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Location
No. CGL` -2,60 Date �t
Check #
30640
TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
F �
Building Inspector
Final Construction Control Document
r
To be submitted at completion of construction by a
Registered Design Professional
for work per the 81" edition of the
V'
Massachusetts State Building Code, 780 CMR, Section 107
Project Title: Bridget Shainwald - 222R-305SHAI Date: 8-26-16 Permit No. 04o y. �01 7
Property Address: 305 Winter Street, North Andover, MA 01845
Project: Check one or both as applicable: 0 New construction x Existing Construction
Project description: PV Panel Installation
I Paul Zacher MA Registration Number: 50100 Expiration date: 06/30/2018 , am a
registered design professional, and I have prepared or directly supervised the preparation of all design plans,
computations and specifications concerning:
[ ] Architectural X Structural
[ ] Fire Protection [ ] Electrical
[ ] Mechanical
[ ] Other:
for the above named project. I, or my designee, have performed the necessary professional services and was present at the
construction site on a regular and periodic basis. To the best of my knowledge, information, and belief the work
proceeded in accordance with the requirements of 780 CMR and the design documents approved as part of the building
permit and that I or my designee:
1. Have reviewed, for conformance to this code and the design concept, shop drawings, samples and other submittals
by the contractor in accordance with the requirements of the construction documents.
2. Have performed the duties for registered design professionals in 780 CMR Chapter 17, as applicable.
3. Have been present at intervals appropriate to the stage of construction to become generally familiar with the
progress and quality of the work and to determine if the work was performed in a manner consistent with the
construction documents and this code.
Nothing in this document relieves the contractor of its responsibility regarding the provisions of 780 CM
OF&fq,9
PAUL K.
Enter in the space to the right a "wet" or ZACHER m
electronic signature and seal: o STRUCTURAL
Cn
No. 50100
06/30/2Q�
Phone number: (916) 961-3960 Email: aul zse.com ONAL�G\
Building Official Use Only
Building Official Name: Permit No.: Date:
Version 06 11 2013
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Arnica Mutual Insurance Company GREATER BOSTON OFFICE
Arnica Life Insurance Company 45 William Street, Suite zoo
Arnica General Agency, Inc. Wellesley Hills, Massachusetts 02481-4050
AUTO HOME LIFE
Town Hall
Building Inspector
North Andover, MA 01845
File Number:
Date of Loss:
Owner/Insured:
Street:
Town:
Type of Loss:
Attn: Building Inspector
F01200209408D
May 4, 2002
Bruce S. Shainwald
305 Winter St
No. Andover
Water
May 6, 2002
Please be advised that we insure the above named
individual(s). A claim has been made for Damage to Real Property
and as the insurer, we are presently in the process of adjusting
the loss.
We are mandated to comply with Massachusetts General Laws,
Chapter 139 and as such, if there are any present liens on the
above property, please notify us within 10 days of receipt of
this letter. If we do not hear from you, we will be under no
obligation to pay you any portion of this claim.
*GT
Very truly yours,
Janet M. Walleston
Claims Department
Amica Mutual Insurance Company
jwalleston@amica.com
Toll Free:1-888-7o-AMICA (1-888-702-6422), Web Site: www.amica.com
Claims Fax: (781) 431-7899, Production Fax: (781) 431-1665
MASSACHUSETTS UNIFORM APPUCATION FOR PERMIT TO DO PLUM81NG
i ` -• (Ptint at TWO p
NORTH ANDOVER, . Maga. Dai ta 10
Building1 !_ Pemtt
G �"(
Location 3' fin/,
/ nr d� Owner'
lV ` l7 Irl N me C Cqv4
New ❑ Renovation ❑ Replacement Plans Submitted: Yes ❑
eck one: Certificate
Installing Company Name �.j <a
Address P�. i, ❑ PartnetaNp _
❑ Firm/Co.
%fi
Business Telephon (��-d
Name of Ucensed Plumber r✓ Q- -e-qr
INSURANCE COVERAGE: ChecUne
1 have a current Ilabilty Insurance policy or to substantial equhWent. Ye: No ❑If you have checked yg}, please Indicate the type coverage by checking the appropriate box
A Itabilly insurance policy Cther type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licenses does not have the Insurance coverage required by
Chapter 142 of the Mass. General laws, and that my signature on that permit application wetves'.this requirement..
Checlt one: - .
Owner ❑ Agent 0 .
Signature of ei or Owner s Agent
I hereby certity that all of the detaAs and Information I hays sutxrmed for entered) In above appAcation ate true and accurate to the best of my
knowledge and that as plumbing work and Installations performed under the permit lasued tot this appikamillbe cmVilanes with all
pertinent provisions of the Massachusetts State Plumbing Code and Chapter 14 due al LaT 13
HY
Signatme o4 Lkensod Plumber
This License Number
Ctty/Town
Type of Plumbing License: Master ❑
APMOVED (OFFICE USE ONLY) Journeyman 15,
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SUM -081011T.
eASSUGHT
LL
1sT FLOOR
2NDFLOOR
SRO FLOOR
4TH FLOOR
STH FLOOR
eTH FLOOR_
I
IL
TTH FLOOR
aTH FLOOR
-
eck one: Certificate
Installing Company Name �.j <a
Address P�. i, ❑ PartnetaNp _
❑ Firm/Co.
%fi
Business Telephon (��-d
Name of Ucensed Plumber r✓ Q- -e-qr
INSURANCE COVERAGE: ChecUne
1 have a current Ilabilty Insurance policy or to substantial equhWent. Ye: No ❑If you have checked yg}, please Indicate the type coverage by checking the appropriate box
A Itabilly insurance policy Cther type of indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licenses does not have the Insurance coverage required by
Chapter 142 of the Mass. General laws, and that my signature on that permit application wetves'.this requirement..
Checlt one: - .
Owner ❑ Agent 0 .
Signature of ei or Owner s Agent
I hereby certity that all of the detaAs and Information I hays sutxrmed for entered) In above appAcation ate true and accurate to the best of my
knowledge and that as plumbing work and Installations performed under the permit lasued tot this appikamillbe cmVilanes with all
pertinent provisions of the Massachusetts State Plumbing Code and Chapter 14 due al LaT 13
HY
Signatme o4 Lkensod Plumber
This License Number
Ctty/Town
Type of Plumbing License: Master ❑
APMOVED (OFFICE USE ONLY) Journeyman 15,
`1
f,r2686
NOR7M
Of t, Sao .a �fti
H 9
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that .�.-r+s� . �� : �� ....................
has permission to perform ......................... .
plumbing in the buildings of .................
North Andover, Mass.
Fee. /A'. Lic. No..?. 7�c7 .......... .
PLUMBING INSPECTOR
11/09/95 13:59 15.00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File