ,1 v rx SUsI—QS..1T. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR TTH FLOOR STH FLOOR (Print or Type) Check one: Certificate ' Installing Company Name �,� c'c��wlc.g C ��or a? P • %t� Address Partner. F-1 Firm/Co. t Business Telephone: 6�y- Name of Licensed Plumber or Gas Fitter \%4 -r zA7 XI' Insurance Coverage: Indicate the type of i.isurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Q Bond Insurance Waiver: I, the undersigned, have been rnade aware that the licensee of this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner Ll Agent n 1 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 al! plumbing work and tnstaUations pctfomud under f ermit itsued lo.- this application will be to compliance with aA peiUnrnt provisions of tho Massachusetts State Gas Code and C6aptet 142 of the Genual Laws. M Title City/Town: APPROVED (OFFICE USE ONLY) YPE LICENSE: Licensed Plumber Plumber S' � ature of Master Plumber or Gasfitter Journeyman - License Number o Ia �- Date... TOWN OF NORTH ANDOVER of 91, F� g�ti�co ,ei6 Op PERMIT FOR GAS INSTALLATION ,SSAc MUSES This certifies that.z s ` has permission for gas installation in the buildings ofa ... . . at ........ . , North Andover, Mass: Fee . t:a::'? z Lic. No. •.., ..................... . GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) I x NORTH ANDOVER,—, Mass. Date ('— / .._Iii �3 BiAding,+ Permit Location �O C� i I'e W S Name s dL' REM New ❑ Renovation Replacement ❑ Plans Submitted: Yes ❑ No ❑ A—Z79, _/, / FIXTURES Installing Company Name (� A C -S 12 WL -')'C- -CS Address &(? L ST-r)2S . SA e -v tri, H. Business Telephone li?1 3 iP fc %F Name of Licensed Plumber Fy&,�K r'YA u+ t" Check one: ❑ Partnership ❑ Firm/Co. INSURANCE COVERAGE: Checx orle I have a current Ilabltlty Insurance policy or Its substantial equtvatent Yes ❑ No ❑ It you have checked y", plessse Indi ie the type coverage by checking the appropriate box A liability insurance policy LAY Cther type of indemnity ❑ Bond ❑ Cartfficate /oa OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 112 of the Maas. General Laws, and that my signature on We. permit,applicatlon waives this requirement. Check one: SlonOwner ❑ Agent ❑ state of er a Owners ent 1 hereby cattily that all of the details and Information I haw submitted to entered) to above app8caLkm we true and acurrale to the best of my knowledge and that aA plumbing work and InstaAations performed under the foe this as will be in Rana with aA pertinent provisions of Lhe Massachusetts State Pfumbing Made end Msptw 11 of t3enerat Laws. AF'f'i1CMD (OFFr—E USE ONLY) Signatme W Licensed Pkmnbw License Number /0 6 y3 Type of Ptunbing lkansa: Master Journeyman 0 w s w • s• s t�t s at f✓ � w_ A � w s a?a r O �: s w w H F V ` w= < MIL a s` U s r s• O O w < w Y• t! /• s w r X w O t J s Q f a O d L V .9 31 11� 1' i : p ! 44 = s s1 F s t a• 1 OIL i O M O ' O °�o $j x o sua—toNT. aAtalaaRT taT FLOOR :HO FLOOR SAO FLOOR 4TH FLOOR aTH FLOOR STT( FLOOR. TTHFLOOR •THFLOOR — Installing Company Name (� A C -S 12 WL -')'C- -CS Address &(? L ST-r)2S . SA e -v tri, H. Business Telephone li?1 3 iP fc %F Name of Licensed Plumber Fy&,�K r'YA u+ t" Check one: ❑ Partnership ❑ Firm/Co. INSURANCE COVERAGE: Checx orle I have a current Ilabltlty Insurance policy or Its substantial equtvatent Yes ❑ No ❑ It you have checked y", plessse Indi ie the type coverage by checking the appropriate box A liability insurance policy LAY Cther type of indemnity ❑ Bond ❑ Cartfficate /oa OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 112 of the Maas. General Laws, and that my signature on We. permit,applicatlon waives this requirement. Check one: SlonOwner ❑ Agent ❑ state of er a Owners ent 1 hereby cattily that all of the details and Information I haw submitted to entered) to above app8caLkm we true and acurrale to the best of my knowledge and that aA plumbing work and InstaAations performed under the foe this as will be in Rana with aA pertinent provisions of Lhe Massachusetts State Pfumbing Made end Msptw 11 of t3enerat Laws. AF'f'i1CMD (OFFr—E USE ONLY) Signatme W Licensed Pkmnbw License Number /0 6 y3 Type of Ptunbing lkansa: Master Journeyman 0 �._....,;r. ...� v-�... .:.,}�I,4. :.1-'r-�6'�"«+�da"-..lw:.•dw+w►`.�.r-_ .--�'�-•--y�`_'�.'-rir ro.`ra...::�.y�Y�.ce�+-. --. _ _� s- �. a Date..�d NTP 26156 NOR71 <•�•° •'"o TOWN OF NORTH ANDOVER do ' PERMIT FOR PLUMBING SSACMUS� This certifies that �J has permission to perform .. ... ...• ........... plumbing in the bui dins of ..�. ........... .. . . e at . (/Z7... ... .. t North Andover, Mass. Fee . ��Lic. No. , ......................:...... . PLUMBING INSPECTOR 0/20/95 16:01 80.00 PRI➢ WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File No 2096 + 0 "SACHU Date/ A? 0 ......................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ... Z ... . ............................... has permission to perform ....... j yf wiring in the building of .... .................... at.. North Andover, Mass. Fee//02— .............. Lic. No4V .. ............... .�4 ........................................... e�ELECTRICALINSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer �\ ThEOOWOAWE4L2HOFAUMMUSE77N Office Use only DFPARTAfIVT0FPUBLICS4= Permit No. 9� BOARD 0FFIREPR&E%M0NREGUL4TI0NS527CMR12.00 Occupancy & Fees Checked APPLICATIONFOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 cMR I2:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 01/11/00 Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below Location (Street & Number) 300 WILLOW ST. EXECUTIVE CENTER Owner or Tenant CHANNEL BUILDERS Owner's Address 355 MIDDLESEX ST. WILMINGTON. MA. 01887 Is this permit in conjunction with a building permit: Yes a No [Z] (Check Appropriate Box) Purpose of Building OFFICE BUILDING Utility Authorization No. 0000? Existing Service 1200 Amps 480/ 277 Volts Overhead Q Underground M No. of Meters f New Service Amps / Volts Overhead Underground Q No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Poo_ I Above Below Generators KVA groundground No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Btimers FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total 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 ® Municipala Connections Other No. of Dryers Heating Devices KW— No, of Water Heaters KW No. of _ No. of Signs Bailasis No. H),ro Massage Tubs No. of Motors Total HP OTHER REPLACE MAIN BREAKER TRIP UNIT AND CURRENT TRANSDUCER UNIT kwa=Caaage Rou3tiothem4mantnisdNbm6selsCknedLaws Ihawaa=tLmbibiyIna==PobcymAxhtgCan#�&Co. a critssksWntiale*Miat YES NO lhme%hnt>edvalidp o(bfsametotheOlireYES M NO ®— If)Doha%ediedWYFS,pkmi dc&thetAvofwmaWbydcda>gtim aocica bcnc. II,&AR M BOND ® OSII-ER M (Pf . Specify) 03/31/01 Wak to Stt 01/15/00 h>Spmtiw DAeRaWesWd Sighedu rda-TiePenaltiesof FIRMNAME PIQMTE AND HOWARD ELECTRIC tNxmonLm Estimated Vakredl l Wait $ Rao Fatal 01/15/00 SERVICE,®INC. MR392 Lica ROBERT B. HOWARD Sigran � ��� „- -i✓ �LioarseNo M d,3'?"l, BusimTdNa 978-685-6145 ams 59 AMES ST. LAWRENCE, MA. 01841 AItTeLNa OWNER'S INSURANCEWAIVER;I.ama�N=ttratheLa=lsedaespot t +etheiamra�oeoaelageorBssil ialaglrivalez>tasue�madby da GaulLaws and tientmysignAwalthepermitapp onwaiAsthismquimnert. (Please check one) Owner ® Agent 13 Telephone No. PERMIT FEE $ // D Date.: � � ..".�� N2 4556 TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING This certifies that . I)-.. t"(.� %% //` . .,- has r has permission to perform plumbing in the buildings of. 1), t ............................ at ..3 �0...�! .� .� �.�-� ... r. � ...... . • .orth Andover, Mass. Fee . :?,..... Lic. No. . ...... ........ PLUMBING INSPECTOR Check # / -ne WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING �(r t or Type) Mass. D�AWner's 4- Permit # LS^�, Building Location Name I V EAUTypeccur3ancv PM11 trlh f New ❑ Renovation ❑ FIXTURES -1j Plans Submitted: Yes ❑ No ;Y - z I N F- rn N o z O Y z03 Q !- W z¢ Q z O J y W N z cn S N ¢ H S U X — < (n 0 U. z U ¢ W ¢ O m ¢ y < W y } ¢< a l... N W z — C o a a m= (7 Q oc F Y d O¢ f' < X >!t- O w F- 2 Z < } Y J G] vI c Q ...1 S t- M LL a = 0 < SU8—BSMT, BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR dTH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR -Installing Company Name (�� (-t i4`�t Z Address E, LaS 09/� art f�� /-J cz--w r"� vvk tet- ® Z 4� �3 Business Telephone (��, r R) Z` -1-c -55� Name of Licensed Plumber ''I I K,,--- i'M C,- n AA a^'� � N W W d ¢ ¢ Z y d T a 3: X CL ¢ 0 Q J W u ¢ V Y lit 0 U C O a F- 3 =I0 o Check one: ❑ Corporation ❑ Partnership ❑ Firm/Co. Certificate 73 9 INSURANCE COVERAGE: I have a Yes curr,nt liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. I fe checkedyes. ❑ Y.. Please indicate the type coverage by checking the a liabilitynsurance policy' appropriate box. Other type of Indemnity ❑ Bond ❑ INSURANCE WAIVER: I am aware that the licensee does not have the insurance 42 of the Mass. General Laws, and that my signature on this permit application waives this re uirement coverage required by Check one:qOwner or Owner's Agent Owner ❑ Agent ❑ 1 hereby certify that an of the details and information 1 h wedge and that all plumbing work and installations Pertinent provisions of the Massachusetts State Plumbir BY Title —/ nal entered) in above application are true and accurate to the best of my XAe the Permit issued for this application will be in compliance with all 142 of the General Laws. QWTown Type Of License: Master Journeyman [j APPt1d1IED (OFFI US NL17 License Number % % °7 N° 1816 O , Date.:.%,........... TOWN OF NORTH ANDOVER PERMIT FOR WIRING Q Q CIL This certifies that......L✓�... ....................... has permission to perform .-� �-t /J wiring in the building of . ...... .................... m at ..S. ?au ......%(� .�,� f. ................ .North Andover, Mass. o Fee l `� . '......... Lic. No.111 o ...... ? '. <� .....: !. - �..� ....... JEL'ECI'RICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Service C114t: Qlam unwealt4 of AasBBC4UStns Department of Public Safety BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Final Office UseAOnly J Permit No. � V I " �h D% Occupancy & Fee Checked I�U 3/90 (leave blank) .APPLICATION FOR PERMIT TO PERFORM- ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat �s City or Town of k29 � To the Inspector of Wires) The undersigned. applies for a permit to perform the electrical work described below. Location (Street & I Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: lYes L No L=�-' r (Check Appropriate Box) Purpose of Building rinlerz��!��y t'"� �l//Q���N(yG�� Utility Authorization No. �9ee`er f .3 `9 1 Existing Service Amps Z77 Volts Overhead ❑ Undgrd L --I No. of Meters _ p New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity � B Location and Nature of Proposed Electrical Work OTHER: 1 INSURANCE COVERAGE: Pursuant to the requirements of Massachusttes General Laws I have a current Liability Insur ce Policy including Completed Operations Coverage or its substantial .equivalent. YES C496 G I have submitted valid proof of same to this office. YES IK NO U , --,, If you have checked S, please indicate the type of coverage by checking the appropriate box. INSURANCE l._! BOND ❑ OTHER❑ (Please Specify) Estimated Value of Electrical Work $ - pQ� (Expiration Date) Workto Start "71 71� � Inspection Date Requested: Rough Final 20 oa—// Signed under the pe allies of perjury: y FIRM NAME �r� e���[/ LIC. NO. ,DII Licenseep, Signature1 r LIC. NO. Address Cf/!/T 0 �3 Bus. Tel. N,!W �I��q ' r ! -7 Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) ( 1 Telephone No. PERMIT FEE � (Signature of Owner or Agent) y J TOTAL No. of Lighting Outlets No. of Hot Tubs No. of Transformers KVA No. of Lighting Fixtures 2 Above Swimming Pool grnd. In - ❑ 9md. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners No. of Air Conditioners Heat Total No. of Pumos Tons 5 ace/Area Heating Total Tons TotafNo. K`vv KW r FIRE ALARMS No. of Zones No. of Detection and Initiating Devices of Sounding Devices. No. of Self Contained Devices Municipal ❑Other No. of Ranges No. of Disoosals No. of DishwashersDetection/Sounding No. of DryersLocalL. Heating Devices KW Connection No. or No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: 1 INSURANCE COVERAGE: Pursuant to the requirements of Massachusttes General Laws I have a current Liability Insur ce Policy including Completed Operations Coverage or its substantial .equivalent. YES C496 G I have submitted valid proof of same to this office. YES IK NO U , --,, If you have checked S, please indicate the type of coverage by checking the appropriate box. INSURANCE l._! BOND ❑ OTHER❑ (Please Specify) Estimated Value of Electrical Work $ - pQ� (Expiration Date) Workto Start "71 71� � Inspection Date Requested: Rough Final 20 oa—// Signed under the pe allies of perjury: y FIRM NAME �r� e���[/ LIC. NO. ,DII Licenseep, Signature1 r LIC. NO. Address Cf/!/T 0 �3 Bus. Tel. N,!W �I��q ' r ! -7 Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) ( 1 Telephone No. PERMIT FEE � (Signature of Owner or Agent) y J N2 19-58 4 Date ._&"2.-. TOWN OF NORTH ANDOVER PERMIT FOR WIRING X,' 7-- Thiscertifies that ... A .­­ .............................................................................. has permission to perform ............... ....... f / .......................................... wiring in the building of ....................................................... at . .n ............................... .......... I .. ............. . ..... North Andover, Mass. ......... L i c. N o .............. ... Z&::a:.':...,................ ej�/ --__ ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer y f W No. of Disposals No of Heat Total Pumps Tons Total KW No. of Sounding Devices (96mmunwealt of Ma5gar4t1gelfg Office Use Only Permit No. 'EltjJartintnt of Vublic bufttjj Occupancy A Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3190 Peave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date /a -/ 9- 9 9 City or Town of /f/o.er.-/ QAuoat/EIP— To the Inspector of Wires: The udersigned applies for a permit -to perform the electrical .work described below. Location (Street & Number) Soo W, t 1 o w S- e-G(ET Owner or Tenant M.D.E. f N C tyvra Llarsagfi" a io Owner's Address (978) 6 8.Z -6576 Is this permit in conjunction with at building permit: Yes ❑ No Z (Check Appropriate Boz) Purpose of Building - Utifity Authorization No. Existing Service Arnpa . P Voils Overhead Undgrnd ❑ No. of Meters New Service Amps _ / Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above In- gend. ❑ grnd. ❑ Generators • KVA No, of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners a Battery Units No. of Switch Outlets No. of Gas Burners `e FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total tons No. of Detection and Initiating Devices y f W No. of Disposals No of Heat Total Pumps Tons Total KW No. of Sounding Devices No. of Sell Contained No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices . No. of Dryers Heating Devices KW Local Municipal ❑Other ❑ Connection No. of Water Heaters KW No. of No. of Signs Ballasts ow Voltag Wiring tyvra Llarsagfi" a io "1 a7. Oi iui6tCr$ TOW. C:P OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws 1 have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES i=: NO ❑ ' I have submitted valid proof of same to. the Office. YES ❑ NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE C BOND. G OTHER ❑ (Please Specify) o a (Expiration Date) Estimated Value of Electrical Work S�� Work to Start- /D - ' 99 Inspection Date Requested: Rough Final Signed undor•the Penalties of perjury: FIRM NAME, - UC. NO. �- Ucensee _ T)nfia 1 d A- Aronks Signature Address 111 Morse Street, Norwood. MA rlon Ali. Tel. No. No. —real 278 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the Insurance coverage or Its substantial equivalent as re-. quired by Massachusetts General Laws. and that my signature on this permit application waives this requirement. Owner Agent (Please chock one) .00 Telephone No. . PERMIT FEES . (Signature of Owner or Agent) _ x•05+35 Locationzoo No. Date 7-70'v" koRTN TOWN OF NORTH ANDOVER ott,..o .�tio 0 p Certificate of Occupancy $ A Building/Frame Permit Fee $ cMu.:Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ vs Building Inspector Div. Public Works PERMIT,NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. V PAGE 1 MAP +40. 0250 LOT NO. 27 2 RECORD OF OWNERSHIP IDATE (BOOK PAGE ZONE Ind. 1 I SUB DIV. LOT NO. I LOCATION 300 Willow Street PURPOSE OF BUILDING Mani fac 1 1 t� r mg/Qf f i ce OWNER'S NAME Executive Center Limited Partnership NO. OF STORIES 1 SIZE 50 800 S.F. OWNER'S ADDRESS 242 Neck Road Haverhl I I , MA. 01835 BASEMENT OR SLAB Slab _ ARCHITECT'S NAME Jam s Bourgeois SIZE OF FLOOR TIMBERS IST 2ND 3RD ,I BUILDER'S NAME Channe I Bu 1 I d 1 m Comapny SPAN _— DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES - SIDES REAR GIRDERS AREA OF LOT 15. 73 Acres FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW No SIZE OF FOOTING X IS BUILDING ADDITION No MATER:AL OF CHIMNEY IS BUILDING ALTERATIONYeS IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER Yes BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER Yes IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS" ki �Ldp SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 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 VXTE FI D /7 ^ �� IGNATURE OF OWI(ER-OR Ab'rHORIZED AGENT FEE - PERMIT GRANTED 19 w!i', i 91; 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST $ 8 5, 0 0 0. 0 0 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY OUILDING INSF[CTOR OWNERTEL.# (508) 373-3000 CONTR. TEL. # ( 508) 373-3000 CONTR. LIC. # 056236 H.I.C. # 77 �oo54 BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES MULTI. FAMILY OFFICES APARTMENTS _ CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH d I 2 13 PINE HARDW D PLASTER CONCRETE CONCRETE BL'K. BRICK OR STONE PIERS DRY WALL _ _ _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T AREA 1/1 1/1 1/1 FIN, ATTIC AREA N_O B M T FIRE PLACES _ _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B _ 1 22 f I_ 3 DROP SIDING WOOD SHINGLES CONCRETE EARTH ASPHALT SIDING ASBESTOS SIDING HARD1!J'D COMMCN VERT. SIDING _ ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 8 FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. WIRING STONE ON MASONRY _ STONE ON FRAME SUPERIORPOOR ADEQUATE I� NONE 10 PLUMBING 5 ROOF GABLEHIP - BATH (3 FIX.) GAMBREL MANSARD TOILET RM. (2 FIX.( FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR 8 GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. 6 COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING _ RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _t 10 13rd ELECTRIC I 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. Please see attached floor plan dated June 27, 1999. F'"g?,'Ix HM �!,o r s.I� x Q d O W V) U Z w° U w O U w w O U w a U 0c cn w p U � d w z w W we z ci) v Ca cn '° ujN M O z :W `CtCAO y V) Cc C �� O O_ C Cc eiC- R O CD R �L E a v� :mom �o CD co �4'om O oCC,, C Dcm O :mom mRcl CIOU 0 z 3 s N ` 'R Qs m J y a - y R O W �\ m m o rn Cdr y m m CC co a, CD m O � �•�Z O o c � c_ H' y m CD C C _ m p N F- o aoH m .r c � •N 2D aL R R c O F- H - Z cr- =, m N O U p C Q m CD.— C/� d •- O� J = eyv O N •_ 0 06, CO ►-V M U G� O C L Cl }� V 0 0 Z �• O CO) o � CO c _ c CA C •Coo CL) E m m CD O CD CD O � CL) O 0 O L m O d CL r" Q CO) C C3 cc C V J 10 CD C CD 0 U � cc cc COD =�_=�`— The Commonwealth of Massachusetts �.IT` =y( Department of Industrial Accidents -, olflee of/ndestigaUons 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit NOW nam Executive Center Limited Partnership location: 242 Neck Road Haverhi I I MA 01835 Phone# (508) 373-3000 I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity y. (2 I am an employer providing workers' compensation for my employees working on this job. Channel Bu:i I d i ng Company addres • 242 Meek Road city: Haverhill, IVA 01835 phone #• (508) 373-3000 insurance co Aetna/Casualty & Safety Company otic # 0024994991 P Y mom, I am a sole proprietor, general contractor, or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation polices: company name: address: cityphone.# insurance co P olicv # c m a address:- city: phone #• insurance co policy # Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of $100.00 a day against me. I understand that a copy of this statement may be forwarded. to the Office of Investigations of the DIA for coverage verification. I do herebv c tjy and the n nddpp naltie of perjury that the information provided above is true and correct � � f :7 July 7, 1996 Print name Ni cho 1 as J. An4agna Jr. Phone # ( 508) 373-3000 official use only do not write in this area to be completed by city or town official city or town: O check if immediate response is required contact person: Irevtsed 3/95 P1A1 permit license # riBuilding Department OLicensing Board pSelectmen's Office OHealth Department phone #; —Other L z?LLJ � ._._-�_; _._..gip16 N � N cr `e z~o`a ate. • ZW t8 .d Z ;Z U Q OIc n ¢ W 2 Qi Q P t/f LN LL Q O V W p° 7j U > Q uj= J a IL Z a tido W� oM o a� Wend Jcc z aQ0 W. wz0 Coen cj aiorac L - I. :._ .- W 0% ' o w F ®� z at WW_..' w N o � C N � N ZW t8 .d Z ;Z U Q OIc O Qi Q P t/f LN G f <MU z ° ! uJ O Ou4u.o a sr > W tsr Z z N s �a G .ZMJ ,LONG L.'.: b - 2 _ '• Z Z Q O V- G Z �Q ,yp �,4, W OO _wu _ Q� W 0% ' o w F ®� z at WW_..' w N o OFFICE OF BUILDING INSNF;C10R T114N OF NOR111 ANDOVER CONSTRUCTION CONTROL 1 ' PROJECT NUMBERS PROJECt' TITLE] A[ lenim Fuse 11 PROJECT LOCATION: 300 Willow Street NAME OF AUILDING: Executive Center NATURE OF PROJECI! Interior Renovations IN ACCORDANCE WITH SECTION 127.0 OF THE MASSACHUSETTS STATE BUILDING CODE, 1, -James Biurgeois Registration No. 4757 BEING A REGISTERED PROFESSIONAL ENGINEER/ARCIIITECT HEREBY CERTIFY THAT I.. HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, CUMPUTATIONS AND SPECIFICA— TIONS CON-CERNING: ENTIRE PROJECT ARCHITECTURAL U STRUCTURAL D MECIV01ICA.L FIRE PROTECTION p ELECTRICAL 0111ER (specify)= FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF NY KNOWLEDGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS HEFT THE'APPLICABLE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRACIICES.' AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AIND OCCUPANCY. I FURTHER CERTIFY TKAT I SHALL PERFORM THE NECESSAP.Y FROFESSIC1iAL SERVICES A11D BE PRESENT ON THE CONSTRUCTION SITE ON A RECULAR AJ1D PERIODIC BASIS TO DEIER11114E TIU1T THE WORK IS PROCEEDING 117 ACCORDANCE WITH THE DOCUMENIS AFPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOW114G AS SPECIFIED Ili .SECTION 127.2.2: 1. Pevies.+ of shop drawit7gs, samples and ether s� dttals of the contractor ®s required by the ne cc=trvcticn ca:tract dooi-,xo s as sur:dtted fcr >*.;ildileg peani,, and appra%al for ccnf Onto to the design ccncept. 2. P€view and approval of the quality ccq.t:vl Prxed=cs for all code—required centrolled materials. 3. Special architectural or engireerirg professiemlAnspeectlon of critical eonstrnr_tion ee'TCTpstS requiring controlled materials or construction specified in the accepted enSir*ering practice standards Iisted in Ap�dix B. PURSUANT TO SECTION 127.2.3, I SHALL SUBMIT WEr-KLY A PROGRESS REPORT TO TILER WITH PERTINENT COMMENTS TO THE NORM ANUUV1~t: 13UlLUlEi(; 1NSi'EC'i'UH. gyo�t UPON COMPL£TID4-0& !HE WORK, I SHALL SUBMIT A FINAL REPO T AS TO .TI S S COIiPLEIiQ:N. n:''S5 OF THE PROJECT FOR OCGUFAIICY• y=_ S1CtlA7 PE r SUBSCRJ$brl; ANDwSWO" 10 BEFORE HE THIS unx OF 19�(p Expires June 10,195 NOTAuv Vllit��ft`. `7 tic CUH!11551pi1 E7,1'IRES TOTAL P-01 Location _'300 tjz4-r_j No. Date �" c) TOWN OF -NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit.Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ z �' 1! ? S , Building Inspector 4 P 03/05/96 12:09 390.00 PAID �,.t`-9,579. ' Div. Public Works C ca rn (D mem Y U co U o CO z d 0 EI1 LL 0 U '00 m 00 a ¢0 m U CO N C Z CO C C N CO N U m 0 h � V ;IIT NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. S PAGE. MpP `00 LOT NO. 27 2 RECORD OF OWNERSHIP (DATEBOOK 1. iPAGE ZONE Ind. 1 SUB DIV. LOT NO. �- LOCATION 300 Willow Street PURPOSE OF BUILDING Manufacturing/Office OWNER'S NAME FXPr'llti Ve Center Llml tpd P NO. OF STORIES I SIZE 8nn R - f _ OWNER'S ADDRESS _ 242 Neck Rd. Haverh i I I MA 01 835 BASEMENT OR SLAB Slab ARCHITECT'S NAME Channel Building Co. SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME Channel Bu i I d i ng Co. SPAN DISTANCE TO NEAREST BUILDING Existing DIMENSIONS OF SILLS -- --_ POSTS DISTANCE FROM STREET DISTANCE FROM LOT LINES — SIDES REAR GIRDERS AREA OF LOT 15.73 Acres FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW No SIZE OF FOOTING X IS BUILDING ADDITION No MATERIAL OF CH14ANEY IS BUILDING ALTERATION Yes IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE - IS BUILDING CONNECTED TO TOWN WATER yes BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER yes IS BUILDING CONNECTED TO NATURAL GAB LINE yes INSTRUCTIONS SEE BOTH 61DES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 12 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 DATE SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE C39 d C!L * 144 8z7, f- ► grZs' PERMIT GRANTED 3 / 19�c"z 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST $30,000. EST. BLDG. COST PER SQ. PT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY ISUILOING INSPBcToF. 508-373-3000 OWNER TEL # CONTR. TEL # 508-373-3000 056236 CONTR. LIC. A N/A H.I.C. # 'FS -7q ____ 3 .�J BUILDING 41CORD 1 OCCUPANCY 12 INGLE FAMILY S1oulES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI FAMILY 1_ �oFFICEs LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. -WITH PORCHES. GA - APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. 14 I Fa 2 3 X96 t: I r i." W. Please see attached floor plan dated 2-21-96. CONSTRUCTION 2 FOUNDATION I— I 8 INTERIOR FINISH CONCRETE PINE d 1 2 13 _ _ CONCRETE 81 K. BRICK OR STONE HARDW D PIERS PIASTER DRY WALL UNFIN _ 3 BASEMENT AREA FULL FIN. BM'T AREA _ Y, '/e 1/. FIN ATTIC AREA N_O 8 M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN _ 4 WALLS I 9 FLOORS CLAPBOARDS 8 1 2 3 DROP SIDING WOOD SHINGLES CONCRETE CRETE EARTH ASPHALT SIDING ASBESTOS SIDING HARD", D COMI.nCN ASPH. TILE VERT. SIDING STUCCO ON_MASONRY _ STUCCO ON FRAME BRI N MASONRY ATTIC STRS. d FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR i .J POOR I- ADEQUATE I NONE 10 PLUMBING 11 5 ROOF GA LE HIP BATH 13 FIX.) BE MANSARD TOILET RM. (2 FIX.) _ EGAMBREL EA SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY KITCHEN SINK WOOD SHINGES SLAT1 NO PLUMBING TAR & GRAVEL STALL SHOWER _ _ ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE GADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM STEEL BMS. d COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H"T'G UNIT HEATERS 7 NO. OF ROOMS G OIAS L B'M T 2nd I., 13rd ELECTRIC NO HEATING 14 I Fa 2 3 X96 t: I r i." W. Please see attached floor plan dated 2-21-96. r �u Th e Common wealth of Massachusetts usetts flt 31995 Department of Industrial Accidents offlce 01IRMS119211OBS -7 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Executive Center Limited Partnership name: location: 242 Neck Road citv Haverhill, Ma 01835 phonc4 508-373-3000 C3 I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. company name: Channel Building Company address: 242 Neck Road city: Haverhill, MA 01835 phone #• 508-373-3000 insurance co,- Aetna Cbsuality & Surety Company 10y # - 0024994991 '1 � 111 � El M i1171111*.Ul�i� I � K,11�211 El I am a.sole proprietor, general contractor, or homeowner (circle one) and have hired the contractors listed below who have the following workers' compensation polices: company namc: citV nhone wo �2 C ompany name: address: ci1Y! -hone insurance co, policy FaI:iu_rerosecure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to $1.500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do h ce y ender e p and pontlt)t es of perjury that the information provided above is true and correct. 2-23-96 Signatured ir Date Print name Nicholas J. Ardagna, Jr. Phone # 508-373-3000 4,eofficial use only do not write in this area to be completed by city or town official city or town: permit/license # FlBuilding Department :7 CDLicensing Board C] 0 check if immediate response is required Selectmen's Office C]lfealth Department contact person: phone #; "Other I , --1 P) A ) D < LIJ IQ Ilk Z FM - 0 L cr (� ) 99' - — W cr a < r%j Lu i- z z W tJ Q. LL cp CC ©i v " LL LI z :li row-, SO 2 z C W) 2 U UGO uj Ix ww CL co ZIL a4 LL Z c UJZ a 0 CMVH LLJ z Li Z ur) < Z 2 0 IL w U) z uj w 0 U- r.1 8cow ci -4 IONG NO Ilk w 00 e"i Cff k.- c ,0 CO zF J 4 uj La`. C:) o cc W W T Q LL Z0 0 Ic U) < CY US 0 cy Ju C)b o L ZI Li vi LLI cr _ ; � M I FORM U VERIFICATION FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills opt this section***************** y'xEc. cIR. Cr,11-0_�N��s .P APPLICANT: 4`n C' lh4AMd JFv, k1,1 (,::r. Phone 3 7-? LOCATION: Assessor's Map Number Parcel �- Subdivision Lot(s) Street :3� ® lo"i SS%: St. Number ************************Official Use Only************************ RECOMMENDATIONS•OF TOWN AGENTS: Conservation Administrator Comments Town Planner Comments Food Inspector -Health Septic Inspector -Health Comments Public Works - sewer/water connections - drive ay, permit v Fire Department u "t Received by Building Inspector Date Approved Date Rejected Date Approved Date Rejected Date Approved Date Rejected Date Approved - Date Rejected Date •" OFFICE -OF BUILDING INSPECTOR TOWN OF NORTI1 ANDOVER x •, ; ..�_� CONSTRUCTION CONTROL _ 'PROJECT NUHBER! PROJECT TITLES Analog Devices Expansion PROJECT LOCATION: 300 Willow Street North Andover, MA - NAME OF BUILDING: Executive Center - NATURE OF PROJECTS Interior renovations INCCORDANCE_WH SECTION 127.0 OF THE MASSACHUSETTS STATE BUILDING CODE, 440 (01 P Registration No. BEING A REGISTERED PROFESSI109AL ENGINEER/ARCHITECT HEREBY CERTIFY THAT I,IIAVE PREPARED OR DIRECTLY SUPERVISED THE -PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICA— ..TIONS CONCERNING: ENTIRE PROJECT Q ARCHITECTURAL Ct/ FIRE PROTECTION ED ELECTRICAL Q STRUCTURAL 17-1 MECIUU41CAL Q OTHER (specify)ED FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF MY KNOWLEDGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE'APPLICABLE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE, ALL ACCEPTABLE ENGINEERING PRACTICES. - AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND BE i "PRESENT ON THE CONSTRUCTION SITE 01; A REGULAR A1ID PERIODIC BASIS TO DETEW11HE IHAT THE WORK IS PROCEEDI14C IN ACCORDANCE WITH THE DOCUMENIS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE -FOR THE FOLLOWING AS SPECIFIED IN .SECTION 127.2.2.- Review 27.2.2:Review of shop drawings, sarrples and other submittals of the contractor as required by time construction contract documents as subadtted for building pezmit, and approval for confornammce to the design concept. 2. Review and approval of the quality control procedures for all code -required controlled materials. 3. Special architectural or engineering prof essional.inspection of critical construction carpenents i, requiring controlled materials or construction specified in the accepted engineering practice standards listed in Appendix B. PURSUANT TO SECTION 127.2.3, I SHALL SUBMIT WCL• KLY A PROGRESS REPORT TOGETHER WITH PERTINENT COMMENTS TO THE NOR -111 ANDOVER: BUILDING INSPECTOR. UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPOR'AS TO THEE A ,.COMPLETION AND kEAbl9ESS,,, F THE PROJECT FOR OCCUPANCY. SIGNAiU i SUBSCRIBED ANIS SWORN TO BEFORE ME THIS r DAY OF 1996 NOTARY PUBLIC MY COMMISSION EXPIRES o.#4757 T/t 0If N a . 0 99 � eW :wvD tFi. s.1 x � o U W O W x w Q ac Z _ z zw z . v z C'' Z '� u w Q° USw co U c z O rr�-. H a w Q w z u cn Ca cn J Lo W o� z =o CO C �. s C � O O C a. O N O V V p_ C m C � O R i O m E¢ C.3 m y o O �c : N R :mm Ca.. O y CA m 3 m C� C CO C � m � C N m ' � N m J. m O mu � L o cm¢ mor V H Z C Q O N m C Q _ O.m w 3 � O O! -O r N mw V� M W C =::,O=:5 ti m � •N �dt m C cc E CJ C y W CD m CD c v� a co ca 2 ev .0 y m E- w a - m G NJ Ni CO O E O L � O fr V O co Z 0. O y D � C C CA 0 co •E = L O co co O i Co O L !� O Q CO2 O O CJ -J -C "O. O,CD c Z � 'O` v O •� C CC CO) 0 V Z Q a L V > C) O O � CO Q W s Cl)t: O LL Z O O W = Q O C. LL W C.) w A o U o a H z H� o wz a OO U o A o� 0 U 4)A U o WW x o:' s •t; =o y a hM04 � xx •♦y e CN o CD c c w o 0 C N O C R O ca V d'O ca cv c CD o L Cc C2 a� C', :Ea L • m C r O V m N om CD C .. :c L o m 3co � m C C � m � C N CQ N � m ►. E -o CD 0 _= o ca :om Vmy O cacc '� Z a O d. HCmC d W COO C ... c •- P Cc N -& .t O C ui E o C.,N CD oo� c CLW.- .- = 'o CD = W � i N •O E L CD N_ t N O N C O 75 cmCDs m O Cf C N d t y.r 0 Z 0 p :O U :W A • U co O E O L O �-+ v O co Z a O H CO CM 0 C CD I W :2 co , O �O •E m m i ~co a CO O i !D O a cQ C o � = C� CJ -J -o a CD zco Q CL L) y CO) is FA L R U w w p w Q w° cn w° cG° U w WczG ° n°' cn w a°' w 2 4 C/) U) o CD c c w o 0 C N O C R O ca V d'O ca cv c CD o L Cc C2 a� C', :Ea L • m C r O V m N om CD C .. :c L o m 3co � m C C � m � C N CQ N � m ►. E -o CD 0 _= o ca :om Vmy O cacc '� Z a O d. HCmC d W COO C ... c •- P Cc N -& .t O C ui E o C.,N CD oo� c CLW.- .- = 'o CD = W � i N •O E L CD N_ t N O N C O 75 cmCDs m O Cf C N d t y.r 0 Z 0 p :O U :W A • U co O E O L O �-+ v O co Z a O H CO CM 0 C CD I W :2 co , O �O •E m m i ~co a CO O i !D O a cQ C o � = C� CJ -J -o a CD zco Q CL L) y CO) is FA CERTIFICATE OF Distribution to: SUBSTANTIAL AO CWNER HITECT � COMPLETION iONDTRACTOR ❑❑ AIA DOCUMENT 0704 OTHER ❑ PROJECT: Ana I og Devi ces I I I ARCHITECT: James Bourgeois (name, address) ARCHITECT'S PROJECT NUMBER: TO (Owner) : Bayfield Development CONTRACTOR: Channel Bu i I d i ng Co. 242 Neck Road Haverhill, IA4 01835 CONTRACT FOR: LI CONTRACT DATE: DATE OF ISSUANCE: 4-1-96 —I PROJECT OR DESIGNATED PORTION SHALL INCLUDE: The Work performed under this Contract has been reviewed and found to be substantially complete. The Date of Substantial Completion of the Project or portion thereof designated above is hereby established as which is also the date of commencement of applicable warranties required by the Contract Documents, except as stated below DEFINITION OF DATE OF SUBSTANTIAL COMPLETION The Date of Substantial Completion of the Work or designated portion thereof is the Date certified by the Architect when construction is sufficiently complete, in accordance with the Contract Documents, so the Owner can occupy or utilize the Work or designated portion thereof for the use for which it is intended, as expressed in the Contract Documents. A list of items to be completed or corrected, prepared by the Contractor and verified and amended by the Architect, is attached hereto. The failure to include any items on such list does not alter the responsibility of the Contractor to complete all Work' in accordance with the Contract Documents. The date of commencement of warranties for items on the attached list will be the date of final payment unless otherwise agreed to in writing ARCHITECT BY DATE The Contractor will complete or correct the Work on the list of items attached hereto within days from the above Date of Substantial Completion. CONTRACTOR BY DATE The Owner accepts the Work or designated portion thereof as substantially complete and will assume full possession thereof at (time) on (date). OWNER BY DATE The responsibilities of the Owner and the Contractor for security, maintenance, heat, utilities, damage to the Work and insurance shall be as follows: (Note—Owner's and Contractor's legal and insurance counsel should determine and review insurance requirements and coverage; Contractor shall secure consent of surety company, ii any.) AIA DOCUMENT G704 • CERTIFICATE Or SUBSTANTIAL C010PLETION • APRIL 1978 EDITION • AIA` m 107n . Tier ,.,— - — ...1.1.E _. a SEP -11-1996 10:23 THOMAS E. t-,IEVE Apusm -eft, Aw— -mm C&fg; 1"c'm iEW WAVOWS PAO"S&MaAL mua-,*#G aar Oto mosilom AQW "UP-JFIQZ.MA Olt" TO ML�en Surrette, —Elder_ North Andover Blg, LQ�t, 120 main Street. North Andoygr, MA 0154 THE POLLONVING WAS p40TE3 REPORT 4 e --- FouTidations st-ructural steel Mascnry Plumbing Fire Prate c tion Eiectzical lntez4-Qr- Finishes .0 -F -r p i r:1 -,'n P. P. 02 3 Allergan Fit. --up TiON 300 Willow Street Channel q��TL 71 SITE TOTAL F. 02 SEP -11-1996 10:" THUIAS. E. F.IE'.)E HS'.SIOIC. ma AM 16 WW MEADOWS PMQF=40NAL KADW. 4470WSON ACAO T0PWmLbJWACI"3 (50$)887-8585 TO MiJ<en Surrette, "19 North Anclove 120 Main street North Apdove�, YlA 01 .4� A, A Allergan Fit--vt) LCCA I if -IN 300 Willow Street Channel � / WEATHE_ UK-) Pl A 91:11SIRT 7A T S i T TIE F(DUOWNG WAS NCTED REPORT I 8_:_te---- Foundations Struct-ural Stee"4 M a s a n r v v Fire Protection HVAC c Electrical lnte,t7ior Finishes tv Roof. &-Exterior Finishes v P. 011 Div. Public Works `Z�c•� Location�� s No. Date 9S� � t of H° RT ; +, o TOWN OF NORTH ANDOVE a ; p Certificate of Occupancy $ �' Building/Frame Permit Fee $ ..Foundation Permit Fee $ -Other Permit Fee $ Sewer Connection, Fee $ Water Connection Fee $ ,TOTAL $ 3 to — .„.!, Building Inspector Div. Public Works X22. f APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OL ATTACHED GARAGES MUST FO 1 PLANS MUST BE FILED A p A C DATE Fd LED , SIGNATURE OF OWNER CYR A INSTRUCTIONS BUILDING ATE FIRE REGULATIONS BUILDIW. INSPECTOR F E E C -4PL-W . 5-b PERMIT GRANTED PAIst1.9's- 3 s s- L 740 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST �D Q� EST. BLDG. COST PER SQ! FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY OWNER TEL. # 73 — 2000 CONTR. TEL. # 3 73 -'3Q cid CONTR. LIC. # 03f 77a H.I.C. # LOT NO. 2 RECORD OF OWNERSHIP DATE BOOK ;PAGE ZONE SUB DIV. LOT NO. I LOCATION, Few -!5--r S a���l 7 PURPOSE OF BUILDING OWNER'S NAME C-xF-�� Cl g. L ,"rp ,•/�JOt I`arA,l(I�,�„ pWLrV � NO. OF STORIES SIZE OK�NER'S ADDRESS ��q N���u /��• l��J BASEMENT OR SLAB i / ARCHITECT'S NAME C%/19NNCZ- IS U) LPIAle- SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME /L4n NA/Lr'�, (301 `D)N SPAN - DISTANCE TO NEAREST BUILDINGf�1���` C !f— DIMENSIONS OF SILLS -_ --- _ POSTS DISTANCE FROM STREET DISTANCE FROM LOT LINES — SIDES REAR GIRDERS AREA OF LOT FRONTAGE _.HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW A)Q SIZE OF FOOTING x IS BUILDING ADDITION �® MATER:AL OF CHIMNEY IS BUILDING ALTERATION X-1 IS BUILDING ON SOLID OR FILLED LAND C l 7 WILL BUILDING CONFORM TO REQUIREMENTS OF CODE P IS BUILDING CONNECTED TO TOWN WATER f BOARD OF APPEALS ACTION. W ANYLk IS BUILDING CONNECTED TO TOWN..SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE l SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OL ATTACHED GARAGES MUST FO 1 PLANS MUST BE FILED A p A C DATE Fd LED , SIGNATURE OF OWNER CYR A INSTRUCTIONS BUILDING ATE FIRE REGULATIONS BUILDIW. INSPECTOR F E E C -4PL-W . 5-b PERMIT GRANTED PAIst1.9's- 3 s s- L 740 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST �D Q� EST. BLDG. COST PER SQ! FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY OWNER TEL. # 73 — 2000 CONTR. TEL. # 3 73 -'3Q cid CONTR. LIC. # 03f 77a H.I.C. # BUILDING RECORD 1 OCCUPANCY 12 i SINGLE FAMILY S-ORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES _ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES, GA - APARTMENTS I RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. @LA. 22`��>-- T 7-,�p `` ,g LL CONSTRUCTION 2 FOUNDATION CONCRETE CONCRETE BL K. BRICK OR STONE PIERS _ $ INTERIOR 3 PINE HARDW D PLASTER DRY WALL UNFIN. FINISH 1 2 13 _ 3 BASEMENT AREA FULL FIN. B'M'TAREA _ '/. 1/1 3/. FIN. ATTIC AREA NO B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN _ 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 �_ _ DROP SIDING CONCRETE EARTH WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING VERT. SIDING STUCCO ON MASONRY _ HARDV✓'D COMMCN ASPH. TILE STUCCO ON FRAME _ BRICK ON MASONRY BRICK ON FRAME CONC. OR CINDER BLK. ATTIC STRS. 8 FLOOR _ WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR I=i POOR ADNONE EQUATE _ 5 ROOF 10 PLUMBING GABLE I HIP BATH 13 FIX.) _ GAMBREL ,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 I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM STEEL BMS. 8 COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING ` RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ 10 13rd ELECTRIC I NO HEATING _ @LA. 22`��>-- T 7-,�p `` ,g LL P H d w c O as i'.2 v C/) u L1 cn z p w z z A ] .� V C 7 w CO O= ,. C U C w O w z z � Cr u: C w' a z x �'•'� W i 0 CG z C r% c U P H d w c O as C c � T1 O w v C/) u L1 cn z p w z z A ] .� V C 7 w CO O= ,. C U C w O w z z � Cr u: C w' a z x �'•'� W i 0 CG � > cn C r% c U Z P4 C [£ w A W 1.1 Qi r� L 6J L cn ^L O cn V J Q o z E m c LL - o � o cc LU Z � _ C O N c CA co cm z z w I C O •� Q CS M 'E O O m m uj cn z :mom L� = O.0 :o co i O N � L O O Q CL cM Q y C .o _� = C� .r: w N E c C2 J w z �=Oro J u - c Z QCD z_ o 0 33 6� m C C2.=E ca L1_ a C CO N N C mN � m � CD � m 7S . L C N C N to O C'3 N R Z z E m J a� L m ym� It 0 V y � Z G ' C C CL H v0! m C C Sm p N co L LJJ G „'. 72 r .� .,., c N 9vLLI � v N CO cm COD O' R m-O:No i. J O 2 O CL m 0 O J Q o z E LL - o � o cc LU Z c O Q CA co cm z z w I C O •� Q CS M 'E O O m m uj cn z = O.0 O i O � � L O O Q CL cM Q y C .o = C� Q C2 J w z �=Oro J u - c Z QCD z_ ca L1_ C a w C'3 N! 0 Z z � � J W W coCl- 01/04/96 09:06pm P. 001 TO %Ctie, G 1 N1c b..; rc N14„`b, 'Frain i �on;cluc �u+►,.c�n Y �rcmivrv� l�owcr Cu.-�. 3o P4�nnir� RA �1lQhc� MAr 6,k21 p,rcr" i vm 1'e WtIr C tC��bYL.�iJ�^ S A�G.nYU�La Yv�� l Arplie Yr� 0.,j -3w W;a, 5tycG�, NCY'i1 A,,je,,t, IiiA top- pla', "b m6yc dvv S11a SS vti &M.G` mc,f- T S Ol.r Qn (yl 4v) 6u s.m 5s Vic �Lv"z t ,-wrucss d T%taS 4ko, .) w 5 i)A `OAAk v 'I wro wrest Rwn � , sys .wtn 35tlNd N06Y1RI Std w I9q¢V a'®IC6MT71 OOf mhm wwm, N INM 3fk LfYJ3X3 C v30 3" 3oND vJNv mm 3RW R" O 1'3wv ta7 lj 'H07 0 ]MO 4/I Silt v40 3 ",j3bw v3n 3" xw . av s wQ www a ww 'w awa wmw a sews a a w vva v WAI wmsn w yn "i Ili- wnq a ian 'iaww 9 3.t-01 7w17v V V\ BP a _ 9R9 371S1D ver 3UVV �` —yrm �a >dsw 1: .1 IuLu ®' ss aws ar--------� aww —4y v I I v3N am 'rHeesv 1 .w� 1 17{10 � ill {VgJ-�1�Nf� 'tR r J 3Duj0 -nvm uwH I ® 5mt8ro JaI.8—s sjDU" 3-[BVgWAtl zoo 'd wd60:60 96/to/t0 W (4 0 awe UW weaa7uw bf' ry, O m1nQ Gy � cSt S Location JUU Wti low ST ,eH�l�� No Date C( ,pRT" TOWN OF NORTH ANDOVER . p Certificate of Occupancy $ a # y Building/Frame Permit Fee $ a, ssAcHus Eta Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ tkv. Water Connection Fee $ TOTAL x Building Inspector r : -� Mu p 1 C-" t) 711 Div. Public Works z Location w ST ' Nc} Date ' 4ORTIy - TOWN OF NORTH ANDOVER Certificate of Occupancy $ + Building/Frame Permit Fee $ 3 f'� s^SMS c� .. Foundation Permit Fee $ Other Permit Fee $ M Sewer Connection Fee $ ' Water Connection Fee $ _ ' TOTAL2-4 j-"- Building Inspector 0 t-19 Div. Public. Works 7 PERMIT NO. �oO APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAG` r MAP i4O. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK :PAGE ZONE SUB DIV. LOT NO. �I LOCATION /_,� Q4i sT W PURPOSE OF BUILDING �+ t L OWNER'S NAME VC (�t t/ 3 _A- 1 ' 1_ R1 C: C t I ✓`Tr /r�/ N� . F STORIES SIZE OWNER'S ADDRESS -2-42_ Nr -,(IL FLO o".e� _11, —4 BASEMENT OR SLAB ARCHITEC"r'S NAME C µ�✓N{,/ 2v`.� <���I�N �O' ('r7 1�...17� SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME S" SPAN DIMENSIONS OF SILLS POSTS DISTANCE TO NEAREST BUILDING t5��� DISTANCE FROM STREET DISTANCE FROM LOT LINES -,SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW // p SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND SO I WILL BUILDING CONFORM TO REQUIREMENTS OF CODE YIf IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER Y� f IS BUILDING CONNECTED TO NATURAL GAS LINE` J INSTRUCTIONS SEE BOTH BIDES PAGE 1 FILL OUT SECTIONS 1 - 3 CF PAGE 2 FILL OUT SECTIONS 1 - 12 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 R DATE FILED -3�-yam If /owNCL a". Lo, µy' (1'. / L / /'�`" SIGNATURE OF OWNER OR AUTHORIZED A ENT FEE Va PERMIT GRANTE 3 PROPERTY INFORMATION LAND COST EST. BLDG. COS ;)L a, OOe. EBT. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 - APPROVED BY OWNER TEL. # CONTR. TEL. # 3 73- 3cv4 3 7 3- 3'ood CONTR. LIC. # © 3 ? 7 7bl H.I.C. # 8fo �1--'Cb(I,C, ttf-72� s� BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES -i MULTI. FAMILY OFFICES APARTMENTS CONSTRUCTION 2 'FOUNDATION 8 INTERIOR FINISH B 1 2 13 PINE HARDW D PLASTER CONCRETE CONCRETE BL'K. BRICK OR STONE PIERS DRY VJALL UNFIN. _ 3 BASEMENT AREA FULL FIN. B'M'TAREA _ 1/1 1/1 l/, FIN. ATTIC AREA _ N_O B M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS DROP SIDING B _ 1 2 3 �_ _ _ CONCRETE EARTH WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING HARDW D COMIACN ASPH. TILE VERT. SIDING _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY BRICK ON FRAME ATTIC STRS. 8 FLOOR _ CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR POOR ADEQUATE NONE ADEQUATE 5 ROOF 10 PLUMBING GABLE GAMBREL I HIP MANSARD BATH (3 FIX.) _ TOILET RM`.12 FIX.) _ FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY I k`.. -- WOOD SHINGES KITCHEWSINK: SLATE !NO PLUMBING _ TAR 8 GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING _ RADIANT H'T'G UNIT HEATERS 7 NO. 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Public Works Locationl3c"o w 4o zrir W� No. _ Date �{ �,. TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ cu-� Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ PERMIT NO. APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE I MAP +40. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK :PAGE ZONE SUB DIV. LOT NO. LOCATION '?aQ (• PURPOSE OF BUILDING OWNER'S NAME'R+ C rc . c AxQ LA NO. OF STORIES SIZE OWN€R'S ADDRESS Z y (' �� " BASEMENT OR SLAB ARCHITECT'S NAME C Nc 1`L P Y SIZE OF FLOOR TIMBERS 1S�Tl� 2ND 3RD BUILDER'S NAME �1ft __ Lr SPAN DISTANCE TO NEAREST BUILDING r, DIMENSIONS OF SILLS DISTANCE FROM STREET -- POSTS --- DISTANCE FROM LOT LINES - SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW /3 ( SIZE OF FOOTING X IS BUILDING ADDITION AJd MATERIAL OF CHIMNEY IS BUILDING ALTERATION �N 1 e+` IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE YDS IS BUILDING CONNECTED TO TOWN WATER I/P� BOARD OF APPEALS ACTION. IF ANY A.1 h ' I IS BUILDING CONNECTED TO TOWN SEWER aj• IS BUILDING CONNECTED TO NATURAL GAS LINE Xe INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE.9 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACKED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE•FILED �AND APPROVED BY BUILDING INSPECTOR DATE.FILED G t-ti1NrL 01 -06 - SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE PERMIT GRANTED 19 qjg7� 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY ->.-.OWNER TEL. # 3 7:3 - Q� CONTR. TEL. #�'7&m CONTR. LIC. # ,/ H.I.C. # iagolc-t;l- BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY SiOR1ES MULTI. FAMILY OFFICES APARTMENTS _ CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH d 1 2 13 PINE CONCRETE CONCRETE BIL BRICK OR STONE HARDW D PIERS PLASTER DRY WALL _ _ _ UNFIN. 3 BASEMENT AREA FULL FIN. B M AREA Ih '/t '/ FIN. ATTIC AREA _ NO B M FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS CONCRETE EARTH B 1 — 2 �_ �— 3 _ DROP SIDING WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING HARDW'D COMMON ASPH. TILE VERT. SIDING STUCCO ON MASONRY STUCCO ON FRAME _ BRICK ON MASONRY BRICK ON FRAME ATTIC STRS. 8 FLOOR _ CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR I --i POOR _ ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH (3 FIX.) GAMBRELMANSARD A 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 I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING _ RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS AIL B'M'T 2nd _ ist 13rd 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. (3v C SLS r— I cw.— � L `IOdc— L 4 Sc' r ?-2d-93 0111-1/ L A � p v u O LaO � Q v cn v z z W j O O 9:4U o roca G iL o z z O 9:4 C w o W O C4 > y cn m G w x z O 1:4 iv w z w A C co z v V) O cn v O D. QC Vi~mcc m= L C O R C-3 E COM H o m COD o v �. C.2 c cc CO3 m m J y J. C M C m O N �� IC i C y to p .-. �'E m a L co 0 C7 y m c = L O C! OcaQ O V _N O i O Z p c C o c H N co C C _cc' N CL m LLJ 0 72 JZ C F to QL R C Z o E c�a�C.,y o CJ co O y C' co O = R p ca O O :z .A � J o z E C v z co .CL •� O D CO) C � I Co CM p w y o� F -- a± cr- U -E m m U.1 z w cm co c oco co _ •�. 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' 4 .Er -a �i LA z7"- K Hr// tT ' kI SO- ., ?y., sr v i ?� � -_.- ,r �\.r "'ii r `s� ,,,�."M w j h -- _ � � � j4 ? p...w � �a?✓ „� s � - Y .,e� C E-, + M3 � s� 1 �y ,�f d Oy •+� � x � z_ rr� _ «a n ax, s ^' �g_��•" a yLL.. ^�. l- �,r^r c, ,:,. r�*sj +.L � a`} -«• � �`�avr�iri k"�`' w- V,..�-�'sa._. "s°.� �it� � F M �t:2 4f a�.5,s1� r?x.+:',�-�.-�'+_ i �� � � +'S�`F�..i.� �` �4- . �s'T. ii'e.�m.-r..•'i� a... «`�-'��..#Nq�B J��.�.�.-.,.:.... ..« _ ... k:Luz watl'K� #tL 4v JZ�'w i tf f Location ' No. �' Q c%'� Date — SORT" TOWN OF NORTH ANDOVER O't�ae �a• BOO . , I Certificate of Occupancy $ © f Building/Frame Permit Fee $�( Foundation Permit Fee $ 7 ?Other Permit Fee 2.5 /) Sewer Connection• Fee $ Water rnnection Fee',��$L TOTAA6 / Building inspector ` 6276 Div. Public Works a, PERMIT NO. . Q APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. i %oL /W y) -9 PAGE 1 MAP d40. LOT NO. 12 RECORD OF OWNERSHIP IDATE BOOK '.PAGE ZONE SUB DIV. LOT NO. LOCATION -300 D._ f S r JDy T!7 PURPOSE OF BUILDING OWNER'S NAME 4t'Xe-CXecWrR G OF STORIES SIZE OWNER'S ADDRESS Zfj Z Har✓ �/ n 1. NAV �I BASEMENT OR SLAB CAI17N / C: 1C (- ARCHITECT'S NAME t Lr�y • SIZE OF,FLOOR TIMBERS 1ST_ 2ND 3RD BUILDER'S NAME /' f -f A., C 0 L .. , SPAN DISTANCE TO NEAREST BUILDING &-x I, ✓ `AI-- a C •/`' DIMENSIONS OF SILLS DISTANCE FROM STREET - " POSTS DISTANCE FROM LOT LINES - SIDES REAR 11 GIRDERS. AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW /VQ SIZE OF FOOTING X IS BUILDING ADDITION /v 61 MATERIAL OF CHIMNEY IS BUILDING ALTERATION 06 IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE r IS BUILDING CONNECTED TO TOWN WATER el BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER y l - IS BUILDING CONNECTED TO NATURAL GAS LINE y e f . INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 �3-� ( e ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING {_ ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUIL ING INSPECTOR DATE FILED _ 71 1 SIGNATURE OF OWNER OR AUTHORI F E E f= L.? / I F PERMIT GRANTE♦ D OWNER TEL. #a 7 CONTR. TEL. # 3 7 y -4S!/ - - - -1.9_ CONTR. LIC. # 0.- E L7 i5' 19 tip L i� JUL 12 71 3 PROPERTY INFORMATION LAND COST A. EST. BLDG. COST Y S"oOO, 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 BUILDING INSPECTOR s BUILDING RECORD 1 OCCUPANCY 12 e SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS MULTI. FAMILY OFFICES OF LOT AND DISTANCE FROM LOT LINES AND EXACT:;DIMENSIONS� OF .WITH PORCHES. GA- APARTMENTS ,B.UILDINGS. RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH " CONCRETE d ! 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY VJALL _ UNFIN. 3 BASEMENT AREA FULL FIN, B'M'TAREA _ '/ 1/2 1/1 FIN. ATTIC AREA _ NO B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN - ` 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING - HARD\4'D _ _—I _ ASBESTOS SIDING COMI.4CN _ — VERT. SIDING ASPH. TILE , STUCCO ON MASONRY - ` STUCCO ON FRAME BRICK N; MASONRY ': ` ATTIC STRS. 8 FLOOR •, BRICK ON FRAME I_ CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME •!✓ I POO_- SUPERIOR 17-WE—NIH ADEQUATE 5 ROOF 10 PLUMBING GABLEHIP BATH (3 FIX.) GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR 8 GRAVEL STALL SHOWER z ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO F 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. 6 COLS. STEAM la STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR - WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS GAS 7 NO. OF ROOMS OIL B'M-T 2nd 13rd I _ ELECTRIC 1 i 1st NO HEATING TO 97 Channel Building Company Inc. 242 Neck Road Haverhill, MA 01835 (508) 374-4511 GENTLEMEN: WE ARE SENDING YOU ❑ Drawings ❑ Copy of letter �stt slr C4 tlrmnsmn��&� DAfE i JOB NO ATTEN11ON Ili RE G N N-► ttached ❑ Under separate cover via_ ❑ Prints ❑ Plans ❑ Samples ❑ Change order ❑ _the following items: ❑ Specifications COPIES DATE NUMBER D SCRIPTION If yod c C,) 1 — 7— THESE ARE TRANSMITTED as checked below: 'For approval ❑ For your use ❑ As requested ❑ Approved as submitted U Approved as noted ❑ Returned for corrections ❑ Resubmit copies for approval ❑ Submit copies for distribution ❑ Return corrected prints ❑ For review and comment ❑ For bids due 19 ❑ Prints returned after loan to us •❑ REMARKS— I'�t✓leJ a— j S r✓A.-, c o f' l3 c n/ _ A4(1� i� f l i, JUL I [ JQQ' f F J SIGNED: �`% J/ 04Z%6 FORM U - IAT 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: �� Phone T 2 f -V,5Z1 LOCATION: Assessor's Map Number Parcel Subdivision Lots) Street �� d �/�f-r�� St. Number ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Conservation Administrator Comments Date Approved Date Rejected Date Approved Town Planner Date Rejected Comments Date Approved Food, Inspector -Health Date Rejected Septic Inspector -Health Comments Public Works - sewer/water connections - driveway permi t'- Fire Department Date Approved Date Rejected Received by Building Inspector Date 120 MainStreet North Andover. - .. Massachusetts O 1845 (617)685=4775 == <ii�. , In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit Number �3� is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 111, S 150A. The debris will be disposed of in: J-6'7 s CU i of ..Facili y) 1 �� Si. (3Q 1 �Td �v r�,d-S f' _ 7-/?-- .,;3 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this -project through the Office of the Building Inspector. Ila Town of OFFICES OF: �� n APPEALS ..:�; NORTH ANDOVER BUILDING DIVISION OF CONSERVATION HEALTH PLANNING & COMMUNITY DEVELOPMENT PLANNING KAREN H.P. NELSON, DIRECTOR 120 MainStreet North Andover. - .. Massachusetts O 1845 (617)685=4775 == <ii�. , In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit Number �3� is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 111, S 150A. The debris will be disposed of in: J-6'7 s CU i of ..Facili y) 1 �� Si. (3Q 1 �Td �v r�,d-S f' _ 7-/?-- .,;3 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this -project through the Office of the Building Inspector. Ila EXHIBIT "B" EAGLE OFFSET PRINTING 13,158 S.F. 300 Willow Street North Andover, NA Tenant Improvements July.2, 1993 Rev. #1 July 7, 1993 01 General Conditions: Supervision/labor, misc. hardware and rentals Building permit Dumpster Final cleaning 01A Demolition: Refer to separate scope divisions for associated demolition. 02 Sitework: A. Demolition: - Sawcut and remove existing paving at excavation for proposed ramp foundations at existing loading dock. B. - Construct new van ramp similar to adjacent tenant dock to provide 2' - 0" loading dock height. 03 Concrete: - Work as required to construct new ramp per 02. See Exhibit 04 Masonry: Not in contract 05 Metals: - Railings as required at -new ramp Refer to 09 for light gauge metal framing. 06 Wood/Plastics: - Provide 16 l.f. nominal plastic laminate counter 24" wide at new openings at office 03. Height to be 42" above floor. 07 Thermal and moisture Protection: Not in contract 08 Doors and Windows: All doors to be 3 x 7 x 1 3/4 solid core birch in hollow metal frames unless noted otherwise. Remove doors at receiving 21 and adjacent to men 16 for re -use. De -activate inside knob at common electric room. Install doors 21, 22, 23, 24 at new hall 02 A,B: doors to have lever hardware and closers. I Rip U JUL 12 1 11 door 20, at room 11, door 25 at office 12, door 26 at room lY. Install Install Install Install lever hardware at door 01. 2 - 3 x 3 vision panels in hollow metal frames at office 12. 8' strip curtain at new opening (curtain by tenant). darkroom door at room 11A (door by tenant) 09 Finishes: A. Demolition - walls: Construct openings as required at the following locations: office 03 (2 - 8x4), stripping 11 (1 - 47), adjacent to mens room (8x8). Remove wall at stripping 11. Remove airlock at receiving 21. B. Demolition - flooring: Remove existing carpet at proposed stripping 11. Prep floor for vct. Remove existing carpet at press area 15, prep floor for paint finish. C. Demolition - ceilings: Remove existing acoustic ceiling and grid at press area 15 (to be re -installed at 12' height). Remove existing ceiling and grid adjacent to proposed partitions (to be reconstructed after walls are painted. D. New Walls: Construct new walls as shown on 1/8" scale floor plan. Walls to be constructed with metal studs and gypsum wallboard with two (2) coats of spackle sanded and two (2) coats of latex paint to match existing. - New openings shall be finished with drywall corner beads and painted to match adjacent work. - New doors shall be finished to match existing. - Existing walls to be patch painted as required. - Note: demising wall at bindery may need to be supplemented to reduce noise transmission (to be determined). E. New Flooring: Install 12 x 12 Armstrong Excelon or equal vct at rooms 11, 11A, and 13 with 4" vinyl base. Install 4" vinyl base at new partitions to match existing. Press area 15 to receive polyurethane floor finish; manufacturer and color to be agreed upon. F. New Ceilings: 2 x 4 lay -in ceiling to be installed at 12'-0" at press area 15 (re -use of existing ceiling and grid at landlord's option). - Existing ceilings to be reconstructed at new partitions. Ceiling to be reconstructed at stripping 11 where wall removed. Damaged tiles to be replaced throughout near completion of work. 2 • iuxbing: - Furnish and install new wall hung sink at room 11 with associated supply and drain piping. Raise any piping as required at room 15. 158 Spr ink ler: Modify existing piping and heads as required at press area 15 to accommodate new 12' ceiling height. Relocate or add new heads as required at new partitions. 15C HVAC: Raise existing ductwork and associated HVAC components as required at room 15. Add or modify ductwork as required at new rooms Re -balance existing systems as required. 16 Electric: Re -work all existing wiring as required at new work. Re -install existing 2 x 4 fluorescent fixtures at press area after - grid raised to 12' height. Re -arrange and supplement lighting as required to provide 70 F.C. at new offices and 50 F.C. at new hall. - Add 20 amp, 120 volt general purpose outlets at new rooms as follows: 11-2, 11A-2, 12-4, 13-2, 02A-3, 15-4. Modify light switching, emergency lighting and exit signs as required by new layout. All power distribution for proposed equipment by tenant '..�-" JUL 0 2 ! K f CERTIFICATE OF USE &OCCUPANCY Town of North Andover Building Permit Number 308 (1993) Date MAY 25, 1994 THIS CERTIFIES THAT THE BUILDING LOCATED ON _300 WTT.Tnw ST. SOILEH MAY BE OCCUPIED AS INTERIOR RENOVATION FOR OFFICES, ETC. IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO EXECUTIVE CTR. LIMITED PARTNERSHIP O'.••6O s.�y0 �•'0 242 Neck Rd. w •f s w'. " ADDRESS Hav,-hri 11 MA O �1J,..,.. �4aa $ACNUi Building Inspector I w rA O O � cc v c- CD0 �i o2 S � � .. ti y� E a J= o c, tye GO C Ci com Lje CL 42 o Q.; N Q� m J H O 'O H _ = C H O O 1 E m v .co O O CLC...) m y eNJ m ' C: st o c� 'o C a ct v m �� o v rn o L Z wk. Cao as = m d LLI cc .vyi c.r ea = Z C'7 ac'E v cao LU o c g C2. o ._ m '� 'D 7 _ A i N.= F-1.. H •t w0+ arm•+ m � O E 0 O G y y .E CL am s C O CD m CL H O O V CO) C O LD O cc CO) 0 0 CD CL CO2 C H c ca i co 0 Q CL Q. Q +�+ O R cc J � O O Z CD CL CA C J Q z F - w a Z F— C:) z w } Q cc LU W z U im i o a a o xP-4 W4 o �i a4 24 wc v e In 9 z au 3 3 m o' 0,4 u 4 " Q w z o a O v w C/)w C O O C2 m O U w a O G a v W Y> O y a to m O X. 7 O G cG w v v o O cA cn cn I w rA O O � cc v c- CD0 �i o2 S � � .. ti y� E a J= o c, tye GO C Ci com Lje CL 42 o Q.; N Q� m J H O 'O H _ = C H O O 1 E m v .co O O CLC...) m y eNJ m ' C: st o c� 'o C a ct v m �� o v rn o L Z wk. Cao as = m d LLI cc .vyi c.r ea = Z C'7 ac'E v cao LU o c g C2. o ._ m '� 'D 7 _ A i N.= F-1.. H •t w0+ arm•+ m � O E 0 O G y y .E CL am s C O CD m CL H O O V CO) C O LD O cc CO) 0 0 CD CL CO2 C H c ca i co 0 Q CL Q. Q +�+ O R cc J � O O Z CD CL CA C J Q z F - w a Z F— C:) z w } Q cc LU W z U im i Location r`T No. � %' ' Date i719 NCRTN TOWN OF NORTH ANDOVER G?G: `t�e ,•,ho�L OQ Certificate of Occupancy $ + a ' Building/Frame Permit Fee $ RFoundation +s Permit Fee $ s�CHusE Other Permit Fee $ P;,qer Connection Fee $ `SON r Connection Fee $ No , 0 TOTAL $ 5w 4ndov8,rC ��� BuildingInspector _• 9 - Div. Public Works Location. ,S No. r Date, 44 S2- TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit F $ 6 Worylonnection Fee $ Water Coppeobon Fee $ TOTAL /00, O Building Inspect6r C. Div. Public Works .aafIT o. �-6 7 � APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. v' PAGE 1 MAP -#%'0. LOT NO. 7 2 RECORD OF OWNERSHIP iDATE BOOK 'PAGE ZONE I . LOT NO. SUB DIV LOCATION .;(3 / %%�"`)L�-�� PURPOSE OF BUILDING OWNER'S NAME NO. OF STORIES i SIZE f OWNER'S ADDRESS ps a -.F ( BASEMENT OR SLAB S�p. ARCHITECT'S NAME / SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME ✓1 SPAN _-- DISTANCE TO NEAREST BUILDINGGpX../S, ! J _/� v ' 101 DIMENSIONS OF SILLS oTl� ✓' aO DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES — SIDES u REAR a GIRDERS AREA OF LOT H FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING, NEW 01 s SIZE OF FOOTING X IS BUILDING ADDITION ew s' ''Q7 . w ��9 I YD r> or" Gyr ich i.v Aq a MATERIAL OF CHIMNEY "v"4, IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE //� J IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY N"9- IS BUILDING CONNECTED TO TOWN SEWER -.r 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 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAaLS MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUSV BE FIL^ED ANDAPPROVEDBY BUILDING INSPECTOR DATE FILED 13LZV ! 2 -- SIGNATURE OF OWNER OR AUTHORIZED AGENT OWNER TF1 N F E E O D e DO CONTR. TEL. #_ . CONTR. LIC. # PERMIT GRANTED E i s 19.92- [� 11{f Building Dept 3 PROPERTY INFORMATION LAND COST Ni9 EST. BLDG. COST �UOc*n 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 CREAM: Assessors CANARY: Treasurer ov�wenv ■neraw vR I 1 OCCUPANCY SINGLE FAMILY 1/ 1/7 % STORIES FIN. ATTIC AREA MULTI. FAMILY N_O 8 M OFFICES _ APARTMENTS 6 FRAMING MODERN KITCHEN / " i, _ PIPELESS FURNACE: CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE CONCRETE 8L K. BRICK OR STONE PINE HARDW D PIERS PLASTER _ f CONCRETE EARTH DRY VJALL _ _JN FIN. 3 BASEMENT HARDW'D AREA FULL FIN. B M AREA 1/ 1/7 % FIN. ATTIC AREA _ N_O 8 M FIRE PLACES _ HEAD ROOM 6 FRAMING MODERN KITCHEN _ PIPELESS FURNACE: 4 WALLS I 9 FLOORS CLAPBOARDS DROP SIDING WOOD SHINGLES FORCED HOT AIR FURN. B 1 _ �{I_ 3 CONCRETE EARTH ASPHALT SIDING HARDW'D ASBESTOS SIDING WOOD RAFTERS COMMGN VERT. SIDING _ ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME _ 11 BRICK ON MASONRY BRICK ON FRAME ATTIC STRS. 8 FLOOR I_ CONC. OR CINDER BLK. WIRING _ /l STONE ON MASONRY STONE ON,FRAME SUPERIOR I� POOR ADEQUATE NONE CHEATING 5 ROOF /y '/,Il 10 PLUMBING GABLE I HIP GAMBRELMANSARD FLAT I SHED BATH 13 FIX.) TOILET RM. (2 FIX.) WATER CLOSET _ _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ J, � � r BUILDING RECORD 12 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. 'J' i r` � �-- , ?.J fir" ✓� f /7 i i r � NULL KUUtING MUUtKN VIAIUKtJ TILE FLOOR f' • <° < - ~ • - TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE: FORCED HOT AIR FURN. TIMBER BMS. & COLS. _ STEAM STEEL BMS. & COLS. HOT W T OR VAPOR WOOD RAFTERS AIR CONDITIONING —' - RADIANT H'T'G UNIT HEATERS GAS 7 NO. OF ROOMS OIL Byt�l 3rd I CHEATING NO g '1 CHANNEL pArE Channel Building Company Inc. 242 Neck Road Haverhill, MA 01835 TO [508] 374-4511 V,���. GENTLEMEN: WE ARE SENDING YOU ElDrawings ElCopy of letter ❑ Attached ❑ Under separate cover via_ ❑ Prints ❑ Plans ❑ Samples ❑ Change order ❑ _the following items: ❑ Specifications COPIES ios No r. ATTEN710 RE ❑ Attached ❑ Under separate cover via_ ❑ Prints ❑ Plans ❑ Samples ❑ Change order ❑ _the following items: ❑ Specifications COPIES DATE NUMBER DESCRIPTION S 1 THESE ARE TRANSMITTED as checked below: ❑❑ For a 14 or use s requested ❑ Approved as submitted ❑ Approved as noted ❑ Returned for corrections ❑ Resubmit _copies for approval ❑ Submit opies for distribution ❑ Retur corrected prints Ulp�or review and comment ❑ For bids due 19 ❑ Prints returned after loan to us REMARKS SIGNE 1, b,, 94, GI F1 9 �-- E1�I�iT, yin�Nr, wJaINhu�. DE�U LA VAP Icy ?tir � o- ITA �O�d 1 PtiF y t AFT�� D�GK GoM��ET�n, INtiT��� 9/Q Z. . 1 top #/ WR To co�uMNti,�c W TO JmT6 1 (GAT�i�I, yUPt'O�T Fa�F�ATFO�M) i Lr. , 12 I J14� 61104 rW& 5j6.F�E P.xIg1@ �M5K 6 TO w1 lh FIRE T�WA� w T�A1En �l.`(1N�b pEcIC 1- � b Fi ,W NV TWO TNRU AT A� 31/gptiw w6I6"D,G,wl I Fpw. OF � I WV� %11 rYl'E x OWB � lKyln� F�c� GHEMIG L y M4; PPM 19i_611 i W rvVln FUL pONNG ro WT (NOTA W5 AW,-) 1, 6, hEnL RLL F600Q6. h �iwpu TRAGIC I6 �h, WEb yTIF�NEfC 3ylb SW 10 � IG°O,G.W� 1 �c�vh oe 6�vNut 4 2 L9YER6 y/s' 1YPE � 60 EA. FAGS 0 IN eanw n•, d•t• 6wbp n.nb« DEfflum GN�I�IG�� tiTD�AGE �oDM GP OT WT APPITIO� 6K' 1 9rchi4ects%ngineers andover, m� 3,2.1 P, 104 CONTra1.;..1.. E_AS..l.. 335 WILLOW ST f;01..TH*WPC, 4 NORTH H ANDOVER BUSINESS PAR NORTH ANDOVER MA SPEC I F I CAT I ORIS F[]I; �LAMNIABLE PTOPAGE Oorl*WE='c REFfcRENCEi. TYPICAL CROSS SECTION DRAWING AND. FLOOR PLAIN SPRINKLER DENSITY AT INTERIOR OE= STORAGE.: ROOM TO BE 0.37 GPM* WPC SPRINKLER HEADS TO BE GZU.I CK RESPONSE TYPE- WITH A LOWER RATING THAN THE 1.65 DEGREE HEADS USED ELSEWHERE MAXIMUM HEIGHT OF STORAGE AGE 19 ONE ( 1. ) DRUM HIGH UNLESS SUITABLE RACKING INSTALLATIONS AEE PROV I DEI) Q EtACK I NG SHOULD BE:: OF THE OPEN rll '�I I TYPE (OEC SIMILAR) TO ALLOW FOR PROPER OVERHEAD SPRINKLER COVE.R6-1GE . *WPC . L I SHT SWITCHING TOBE EXTERIOR TO STORAGE'. ROOM L_:IGHTING TO CONSIST OF FOUR 141 1.75 WATT EXPLOSION PROOF FL._C:)I..IFiI: SC:,ENT TYPE F IXTURES*WPC, VENTILATION TO CONSIST ST- OF A �.� 50 & M EXHAUST FAN WITH RATED DAMPE:=RS/L_OUIVR S AT FIREWALL PENETRAT:IOwS e FAN TO BE INSTALLED AT . EXTERIOR Of= ROOM .OWNER TO FURNISH AND INSTALL VENTILATION. WF'C, DOORS TO BE RAVED AND HAVE CLOSERS A DOUBLEACTION F't.JLL._ STATION TO BE INSTALLED ED Al_ .1..E -1E=: EXTERIOR OF TIME:= STORAGE ROOM AT ADJACENT TO THE ::.AST EXIT DOOR e A DOUBLE ACTION TYPE PULL_ STATION WILL ISE T I\IS-1 AL_L_L Eb AT CLOSET PROXIMITY TO THE:: WEST EXIT DOOR/EXTERIOR E=GRESS DOOR„*WPC AN EXPLOSION PROOF HORN LIGHT DEVICE WILL BE INS TALLED AT THE INTERIOR OF T H E. FLAMMABLE STORAGE ROOM. *WPC • t � • NOR IN NORTH ANDOVER FIRE DEPARTMENT CENTRAL FIRE HEADQUARTERS 124 Main Street North Andover, Mass. 01845 WILLIAM V. DOLAN Chief of Department Mr. Steve Foster CHANEL 242 Neck Rd. Haverhill, MA 01835 RE: CONTACT EAST Dear Steve, % i 4 Tel. (508) 686-3812 October 17, 1991 The following is a list of items which we discussed during our review of the proposed one thousand square foot flammable liquid storage room for Contact East. 1. The fire department recommends the installation of a double action pull station on the exit door frotri the room. If an exterior door is located on the sar'6e 6ide'of the building as the proposed room a double action pull' station would be required within five feet. This pull'station would negate our recommendation since a device would be installed. 2. An explosion proof horn light device should be installed in the room as a notification device for occupants of the room that a fire alarm has been activated. 3. Lighting in the room should be explosion proof. Jurisdiction of this matter is with the Electrical Inspector. 4. Your recommendation for a six inch depression of the floor to provide for potential ebntaihment of any spilled materials is acceptable. 5. Ventilation for the room as discussed from devices exterior to the room is acceptable. 6. Fire sprinkler heads for the room should be quick response, or a lower rating that the 165 degree heads utilized in the other areas of the proposed addition. If there are problems with ambient temperatures and the use of these heads please contact us. 7. Your client 'will have review his license for flammable liquid storage and advise us 'on' the status." our "recommendation for storage as discussed is favorable. S. A permit for the flammable liquid storage will be required from us and this permit is renewable annually. Permit cost is $25.00. "SMOKE DETECTORS SAVE LIVES" 9. The building inspector shall determine the construction required for the walls enclosing the room and also address the exterior door which had been removed. 10. It is recommended that two multi purpose dry chemical extinquishers, of twenty pound capacity UL rated as 20A:120B-C be installed at each entrance to the room. 11. The materials used in the construction of the racks for storage within the room shall not be of a solid construction. By installation of mesh, ladder or open bar racks the department will not required the extension of sprinkler heads to cover the rack storage. Thanks for your time and if there are any questions please contact either Lt. Long or myself. --------------------------- William V. Dolan Fire Chief cc. Lt. K. Long R. Nicetta C. Huntress dHANNEL TELEPHONE CALL SUMMARY Arthur White, Travelers Ins. Party= Greg Wiech & Steve Foster PROJECT: Contact East PROJ.N: PREPARED BY: Steve Foster DATE: 10/22/91 DisTRiBUTiorv: Arthur White, Travelers Ins.; Greg Wiech and Cliff Page, CBC: Steve Biggs, 1. The required sprinkler density at the flammable storage area should be 0.37 gallons per minute. 2. The drums of the Isopropanal are not to be stored over one high. 3. The switch for the electrical lights is to be exterior to the Storage Room. 4. Ventilation to be provided at 1 cubic feet per minute per one square foot of floor area and the vent is to be not over 1' above the finish floor of:the storage area. 5. Lighting to be of the non-incendive type. 6. The enclosure walls of the room are to be two hour "rated. The walls can be constructed of metal stud and gypsum wallboard. 7. The doors are to be automatic closing type doors with a fusible link or self closing type door. 8. The electrical environment shall be a Class 1, Division 2. 9. The area is not believed to require explosion release panels as there is continuous ventilation and there is no processing of the chemicals within the storage area. 10. Storage above the rated ceiling is okay as long as the ceiling is rated per code and sprinklers are provided above the ceiling area. 11. Manual pull stations at each entrance to the storage area are required. 12. The sprinkler densities at the balance of the warehouse building shall be the same as the densities at the existing warehouse area. This report represents our understanding of the meeting, discussions, and agreements. If errors or omisisons do exist, notification in writing is requested within sever (7) days; otherwise, all is accepted. Channel Building Company Inc. Should you disagree with any of the above conversation sum - 242 Neck Road mary, please contact, Channel Building Company within five Haverhill, MA 01830 374.4511 (5 ) days- FACE OF EXIST FOUND, w Cts Ix Q O\ Z cts QLTpCL 6,3,6s60 >6" 'U 0- LL V LL D LOc rr 4) cc Ia)m Z U " LL p CL E V- LL O d 0 -c J O e c 3 LLo = m c m c U o w 0 � �tQ- a U J V OQ.�tR •�►• e pi i o. Lr� ajy` Op -j Z Mol s r» Lr) C 3 0 FM4 O z r� Ulj CL z Lu LU •: Tv s UO OR H 0 .N C. L a -a c tv ow c E c C6 V _ 3 z •V CL. o �, c � o V 0 0 CL WD a✓ Z L V CL H c WD .c an oe G . Or u V u cc Q v O _ V) W � u CL W z z z W W O fA C t7 z i c o z _� m LU m L C a L L U L mUY E a u, O of o o m c o ¢ U ii a: U- Ir V) iL Q U- fD to •: Tv s UO OR H 0 .N C. L a -a c tv ow c E c C6 V _ 3 z •V CL. o �, c � o V 0 0 CL WD a✓ Z L V CL H c WD .c an Q CL. ;V gg LMU u ion C 6d� O a D u u d a Lao o gra,. be 11.1am C �o o > _ p F sG, e 06 rx W d z 1 u �c W L V K1 .J 0) . V W > ` C cc V) iTLLO L y CIO arr C� C) W >= o— e� �� C� m LIJ O 00 e �C 0 N r 0 u z D a m LO 0 U M, LN i A 1. CL. P 0H J V W dAl�i H = iz O vi ° z m i O Dick =J m0. L 0) cc CL. ;V gg LMU u ion C 6d� O a D u u d a Lao o gra,. be 11.1am C �o o > _ p F sG, e 06 rx W d z 1 u �c W L V K1 .J 0) . V W > ` C cc V) iTLLO L y CIO arr C� C) W >= o— e� �� C� m LIJ O 00 e �C 0 N r 0 u z D a m LO 0 U M, LN i A 1. CL. P M O 0 W 0 O LU Q v W u 0 �z Vol 161 te lM Il: - 'gr Lam" �Y. uo E 7 z d O C m s 01 z a a tiM 01 ;rtrt Location �30!2 No. d 7 Date - Z 0M TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ N Foundation Permit Fee $ Other Permit Fee $ %U ' U Sewer Connection Fee $ `14 (Water Connection Fee $ MAR � TOTAL r $ %0, OO ner�.. r Building liispector 505, Div. Public Works PERMIT NO. EMAP d.10. k APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 LOT NO. 12 RECORD OF OWNERSHIP IDATE BOOK "PAGE I ZONE SUB DIV. LOT NO. �I LOCATION = -.bo kxZ t11B t _,_SQ"--) PURPOSE OF BUILDING k���" x, 11-_-�� �LC Wo OWNER'S NAME x�GltiiZVC /1L r � ,I,�efg(�I� � NO. OF STORIES I SIZE 1I�t- OWNER'S ADDRESS ./O pal*twl• }„ �" M- BASEMENT OR SLAB 5JAL ARCHITECT'S NAME / SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME atG S1'� 4K���>t %J�� / `/ 7 SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS �s DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES — SIDES REAR "' GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING. NEW E*t5: •_ 77ttMs� SIZE OF FOOTING X. •' IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE (��s Cf 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 O S l4aLL d T 13E'✓t RA� � vim} . SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAAiE 2 FILL OUT SECTIONS 1 - 12 CTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ri TTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE F ED_ ` I. _ .- -z- 7 SIGN-ATUR"F OWNER OR AUTH+DRIZEO AGENT OWNER TFL. A FEE 7 ©, Q p CONTR. TEL. #tog CONTR. LIC. # PERMIT GR NTED WHITE: Building Dept 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY CREAM: Assessors CANARY: Treasurer BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN BUILDING RECORD 1 OCCURANCY;, ••'. 12 >r TI IIS SECTION MUST SHOW `EXAeT- DIMENSIONS O'F LOT^AND D 6TANCE FROM - LOT LINES AND EXACT .-DIMENSIONS O.F,' `BUILDINGS: 'WITf+ PORCHES. GA - ES. ETC. SUPERIMPOSED. THISRREPLACES PLOT PLAN. ^�•_ ` '� '" "��£ ' a ~ 't }" -i: ;. '..�,% •=', ^, iA— Ell _ • "4 _ "`' •• , t , i SINGLE FAMILY SORIES MULTI. FAMILY OFFICES APARTMENTS 1 CONSTRUCTION 2 FOUNDATION _I 8 INTERIOR FINISH CONCRETE X d 1 2 13 CONCRETE BL K. PINE BRICK OR STONE HARDW D— PIERS PLASTER DRY WALL _ UNFIN. 3 BASEMENT I /".It. AREA FULL FIN. B M'T' AREA '/, '/a s/, FIN. ATTIC AREA NO BMT FIRE PLACES _ HEAD ROOM MODERN KITCHEN _ — — 4 WALLS I 9 FLOORS CLAPBOARDS CONCRETE EARTH B 1 22 J 3 I _ _ _ DROP SIDING WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING VERT. SIDING _ HARDW D _COMMGN ASPH. TILE STUCCO ON MASONRY STUCCO ON'FRAME _ BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR I�POOR _ ADEQUATE NONE 5 ROOF 11 10, PLUMBING GABLE HIP BATH 13 FIX.) _ GAMBREL MANSARD TOILET RM. 12 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 II 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. _ STEAM STEEL BMS. & COLS. _ HOT W T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING _ RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL BMT ` 2nd ' _ Is1 13rd I ELECTRIC NO HEATING t uo ` W O 0 H> 0 N° O p m x a ° ZGo Q co m 6% 60 603 6s Z Ui ii v a E m o c O O (D U 5 As o E a o E aD ' o 0 U m a 0 W 0 I *�• oo�ia le in P ON . ° +o cc CD J L1i t 0 FMO Is V) 0 71 0 7 09 of O °C O 0 ~ v O a H H 0 06H z z z W o -o O z c u u' z W D c z V ac w O d u a. c y. (A c p _ c c m m L C .J L cm W L V t ui �u Y w C o f o' �_ o' m o' �� E B U LL Q LL C cc fA E Q LL. m N V) 0 71 0 7 09 Z a H H 0 L a -o � c � c w O d u a. c y. (A c p _ c c Z D .- CL p w C C � V � C cm .a c Z �.� - - r' �. L," � Y �^ _ I. -� a ?' �� �. ' ` � k, < N ��� �, � �� � �; ., cal 016D 4 1? 85 Hull Street, Bev I erly, MA'01915, Telephone: 508-922-2083 Fax: 922-2005 S. C., T1 0 ft 5 4, (3 ol j:- j!", w cal !ild gas c O-ew � t, f q 4 1? 85 Hull Street, Bev I erly, MA'01915, Telephone: 508-922-2083 Fax: 922-2005 ol w a. I q !ild gas c O-ew � t, f q 4 1? ol w !ild gas c O-ew � t, f q Lq.cation 1_30 No.Date x Y .. „oRTh 'TOWN OF NORTH A DOVER p Certificate of Occupancy $ Building/Frame Permit Fee $ s';c t� Foundation Permit Fee $ ether -Permit Fee $ Sewer Connection Fee $�sa Water Connection Fee $ TOTAL $ iU Y/Building Inspector 10598 `.� t Div. Public Works PEa'ltIT NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP h40. LOT NO. 2 RECORD OF OWNERSHIP DATE BOOK ;PAGE ZONE SUB DIV. LOT NO.I LOCATION n 3 0 V PURPOSE OF BUILDING OWNER'S NAME Gym n .� / NO. OF STORIES SIZE ,p%% qws N�-- OWNER'S ADDRESS 3S J� .R� `W `✓IIvC•J_" BASEMENT OR SLAB ARCHITECT'S NAME BUILDER'S NAME l -- SIZE OF FLOOR TIMBERS IST 2ND 3RD SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS 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 MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE 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 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED 7 APP ED BY BUILDING INSPECTOR DATE FILED SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE !— PERMIT GRANTED X/ 19 3 PROPERTY INFORMATION LAND COST / E�1 ST. SLOG. BLDG. COST -I LT/) iJ�/) �JV) EST. BLDG. COST PER SQ. (FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY i SUILDINO INSPECTOR OWNERTELJ kC-Oli - <;-5-7-73C)() CONTR. TEL. k CONTR. LIC. k H.I.C. # BUILDING RECORD I 1 OCCUPANCY 12 SINGLE FAMILY I STORIES MULTI. FAMILY ., OFFICES APARTMENTS '•, _ CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH 3 1 2 13 PINE CONCRETE CONCRETE BL'K. BRICK OR STONE P _ PIERS PLASTER DRY WALL — — — _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ 1/1 1/2 14 FIN, ATTIC AREA N_O BM'T FIRE PLACES _ HEAD ROOM MODERN KITCHEN _ 4 WALLS I 9 FLOORS CLAPBOARDS DROP SIDING CONCRETE EARTH B 1 2 3 �_ WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING VERT. SIDING STUCCO ON MASONRY _ HARDW D COMhACN ASPH. TILE STUCCO ON FRAME 11 BRICK ON MASONRY. BRICK ON FRAME ATTIC STRS. & FLOOR I_ CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR (.1 POOR _ ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE GAMBRELMANSARD HIP •. BATH (3 FIX.) TOILET RM. 12 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 I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING _ RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL ELECTRIC B'M'T 2nd _ 3rd NO HEATING THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM { LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH 'PORCHES, GA- J RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. 1st I j k.' •.a`b:�A Lib CD wE` W O Z CD o. O H p C CM 3� I C C y � � G3 p •— CD ca an CL �3 0 CD G3 G3 p O caw 0 CL m tm < y E +_+ ccC •v .. ca zCL� �. C cc —. C•— • C r� m _y V CD p 1 O N _O C V V •d � 0 C C C 0 O m .` E a CD c H E � . p 0 C Q v O ma I= E ... W :mCD L- �. N . m a A L y H � �E� CO 'o O CLC,3cm � m � ((� «� cm c c o '4 a m o cc c c' ccoo a t •O mm� N coo a� W O 0 'y o W SID CJ CD 'O cc,O �; O �_ CD wE` W O Z CD o. O H p C CM 3� I C C y � � G3 p •— CD ca an CL �3 0 CD G3 G3 p O caw 0 CL m tm < y E +_+ ccC •v .. ca zCL� �. C cc —. C•— • C r� m _y V ri Town of North Andover f NORTH , OFFICE OF 3?Oa1♦�aD /6.6{OOL COMMUNITY DEVELOPMENT AND SERVICES p 146 Main Street, s North Andover, Massachusetts 01845 �'"o 001 WILLIAM J. SCOTT SS CH Director In accordance with the provisions of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 111, S 150A. The debris will be disposed of in: / Ae n of Facility) Signature of Permit Applicant Date NOTES Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 W O (L a W ,s OrYX< UJ 70 0�(n pa. Wiz al tn_ �SOWm lZ�.a- ZI- Q C?t� c4_® t W0 a.l= m=. <W2, `� Q CL N[X(/1 >-�}M >---iM z-i(n �moz02Q WW<Wt''J �v0 z0:2 r �0 Z XtA- BZW <WwW mo- D o n p 0 (n m- a. O gEtYd Z Z 125 �n o' Z.�F=-per T� Ld E -i! -W LLJX Q Z. 1- W Ei nc�--v�av, (rvp X LAJ W ,C3 Z W j -r W V r N N} Y ��Itl'-6� .,� \n7 Wb39 0703 3dYJ 10 MNLz,L*.zBS V4839 3dVO + _ ! I TT A- L LI -d T �bdS 4"I S30VdS L7 J I Z C N '_i 31380NOO SnommiJB � U)i x ' w -�� 00 3dd� ! O m wr F 1TIT U { ..F 3_bds s { l� w tj o - mno 313a3NoO � L 1'Z6 I P�. o fLU � d? N a a �g z a { { C-) IM LOm z I + W W I �g z Z W � 0- W {1, O { O - { Oz ►-- _ ° rk! I Z?- LT3 • t � �Aj W o W I w m OZN o L�QD o - Wp a— c, WW 3 cr r, W J v� IL z h- v, U 0WW vol rwl,_ _ QI :v W W Ia 0 U 1L�izo � I W ¢ 0\ W p m IF x p30MA 49 0-02 D flu x A R i _a w; I o I o /! h WIx z x 1 ©0 ff CID � 1 U Q i 0. O� Q F v G �z Iw � - o N , 000p, qt zA 81, Ti IF .� ` -r Restricted To: 00 DEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE 00 - Hone Huaber: Expires: Birthdate; 1A - Masonry only CS 039110 05(29/1998 05/2911959 1G - 1 & 2.Fanily Ho®es Restricted To: 00 Failure to possess a current edition of the Massachusetts State Buiilding Code GERARD F DIORIO is cause for revocation of this license. 215 PIHGRER HILL RD AUBURN, HH 03032 • 'r 3 J17r .r! MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) _ r ' elbtiV-u AAg61e a . Mass. Date 6 19 Permit # Building LocationSoo cotll%Dl7/ PC PQ,U, e wner's Name6*,� Goy✓ -, 0-4$l�—a.=kc-5 Type of Occupancy_ (1-0-101YA4 New Renovation ❑ Replacement ❑ Plans Submitted: Yes[-] No Ej Installing Company Name CAC MECHANICAL Check one: Certificate Address --68 Stiles R d Corporation 2101C SALEM, NH: ❑ Partnership Business Telephone 1-800-840-2158 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter F R A tUC` FS C: C P R M T T C:0 INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes )a No ❑ If you have checked Vis, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy R Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws. and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner❑ Agent ❑ I hereby certify that all of the details and Information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under the permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. BY Type of License: Title Plumber gna�i lure oTcense um er or Gas itter Gastitter 10 0 4 5 aster License Number City/Town Journeyman APPnOVED (OFFICE USE ONLY) I YET__ a WUI N H X V Z rC O rn W C J Ow H w F O V n m o = r2.. Z %1 Z O W~ O < }t CC) -- = o~= < m N$- y W O ti r ►- N W = V W N W < Cc F- C W O W H 2 J H Z F. W W O cc O W > W f- U J W Z Q W m Z O Z W R O S Q W > W O Z < 6 Q < O O W O �y H cc x O O Y W 3 D t7 J V ¢ % O a F- O SUB—BSMT. BASEMENT IST FLOOR 2ND FLOOR 3RDFLOOR 4TH FLOOR STH FLOOR 6TH FLOOR LOORLOOR E Installing Company Name CAC MECHANICAL Check one: Certificate Address --68 Stiles R d Corporation 2101C SALEM, NH: ❑ Partnership Business Telephone 1-800-840-2158 ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter F R A tUC` FS C: C P R M T T C:0 INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes )a No ❑ If you have checked Vis, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy R 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: Signature of Owner or Owner's Agent 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 the permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. BY Type of License: Title Plumber gna�i lure oTcense um er or Gas itter Gastitter 10 0 4 5 aster License Number City/Town Journeyman APPnOVED (OFFICE USE ONLY) I YET__ z O_ F u W a N z J Q z .n r 44 1 1W z ME O Z H h IL N J a U z O O W G N O � f LL. p W O z a Ir cc O o LL W 3 z O O w F Gl � J IL IL a W W LL z O_ F u W a N z J Q z .n r 44 1 1W z ME 1875 Date . . . . 7. TOWN OF NORTH ANDOVER + 6 0 PERMIT FOR GAS INSTALLATION 19 This certifies that .............. has permission for gas installation . t:K'9 ti W46 in the buildings of .4 ... (.&.......... rf..\ ................. Z. at 3 .. w�t Wy_. S—( ........ I North Andover, Mass. Fee. 357.�.. Lic. NoA�A­�.......................... QUV—iik— +1 (el 6) GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File S( ,S lc)' MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTIKo � (Print or Type) t\ NORTH ANDOVER Mass. Date 16 8 '� _ r �uilding Location Soo!! `j�'ow �S Permit 27-3^Y Owners Name C d,., CL • - New .7 Renovation Replacement p Plans Submitted FIXTURrS 1 � x � z rc ari (— W U1 m o v m x N m o 0 o a f. to a tx to W Ha a z sn a cc z y t- 4 to cC 0 w z v Q W 2 d 07w rr 'c cc x W o o W F w o tt W Q W F• 1 ! � X f. t' r a to O 2 V= sat Q N x • Z Q 4 W W > � u1 a � "'�t- Z Q •u x O CS Y U. Q C9 . t U rr �• Q a t— of i sva—ss1�T. BASEMENT I ST FLOOR r / 2ND FLOOR 3RnFLOOR 6TH FLOOR STFi FLOOR 6TH FLOOR TTR FLOOR 8TH FLOOR (Print or Type) C":ec one: Certificate Installing Company Name q4 Corp. O? -G Address cA _ jj v x J/r7 _ _ _ Partner. !ii?�`�e.�✓,�lf D!�`r� L.1 Firml-Co. Business Telephone:._ 'blame of Licensed Plumber or Gas Fitter Tlt es %p tiAAt C-- f!a Insurance Coverage: Indicate t type of insurance coverage by checking the appropriate box:. Liability insurance policy Other type of indemnity Q Bond D lnsura�Ace Waiver: 1, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner E-] Agent El i hereby certify that all m of the deuds and information I have submitted (or entered) in above application are true and accarate to the best of my knowledge and that atl plumbing work and Installations perfomied under Permit issued for this application will -be -in compliance with dl pettln=t provisions of the Massachusetts State Gas Code and Cluptes 142 of the General Laws, • •. By Title City/Town: APPROVED (OFFICE USE ONLY) TYPE LICENSE: Plumber pdsfitter Master Journeyman ignature of Licensed. Plumber �or Gasfitter License Number r r r MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTIN' G (Print or Type) NORTH ANDOVER Mass. Date �uilding Location 300 WIllvGU .Sr `,o y /h. Permit # . Owners Name • New '1 Renovation] Replacement Plans Submitted =j .S' FIXTUD=c (Print or Type) Check one: Certificate Installing Company NameL'40-/27c [ Corp. Address cis - A0 p Partner. Firm/Co. Business Telephone: (f _62Pv ) % y,9 Name of Licensed Plumber or Gas Fitter �j�U/� �l h IP/40/ Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity 0 Bond Insurance Waiver: 1, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner Agent 1 hereby certify that all of the details and information 1 have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing wort and Installations petformcd under Permit kwed fo: this application will -be in compliance with all pertinent provWoru of the Massachusetts Slate Cas Code and Chapter 142 of the General Laws. By Title City/Town: APPROVED (OFFICE USE ONLY) i TYPE LICENSE: � 7,44, _.4 Plumber Gasfitter Signature of Licensed Master Plumber or Gasfitter Journeyman /DXc/P License Number H t/f ul ¢ Q Z �� U3 W ustu as . CO = F LLI Cr d ccw m H h< W ¢ O o= G Z N W Z U W 07 .. W f- 4 o> cc 0 C >. h ... W ul Qf d W W ca Q W W .^ e1 t? 2 F- d Z W h G Z a: �.. _ l' W >. M o al ? = ts. O h W .r O r s x d W Q r= z O 0 U. 10 n. F- o SUa—SS..IT. t BASEMERT IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TK FLOOR 8TH FLOOR (Print or Type) Check one: Certificate Installing Company NameL'40-/27c [ Corp. Address cis - A0 p Partner. Firm/Co. Business Telephone: (f _62Pv ) % y,9 Name of Licensed Plumber or Gas Fitter �j�U/� �l h IP/40/ Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity 0 Bond Insurance Waiver: 1, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner Agent 1 hereby certify that all of the details and information 1 have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing wort and Installations petformcd under Permit kwed fo: this application will -be in compliance with all pertinent provWoru of the Massachusetts Slate Cas Code and Chapter 142 of the General Laws. By Title City/Town: APPROVED (OFFICE USE ONLY) i TYPE LICENSE: � 7,44, _.4 Plumber Gasfitter Signature of Licensed Master Plumber or Gasfitter Journeyman /DXc/P License Number Vey 2162 NORTH Of „au 4'b0 T r This certifies that �-. .. �?.[T L.cm , has permission for gas installation ... f1'? r:. ?:..�' �! in the buildings of .... . QU.. t. d -..f 4- '..5. t.. Q at ... ........ North Andover, MagE Fee. 75.,d(). Lic. No...M.7/09V!�....................... ..... G 6I GAS INSPECTOR WHITE: Applicant CANARY: TBuilding Dept. PINK: -Treasurer GOLD: File 2 2 4 Date f /. ...: v "ORTM - TOWN OF -NORTH ANDOVER or p� PERMIT FOR GAS INSTALLATION 9SS4CMUSE� This certifies that . ,Y� G�... ...... . . has permission for gas installation ....C.Ct'.� in the buildings of . h r _.(. ata... L{r,...... h Andover, Mass., Lic. Nd:. ? AS INSPECTO --. WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: Fly' �r Office Use only idle Tommonwralth of fttssadiml lfs Permit No. � a 5 _ lepartriieri2 of ptihlii 06afet4 Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 WN (leave blank) jcog APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 7 �� QW or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number Owner or Tenant 0 P T Owner's Address Is this permit in conjunction with a building permit Purpose of Buildina Existing Service Amos _J Veits New Service Amps _J VOits Number of Feeders and Amoacity Location and Nature of Proposed Electrical 'r"lerk 7-7 Yes No (Check Appropriate Box) Utility Authorization No. Overhead _' Undgrnd No. of Meters Overhead ' Uncgrnd r No. of Meters INSURANCE CCVERAGE: Pursuant :o the reouirements at t.tassacnusens general Laws _ I have a current Liabiiity Insurance Policy inc!ucing Corg etea Operations Coverage or its substantial equivalent. YES NO _ I have suomrtea valid proof of same to the Office. YES �,Pfr NO = If you nave checxea YES. please indicate the type of coverage by checking the p ` prate box. INSURANCE BOND = OTHER = (P!ease Scec:fy) (Exoirauon Date) Estimated Value of Electrical Work 5 Work :o Start Signed unser thP aloes of p�rlur FIRM .14 Licensee 92,2et Insoecuon Date i;iecuestec: Fnai Address 'F / V " 41 rL,1tj Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Lice see aces not nave the insurance coverage or its substantial equivalent as re- ouaea by Massachusetts General Laws, and that my signature on :his permit application waives this reautrement. Owner Agent (Please check One) C 00Teteonone No. PERMIT FEE 3 (Signature of Owner or Agent) x -65o5 Total No. of Lighting Outleto _f H No.., ct �•ds I No. of Transformers KVA No. of Lighting Fixture i Swimming Pcoi Above � arnd. _ I 77 Generators KVA of Emergency Lighting No. of Recectave Outlets No. of Oil Burners iNo. Battery Units No. of Switch Outlets I No. cr Gas Burners FIRE ALARMS No. of Zones No. of Detection and Total No. of Ranges I No. cf Air Cone. tons Initiating Devices No. of Sounding Devices No. of Sell Contained No. of Disoosals No.of Heat Totai Total Pumcs Tons KW No. of Dishwashers I SoaceiArea Heating OetecnoniSounding Devices Local — Munic!aai Other _ Connection _ Devices No. of Dryers Heaurc ev,ces KW No. ct No. of Low Voltage No of Water Heaters KW I Sicrs Ballasts Wirinc I No. Hydro Massage Tubs I No. of Motors Total HP OTHER: //i� / l� /®// /J/T/ C� 1 — INSURANCE CCVERAGE: Pursuant :o the reouirements at t.tassacnusens general Laws _ I have a current Liabiiity Insurance Policy inc!ucing Corg etea Operations Coverage or its substantial equivalent. YES NO _ I have suomrtea valid proof of same to the Office. YES �,Pfr NO = If you nave checxea YES. please indicate the type of coverage by checking the p ` prate box. INSURANCE BOND = OTHER = (P!ease Scec:fy) (Exoirauon Date) Estimated Value of Electrical Work 5 Work :o Start Signed unser thP aloes of p�rlur FIRM .14 Licensee 92,2et Insoecuon Date i;iecuestec: Fnai Address 'F / V " 41 rL,1tj Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Lice see aces not nave the insurance coverage or its substantial equivalent as re- ouaea by Massachusetts General Laws, and that my signature on :his permit application waives this reautrement. Owner Agent (Please check One) C 00Teteonone No. PERMIT FEE 3 (Signature of Owner or Agent) x -65o5 I a Date ...... e+ a— 728 HORTH 3? °°,,, _.•.°`e �a� TOWN OF NORTH ANDOVER-,;- Owe p PERMIT FOR WIRING SSACMUSE M This certifies that '7 has permission to perform / if ............. .. wiring in the building of .....L-Ak! .. ' ...%.� 1:�//r �!. �- ,cfCl.-�, l at .:.......::.. ,North Andover, Mass: Fee ....30 ...... ..... Lic. No. ff ..... ... n; .ELECTRICAL INSPECTOR CU a O WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 6 TO. Location l� �� . / r � No. 31) 2,D ate TOWN OF NORTH ANDOVER Certificate of Occupancy $U !lL 4 Building/Frame Permit Fee $ Foundation Permit,Fee $ Other -,Permit Fee $ r l.i Sewer Connection Fee $ N0. v Vat§rtCbnraection Fee $ TOTAL $ ea % Building Inspector Div. Public Works Div. Public Works ``vocation 30o No. 0'Z''r Date 719 7 l N0R7h TOWN OF NORTH ANDOVER • . OA p? � „ Certificate of Occupancy $ Building/Frame Permit Fee $ s�CHus Foundation Permit Fee $ PAID C,�,�,Y Permit Fee $ Sewer G�'b" , Fee $ ' J Matqr %vection Fee $ TOTAL $ Mo. AndoVgr C011ec SOP Buildi g:lns actor Div. Public Works ""bcation No. Date N°RTtl TOWN OF NORTH ANDOVER F „ Certificate of Occupancy $ Building/Frame Permit Fee $ f ' s�cMuS Foundation Permit Fee $ Other PermitFee $ S &4Wp_ fiction Fee � $ PAIDV; pWater Connection Fee $ * , p��Qliet Collatorr ri C Building Inspector �, Div. Public Works ;r 10 APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. 1/ PAGE 1 MAH`K40. LUT NO.X I 2 RECORD OF OWNERSHIP iDATE BOOK PAGE ZONE SUB DIV. LOT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING LOCATION -?pd Willow St. South, N. Andover, MA PURPOSE OF BUILDING offices OWNER'S NAME Bayfield Development Company NO. OF STORIES SIZE 50,000 s.f. J OWNER'S ADDRESS 242 Neck Rd., Haverhill, MA BASEMENT OR SLAB slal.2-_ ARCHITECT'S NAME - _ _ "` - SIZE OF FLOOR TIMBERS IST N/A 2ND N/A 3RD N/A BUILDER'S NAME Channel Building Company SPAN N/A -- DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS N/A DISTANCE FROM STREET POSTS N/A DISTANCE FROM LOT LINES - SIDES REAR" " GIRDERS N/A AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION Existing THICKNESS IS BUILDING NEW No SIZE OF FOOTING Existing X IS BUILDING ADDITION NO MATERIAL OF CHIMNEY N/A IS BUILDING ALTERATION Yes IS BUILDING ON SOLID OR FILLED LAND Solid WILL BUILDING CONFORM TO REQUIREMENTS OF CODE Yes IS BUILDING CONNECTED TO TOWN WATER Yes BOARD OF APPEALS ACTION. IF ANY N. A. IS BUILDING CONNECTED TO TOWN SEWER Yes IS BUILDING CONNECTED TO NATURAL GAS LINE Yes INSTRUCTIONS ` SEE BOTH SIDES 04 �• PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED ANDAPPROVED BY BUILDING INSPECTOR DATE FILED SIGNATURE OF OWNER OR AUTHORIZED ,AGENT n 1 F E E l PERMIT GRANTED CONTR. TEL. N CONTR. LIC. # 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST S� Q 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 Interior renovations consist of: adding new doors (4), new floor- ing, repainting, new office partition (121 long +/-), new kitchen counters (2). Reference attached plans "Optical Micro Systems", dated 4/12/91.and Optical Micro "Scope of Work", dated 4/9/91 (at - BUILDING INSPECTOR tached). *Scope of new construction is limited to those yellow hi -lighted items shown on plans as also referenced on written Scope of Work. 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Iq U C • 4 -,1 ([ - � 3 rls, crop ,���,.�, o S � EaE fir-, r0 C} v] 3 '� p •3 ' i N O 6• 'L3 Y) N x .:.cry .aN-H -11 � 2 ,.4 x `u ai �a u UN.r.k (Ij 04 04\ + 0 valj N0 0 EC: .-r 3 N LQ~. O r-1 -1 -11V '� r -I-1 %j -�. rp sy �, ,� Q+ C O w w N ro 3 g 41 E N U 1 b Qom, 0 w z U -9 � O C O 3 0 C 3 tj C > O V) S1 ro l� r -I O a1 O r -I ,\a -H -4 U N >C �' ro � ro a) O �p Ox a) 3 a1 rr-I r $ o U� r-1 40.1 �p -4 i.1' [ � -I S� 14 4-) a) O 'U0 N M r I 7 C r I ro 1t1 •rCi m N C U b .� b N '� ro $ aKC 3\ O '�• 0 °� m + r -I< n c a 4-) > � Hi o N -8 n C 0; f ij �0 "'I"' Town of Northn over Building Permit Number 360 (1989) Date AUGUST 27, 1991 THIS CERTIFIES THAT THE BUILDING LOCATED ON 300 Willow Street, So. (Micro Optical) MAY BE OCCUPIED AS TENANT OFFICE RENOVATIONS IN ACCORDANCE WITH THE PROVISIONS OF THE. MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. �ett�cD ra*�N O CERTIFICATE ISSUED TO Bayfield D e v. Co. 242 Neck Rd. ADDRESS MA y9 °q�IED �PPy (5 Building Inspedor " r 1, ' ..•rte. c 0 U V) W J ZD AR b. C r� a V �- oc Q V W -. ` W O p W W — d. Z in W Q: m \ V N DL W mLAJ d V _ � m L C J L U t m O> — G.' W = > pJ LU Y O a: U a LL ¢ co LL Q U. Co W cn c 0 U V) W J ZD AR b. C r� idle UauJutnutueulUj of flinlitttlluattli 12 vy department of public Eafetll BOARD OF FIRE PREVENTION REGULATIONS 521 CMR 12:00 Permit No.� OccupancyA Fee Check 3190 (leave blank) � G� APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed In bccordance with the (Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK On TYPE ALL NronmATION) Osie`'~ 7�a 6 J96 Qij{r or Town of_A4_A J dye a To the Inspector of Wires: The uderslgned applies for a permit to perform the electrical work described below. Location (Street Owner or Tenant Owner's Address Is this permit in conjunction with at building permit: Yes 0 No ❑ (Check Appropriate Box) Purpose of Building C tri Utility Authorization No. Existing Service Amps _ J Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps _/ Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work /TUvT �1elLC�G/� i/�h E 1 /dC No. of Lighting Outlets No. of Hot Tubs No. of Tonsformers/ Total 7 S No. of Lighting Fixtures Swimming Pool Above grnd. ❑ In- grnd. ❑ Generators RVA No. of Receptacle Outlets 3 No. of Oil Burners No. of Emergency Lighting �1 Battery Units 7 No. of Switch Out f f No. of Gas Burners FIRE ALARMS No. of Zones No. of Delection and Initialing Devices No. of Sounding Devices 3 No. of Sell Contained Detection/Sounding Devices LocalMunicipal ❑ Other 0 Connection No. of Ranges No. of Alt Cond. Total _3 tons �� No. of Disposals No.of Heat Total Total Pumps Toni KW No. 01 Dishwashers SpecelArea Heating KW No. of Dryers Nesting Devicoii KW No. of Water Heaters KW No. of No. of Signs Ballasts Low Voltage Wiring No. Hydro Massage Tube No. of Motors Total tip OTHER; o200 > � e- r• e�q a 77 / 5�� D (iv J f INSURANCE COVERAGE fur suent to the requirements of Massechusetts general Laws 1 have a current Liability Insurance Policy including Completed Operations Coverage or Its bubs1an11al equivalent. YES C NO C I have submitted valid proof of some to the OfflcA, YES C NO Q If o hev checked YES, lease Indieat8 the 1 I the Appropriate box. ypb of coverage by INSURANCE ck BOND C OTHER G (Please Speclty) ` �/ l� p Estimated Value of Electrical Work 6 (Expiration Date) Work to Start _ a" 7_ -'??Z -Z/_ Inspection Data Requested: Rough w/04/� �inat 1�i1 /e4o Signed under thf,Penaltles of oariurv. w _ _ FIRM NAME G Lleerisse Signaturb Lic. No. _ 2 0S3 e) Address PO Bus. Tei. No. SO R 3 ?� B 7 -?fz AllCywNER'S INSURANCE WAIVQR: 1 AM flware %het the Licenset floes not have the Insurance toversge or Its substantial equivalent is ra- quired by Massachusetts General Laws, And that my signature on this permit Application wolves this tequirement. Owner Agent (Please check one) (Signsture of Owner at Agent) Tblephon6 No. PERMIT FEE Ili it -6565 Date... �7::�4�... .124 34 NORrM .. TOWN OF NORTH ANDOVER. r 9 PERMIT FOR WIRING �,SSACMUSEt This certifies that ......�.�,.. ... �::.............. ...... �......... .:........ . has permission to perform _ wiring in the building of.- . . / . at .: ..� �?......:...... •••..a......... , North And ver Mass, Fee../.0..q ... Ltc. No. ........... ............. _ u (�ECTR[CAL INSPECTOR 190.40 RAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer idle Unmm1311111COW1 Of MHOSUellUSE Rs IDcpadment d Public enCdv BOARD OF FIRE PREVENTION REGULATIONS 521 CMR 12:0 Permit No. Occupancy "Fee Checked 3190 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed In accordance with the Massachusetts Electrical Code, 527 VAR 12:00 (PLEASE PRINT IN INK OR TYPE ALL i FORMATION) (X* or Town of— /1f ✓f To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) _l6y r'y 11 6 %�✓ S�'. Owner or Tenant � A111;o f �,"- Owner's Address Is this permit in conjunction with q building permit: Purpose of Building Existing Service - Amps _J Volts New Service Amps __/ Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work Yes [W No ❑ (Check Appropriate Box) Utility Authorization No. Overhead ❑ Undgrnd ❑ Overhead ❑ Undgrnd ❑ No. of Meters No. of Meters No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures / / Swimming Pool Above In- ❑ ❑ grnd. gmd. Generators KVA No. of Emergency Lighting No. of Receptacle Outlets �� No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of zones No. of Detection and No. of Ranges No. of Air Cond, Total tons Initiating Devices No. of DisposalstJo.of Heat Total Total Pumps Toni KW No. of Sounding Devices No. of Sell Contained No. of Dishwashers Space/Area Hosting KW Detection/Sounding Devices Local Mvnieipti ❑Other ❑ No. of Dryers Heating Device! kW Connection No. of No. of Low Voltage No. of Water Heaters I W Signs Ballasts Wiring No. Hydro Massage '1'Lbs No. of Motors Total NP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy Including Compl d Operations Coverage or Its substantial equivalent. YES re/NO C 1 have Submitted valid proof of same to the OMce. YES O' NO C It you have checked YES, please indicatb the type of coverage by checking the Appropriate box. - INSURANCE C C BOND OTHER ®' (Plbese Specify) Estimated Value of Electrical Work $ (Expiration Date) 55 // / Work to Start � - 13-16 Inbpection pate Requested: Rough _ �✓/l Gd- (l hnbl _fir `� Ci -11 Signed under the Penaltles of p,odury: FIRM NAME , �R (CP— fid (( G.i-ct 0%e C . Llc. No. 31�A Liesrieee _ 1�►�l� �<< I Signature (.IC. NO. Eo_QS30 Address 1'1 6 )e 6 Bus. Tot. No. �9 —8 73y Alt. Tel. No. O'WNER'S INSURANCE WAIVER: 1 tm iware that the Licensai! does not have this Insurance eoversge or Its 'substantial equivalent is ri!- quited by Massachusetts General Laws, and that my signature on this permit application walves this requirement. Owney Agent (Please check one► Telephone No. PERMIT FEE 11; (Signature of Owner or Agent) x-6565 ;#.�.2924 NORTH TOWN D '�`f%x4,�a.�'�;�iAt�t+6 ['�r'.'cr'.�p4(Ard'-...�� - �. .�-.�,r�,.--•.,'�- .. Date ......3.." 1.3..`. 9.4 OF NORTH ANDOVER x PERMIT FOR WIRING This certifies that ......r.:....................t:r....:........ has permission to perform :. /r/' 2 .. ......... wiring in the building of .:. tet , ... ......... .. . .. ...... ...... at .:.:. ....AL .. ........ .. ............. , North Andover, Mass. t/1> r - Fee .J.........:. Lic.` N©�.. .� Q .............. ELECTRICAL. INSPECTOR r l :17 100.00 PAID s WHITE:, Applicant -CANARY.. Building Dept. PINK:..Treasurer GOLD: File