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HomeMy WebLinkAboutMiscellaneous - 381 MASSACHUSETTS AVENUE 4/30/2018Date (?/ " .�� . p/<„paT TOWN OF NORTH ANDOVER X � .r - -'• ppL PERMIT FOR PLUMBING This certifies that ... ................. f .'� ............. has permission to perform ..... ...: �....................... . plumbing in the buildings of . `..1 .................... at.. ...... , Nzrth Andover, Mass. Fee;2 ..... Lic. No.. a` . . P` UMBING INSPEC40R Check 85-02 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS / Date C� ' y-16) Building3 V /Mss Location % tT & Owners Name j V WL) %�I�f t/P/rJ�jU� Permit # -Type of Oc cupancy 4 to cu -,51),e Amount New ❑ Renovation ❑ Replacement M Plans Submitted Yes ❑ No FIXTURES (Print or type) Check one: Certificate Installing Company Name_ _i A/- L l �} / P-01 ❑ Corp. Address P` O , sox 1 l,s�'�/✓e'� IVA y' " a� Partner.* Business Telephoness, 5-77J;'� ❑ Firm/Co. Name of Licensed Plumber. /0—M Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy ® Other type of indemnity 11 11 ❑ Insurance Waiver L the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Phunb' g and Chapter 142 of the General Laws. By: i.=_ vignalurF vi LiMnsca riurriDer Title Type of Plumbing License City/Town i e um er Master ❑ Journeyman M APPROVED la�cE uss ONLY�.J Date. ....... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION 14 This certifies that ... ,rt` , I/ -/'m .? I .... /?� .`—/ ......... has permission for, gas tinstallation ... ................ in the buildings of ..... ...................... . at .�..�,��. �..''........... . Nort_Andover, Mass. Fee.2.LyLic. No..? ........ y... i, G S INSPECTOR /" Check # ,7265 MASSACHUSETrSUNIFOP.MAPPLICATONFORPERAWTO DO GAS FTI TING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Locations 3 F1 s x yle �Q 1-1N 1*4#? lyAIS - Owner's Name New ❑ Renovation ❑ Date 6 - q--/ Q Replacement © Plans Submitted ❑ Permit # Amount $ (fit or type) T 1�/� j G L o �i'/a r✓ /��/ one: Certificate Installing company Name. 77 Corp. Address , /0 d - /3 O X 5'7 aZ ❑ Partner. e-4w4envre 144 - e leyz- Business Telephone 7-71 to YS- 9 5So y ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter TL/vrr o s ej INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalem Yes ❑ No ❑ Ifyou have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy ® Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver. 1 am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement Check one. ❑ Signature of Owner or Owner's Agent Owner ❑ Agent i hereby certify that all ofthe details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Pemrit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code anfl Chapter 142 ofthe General Laws. (OFFICE USE ONLY) Signature ofLicensed Plumber Or Gas Fitter ® Plumber 3 33 ❑ Gas Fitter Lice" nse Num er ❑ Master ® Journeyman �l♦�l♦���1♦t♦��l♦�l♦�l�l♦�)♦�� (fit or type) T 1�/� j G L o �i'/a r✓ /��/ one: Certificate Installing company Name. 77 Corp. Address , /0 d - /3 O X 5'7 aZ ❑ Partner. e-4w4envre 144 - e leyz- Business Telephone 7-71 to YS- 9 5So y ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter TL/vrr o s ej INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalem Yes ❑ No ❑ Ifyou have checked yes, please indicate the type coverage by checking the appropriate box. Liability insurance policy ® Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver. 1 am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement Check one. ❑ Signature of Owner or Owner's Agent Owner ❑ Agent i hereby certify that all ofthe details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Pemrit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code anfl Chapter 142 ofthe General Laws. (OFFICE USE ONLY) Signature ofLicensed Plumber Or Gas Fitter ® Plumber 3 33 ❑ Gas Fitter Lice" nse Num er ❑ Master ® Journeyman Date.—. ;L? -- (V. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ..�.`t.�•� ii -- has permission to perform . ► 1. .... P�...� 1 !M� .¢' ... � .tn Yxi45 plumbing in the buildinAf .� . `1. . .. �.lke ......... at ....�'.I�t/9 ................... North Andover, Mass. Fee /)f. . Lic. No.?) 5-- . ) C t• .f ........ PLUMBING INSPECTOR jr� tr Check # � U 6849 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO (Print or Type) Mass. Date Permit #r _ A _ W 0 Building Location 3 f/ "!5� r ,diII New Renovation ❑ Replacement ❑ PLUMBIN�7/ru Owner's Name Type of Occupancy FIXTURES Plans Submitted: Yes ❑ No ❑ Installing Company Name Crane's Plumbing & Heating Check one: Certificate Address 70 Douglas Street ❑ Corporation Haverhill, MA 01830 ❑ Partnership Business Telephone ( 9 7 8 ) -Iq/ ❑ Name of Licensed Plumber Peter J. Crane INSURANCE COVERAGE: have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes gR No ❑ if you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy IX Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. W Check one: Owner Agent Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted (or entered) in the above application are true and accurate to the best of my knoevled,ge and that all piun:hir•g ,%axk and installations performed under the permit issued for this application will be in co with11tment provisions of the Massachusetts State Plwnhing Code and Chapieei=-?_=:...-r General Laws. ap By Signature of Licensed'�'1� -u By Type of License: rNlaster; i ; lour9eyman i. City[Town License Number APPROVED (OFFICE USE ONLY) ■■■■■■■■■■■■■■■■■■■■■■■■■ org"Ork.. ■ti■■■[lei■■■■■■■■■■■■■■NONE ,•• NOON■■E■■■■■■NNNN■■DEED■N FLOORNOON■■■NN■■■■■■■■■■■■■■■■' ••• NOON■E■■■E■■NN■■■NNNNNEON •• ■■■■NEN■■■■■■■■■■■■■■■■■■ ••' ■■■■N■E■■E■■■■■■■■■EEN■■■ EnTIffe • ■■■■■■■■■■■■■■■■■■■■■■■■■- Installing Company Name Crane's Plumbing & Heating Check one: Certificate Address 70 Douglas Street ❑ Corporation Haverhill, MA 01830 ❑ Partnership Business Telephone ( 9 7 8 ) -Iq/ ❑ Name of Licensed Plumber Peter J. Crane INSURANCE COVERAGE: have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes gR No ❑ if you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy IX Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. W Check one: Owner Agent Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted (or entered) in the above application are true and accurate to the best of my knoevled,ge and that all piun:hir•g ,%axk and installations performed under the permit issued for this application will be in co with11tment provisions of the Massachusetts State Plwnhing Code and Chapieei=-?_=:...-r General Laws. ap By Signature of Licensed'�'1� -u By Type of License: rNlaster; i ; lour9eyman i. City[Town License Number APPROVED (OFFICE USE ONLY) v T '9 m C) z -4 m v Z rm a� 'C T 0 T W c v z C) a a �i 0 Z T 0 M M 3 1 0 v 0 T r c 3 W z 0 z 0 _T Z a r Z H T T n d 0 z w FM r- 0 00 G T 0 X 0 n T c rA T 0 z Z O W Ln W V L6 N. O ck O LL 3 O W m rI 0 u CL N e e4 C E a os N z ro _Z z � 0 6 m 6 O m mi 6 66 O W Z zofa _O ~ O W m d c a 5 c Z to A m 0 u CL N e e4 C E a laqumN asuaal3 '� urulA, mo( s,ajq!LN :asuaol3 io adAl (AINO 3sn 3DId30) 03AObddV um011APp MU Ag ,agwnl pasuao)3 )o a,nieugis usmej lelauag �ua ,ad�q� ;we apu) iulgwnl,l aieis suasnuoessew aqi )o AIDISIAOId q pim uoneoildde siyl !o) panss) pw,ad ayi lapun pawa,ad suonelleisui pue ,o.o. Xoa{wrlci llc leul pue o�pal,sou,l Au, )o isaq ayl w ale,nooe pue ann a,e uope3lldde anoge ayi u) (pa,awa,o) paulwgns aney I uo!lew,oju) pue spelap ayi )o Ile Ieyi A)pja Aga,ay I luaSV s,jaump ao jaump 10 ainleuSis lua�f Jaump :auo joagD i 7uawaiinbai siyl saAIeM uoile:)ildde liwaad siyl uo amleuSis Aw leyi pue 'smei lejauag •ssl? nN ayl jo Zb I jaldey:) !(q paimbai AMnoo aauemsui ay aney >)ou saop aasuaoij ayl leyi ajeMe we I :113AIVM 3JNvH nSNl S,213NM0 0 puog p ,(liuwapui jo adA1 jaylp �o Aayod aauejnsui ,(liligeil y •xoq aleudoidde ay duipayo Aq aSeaanoo adq ay aleoipui aseald 'saA paloaya aney nog( ji ❑ ON PS saA Zhl 'yD l!DW p sluawaiinbai ay slaaw y:)iym lualeAinba lepuelsgns sli jo A:)ilod aouejnsui pijigeij 7uajAn3 e aney :39V113AOJ 3JNVNnSNI a u -e a r a a -j @,I aagwnld pasuaail Jo aweN ❑ �r//` �� i 8 L 6 ) auogdalal ssauisn8 diysaaulied ❑ 088To Hid TTTgaaAL uogeaodiOD ❑ -Ja a a l S s a T n o Q OL ssaippd a;eai}!IaaD :auo Pa4J uz a a g uz quip T d s i a uu a D aweN AuedwOD Sullieisu) 0 ❑ sa,, :pailiwgnS sued SINAiXIA ❑ juawaaeldaN 'r t .-)uednaa0 to W1 aweNS�auM uoiienol duip�in8 I.-- # 11wiad Rn�{p Frt SD_ �O aae(j s e /V,►'G 4 4� (adAi ao iuud) ❑ uoijenouaN MaN 0 JY z NISIC(11d 00 01 11W213d NO3 NOIIV:)IlddV WSO3INn S113S( H:)vssvw N ■■■■■■■■■■■■■■■■■■■■■■■■■ ■■■■■■■■■■■■■■■■■■■■■■■■■ 0 ❑ sa,, :pailiwgnS sued SINAiXIA ❑ juawaaeldaN 'r t .-)uednaa0 to W1 aweNS�auM uoiienol duip�in8 I.-- # 11wiad Rn�{p Frt SD_ �O aae(j s e /V,►'G 4 4� (adAi ao iuud) ❑ uoijenouaN MaN 0 JY z NISIC(11d 00 01 11W213d NO3 NOIIV:)IlddV WSO3INn S113S( H:)vssvw N Date............................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..:..........%................... has permission to perform ... .............. wrong in the building of �"-tom'. t --J .................................... at` -?19i.... (egL.- ...................... . North Andover, Mass. Fees �5. ,........ Lic. No.,?R)k ? V•:.„t• • • ........... ELECTRICAL.INSPBL�k Check # 64.31 Date ... ?�-n (9h. p TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION . G . This certifies that .6 jVA• hj to 1� r .. 1.yF1 •� . U t has permission for gas installation 'f rt/f in the buildings of ... N9.r9 w ..... ...... • • ....... • ........ • • at ........... North Andover, Mass. Fee .c.. & ,P Lic. No.. AA r,7 P•• . ! .'+� - - 0 *'-P7- ' ..... GAS INSPECTOR LSvI Check # 54'62 11 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) ,Mass. Date— C�� Permit # rI] Building Location ,3e/ 4, New ❑ Renovation ❑ Replacement ❑ Owner's Name /,(/,/ 61W V `' Type of Occupancy/ r ' Plans Submitted: Yes ❑ No ❑ FIXTURES Installing Company Name Crane's Plumbing & Heatin Address 70 Douglas Street Haverhill, MA 01830 Business Telephone �1 % ?k Name of Licensed Plumber or Gas Fitter Peter Crane Check one: Certificate ❑ Corporation ❑ Partnership ❑ Firm/Co.. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes Q No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy ® Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted (or entered) in the above 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 with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. Type of License: By ❑ Plumber ❑ Gasfitter Title ❑ Master Signature of Licensed Plumber or Gas Fitter O Journeyman City/Town License Number 2180.5 APPROVED (OFFICE USE ONLY) LU Uj • CA Lu .. - - ■■■■■■■■■■■■■■■■■■■■■■■■■ IRT.- .. ■■■■■■■■■■■■■■■■■■■■■■■■■4th FLOOR8th FLOOR Installing Company Name Crane's Plumbing & Heatin Address 70 Douglas Street Haverhill, MA 01830 Business Telephone �1 % ?k Name of Licensed Plumber or Gas Fitter Peter Crane Check one: Certificate ❑ Corporation ❑ Partnership ❑ Firm/Co.. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes Q No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy ® Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted (or entered) in the above 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 with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. Type of License: By ❑ Plumber ❑ Gasfitter Title ❑ Master Signature of Licensed Plumber or Gas Fitter O Journeyman City/Town License Number 2180.5 APPROVED (OFFICE USE ONLY) i Commonwealth of Massachusetts Official (011IN Permit No. - Department of Fire Services Occupancy and Fee Checked ] BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9,05— i (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All Nuork to he performed in UCOI-dance with the \lassachusetts Flectrical Code I\IF,C). 52' CAI 12.00 lPLE.ISE PRAT LV INK OR TYPE, ILL LVFORJL1TION) Date: 2,3-0)6 City or Town of: NoetH n Nod ilex_ To the It ypecior of [Vires: By this application the undersigned gives notice (W his or her intention to perform the electrical work described below. Location (Street Sr. Number) 3 �b 11 mps5 S .,A Owner or Tenant a "-I) w P"a- l_cJ a5 Telephone No. Owner's Address 3 6 1 "SS tq V& Is this permit in conjun ton with a building permit? Yes � No E](Check Appropriate Box) Purpose of Building c— S fi7u-NCE_ Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: innrr�lnlrnn ../ IFr,. 1; •ll.,.. ;�,., .,.l. l..... ... .........r l_ .r_ r .• rIn No. of Recessed Luminaires _ ... .. _...... .......�..••., ,...� No. of Ced.-Susp. (Paddle) Fans a1 �ilc 11IU_V Ile il'al4eti "y 111c 1!111 /('lll/Il// {1 11 eA No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool, 'kbove l,-1 In- ❑ No. of Emergency Lighting rnd. rid.3att_ er / [)nits No. of Receptacle Outlets / No. of Oil Burners _ FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners of Detection and -No. Initiating Devices No. of Ranges No. of Air Cond. TotaTons! No. of Alerting Devices No. of Waste Disposers Heat Pum Number Tons KW ; No. of Self -Contained Totals Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW _ Security Systems:* No. of Water No. of No, of No. of Devices or Equivalent Heaters KW S i ns Ballasts Data Wiring: - No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors T43114 P _ Telecommunications Wiring: No. of Devices or Equivalent UTHER: L%W�AvL IJnI -M w�., a.:y .INuck allcliliortal retail l/•rlrswucl, or as rcc/uired hr lltc• Iris/;color uj' Estimated ValuVZ lectrir I Work: %� • ( When required by municipal policy.) Vvork to Start: U Q So Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE C VERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" aiverawe or its substantial equivak nt. f he undersigned certifies that such cope - tie is in Ibrce, and has exhibited proof of same to the permit issuin; office. ClIEC'KONE: INSUR, kNCEI BOND ❑ (.)Flll:R ❑ (Specily:) I c•erfilj,, ander the pains and penalties of perjury, ,lira the infarmatiarr un this applic•admi A true and c•onrplele. FIRM NArNIE: P4 U I IVAG,l Licensee: UI /MACaN1,J-qco ;signature Cit1•c�" LIC.:VO.:Z - �ll ;;1�/;Iiral;le, . l;lrl'•c.,�m l in l ,r Lel ns� rtan err rirxl./ -..-- Address: t` wi4rTLS3 Est) N Bus. Tel. No.: 7813drff6i lIt�S? 9 14— 0 By'/ kit. Tel. Vo.6�73z5'�S"as' VSecurity System Contractor License required for this work, if applicable, enter the license number here: OWNER'S INSURANCE W AIV ER: I am aware that the Licensee diw.r not have the liability insurance covcra_e nornlally required by law. By my :;ignature below, I hereby waive this requirement. I :un the (check one) ❑ owner ❑ owner's agent. Owner/Agent _ M 'Agnature Tcicphone .No.PF'RW T ,FES S —� k Commonwealth of Massachusetts 01,11cial (;Se thdy Fpcirnlit No. lq3% Department of Fire Services Occupancy and Fee Checked —Owl BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9.05] (lzave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORN All N%ork to -he performed in accordance,\Qh the 4lassachusetts Electrical Code (\IEC). 52CA'v111 12.00 „ r itiVE PRINTIN INK OR TYPEALL NFORY1.4TION) Date: Z 3— Q fo City or T6w•n.of: Nrile nkNo� im To the Inspector i#J-Vires: Sy'tliis application the:.uirdersigned gives notice 617 his or her intention to perform the electrical work described below. �'ha+cationStreet & Number S S' (� ) k' Owner or Tenant <;.O NTS. YVI. tifL ty *rS Telephone No. :. Owner's Address 3, 3 - M1g tAS V tai J t - Is this permit in conjungion with -a building permit? Yes EK No ❑ (Check Appropriate Box) Purpose of Build-ing !` (LCA Utility Authorization No. Existin Service Amps Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Ams / Volts Overhead UndgrdE1 No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: CmIlr11P111117 1)1,111A, fr,llmvilia f,11)1u 011"1; 11a l,vlil.,,l by tl)o lo"I", Lv• )/,I No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of •foto Transformers KVA No. of Luminaire Outlets ,'L No. of Hot Tubs Generators KVA No. of Luminaires Above In Swimming Pool rnd. ❑ rod. ❑ o,o Emergency ig ung Batter Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS _ _ No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiatinz Devices No. of Ranges No. of Air Cond. Total Tons g No. of Alerting Devices No: of Waste Disposers .: ,. eat Pump I Number. ......................................................... Tons K No. of Self -Contained Totals: Detection/Alerting Devices No. of Dishwashers:;:..` ..; Space/Area Heating KW _ Local Municipal Connection Other No. of Dryers Heating AppliancesKW Security Systems:* No. of Devices or Equivalent No. o Water KW No. o No. o Data Wiring: Hcaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: (('' L OVL tSTrN xirLf 4ui�js-9 Af)o rniC2c dA/QGst INuch udditiolial detail il,desired, ur UN required by the In"t •'I"r• l ' t Estimated Value off lectrie l Work: (i J • (When required by municipal policy.) Work to Start: Z. U Oso Inspections to be requested in accordance with NIEC• Rule 10, and upon completion. INSURANCE COVERAGE:. Unless waived by the owner, no permit for the performance of electrical work may issue un the licensee provides proof of liability in •uranee including -completed operation" coverage or its substantial equivalent. T1 undersigned certifies that such co%e a is in force, and has exhibitedproofoF -ame to the permit i;suinll office. CI-IECK ONE: INSURANCE, 130ND ❑ aruiER ❑ (Specily:) / rertiljl, ,rrno/er 1/re.�jmins unJji ztltlrx i br rrt �, that the infurrnntion on this rtpp/ic•ntion is true and comp&e FIRM NAME: YJ4`i���, t � � t `��Zr.�1'C' LIC..NO::.'� f Licensee: X11, M, Y°it tl/•;pplir.nble, Chler'*i' 6dress: :..W •,_ `Security System Copt M OWNER'S INSLR(iYC required by law. Byfh; Owner/Agent Signature ts+e requttt�tt=tt`it tpiilicub►e, eritcr the license numl ,� 1 , /ER: I am at4 �;tli�'t the�censec clihr nri/ hrn�4 the liability. below, l hereby waive this requirement I ain -the' (check oiie) Telephone . lo. Location a, No. ? / Date — r� NpR,M TOWN OF NORTH ANDOVER d 0 9 • ; ; Certificate of Occupancy $ �� J"'••�' Eta' Building/Frame Permit Fee $ �GMUS Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 174, Check #_ 18935 P---, f , Building pector M • TON" OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BMDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Building Commissioner/Inspector of Buildings Date SECTION I- SITE INFORMATION 1.1 Property Address: ;M MAss AVS 1.2 Assessors Map and Parcel Number: 6 Y5,14 Map Number Parcel Number Ar, ho1auer- fy 1.3 Zoning Information: Zoning District Pr Proposed Use 1.4 Property Dimensions: LA Areas Frontage (ft) 1.6 BUILDING SETBACKS ft) Front Yard Side Yard Rear Yard Required Provide RegWred Provided ReqWred Provided i 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: Public 0 Private 0 Zone Outside Flood Zone 0 1.8 Sewerage Disposal System: Municipal 0 On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No 2.1 Owner of Record -Pct.* r", I C-1 I cll, -I— lv-� t�5 s- AV - Okr-\ P�Pc'd<uA5 Name Address for Service: (0�9 -3�, I ,SignArj— Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: �Ieonav� Z�Iow \ev Licensed Construction Supervisor C_,tjdbUrAj IVIA5�03 1 Address Signature Telephone Not Applicable 0 6 7 License Number Expiration Date 3.2 Registered Home Improvement Contractor SA Not Applicable 0 Company Name Registration Number 0 - "Lo 7 Address Expiration Date Signature Telephone M M z 0 0 Z M 90 0 mn ic M Z 0 T 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 .......0 No ....... 0 SECTION 5 Description of Proposed Work check all applicable) New Construction 0 Existing Building ❑ Repair(s) ❑ Alterations(s) Addition 0 Accessory Bldg. ❑ Demolition ❑ Other 0 Specify Brief Description of Proposed Work: 1 IVO �A Del ChA+ e SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE ONLY I. Building $$�Ov ��-"�� /*I_ (a) Building Permit Fee Multiplier 2 ElectricalQ 50L (b) Estimated Total Cost of Construction 3 Plumbing O Building Permit fee (a) X (b) �, 7 6.00 4 Mechanical HVAC 5 Fire Protection 6 Total1+2+3+4+5 60 Check Number SECTION 7a OWNER AUTHORIZATI N TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT IIT�o49 _Nr��� V^� , as Owner/Authorized Agent of subject property Hereby authorize s`) Q Y1 —C -c—, n to act on My I.1,1i n aIto work authorized by this building permit applicat' n. i a\ o Si ature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 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/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS iST2 ND3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE �, z F2 x � 04 OH o ro v cftl x 94 O a w F U W W a°' w a O w z � a W x o � u O E 8 O rn O U i 97 U O v y y O CL CO2 0 ts CL CO3 O V O LLI 0 U) LLI0 19 W UA 19 W N e J,6n 12 06 03:19p Ionic Kreaga► CLU► CWC • 22014. BraadwaY . Stata Farm b surawO e Floor impedes Salem. NH 03079 Ph 603493-5200 Fax 603-893-4944 FAX Atte: 1 TO: operations Center 1-61884 • _AutoAuto (5915) Firs: Personal (6993) 0 '1 6402, Fax -4� " �S L Life 61477 S 781) + Phone ------ Pages� SFPP (6997) w R,ep rding: Insured Policy.# Binder Requested CerdBcate of Insurance Fro= eanriie Krueger arbam Pratt Joanna Emerson PatBlasioli Barbara Valletta ►-,--AttarW per your request Stephania Leahy Dave Anderson Jeri Swan &'an 12 06 03:19p p.2 Prev risk: 0 Deductibles applied:NONE Messages: Amount due: SFPP JANUARY 12, 2006 due: Fire Policy Status H Ph. (603)216-2268 to: FIRE Policy: 94 -BK -5335-1 Yrissd• 2004 F ' SVENCON GENERAL SFPP Xref: CONTRACTING LLC 8 DANIEL RD 03038-7309 Location: 8 DANIEL RD NH 03038-7309 DERRY NH DERRY Term: 1 YR PP Renew date: OCT -14-06 Type: WORKERS COMP Premium: 9, 316.00 Written date: OCT -14-04 Coverage information LOC BUILDING CONTS C PREM 7.00 13.00 TERRSM PREM Prev risk: 0 Deductibles applied:NONE Messages: Amount due: SFPP Date due: SFPP Bill to: SFPP Prev prem: 0 SFPP acct:1002-5567-28 NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: 3<6 i M55 AVF-- is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. Also, note Permits are required under Fire Prevention laws,'Chapter 148 Section 10A. The debris will be disposed of in: Fire Department Sign off: Dumpster Permit (Location of Facility) v ////Signature of Permit Applicant %— f�—o-zS Date r SvenCon GENERAL CONTRACTING LLC 603-216-2268 Proposal John and Patty Markuns DATE 12/20/05 381 Mass Ave North Andover, MA Scope of work: Remodel Kitchen Demo: 0 Remove kitchen cabinets , countertops and closet 0 Remove drywall on all walls and insulation from exterior walls 0 Remove two layers of flooring Electrical: 0 Supply and install 2 under cabinet florescent lights On two switches 0 Install new customer supplied microwave and duct to exterior (Exterior to be finished with white aluminum) 0 Install new outlets and switches at existing boxes 0 Rewire dishwasher at same location 0 Install 1 customer supplied lite fixture and switch Plumbing: 0 Install new refrigerator water line as needed 0 Install 2 customer supplied sink and faucets 0 Install new customer supplied dishwasher at same location 1" . Drywall: 0 Install R-13 faced insulation in existing exterior wall where Drywall was removed 0 Install new drywall on walls 0 Tape new drywall 3 coats ,sand to paint ready condition Cabinets: 0 Install Customer supplied kitchen cabinets and trim per Cyr lumber drawing 0 Countertops by others Flooring: 0 Supply and Install Bruce prefinished 2-1/4" Natural red oak flooring and transitions in kitchen 0 Install new 3-1/2" baseboard to kitchen Finish/ Windows: 0 Install new casings at kitchen window 0 Install new oak cap and trim to existing 1/2 wall All debris to be removed from site h' Excludes Permit cost Painting and stain Countertops Appliances Payment as follows: COST $9500.00 25% upon acceptance 25% upon start 15% upon start of cabinet installation 15% upon start of flooring 20% upon completion Acceptance hn and Patty Markuns Date SvenCon General Contracting LLC Date Job to start Saturday, Feb 18th and will take two weeks to complete Warranties: 0 Structural integrity guaranteed one year from completion of project 0 Any item that needs to be addressed will be remedied by SvenCon within a 30 day period Other terms: All work shall be performed in a professional manner and in compliance with all building codes M SvenCon will maintain all insurances required by law M SvenCon will be solely responsible for all payments to subcontractors and suppliers U Changes to this contract will be handled by written amendments •.. i I I .._.. ..... ..._.....__..w_.. ___�_.........�_. .� -a' Zia LEONARDP. BOWLEY LEONARD :BOW LEY 7:P.ATRICIA CIRCLE IWOBURN,IIMA 01809 ]�tlminletntor i f- AM i+m��ugalm��es�+s Elmer: acs U7577 sem: MWI"9 ELQ:SCi14EH7ERiD iP 00MEY 7 PATMICK CiR Y ont", VA 01891 �Dmnmhmiaasr imom IMMVEMLIMITCONIMCM ROOMhatiah: 44.7350 EKPln R W S 9l2OC7 IfMe: do bAdual LEONARDP. BOWLEY LEONARD :BOW LEY 7:P.ATRICIA CIRCLE IWOBURN,IIMA 01809 ]�tlminletntor i f- AM i+m��ugalm��es�+s Elmer: acs U7577 sem: MWI"9 ELQ:SCi14EH7ERiD iP 00MEY 7 PATMICK CiR Y ont", VA 01891 �Dmnmhmiaasr The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, SNA 02111 w tvww.mass.gov/din Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers A pplicant Information Please Print Leyzibly Name Svezl6ri G` &)erw( �_,L,C---. Address: 4K hk�J, City/Stater'Zip: aJt?�`y /U �� 0303 Phone #: 603—N_5"2W/ Are you an employer? Check the appropriate box: 1.0-1 am a employer with 4. ❑ I ata a general contractor and I _Z employees ( full and/or part-time).* have hired the sub -contractors 2. ❑ 1 am a sole proprietor or partner- I isted on the attached sheet. ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 3. ❑ I am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. Olkernodeling 8. ❑ Demolition 9. ❑ Building addition 101-1 Electrical repairs or additions I I .❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other 'Any applicant that checks box d 1 must also till out the section below showing their workers' compensation policy information. y Homeowners who submit this affidavit indicating they are 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 intimnation. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. ' Insurance Company Name: _S � t�if KAVt � --l-nSLr6_1,-e_ Policy 4 or Self -ins. Lic. It: 6 PK 53-S-1- Expiration Date: 6 Job Site Address: -39SSS AV>° /l% AnCOUes— City/StateiZip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a tine up to $1,500.00 and/or one-year imprigonment, as well as civil penalties in the form of a STOP WORK ORDER and a title 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. / do hereby ecrtif n#r thgains and penalties of perjury that the information provider) above is true and correct. Phone :1:---- Q11icial use only. Do not write in this area, to be completed bY city or town ollicial. City or Town: Permit/License # Issuing Authority (circle one): I. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: A Location `?ej'l No. Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Mus c� Building/Frame Permit Fee $ I Foundation Permit Fee $ 4 Other Permit Fee $ TOTAL Check # r/ 166,,'1 $ S0 `A /,'-'--Building Inspector w TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE,OR DEMOLISH A ONE OR TWO FAMILY DWELLING 7,77.77777, �XNifRll1';�I .. w BUILDING PERMIT NUMBER: DATE ISSUED: — a 3 O SIGNATURE: Building Commissioner/In spec or of Buildings Date I SECTION 1- SITE INFORMATION I 1.1 Pr y Address: 1.2 Assessors Map and Parcel Map Number Number: Parcel Number Arb di M — rn , lY Y ,A ' 1.3 Zoning Information: Zoning District Proposed Use (� - ���' A 5-S'- -3:NaL 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Name me ( 'nt) Address for Service: Front Yard Side Yard �93-Y1� Rear Yard Required Provide Required Provided Required Provided 1 4— 2.2 Owner of Record: I.Mater Supply M.G.L.C.40 54) 1.5. Public ❑ Private ❑ Zone Flood Zone Information: Outside Flood Zone 0 1.8 Municipal Sewerage Disposal System: ❑ On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record /' L�; !J �• l< ffS (� - ���' A 5-S'- -3:NaL V /�. /41 Name me ( 'nt) Address for Service: �93-Y1� Telephone IV 2.2 Owner of Record: 1 Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicabl Licensed Construction Supervisor: t License Number Address; Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ to"Z- �/` 1 Company Name / �-4) (�'/ b -j Z -,e .t 7- L A z-- eZL - 14A Registration Number Address Qr C)7.4 L r- At (5-- -AV's r- Expiration Date Signature Telephone 00 rn X Z O 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 .......0 No ....... 0 SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ JAIt erations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ( Specify Brief D ption of Proposed Work: X L,/ P 4- A t- L," V I rr/N r- AA ✓ -J�-- I SECTION 6 - FSTTMATF.D CONSTRTICTION COSTS I Item Estimated Cost (Dollar) to be Completed b permit applicant OFFICIAL USE ONLY 1. Building (a) Building Permit Fee Multi Tier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X tbl 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, (1� ''� /t'� A It V W as Owner/Authorized Agent of subject property Hereby authorize to act on My be : in all matters lative to work aulhorized by this building permit application Si nat of Owner Date SECTI N 7b OWNER/AUTHORIZED AGENT DECLARATION 1, 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 Si attire of Owner/A ent Date ON NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS I ST 2 No 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS Di-WNSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE h FORM U'- LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not retie the applicant and/or landowner from compliance with applicable orrequirements.v an P Y PP e *APPLICANT FILLS OUT THIS SECTION APPLICANT d JJ F J-4/1 /'-I<- vJ I LOCATION: Assessor's Map Number STREET IV A �1', �@ ^c/C ,/cUNSERVATION PHONE_ �-- b `� PARCEL 0,) LOT (S) ST.NUMBER� `OFFICIAL USE AGENTS: DATE APPROVED DATE REJECTED COMMENTS �► TOWN PLANNER DATE APPROVED DATE REJECTED FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH COMMENTS DATE APPROVED DATE REJECTED DATE APPROVED DATE- REJECTED PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPE Revised 9197 jm G DATE Town of North Andover Building Department 27 Charles Street North Andover MA 01845 Tel: 978-688-9545 HOMEOWNER LICENSE EXEMPTION Please print. DATE 7 - a ,F-- L) { JOB LOCATION _755,71 X S -j _ '%( 0- . Number Street Address Section of Town "HOMEOWNER Number '?7f -6 Home Phone _f _/ d' '? a Work PRESENT MAILING ADDRESS ,ti! -f". City Town State Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings of six units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. (State Building Code Section 109.1.1) DEFINITION OF HOMEWOWNER: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one to six family dwelling, attached or detached structures ac- cessory to such use and and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official, a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other Applicable codes, by-laws,.rules and regulations, The undersigned "homeowner" certifies that he/she understands the Town of No. Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requjMments. HOMEOWNER'S SIGNA APPROVAL OF BUILDING OFFI Note: Three family dwelling 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0 Construction Control. MAY -17-01 08;48 AM I-. E K SURVEY INC r' ♦ HAVERHILL, MA 4 Phone 978-46 ISS # Fax 978.4f&7W E K SUkYhY MORTGAGOR MMA) f' ft:§Aet ADDRESS OF PRINCIPLE BUILDING Ag jgifff. Aid. v r afeow r aero DEED REF. __ P4• d4y - PLAN REF. cm Wrie OF INSPECTION / SCALE:1- n 10' � jd$ I�Atrf ,,rr ur • Pon 1�tt_ C� MASAGNUSO-rs . t RUM r .o 0 t4VexJ U1, ;-r.T IFICA I ION TO: � aw pe � The tocatlon of me This Mottgsge Pia pin was prepared speclficslly for principle structuta/S Age ptrrpooes anly and it is not Intended of represettted * �tSt ►- lo a Properly ants or land sure This tan Is nai to be used �QN iii. VAh the IwW zoning m in a{fe0 y,� WuGW to any of P M� and/ or 18 Etoempt from Wdatlon enforcemr eM Pd to th fines for any lytomup• No action under Mess 9.L, This VII, chop 401, 840, 7, ►es neibillly h to ba ed a t the land owner or occupant, w Gubjeoi building is not In a Flood Hazard Area, 7gls dincalion is basad 4n the Ioaotion at survey martcer O Subject building is In a Flood Hazard Arim, 4r6. Flood Hazard detshltlned from the FIRM maps. Dated r WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY AR INFORMATION PAGE WC 00 00 o1 A POLICY NUMBER: (6S16U13-996038-A-03 ) NEW -03 .INSURER: ST.PAUL' • FIRE AND'-MARINE'INSURA.,NCE�-COMPANY NCCI CO CODE: 80063 INSURED; PR ROGERS POO -PATIO'!& TOY.P' OPOLIZIO INS* AGENCY COMPANY INC :" ;.175:': LITTLETON ROAD _150 MI00,49 ;STREET WESTFORD MA 01686 LOWELL MA 01852. Insured.ls A ,C.ORPORATION.:; Other work places and Ids ,ntltIcatlon rlumbo�e, a a 9.bgNq. In the schedule(s) attached. 2. The policy period Is from 02-28-03 to 02-2804 12:01 A.M. at the Insured's mailing address. 3. A. WORKERS COMPENSATION INSURANCE:., Part One of the policy applies to the Workers Compensation Law of the state(s) listed here;' , eDma MA om 8. EMPLOYERS LIABILITY INSURANCE: Part Two, of the policy applies to work in each state listed In hem 3.A. The limits of our liability under Part Two are: JM M Bodily Injury by Accident: S 100000 Each Accident Bodey Injury by Disease:: S, 500000 Policy Limit Bodily Injury by Disease: • S 100000 Each Employee C. OTHER STATES' INSURANCE:;.PaR.!Three,of,the•pdicy applies to the states, If any, listed here: SEE ENDORSEMENT WC 20 03 06 D. 'Thls polcy Includes the se,91d raems d s Is: SEE LISTING OF.ENDORSEMENTS::=`EXTENSION OF,INFO PAGE e� .= 4. The premium for this pollcy will be determ.Ined,•by our Manuals.of Rules, ClasaNicatlons, Rates and Rating W111 Plans. AN required Information Is subject to verification and change by audit to be made ANNUALLY . DATE OF ISSUE: 03-04-03 OFFICE: ORLANDO -ST': P,AULZ :.805:. PRODUCER; POPOLIZIO INS AGENCY 29HW T0'd ZTSSbSb8L6 '00`A01'9100dSN300N ST ASSIGN: MA WU L£:60 £99Z-8Z-inr & TOY CO., INC. Qver 56 Years of Quality Sales and Service 150 Middle- Street LOWELL, MA 01852 (978) 454-5517.1-800-698-7946 DATE 20 n3 SOLD TO ADDRESS was,4&/c,4�4RS Ave - e) CITY A/4 1'qrw�e T E L. C/10 3 PLEASE PAY THIS INVOICE - NO STATEMENT WILL BE SENT QUAN.. -E:59-ec ARTIGLFj --two I -Ito AMOUNT POOL 37760 FILTER Lbs. DE LADDER: AqgRME IN -WALL SKIMMER IAJ& (LD 3 PC. DELUXE WEIGHTED I VACUUM SET START-UP CHEMICAL KIT LINER - - MAINTENANCE KIT ------------------ oe Ge jaw RZftE _aLCL" Normal Dig (Flat Grade) Pool Installation • Blocks • Base Final .IPayment Due on Pick -U h-or.0ank Checks ONLY. REORDER FROM: BRADY BUSINESS FORMS LOWELL. mA. SIGN CUSTOMERS SIGNATURE O z fl I cl O 0 CD cc 0 Z y co .y CD a� C 0 CD v _cc CL CA O Q .y C O C.3 L O Is CL y C 0 CD 3� �D O Q CL O O. 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