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Home My WebLink AboutMiscellaneous - 335 CHESTNUT STREET 4/30/2018LUu Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance with the provisions of M.G.L. c. 143, § 3L, the r permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed on the prescribed form. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166, § 32, an firm or corporation stated on the permit application. Such entity shall be responsible for the electrical permit shall be issued to the person, notification of completion of the work as required in M.G.L. c. 143, § 3L. s Permits shall -be limited as to the time of ongoing construction activity, and may be_deemedby.the.Inspector_of_Wires abandoned_and_invalid.if he—.. _ or she has determined that the authorized work has not commenced or has not progressed during the preceding 12 -month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or -the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of the Acts of 2012. The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses conceming the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effect or existence" during the qualifying period beginning on August 15, 2008 and extending -through August 15, 2012. ❑ ule8 —Permit/Date Closed: F— �_TL/ ***Note: Reapply for new permit ❑ Permit Extension Act — Permit/Date Closed: 961S i � NOR7M SSACMUS� P Date ..........t....,?- 1 b.... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...............ti.J.......... A t� . .............................. has permission to perform ....... !YO-W..ol ....... �............... wiring in the building of ............................................................... at..........�3�s`../.!!�l�tr ....T ............ . rth Andover, Mass. Fee ....4.S—O' Lic. No.,FAe/�I.................... s ELE RICAL INSPECTOR Check # _F' CJ � V r f f OfdattimOntr BOARD OF FIRE PREVENTION REGULATIONSY and Fee Cid APPLICATION FOR PERMIT TO PERFORIN ELECTRICAL WORK (,l"=Pi?JxrM&W OR TPPBAU IWOMMM6V . Dmem CRY wrTWUat kDYE %mdOJer Tothe 'of Wires: BytbissWfi=tiiantlreatodasto I nati=aMocbrrhft8* niapia�mmedeoteicatwo�aesanlradi xr. Laukdomoblem - _3 35 e h e,5 4p u .5 free �- Chraw or Tamt o y, to —1 --Ob) Vl Tdepbaae No► O"neesAddrem - ---Sa K4 97f-557--: Is this pew b oma wlii a Ing p@=W Yes ❑ No ❑ ((Seek Appropriate ZMzj Pwpm oil 4eo-demc-P UWAy A.OWWWIm 6 RxbftSnv Aarps I Oce. - O.erieaa ❑ v„ aid ❑ No. eeING Nmsm ioe Amps Voda Ow b=d❑ vadW❑ Ne ofillels m ft"etrafftedersaatlAmpo ty I.ontim cad Natme '5)--A A,.n dtm*adlVdmbw4araaregdmdbythrbAwedorofWwez Bstimatod varve aEleMW Wdi*: v v (Wbm regsaed by pow ) Wadc is Stsrt 0 Llsllectialts to 6e regseated iQ mooatlae m vrM M3C Rda lO mrlW=completion. 11URAWM CDVAMAGM Unbm waived b9lim n , ,net au pomdt Blrte pedbm m m aldect&d wa& m ► lasm mim th®L'oeasee provides proafclhmbKrmg cpm doareche arils sabslentid egaivdac The uodersi�edeatti6eatbstsact! isiQloroe,�aLasodproo�afseawtuR,apemitaNioe. c UNM nORALI= B OTHM O OPOd6:) Z. u C e- IcmVj ymmdWAeFaies� rf tirttff�t m dirdlyffm Isoeaadeasrmz FIItllf MAMW Ld TAG N@: sl�+tttu+e ,4wsm*k ._ Iac rra: F 3 ci / 5 7 ( arar 'eaapt" ar fire hiann+e aa� Bnt Td. No.: ? 7 e , ,f -- 5 7 M2,�±L/�h //�j4 0/��i�/AlkTA•Perl►LG.Ga147,a57-61'w�ariiaep�tormtofP+Ib3sfatY`�"'Iaoeosa i3cNo. owNM.sff4antAx[ZWAivM Ior effiritbeL:oeaseado" aorJfneethe j,Mu ma�ooeoavmyewam-ally � by kw- vr By my iX - bdow.Ibwcft aiAbtognhm= L 1mmffie(Cho*am owsm owner's mL re lekplsmNe. PmRIl1ffPM f iL% - m ?e &-wai ed awWV, = Nia. oilisoessrd Limes oTG10 tamp. r4ft of I= y amwsrm t KVA olL�i■slre0isddsNwormItTedis Cors HVA 146. of Immiarkm v aumb U nib N66 Of 4fcmm Ft D olBaNgm ef"Coed. TOM Tons olAlerliagDevi= ofWaste Diapserss Tah� ora rp Daviors Na ofDbitnoias SpMdAMMMft SW ❑ ❑ olrar ofDiye:a KW I�7oof or N& of Water MOM HW of, NsDeriocs or 140. e lbs oI b[oeera Towle e OffmalwNa. of Dmhm or Baaivamot '5)--A A,.n dtm*adlVdmbw4araaregdmdbythrbAwedorofWwez Bstimatod varve aEleMW Wdi*: v v (Wbm regsaed by pow ) Wadc is Stsrt 0 Llsllectialts to 6e regseated iQ mooatlae m vrM M3C Rda lO mrlW=completion. 11URAWM CDVAMAGM Unbm waived b9lim n , ,net au pomdt Blrte pedbm m m aldect&d wa& m ► lasm mim th®L'oeasee provides proafclhmbKrmg cpm doareche arils sabslentid egaivdac The uodersi�edeatti6eatbstsact! isiQloroe,�aLasodproo�afseawtuR,apemitaNioe. c UNM nORALI= B OTHM O OPOd6:) Z. u C e- IcmVj ymmdWAeFaies� rf tirttff�t m dirdlyffm Isoeaadeasrmz FIItllf MAMW Ld TAG N@: sl�+tttu+e ,4wsm*k ._ Iac rra: F 3 ci / 5 7 ( arar 'eaapt" ar fire hiann+e aa� Bnt Td. No.: ? 7 e , ,f -- 5 7 M2,�±L/�h //�j4 0/��i�/AlkTA•Perl►LG.Ga147,a57-61'w�ariiaep�tormtofP+Ib3sfatY`�"'Iaoeosa i3cNo. owNM.sff4antAx[ZWAivM Ior effiritbeL:oeaseado" aorJfneethe j,Mu ma�ooeoavmyewam-ally � by kw- vr By my iX - bdow.Ibwcft aiAbtognhm= L 1mmffie(Cho*am owsm owner's mL re lekplsmNe. PmRIl1ffPM f 8719 Date NONT/ •_°,;•_1�00� TOWN OF NORTH ANDOVER o?o,',., F PERMIT FOR PLUMBING ,4,4cwus� This certifies that ..Q� 4.C�1 �....wYh.�\ ............ has permission to perform .... . �� s �,............... . plumbingin the buildings of ... .. .... . at. . ...ekes . n u.. �... �\....... , No5h A dower hvUss. F $NS .(D. Lic. No. 1().140.<K . PLUMBING INSPECTOR Check N C t' MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING MA. Date: L'-7— U Permit# 5 City/Town: ? LL Owners Name: Building Location: J 3 ,.7 Type of Occupancy, Commercial ❑ Educational ❑ Industrial [I institutional E] Residential - New: ❑ Alteration: ❑ Renovation: ❑ Replacement: Plans Submitted: Yes ❑ No ❑ FIXTURES C) z 0 0' in u, v Cn w . z �. Z d N Q 0 Z z a IL jF J D Q N o Q W o o° w to a= w w w °LL�- Y.3 0 0 i— x Z¢ LL n. Y z I— x SU-SBSMT. BASEMENT 115T FLOOR 2 FLOOR ' 3 FLOOR 4 FLOOR 5 FLOOR 6 FLOOR 7 FLOOR 8 FLOOR %f Check One Only Certificate # installing Company Name: SPC�iR`i� ❑ Corporation - Address: 1� Cityrrown: C- _ State: r! Partnership 'Business Tel: � g > q�� Fax: !7 �� 33� arm/Company Name of Licensed Plumber: �!R` e INSURANCE COVERAGE: i have a current liabilityinsurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes7No if you have checked Yes, please indicate the type of coverage by checking the appropriate box below. Other t e of indemnity ❑ Bond ElA liability insurance policy yp OWNER'S INSURANCE WAIVER: l.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 Check One Only Owner ❑ Agent ❑ Si nature of Owner or Owner's AgenticatiDn I hereby certify and d that all f the details ing woak and installations lations performed under the permit s issued for th spapplicationrwill be compliancendwith aaccurate to the ll t of my Knowledge Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.pe f By Type of License: S rtatur of.�ic�eed Vurriber Title ❑ P134mber aster C�IJ 6 City/Town Journeyman License Number: APPROVED (OFFICE USE 0NLY) i e _Tile, Com7nortwealtlr nf. assacltttsetis DepartrncW 47"7nilrtstt'iniior cidc7zts ; . Officc af771uest:tga d 600{as7tir7gto7t S't> eet l �nsta7t, liL4.OZZ1� �tnr�w.77tass.701'/dia ce leftricians/Plumbors nl wee �1 'Vitorlcers'•Cumpensatinnlnsuran please P AnWIC2171:.t711nrmu Lru,i . a m (Business/Drgntiizntion/hdividual); S' .l` G G ; P .Address: 'W :�- /yQ . Thonef 7 Arc yon an employer? •Check thc.apprap Qata am contractor and1 1..❑ :I am n employer with• a general have hired the sub -contractors e loyees (full and/or part-time); listed on the attached sheet y,-ISro a•sole proprietor orpartner- These sub.contractors have , ship.and havcTo employees employees and -haw workers •ivorldng for me ih tiny capacity, [No wcr crrs'.comp..insurance,S comp urancei# VJe area corporation and its :required:] officers have exercised their 9, :I am ahomeowner doing all work right a£ exemption per'MCiL :myself'[Noworlters' comp. c 152, §1(4), aadwehaveno :insurancezequired.]'t employees, [No workers' ' ' insurance required:) '�'ype•of pxnject (rerluired): •. 6, Now construction -7;'Remodeling g, [� Demolition g :.Building addition '10::Electrical repair's ar. additions 11,0plumbingrep2118 or addiiinns :12,Q•RoofSepaixs •,'. . :13,� Qther '•' • I camp. tion, con7oensntionpolitsub stn, t submitane�vniadatnt iucLonttng suah. "�Y nPAv tit obecks hoX#1l mttstalao fill out tha section below showind loco. wIro out �d atatc Whether et•natthose eatifies i�4ve Any Ap Boca who suhmitthis ntndnvif indicating they are doing sll'worle and G6 but , j I).o co=Ctoars mus Boroc own rs Who au this box must aturphed an additional sheet Showing the nann of the b.000ttnctar employees. Iftbesubcontrnctorshaveemployecs theymustpmvidc•thai workers' eamp,p I'l,mba. ;CcU7.anr.mt efnplgyerthatis}7rovtdtng7 vorlcers'.co7rrperzration ittsuraucefor pty err�lpYees' .Below,is.�lte pol'ica� ctnd jAb.site .ittfDrl7ratinn, , l mursmce Company Name; j7iration:Daie: , .policy rr or.Self-imlic, T: lityl3tatelZ?P_ : ..:......... te Jeob SitAddress: ------------- e shnw7n« hhepnlie}r n b z�a d- ;par Attaoh=o eolry of-thte�toriters=eampenaation palietideeltrratiorrpa osition of criminal penalties of.a r and t flue :Failure to secure noverage as•required.under Se tion�5,A Il -Mc v 1 pen ties cthey rM of E .STDp WOM aRDE' :nne.up to. 1,SOD.OD andidr one year imprisonm °f this statement ma be:forwarded to'.the Office of of up to: n250.00 a day.against the violator. _.Be advised.iliat'a cop)' }� erifcation. acl of .7.do hereby cert(�y.ruder.tlte pmns: 7111y,, IJo 1101 sprite r o fperjltr� ltal sire i{rfarntation provided.above ts.irrrc.art .carr __ _----- 10 ha.canrpleted by ciq ar tmvn oftial ,.�, ermi t/Liaense -City or YoV m .Jssuinb Authority (circle one); nTYn C]erl: �I..7✓lectrical:InspecngZnn t�'aumbiP°ct0r 1.:I3oard afIlenith �,Buildind.T�epnrtment. City/T •G. Other — erson: OCT -04-2010 MON 11:09 AM FAX NO, P. 05 Town of North Andover ,CORD'26-S (7197) INS026S (991x) -o1 ER LETTER: _ CANCELLATION SHOULD73A 71Q ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATTHEREOF, THE ISSUING INSURER WILL ENDEAVOR -TO MAIL -10 IN NOTICETO THE CERTIFICATE HOLDER NAMED TO THE LER, BUT FAILUREHALL IMPOSE NO OBLIGATION OR UARILRY OFANY KIND UPON THE INSURE i OR REPR;SEWTATIVES. AUTHORI ESI:NTATIV ` Af ELCCTRON(C LASER FORMS, INC;loop"_M6 0 ACORD CORPORATION 1988 Page I D12 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 RESPECTTO WHICH THIS CERTIFICATE THE INSURANCE AFFORDED BY THE MAY BE ISSUED OR MAY PERTAIN, POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THI@ TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE Lam' POLICY NUMBER POLICY EFFECTIVE POLICY EX ON GENERALUABILITY DATE MIOD DATE M )DOM' LIMITS X COMMERCIALGENERAL LIABILITY / / / / EACH OCCURRENCE $ 500,000 A CLAIMS MADE FX OCCUR 08 SBA PNOSB7 0@/13/2010 FIREOAMAGE(nn ImeGre) S 300,000 04/.13/2011 MED EXP (Anv one rson) S 51000 PERSONA $ 5001000 GENT AGGREGATE LIMIT APPLIES PER: GENERALAGGREGATE $ 11000,000 POLICY JERROT LOC PRODUCTS .COMPIOPAGO S 11000,000 AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT ALL OWNED AUTOS (Ea accident) S / / / / SCHEDULEpAUTOS SODILYINJURY I HIRED AUTOS (Pet Person) $ NON -OWNED AUTOS BODILY INJURY .. - (Per accldenl) PROPERTY DAMAGE GARAGE LIABILITY (PerecGdent) S ANY AUTO AUTO ONLY - EA ACCIDENT S OTHERTHAN - FA ACC S AUTO AUTO ONLY: EXCESS LIABILITY .a OCCUR. 0 CLAIMS MADE EACH OCCURRENCF AGGREGATE x DE=DUCTIBLE S / / ./ I WrENTICr4 3 - $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY S TO LIMITS E -L EACH ACCIDENT S E.L. DISEASE - EA EMPLOYEE $ OTHER - E,L,OISEgSE-POUCYLIMIT $. DESCRIPTION OF OPERATION SILOCATIONSIVEHICLESID(CLUSIONS ADDED BY ENDORSEMENTISPECIAL PROVISIONS Town of North Andover ,CORD'26-S (7197) INS026S (991x) -o1 ER LETTER: _ CANCELLATION SHOULD73A 71Q ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATTHEREOF, THE ISSUING INSURER WILL ENDEAVOR -TO MAIL -10 IN NOTICETO THE CERTIFICATE HOLDER NAMED TO THE LER, BUT FAILUREHALL IMPOSE NO OBLIGATION OR UARILRY OFANY KIND UPON THE INSURE i OR REPR;SEWTATIVES. AUTHORI ESI:NTATIV ` Af ELCCTRON(C LASER FORMS, INC;loop"_M6 0 ACORD CORPORATION 1988 Page I D12 FORM U - LOT RELEASE FORM INITRUCTIONS: 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. '"*AlF1'LICANT FILLS OUT THIS SI✓CTION************'�`*"**"`*�" APPLICANT PHONE LOCATION: Assessors Map Number 91' PARCEL �j SUEDIVISION LOT (S) STREET —YJ C��S�• ST. NUMBER *** OFFICIAL USE ONLY **'` RECOMMENDATIONS OF TOWN AGENTS: R CO SERVATION ADMINISTRATOR DATE APPROVED Q f DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENT FOOD INSPECTOR -HEALTH DATE.APPROVED DATE REJECTED SE?TIC INSPECTOR -HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS - SEWER WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED EY BUILDING ii"ISPECTCR Revised 9197 jm DATE M.'0-0 RAiNAGE 1 20A I9A 25,030 1� N IN OEC �a MORTGAGE SURVEY PLAN Location ........... MQ:..ANDOVER................................: i Scale I in.= 30 ft. Date......Noy, EASEMENT Plan reference:...�NG SOT 19A ON A PLAN BY FRANK C. GELINAS. C.E. DEC. 11 1974 ...... r ..................... :s RECORDED %v/ESSEX NO. REGISTRY OF DEEDS AS PLAN No. 7246 .....................................................11....................................... ............................................................................................... : 1®A ERNEST N. FAGERSTROM, R.L.S. 138 Nowell Avenue, Norwell a I hereby car .6. that the buiiaing Shown on th*--- plan is located on the ground as shown thereon and, that it conforms to the zoning and building ws laof t6J..9.Wr.. of ..NA..Andover....... .. when�On*4and to restrictions on record. J;./.i. ........... N r, FAGEnoiRON!. N Q I P No 1122'-- 61 0 122'F`G QO° a �vAI (AIn fa \� CES EW X M` �j BOOK 1 299 PAGE 699 s w\v aWOOD \� tk•'S3S sAnn� a, 46.04 7696 CHESTNUT STREET A O, 'MIS PLOT PLAN WAS NOT MADE FROM AN INSTRVAIJ`SNT SURVEY AND IS CRtAWN FOR TNF USG OF MORTGAGEG ONLY. TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING t , rz.:2a+'-a #.,axy�,,, ..�i'-'i1 '.�. ,.x „. EThis Section for Official Use Onl BUILDING PERNUT NUMBER: DATE ISSUED: SIGNATURE: Building Commissi2RSEj2T2qSLr of Buildings Date 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 Re red Provide Required Provided Re red Provided 1.7 Water S° M.G1 C.40. 54) 13. Flood Zone Infotmatioo: Sewerage Disposal System: Zone Public $� Private 0- Outside Flood Zone 0 Municipal On Site Disposal System ❑ 2.1 2.1Ownnerr of Record �J VAIN �V �y 1yCj V Name (Print) Address for Service Signature Telephone 2.2 Authorized Agent (� Name Address for Servtce: Signature Telephone A,y. r• fr 3.1 Licensed Construction Supervisor Not Applicable ❑ 1(Ow`) �-UW �� COQ C `Mb5 S 6 D n!� Address ��b��bJ License Number VoYylligi N , 5 1 ��'„� Licensed Constructio Supervisor. 4�Expiration bate Signa tu Telephone 3.2 Registered Improvement Contractor Not Applicable ❑ �nM.NvS C o C . � \-� `1V3�-. Company Name Registration Number (— Address Expiration Date r ' 'a Signa TelephoneR" re F _ Ck IM M Z v M 0 M X D z z M SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 § 25c(6) Workers Compensatiorr.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 .......0 No ....... 0 SECTION 5 Description of Proposed Work(check all applicable) New Construction 0 Existing Building 0 Repair(s) 0 Alterations(s) ❑ Addition 0 Accessory Bldg. ❑ Demolition ❑ Other Specify Brief Description of Proposed Work: I SFCTTON 6 - F.STIMATM CONSTRITCTION CORTR 1 Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE ONLY 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) s (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 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 1, W 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 me (^1 Signature of Owner/Agent -'-- \ Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TRABERS 1 ST 2 ND 3 SPAN DDAENSIONS OF SILLS DIIvtENSIONS OF POSTS D11VIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDIN60-ONNIAND TO NATURAL GAS LINE fi. &C '.i '� \ • �Q i U t •i V i 9 i••, ,.v� I� • ,� • • Ate' •-°. r 6i i ; ", ••• _ a f y k ,• �••, X11 9l 1ncP � � w �' r fi. &C '.i '� \ • �Q i r Is r.• � i � Tj• I� • ,� • ,. r ;Iw ; ", ••• _ a f tI • ,• �••, X11 9l 1ncP � � w �' r ,� � �e•I R>ll�flf!, a •^ •''n:� f •A to' `� - IIIM, _ ••vIC Al • T rl • Y t i I1 •• 1 • 1t • •� A� S ,{R t► :i i •1w tr n60 {��r •i I I � I 1 • 1 V ��•r , • w �} r t j: ti f an< '• •� r t S I a a: "e J �' 3 r r 'ry .T� F: 9•` , ...,,:•. till,: tj1 : = � : _ fi. &C '.i '� \ • �Q i r Is r.• r, I� • ,� • ,. r ; ", ••• ? tI • • r 1� `nn� ),1 r 1 Zy 1, • • .� w �' r IV �e•I [ 1 f •A i IIIM, _ ••vIC Al • T rl • Y t i I1 •• 1 • fi. &C '.i '� \ • �Q IA s 4�• Is r.• �.•1 • I� • ,� • ,. r•�i ; ", ••• ? tI • • r 1� `nn� ),1 r 1 Zy 1, • • .� w �' r ! i �e•I [ 1 f •A i IIIM, _ ••vIC Al • T 1^ Y •� .� •• 1 • •• • •� •i I I � I 1 • 1 %dI._.t 0 w� M � ' • fff��. ' �' z •r I \ • �Q i f 2 � w H / srs1, MV ; ", ••• �Y • I � 1 F tI • ' �' z •r I N 1 H / .• . •: i a 14 [ 1 f •A i IIIM, _ ••vIC Al • S 1^ Y •� •• • • •• • r• 9.4e Board of Buil din j e julations Pl One Ashburton ace, Rm 1301 Boston, Ma 02108-1618 License: CONSTRUCTION SUPERVISOR LICENSE _ , . Birthdate: 03/14/1934 Number: CS 027999 Expires: 03/14/2002 . _ _ - Restricted To: 00 RODNEY P ANDREWS 1647 LOWELL RD CONCORD, MA 01742 Tr. no: 17928 Keep top for receipt and change of address notification. -,f..s+-+•.- 4qr,•.w•d.5-:+},egrxc.reacm�yly. s?�tw.�.('s� .._.-...FETI.". ""w 4^> r'T'.•a"�.'q�:.9"`zt^+.sH ... a _. - _ aq. ;+ _ -- z r •'{... HOME IMPROVEMENT CONTRACTORS'REGISTRATION I Board .of Building',:RegulationsT and 5t6ndards,'�' One .Ashbur.ton Place Room- 13b1 , I: r Massachusetts 02108 rIF, n_ _x HOME^IMPROVEMENT CONTRACTOR say ,y Registration_113772 Expiration 07/15/01 i. � �„�,,, ✓ ,, fi ..ORPORATION Type PRIVATE NOME ,IMPROVEMENT' CONTRACTOR. Registr`eton 113712 ANDREWS GUNITE CO ;, INC I Type PRIVATE: CORPORATION RODNEY R .. ANDREWS `` i r =. ' ExPiratlon ..'6: --REPUE3L IC RD' - N BILLERLCA MA 91b j ANDREWS fiUNITE CO., INC 3 r D'NEY P. --ANDREWS t G�`eM�o�REPUBLIC RD s°'. -- ADMINISTRATOR * ? °I N BILLERICA. MA 01862 A CORD RTFICATE. 17111 ::. :...:..:::... ..,.......:!.:.. :, PRODUCER (603)893-9450 FAX (603)893-9480 wakesid`e'In'surance Agency, Inc. 88 Stiles Road Salem, NH 03079 Ext: INSURED Andrews Gunite Co Inc Andrews Realty Trust ATIMA 6 Republic Rd N Billerica, MA 01862 • ■, ■ _..a• �. ww,w s v www ww+ ::i. :-Si 02/22/200 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANY A COMPANY B COMPANY C COMPANY D COMPANIES AFFORDING COVERAGE Transcontinental Transportation 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 NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE (MWDD/YY) DATE (MMIDDIYY) GENERAL LIABILITYGENERAL AGGREGATE $ 2,000,000 :.................................................................................... X COMMERCIAL GENERAL LIABILITY : PRODUCTS - COMP/OP AGG $ 1,000,000 ni> CLAIMS MADE X OCCUR : PERSONAL&ADV INJURY $ 0 .:: 1 000 00 A 174087794 03/01/2000 03/01/2001...............................................................�..........,.......... OWNER'S & CONTRACTOR'S PROT ; EACH OCCURRENCE $ 1,000,000 FIRE DAMAGE (Any one fire) $ S 0 000 ..................................................... .. MED EXP (Any one person) $ S.000 �rojects: Avalon Oaks, Route 125, Wilmington, MA 01887 and Faxon Park additional Insured: Avalon Bay Communities, Inc., aiver of Rights of Recovery in favor of Avalon Bay Communities, Inc. AVALON BAY COMMUNITIES INC 1250 HANCOCK STREET SUITE 80 QUINCY, MA 02169 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILLENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Joseoh Rossetti/USER39 AUTOMOBILE LIABILITY • ••� :COMBINED SINGLE LIMIT $ ANYAUTO 1,000,000 ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) A $AP1082055940 03/01/2000: 03/01/2001: X HIRED AUTOS BODILY INJURY $ X NON-OWNEDAUTOS (Per accident) ............................................................: PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO ................................................................................... OTHER THAN AUTO ONLY: - : E EACH ACCIDENT ;.._....................... $ ..._...................... ......... ........................ ....... ,...... ,....._...........,......_......._....._. AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ 2,000,000 B X UMBRELLA FORM 174087827 03/01/2000 03/01/2001 .................................................................. AGGREGATE $ 2,000,000 OTHER THAN UMBRELLA FORM $ A - WORKERS COMPENSATION ANDTORY LIMITS ER EMPLOYERS' LIABILITY ELEACHACCIDENT $ 1,000 OOp A 120530275 03/01/2000 03/01/2001 THE PROPRIETOR/ INCL ; EL DISEASE - POLICY LIMIT $ 1,000,000 PAR TNERS/EXECUTIVE OFFICERS ARE: EXCL `. EL DISEASE - EA EMPLOYEE $ 1,000,000 OTHER �rojects: Avalon Oaks, Route 125, Wilmington, MA 01887 and Faxon Park additional Insured: Avalon Bay Communities, Inc., aiver of Rights of Recovery in favor of Avalon Bay Communities, Inc. AVALON BAY COMMUNITIES INC 1250 HANCOCK STREET SUITE 80 QUINCY, MA 02169 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILLENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Joseoh Rossetti/USER39 No 2 Il 5 ........... pORTM TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSA MUS This certifies that ........... I .............................. has permission to perform . (1... . �,� -t-........ - (1z', c. - 4 t . ............... ..... wiring in the building of ...... ................................................................... at ...... ........................... �-,�l ......... 4!t ........... ,North Andover, Mass. ........ FeJ.U.;'70� . ........... Lic. No ..... ..... ........................ -Z�EECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer Office Use Only , of 4e (RBmmunwtuit of massar4li etts Permit No. l l S 1hpartintnt of Vublic $aftta occupancy a Fee Checked BOARD OF FIRI: PREVENTION REGULATIONS 527 CMR 12.000 peeve blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 2:00 (PLEASE PRiNT IN INK OR TYPE ALI, INFORMATION) Date lzlal City or Town of__T To the inspector of Wires: The udersigned applies for a permit to perform the etectri'cal /work described below. Location (Street b Number) . -T --g,� 2j - -- l� , :�-/ —, Owner or Tenant Owner's Address la this permit In conjunction w!th it building permit: Yes ❑ No 9 (Check Appropriate Boz) Purpose of Building Utility Authorization No. Existing Service _ Amps _/ Vohs Overhead ❑ ' Undgmd ❑ No. of Meters New Service Amps _I Wits Overhead ❑ Undgmd ❑ No. of Meters Number of Feeders and Ampacity location and- Nature of Proposed Electrical Work . of Llghtinq`Ouiiets i. No. i t°ray ( "±nformers KVA S` No. of Lightini:Fixtures Above Swimming Pool gmd. ❑ �' In- . grnd. ❑ Generators • KVA _ No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Sumers No. of Switch Outlets No. of Gas Sumers No. of Ranges lbta No. of Air Cond. tam �,� Heat Total f (� l� �T 1p 0 No. of Disposals; Pumps Tons No. of Dishwashers SpacerAtea Heating No. of Dryers Heating Devices {.®. W No. 0i No. of Water Heaters KW Signs Ballaste No. Hydro Massage Ttrbe No. of Motors Tbl INSURANCE COVERAGE: Pursuant to the requirements of Massach I have a current Liability Insurance Poky Irictuding Completed Ope NO O 1 have submitted valid proot of same to the Ottice. YES O NO O coverage by checking the appropriate box. INSURANCE O BOND. O OTHER )3, (Pies" �� Ex alb Data /�C/ t P i Estimated Value o ( _ - O� Work to Start v Inspection Date Requested: Rough Final Signed under thIf Penaltles of perjury: 1 t r! FIRM NAME LiC. No. Ucensee nnnald A. Rrnnks Slgnalure LIC. NO.. 12310 Bus. Tel. No. (M) �) '141-4008 — Address 111 Morse Street, _Horwood. MA Aft. rel. No, (JU) OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the Insumnce coverage or Its substantial equivalent as to* quired by Massachusetts General Laws. and Ihnt my signature on this permit Voicsiuon walvee this requirement. Owner Ag!nt (Please chock one) . Telephone No. �_PERMIT FEE i 3i) �%� — (Signalura of Ownor or Agonl) Inr�y 011ke Use Only of 4e Permit No. 8eyarttttcttt of Public %fetg Occupancy ,& Fee Checked ,a U BOARD OF FiRt PREVENTION REGULATIONS 527 CMR 12.00 1 X90 peeve blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 2:00 (PLEASE PRINT IN INK OR TYPE AL INFORMA ION) Date 0O City or Town of To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street a, Number) Owner or Tenant Owner's Address Is this permit in conjunction with at building permit: Yes ❑ No EY (Check Appropriate Boz) Purpose of Building Utlfity Authorization No. Existing Service Amps __! Volts Overhead ❑ Undgmd ❑ No. of Meters . New Service Amps __! Wits Overhead ❑ Undgmd ❑ No. of Meters Number of Feeders and Ampaclty Location and Nature of Proposed Electrical Work of Lightin�OuQBots No. ��1 .' %bo TO � A s.' No. of Lightln�'Fixtures Above In-.. Swimming POO _.. gmd. ❑ grnd. ❑ Generators • KVA No. of Emergency Lighting No. of Receptacle Outlets No. of ON Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranged No. of Air Coed. TOW tons No. of Defection and Initiating Devices s No. Of Dispoals Total No of perm s Tons U&I KW No. of Sounding Devices No. of Sell Contained No. of Dishwashers Spacarllrea Heating KW/ DeuctbnlSoundirtg Devices No. of Dryers Heating Devices KW Local ❑ Connnecction 041tor No. a «o: Qi GsU'►�- No. of Water Heaters KW Bigni Ballasts wiring No. Hydro Massage Tubs No. of Motors lbtal HIS e-0- .S OTHER �(!%D/�j �� /� d i S INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Poky including Completed Operations Coverage or Its substantial equivalent YES G NO O 1 have submitted valid proof of same to the Office. YES O NO O It you have checked YES. please indicate the type of coverage by checking the appropriate box. INSURANCE O BOND. O OTHER (Please/SpedW (Exp atio Date) Estimated Value o Vock = w oK Work to Start d Inspection Date Requested: Rough Final Signed undor tit Penaltles of penury: LIC. NO. 1 1 f! FIRM NAME Licensee 11nn 1 d A Arnn v _Signature _ LIC. NO.. 123---- e is. Tel. No. _ 5 04) 741-4098 Address 111 Moree Street, Norwood- MA All. Ta. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee 6009 not haw Ire 1natJranCA Coverage Or IIs substantial equivalent as re• qulrsd by Massachusetts General Laws. and thrill my signature on this permit "Olwuon waives this requirement. Ownner� /Agent (Please clack one) PERMIT FEE S ... T9lephone No. - (Signsturs Of Owner or Agont) ,.gSAS