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HomeMy WebLinkAboutMiscellaneous - 40 MEADOWVIEW ROAD 4/30/2018 (2) 40 MEADOWVIEW ROAD 210/103.0-0092-M-0 i 1 Date. C'.. . .C' �. ... . NORTh o� '` TOWN OF NORTH ANDOVER . n • PERMIT FOR GAS INSTALLATION Io r + 9SgAGHUSEt tj This certifies that . . . %_*. f.p. . . . . . ` . . . . . . . . . . has permission for gas installation . . . . . .A'..`I . . . . . . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . at North Andover, Mass. Fee. '. . .`. . . Lic. . . . . . . .�� . . ..j. . :c .. . . . . GAS INSPECTOR Check# / c 1/ 4131 MASSACHUSETTS UNIFORM APPUCATON FOR PERNU 'T )DO GAS FITTIlVG (Type or print) Date (�//3/0 -L- NORTH NORTH ANDOVER,MASSACHUSETTS Building Locations U "lti e-* U w vj e Permit# Amount$ Owner's Name' c�-/t• L) New[] Renovation 0 Replacement �/ Plans Submitted 0 d A U C C p SUB-BASEM ENT BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR I6STH. FLOOR 6TH. FLOOR i 7TH. FLOOR 8TH. FLOOR Mint or type) n� t� one:- Certificate Installing Company Name /<< V . C��`I e 1,44 PuP /I Corp. Address h D f 3 o )4 d A V O` PT � � Partner. Business Telephone o R n a Z U [:j-Firm/Co. . Name of Licensed Plumber or Gas Fitter J jvrV Gam. vt� I1�1SLiRANCE CQVIxRAGE Check one: I have a current liability Insurance policy pr-rt's substantial equivalent: des ' No Ifyou have decked l�ts.Tease indicate the type coverage by checking theappropriate box Liability imsurance policy Other We of indebmity E 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 applic hon waives.this requirement theca one: Signature of Owner or owner's Agent Owner 0 Age Q t 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 installationsperknWd under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts a Gas a and Chapt 142 of the eral FT- ty/T(;; ignature ofLicensed Pl Or Gas Fitter Plumber Gas Fitter ICeT1Se um er faster APPROVED(OFFICE USE ONt I) Journeyman Date. .`. . 1. . . .U.i- f NORTh�1 <. �° . ti, TOWN OF NORTH ANDOVER F p PERMIT FOR PLUMBING Y ,SSAC14USE� This certifies that . . . . . . . . . . . . . has permission to perform . . . �. . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . .44 !.>. . . . . . . . . . . . . . . . . . . at . . .�!. . . . . . . . . North North Andover, Mass. Fee. .? . . . . .Lic. No.. . .G.}. �. PLUMBING INSPECTOR Check # f- G 3 _ 5371 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS BuildingLocation � l� �-C} Date ! �2 ----� lLt i/ J WOwners Name .,,� 14 0 p � Permit# Amount Type of Occupancy ., Q, `,� New Renovation Replacement Plans Submitted Yes 0 No ❑ FIXTURES w O o w w x U z a N x x a a � w � `� d o w M A a A 1 SLRIi4 E B4SE" I' lSL)NIDCit ZD HfM fid. HDM 4MHIM 5M HDM 6M ROM 71H FWOR SIH FIDM (Print or type) Check one: Certificate Installing Company Name /IOGLta,,, .,> A7 �-� ❑ Corp. Address {� K 1`y S ( Partner. mess Telephone (o L U Firm/Co- Name of Licensed Plumber: _ IJ b f 11¢�&4--k Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ Bond ❑ Insurance Waiver: I,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 ab a application are true and accurate to the best of my knowledge and that all plumbing work and4insNation performed der Pe t Issued 103^s application will be in compliance with all pertinent provisions of the Massatts e P_mbin ode an Chapter 1 of the General L By: ig icenseu er Title Type of Plumbing License City/Towns a um er Master Journeyman ❑ APPROVED(OFFICE USE ONLY r7=77 Date. 2- "OR Of + "OR1+ TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING CHUS This certifies that . . . . . . . . . . . . . . . . . . . has permission to perform . . . . .S. . . . . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . ).G. 0. . . . . . . . . . . . . . . . . . . at. . .G�l.li . h-t.r d?5�c,�.�-�.t. . . . . r. . ., North Andover, Mass. Fee.,?? Lic. No.. . v 3 6 . . . . . . .'«, . . . . . . . . . . jPLUMBING INSPECTOR Check # 5333 i MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Building Location Lb' 'l � Owners Name ! /4C 0 iA o Date C f Permit# Odd/� %/ .--L— Amount Type of Occupancy L t New Renovation 0 Replacement Plans Submitted Yes ❑ No Q FIXTURES �J Y . ryryl��JTTL 1ni7//lJI��,L� 3M`f! FLOyCqI� iM ii]IA,R\ 5MHDM 7M 81H FLOOR (Print or type) Check one: Installing Company Name (�:iA�- � Certificate ' � 0 Corp. Address U C)2 0 Partner. Business Te ephone L^ K2 Firm/C0. Name of Licensed Plumber. 13 0 h 0 f p Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity BondEl ❑, Insurance Waiver. I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Q 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 install i ns pe, rmed under Permit Issu d for this application will be in compliance with all pertinent provisions of the Mass t to um inc, o e and Cha r 142 o e General Laws. By. Signalo icense um T e of Plumbing License Title ` Ci3 City/Town icense um er Master APPROVED(OFFICE USE ONLY 11 Journeyman 3 ; 50 Ft Date........ . . ...... . NORTI{ °f,"`°:•�"a TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ,SSACNUS� F �zrr�j p This certifies that '\1 ��................................................... has permission to perform I � wiring in the building of S a V� .-� A C U ........................ ............................................... ....................................................... at y i� R �............. .North Andover,Mass. ........... Fee....�J. ..... Lic.No. Ia3m� ... ............. ............... .............. ............................. ELECTRICAL INSPECTOR Check # L 3 Ir S Ci ar i� ties. .ce to your stonewall and have him rectify the n the R-4 district one and two family dwellings y additional units above two and up to five are upeals. ns in this matter and if you should have any curs of 8:30— 10:00 AM and 1:00—2:00 PM at Health Department 688-9540 Zoning Board of Appeals 688.9541 Official Use Only Permit No. 4 �f��L1�LO�lZU��f1'?�tY,�?�S.S�fr✓'32L.S�7'IS DeKs �uBUe Sa�ety Occupancy&Fee Checked BOARD OF FIRE PREVENTION REGULATIONS.527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527 CMR 12:00 (Please Print in ink or type all information) Date 7- / SA' D Z To the Inspector of Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number LJ C) M"t If* I(--"-s V I -e w Owner or Tenant s Ii v^ Owner's Address 4 Is this permit in conjunction with a building permit Yes,� No ❑ (Check Appropriate Box) Purpose of Building ��� Yl-e ti c>e•i4�1 CT-v^ Utility Authorization No. Existing Service d© Amps 126Z'/G Voits Overhead � Undgmd ❑ No.of Meters New Service Amps Voits Overhead ❑ Undgmd ❑ No.of Meters Number of Feeders and Ampac'ity Location and Nature of Proposed Electrical cal Work ' i Total No.of Lighting Outlets No.of Hot fuse No.of Transformers KVA —7 n Above ❑ In ❑ �! No.of Lighting Fixtures QCC-ES e Swimming Pool gmd ❑ grnd ❑ Generators KVA No.of Emergency Lighting No.of Receptacles Outlets No.of Oil Burners Battery Units No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone lTotal No.of Detection and No.of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No.of Di sal No. Pumps Tons KW No.of Sounding Devices No./of Self Contained No.of Dishwashers �C �' e S ace/Area Heating KW Detection/Sounding Devices ❑ Municipal ❑ Other No.of DryeTs Heating Devices KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Bailases Wiring No.Hydro Massage Tuds No.of Motors Total HP OTHER: Cr C PV e INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including—Completed Operations Coverage or its substantial equivalent YES= NO = halp+e submitted valid proof of same to the Offi YES= NO = If you have checked YES please indicate the t �f ra9e by checking the appropriate box 1a4 URANCE = BOND = OTHER =_(PI a pacify) }$ (Expliiration Date) Estimated Value of Electrical Work E 7" (,_p- W"uf k to Start '7-15--t 2 Inspection Date Resquested Rough Final Signed under the enafties of peau 1 11"7>YYt tti FIRM NAMELIC.NO. ` ( a �'���r� t Licensee L.Afr Signature '!� LIC.NO. t ,�� N B �i93 • �'2� 3a� t Address PI)(7 IBX 1� Ct�v����,v ('�} l$ z+ E�lMTel.No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws.And that my signature on this permit application waives this requirement Owner Agent (Please Check one) Telephone No. PERMITTEE $ (Signature of Owner or Agent) r s Date..........:.... . . . 92£ NORTI{ TOWN OF NORTH ANDOVER O 9 PERMIT FOR WIRING ��SSACMUS� y This certifies that .......................... ..........nlj� ................................... has permission to perform ........ . .V-S...... .......... L wiring in the building of...... .... . ,,... ... ....................... at.....�,7� .. C�!!� .. .ys(.Q�?. . ..( North Andover,Mass. Fee.. ..W... Lic.No �C/4 :....................`.=...1. ............................. ELECTRICAL-1-NSPECTOR 0 •T50.� WHITE:Appcant CANARY: ing Dept. PINK:jTreasuRr �� .. Office Use Only u t &M1Wt1Wr# of Magoar4usEfts Permit No. lepartmEm of Pu6Ht 3$dztg Occupancy A Fee Checked - BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527CMR12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date CP TA or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work )described below. Location (Street & Number) Owner or Tenant Owner's Address ��{����� Is this permit in conjunction with a building permit: Yes ❑ Ne' LT (Check Appropriate Box) Purpose of BuildingUU ility uthorization No. 170-3 C S Existing Service�� Amps _4/oIts Overhead's Undgrnd ❑ No. of Meters New Service Amps.,2y6lQolts Overhead�dgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Transformers Total No. of Lighting Outlets No. of Hot Tubs KVA No. of Lighting Fixtures Swimming Pool Above In- grnd. ❑ grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets I No. of Oil Burners ' Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones iTotal No. of Detection and No. of Ranges No. of Air Cond. tons Initiating Devices No. of Disposals Dis No.of Heat Total Total P Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers I Space/Area Heating KW Detection/Sounding Devices i Municipal No. of Dryers Heating Devices KW Local ❑ Connection ❑Other No. of No. of Low Voltage No. of Water Heaters KW I Signs Ballasts Wiring No. Hydro Massage Tubs I No. of Motors Total HP OTHER: I` r INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES = NO _ I have submitted valid proof of same to the Office. YES = NO If you have checked YES. please indicate the type of coverage by checking the apq o ate box. — Z�'--'- �� --20-J INSURANCE 42 BOND OTHER C Please Specify) k i (Expiration Date) Estimated Value of Electrical Work 5 Work to Start Inspection Date Requested: Rough Final Signed under the Pe es perjury:r n / J FIRM NAME �Ve Q� LIC. NO. 2 c � Licensee ZE44/-Af '— Signature Bus. Tel. Address Cov���2 Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the icensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) D� & Telephone No. PERMIT FEE $ (Signature of Owner or Agent) x-6565 Date. . . .1. . . ... . . . . . ,4pRTH pF ,�w 1tip o� y` °� TOWN OF NORTH ANDOVER � 9 • PERMIT FOR GAS INSTALLATION •'�th ' C 14uset N l This certifies that .�.t i . c /'!` �{ has permission for gas installation . . / .,V:,: .G . . . . . . . . . . . . . . . in the buildings of . .14:r.C. !.f . . . . . . . . . . . . . . . . . . . . . . . . . at . . . ! �. . .,,North Andover, Mass. Fee,„ �. " . . Lic. No..R S f. 3. . . . . . . . GAS INSPECTOR Check# ' `/) 3577 MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GASG tType or print) Date„,^""'" NORTH ANDOVER, MASSACHUSETTS >:4 9ui1dine Locations �I 4ead >w Vi Permit Amount S = Owner's Name �'lil�e £ vc re,V1 Renovadon ❑ Replacement ❑ Plans Submitted ❑ `^ n y N C .Zn � r N n L it '� '. Z C C - ' z %C C �- i y Z C C C r t� r v l: t3 B :kSE .'Yl ENT — — — — — — — Is iE h ENT t 6 r . F" L0 U R 0 FL 0 0 R J R 0 . F L 0 0 R :Vr if F L 0 0 R r11 F 1. 00 R oT II FLO U R 'SII . FLOOR YT II F1. 00R or type) Chrck ne: Certifi to Installing Company Andover Plbd. & Htg. Co., Inc. Corp. PJ99 or�Ss 20 Agean Dr., Unit-10 ❑ Partner. Methuen. Ma. 01844 cs,ness Telephone (978) 685-8383 ❑ Firm/Co. ,�Mt or Licensed Plumber or Gas Fitter George LaRote SLR.-\NCE COVERAGE Check one: `lave a current liability Insurance policy or it's substantial equivalent. Yes [:�—'. No[:] ou nave checked ves_,please indi the type coverage by checking the appropriate box. insurance policyI Othertvpeofindemnity ❑ Bond ❑ n.r s Insurance Waiver. I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the 1:!s s. General Laws,and that my'signature on this permit application waives this requirement. Check one: enarure or Owner or Owner's Agent Owner ❑ Agent ❑ ere!)y certi fv that all of the details and information 1 have submitted(or entered)in above application are„.ttug.and accurate to the u. o(my knowledge and that all plumbing work and installations performed under Permit Issued for this..application will be in --)moiiance with all pertinent provisions of the-Massachusetts State GaSa and Chapter 33 of the Gcneral�.Laws. I�... ignature of Licensed Plumber Or Gas Fitter T: Plumber 9983 -:Town R � Fitter License umoer Met, I -�.PPROVED ()FFIci:USE ONLY) ❑ Journeyman Location I//elv l' V No. Date ' NORTH TOWN OF NORTH ANDOVER Certificate of Occupancy $ MUS Building/Frame/Frame Permit Fee $ a s,+cE 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 15 6 0 / Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING k,x Rx BUILDING PERMIT NUMBER. DATE ISSUED. zr SIGNATURE: At Building Commissioner/12§eEtor of Buildings Date Z SECTION 1-SITE INFORMATION o 1.1 Property Address: 1.2 Assessors Map and Parcel Number: ILo3 9a L 10 l/}')�3�� i w Number Parcel Number �p 7t(J �// I V' 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use I Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water SupplyM.G.L.C.40.1 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record Name(Print Address for Service gnature Telephone (� 2.2 Owner of Record: Z_ C--,/ D 4/0 Name Print �j Address for Service:1�7 / '_ x22.97 •'• Si ature Telephone go SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: Licensed mbermn Address Expire O 3 ic a_ tgnature Telephone r 3.2 Registered Home Improvement Contractor .Not Applicable ❑ cv 611)ess�/V, -TC, S C Company Name Registration Number r Address �w r — 0 Expiration Date n� Signature Telephone _/ i SECTION 4-WORKERS COMPENSATION(M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work(check all applicable) New Construction ❑.• Existing Building ❑ Repair(s) ❑ Mterations(s) 0 Addition 0 Accessory Bldg. ❑ Demolition 0 Other ❑ Specify , Brief Description of Proposed Work: �7,2 019 f At? VV131f gz L L I SECTION 6-ESTIMATED cWTsTRUCTION COSTS Item Estimated Cost(Dollar)to be {)F `ICIAI:USE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee 2 Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a) X(b) D 4 Mechanical HVAC f 5 Fire Protection 6 Total (1+2+3+4+5) Check Number SECTION 7a OWNER AUTHORIZATI N TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property Hereby authorize /���'�G/Ci<i.. /?C r te-, f P to act on My behalf 1 all tters relq i ye to irk auttlorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I,�CC �'' G��� ��/� �1 as Oumer/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 at e of Ownei/A e Date TP NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR T ABERS 1 2 RD 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIIMENSIONS OF GIRDERS I-iEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHEVINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE UM All home improvement contractors and subcontractors Inc.Designing Kitchens, IADDEND UI1� engaged in home improvement contracting, unless 246 Main Street specifically exempt from registration by Provisions of No. Reading,MA.01864 Chapter 142A of the general laws,must be registered with TEL(978)276-3230 Date: 2/20/02 the Commonwealth of Massachusetts. Inquiries about registration and status should be made to the Director, FAX(978)276-3240 Home.Improvement Contract Registration, One Ashburton Place,Room 1301,Boston,M.A.02108. 617 727-8598. Submitted to: Job Name&Location: MR. & MRS. IACONO SAME 40 MEADOWVIEW RD. NORTH ANDOVER, MA 01845 We hereby submit specifications and estimates for work to be performed and materials to be used: LPROVIDE ALL NECESSARY PERMITS. 2.REMOVE EXISTING CABINETS AND COUNTERS. 3.REMOVE EXISTING FLOOR TO SUB-FLOOR,SEPARATED AT FAMILY ROOM ENTRANCE. 4.SUPPLY AND INSTALL TEDD WOOD CHERRY NATURAL CABINETS WITH FULL OVERLAY PRESIDENTIAL DOORS AND DRAWERS PER PLAN. 5.SUPPLY AND INSTALL 7 RECESS LIGHTS CONNECTED TO TWO SEPARATE DIMMERS.ADDITIONAL LIGHTS WILL BE $150.00 PER LIGHT IF MORE ARE USED. &SUPPLY AND INSTALL NECESSARY OUTLETS PER CODE. 7.RECONNECT ALL APPLIANCES. &INSTALL NEW RANGE OUTLET FOR NEW LOCATION OF RANGE TO CORNER. 9.WIRE FOR MICROWAVE 10.SUPPLY AND INSTALL NEW UNDERLAYMENT(OWNER TO SUPPLY AND INSTALL FINISH FLOORING) I 1.SUPPLY AND INSTALL NEW LAMINATE COUNTERS PER PLAN:OR$900.00 CREDIT TOWARDS OTHER TYPE 12.SUPPLY AND INSTALL NEW ELKAY STAINLESS STEEL SINK(BOWL AND 1/2)OR$400.00 ALLOWANCE TOWARD OWNER SUPPLIED SINK. 13.SUPPLY AND INSTALL NEW FAUCET SINGLE LEVER WITH PULL OUT SPRAY(GROHE P/O KIT FCT)OR A$300.00 ALLOWANCE. 14.INSTALL OWNER SUPPLIED TILE BACKSPLASH. 1.5.SUPPLY AND INSTALL ONE C 335 ANDERSON CASEMENT WINDOW WHICH WILL BE BUMPED OUT APPROX. 10" FROM HOUSE. WE WILL BUILD A SLANT ROOF OVER TOP,MATCHING EXISITING AS CLOSE AS POSSIBLE. 16.DISPOSE OF ALL BUILDING DEBRIS. NO APPLIANCES,PAINT OR PAPERING INCLUDED. NOTE-ANY TILE WORK INSTALLED WITH BORDERS OR INSTALLED ON A DIAGONAL WILL BE QUOTED SEPARATELY OR WITH ADDITIONAL CHARGES TO THIS CONTRACT ACCEPTANCE OF PROPOSAL-I have read both sides of this document and accept the prices,specifications and conditions stated.I understand that upon signing,this proposal becomes a binding contract. You are authorized to do the work as specified.Payment will be made as outlined above. You,the Buyer,may cancel this transaction at any time prior to midnight of the third business day after the date of this transaction. Cancellation must be done in writing. DON I T SIGHT THIS CONTRACT IF THERE ARE ANY BLANK SPACES. Signature _ � w Date yy OZ Signature Date n3AI {D1!}i 0 11�� IS30. 00;1 Y-jGdl-100131'` We :sc!!t 6Z f l l J,c-fens a `} }�b ##••q{ ]] r�6. 1 'J �. �:..'f.J{ Fier /� .� N�N•✓�v��4e,faF dl� 1 -:�V38i�#P�:.li � y -�4 Rsri ae16 su�yr.;It�at � Jae (lnmmnnl� `�'� sriuse ar�,tella F BOARD OF BUILDING REGULATIONS Lice CON UCTION SUPERVISOR N ber: CS 04$236 " Birt date: 08/16/19 , T pires: 08/16/2 Tr.no: 5809 t Re cted: 1G RAYMOND`C BAS MAN l 246 MAIN STS NO READING,.M 01864 Administrator North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Location of Facility) �— Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector The Commonwealth of Massachusetts q Department of Industrial Accidents Office of Investigations 'I Boston, Mass. 02111 Workers'Compensation Insurance A>�davit Please Print Name: Location: 2 Vei City /y. QPhone am a homeowner performing all 4ork rnyserf, �am a.sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for my employees working on this job. company name: Address Com' Phone Cempaew-name: Address City: Phone#- insuga a Go. Pollcy# failure to secure,coverage as required under Section 25A or MGL 1,52 can read lathe bion of criminal penaWes.d a fine up.to$1.5o0.oo and/or one years'Imprisonment as well as cfW penalties in the form of a STOP WORK Ot7M and aline of SIOD-00)a day against understand that a copy of this statement may be forwarded to the Office of kwestigations of the DIA for coverage verification. I do herby certify under tris amt pena�les of then inforrnaiim provided above is true and-correct Signature Date 2R Signature Print name Phone# Official use only do not write in this area to be completed by city or town official' Building Dept" pGheck i-immediate response is reti�uired building Dept 0 Licensing Board El selectman`s Office Contactperson: Phone# 0 Health Department 0 ©tater NORT#j Town of - 4 dover 0 No. 0 �oC ,C � dower, Mass., ADRATE D F'P? S G`"♦ 4 BOARD OF HEALTH PERMIT . T Food/Kitchen Septic System 41 e. , BUILDING INSPECTOR THIS CERTIFIES THAT........S..*. ........ 110 .................................................................................................................. Foundation has permission to erect..N�I .�................ buildings on .... 0...... aw vim..,...RW... Rough to be occupied as K4 o k0*4 11" SO0 �r S� ������ Chimney .... ............................... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Lawl,relating to thej1pection, Alteration and Construction of i Buildings in the Town of North Andover. O Wela a8 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS - Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTION START Rough .. . ..A ......... ....................................................... Service. ............M BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner FlRE DEPARTMENT Street No. SEE REVERSE SIDE Smoke Det.