HomeMy WebLinkAboutMiscellaneous - 32 MAY STREET 4/30/2018 32 MAY STREET
210/018.0-0013-0000.0
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Date .
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
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This certifies that . . '.C A 6k e! . . �. :�-!?�S�. . . . . . . . .
has permission to perform . k. Alrlo-j'
7 . . i��i. . . .l .! w. .117-
plumbing in the buil ings of. 1�!9 . . . . . . . . . . . . . . . . . . . . . .
at 4--:� .!"l of C 'lX�-�'''
�! . . . . . . . . . . . . . North Andover, Mass.
Fee . . Lic. No. . .
J.� ?�. . . . .. . . . . . . . . . . . . . . . . . . . . . .
PLUMBING INSPECTOR
Check# /o?a�-
P
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK
CITY MA DATEPERMIT# tf
JOBSITE ADDRESS OWNER'S NAME
POWNER ADDRESS TEL - FAX j
TYPE OR OCCUPANCY TYPE COMMERCIAL E] EDUCATIONAL ® RESIDENTIAL .
PRINT
CLEARLY NEW: RENOVATION- REPLACEMENT:el PLANS SUBMITTED: YES�]l NOQ
FIXTURES Z FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BATHTUB d ( I � I I f ._._ I ! _.____1 _I
CROSS CONNECTION DEVICE
DEDICATED SPECIAL WASTE SYSTEM
DEDICATED GAS/OIL/SAND SYSTEM
DEDICATED GREASE SYSTEM J _...._.__I I I ._..._.__! l .__ _I _. 1 ____._.1 ...__....i __.( _------_I ( _�
DEDICATED GRAY WATER SYSTEM
DEDICATED WATER RECYCLE SYSTEM
DISHWASHER _ ( .. ..__.! ._. _.._...__! - ! .-._._1 ..__..___( ....___� .___._1 J ___..._1 ..-__I I _--------I
DRINKING FOUNTAIN ( .._-..._-) 1 I _._._. _ -1 I _...._-._i
FOOD DISPOSER _I -- _l _.__.._I i l I .__ ..._.-
FLOOR/AREA DRAIN
INTERCEPTOR(INTERIOR)
KITCHEN SINK -�_I -- _ .l -_..J _._.--_.I
LAVATORY
ROOF DRAIN I __...._1 ( _.._ ( _.__.1 ._.__I t-_
SHOWER STALL
SERVICE/MOP SINK __f
TOILET
URINAL ! --J==
WASHING MACHINE CONNECTION { _ I .. 1 I . ! ? _I __ .I ,. . .J
WATER HEATER ALL TYPES _ i
WATER PIPING
OTHER
.._._-_.I ! ._ _._I ._..__-JI___-._—i _ i ..._.___I _-_.. ..l _._..__.I ..._ _._f -JI
INSURANCE COVERAGE:
have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES F-]1 NO 0
IF YOU CHECKED YES,PLEASE INDICAN THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
Im
LIABILITY INSURANCE POLIC = OTHER TYPE OF INDEMNITY BOND Q
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 a 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 compliance wit I inent provision of the
h4assachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUMBER'S NAME _ LICENSE# SIGMATURE
MP- JP CORPORATION F#=PARTNERSHIP 0# LLC D
COMPANY NAME ((' c�j(y� 1 �q0 _
� , ADDRESS
CITY _A 71STATE ZIP TEL \�
FAX ! CELL EMAIL _._.__..__._......__.__..___...___......___._.___ ..___.....__.....__...__ s
ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES
Yes No
THIS APPLICATION SERVES AS THE PERMIT ❑ ❑
O FEE: $ PERMIT#
PLAN REVIEW NOTES
Ilk-
The Commonwealth of Massachusetts
Department of IndustrialAccWhis
Office of Investigations
UV 600 Washington Street
Boston,MA 02111
www.massgov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information / Please Print Leeibly
Name(Business/Organization/Individual)::` 10 a�cz K
AddressAQ A PLOkAnT
City/State/Zip:O� A Phone#:
Are you an employer?Check the appropriate box: Type of project(required):
1. II a employer with 4. El am a general contractor and I 6. E]New construction
employees(full and/or part-tune).* have hired the sub-contractors
2.E] I am a sole proprietor or partner- listed on the attached sheet. �• ❑Remodeling
ship andhave no employees These sub-contractors have 8. ❑Demolition
working for me in any capacity. workers'comp.insurance. 9. ❑Building addition
[No workers'comp.insurance 5. ❑ We are a corporation and its
required.] officers have exercised their 10.❑Electrical repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL 11.El Plumbing repairs or additions
myself. [No workers'comp. c. 152,§1(4),and we have no 12.❑Roof repairs
insurance required.]t employees. [No workers'
comp.insurance required.] 13.❑Other
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
Homeowners who submit this affidavit indicating they aie 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. j/
Insurance Company Name:.A-t�A nT1(, �9 TzV__,
Policy#or Self-ins.Lic.\\9: Expiration Date: !/
Job Site Address: City/State/Zip: `!C
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 cert fy underflZe p ' a Penalties ofperjury that the information provided above is true and correct.
Si ature: 7 Date:
Phone#:
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#'
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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 employeiis 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 ofzndustrial Accidents
Office ofIavestigations
604 Washington Street
Boston,MA,02111
Tel,#617-727-4900 ext 406 or 1-877:MASSAFB
Revised 5-26-05 Fax##617-727-7749
www-mass,govldia
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COMMONWEALTH OF MASSACHUSETTS
PLUMBERS AND GASFITTERS
f LICENSED AS A JOURNEYMAN PLUMBS
1
i ISSUES THE ABOVE LICENSE TO::.. s
411rHAEL,�N ICAPEIESS
'TYLER QST
fir-iHUEN -MA 01844 1905
31787 05/Q1/14 .•176376 I
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( COMMONWEALTH OFMASSACHUSETTS ' Y
f FI'UMBERS AN'D GA'SFITTERS.`7
ICENSED AS A:JOURNEYh9ANaPLUMBF
ISSUES THE ABOVE LICENSE TO
lA ,
t'i u�I'rNAFI -(N fCAF.ELESS - �`
fY;LE!R ST
{i 't1C tHUEt� MA. '01844.=1905
li a tr .31787 05/Q1/14 176: 6
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CONTROL# H384920
IMPORTANT
If this license is lost or destroyed, notify your Board at the:
'. Division of Professional Licensure, 1000 Washington St.,
Suite 710,Boston,MA 02118-6100.
If your name or address shown is changed, notify your board
of correct name or address to insure proper mailing of next
Renewal Application. Always refer to your license numbed,
i This license is subject to the provisions of the General Laws'
as amended.it is a personal privilege,and must not be loaned
{ or assigned to any other person. Keep this license on your
1_ person or posted as required by law.
T f / WFr }rrr AF
ENHANCt o t. -,01 S
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Date. 3...............
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OF pORTIy,�
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
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This certifies that '`v-�. ?........... `. :..'.
. ..........................................................
has permission to perform ...�......). �!W i ....a,
i
wiring in the building f..... :.....•',a C i�. :................................................................. ....
2 -� s-I��
at .................. ...................G............................ .................. Orth Andover,Mas
,Fee.. . .........Lic.NoZ]m ...HC '�. �............
E CMCAL i SPECTO
Check#
Commonwealth of Massachusetts Official Use Only
Department of Fire Services Permit No.
Occupancy and Fee Checked
N, BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leave blank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
Ali tkork to be pertbrnied in accordance with the Massachusetts Electrical Code(MEC) 527 MR 12.00
`.( (I'LE,4SE PRINT AT Ia'VI:OR TYPE ALL A,'1-OR,,s-AiTTOA!) Date:
iI]y `itV o3 "Ioivn of; (A-Zi rANDOVER r �litelnstt cleta
(.ilia applicatioll the urlcCrJigilk.0 pvCJ vU.-C of IJIS of 11CIiltcnivtl to P l"nul Ul"CiLlLLtCalW-
OO
Ct.fJsi.
iI CC:vviirt ,
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Location(Street&Numb e°)..�
Owner or Tenant L.1–�/�— ��v'`G l,� Telephonee No.44'_4f2elly
Owner's Address
_.. i:._ � ....�__ .. r i _ .. ._
Its iittJ tlCr relit til LVitjti�i46iUdt t11ii1 2! tt UilUlil�'PCI ils'it: 1 C9 i.\t/ �� (Che�:flr..Hpp op[iiite'OX,
Purpose of Building I >ht� Ufflity author nation No.
Existing Service J Q.0 Amps 1 Volts Overhead Undgrd❑ No.of Meters
New Service Amps Volts Overhead Undgrd EJ No.of Meters
Number of Feeders and Ampacity
I jir nf;nr and i!?ifiwe of Primn-rd Fln.-frier.,W
[,om letion of thefollowing table may he ivai ell ny the Inspector of lei fres.
No.of Recessed Luminaires No.of Ceil:Susu.(Paddle)Fans No.of Total
Transformers KVA
No.of Luminaire Outlets I No.of Hot Tubs lGenerators K A I
Above r7 i In- o.o mergency ig ing
No.€:f Luminaires Swimming fool arnd. rnd. Battery Units
No,of Receptacle Outlets 7 No,of Oil Burners FirRF At,AlthtS No,of 7oret
No.of Detection and
No.of Switches `Z � Na.of Gas Burners1
a tal Initiating Devices t d
No.of Rant es No.of Air Cond. Tans No.of Alerting Devices
No. of NVaste Disposers %Teat Pump `.ta!n aۥ.'Tons....iK`VV eNo.of Self-Contained
Totals: l?etectiastl. lertint;Devices l
sitttaicipal
No.oft)is#alr x4fiers lSpace/Area Heating KW Local
cal I� Q t)tber I
r � Connection
;No.of Dryers tieatin; .appliances Securitt=Svctems
No.ssf Devices or Equivalent N
No of Water �.AN, i`o,of No.of Bata Wiring S
its'<t o c Ballasts •
j-- >i�tts No.of Devices or Equivalent I
Nes. Hydroanassage Bathtubs :o,of Motors Total HP Telecommunications Wiring: r `Z
No.of Devices or E uiQent �
�+ 'Itf!C a turlierrral rletoir rf uewreel n+-(IN reyttireu 1n,.the Irt pf clo n;`I}'ires�
sti)nats d 1% inc of i leci:ic�i Burk: to �d� (��i:ei. z ireit icy :n ..j ipai huiic�`.)
�'ivk-to Start-_ Inspection;to be retTaested in accordance with Ml-i' ;Nile 10,and tipon completion
INSURANCE COVERAGE. Unlcss\l'am'ed b;, tllc-owiicr,Iio for the perf'orIiiilace of cicctric ai Work a 7y i_�sU tirt,:ss
tic: liccnsec provicies proof of liability insuralwc including"con,pk,tcd operation"coverage or its stibstan.tial ecitiivaient. The
lind�l tii.�ilLd (Lllllms iliiil Siicll ci11 S ri1 4 IS I11 for(.iaIld hilaexi�1i`16;0 DR.) vl.:iiIIlL'it) liic q�t'1'IIlIt 1 SUiIl�U111cC.
CI EC K CONE. NSC RA'C'E ❑ B(-)--ND ij OTHER
under the pa ins aand penaallies qj ale(.faun y',,'1;u#the inlaraaaaation on this aapf%lat-aafaa)n as true Land couilJiE.'w.
FIRNN1 N 1N1E: LIC.No .:
i,icetisee: _I i f�hv _� l�A/ �j �Z _ iigaiatu e� — i.if'.NO.:
il1 apphcabl )rtcr :uaz�t )t,i�c°1ic.:ILi 441M& li
vr ne°) '60-q
Address: __3 I�/ 016 A-je- k"Y"4 /\L-�•1 03077 Bos'.Tel. u,� 60 S-c
Y Alt. i'rl ^ .s
_
c, i �7,s. ?7-ill.s+ccti ity 1.t ork r equiri a f cpa_rtliiQnt of l'iiblic Sakt'b „til`Lil't I}tiC: Lit. No. —
OWNFR'`+ INSURANCE WAIVER; I "till aN are ihat the 1.licensee doe,not have the liability instiranec:coverage normally,
required bN law. By Itiy sidonature below,I hereby waitie this requiretne t. I atn the(clieclt>>Ite)� _=:vner 0 owner's ar=ent.
Owned igen(.
• �.. - �' Ylrt ° :e gat � � ._.. ��`�' a;_ �'�:. .- _ T�
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'�--COMMONWEALTH'OF MASSACHUSETTS'
I
,q,S A REG JOURNEYMAN ELECTRICIAN:
ISSUES THE ABOVE LICENSE TO .
TIMOTHY .-JrCARTA SR i
3= PHYLLIS AVE `�'`
RAYMOND
NH, 03077 2,06-3
07/31/16 27.80JR:
13`0613 ;..
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Location ��Z �/ T .
No. Date
NORTH TOWN OF NORTH ANDOVER
O.t .ao ,a,•yO {�j
Certificate of Occupancy $
Building/Frame Permit Fee $
CMFoundation Permit Fee $
wliVr Permit Fee $
Sewer Connection Fee $
U
Water Connection Fee $
TOTAL $ a ,
;wilding Inspector
a :=
9232 Div. Public Works
PEbtl Ii T NO. APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1
MAP a40. LOT NO. 2 RECORD OF OWNERSHIP DATE (BOOK :PAGE
ZONESUB DIV. LOT NO.
I F -
LOCATION PURPOSE OF BUILDING A�
OWNER'S NAME I NO. OF STORIES VSIZE
OWNER'S ADDRESS BASEMENT OR SLAB
ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD
BUILDER'S NAME 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 3 PROPERTY INFORMATION
LAND COST
SEE BOTH SIDES EST. BLDG. COST
PAGE 1 FILL OUT SECTIONS i - 3
EST. BLDG. COST kit SQ. FT.
PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
ri
DATE FILED J` / F,`� ILDINO INSPtCSTOR
SIGNATURE OF OWNER gfr)AUTH(:IFVZED AGENT '
r
F E E f OWNER TEL.#
PERMIT GRANTED CONTR.TEL.N
CONTR.LIC.#
H.I.C.# / d 3 3 12
BUILDING RECORD
1 OCCUPANCY 12
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 RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
CONSTRUCTION
2 FOUNDATION 8 INTERIOR FINISH
CONCRETE 3 1 2 13
CONCRETE BL'K. PINE
BRICK OR STONE HARDW D —_ __
PIERS PLASTER
_ DRY WALL _ _
UNFIN.
3 BASEMENT
AREA FULL FIN. B M'TAREA _
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 2 3
DROP SIDING CONCRETE �_
WOOD SHINGLES EARTH _
ASPHALT SIDING HARDN'J'D _
ASBESTOS SIDING _ COMMCN _
VERT. SIDING ASPH. TILE {I
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY ATTIC STIRS. b FLOOR _
BRICK ON FRAME
CONC. OR CINDER BLK.
STONE ON MASONRY WIRING
STONE ON FRAME
SUPERIOR I� POOR _
ADEQUATE NONE
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 & GRAVEL STALL SHOWER _
ROLL ROOFING MODERN FIXTURES _
TILE FLOOR
TILE DADO 1
6 FRAMING I 11 HEATING
WOOD JOIST PIPELESS FURNACE _
r
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
B'M'T 2nd _ ELECTRIC
Itt 13rd NO HEATING
:.f
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r NORTH
Town of L over
No. 526
h I5
.. fir dower, Mass., r 19�
COCMICMEWICK
7� ADRATED
5 BOARD OF HEALTH
Food/Kitchen
PERMIT T Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT.......... ... ...... .. .................................................. ........................................ Foundation
has permission to*a�el..... .. .4.7IEW . ............ buildings on ........:3.Z,....►.. ...!.1�` .......... '1.:.................................. Rough
P . l
............ , `,. -` .,.,.... I�.a.L-...CI...I....... .....�.. ..... lump
to be occupied as.... Chimney
ey
.......... ..................................
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. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
PERMIT EXPIRE 6 MONTHS Final
UNLESS CON TR C T' ELECTRICAL INSPECTOR
Rough
Service
BUILD G 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.
Smoke Det.
IYI�r.I UIv1( LJI1Ivl Hl'I'LlUAIIUIV VUH 1jtH1VIII IU UU VL�IIVILANU
..,•i (I lint or 1 y�o) /v�—
': 1 %-`-' Mass. Date 19 c 7 Pemill
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_= Uullding Location' �� /�.g ✓�
Owncr's Narne�
Type of Occupancy_
New U tlerlovatlon O Ileplacernent�T Plans Submitted: Yes O No O
�1 FIXTURES
x ur [ 7
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4
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I- U d x x 11 z x yG R O I- -( x ul u. )e W r`'
1 1- >. 1( x to N a N 1- x U O 0 x X u1 1- o U I: H
W BASEMFNT _- - ----- - — -- - — --
IST FLUOII -- - -- — -- - - --- - - —
2111) FLoon -- — — ---- — — - --
3m) ri-oon _-- — — --
4T11 171-0011 —
5T11 FLOorI --
DTII rLOOn — -"
7Til FLOOn — —
13TIl FLOOR
lalling Company Natrle N iC 1'I_,l_'Pi 3I1'•;l; F; f I i 's`f I 'i; 1.I"i;.
�'--- Check one: Cetlllicale
Idies.s h/r 1))?L,ANn , V�—'
Corporation --1236
2jjTf;CY )1;15 02109 O Partnership
rsinc<:s fcicpholle 617-773-2()36
Cl Firm/Co. '
t_I L�rc,_lt Plumber Tjl p_;1.'L 1yILI
'MRANCE COVEIIAGE: -------_ _
Ive a current Ilablllty Insurance policy or Its substantial equivale
Ycs Ind
t which Meets the requlrenrenls of MGL Ch. 1,12.
.I No IJ
vu have chccke(i_ycs, please Indicate
lability Insurance policy Uthe lyl;e cavera9e by checking the appropllale box.
Other type of Indemnity ❑ pond ❑
'41L=11'S INSUIIANCE WAIVER: I aril aware that the Ilcellsee docs not have the insurance coverage aptcr 14?_ of the Mass. General Laws, and that rTry signature on this permit application waives 1111sequl emenl�y
Check one:
nature oI Crr�nor or (Miler's Agent Owner C) Agent
Ll
!(()by certify Ilial all of rho detwork ails and Information I have submitted(or entered)in above application aro into incl accurate to the best of rn
linenl piov siolr IsOfhlassa I usotts State and Plumb ng ns Icodlo trand Ch X110 p�nnil Issued for this appllcatlon will be In compliance with all
Y
I 2 of lho General Laws.
r__ �iynaluro oI Lice ',miller
/Town Typo of License: Maslor U
I�l Jouhroyman []
'IK7Vl U (01'f ICCUSL-UNIT} license Number 2
BELOW FOR OFFICE USE ONLY
PROGRESS INSPECTIONSFINAL INSPECTIONS SKETCHES FEE -
N0.
APPLICATION FOR PERMIT TO DO PLUMBING
NAME &TYPE OF BUILDING
LOCATION OF BUILDING
PLUMBER
PERMIT GRANTED
DATE 19
�I
i -
1 PLUS: =:NG INSPECTOR
ACOR CER`TI�I�CA►T ,:0* ...IIABILITY INSURANCE ��X.
PLM1 s D 01/16/97) .
PR DUCER • THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Rodman. Insurance Agency, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
75 Wells Ave ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Newton MA 02159 COMPANIES AFFORDING COVERAGE
COMPANY
Phono No. 617-527-3000 F.No. 617-965-2947 A Travelers Insurance Co
INSURED
COMPANY
B Travelers Indemnity
M.M.C. Plumbing & Heating Co. COMPANY
Mrs. Madigan C
64 Delano Avenue
Quincy MA 02169 COMPANY
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
CO TYPE OF INSURANCE POLICY NUMBL7t POLICY EFFECTIVE POLICY EXPIRATION
LTR DATE(MMIDD/YY) DATE(MM/DD/YY) LIMITS
GENERAL LIABILITY GENERAL AGGREGATE t2,000,000
A X COMMERCIAL GENERAL LIABILITY I680493K4859TCT96 12/31/96 12/31/97 PRODUCTS-COMP/OPAGG $ 2,000,000
CLAIMS MADE a OCCUR PERSONAL&ADV INJURY 41,000,000
r OWNER'S&CONTRACTOR'SPROT EACH OCCURRENCE $ 1,000,000
FIRE DAMAGE(Any one tire) $ 5 0,0 0 0
MED EXP(Any one person) $ 5,000
AUTOMOBILE LIABILITY
ANY AUTO COMBINED SINGLE LIMIT $
ALL OWNED AUTOS
SCHEDULED AUTOS BODILY INJURY(Per(Per person)
HIRED AUTOS
NON-OWNED AUTOS BODILY INJURY(Per IPer occldentl
e'
PROPERTY DAMAGE $
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANY AUTO
_j
OTHER THAN AUTO ONLY.
EACH ACCIDENT $
EXCESS LIABILITY AGGREGATE $
EACH OCCURRENCE $ 11 OOO,000
13 X UMBRELLA FORM WSFCUP446W6342IND96 12/31/96 12/31/97 AGGREGATE $ 1,000,000
OTHER THAN UMBRELLA FORM
8
WORKERS COMPENSATION AND WC STATU• OTH
EMPLOYERS'LIABILITY TORY LIMITS ER '
THE PROPfiIETEL EACH ACCIDENT $ 100,000
C�� INCL 'jFjl
PARTNERS/E;ECIfrIVE 01/15/97 01/15/98, EL DISEASE-POLICY LIMIT $ 500,000
OFFICERS ARE: EXCL
OTHE}i
EL DISEASE-EA EMPLOYEE $ 100,000
A Contents I680493K4859TCT96 12/31/96 12/31/97 RC/SPEC $32,252
$500 Ded.
DESCRIPTION OF OPERAI'IO-alS/LOCATIONS/VEHICLFS/SPECIAL ITEMS
Plumbing & Heating Contractor
CERTIFICATE HOLDER
CANC�LLATtON
BLANK—-_ SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
TOWN HALL ANNEX EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL
PLG INSPECTOR 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
146 MAIN STREET p BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR UABIUTY
N ANDOVER MA 01845 OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES,
AUTHORIZED REPREFANTATIVE
r
r
ACORD 25-S
` ' ` COF�D CORPORATION 1988
COMNIONWEALTH OF VlA`.;`)'AClllUlSET'FS
IN PLUMBERS AND GAS[--'[T'T[-.Illr;
i �1 ,,
LICENSED AS A JOURNEYMAN PLUIA1 ,
ISSUES 1-111S LICENSE TO
JAMES L MADIGAN
66 DELANO AVE
QUINCY MA 02169-3:
16,965 05/01/98 17°10.1
ilQll"19,�il�41 � PRO-,
COMMOIAWFALTI-1 OF MASSACHUSETTS
IN PLUMBERS AND GASFITTERS
LICENSED AS A MASTER PLUMBER.
ISSUES THIS LICENSE TO
JAMES L MADIGAN T
64 DELA140 AVE
QUINCY MA 02169- 5
7725 05/01/98 17 072
COMMONWEALTH OF MASSACHUSETTS
IN PLUMBERS AND GASFITTERS
REGISTERED AS A PLUMBING CO '
ISSUES THIS LICENSE TO
C
MMC PLUMBING AND HEATING IN
JA14ES L MADIGAN M-7725
66 DELA140 AVE
QUINCY MA 02169-3 1:3
1234 05/01/98 17 6 U J7
Date 3/�� .9 7
�= 329?
i
II f Hoa71{1
,, •° TOWN OF NORTH ANDOVER
�A. — PERMIT FOR PLUMBING
40
,SS�ICMUS6 p
Il]
This certifies that . . . .
has permission to perform . . . !. ..... . . . . . . . . . . . . . . . . . . . . . . .
plumbing in the buildings of . . !: . C J.,13.C'.r. . . . . . . . . . . .
at. . . . . . . . . . . . . . . . -. , North Andover, Mass.
Fee. Lic. No.. �.!'1.�'� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
PLUMBING INSPECTOR
M
O
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer
r _ _
!;•ti_ ;� r�
.� 0Ile 011111111tolluralIII or 011#1t10111AH111 hermit No. ----���
Al ` t�
Pv11111'Itllt ill K 1It111I1t NMI) OccUlishcy A fee Checked -___-___-'Ile
r 3/90 (leave b16,10BOW Of rI11E PnEVOTION hECULMOM X21 On 12:00 _-
AF11"LICATION role pMAIT TO pL IMIM �LMTNICAL WOHK
All walk to bn hnrlorhte(1 In nccoidmien *1111 the MdsOchUnells bleciticel rodb, 527 CMH 12:00
`r' (111..1=n5t HAW IN INk till tYPt ALL Mr-OhMAtIU1J) b(�l( _�/O
l c l /tor-4i %r?dvve� t6 1116 Il►specfot- of Wlirs:
(_� N 1110 urle►slrlond vilipilen for n pmmll to f/erlortit (lie t,leciticnl work described bolovV.
oevner or lenntil -AIL)
)_Li
Owtvr�r'q Address
r, is Ilii^ pt+rf,ti( ii conlUncll(,n Mill a bUildittg pftlnil: Y!+S U NO U (Clidek Appteptlnle box)
Pur ,o�e of E3uildh,c Dwelling -- --- Utility Aulhoilzd(ion No.
v� I- f ----...--—..-- —---
i Existing 6elviro _..___—._ Anlps _---./—_-----VoIlS Overhead U uridgrttd No. of lvlolois _—.__-_--
v� New Sorvlctt Amps .-----_/..— _Vohs Ove►hdnd (J Undflitid Ila. of Motels ------------
�, 1 Numbor tit f nn(Intr and Att,pnc:ily .—... -- --------..----- -- ----
p ^'
F•'� a� I_ncnllr,n Arid r I;,lUre of hrol,nsr.d r'leclrical W!nk INSTALL WATER�.._— ----------BEATER-- ------------.--------
n
lirlal
f lo. of I"Ilffdbh, ouunh No. of I lot Tbbs No. of Tianstonners RVA
r f� Abover-1 In- r-
(.. F j th,. nl I_I9lrhntl r L lurrn $wlrnn,lnq t oc,l gmd l—I �rnd. 1—I on,w-tor9 I(Vn
( - — .._..... —._ - -- - --------- ---------- fin. of Emergonry Llghth,d
c% No, of nocepticir awiets Ila. of 011 duil,ets bntlory U11119 —
No. of Switch Oulh+ls No. of fans Etutno,9 t ht= ALAhMS No. of 7-000s
d fin. of flnl,pns No. of Alt Cond. Total flo. of 0olecilon end
tons Inllinlh,g Devices
01, ^� I tnal Vol Total
N+, of Ulshosatn No.of rumps T'ot,s kW No. of Soundh,d bovices
IJo. of Soft Conlnh,oc
of hishwnshfrs ' -- --- Spnr:o/Arse I lonUnd ---I.W bolecflnn,Soundtnc►bbvlcos --- —
vy munlcipoi r
Nonlh,g bnvtcn9 I<vV Local 17 Connection I—101hat
f l,t. of hrynrs -
I+7 of I-lo. of Low Volinge
of'A'alet 1 tc nintc 1<vV Signs bnllasis WAMg
Ilyrlid Mnr-n(to It.rtrs No. of l,Aulors Tolat Iit, --
w
Fi ild,-,litl�f I(:1: COV[►1MlC: Pursuntd to tin ►ngnl,rnrows pl Meahaciusolls denecal Lnws
rq �� 1 hm•r n bultpol I.Inbllily Itimunncp Policy 1110tidl„g Cpm loled OpArnlluns Covetage or Its subsinmilnl equlvotenl. Yps fJ0 1.1 t
i:,vn s+rhr„hlod vnlld proal of snrne In the Office. YES �9 Nd L1 It yntl linv9 Checked YDS, hteose indlcn(d 1116 type of covorngn by
H ct,nckh,q Itin E.� n ,p or,,t,le box.' tta!;t h.ntlrt; 1 A�NU 1:1 of I Irrl rl (rinase sprcilyl— _ _ —-- — --
- (�r,pirnlbn fJelr)
(,
t. A r illr•mtod Vnhrn of 1 lrchlcnf Wntl( f
bbrnl: i„ $Intl _ _ _ __ __ In^pncllnn I)nle harpinslod: hot;(h ----- —t innl--- ---------..- ...
I,] ``+ nr nn f nnrint Il,n f nnalllna rf nr n
rhnl f1AM17 -- Jame y---M --Wl�e�a.t �:), a�-t lrc—Co — t_Ic. flo. _A1110.2..
Llcm,st'n--Jame
ttus. ToIla. .__U2
A,lr�t o.^•5 __�-•_ _0.._-.13.ox.--4.5�—QU-inch 02170-----'J--------------------- Arl. tbl. Ho. ---------------------------.
hWflrll'S IN,GUMNfIct_\NAIVrn: I nm nwrim II,nl Ilia 1_Icnnsod Hods not bdva Ibn hsurnnco cnvningtf or IN sbbsianllal prpilvnlnnt or rr-
gnhnrl by Maz.ncl,urnhs Gennini i_Aw4, mid tint my slgnniuro on Ibis prrn,l) splAcnllon wrilves this rerlutrelngml. Ownot nand
(/''rasa rhn!I< one)
I;IOnoUnn rt n•vnr, nr Ari^All
ti
Date....
T�2
755
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
,SSACNUS
This certifies that ........T fr:f!S....... ....... .W. ..k.0q.t!.......
has permission to perform .......\/1jA'ft:f........... .......kc"� &......
wiring in the building of......W
. . .......C
...............
at............:2-�........ ........5.1 ...................... .North Andover,Mass.
Fee. .... Lic.No.14 I.
.......�C�TRICAL INSPEC1116t'll���
0 /9712:59 15.00 qAID
WHITE: Applicant CANARY: Building Dept. PINK: reasurer
Location L
No. 3q Date -/0z
i
TOWN OF NORTH ANDOVER
F� w
a
Certificate of Occupancy $
Building/Frame Permit Fee $ a
�cMus
Foundation Permit Fee $
Other Permit Fee $
a TOTAL $ v -
T Check # 7
6537
Building Inspector
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
BUILDING PERMIT NUIVIBE
R: a DATE ISSUED. _ O
C� l 3
SIGNATURE:
C
Building Commissioner/Inrpector of Buildings Date Z
SECTION 1-SITE INFORMATION O
1.1 Property Address: 1.2 Assessors Map and Parcel Number:
Map Numtrer Parcel Number
y-
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 Required Provided Required Provided
1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: v
Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑
Public ❑ Private ❑ P posy ys
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No M
2.1 Owner of Record
game(Print) A dress for Service
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service: o
Z
rn
Si n ture Telephone
SECTION 3-CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor: Not Applicable ❑
Licensed Construction Supervisor: O
License Number
mn
Address
Expiration Date ic
Signature Telephone
A
3.2..kegistered Home Improvement Contractor Not Applicable ❑ v
Company Name
3 5 r Registration Number r
ss
Expiratiqfi Date
is /e
nature Telephone V/
r
SECTION 4-WORKERS COMPENSATION(M.G.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 all applicable)
New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑
Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify
Brief Description of Proposed Work:
SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar)to he OFFICIAL USE ONLY
Completed bV permit applicant
1. Building (a) Building Permit Fee
Multiplier
2 Electrical (b) Estimated Total Cost of
Construction
3 Plumbing Building Permit fee(a)x (b)
4 Mechanical HVAC �fD
5 Fire Protection
6 Total 1+2+3+4+5 Check Number
SECTION 7a OWNER AUTHORU-XTtOlq TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I> as Owner/Authorized Agent of subject property
Hereby authorize to act on
My behalf,in all matters relative to work authorized by this building permit application.
Signature of Owner Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
c
I, as Owner/Authorized Agent of subject
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
Signature of Owner/Aent Date
NO.OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TIMBERS IST 2ND 3 fuD
SPAN
DIMENSIONS OF SILLS
DMIENSIONS OF POSTS
DiNIENSIONS OF GIRDERS
I[EIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CHEVINEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
AC Exteriors, Inc.
dba Joe's Vinyl Siding
PERSONAL AGREEMENT
Proposal Agreement
Proposal ubmittedPhone l Date
T
Street � � � Job Name
43
City,State&Zip Job Location
Z229:e 15
Date of Plans
We hereby propose to furnish all materials and labor as necessary for the completion of the following products in`�
accordance with the specifications and drawings: kjlh u �� a �1�S�-,arc W t�""k
3f 1'a eY, .i U CvvPK c ,l 4%*YV\ '�A(. W`1Jy-j
f,Yh��CjlU1i>nu endo �J
C!o L sego c�C
Total Contract Price Is: ( Y_ qAn(,�U Sr� ►( ]AUL ndf -9--dollars($�, )
Payments to be made as follows: 6 5 �
All material is guaranteed to be as specified. All work to be completed in a workman-like manner according to the
specifications submitted per standard practices. Any alteration or deviation from above specifications involving extra cost
will be executed only upon written orders and will become an extra charge over and above the estimate. All agreements
contingent upon strikes, accidents, or delays beyond our control. Owner to carry fire,tornado and other necessary
insurances.
Note: This Proposal may be withdrawn by this if
thorized nature
not accepted within days.
ACCEPTANCE OF PROPOSAL—The above prices, specifications and conditions are satisfactory and are hereby
accepted. You are authorized to do the work as specified. Payment to be paid as outlined above.
e Signature
Date of Acceptance �j /`
Signature
Board of Building Regulations and Standards License or registration valid for individul use only
HOME IMPROVEMENT CONTRACTOR befere the expiration date. If found return to:
Registration:,.: 137640 Board of Building Regulations and Standards
4 Expiration= 1;2/13/2004 Onc Ashburton Place Rm 1301
Bosr,.on,Ma.02108
Type Private Corporation
AC EXTERIORS INC ;
ANNA CURRAO .
35 SORRENTO AVE.—'
E METHUEN, MA 01844 i�Sow MAO A
Administrator Not valid ithout signature
At
I
v
NpRT�y
own ofAndover
0
No. 031
o� �-ocmllc- dover, Mass.,
A0RA7ED pC,
S H BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT........W�..I��.A.»�........C.a.R.a� ..//0
............................................................. Foundation
has permission to erect.....V�NY. .......... buildings on .... ... ........MAY ...ft................ Rough
to be occupied as.............&. I�V�........ . ......c�� . AI
��0................................................... Chimney
Ch'
provided that the person accepting this permit shall in every respect conform to terms of the application on file in Final
this office, and to the provisions of the Codes and By-Ljws relating to th Ins ection, Alteration and Construction of
Buildings in the Town of North Andover. , Q �D PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
PERMIT EXPIRES IN 6 MONTHS Final
UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR
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. Burner
Street No.
j SEE REVERSE SIDE smoke Det'