HomeMy WebLinkAboutMiscellaneous - 35 JOHNNY CAKE STREET 4/30/2018 (2)951 4 Date..'-) - d
... .................
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
0-.-- 1
This certifies that .. .................................
J'a. n..n. / ......... 7.F,./ 4e-�
has permission to perform...... .......................................
,
wiring in the building of .... J. C4.44 r ..........................
at .......... J. k...... . r.40049.4 A orth Andover, Mass.
Fee ....cd ........ Lic. No.../JT.30Z..........*.
.�ELE�M
ELECTRICAL
Check #
Commonwealth of Massachusetts
Department of Fire Services
BOARD OF FIRE PREVENTION REGULATIONS
Official Use Only
Permit No./
Occupancy and Fee Checked
[Rev. 11/991 leave blank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 06-13-2010
City or Town of. NORTH ANDOVER to the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location (Street & Number) 35 JOHNNY CAKE STREET 171 &07 ol- 9 3 c°?
Owner or Tenant JOSEPH TROMBLY Telephone No.
Owner's Address SAME
Is this permit in conjunction with a building permit?
Purpose of Building RESIDENCE
Yes ❑ No ® (Check Appropriate Box)
Utility Authorization No.
Existing Service 200 Amps 120/240 Volts Overhead ❑ Undgrd ® No. of Meters
New Service Amps Volts Overhead ❑ Undgrd ❑ No. of Meters
Number of Feeders and Ampacity
e2
Location and Nature of Proposed Electrical Work: 20 KW STANDBY EMERGENCY GENERATOR — NATURAL GAS
No. of Recessed Fixtures
No. of Ceil.-Susp. (Paddle) Fans
No. of Tota
Transformers KVA
No. of Lighting Outlets
No. of Hot Tubs
Generators 20 KVA
No. of Lighting Fixtures
Swimming Pool Above ❑In- 1:1
rnd. md.
o. o Emergency Lighting
Battery Units
No. of Receptacle Outlets
No. of Oil Burners
FIRE ALARMS
No. of Zones
No. of Switches
No. of Gas Burners
No. o Detection an
Initiating Devices
No. of Ranges
No. of Air Cond. Total
Tons
No. of Alerting Devices
No. of Waste Disposers
Heat Pum
Totals:
Numer
Tons
KW ..........
No. o Sem
-Contae
Detection/Alertin4 Devices
No. of Dishwashers
Space/Area Heating KW
Local ❑ Municipal❑ Other
Connection
No. of Dryers
Heating Appliances KW
Security Systems:
No. of Devices or Equivalent
No. of Water KW
Heaters
No. of No. of
Signs Ballasts
Data Wiring:
No. of Devices or Equivalent
No. Hydro massage Bathtubs
No. of Motors Total HP
Telecommunications Wiring:
No. of Devices or Equivalent
OTHER: WHOLE HOUSE GENERATOR & SERVICE ENTRANCE TRANSFER SWITCH
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licen-
see provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certi-
fies that such coverage is in force, and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:)
(Expiration Date)
Estimated Value of Electrical Work: $9,000.00 (When required by municipal policy.)
Work to Start: 06-13-2010 Inspections to be requested in accordance with MEC Rule 10, and upon completion.
I certify, under the pains and penalties ofperjury, that the information on this application is true and complete.
FIRM NAME: WILLIAM J. IANNAZZI, INC. V LIC. NO.: 13592A
Licensee: WILLIAM J. IANNAZZI
LIC. NO.: 13592A
Bus. Tel. No.: 978-686-7300
Address: 191 CHANDLER ROAD ANDOVER MA 01810 Alt. Tel. No.:
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law.
By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent.
Owner/Agent PERMIT FEE: $
Signature Telephone No.
I
a
Date. . ..........
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
This certifies that...................
. .
has permission for. gas installation (fPs. . . . . . . . .
in the buildings of J. I. -/ .............................
at ... :I rA.11. S North Andover, Mass.
Fee. ...... Lic. No..qX,,r.).'... ....
.........
,GAS INSPECTC(R
Check #
7294
21-
4
MASSACHUSETTS LT*N ORM APPLICATON FOR PERMIT TO DO GAS FITTING
(Type or print)
NORTH ANDOVER, MAS
Building I{ocations 5
NewI Renovation F1
LUaL'11a
�-r4 VV 4 0- Kc
Owner's Name
Replacement
Date 7�i3���
Permit # L C Y
Amount $ .7=
Plans Submitted 11 ..
C I
(Print or type)�J
Name V 1 (� U�vi i ,!
Address
Name of Licensed Plumber or Gas Fitter 11 d
T� '". h k one: Certificate Installing Company
Corp.
Partner.
A , Firm/Co.
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes13 Nor—]
If you have checked yes, plea indicate the type coverage by checking the appropriate box.
Liability insurance policy Other type of indemnity El Bond11
Owner's Insurance Waiver:am aware that the.licensee does not have the Insurance coverage required by Chapter 142 of the
Mass. General Laws, and tha my signature on this permit application waives this requirement.
Check one:
Signature of Owner or Owner's Agent Owner 0 Agent 0
I hereby certify that all of the details and information I have submitted (or entered) in above a 'ca on a and accurate to the
best of my knowledge and that all plumbing work and installations p Orme er ermit sued or application will be in
compliance with all pertinent provisions of the Massachusetts Stat Gas Co e a d pt 42 eneral Laws.
City/Town I
11-krri-,V V r.L (OFFICE USE ONLY) '
Signat`s�
Plumber
XM
as Fitter
aster
journeyman
w
v�
a
V1
c
zd
x
W
rA
0
U
a
F+
7+
a
o
z0
a
.
z
C�7
w
to
0.1
W
z
w
�
a
W
Q
Q
w
Q
F
W
z
w
o
H
z0
U
.a
H
3
0
°
x°
>
SUB -BASEM ENT
.
BASEMENT
1ST. FLOOR
2ND. FLOOR
3RD. FLOOR
4TH. FLOOR
STH. FLOOR
6TH. FLOOR
7TH. FLOOR
8-TH. •FLOOR
C I
(Print or type)�J
Name V 1 (� U�vi i ,!
Address
Name of Licensed Plumber or Gas Fitter 11 d
T� '". h k one: Certificate Installing Company
Corp.
Partner.
A , Firm/Co.
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes13 Nor—]
If you have checked yes, plea indicate the type coverage by checking the appropriate box.
Liability insurance policy Other type of indemnity El Bond11
Owner's Insurance Waiver:am aware that the.licensee does not have the Insurance coverage required by Chapter 142 of the
Mass. General Laws, and tha my signature on this permit application waives this requirement.
Check one:
Signature of Owner or Owner's Agent Owner 0 Agent 0
I hereby certify that all of the details and information I have submitted (or entered) in above a 'ca on a and accurate to the
best of my knowledge and that all plumbing work and installations p Orme er ermit sued or application will be in
compliance with all pertinent provisions of the Massachusetts Stat Gas Co e a d pt 42 eneral Laws.
City/Town I
11-krri-,V V r.L (OFFICE USE ONLY) '
Signat`s�
Plumber
XM
as Fitter
aster
journeyman
The Commonwealth of Massachusetts
Department of£rzdustria1:4ccidents
IV
Office of hivesd ations
600 Washington Street
$ ostan, AM 02111
NrWW-masSgov/dia
,Workers' Compensation Insurance Affida,irrt: Builders/Contractors/Electriciazts/Plumbers
�Plicant Information
..
Na -"'e (Business/Organization/Individual):
Address:
City/State/Zip:
Phone #:
Are you an employer? Check the appropriate box:
1. ❑ I asn a employer with
4. ❑ I am a a contractor
emVeneral
ployees (full and/orpaxt time).*
2. ❑ I am a sole
and
have hired the sub ntrac ors
proprietor or partner-
Misted on the attached sheet t
Ship and have no employees
These subcontractors have
working for me in any capacity,
[NO workers' comp. insurance
workers' comp. insurance.
e are a corporation
required-]
3. ❑ am a homeowner doing work
and its
officers have exercised their
.I all
myself [No workers' comp.
right of exemption per MGL
c. 152, I (4), and we have no
insurance required.] t
employees. [No workers'
ie-� w t ±thYt ���� temp. insurance required.]
y _ -ir2n bov,4J ���ci �� ,,.,, L^.e
' Homeowners who submit4w_ _=j_:,o eceT eeeor.• ...as = . mer:= com^��= 4
Type of project (required):
6, ❑ New construction
7. ❑ Remodeling
8, ❑ Demolition
9. ❑ Building addition
10.0 Electrical repairs or additions
.11•❑ Plumbing repairs or additions
12.❑ Roof repairs
13.❑ other
indicating Jnr dc -419 `�' `�` and thea hire outside contractors r�ttct submit a ewWamaavit indicating such.
+Contracors that chec'z �;s boa mu• attached an additionaI sheet showinP the
name of the sub -contractors and th
t Mr Wotkrc
e,
er rs prov uig workers' compensation insurance for my employees Below is the policy and job site
inform¢twn.
Insurauce Compy an Name:
AA
Policy # or Self -ins. Lic. #:
Expiration Date: ^
Job Site Address:..� M e
City/State/Zi
Attach a copy -of the workers' compensation oiicy declaration pagp: e (showing the policy number -and expiration date).
Failure to secure coverage as required Under Section 25A ofMGL c. 152 can lead o the imposition of criminal penalties of a
no ne up $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a S
of up to $250.00 a day against the violator. Be advised that a copy of this statemand a n"ne
ent may be forwarded to the office TOP WORK ORDER aa
Investigations of the DIA for insurance coverage verificationof
I do hereby
thrzt the information. provided above -is true and correct.
Phone 4. - - - - ---------
Official
- Official use only. Dc not write* in this area, to be completed by city or
town offzczaL
f
City or Town: Perm-it/License #
Issuing Authority (circle one):
I. Board of Health Z, EuiIdiizb Department 3. City/Town Clerk 4, EIectricaI Inspector 5. PItimbinb inspector
6. Other
Contact Persoxv
Phone'#:
Information ars. d. Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compeniation for their employees.
Pursuant to this status:,, an employee is defined as "...every person in the service of another under any contract of hire,
express or implied, oral or written."
An employeris defined as "an individual, partaefship,•associaLtion, corporation or other legal entity, or any two ormore
of the foregoing engaged in a joint enterprise, and including tine legal representatives of a deceased employer, or the
receiver or trustee of an individual, parinership, association 02-,7 other legal entity, employing employees. However the
owner of a dwelling house having not more than -three apartrQ eats 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 burTaing appurtenant thereto shall not beicause of such. employment be deemed to be. an employer."
MGL chapter 152, §25C(6) also slates that "every state or Io.cal licensing•agency shall withhold -the issuance or f
renewal of a license or permit to operate a' business or to construct buildings in the commonwealth for any 1
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 nix -til 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 bores that apply to your situation and, if
necessary, supply sub-contractor(s) name(s), address(es) and phone numbers) along with their certificate(s) of
insurance. Limited Liability Companies (LLC) or Limited Liability partnerships (LLP) w#
.no w.no employees other than the
members or partners,. are not required to carry workers' comp a nsation 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 snare to sign and date the affidavit The affidavit should
a f •i.. _c sa t• i r_ t
be ret-arncu to the citf o efiirn that, the au: uc '0rt i +T the permnit'OT 11^el:Ce :s ile:ng regtees�.ed, fiat the Drpart'.:'e:lt of
Industrial Accidents. Should you have any questions regardLg the law or if you are rg :sired to obtain a worL'ers'
compensation policy, please call the Department at the number listed below. Salf-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/lic--me number which will be -used as a ireference 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
(Le. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit.
The Office ofInvestigations 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.fagmumber._..
The Camonwealh of Iv =achusetts
Depar n2ent 0-fFndustria-1 Accidents
Oflice of 1R1estigatiGas
600 Washina-ton Street
Briton, ILA 02111
Tel. # 617-727-490.0 eat 406 ar 1-9 —/7-I�L�4S.SAFE
Revised 5-26-05 Pax # 6.17-727-7149
vmm, mass.-Dov/dia
w
Location
� 9
N&i Date
TOWN OF NORTH ANDOVER
mac.°. cp
Certificate of Occupancy $
# Building/Frame Permit Fee $ ,—
�'�b'•••°''t�' Foundation Permit Fee $
Ss4CMust
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL $
59 09¢09 25. 00 PAID
Building Inspector
Div. Public Works
f
Location
No.
Date
NaRTM TOWN OF NORTH ANDOVER
16. O ° • OA
Certificate of Occupancy $_
Building/Frame Permit Fee $
;7bAC 9 Foundation Permit Fee $
ss
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL $
Building Inspector
Div. Public Works
r1
Q
(_
z
z
cor)
y
�
�
1�
9
u
Z
rJ
L
z
—z
c
<
G
w
w
w
vi
-r
Q
F
C
MMo
"J
O
a
—
z
N
tkt
ON
C
ti
Z
y
O
Z
z
N
Gvi
z
y
z
v
y
0
y
LL
...
..
W
Z
Z
W
L
1a'J
Z
W
_J
LL)�J
r.
r
O
"
O
Q
U
z
}
..r
�
I
cr
11
y
Z
y
C,W
yLU
Lm
W
W
�
J
V)
+=
�
5
w
y
Q
-
3
-
I
F
:1
E
y
Z
Lu
z
...j
6
to,
V
y
r
W
_
:JJ
W
Y
L
YL
Z
y
Z
W
<
<
¢
Q
r-1
L
?
''
=
in
•n
n
m
1
W
.Q.
v`�
z
z
z
y
�
�
1�
9
Z
rJ
1
W
.Q.
v`�
z
z
z
y
�
�
9
Z
rJ
L
z
—z
c
<
w
w
w
vi
-r
1
W
.Q.
A
i - �. • � fooinwe.wnnlbi o f✓�(aee�roeQa.
Hom BPM MENT CONTRACTOR ' .
ReOistatioa 101862
Type - pR Y42, CORPORUION
Et0latlon . 06i24I9a'
{ .. RAYNOAD E. DANPHOUSSEi JR.
Raymond f. Datphouase,:I
L� Bdttaraat Leis", ti .
AOMIMSTRATOR ��tdN' NA 01844
1
•
W
co
O
H
:.CIS
• c 'i
o `
C y
O C
V V
Cc ea
m C
E
a
�� �'6I��•-i `m
�v. C
d O O
Y V
u
t+
�o E�
•PQ �: o r
t; cm
E
nS
C." A
0
O
N 3
Q!
V C
m
CA
N O O
N
m
a - o
N o cc
t = O Qf
CD's
'acr m
0
601 h Z O
C CC
L_
Q y O C �C
_ 'moo N
:d
y A O
W C o
LL _m C O
.h at o - Z
...
U= �E 5 -o o cm o
U=
a 5
_ 0`ti o
z . ai m
z
0
W
w
.,
Ml
MY
O
O
CD
O
Z W
v.
O h
G C
C cm
ca
O •C
CD
0
y O �O
m m
CD
CL0_
= O �
CD L
�C O d
a �Q
o
Cc
EL 0 CD
ce Z Cs
CD
0 CL
U CO)
� }r
C
CO)
uNto
a
�
•o
:�
a
w
x
o
w
a
w"
a
o
w
c�'
0
w
o
w
co
c
ii
w
o
co
b
cn
0
cn
:.CIS
• c 'i
o `
C y
O C
V V
Cc ea
m C
E
a
�� �'6I��•-i `m
�v. C
d O O
Y V
u
t+
�o E�
•PQ �: o r
t; cm
E
nS
C." A
0
O
N 3
Q!
V C
m
CA
N O O
N
m
a - o
N o cc
t = O Qf
CD's
'acr m
0
601 h Z O
C CC
L_
Q y O C �C
_ 'moo N
:d
y A O
W C o
LL _m C O
.h at o - Z
...
U= �E 5 -o o cm o
U=
a 5
_ 0`ti o
z . ai m
z
0
W
w
.,
Ml
MY
O
O
CD
O
Z W
v.
O h
G C
C cm
ca
O •C
CD
0
y O �O
m m
CD
CL0_
= O �
CD L
�C O d
a �Q
o
Cc
EL 0 CD
ce Z Cs
CD
0 CL
U CO)
� }r
C
CO)
RAYMOND E. DAMPHOUSSE, JR. AND SONS
ROOFING CO., INC. 9
BOX 431 LAWRENCE P.O.
MA. CQNSTRUCTION LAWRENCE, MA 01842
SUPERVISOR LIC. #046636
HOME IMPROVEMENT
REG. #101862
TEL: 683-4588
ROOFING - SIDING - INSULATION
J S� �� H` Z 1,,17 /3
From: (Name)
Date
rebs)
I
TO: YATMOND E. DAVEDISSE, JE. AND SONS HOOFINC CO., INC., BOX 431 LAWRENCE P.O., LAWRENCE, MASSACHUSETTS 01842
1 (we) hereby authorize the Contractor to furnish all materials and labor necessary to install, construct and place the
�� / G� - Street,
improvements described below in -on building located at No.
�%fJQU tE,A State /�_5-�--- _ in accordance with the following specifications:
City `. f—�,�
�Cl moi_ r� %I L �% /9I U /�/(r �,!i ✓� � �i /i�O G r1 c,
1.2
/ �-� jai S /7 . � [1- �.C/ iia �,=✓ ,�)/7/I�, j= ,. / r i'/J i r� l_ �-- /-��� c.� Uc= ��i -- ,.
�/f
L��:n." r
l7� �.t "% 3✓/. ✓71 �,-�/"Lr r� Lyl-� r -
All of the above work to be done in a good and workmanlike manner. j��j�`�✓�r / ,�• �0
1 nli6;w-'/.i.b 1•�t iii JlJl Ov. 1'I �i1: ii5aJ lli U6 ,Vtl labaii U`1 iIU �. iJi il✓OJoii of Wl 11
X1dO:CI�UI—
�. 1 --- --------- -- dollars. •) ��� �.
For the total sum of — -
as shown below
Entire Sum to be paid immediately upon completion in accordance with plan -------
TOTAL CASH SELLING PRICE ......... .
f) G DOWN PAYMENT IN CASH
c.�/'���� J DEFERRED BALANCE
UPON COMPLETION ............ ---
The undersigned agrees to keep property mentioned in this agreement properly insured against loss by fire including the
Contractor's interest therein.
on the written acceptance hereof by said Contractor, and upon such acceptance
This agreement shall become binding only up
this shall constitute the entire contract and be binding upon the parties hereto, there being no covenants, promises or agreements.
written or oral except as herein set forth. It is the intention of the parties hereto that this contract shall be binding upon their respective
heirs, executors, administrators, successors and assigns.
s and Court Costs if placed in hands of attorney for collection.
Customer agrees to pay a reasonable sum as attorney's fee
The owner further agrees that in event of cancellation of this contract after acceptance by the contractor and before the work is
commenced the OWNER agrees to pay 20% of the total consideration herein named as liquidated damages for breach of contract
dr; y riu? c, ri4,gc fisc a,, ,., ,•.,t; �,ti C __. t :i'/C..,`i
Said contractor shail not be responsible for dampno or la, ...
reasonable control.
We, the undersigned, certify that we are the sole owners of the property herein described on which said work or repairs are
J%7c� ��C1 d l �G+� 1'.f/ � �/ U �',�/J /.-3l-L�i7 Gya i �,;,;"2i�i'l�� r• .� r �'i J % �'�/G- ��rf. � i'�vr" >
All of the above work to be done in a good and workmanlike manner.
All town aiid equipi-ne if insui-oi, Pi*� (N35o tU be leN cleait upo.) of worn.
For the total sum of _ dollars.
Entire Sum to be paid immediately upon completion in accordance with plan as shown below.
TOTAL CASH SELLING PRICE ..........
DOWN PAYMENT IN CASH ............... �� 6
DEFERRED BALANCE
UPON COMPLETION ....... . ........
The undersigned agrees to keep property mentioned in this agreement properly insured against loss by fire including the
Contractor's interest therein.
This agreement shall become binding only upon the written acceptance hereof by said Contractor, and upon such acceptance
this shall constitute the entire contract and be binding upon the parties hereto, there being no covenants, promises or agreements,
written or oral except as herein set forth. It is the intention of the parties hereto that this contract shall be binding upon their respective
heirs, executors, administrators, successors and assigns.
Customer agrees to pay a reasonable sum as attorney's fees and Court Costs if placed in hands of attorney for collection.
The owner further agrees that in event of cancellation of This contract after acceptance by the contractor and before the work is
commenced the OWNER agrees to pay 20% of the total consideration herein named as liquidated damages for breach of contract.
Said contractor shall not be responsible for dama;e or delay d1 -1e to strikes, fires, other causes beycnd his
reasonable control.
We, the undersigned, certify that we are the sole owners of the property herein described on which said work or repairs are
to be performed.
IN WITNESS WHEREOF, the undersigned has (have) hereunto set his (their) nd(s) and seal(s) the day and year written above.
Accepted By
N9 L-DAMPHOUSSE, JR. AND SONS
ROO ING CO., INC.
ignature an);(Tylle ofbfficial)
usband
Wife
Mail Address / y
(If different from above) f
I
Location �� /v Y 0r41
No. O' Date
Building Inspector
939.4 Div. Public Works
�OR7M
,ti0
TOWN OF NORTH
ANDOVEN
��u
Ot��
Certificate of Occupancy
$
Y7
Building/Frame Permit Fee
$"
yob'"°'�<�'
Ss,�C14Ust
Foundation Permit Fee
$
�}
N~
Other Permit Fee
$
Sewer Connection Fee
$
Water Connection Fee
$
Tl1TA 1
0�
Building Inspector
939.4 Div. Public Works
W I�
a
< 0 A
IL_
o
0 N
m 0
30
wo
k
'I N
o/ W
N
rJ �
jA d
� N ! !
OC W ^
w Z
C 0 z m ►m o
Z
0 J S O
° O m
O u °� r LL o
g LL f o Z
0 :
I W Z W
C N N
< f
N d Z m m m O
1�1
0
H
c_H
K
ac
OC rl N W
2 B1 Q
ai .o cf
U Q H
IL
�O Z H
Q Z Z 111
r m /7
° N 7h D W
( r W Z_
\V�) J
WC r
W i W a N 0
W 0 Z i i 0 0
Z <O 0 Z O m m
Z < f N
0 0 N Wzzz
W K U u u
W Q W W F O < < <
Q Z u z z u N N N
z f N J 0 0 i m a o 0
F
WIa
s
W
N
C\
1
vl
V
0
Z
�
QQ�
C
}
m
z
x
x
0
ui
U
Z
j
r
W
a
p
O
OJ
z
t
p
W
0
iz
O
O
0
<;
W
�
W
;
a
<
0
d
(OJ
a G
o
m
m
(
C
m
W
d
u
W
J
0
0
4
01
t
3 W
N
W
we
Ir
r
e
r
e
Z
o
r
0
LL
O
W
K
0
z
0
0
LL
0
W
N_
3
W
Z
0
z
O
m
N
V
9
N
C\
1
�
�
�
0
ui
U
W
O
O
O
()
Q
S
�; V �m; 0
�m O
H O A Q
DN; 0
N a
a 'a 0. 0 n
� NO
0
_ N
.�I T
Z m O" Ic A D I:c 1" T 1:2
O n �• N y� A O D A T�
D n m � O9 £ o IAA
2
T
N
Z x
0=4
ax
C m
Z Z
C
0
0 m
0
c
D
-1
O m
C
0
AI Io�ml. IDI N
IIIIIIIIIII
D;N
D=Iz .•
-oZZN
Nicnn
_
ISL
D
+
D n
NODDO
x m101
A A
m m
toA
;
00
T T
Z
n
i
x
+�
p
m
a a
N
N
• Z
C
m
N
Z
D
v~Ai
x
2
m
0
--
< i
mm�
m
P
f
-
N
I I I I
O
O
m
y
z
mo. nn
Lo
D;N
D=Iz .•
-oZZN
Nicnn
O
A A
m m
A
TT
^`
+�
ZDyy
T
N
W
C
N
>
O�
x
C
--
< i
m
f
O
Z
n
Z
I I
^
C
CO
T j
a x
N A
a
TI
W
.ZrI
f"
o N
T O
D
z�m£
m
Z
r
A O
y
O
N N
n
x
Z
II ISI
ISI 'I IL's
�L1� IN
N_
C)0 N
m N
NDN
Zm
D0
yZZ
COX
�XN
D
n
0 10
p3m
mx
-4 ZD
3:(An
66-1
�Z°
m�3
�
OZ
mN
M 0
Wsz
m
0r
00
-ic)r
•U(0
Z�z
2�
Ol
XD
0
20
mm
mm
/Y m
00
3
C
r -
v_
z
O
m
A
O
ov
v
M
Z` D
031NVM9 liWa3d
33d
1N303Z V HO W3N O d0 nJNN'IS
03114 31V0
VOI0DUSN1 ON1011n9 AS 03AOMddV CNV 0311.135 1SnW SNV1d
SNOLLYlnO3N 3211.1 31V1S Ol WNO.1NO315nW s3OVMVO 03H0V11V
9NI011nS .1O 30151n0 NO 3s 1SnW Sd313W 01M10313
SNOIl:)nM1SNI
1VN Ol 03103NN00 9Nta ims SI
91 - t SN011036 ln0 -rim Z 39Vd
£ - t SNOt103s lno'riu l 39Vd
S301S H1O8 33S
d�
Ol 03103NNOZ) oNIO11ns 51 ANV .1l 'NOIlOV S-IV3ddV .1O aNV08
Ol 03103NN00 ON1011ns Sl S� 3000.10 S1N3W3NIn03a Ol WNONOO 9NIal1ne -mm
Id Mo amus NO ONIO11n9 st S a' NOI1VM311V ONIa11nH Sl
A3NWIH0.101V:tl31VW NOI110OV 9NIalIns SI
9NIIOOd .10 3ZIS M3N ONIO1Ina SI
NOI1VaNn0.1.1O 1H913H 30VINOMA 101 d0 V37dV
SH30MI9 . MV3M / S301S—.S3NIl 101 WOMB 3aNVISla
slsod . rVy�a 133M1S WON.1 30NVISIC
SMS d0 SNOISN3WIa (� /O/NIOItna 1S3HV3N Ol 37NV1SIO
NVdS u O rd%7� 3WVN S.H30ltna !
j
lst SM3t3Wil NOOI.1.1O 3ZIS 3WVN S.10311HOHV
SVIS HO1N3W3SV9 �`-�/y6�p� ✓�(�� SS3NaOV S.H3NMO
S3luols A0 'ONas�1C� 31VN S.M3NM0-
d'
a�Olu?a/ 9Nlallns .1O 3sodMnd ,fS ay�i MJO(� ,.7 NOIlV:)O-1
'ON .10•l 'AIa 9t1S 3NOZ
HS213NMO d0 07dO::)3N Z �L�0 •ON 10'I I 9/. •O?+ dVW. .
W VAOaNV HINON — amns Ol lIW83d VOA NOIIVJIlddV ��L2 ou z.[srg3a
0
z
cz
w
a CD
gi
c� c
co
'Coo
mo
O
�ciCD
z Q
m
co
�� p
CE COa,
ts
CA
EE O y p�0
m Z
m
OU m
oo C� O Co
o .0 O i F—
m c co �p
Q U
C',
rn � CLI
C ?, 1-.-1 COco
io ,o Q
co
ci, c
C/)� o +� ev
y m m
C
y Z Com.)
y O CD
m o m O d
: CC.,co
o O C
Z
c c cm O
o a
t _
W C cGL-.
LL. m
'rn cc m c N�
rn 'nt .—z
cc 'ELl L- B., 1= co,y O D
CIOCA CD!E
C. m o
S cyv C, y'C O
F- z $aim ::p
0:
a
x
O
A
Q�
v
'$
w
v
�g
JS
z
Q
o
;
ci
42
U
x
COD
C7
aa
w°'
m
lz
w
a
U
�
W
2
J�
c
w
u
a
W
(�''
,
C2
�
w
a
A
w
v
ro
6
z
V)
v
Q
v
o
—C !/)
a CD
gi
c� c
co
'Coo
mo
O
�ciCD
z Q
m
co
�� p
CE COa,
ts
CA
EE O y p�0
m Z
m
OU m
oo C� O Co
o .0 O i F—
m c co �p
Q U
C',
rn � CLI
C ?, 1-.-1 COco
io ,o Q
co
ci, c
C/)� o +� ev
y m m
C
y Z Com.)
y O CD
m o m O d
: CC.,co
o O C
Z
c c cm O
o a
t _
W C cGL-.
LL. m
'rn cc m c N�
rn 'nt .—z
cc 'ELl L- B., 1= co,y O D
CIOCA CD!E
C. m o
S cyv C, y'C O
F- z $aim ::p
COMMERCIAL - RESIDENTIAL
DATE
Office and Exhibit Area:
146 DASCOMB ROAD
(Route 93 - Exit 42)
ANDOVER, MA 01810
JOB
Brockway -Smith Company
Brosco Architectural Group
Serving Greater Northeast Architects since 1890
800-225-7912
FAX (24 hours) 800-242-4533
-
�, ti
fb
a_
- `0
/ 1 W
4_1 z Ole
16
2oailaUe fo seroe you wills Tuaffel rices, &inorow 17efalf'n9 anon c3pec Nrifln9
I ENTRY DOOR SYSTEM Andersen "Rain Sensitized"
I I I Wood and Steel Automatic Closing
Hinged French Patio Doors ROOF WINDOWS
Andefsen*
WM&Wau?
qV .
COMMERCIAL - RESIDENTIAL
DATE
Brockway -Smith Company
Brosco Architectural Group
Serving Greater Northeast Architects since 1890
Office and Exhibit Area:
146 DASCOMB ROAD
(Route 93 - Exit 42) 800-225-7912
ANDOVER, MA 01810 FAX (24 hours) 800-242-4533
JOB
_ _ +.++ + I t Fi _
a _
V,
.�.+++ + ++.e
�. _... _ d-.-4 .. 4.
I
r I �
/ r 7L
70
W
T _
✓`7ualfa6le lo serve you . wife J13u yel J rices, &lnAw 17elailn9, anon c5pec brillny
ENTRY DOOR SYSTEM Andersen "Rain Sensitized"
I I ( Wood and Steel Automatic Closing
Hinged French Patio Doors ROOF WINDOWS
COMMERCIAL - RESIDENTIAL
DATE
Brockway -Smith Company
Brosco Architectural Group
Serving Greater Northeast Architects since 1890
Office and Exhibit Area:
146 DASCOMB ROAD
(Route 93 - Exit 42) 800-225-7912
ANDOVER, MA 01810 FAX (24 hours) 800-242-4533
JOB
0
re
_ T
_ 3
Voarla6fe 16 seroe .you.will? _Tuo(yel :/rices, binc(ow Delaifny an c( 6,oec briliny
Lull
ENTRY DOOR SYSTEM Andersen "Rain Sensitized"
( IWood and Steel Automatic Closing
Hinged French Patio Doors ROOF WINDOWS
Brockway -Smith Company
4fseir Brosco Architectural Group
WmdowalW Serving Greater Northeast Architects since 1890
qF Office and Exhibit Area:
146 DASCOMB ROAD e
(Route 93 - Exit 42) 800-225-7912
ANDOVER, MA 01810 FAX (24 hours) 800-242-4533
9CIAL - RESIDENTIAL
JOB
L
TZr,
Avaifa6fe 16 serve you rrwilh Tuayf el Jrices, Mno(ow Delallny and 6,pec brilin9
I ENTRY DOOR SYSTEM Andersen "Rain Sensitized"
I 10iWood and Steel Automatic Closing
Hinged French Patio Doors ROOF WINDOWS
:,;77TT ZZ777'--.7,
f.
4rw26Date. . . . 54 .. ..... . ....
TOWN OF NORTH ANDOVER
0 ht �op PERMIT FORXAASOI'NSTALLATION
This certifies that ......................
has permission for J
,Aag'oinstallation .............
in the buildings of ...
.. ............. I ............
at ..... I No h AndoyeT, ;as.
Ze . . .......
Fee No. /
�3c �S-;A INSPECTOR
WHITE: Applicant ZXARY: Building Dept. PINK: Treasurer GOLD: File
The Commonwealth of Massachusetts
` Yi Dcpertment of Nblic SoJcty e•••t` �• �:: T (�
' Ocr "Acir a Iaa'Q�eeLat >•> VJ•
BOARD OF FIRE PREVENTION REGULATIONS S27 CMR 12.•00 3/90 (14a.4 at...l
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be periarmed in accordance Frith the f tauachusetu EJectrkal Code. 527 CHR 12..00
(PLEASE Puri IN INR OR TYPE ALL MORiMON) Date l
City or Town o. To the Inspector of Wires:
The uneorsigned applies for a permit to perform the electrical work described below.
Location (Street 6 Number) /d SGQ �s"c/� /1,14 V
06mer or Tenant
Owner's Address
Is this permit in conjunction with a building permit: YesNo (Check Appropriate Box)
Arpose of Building. Utility Authorization NO.
Existing Ser -..ice 7-O /Amps /z / Zrl Volts Ovetncad `j r, C---
Undgrd ❑,�No. of-•et!Ys l
New Service Amps / Volts Overbcad ❑ Undgrd ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
No. of Lightirtg Outlets
'lo. of Lighting Fixtures
No. of Receptacle outlets
No. of Switch Outlets
No. of Ranges
He. of Disposals
;lo. of Dishwashers
No. of Dryers
No. of Water Beaters KW
No. Hydro Massage Tubs
R:
No. of clot Tubs
Switiming Fool Above
grnd. ❑
No. of Oil Burners
No. of Gas Burners
No. of Air Cond.
No. of Heat Total
APs Tons
Space/Area Heating
Keating Devices
no. at
Ballasts
[n -
rnd. ❑
No. of Transformers +o tai
IN A
Generators KVA
No. of Emergency Lighting
Battery Units
FIRE ALARMS No. of Zones
No, of Detection and
Initiating Devices
No. of Sounding Devices
KW
KW /
No, of Self Contained
Detection/Sounding Devices
KK _
❑ Munici al
Local Connet:tton❑Other
Lowvoltage
No. of Motors Total HP
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws
I have a current Liab ty Insurance Policy including Cocpleted Operations Coverage or its substantial
equivalent. YES NO I have submitted valid proof of same to this office. YES Q--iro ❑
Ii you have checked. YES; please indicate the type of coverage by checking the appropriate box.
INSURANCE BOND❑ anmR ❑ (Please Specify)—� ,
Estimated Value of Electrical Work S tExpirstion Date
Work to Start le " y In Date Requested: Rough 4� — 1r g� Final
Signed under the penalties of perjury:
FIRM HAM
Licensee
Address
LIC.. N0. 33 .
LIC, ti0. Jr j,3
OWNIZ'S INSURANCE WAIVER: I an aware that the LicenseE does not have the insurance coverage or its sub- /
stantial equivalent ay required by Massachusetts GeneralwsZ a ,and that my signature on this permit
application waives this requirement. Owner Agent (Please check one)
s-
Telephone No. PERMIT FEE S I" ��
Signature of Owner or Agent
C �� � x(,39 `{.