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Miscellaneous - 31 HUCKLEBERRY LANE 4/30/2018
T HUCKLEBERRY LANE 210/065.0-0221-0000.0 r Location No. d3 Date '1- 2. L/ MORTIy TOWN OF NORTH ANDOVER 3? i • O }co •;s Certificate of Occupancy $ sAGMUSEt� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ i Check # .6-41S-3 17686 /�--�---- -1 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING so BUILDING PERMIT NUMBER: �^O 2 DATE ISSUED: a X SIGNATURE: Building 0i6itlissioner/Inspector of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: / 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide R redProvided R red Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record / S�.�U6- JO/Z.c1RA.- Name(Print) Address for Service: Signature Telephone 2.2 Owner of Record: 1 Name Print Address for Service: z M Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: � g Z J / License Number e�q Addre p � n��6 Expiration Date ignature Telephone r i 3.2 Regis'red Home Improvement Contractor Not Applicable ❑ E,- ' �-6� " &,/c/o , r` Company Name 16S 5!S d M Registration Number J� z Rcl*.,r s ��� /moo Add re � P Q6 co 7 o Expiration Date ^ i nature Tele hone Y SECTION 4-WORKERS COMPENSATION(NLG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work check a0 applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ 1 Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: or ua. r,ov �i •,J - SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be „ OMCIAL USE ONLY Completed by pemiit applicant 1. Building (a) Building Permit Fee 8 2,00, Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)x(b) / 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, ,as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building pennit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION as Owner/Authorized A ent subject 1 g property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name 2i Si at e of Owne A ent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 ST 2ND 3 RD t SPAN DIMENSIONS OF SILLS DMIENSIONS OF POSTS DRV ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHI VMY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE r� ✓fe �a�rimanurP,a�lf a��'�(n.s.suc�u,1�1 Board of Building Regulations and St2ndaib3 ' HOME IMPROVEMENT CONTRACTOR I yi Registration: 108450 Expiration: 8118/2004 Type: DBA j R.S.NEBERT BUILDING&REMO ` ROnaj,�'Hebert ' 102 Adams Ave. -� 11inistrator, No.Andover,MA 01845 Adm BOARD Of BUILDING REGULASONS + f License: CONSTRUCTION SUPER I Number: CSR 058241 I Birthdate: 01/08/1955 Expires:01/08/2006 Tr.no: 14973 Restricted: 00 RONALD S HEBERT s 102 ADAMS AVE t N ANDOVER, MA 01845g of w� E Actinmiss er The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name: F A.,a Location: 3/ City Phone d 7�f aT am a homeowner performing all work myself. R 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: Address City: Phone#: Insurance Co. Policy# Company name: Address City: Phone#: Insurance Co. Policy# Failure to secure coverage as required under Section 25A or 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 DW for coverage verification. I do herby certify under the ains and penalties of perjury that the information provkJed above is true and correct Signature ; Date o Print named Phone# Official use only do not write in this area to be completed by city or town official' ❑ Building Dept ❑Check if immediate response is required Building Dept ❑ Licensing Board ❑ Selectman's Office Contact person: Phone 4P Health Department ❑ Other FORM WORKMAN'S COMPENSATION North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision 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 c11, S150A. The debris will be disposed of in: (Location of Facility) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector SHORT-FORM FIXED PRICE AGREEMENT CONTRACTOR'S NAME: R.S. Hebert Building & Remodeling ADDRESS: 102 Adams Ave. No. Andover Ma. PHONE: 978-6860786 FAX: 978-6860786 LIC #: 058241 H.I.C. Reg.# 108450 DATE: 02/17/04 OWNER'S NAME: Steve Jordan ADDRESS: 31 Huckelberry Lane No. Andover Mass. 01845 1. PARTIES This contract (hereinafter referred to as "Agreement") is made and entered into on this _17 day of_Feb — 12004 , by and between _Steve Jordan , (hereinafter referred to as "Owner"); and_Ronald Hebert , (hereinafter referred to as "Contractor"). In consideration of the mutual promises contained herein, Contractor agrees to perform the following work: II. GENERAL SCOPE OF WORK DESCRIPTION Laundry Room Remove blueboard and plaster from walls,baseboard and door unit. Supply and install blueboard and plaster walls. 41/4" baseboard,4'-8" x 6'-8" double door unit to match. -Paint walls and trim two coats. 2"d Floor Hall Pull back carpet and remove tack strips from laundry room side. Renail subfloor in damaged area. Install new tack strips and restretch carpet and reseam two doorways. 1st Floor Bath Remove baseboard. Install new 51/2" col. Baseboard. Paint baseboard two coats. f Hall Closet Remove blueboard and plaster walls and ceiling , baseboard, door trim and shelving unit. Install Blueboard and plaster walls and ceiling 51/2" col baseboard Door trim and reinstall shelving unit. Paint walls and trim two coats. Kitchen Remove blueboard and plaster ceiling Island granite top and save Island cabinet Hanging light fixture , two ceiling speakers. Install blueboard and plaster ceiling New island cabinet Reinstall granite top and light fixture. Two new speakers. Paint walls and ceiling two coats. Den Paint wall that continues from kitchen. Dining room Remove baseboard, crown moulding, blueboard and plaster ceiling and hardwood flooring. Install blueboard and plaster ceiling. Renail subfloor. Install new hardwood floor. 51/2" baseboard, crown moulding. Sand and finish floor two coats. Paint ceiling and new trim two coats. Paint walls with Faux paint $ 600.00 allowance. Livingroom Remove baseboard and hardwood flooring. Install new hardwood floor, 51/2" baseboard. Stain kill ceiling. Paint ceiling, baseboard and crown moulding two coats. Paint walls with Faux paint $600.00 allowance. Sand and finish hardwood floor two coats. General Supply permit, dumpster and porta,jon. (Additional Scope of Work page(s) attached: Yes_x No) LUMP SUM PRICE FOR ALL WORK ABOVE: $18200.00 Payments $3640.00 at start of work $3640.00 Demo $3640.00 Plaster and trim $2730.00 Paint $2730.00 Hardwood floor installed $910.00 Completion 2. STANDARD EXCLUSIONS: Unless specifically included in the "General Scope of Work"section above, this Agreement does not include labor or materials for the ftlowing work: Plans, engineering fees, or governmental permits and fees of any kind. Testing, removal and disposal of any materials containing asbestos (or any other hazardous material as defined by the EPA). Custom milling of any wood for use in project.. Labor or materials required to repair or replace any Owner-supplied materials. Final construction cleaning (Contractor will leave site in "broom swept" condition). correction of existing out- of-plumb or out-of-level conditions in existing structure. Correction of concealed substandard framing. Rerouting/removal of vents,pipes, ducts, structural members, wiring or conduits, steel mesh which may be discovered in the removal of walls or the cutting of openings in walls. Removal and replacement of existing rot or insect.infestation. Failure of surrounding part of existing structure, despite Contractor's good faith efforts to minimize damage, such as plaster or drywall cracking and popped nails in adjacent rooms or blockage of pipes-or plumbing fixtures caused by loosened rust within pipes; Exact matching of existing finishes. Public or private utility connection fees. Repair of damageAa roadways, driveways, or sidewalks that could occur when construction equipment and vehicles are being used in the normal course of construction. B. DATE OF WORK COMMENCEMENT AND SUBSTANTIAL COMPLETION Commence work: _02/17/04 . Construction time through substantial completion: Approximately_4 to 5 weeks/ not including delays and adjustments for delays caused by: inclement weather, addition al..time required for Change Order work, and other delays unavoidable or beyond the control of the Contractor. C. CHANGE ORDERS: CONCEALED CONDITIONS AND ADDITIONAL WORK 1. CONCEALED CONDITIONS: This Agreement is based solely on the observations Contractor was able to make with the structure in its current condition at the time this Agreement was bid. If additional concealed conditions are discovered once work has commenced which were not visible at the time this proposal was bid, Contractor will stop work and point out these.unfefeseen concealed conditions to Owner so that Owner and Contractor can execute a Change Order for any Additional Work, 2. DEVIATION FROM SCOPE OF WORK: Any alteration or deviation from the Scope of Work referred to in this Agreement involving extra costs of materials or labor (including any overage on ALLOWANCE work and any changes in the Scope of Work required by governmental plan checkers or field building inspectors) will be executed upon a written Change Order issued by Contractor and should be signed by Contractor and Owner prior to the commencement of Additional Work by the Contractor. 2. PAYMENT OF CHANGE ORDERS: Payment for each Change Order is due upon completion of Change Order work and submittal of invoice by Contractor. 3. ADDITIONAL PAYMENTS FOR ALLOWANCE WORK AND RELATED CREDITS: Payment for work designated in the Agreement as ALLOWANCE work has been initially factored into the Lump Sum Price and Payment Schedule set forth in this Agreement. If the actual cost of the ALLOWANCE work exceeds the line item ALLOWANCE amount in the Agreement, the difference between the cost and the line item ALLOWANCE amount stated in the Agreement will be written up by Contractor as a Change Order If the cost of the ALLOWANCE work is less than the ALLOWANCE line item amount listed in the Agreement, a credit will be issued to Owner after all billings related to this particular line item ALLOWANCE work have been received by Contractor. This credit will be applied toward the final payment owing under the Agreement. Contractor profit and overhead and any supervisory labor will not be credited back to Owner for ALLOWANCE work. E. WARRANTY Contractor provides a limited warranty on all Contractor- and Subcontractor- supplied labor and materials used in this project for a period of one year following substantial completion of all work. No warranty is provided by Contractor on any materials furnished by the Owner for installation. No warranty is provided on any existing materials that are moved and/or reinstalled by the Contractor within the dwelling (including any warranty that existing/used materials will not be damaged during the removal and reinstallation process). One year after substantial completion of the project, the Owner's sole.remedy (for materials and labor) on all materials that are covered by a manufacturer's warranty is strictly with the manufacturer, not with the Contractor. Repair of the following items is specifically excluded from Contractor's warranty: Damages resulting from lack of Owner maintenance, damages resulting from Owner abuse or ordinary wear and tear; deviations that arise such as the minor cracking of concrete, stucco and plaster; minor stress fractures in drywall due to the curing of lumber; warping and deflection of wood; shrinking/cracking of grouts and caulking; fading of paints and finishes exposed to sunlight. THE EXPRESS WARRANTIES CONTAINED HEREIN ARE IN LIEU OF ALL OTHER WARRANTIES, EXPRESS OR IMPLIED, INCLUDING ANY WARRANTIES OF MERCHANTABILITY, HABITABILITY, OR FITNESS FOR A PARTICULAR USE OR PURPOSE. THIS LIMITED WARRANTY EXCLUDES CONSEQUENTIAL AND INCIDENTAL DAMAGES AND LIMITS THE DURATION OF IMPLIED WARRANTIES TO THE FULLEST EXTENT PERMISSIBLE UNDER STATE AND FEDERAL LAW. F. WORK STOPPAGE, TERMINATION OF CONTRACT FOR DEFAULT, AND INTEREST Contractor-shall have the right to stop all work on the project and keep the job idle if payments are not made to Contractor in accordance with the Payment Schedule in this Agreement, or if Owner repeatedly fails or refuses to furnish Contractor with access.#o the job site and/or product selections or information necessary for the advancement of Contractor's work. Simultaneous with stopping work on the d project, the Contractor must give Owner written notice of the nature of Owner's default and must also give the Owner a 14-day period in which to cure this default. If work is stopped due to any of the above reasons (or for any other material breach of contract by Owner) for a period of 14 days, and the Owner has failed to take significant steps to cure his default, then Contractor may, without prejudicing any other remedies Contractor may have, give written notice of termination of the Agreement to Owner and demand payment for all completed work and materials ordered through the date of work stoppage, and any other loss sustained by Contractor, including Contractor's Profit and Overhead at the rate of_20 % on the balance of the incomplete work under the Agreement. Thereafter, Contractor is relieved from all other contractual duties, including all Punch List and warranty work. G. DISPUTE RESOLUTION AND ATTORNEY'S FEES Any controversy or claim arising out of or related to this Agreement involving an amount of less than $5,000 (or the maximum limit of the court) must be heard in the SmalL.Claims Division of the Municipal Court in the county where the Contractor's office is located. Any controversy or claim arising out of or related to this Agreement which is over the dollar limit of the Small Claims Court must be settled by.-binding arbitration administered by the American Arbitration Association in accordance with the Construction Industry Arbitration Rules. Judgment upon the award may be entered in any Court having jurisdiction thereof. The prevailing party in any legal proceeding related to this Agreement shall be entitled to payment of reasonable attorney's fees, costs, and expenses. H. EXPIRATION OF THIS AGREEMENT This Agrgement will expire 30 days after the date at the top of page one of this Agreement if not first accepted in writing by Owner. I. ENTIRE AGREEMENT This Agreement represents and contains the entire agreement between the parties. Prior discussions or verbal representations by the parties that are not contained,in this Agreement are not a part of this Agreement. I have read and understood, and I agree to, all the terms and conditions contained in the Agreement above. Date CONTRACTOR'S SIGNATURE Date OWNER'S SIGNATURE Ttyo o #6,,,0 :_ , Andover 0 ad , 0 No.�JV 3 C% T dower, MaSS., .? • y` �� Y O >_ LAKE COCMICMEWICK ADRATE D `S V BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...... Y V �' �0^ ................46AA �............................... Foundation has permission to erect.... .... buildings on..................... .......... Rough ................... to be occupied as... / ....}�A NWA ri E ....Coo..�l j.r .. �0 N ...................... Chimney .............................. .... provided that the person accepting this permit shall in every respect conform the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspe ion, Alteration and Construction of Buildings in the Town of North Andover. PO dOW PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST TS Rough ......`r/ ................................ ..... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and.,Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE 11 Smoke Det. _ r N° 1463 Date-......... ..i............ w s f NORT►{� S. TOWN OF NORTH ANDOVER p PERMIT FOR WIRING �SSAcMusf� . 1 This certifies that ....... haspermission to perform ...: : ...�::...........�.............................. ;.... wiring in the building of........ .............................................................. -.. :�-�-:: ' p North Andover Mass. -' -/� Fee�:.............. Lic.No. ............. ............................................................... 9 n ELECCRICAL INSPECTOR 03/02/98 10:02 35,00 WHITE: Applicant CANARY: Building Dept. PINKN49}Surer .j The C01)"tionwe- 1 ; LONrcumancy ffice Use Only -- _.` k Depanmenf of f'trhfir. Safe fV�� BOARD OF FinE PREVENTI(_)N RE_GUl-ATlOr1, 5 27 cmn 17_:00'7Fon Chncknavn blank) ---- APPLICATION FOR PERA41-F 7*0 PERF=O '.A'r+ar4!o a mfnmm d to sr ,rernr-r_111 the(.r"11mchU79n7 Ef, ,_2M ELECTRICAL WORK (PLE..ISE F(11NT IN INK OR TYPE ALL INFORMATION cO'" "t)clue rzoo City or To, of The underricned applies fer a permit to perform the dnscrib,ad--- ho!ow. ----- -_—To the Inspector of Wires: Location (':'treat h Number)- Owner or'-errant .____ /' f/jl' IA1 tJ f�_� •L 1IV d '��------•-- C,vner's Addre. --__— TE Is this permit in conjunction with a builclinq permit E (7 SE Purpose of Building (Ch-•;k Apornpriate Box) L ,1l.Q " �'�- --_-Utility Authorizat!or- No. E.xisting Service ----imps-----J------Volts `+erhead i_ ----------__--------• New Service O ] Undgrd Flo. Of Meters Volts Cverh.._,d — _..J1mps�--_---J__------- �-1 - Number of Feeders and Ampacit - Undgrd ❑ NO. of Location and Nat'•re of Proposed Electrical Work__ No. of lighting --_--_----- ---__._ - --------------- Flo. of Hct Tubs --'- No. of Ughtin Fixtures _-' --- r—{ - __Ilio• of Tmnslormers 101A1-- Above U In�- _--------- fCVA Swirruninq Pawl _ arnd. red - No. of Recootacle Outlets. -- -`-..- -2' Zrid -- Generators Nn. of Cil Burners fio. of Emer nHc.- ----- -_KVA --- g- ,y Lighting No. of Switch Outlets —_--___ -- ---- --- Battery Units No. of Gas Bu,Hers No. of Ran es _._-i_ FIRE ALARfAS No. of Zcnn, TOI-AL tlr� of Detection and No. of Air<;onditianers _ TOFJS -----'- tJo. of Otsoosals - HF -- Initiating Devir•ee 1,tJ 1,1L f O ir1L tlo. of Sounding fJo_of Pumps- KW g Devices _ TUNS _ tJa. of, o No. of Dishwashers ---- - S.If Contains-} Soaca/Area Heat'n Detection/Sodnding Devices No. of Dryers -------q--- -—KW -_- Heallr D__vices KW Municipal '---- No. of Water Heaters .- 4__ ---' -- - Lccal ❑ KW No, of Na of Connection U Other Si ng___ Ballasts Lo v`voltage- '----------_ No. of Hydro Massage Tubs `—' itinq- Flo_of Motors ---------___ Total }{p 7 -- OTHER: - _ J_._- 1 INSURANCE COVERAGE: Pursuant to the requirements of Massar..husetts General Laws -_-_'__� I have a current Uabiitty Insurance Policy Including Cam Of M s _--- valid proof of same to this office, p Feratinns Coverage or its subshntial equivalent YF3 L� NO p I haave •uhrniltnd If you have chocked YES, please ndiic O the type of covers a by 9 checking the ::appropriate box. INSURANCE ❑T BOND ❑ orHER El (I'lease Estimated Value of Electrical Work S - _—� (Expiratlon Dere) Work to Slart_�- Slgned under the penaitlea of - Inspection Uaro ' ?raue3ted: perjury: Rar.rgh_ i !�!^'� NAME -Final .� • �,�=%1-'��� L�� /A e1 a l NO. tiJ�Ff- I- Ad e ,�Q• (f S dr s '1 /1 �k c �---- LIC. NO._Q_r t� F ///f/V °x1'T�. 1S, �' hN' Q'. 7 -l_. / —_ --- Bus. col. No.� rIER•S INSunANCE WAIVER: lam- '- }l-" chusetts General Laws, I am aware That the LlCensrry r:! ,^s not hnv! the in urn n c ve , Alt. Tel. No.That my signature on chi. al"C!'- �tlrn wa"? Ihie rn ° rage or its sub;tnntlnl ;• -'- "------ quirnrnent Owner Agnnt (F 1n,ge clh^rk cnnrt rirr♦ hY Location—3 fav 4 No. < C Date J. M�RTM TOWN OF NORTH ANDOVER � R 9 Certificate of Occupancy $ CMUs<�' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Cgs C) - " Check # / 7 1 17592 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVAT& OR DEMOLISH A ONE OR TWO FAMILY DWELLING fiw 001"t* BUELDING PERMIT NUMBER: f y DATE ISSUED: _ _ © M SIGNATURE: Building Commissioner/IpEL=tor of Buildings Date assal SECTION 1-SITE INFORMATION z 1.1 Property Address: 1.2 Assessors Map and Parcel Number: O 3J /-Aca4amr le 5 n Number A {T,fJ, -w< /yl�¢_ Parcel Number r� 1.3 Zoning Information: 1.4 Properly Dimensions: Zoning District Proposed Use Lot Area Fronts 11 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided RzqWred Provided v 1.7 Water Supply M.G.L.C.40. 34) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System; Public ❑ Private ❑ zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT '1��i 011 t= l"tr!Ct: \I/r_,3 m 2.1 Owner of Record ff ccEy Cn�E f j� aEc Eu/E7T— 3 l u Name(Print) Address for Service 9�8 ins� c Signature Telephone 1 1) 2.2 Owner of Record: 1 Name rint Address for Service: 0 i Signature Telephone rnM SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Nyza4 r W—, tS# e Licensed Construction Supervisor: 0 License Number Wk&0�ct TKSBa�y /h/� o/dib ^� ess Expiration Date a.. Si a Telephone r 3.2 Retistered Home Improvement Contractor. Not Applicable ❑ v Company Name 37 9413 Registration Number r ezoz dr" Adr NEEDEDExpiration Date G) Signature' Telephone z , SECTION 4-WORKERS COMPENSATION(KG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Si ed affidavit Attached Yes.......0 No.......0 SECTION 5 Description of Proposed Work check au a ble New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: f/J/IS,4 ?WS901 ? u.srAfC, al&U5&X0iti6 krso7ayr-K K1,ry1,,6 SVSrni 66'40X 7/� !V)Z?t Z 'XL ' hVfAS /re,✓& P,40&61QW& PrnyCcs SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFIML USE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee of Multiplier 2 Electrical (b) Estimated Total Cost of Construction l 3 Plumbing Building Permit fee(a)x(b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property Hereby authorize 4'wr4o J we-9 to act on My a ,id all matter relativ ork authorized by this building permit application. ,1(, /1 t Q/ Si tat er Date SECTION 7b O NER/AUTHORIZED AGENT DECLARATION 1, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are Lue and accurate,to the best of my knowledge and belief Print N Signatj o Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS lyr2 ND 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DUV ENSIGNS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS }" SIZE OF FOOTING X MATERIAL OF CHBANEY 1S BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****'APPLICANT FILLS OUT THIS SECTION ******-*************** �O APPLICANT &,PHONE_J2l3S- LOCATION: Assessor's Map Number PARCEL SUBDIVISION LOT (S) - to ST. NUMBER_J, OFFICIAL USE ONL RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS -SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENTS/! �e�,�,, s �cg�a�e� o � ' �,✓/Q� � --J ����_ r�� O RECEIVED BY BUILDING INSPECTOR DATE Revla d 9197 jm 92. "�v�norurreal���/Lfaova�/�� BOARD OF BUILDING REGULATIONS 6 License: CONSTRUCTION SUPERVISOR Number: CS 079893 Birthdate: 10/05/1962 Expires: 10/05/2005 Tr,no: 79893 Restricted: 00 DANIEL F WALSH 488 KENDALL RD TEWKSBURY, MA 01876 Administrator SOCA International Evaluation Report p 't/, C ��� • �/ A .� ��� 11: 1 - + vaivaton sceape condition of use Research Report otxtpltatt e with the follosvuag bodes This report is limited to applications and gpC Natpat Btttldtrt Ct� c fgcg` products as stated herein. BOCA-ES intends 21 *2 ■ Section 8{l3 Classtficati€n that this report be used by the code official to determine that the report subject complies with ■ ecttctm 8U 6 Carpet and carpet lalt the code requirements specifically addressed, MANUFACTURER: 1va11 covnngs provided that this product is installed in accor- dance with the following conditions: ■ Sctac�n ltl 4 Aitrttattve n,tenals OWENS CORNING attd equipment ■ OWENS CORNING Basement Wall Finish- ONE OWENS CORNING PKWY ■ Seetton 2f€1 7 Inti rtor trizm ing SystemTMis intended for finishing walls TOLEDO,OHIO 43659 in basement applications.Other applications ■ Section 13f11 I Beope(1✓nrgy are outside the scope of this report. conservatton) DIVISION 7—THERMAL AND ■ The maximum permitted area of the PVC MOISTURE PROTECTION 1998 irttemrttirmal L?:,c ,grad 7t� moldings shall not exceed 10 percent of the Feirrral�=1?�tiltangr�d aggregate wall.and ceiling area of the room. Section 07200—Insulation ■ Seaton 318 I 'UG�all and eeltng ■ Installation of the Basement Wall Finishing {tame spread Index) SystemTM shall be in accordance with this DIVISION 9—FINISHES ■ Secttrsn 31 .2 Srmke developed report and the manufacturer's installation Index manna]• Section 09540—Special Wall ■ Seaton 3l 1 Iestrng ■ Basement Wall Finishing SystemTM shall be Surfaces VD installed over cast-in-place concrete or concrete masonry unit walls, or wood or EVALUATION SUBJECT' description metal stud .framing. Supporting structural systems shall conforming to code require- OWENS CORNING Basement Wall Finishing ments for that system and are outside scope BASEMENT WALL FINISH System"m is an alternative to conventional wall of this report. SYSTEMTM framing and gypsum wallboard.The Basement ■ The electrical wiring in the chase at the Wall Finishing SystemTM consists of PVC bottom of the Basement Wall Finish Sys- support lineals, base, batten, and cove mold- temT�'shall conform to the requirements of Ings, and rigid pre6nished fiberglass panels. the code and is outside the scope of this Panels are prefinished with a fabric cover. report. Basement Wall Finishing SystemTM is primar- ily intended for installation. in residential items requiring applications. Refer to Figure I at the end of this report for illustrations of the Basement Yerification Wall Finishing SystemT''r. The following items are related to the use of the The Basement Wall Finishing SystemTM shall report subject, but are not within the scope of be installed in accordance with the manufac- this evaluation.However,these items are related turer's installation instructions and this report. to the determination of code compliance. Installation typically consists of either me- 6/ Concealed electrical,mechanical,orplumb- chanical fasteners or adhesive.fastening or a ing components shall be inspected prior to combination of both to the supporting sub- the installation of the Basement Wall Fin- strate. Thermal resistance (R-value) for the ishing SystemTM panels to verify compli- fiberglass panels is 1.1. ance with related code requirements.Evalu- Basement Wall Finishing SystemTM panels ation of these components is outside scope PRINTED AUGUST,2000 meet the requirements for classification as a of this.report. Class I interior finish as tested in accordance d Framing supporting the Basement Wall page 1 of 2 with ASTM E84 and also has demonstrated Finishing System""'shall be inspected prior that it will not spread fire to the edge of the to the installation of the panels to verify Copyright©2000, specimen or cause flashover in the test room.in compliance with related code requirements. BOCA Evaluation Services, Inc. accordance with the testing requirements Evaluation of this framing is outside scope specified in Section $03.6(2) of the BOCA of this report. A Participating Member National Building Code/1999. ' of the NES, Inc. Page 2 of 2 Research Report No.21-24• Information submitted product identification ■ IntegrexTM Testing Systems,Report No.73143,dated April 17, All OWENS CORNING Basement Wall Finishing SystemsTM 2000,containing.results of physical testing. manufactured in accordance with this research report shall bear ■ IntegrexTM Testing Systems,Report No. C423-99065, dated the following identification: August .19, 1999,containing results of physical testing. ■ "See BOCA Evaluation Services, Inc. Research Report No. ■ Omega Point Laboratories,Report No.13060-1.03216a,dated 21-24." Akk� m a' May 14, 1999,containing results for fire testing to accordance with ASTM E84 for rigid fiberglass wall panels used in All Molding Basement Wall Finishing System"m. Snaps Existing Foundation Wall ■ Omega Point Laboratories,Report No. 16218-106644,dated PVC or Interior Partition April 13,2000,containing results for fire testing in accordance Support with ASTM E84 for moldings used in Basement Wall Finish- Grid i.ng SystemTM. ■ Omega Point Laboratories,Report No.1.3060-.10321.3a,dated 2.5"Glass June 7, 1998, and Report No. 1.3060-104470a, dated March Fiber Board 24, 1999,containing results for.fire testing for full-scale room Panel with Facing corner testing in accordance with requirements contained in PVC Section 803.6(2)of the BOCA National Building Code/1.999. �__.-....--__ ____ `. Cove Molding ■ OWENS CORNING Product Literature, dated.May .1998. PVC Support Lineal ■ OWENS CORNING Submittal Sheet for Basement Wall (top, bottom, Finishing System(BWFS), dated April 2000. vertically every 48") ■ OWENS CORNING Basement Wall Finishing System Installation Manual, dated January 2000. application for permit To aid.in the determination of compliance with this report. the PVC following represents the minimum level of information to Molding PVC accompany the application for permit: Vertical Molding g ■ The language"See.BOCA Evaluation Services,Inc,Research Base Report No. 21-24"or a copy of this report. -r ■ Plans indicating the aggregate area of the room and the area of the PVC moldings being used. Figure 1 Sketch of Basement Wall Finish SystemTM ■ Plans and specifications of any electrical, mechanical, or Showing Typical Components plumbing items installed within the wall system. 'THIS DRAWING IS FOR ILLUSTRATION PURPOSES ONLY.IT IS NOT ■ Details and specifications of the supporting construction to INTENDED FOR USE AS A CONSTRUCTION DOCUMENT FOR THE which the system is to be applied. PURPOSE OF DESIGN,FABRICATION OR ERECTION. 9}, NOTICE TO REPORT USERS This report is subject to annual certification.Reports that are not certified shall not be used or referred to.To determine the status of certification of this report,contact BOCA Evaluation Services,Inc.,or consult the latest edition of the BOCA International Product Evaluation Listing published periodically in the BOCA magazine. This report is subject to the conditions listed herein and to the specific product,data and test reports submitted by the applicant requesting this report. Independent test were not performed by BOCA Evaluation Services,Inc.and BOCA-ES specifically does not make any warranty,either expressed or implied,as to any findings or other matter in this report or as to any product covered by this report. Evaluation reports are not to be construed as representing aesthetics or any other attributes not specifically addressed nor as an endorsement or recommendation for the use of the report subject.This disclaimer includes,but is not limited to.merchantability. Please contact BOCA Evaluation Services,Inc.,with any questions you may have regarding this report.Additionally,please contact us if you have any information on the performance of the product described herein which is contrary to this report. 4051 West Flossmoor Road•Country Club Hills, IL 60478-5795 telephone(708)799-2305•fax(708)799-0310 e-mail: boca-es@bocai.org•http://www.bocai.org "0:197885100Uo P.1'1 Liberty Mutual Group Liberty PO Box 7202 X11 7\Alu•u,_7° Portsmouth; NH 03802-7202 illTelephone(800)653-7893 Fax(603)431-5693 Scptcnuber 21,2004 FOR RECORD PURPOSES ONLY RE: Certificate of Workers Compensating Insurancr Insured: BAY STATE BASEti4ENTS LLC DBA ONVENS CORNING FIN]SHED BASEMENT 960 TURNPIKE ST Policy Number: WC,5-31S-344351.011 121roctive: 5/24!101)4 Expiration: 5/24121005 Co,,,wage afforded hinder Workers Compensation Law of the following staze(s) MA �niplot,crs i.iabilily. Soddy hilury by Accident: 5 5170,000 Eacb Accident Bodily Injury by Disease: $ 5110,01111 Each Person Budil}'injury by Disease: $ 500.0011 Pak)Limits Al.of this date,the above-refereaeed policyholder is insumil by LNI Tnsuranr e Ccrporatioi tinder thepolicy listed above ;hc insurnace afforded by the listed policy is snlnjecl.to all the Terms, exclusions and conditions,and is ODI olimd by any requirement-innii or ccodition ofany or other documents tvWi respect to which this ccnifictite inar be issued. ';'h'fs certircate is issued tis a mntler of information only and confers nQ rig!It LIl?ort you.(lie certificate holder. ';'itis=-tificate is not an insurance policv and does not amend, extend,or alter the coverage afforded by the policy listed above. If this policy-is cancelled before the mated a%piratian dale,Liberty Mmuuil will c-sideavor to notify you of such c:anceItation. ,_L AI rT•I 1021L1:1)Kh:P OXENTATIVR I.WL94Y!-gMJALIN811R. NL1,0IM? 'I;Rin.'•.rtH7�ae.�u..c tied hp Lf1ZTsR9 Y P.A t r rl'N_fNv�A2.1�nC6 e.iA.nu r ux tuvpsa�slcr,i t'ttrun v.r; •e�9 on:ea 1!p llcusc+wgtpanirs.. n,,QLltt r ru f R Cr0 fd, cc: IL1Snref3. � BAY STA'L'E EASEMENTS LLC DBA ONVP?gS ANDREW G GORDON INC PSTr-r"Of17� CORNING FINISHED P O BOX�`l9 nASUMENT NORWELL, MA o2061 SEP -3 U 200A R S?00 TURNPIKE ST The Commonwealth of Massachusetts Department of Industrial Accidents Office of lnvesdgedons Boston, Mass. 02111 Worlkers'Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. aI 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: &Y1,1g �r SySTc�v Address 9,0azll de,-E O City; /,s� Ahe eZO2,1 Phone U Insurance.Co. 4/', Pdlcv VV Company name: Address CHy: Phone Insurance Co. Policv 8 Falkne to secure coverage� wired under Section 25A or IWIGL 152 can lead to the imposition of criminal penalties d.e tine up to$1,500.0D andlor one years'impris .as. 6may analttesln lboh=XfA.STOP WDM ORM Ra wd e fins d.(i1II0.0M-aAmV apaind.m.. I understand that a c of this stats ed to the Office d Investigations d the DIA for coverageverification. I db hereby u the pa/ o/ that the information provided above is bue and carmcf. Slgnature Date f. /gyp Print name �Ah11- / , �t Phone# Official use only do not write In this area to be completed by city or town d5clel' City or Town P sing ❑ ❑Check d immediate response Is required Building Dept ❑ Licensing Boefd Contact person: Phone# ❑ Selectman's Office ❑ Health Department ❑ Other North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision 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 c11, S150A. The debris will be disposed of in: / �%�j1%J (,(JLIP%%%V(� 1yy •� v (Location o lity) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector JX -P Board of Building Regula ions and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement,Contractor Registration Registration: 137943 Type: Ltd Liability Corporation Expiration: 1/29/2007 OWENS CORNING BASEMENT FINISHING) PAUL DEGUGLIELMO 960 TURNPIKE ST. } CANTON, MA 02021 ?.' P _- Update Address and return card.Mark reason for change. 50M-04/04-G10 DPS-CA1 Ca Address F-] Renewal ❑ Employment Lost Card //1216p �lLE Vdi77/I➢ZOOBCI/CCLGUL a�✓UCabJa,C�T.l.6eG�6 Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Board of Building Regulations and Standards Registration:. 137943 - ---� One Ashburton Place Rm 1301 Expirat'i6 -/2"9/2007 Boston,Ma.02108 Type Ltd:Liability Corporation X. OWENS CORNING BASEMENT,FINISHING SYS PAUL DEGUGLIELMO " 960 TURNPIKE ST. CANTON,MA 02021 Administrator Not valid witho ignature t NORTFI Town of :.� Andover No. q?o T % - LAKE Clover, Mass., COCNICMEwICK 7d�oRATED BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT '51e a qe �'o a BUILDING INSPECTOR ...................................................�.......................................................................... .......... Foundation has permission to erect... �� fit. ........... buildings on 14V 4��r M � i �, . ... .................................... .........~�................... Rough to be occupied as.......... ......�G..��..M..'�..........I.m. ........... A.S#ft A'4j Chimney ............................................ provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. ` S/� PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Roush Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRU S T Rough .. Service ... ... .. . .......... ............ BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Bumer Street No. IFSEE REVERSE SIDE Smoke Det. GENERAL BUILDING NOTES/CHECKLIST-NOT LIMITED TO ITEMS BELOW POST ALL LOT NUMBERS,ADDRESS, AND PERMIT(COPY OK)..or no inspections INSPECTIONS: (Minimum) Excavation , Footing, Foundation, Frame, Insulation, Final. FOOTINGS: Continuous Full 2x4 Keyway Continuous strip footings for interior columns FOUNDATION: Rebar as required Anchor bolts or straps Damproofing Foundation drain-pipe/stone/fabric filter/cover and outlet connection. FRAME:Fireblock-over girts/plates between floor joist Penetrations for plumbing, heat, elec, etc. Walls at stair stringers. Windbrace comers and center bearing partitions. Size ridge to provide full bearing at rafter cuts. Hip and Valley rafters-watch bearing at walls. Ridge&Hip-Provide proper connections. Cathedral roof rafters provide proper connections and use"Hurricane Clips"tie to plate. Stair stringers-watch cuts and heal support. Joist hangers-fully nailed w/hanger nails. Sill plates 2-2X6(1 PT)w/sill seal. Girls-solid brick or steel plate bearing at foundations %"air space at sides in foundation pockets. Lateral bracing at ends. Certified calculations. required for Beams/LVL's Trusses. Solid bearing support for Headers/Beams etc. Check headroom clearances-stairways, under beams Attic Access. (min. 2240 w/3'headroom above). Crawl space access. (min. 18x24). Bath exhaust fans to have metal duct to exterior(not in soffit). Firecode S/R wood frame of"0"clearance fireplaces&stoves Window Schedule or Every Habitable Room Must Have: Natural light equal to 8%of floor area. 'A of required glazing shall be openable. Bedrooms required min. 20x24 egress window or door. Vent attic spaces-"proper vent", soffit and required ridge vents. Firecode under stairs if used for storage FIREPLACES: Separate permit required. Inspections at Footing-Smoke Chamber-Finish Smooth parging, clean joints, 8"solid @ combust. Surf. DECKS: Separate permit required: Lag to house, provide flashing. Rails min. 36"high, Baluster max space 5"on center. Over 8'above grade, use 6x6 posts w/lateral bracing. Lag all posts and rails. Pier footings down 48", Conc. pad at stair base. FINISH: Handrails returned to wall/newall post. Guardrails required alongside open cellar stairs. Exterior grading complete. Certificate or occupancy required prior to occupying structure. Temporary Stairs required for inspection. Re-inspection fee- $30.00(Be Ready). Certificate of occupancy required prior to occupying structure. • _ • • ��.tea%'/� CORNING �� i�w���i�►� i ■®���!`3 7���� SEMEMEM MENNEN' Neil 1k ME MEN I MOM ME NESEEMEME 10101,04 M- 0-MENEEM MEMO ' W � moms MEESE SEEN SEEMS= GREMEMOMMIN ON mom bloom 10" MENIN No IMISMEMENWEEM aam ONES Emma ■ 1 prf® am ■ENEM, - - A/i` �����■ SME No ■am® � 0,45 mom MEMEMENEM No on CURB a ME al www' ' .01 0 SESSIONS mom ME No's mom SEEN R I MEN M 0 SEEM�EMENESEEMEMEME��MEMO��� ®® EEM MENNEN ■Mid. Mr. MENEM 1111 ME moommmoom 2,25 zzoComm= [ ; o ®� ®��■���������� ■EMM■WEMN MRAMEME ■ 11NESSEEK,BEEMENEEMENEEN so MIREENEENEEMMENEMEN 0 NNW" SnaME ME MEESE���MENEM EMEEMEN JEENEEM EMEMENI�EM 2 kbvEENM SEEMED 0 0 NONE ■ENEMp,No MENNEN 0 ME ME MEME /AMEMEMENNEN M�� ■ MENS MEMS E MENNEN WINE ■�r����������i UNMEMEE■ MENNEEN 1NEEMEN ME MEMSEM MEN ■���mom MSEM= =Nm . libbibk sow® w= IN a ■ CORNING , 1E WERE OMEN Usow I ■■■■�■ �■■■■■■���■��i U�rl�■■�U�r I _- ISE■■■■■■■ It■t■k t■t■MOMEMEM■■■■M■MSE HourdEM■NN■EM �.ir;�■■�■■■■��■n� �; r��■ri■�■ ■Emig ,. .. 110ME ■EME■Err■ME ■■�■■■■■■■sem■�■r�■�n.�■■■■�■���®®■� EEE E ■. ■■■■ ■MEMEM■■■■�r .MO■■■■EMENVE /SUMEMEMEEMOMNI I AI ■■■ ■■M■M■M■M■MM■MK( 14M."1 ■■■M■M■■M■■■■■■■■■■■■■■■ aQ .1 ,1■..r■■■W■■0 ■■■■■■■■■�� IL ®■�■�■■��■�■���■■��■®■��■■®���■ ■ IMM■■■ ■E■■■NMEEN w■�■■■■■■■■�■■■■■■■■■■■ ■�■■■■■. �■■■■■ ■■■■■■o ■E r ■■■■■■■■■■■■■■■■■■■■■■■■■�■ �r ■■■�■■■■®■■��r■MEN ■�■■■■■■■�.■..: UNIM■■■■�■■■M■�■M■MEN I■■■MM■■EE■M■■■���, JAN-31-2005 01:48 FROM: T0:19796BB95Q P.2/2 .•...•.•,-• .- •.,-.--+...u._—ovv,uu+vav wogo Luir-vAa III to a tel t3Ra Bey F,.e Basement Systems,U.C.dlblal Owens Corning A, Dorn FW$hlno Systeme o1 Boston(the contractor)hereby aLdNAae this pro- POert.SWIl 7W Matra the Owens Cornhv Basement Was Finishing System and related items as desrllbod hatatn at the residential promises W tor.h balaw.TINS proposal shell not beaoma a)winding commWrwm unlaes and tsdY h has been signed by the Cordran VW the Customer. CoMraator: Bey Stara Basement SYMams.LLC.dm/a Owens Coming easement Systems of Boston i Oso Turnpike Ebaet.Callon.MA 02021 a Telephones 77818 821-0020 Fatblrr,lss(781882t�63s2 Federal TWOO 914.1 a552O7 Mass.lbma NrtfX vwmnt CWMM Reg.s 137543 Date Customer: CwtOmer Name v ��(/l� Street City,State,Zip Telephone TMs Is a contract between Ste Contractor and the above named Customer b eA ane Install the Owers Corning Basement Wag Finishing;System and related Meme specified specified herein at the Cuatomefs roaldsMlal promisee identified below: Installation Premises: Sheet Address' . CIA'.State.Zip Soope of Work: AroSkatottwand/orspeeyieapori.et ?lMr .Xi�t' !t,..` .7.'•. -au Y4mmrnr Ya111CplpolaledYaD Iwl ' u•:, Dasaptlon d WoWSped Work Scholl .* AppmWmafeCe �1rt�tn:Galrt, .. "me p q)md Work Wit y�I Contract Prim Total Contract Price: ti r':+ ..r. Depoell wllh order ': `.•' Balance Oue: Terms; /LS Coo (Oesh term)ere tOSL i>a t; a sOw on CornplaBaa 00 NOT SKIN TMS CONTRACT UNTIL ALL APPLICABLE BLANKS ARE COMPMUY FILLED M AND UNTIL YOU PJIMT READ AND UNDERSTAND T KEPXME.CONFRACT,INCLUDING ANY ADDENDUM ATTACHED HzRuro,AS WELL AS ANYATTACHED SKETCHES,MATERIAL LISTS OR TNS LIKE,AND THE TERNS AND CONDITIONS ON THE BACK OF Tien CONTRACT DOCUMENT YOU ARE ENTITLED TO A COMPLETE;FULLY EXECUTED COPY OF THIS CONTRA TITHE TIME OF EXECUTION. Witness our hand(s)and teal(s)below s Ifo .day of Cord1aMr/Austorfzed R.Pletsenla SWAMand Tiei , Rini Noma � DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Customer•^.- Oleornar$�Pkae WtaemertilgflaWn PM Name Contractor May have osrtaln Yen Agnes In ds promless tate the price is paid in full You hew the rigid b canal this to*oa without any penalty or obtllllkl ry al any Mme Prior b mlOnight of vw Mtrd busklesa day after the dab You eIMW thtt oordrea.See the W tke d carrrofiall. below for an etglaneson at rids riots. -'Cusiwlwacknak4edWroceiptolatmoopyolft,,rttreel whid7 was onnplanyDNa Nprbr q natonpra axwc spm hareo4 NOTICE OF CANCELLATION �0 dL� r " Date...�5l. if.(.U.> . j f NORTH 1 TOWN OF NORTH ANDOVER p PERMIT FOR WIRING CHUS This certifies that .... ...................................... .................................................. has permission to perform ....! Iu'.'� '� ................................................... wiring in the building of.. 'c - at....................................c•C ..h Lw..'7n . ........ ,North Andover,Mass. Fee...�..-:?........ Lic.No.�* ..1 �........ . .� 5:�1.!.. .......!Ll..(C;•"' ,l ELECTRICAL INSPECTOR Check # 563 ka Com rrronweaitia of Massachusetts official use only ` Department of Fire Services Permit No. 3 1 BOARD OF FIRE PREVENTION REGULATIO S Occupancy and Fee Checked [Rev. ll/94J leave blank APPLICATION! FOR PERMIT TO PE ORM ELECTRICAL WORK All work to be perforred.in accordance with the Massach etts Electrical Code(_t2EG�,527 CMR 12.00 (P1E.4SEPRIIVIININKORY-YPEALLINFORrYt,4 ION) Date:�____�—ZppcS City°r ° ' of: D To the Inspector of Wires: By ibis application the undersigned gives not'ce of his or hbr int noon to perform the electrical work described below. Location(Street&Number) Ow ler of Tenant Telephone No °ll —135 Ow.ier's Address Is this permit in conjunction with a building permit? Yes t`� No ❑ (Check Appropriate Box) Pur,.)ose of Building .Utility Authorization No. Existing Service 9LMbsaips �'a�/ a\JoVolts Overhead 9-11" Undgrd❑ No.of Meters Nees Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ac p V, O�►^� ~ Completion of the ollowin table may be waived bv the Ins ector of Fares. No. of Recessed Fixtures I'S ;No. of Ceil.-Susp.(Paddle)Fans °•° Tota Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA Na. of Lighting Fixtures Swimming Pool ove ❑ _ ❑ o. a anergency ig ang rnd. rnd. Bate Units �No. of Receptacle Outlets No.of Oil Burners TgItE ALARMS Na.of Tones No. of Switches No.of Gas Burners o.of Detection an Initiating Devices No. of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No. of Waste Disposers Feat Pump umber Tons o. of Self-Containe T°tals; Detection/Alertinz Devices INo. of Dishwashers Space/Area Beating KW Local ❑ Municipal 0 Other Connection No. of Dryers Heating Appliances KW ecunty ystems: t 'o MWaterNo.of Devices or Equivalent Heaters KW ° Signs Ballasts Data Wiring: No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total lip Telecommunications [ER: ' irang: No.of Devices or uivalent I � OTI� Attach additional detail if desired,or as required by the Inspect orofWires, MISLI ANCE 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 underaigied certifies that such coverage is in force,and has exhibited proof of same to the permit issuing offic . CHECK ONE: INSURANCE a BOND EJOTHER ❑ (Specify:) � b Estimated Value of Electrical Work (Exprr tion Date) `��. (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. Y certify, under the Gins a d penalties o perjury, that the information on this application is true and complete. FIRNA' LI M: C.NO.: {Loy Licen lee: Signature LIC.NO.: ts—oy a �lfapp'icable,enter "exert. E"in th icerse number line. ' Bus.Tel.No.:S2 Sb�- `�R Ii 3 .Address: 1 p 06.011 r�iy ,arc 1 ynAA,sM �4 O Alf.Tel.No.: 64' -3743 OWNER'S IllSUKANCIE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally irequir,.d by law. By my signature below, I hereby waive this requirement. I am the(check one)❑owner ❑ owner's agent. Owner/Agent Signarure Telephone No. PERM2'T FEE. S i Commonwealth of Massachusettsofficial Use only A '{ -m �� 3 Department of Fire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Pee Checked[RI ev. 11/99] leave blank `� APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work:o be performed.in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PZ E_4SE PR1�VT I1V ENW OR TYPE ALL NFORMATION) Date: cw-3, ll ZO 0� City o>~Town s To the Inspector of Wires: w By si is application the underersigr•ed gives not'ce of his or her intention to perform the electrical work described below. Location(Street&Number) Ow zir or Tenant Telephone No Ow ier's Address Is this permit in conjunction with a building permit? Yes 9" No ❑ (Check Appropriate Box),- . Pua_at,se of Building .Utility Authorization No. Existing Service g1OD Amps YD-0 a\4 oV°lts Overhead Undgrd❑ No.of Meters Nn,Seervice Amps / Volts Overhead❑ Undgrd ❑ No.of Meters N niber of feeders and App achy s. Location and Nature of proposed Electrical Work: Com letion o the ollowia table maybe waived by theIns ector o Y✓ires. ,No. of recessed Fixtures l S 1�0. of Ceil:Susp.(Paddle)pans o.° Tota I --- Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA s No. of Lighting Fixtures Swimming Pool Above ❑ - ❑ A o.of 19me,,gency Ligliting i rnd. 2rnd. Battery Units No. of Receptacle Outlets t� No.of Oil Burners PM ALARMS No,of Zones q Flo. of Switches No.of Gas Burners o.of Detection an !� �- - Initlatine Devices INo. of Ranges No.of Air Cond. o i= Tons No.of Alerting Devices I�.°�io. of Waste Disposers ijeatrump.lNumberITonso1KW .o e - on Totals: Deotectlon/Alertin Devices INo. of Dishwashers Space/Area Beating KW LocalC3 municipal _— Connection [ Other No. of Dryers Heating Appliances KW Security ystems: 'Nlc_. s)f erNo.of Devices or Equivalent HeatersKms' o.o __W0_-0T Data Wiring: Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total HP a ecommu cations Wiring— No.of Devices or Equivalent ' OTHER: -I( Attach additional detail 1fdesired,or as required by the Inspector of Wirer. 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 under3igned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing offic . CHECK ONE: INSURANCE �BOUND ❑ OTBER ❑ (Specify:) b Estimited Value of Electrical IeVork Q (Expw tion Date) `�0. (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. T certify, ztnder tfie gins a dpenaI ' o perjury,,�that the information on this application is true and complete FIR1V NAi t i LIC.NO,: N-Z,DO`e Z,� Licen>ee: _ Signature LIC.NO.: !if app'icable,enter "exem,pt"in fcensq number line Bus.Tel.No.•!7S Sbq- �$g3 .Address: 1'p ,01S. r. "c ) W AA etM '(V\a O t 17 5 Alt.Tel.No.:``OY b4l)-3743 OWNER'S INSURANCEWAIVER: I am aware that the Licensee does not have the liabiiityinsurance coverage normally equir-d by law. By my signature below, I hereby waive this requirement. I am the(check one)❑owner ❑ owner's agent. Owner/Agent ;Signai:ure Telephone No. PERMIT FEE. S