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Miscellaneous - 41 SAILE WAY 4/30/2018
'� �\ rte__ vJ �� �� r Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance NACC#10 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP A. Project Information Important: When filling out 1. This Certificate of Compliance is issued to: forms on the Contemporary Builders, Inc. computer, use Name only the tab key to move 200 Park Street, Suite 2 your cursor- Mailing Address do not use the North Reading MA. 01864 return key. City/Town State Zip Code 2. This Certificate of Compliance is issued for work regulated by a final Order of Conditions issued to: Eight Meadows Realty Trust Name January 5, 2001 NACC#10 Dated DEP File Number 3. The project site is located at: 41 Saile Way North Andover Street Address City/Town Map 63 Parcel 49 Assessors Map/Plat Number Parcel/Lot Number the final Order of Condition was recorded at the Registry of Deeds for: Property Owner(if different) Essex North 4839 212 County Book Page Certificate 4. A site inspection was made in the presence of the applicant, or the applicant's agent, on: 11/14/06 Date B. Certification Check all that apply: ® Complete Certification: It is hereby certified that the work regulated by the above-referenced Order of Conditions has been satisfactorily completed. ❑ Partial Certification: It is hereby certified that only the following portions of work regulated by the above-referenced Order of Conditions have been satisfactorily completed.The project areas or work subject to this partial certification that have been completed and are released from this Order are: wpaform 8b.doc•rev.7/13/04 Page 1 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance NACC#10 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP B. Certification (cont.) ❑ Invalid Order of Conditions: It is hereby certified that the work regulated by the above-referenced Order of Conditions never commenced. The Order of Conditions has lapsed and is therefore no longer valid. No future work subject to regulation under the Wetlands Protection Act may commence without filing a new Notice of Intent and receiving a new Order of Conditions. ® Ongoing Conditions: The following conditions of the Order shall continue: (Include any conditions contained in the Final Order, such as maintenance or monitoring, that should continue for a longer period). Condition Numbers: 46 C. Authorization Issued by: Y North Andover _ �� 06 Conservation Commission Dat of Is uance This Certificate must be signed by a ity of the Conserv ion Commissio a copy sent to the applicant and appropriate DEP nal Office(See Attach nt). Signatures: c, • a, X4, wpaform 8b.doc•rev.7/13/04 Page 2 of 4 f Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance NACC#10 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP C. Authorization (cont.) Notary Acknowledgement Commonwealth of Massachusetts County of Essex North b aoo 6 On this Day Of Month Year before me, the undersigned Notary Public, personally appeared Name of Document Signer proved to me through satisfactory evidence of identification, which was/were Massachusetts License Description of evidence of identification to be the person whose name is signed on the preceding or attached document, and acknowledged to me that he/she signed it voluntarily for its stated purpose. As member of North Andover Conservation Commission City/Town ignature of Notary Public 7lll�� ,l��i•�.9 �!I. Gy�OG� DIOMKWMGE Printed Name of Notary Public NOTARYFUBUC NWEALTH OF MASSACHUSETTS mm.Expires Aug.7,2009 My Co is ion E fres(Date) Place notary seal and/or any stamp above �"�- 7n Signature of Notary Public I I wpaforrn 8b.doc•rev.7/13/04 Page 3 of 4 Massachusetts Department of Environmental Protection Bureau of Resource Protection - Wetlands DEP File Number: WPA Form 8B — Certificate of Compliance NACC#10 Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Provided by DEP D. Recording Confirmation The applicant is responsible for ensuring that this Certificate of Compliance is recorded in the Registry of Deeds or the Land Court for the district in which the land is located. Detach on dotted line and submit to the Conservation Commission. --------------------------------------------------------------------------------------------------------------------------- To: North Andover Conservation Commission Please be advised that the Certificate of Compliance for the project at: NACC#10 Project Location DEP File Number Has been recorded at the Registry of Deeds of: County for: Property Owner and has been noted in the chain of title of the affected property on: Date Book Page If recorded land, the instrument number which identifies this transaction is: If registered land, the document number which identifies this transaction is: Document Number Signature of Applicant wpaform 8b.doc•rev.7/13/04 Page 4 of 4 j P Massachusetts Department of Environmental Protection ILI Bureau of Resource Protection - Wetlands DEP Regional Addresses Massachusetts Wetlands Protection Act M.G.L. c. 131, §40 Mail transmittal forms and DEP payments,payable to: Commonwealth of Massachusetts Department of Environmental Protection Box 4062 Boston, MA 02211 DEP Western Region Adams Colrain Hampden Monroe Pittsfield Tyringham 436 Dwight Street Agawam Conway Hancock Montague Plainfield Wales Alford Cummington Hatfield Monterey Richmond Ware Suite 402 Amherst Dalton Hawley Montgomery Rowe Warwick Springfield,MA 01103 Ashfield Deerfield Heath Monson Russell Washington Phone:413-784-1100 Becket Easthampton Hinsdale Mount Washington Sandisfield Wendell Belchertown East Longmeadow Holland New Ashford Savoy Westfield Fax:413-784-1149 Bernardston Egremont Holyoke New Marlborough Sheffield Westhampton Blandford Erving Huntington New Salem Shelburne West Springfield Brimfield Florida Lanesborough North Adams Shutesbury West Stockbridge Buckland Gill Lee Northampton Southampton Whately Charlemont Goshen Lenox Northfield South Hadley Wilbraham Cheshire Granby Leverett Orange Southwick Williamsburg Chester Granville Leyden Otis Springfield Williamstown Chesterfield Great Barrington Longmeadow Palmer Stockbridge Windsor Chicopee Greenfield Ludlow Pelham Sunderland Worthington Clarksburg Hadley Middlefield Peru Tolland DEP Central Region Acton Charlton Hopkinton Millbury Rutland Uxbridge 627 Main Street Ashbumham Clinton Hubbardston Millville Shirley Warren Ashby Douglas Hudson New Braintree Shrewsbury Webster Worcester,MA 01608 Athol Dudley Holliston Northborough Southborough Westborough Phone:508-792-7650 Auburn Dunstable Lancaster Northbridge Southbridge West Boylston Fax:508-792-7621 Ayer East Brookfield Leicester North Brookfield Spencer West Brookfield Barre - Fitchburg Leominster Oakham Starting Westford TDD:508-767-2788 Bellingham Gardner Littleton Oxford Stow Westminster Berlin Grafton Lunenburg Paxton Sturbridge Winchendon Blackstone Groton Marlborough Pepperell Sutton Worcester Bolton Harvard Maynard Petersham Templeton Boxborough Hardwick Medway Phillipston Townsend Boylston Holden Mendon Princeton Tyngsborough Brookfield Hopedale Milford Royalston Upton DEP Southeast Region Abington Dartmouth Freetown Mattapoisett Provincetown Tisbury 20 Riverside Drive Acushnet Dennis Gay Head Middleborough Raynham Truro Attleboro Dighton Gosnold Nantucket Rehoboth Wareham Lakeville,MA 02347 Avon Duxbury Halifax New Bedford Rochester Wellfleet Phone:508-946-2700 Barnstable Eastham Hanover North Attleborough Rockland West Bridgewater Fax:508-947-6557 Berkley East Bridgewater Hanson Norton Sandwich Westport Bourne Easton Harwich Norwell Scituate West Tisbury TDD:508-946-2795 Brewster Edgartown Kingston Oak Bluffs Seekonk Whitman Bridgewater Fairhaven Lakeville Orleans Sharon Wrentham Brockton Fall River Mansfield Pembroke Somerset Yarmouth Carver Falmouth Marion Plainville Stoughton Chatham Foxborough Marshfield Plymouth Swansea Chilmark Franklin Mashpee Plympton Taunton DEP Northeast Region Amesbury Chelmsford Hingham Merrimac Quincy Wakefield 1 Winter Street Andover Chelsea Holbrook Methuen Randolph Walpole Arlington Cohasset Hull Middleton Reading Waltham Boston,MA 02108 Ashland Concord Ipswich Millis Revere Watertown Phone:617-654-6500 Bedford Danvers Lawrence Milton Rockport Wayland Fax: 617-556-1049 Belmont Dedham Lexington Nahant Rowley Wellesley Beverly Dover Lincoln Natick Salem Wenham TDD:617-574-6868 Billerica Dracut Lowell Needham Salisbury West Newbury Boston Essex Lynn Newbury Saugus Weston Boxford Everett Lynnfield Newburyport Sherborn Westwood Braintree Framingham Malden Newton Somerville Weymouth Brookline Georgetown Manchester-By-The-Sea Norfolk Stoneham Wilmington Burlington Gloucester Marblehead North Andover Sudbury Winchester Cambridge Groveland Medfield North Reading Swampscott Winthrop Canton Hamilton Medford Norwood Tewksbury Woburn Carlisle Haverhill Melrose Peabody Topsfield wpaform8b.doc•DEP Addresses•rev.11/14/06 Page 1 of 1 + .SAILE WAY,,///� ----� o. 210/063.0-0049-0000.0 I i i Date . . . . . . . . ' • f+w�t�Hby�q�' , TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,j This certifies that . . . . . . 0-1 ".d(2 j h has permission to perform . . '0`J e --,6` `. . . . . . . . . . . . . . . . . . . wiring qhe buildi fl-.l . . .`. `.� � . . . . . . . . . . . . . . . . .�. . at . . I./�`�e' . . . . . . h Andover, ass. U' (� Fee . . . . . . . . . Lic. No. P2� . .�J. . . . rf ELECTRICAL INSPEC OR . t i 1249 2012 Massachusetts Electrical Code Amendments 527 CMR 1.2.00§Rule 8: in accordance-with the provisions of M.G.L.c.143,§.3L,the permit application form to provide notice of installation of wiring shall be uniforin throughout the Commonwealth,and applications shall be filed' on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.01 c. 166,§32,an electrical permit shall be issued to the person,firm or corporation stated on the permit application.Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. 11 Permits shalLbelimited as to the time of ongoing construction activity,and maybe deemed_bythe Inspecto>_of_Wires abandoned.and.invalid if-he—. or she has determined that the authorized work has not commenced or has not progressed during the preceding 12 month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit(Extension Act was created by Section 173 of Chaoter 240 of the Acts of 2010 and extended by Sections.74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job,growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain-permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying per' d beginning on August 15,2008.and extending trough August 15,2012. Rule 8—Permit/Date Close ��� * � Note:Reapply for new perm' ❑Permit Extension Act—Fermi/Date Closed: Commonwealth of Massachusetts Official Use Only �_Va = Department of Fire Services Permit No. Z I I Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.l/07] (leaveblank 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 ININK OR TYPE ALL INFORMATION) Date: I (— a,:) a 0 1 City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives n tice qhis or her intentio to perform the electrical work described below. Location(Street&Number) 1 l Ai Q Owner or Tenant k-en Telephone No. Owner's Address �- Is this permit in conjun ion wit a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Building 1' Utility Authorization No. - Existing Service �CD Amps 1 / QVolts Overhead❑ Undgrd[Y'- No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and ature of Proposed Electrical Work: Completion of thefollowing table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators l KVA a0 No.of Luminaires Swimming Pool Above ❑ In- ❑ o.o Emergency Lighting rnd. rnd. Battery 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 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained p Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW SecNoto Device s or Equivalent �-�)No.of Water KW No.of No.of Data Wiring: r Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: �j�D00-00 (When required by municipal policy.) Work to Start: Nk Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: 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"coverage or its substantial equivalent. The undersigned certifies that such covera e is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [/BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties ofperjury,that the information on this appli ytion is true and complete. FIRM NAME: " LIC.NO.: 13a9 Licensee: Signature LIC.NO.: &3 �— (If applicabl nter "exempt"in the lice se numb line.) Bus.Tel.No.-__9��iS��3 Address: 0/t?/,3 Alt.Tel.No.: *Per M.G. c. 147,s.57-61,security work require epartment of Public Safety"S"License: Lic.No. • OWNER'S INSURANCE WAIVER: I am awar hat 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: $ Si nature Telephone No. 1��Z I �Z C.c,�r�re.�' , sem.► tri �� ❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance with the provisions of M.G.L.c. 143,§3L,the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166,§32,ar. electrical permit shall be issued to the person,firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall-be limited as to the time of ongoing construction activity,and may be deemed by the Inspector of Wires abandoned and invalid if he or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of . the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008 and extending through August 15,2012. ❑ Rule 8—Permit/Date Closed: ***Note:Reapply for new permit ❑ ❑Permit Extension Act—Permit/Date Closed: Trench Inspection Pass 0 Failed 0 Re-Inspection Required($.) ❑ Inspectors Comm ts: Inspectors Signature: Date: 3 — SERVICE INSPECTION: Pass IN Failed Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: PARTIAL ROUGH INSPECTION: Pass 0 Failed Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: ROUGH INSPECTION: Pass Failed Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: FINAL INSPECTION: Pass F?] Failed 0 Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: DEB WEINHOLD ...TOWN OF MERRIMAC,MA. .......dweinhold@townofinerrimac.com The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): 5.,,L, Address: 21) Vs`Eafn j^ City/State/Zip: Phone Are you an employer?Check the appy priate box: Type of project(required): 1.El-ram a employer with Irol, 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. t ?• ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition Zuworkers' comp.insurance 5. ElWe are a corporation and its 10.El Electrical repairs or additions ired.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers'comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.] employees. [No workers' comp.insurance required.] 13.❑ Other Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they 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 information. am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site !formation. _ isuranceCompany Name: ( �(�.{Azo olicy#or Self-ins.Lic.#: 9 -11-0 Expiration Date: Cl O 'J Y )b Site Ad ess: �1 r I t7 City/State/Zip: .ttach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). ailure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a ne up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine "up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Lvestigations of the DIA for insurance coverage verification. do hereby certify under the in an pec Ides ofperjury that the information provided above its true and correct. r //nature: Date: ��/ 1 lone#: n-An (3 9 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to-be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom r of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant J that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE evised 5-26-05 Fax#617-727-7749 www.mass,gov/dia Date ��- . TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION a This certifies that . :1,o1.4e.-1. . . , L, i t . . . . . . Chas permission for gas installation . .7,1 1. A� in the buildings of. -7P 4 L 6-c at . . . . . . . . . . . . . . . . . . North Andover, Ma Fee . . . . . Lic. No. . . ? . . . . . . . . . . . . . . . . . . GASINSPECTOR Check# v 8468 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS.FITTING WORK lug CITY O e—f�— MA DATE 2 PERMIT# JOBSITE ADDRESS IIOWNER'S NAME GOWNER ADDRESS TEO � FAX�.__LLI TYPE OR OCCUPANCY TYPE COMMERCIAL❑ EDUCATIONAL ❑ RESIDENTIAL PRINT CLEARLY NEW:[& RENOVATION:❑ REPLACEMENT:❑ PLANS SUBMITTED: YES❑ NO❑ APPLIANCES 1 FLOORS BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER i CONVERSION BURNER ( I COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE E .. F GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN ° POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHER INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES Q NO I ISS YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Q OTHER TYPE INDEMNITY ❑ BOND ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER ❑ AGENT ❑ SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are tryp and accurate toye b t of my knowledge and that all plumbing"work and Ihstallations performed under the permit issued for this application willin "ant nen o"vision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME I Richard Ebacher ILICENSE# 8926 ��� SIGNATURE MP F-1 MGF JP❑ JGF❑ LPGI® CORPORATION Q# 1659 PARTNERSHIP❑# LLC[J#� COMPANY NAME:j Ebacher Plumbing&Heating, Inc ADDRESS 140 Portsmouth Road,P.O.Box 548 CITY Amesbu STATE MA ZIP 01913 i ]TEL 1 978-388-4086 FAX 978-3884086 CELLI . JEMAILebache ebachercom an .com ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES The Commonwealth of Massachusetts - Department of Industrial Accidents f: m Office of Investigations 600 lashin ton,street Boston, MA 02111 www.rnass.gov/dia Workers' Compensation Insurance Affidavit. Builders/Con>tr.%cto rs/Elec tlricia s/Pl umbers A� fliegnnt Information Please Prin Legibiy Name(BusinessIOrganization/Individual): Address. POD 60y'. "t z7% ���-Fs�0" Cfty/state/zip to�10� ©�`�'(3 Phone M Are yoi! an employer?Check the appropria a box: Type of project(required): 1.V I ani a employer with'_ 4.❑I am a general contractor and I 6: E]New construction employees(full and/or part-time).i` have hired the sub-contractors 2.Q 1 am a sole proprietor or partnei= listed on the attached sheet. ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in anycapacity. employees and have'workers' 9• Q Building addition [No workers'compo insurance compo insurance.t required.]. 5.Q We are a corporation and its ME] Electrical repairs or .additions 3.QIam a homeowner doingall work officers have exercised,their. I LEE Plumbing repairs or additions myself. [No workers'compo right of exemption per MGL c. 12.Q Roofrepairs insurance required.] or I have hired 152,§1(4),and we have no 13.[]Other the con'.*rn.cto listed on the attached employees.[No workers' sheet conmo insurance required.l Any ap,ilicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeov!ners who submttth?s affidavit indicating they aredoing all work and then hire-outside contractors must submit anew affidavit indicating such. iContractors that check this box must attached an additional sheet showing the name of the sub-contradtors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'compo policy number. f am an:entplayer that is providing workers'cornpensation insurance for my employees.Below is the policy avid job site information.. . 11 — Insurance..Company Name: Polity#or Self-ins.Lie:_ C Expiration Date: Job Site Address: �Z� R, WatA _ City/State/Zip: C6 G Attach'a copy of the workers'compensation policy declaration page(showing.the policy number and expiration date). Failure to secure ,overage as required under Section 2.5A.of MGL e,152 can lead to the imposition of criminal penalties of a fineup to$1,500.00 and/br one-year imprisonment,as well as civil penalties in the form of a STOP WORK.ORDER and a fine of up to$250.00 a day Against.the violator.Be advised that a copy of this statement may be forwarded to the Office of Investieations of the DTA for insurance coverage verification. I do hereby certifY under the pains and penalties of perjury that the information provided above is true and correct. signature: ID ate: . Phone: s COMMONWEALTH OF MASSAGH'USETTS DIVISION OF PROFESSIONAL LICENSURE-BOARD. PLUMBERS A-ND GAS FITTERS LICENSED ASA.MASTER PLUMBER , ISSUES THE ABOVE LICENSE TO. j RICHARD, S EBACOi.--R rc m PO. BOX 548 1 . AMESBURY MIA 01913. 0013 i` 8926 05/01/14 J1,64586 .. EXPIRATION DATE SER Fold,Then Detach Along All Perforations COMMONWEALTH OF MASSACHUSETTS', DIVISION OFFROFESSIONAL LICENSURE-BOARD OF;!: PLUMBERS AND GASFITTERS REGISTERED AS A PLUMBING CORP . ISSUES THE ABOVE LICENSE TO 1'I;C`HARD: EBACHER � 1 BA'CHER' PLB & HTG INC 148.926 . k0. PORT-SMOUTH RD PO BOX"`:548 . AME.SBUY MA 01913-0013`.` 1659 05/01/14 1.68584{ LICENSENO. EXPIRATION DATE SERIAL NO. Fold,Then Detach Along All Perforations COMMONWEALTH OF MASSACHUSETTS . . OLUMBERS AND GASFITTERS LIC► POSED AS A JOURNEYMAN PLUMBS ISSUES THE ABOVE LICENSE TO. RI:CHA7*1-T, S EBA.CHER -46 ObRf-SMOUTII RD Al4ESBU_R.! MA 01913='0013 ' 16590 05/01/14 168585 LICENSE NO. . Y Fold,Then Detach Along All Perforations 1 GENERATOR APPLICATION DATE: I I I Z1I LOCATION: OWNERS NAME: GENERATOR kw NO INSTALLATION OR GROUND DISTURBANCE BEFORE APPROVALS* CONTRACTOR: PHONE NUMBER: ELECTRICAL GAS RESIDENTIAL MMERCIAL TEMPORARY LOCATION OF GENERATOR: *ZONING DISTRICT: *CONSERVATION APPROVAL (7 � � �• � �Gt.1+x Q�w.'� �� e Town of North Andover Page 1 of 1 s - D• ❑ Base Map Zonis 2012 Aerials Watershed Zone Utilities ❑ Size(JOEJ Selection Legend Location M Help Scale 1 138ft .Select wall) lsho _ ' ' "` '4 Owner Prop_ID Ad . I$ d'r - iDOLBEN DEANS 063.0-0049-0000.0 41 1� V. Y 2 V W I A F �JJ 1 i M M.r z e I i r, 1 selected To Mailing Labels To Spre. I{,F i5- b ❑ Property Building Permits �I Pla d 4 Ownerl DOLBEN,DEANE Owner2 Address 41 SAILE WAY PropertyID 063.0-0049-0000.0 Lot Size 5.06 A �" Fispl Year 2013 Land Use 101 Code Last Sale 08/15/2007 p Date 0 Book/Page 10878 Total$1258800 � � 1 � Valuation Building CL x Type "i "' - ; Year Built 2001 Get Pictometry Imag j_;!Go vs.z.o AppGeo Save Map as Image .__.. . -- M Mw.1:�"k..rq C.--w aus nanawa aaY+.Wa Ae4reaoed v k."M,raa mar awwp WAY a.4-ftbby rorara--V aree�lassabe Cegaaie J+cmutm SrsRJpeg omaavyaMrCwa apMneom do-iro tlmaCoa imt�evK�eaaPaen�mnneY aria wsao .�_^{/}y'� kpl eeaMem/rc hetimr.`"."bettbriae.Lemdts�Jd+c tmme pmety Y�GapfiexAm°yenlMui N4ntrxaVstey p�m'aourmia^an eaw_t+ �j'`` tilatJMrHG dtlW HalrtIMb10.`�W�ablJll/trCLTbRsIOUC!JMbl Y10MU[kg9lY P��y9 rArWl6Cnh!MaER1/m�SnO wYllmtlEsa nFYYNJm1aa JBbleamN4ydia0 tial tIM.MPu6ea tlfSYramftla;i4b fitr�&G'!'6aMr HLt http://mimap.mvpc.org/NorthAndovermimapNiewer.aspx 11/28/2012 NORTH-AND®VER NI 6inwo,Nallrc Plannld� C� MA 510 SO .• . � 1. 1 11'• 1111 I ./ .� GENERATOR APPLICATION DATE: II 1�lI�v LOCATION: 41 . /�It-, Gill OWNERS NAME: � GENERATOR kw Z� NO INSTALLATION OR GROUND DISTURBANCE BEFORE APPROVALS* CONTRACTOR: j �4j/L� + �b i PHONE NUMBER: EL GAS SIDENTIAL COMMERCIAL TEMPORARY LOCATION OF GENERATOR: m rkw.. *ZONING DISTRICT: *CONSERVATION APPROVA �C6 �F,Jh-,�� ,n„� I�,� HI2fl12 Location /(/7 l �� i Gv A No. �3 Date -S) O/ MORTFTOWN OF NORTH ANDOVER 0 9 Certificate of Occupancy $ �' •E1�' Building/Frame Permit Fee $ s^cHus C� a- Foundation Permit Fee $ f 1 Other Permit Fee $ TOTAL $ 5 Check # Y'.r) ' f J ' Build 1 TOWN OF, NORTH ANDOVER I BUILDING DRPARTMENT 1 APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING 1 t :: *s+£'F._€ .^^ a • : a z � K� r<'' , - EN BUILDING PERMIT NUMBER: DATE ISSUED: I SIGNATURE: Building Commissioner/I for of Buildings Date SECTION 1-SITE INFORMATION z 1.1 Property Address: 1.2 Assessors Map and Parcel Number: S 0h&I s td &15 Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 3o O � 1.7 Water Supply M.G.1-C.40. 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 R cord n000 6PA'A &Z,)A_<_ �) Name(Print) V Address for Servi e b rl Sign re Telephbne 2.2 Owner of Record: Name Print Address for Service: z M Signature Tele one 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ 1h A, /) Licensed Construction Supervisor: V J C.1 0 0 License Number �y s ,f Address,-V / /—/ A3 r E 4 ration Date Signature Telephone a 3.2 Registered Home Improvement Contractor � �� Not Applicable ❑ Company Name /0 J 3 Registration Number da't ss C � �? �' Expiration Date Si nature 'r / Tele hone v i SECTION 4-WORKERS COMPENSATION(NLG.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 au applicable) New Construction Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be Completed permitapplicant , 1. Building (a) Building Permit Fee p K t- So o 0 O©� Multiplier 6 2 Electrical (b) Estimated Total Cost of / 190 r) Construction 7 3 Plumbing Building Permit fee(e)X (b) 4 Mechanical HVAC p2 f 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 BUH.DING PERMIT 7 I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner I 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 l SIZE OF FLOOR TIMBERS 1ST2 ND 3 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 Oct-12-00 11 : 53 North Andover Corn_ Dev_ 508 688 9542 P_01 �`ew FORM -_U - LOT RELEASE FORM � VIti-4 ,�1 INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from ba Boards and Departments having jurisdiction have been obtained_ This does not relieve the applicant and or landowner from compliance with any applicable requirements. �.rr.r.r.rr.r. �.r.r.rrrrrr.r..rrrr.�trrrr ■rrrrrau.r.rrr.• ■.r.rr...r.r.r.r �r�yR�z APPLICANT_ r�a���` ,,r�i'Or t J x,11 /"� r'PHONE CEJ ASSESSORS MAP NUMBER 6J3 LOT NUMBER � SUBDIVISION rJj-fr!+ 4 LOT NUMBER STREET 3 � (� ^' STREET NUMBER I.rrr..rr.■ �'r■ ■.r...... ..... ■.....ryr...rrrr■rr■■1.■..a r.r..■■rrr.r. ■rrr dtmcirAL USE ONLY �.■sur■■r.rrr.r.r.r..r..r.rrr......s.rrrr..r..u...rr...r..rrrr....�rr.rrr. RE NDATIONS OF TOWN AGENTS rr ■�■ ..rr •a■..■rrsr.....■■■r.r..rrrrrrr.r..r..r..r...rr.. ■......r.r. t D ✓� f!� DATE APPROVED Ids y CO RVATIONADMWISTRATOR DATE REJECTED COMMrrrrS I . DATE APPROVED TOWN P , DATE REJECTED CO � -- DATE APPROVED FOOD INSPECTOR-MALTH DATE REJECTED ( �-- DATE APPROVED v SEPTIC INSPECTOR-BEALTH DATE REJECTED COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS _ DRIVEWAYPERMI'I' DATE APPROVED . FUZE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BT JILDING INSPECTOR DATE U��P. `(Jn'I/tmzo97TIJPIJI�� !71 i .QOJQCI6[OGCW BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 052309 c Birthdate: 01114/1965 s Expires:01/14/2003 Tr.no: 7303 Restricted To: 1G THOMAS M HURLEY 5 SALEM STREET zz—, N READING, MA 01864 Administrator 'c,�a��� �nnrrwroneawlr�s e�✓�{adeaa�ttl�3. ' y±c• 3 HOMErIMPROVEMENTaCONI.k4VOR Re$ stration;105931 ` Expiration'.S} 01/21/00 HURLEY:,CON STRUCTION a °.Thogas`M jurley ADMINISTRATOR t �,Nr Reading MA`01864 r ,� ,_� Ioyn� DATE(MM/DD/YY)( l NY) `X.A. «<: >;;> ; A CORD :::. I-r -gym LIAB,IL1 0 5/14/01 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION A & K FOWLER INSURANCE AGENCY ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 200 PARK STREET ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. SUITE #3 COMPANIES AFFORDING COVERAGE NORTH READING MA 01864— COMPANY (978) 664-0366 ( ) — A MARYLAND CASUALTY INSURANCE CO. INSURED COMPANY CONTEMPORARY BUILDERS INC. B TRAVELERS INSURANCE CO. COMPANY 200 PARK ST. C LIBERTY MUTUAL INSURANCE CO. NORTH READING MA 01864— COMPANY (508) 664-2868 D THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS CO DATE.(MM/DD/YY) DATE(MM!DDNY) A GENERAL LIABILITY GENERAL AGGREGATE s600, 000 X COMMERCIAL GENERAL LIABILITY SCP 3 0 3 4 2 9 0 2 10/22/00 10/22/01 PRODUCTS-COMP/OP AGG s600, 000 CLAIMS MADE X❑OCCUR PERSONAL&ADV INJURY s300, 000 OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE s300, 000 FIRE DAMAGE(Any one fire) $ 50, 000 MED EXP(Any one person) $ 10, 000 B AUTOMOBILE LIABILITY ANY AUTO 1810971K8980 01/27/01 01/27/02 COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY X SCHEDULED AUTOS (Per person) $250, 000 HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $500, 000 PROPERTY DAMAGE $100, 000 GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO / / / / OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM / / / / AGGREGATE $ OTHER THAN UMBRELLA FORM $ C WORKERS COMPENSATION AND X WC STATU- OTH TORY LIMITS ER EMPLOYERS'LIABILITY WC 131 S 315 6 4 6 07/19/00 07/19/O1 EL EACH ACCIDENT $1, 000, 000 THE PROPRIETOR/ X INCL EL DISEASE-POLICY LIMIT $1, 000, 000 PARTNERS/EXECUTIVE OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $1, 000, 000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS INSURANCE VERIFICATION FOR LOTS 3 , 5, & 6 SAILE WAY. .......................................................................................................................................................................................................................................................................................................... ........................................................................................................................................................................................................................................................................................................... »:»:<'>::>:<' <'<>< ><iii'<;''<<ii>': '<;<;''<<;:'G/1hsIC.: TltisE><::><»»<»:»»> :>:> :>«:::>:><::<::.:;:;:<:;:::.:<;::;:':'<:':'<:':'<:':'<:':<isisi:>':;:<:i::<:>':::<::>:>::<::<::::<: ............ ...... .... i 1 h .. ..... .... .. ..................... .......................................................................................................................................................................................................................................................................................................... .......................................................................................................................................................................................................................................................................................................... SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, TOWN OF NORTH ANDOVER BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 27 CHARLES ST. OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. NORTH ANDOVER MA 01845 FTPRtSEN 1............................................................................................................:.:.:..............:.:.:.....:.:.:.:............A...U..T ..H..O VE ................. ................ .............. ....................:: :::.:... . ....... ..................... : :{ . . .... ......................... ............ z w The Commonwealth of Massachusetts Department of Industrial Accidents a w d Office of Investigations R` Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Name Please Print Name / �r::z�.� �,' Location c � �� ,� <J \ /"L��� �;r� f � U 6�% City Phone # 3�7 <� F-1 I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity i aI am an employer providing workers'compensation for my employees working on this job. I Company name: i Address Ci : Phone#: Insurance Co Policy# Com n name: Address i CitX Phone#: 14 Insurance Co Policy# I Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of,a fine up n .e. 100 and/or one years'imprisonment as Htell_ass_civil penalties�nshe�ormofa-STOP_WORKORE)ER.and.afine ofIS1.0-0..00)-a-da—against-m I i understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. al I do hereby certify under the pains and pe alties of pedury that the information provided above is true and correct. " Date Signature Print name .rT �e' V �1 Phone '�% Official use only do not write in this4area to be completed by city or town official t# City or Town Permit/Licensin Building Dept ❑Check if immediate response is required !] Selectman Board E] Selectman's Office Contact person: Phone#: [:] Health Department Other 1075 ' APPLICATION FOR WATER SERVICE CONNECTION ;a a pp l North Andover, Miss. Application by the undersigned is hereby made to connect with the town water main in F� Street, subject to the rules and regulations of the Division of Public Works. } The premises are known as No. l 411 a L4 Street or su divisi n lot no. ralz)�f La 2741-2 ParP- :2( AL 2e;�11111e4 Owner Address Contractor Address ". il, A pli nt's Signature AI i t 7z5o . � I PERMIT TO CONNECT WITH WATER MAIN I R ` The Board of Public Works hereby grants permission to PW n 0,,,J/ e,V to make a connection with the water main at r Street subject to the rules and regulations of the Division of Public Works. r _ Board of Pub is Works By Inspected by Date See back for rules and regulations r1'feT�2C o� l.�G-i � . 1677 . APPLICATION FOR SEWER SERVICE CONNECTION 2f QO/ North Andover, Mas q44 © 1q-� t Application by the undersigned is hereby made to connect with the town sewer main in 0c/ Street, subject to the rules and regulations of the Division of Public Works. The premises are known as No. 41 Street or subdivision lot no. Owner Address ' Contractor Ad anEks s Applicant's Signatu/17 PERMIT TO CONNECT WITH SEWER MAIN The Division of Public Works hereby grants permission to �� /'�� Ru i ve"� to make a connection with the sewer main at ed Street subject to the rules and regulations of the Division of Public Works.. 7ision Pu lic Works c By Inspected by Date See back for rules and regulations DPW 359 Date .....`5..:'..r 15_714--c/ � OF NORTN,� TOWN-OF NORTH ANDOVER O � A RECEIPT `S`SACHUS� J.WILLIAN Telephone(978)685-o95o G Fax 978 This certifies that ...........�.�. .l,�:. ..�l.?Z. ��.� .....80--t1ijer5 ( )688'-9573 1 � (X has paid. ®Q..�. ��................................ ow-e for ......6. a-w.e .. �� .L .,....4.�.... ��1..!. ..1/` .G..... r..l� F —� � ®®��F�l Receivedby............................................ ...1sV.B LL .................. s Department .......................... t}. 1. ........ .......... WHITE: Applicant CANARY:Department PINK:Treasurer DRIVEWAY PERMIT DATE a LOCATION i(. D-,f- � �. J BUILDER phone f , OWNER la azi&16 2hone � THE NORTH ANDOVER SUPERINTENDENT OF OPERATIONS MUST BE NOTIFIED OF THE GRADE AND SETBACK FROM STREET . CALL THE SUPERINTENDENT'S OFFICE BEFORE FINISH GRADING AND SURFACING FOR APPROVAL OF SUCH ENTRY. FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT. I A Town o �I%*- .1"Vo. Andover CP38 C,' z-- - o dover, Mass., ,�'b�Ste• d T O LAKE COCMICMEWICK ORATED PPS`V �SSA C HUS�� FOR EXCAVATION AND FOUNDATION . THIS CERTIFIES THAT C00 . r. . r0 .. . ....... . �/ ............... ... ........... ..... has permission to excavate and pour foundation at JiNg...opv......aAX.......... .. VI �. for the purpose of........ /.N ...... .... .....Nle. .. ........Z ... .. . .x............................................. The person accepting this permit must return to the o ice of the Building Ins ectdr a certified lot Ian show of building thereon before Foundation will be inspected. ` 3 ows/� P Aj!�40'#qw� VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS The holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS assurance that a permit for entire building structure will be granted. . ......row. .. ............................ BUILDING INSPECTOR NORTH E Town of over No. dover, Mass., T O l A l^J /�. COC MIC ICA � ADRATED F "VLC S H E BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT....CQA l ' ! BUILDING INSPECTOR ....................... Foundation has permission to erect..............1........................ buildings on .�.o l)*...V.......�A.1.1.4......�ay..... Rough to be occupied as.1.4...R.00PUL.p..0��. a { vlt (3 A +s.�13 11 l(...A.�9��..e� 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-Laws relatin to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 3 y q ` `� PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST S ELECTRICAL INSPECTOR Rough Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. JUN-05-01 03 :20 PM O 7812461683 P.02 k ' N,Scheek COMPLIANCE REPORT I i M:.ssachusetts Energy Code MJ.scheckSoftware Version 2.01 Release 3 I 'Permit I I i __ i �'''wr..r I Chocked by Jate "Arm, SAILEWAY - LOT 6 CITY., North Andover 37ATE: Massachusetts HID: 6322 CCNSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE1 Other (Non-Electric Resistance) DPTE: 6-5-2001 DATE OF PLANS; 5/30/2001 CCAPLIANCE: Passes Maximum UA = 952 Yoir Home = 952 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------ --------------------- - CECLINGS 3182 30.0 0.0 111 WA-,LS: wood Frame, 16" O.C. 3420 1910 0.0 205 GLkZ,ING: Windows or Doors 1121 0.390 440 GLkSING: Windows or Doors 74 0.400 30 DORS 20 01350 7 FL)ORS: Over Unconditioned Space 3387 19.0 0.0 159 HVkC EQUIPMENT[ Furnace, 9C.0 AFUE --------------------------------------------------------..-_ CO!4PLIANCE STATEMENT: The proposed building design described here is - co:isistent With the building plans, specifications, and other calculations su:)mitted with the permit application. The proposed building has been deiigned to meet the requirements of the Massachusetts Energy Code. Th,: heating load for this building, and the cooling load if appropriate, ha;; been determined .:sing the applicable Standard Design Conditions found in the t:ode. The HVAC equipment selected to heat or cool the building sh;:ll be no greater than 1259 of the design load as specified in Sei:tions 780CMR 1310 d J4.4. Bu:.lder/Deaigner Date t� a/ Building Value Calculation - for Pro a at..... LOT#6 kddt'es� 4i a +r��,�tN w F 5 ? Room Length Width Sq.Ft. Cost per Sq.Ft. Total Cost Kitchen 24 .17 408.00 65 $ 26,520.00 Brkfstnook 8 5 40.00 65 $ 2,600.00 Dining Room 17 16 272.00 65 $ 17,680.00 Family Room 28 19 532.00 65 $ 34,580.00 Media 15.5 13 201.50 65 $ 13,097.50 Living room 20 16 320.00 65 $ 20,800.00 Garage 24 32 768.00 35 $ 26,880.00 Entry 15 14 210.00 65 $ 13,650.00 2nd floor foyer/sitting 25.5 15.5 395.25 65 $ 25,691.25 Sunroom 18 17 306.00 65 $ 19,890.00 mudroom 14 11 154.00 65 $ 10,010.00 Walkin closet 18 15 270.00 65 $ 17,550.00 Basement Finished 575.00 65 $ 37,375.00 Balcony 14 10 140.00 65 $ 9,100.00 Screened Porch 19 13 247.00 35 $ 8,645.00 laundry 11 8 88.00 65 $ 5,720.00 Bedroom 1 17 16 272.00 65 $ 17,680.00 Bedroom 2 17 16 272.00 65 $ 17,680.00 Bedroom 3 16 12 192.00 65 $ 12,480.00 Bedroom 4 15.5 15 232.50 65 $ 15,112.50 Lav/Bar 15.5 6.5 100.75 65 $ 6,548.75 Bathroom 1 16 14 224.00 65 $ 14,560.00 Library 15.5 14 217.00 65 $ 14,105.00 Computerrm 14 13 182.00 65 $ 11,830.00 Bathroom 4 9 9 81.00 65 $ 5,265.00 Balcony 14 9 126.00 65 $ 8,190.00 g¢SelJ1CcJ/ �o /Sf,fil a- /2 i3 4-7-A s ��,w5 aN� 6�' S ti�0 1 o� f�� �oP 6/\ r .3;1- ;7 Date..................f......... HORTN TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING SAcmU This certifies that ........................................................................ has permission to perform ......................................................... .................. wiring in the building of ........................ ................. .................... .......... ...................... at . ......... North Andover,Mass. Fee..�1.'L.::-:77.... Lic.NoA$-.F,& .................... .. '�'J- MICA�IN� Check # 7760" Commonwealth of Massachusetts Official Use Only � Elm Department of Fire Services Permit No. X?17" _ BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/071 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(NEC),527 CMR 12.00 (PLEASE PRINT W INK OR TYPE ALL INFORMATION) Date: (lett 3/) p 7 City or Town of: NORTH ANDOVER To the Inspector of Wi es: By this application the undersigned gives notice of 's or her' tention top rform the electrical work described below. Location(Street&Number) Owner or Tenant 77;:QJn Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building 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: '7" 7u6 Lem f_ �-- .�4 Completion of the ollowin table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans o.of Total Transformers KVA • No.of Luminaire Outlets No.of Hot Tubs Generators KVA No,of Luminaires Swimming Pool Above ❑ In- ❑ o.o mergency ig ng rnd. rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection an Initiatina Devices No.of Ranges No.of Air Cond. Tota No.of Alerting Devices No.of Waste Disposers eat Pump Number Tons KW No.of Self-Contained 4 Totals: I------- """"' ������ Detection/Alerting 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 3eaters KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or E aivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: L' �•� Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of pectrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE C RAGE: Unless waived y the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability im5mrance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cover a is in force,and has exhibited proof of s e pem, issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) �U�I ICILS I certify,under the nd pen tie of erJury, t t the in ormation on this application is true and complete. FIRM NAME: �� �� t( LIC.NO.: i/-�3? Licensee: U Signature g LIC.N (If applicable, en em 7 n the hc9me number line y/ Bus.Tel.No.• Address: C�All .j21y1 �/l� Alt.Tel No.: J *Per M.G.L c. 147,s.57-61,security work r uires Department of Public Safety"S"License: Lic.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 Signature Telephone No. PERMIT FEE: $ Cj Q; Location 1b;16 #y� /�- (,VA Y f No. .3 6 Date r ' MQ"TM TOWN OF NORTH ANDOVER f � Q «w Mti Certificate of Occupancy $ 'Ss,cMustt Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ C> Check # c Building Inspector Civil Construction Management, Inc. 8 Merrimac Road, Box 225 FOUNDATION AS-BUILT Newton, N.H. 03858 LOT 6 — SAILE WAY Tel (603) 382--7650 NORTH ANDOVER, MA PLAN REFERENCE: "GREAT POND ESTATES A DEFINITIVE SUBDIVISION PLAN IN NORTH ANDOVER, MASSACHUSETTS, PREPARED FOR EIGHT MEADOWS REALTY TRUST", SCALE: 1"=40', OCTOBER 7, 1991, REVISED DECEMBER 11, 1992, BY DEFEO & WAIT & ASSOCIATES, INC. PLAN # 112515. / �/" 1 v2 p /SS v sJP =cD Y 02 CJ — — i res�e►^n �e ct N09'24'44"E I.P. 41.98 S84'2g'35`E 48.6' 448.70- L = 52.32 08'11 6"W G.B . 86.35 347.5' 36.1 ' EXISTING FOUNDATION a � ,h o V, N LOT 6 0 ll l 220,397.75 S.F. c-4 1 5.1 Ac. ,o R = 45.00' G.B . 310.4' N L 91.59' =2'35-41 70.63 S00'23'S9"W 201.00' r 39.07' R = 125.00' o ry' 149.14 L = 10.50 •+� 279.12' S82741'28"w .W G.B. s-77-5611 7 SB2741'28"W N12'36'24"W 1.P. 35.00' Scale: 1 " = 100' I certify that the foundation is located on the lot as shown and that it does conform with the Town of North Andover Zoning Regulations regarding setbacks from the street and lot June 28, 2001 lines. 1 further certify that the dwelling Fs not located in a federal flood hazard zone. QWWA This plan does not represent a property survey. IM Of Zoning: R-1 CM MINIMUM SETBACKS: R&W427 FRONT: 30 Ft. SIDES: 30 Ft. E REAR: 30 Ft. Date. .} �. .. ... .. NORTH 3r TOWN OF NORTH ANDOVER O P t o 4e = • PERMIT FOR GAS INSTALLATION ,SSACHUSE4 This certifies that . .�/'r?� /�.1 `� . . . 1,� has permission for gas installation . a?. .. . . . . . . . . . . . . . . . . . . . in the buildings of . .1F1*61 . . . . . . . . . . . . . . . . . . . . . . . . at . . Yj. . . . .4a . . . . . . . . .... North Andover, Mass. Fee.3.>. .'�. . . Lic. No..?, . . .�. . . . . . . /GAS INSPECTORl�� Check# 54?-2 MASSACHUSETTS UNIFORM APPILICATION FOR PERMIT TO DO GAS 1]7TTING (Print or T v ) nr_OVe( missl�'�" µ Date 20P_� Permit# L V Building Location rti 1> ' /V� Owners Name Mon y on�'f.�.e/ Type of Occupancy New ❑ Renovation ❑ Replacement Plans Submitted Yes ❑ No ❑ m m q Z 0 x E m E i m m m c c D 8 c m y cc m W Z c o m n Pf .Y p 1Q° > r6 {0 E q J.J C g C w„ Q y Z CD( � b T LL o C3 ci aC >. o a r O SUB BSW &l5�`rT i STFLOW 2 ND FLOM 31ORDM 1/ 411-!FUM 9 Company T�ta..� 7` (v M lj r�� � One: Corp. Certificate Installin Coman Name Address ❑ Partnership �/'N1 S 2 1►� ❑ Frm/Company Business Telephone_ 4K/ 7"'o'er `�7 1Name of Licensed Plumber or Gasfitter. INSURANCE COVERAGE: I have current F#Aty insurance policy or its substantial equivalont which meets the requirements of MGL Ch.142. Yes No ❑ if you have Y ,pt Indicate tho typo of coverage by clieddng the appropiate Lox. A liability Insurance policy Other typo of indemnity ❑ Bond ❑ !I OwNEtr'slNst1F11udCE W • I am aware that the liiconse doss not have the insurance coverage required by Chapter 142 of the Mass.General haws. and that my signature on this rmit application waives gig rvquimmont ; Check Ono: Signature of owner or Owrwfs Apert Owner ❑ Agent 1 hereby certly that all of the details and information 1 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 the permit issued for this app6ca6on w6A be in compriance with all pertinent provisions of the Massachusetts State Plumbing Code and Chadar 142 of the General Laws. Type of Uconso: Signature of Licensed Plumber orG-fitter Title ❑Plumber - ❑Gasliittor City/Town Master ^ APPROVED (Office Use Only) JA Joumoyman V � Lioonse Number Date TOWN OF NORTH ANDOVER 41 s PERMIT FOR PLUMBING 1s TACMUSE� This certifies that . . . /,?!. �` . . . . . . . . . . . . . . has permission to perform . . . . : . . C . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . .L!l�d' ?�".�`.�. �. . . . . . . . . . . . . . . at. . . . . . . . . . . . . North Andover, Mass. Fee. . � . '.Lic. No.?.0 5 . . . . . . . r--. . . . . . . . . . PLUMBING INSPECTOR Check # >> 7 6$ fj2 L7� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type)An. �, �` • if' /'Vn d uV¢� , Mass. Date r 19O Permit# Building Location e � , . wrier's Name _Type of Occupancy 19, New ❑ Renovation ❑ Replacement Plans Submitted: Yes ❑ No ❑ FIXTURE'S co Go � � z J Go z I- - W —j CA 3- U d Go z W W co d Z CC Cc = a Z) d w c~i� = � � � °CGO add - z0 U-1CE zode7zCCa O � °C z F _ � 39 O z = � Ne CL O � Q Cz u- u- w !— OI a � dl— z0OcnzEWW0 � = ;c -imcznoo � 39 C0LL Z) 0 � aOcm0 SUB-BSMT. BASEMENT • 1ST FLOOR 2ND FLOG ti 3RD FLOG 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Check one: Certificate Installing Company Name Mews PI�^^��'� ► Corporation _ Address �4 �OSGtMb rrE .; ❑ Partnership - �' ❑ Firm/Co. Business Telephone Name of Licensed Plumber - INS!URANCE COVERAGE: I have a curr nt liability policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Ye No C) i If you have Necked 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. Signature of Owner or Owner's Agent Check one: 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 the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By Title . Signature of Licensed Plumber City/Town Type of License: Master ❑ Journeym APPROVED (OFFICE USE ONLY) License Number Apr 04 01 03: 32p Richard J. Montaill 847-573-1397 p. 1 r a � �f CAW hom ; 04ff4L MoIO-I-wlu- � �I act L DT LOC'.�G-��cNEu�1CK 63 As Pkg, oux o-t tivctm-1 ori YFflrr boy , bk� JC �rc_.DrN� not ABY �(��AGN Ilk G Prez e N G� -T7 f r S Lm F W bu t_A g C M 63 AJEL4 Sa IF YOU Al? `� ► Li/?f2 u}�rM i3ur cA MIiL- 9r���� N.Ps , o� fps Ci OU I` = c+e�N► M � 13u►�����, T-,.,i G (J'i int. D Cm Er2Z /�tit 14(4k-LF-,Yl L t N D lvdtf l-Z RPPX-C-e1POM' AIVY ~---IkAN L- yD fvyt yo u r2 Z vvit(_ �N i -r YomWr 40v-" yov- S/1!�=C�Fi�.Q of-) �.�s�Z{ ,� ��Nvoijv 6 3 �_ 07 UP I Apr 04 01 03: 32p Richard J. Montwill 847-573-1397 p. 2 04/04/2001 14:12 9786648415 PAGE 03 OUINTRL 603;9� 0t9 I P.OI40 i'&A , ' LL n�nmsr a O \ I jl 4 w .I 3 i LA ! $ i 0 s c i � �� ► `ice m ` '� II y� l � �\ c � li � • i Date// . .. .. . . .... ,AORT" 6?oy�•..lo ,s1ti O� TOWN OF NORTH ANDOVER ;y^off a PERMIT FOR GAS INSTALLATION 9 SSACMUSEtS This certifies that.. . . . . . . . . . . ... . . . . . . . . . . . . .. . . . . . . . . . . . . . . . has permission for gas installation . . . . ..... . . . . . . . . . . . . . . . . . . . . . in the buildings of . . .. . . . .t: . . ... . . .. . . .: . . . . . . . . . . . f-• at . . �.% . . . . ...=.. t 4� . ./. . . . . . . . .. North Andover, Mass. Fee. :•�-: .�.'. . . Lic. No� . '��. . . . . . . .!Yr-3fi. . . . . . . . . . GASINSPECTOR Check# 37 . J MASSACHUSETTS UNIFORM APPLICATON FOR PERACT TO DO GAS FITTINGitor print) Date r % '�L( 19 i NORTH ANDOVER, MASSACHUSETTS i t Buildin_e Locations LoL Permit# 71R5 Amount S �• Owner's dame New Renovation F� Replacement F Plans Submitted Cn cn G z z z S U 3 -[3 A S E E N T I B A SE .M E N T I I IST. FLOOR 2N D . F L O U R 3 R D . F L O O R 1T I1 FLOOR 5T II F L O O R 6T 11 F L O U R 7'i 11 FLO G R 3T 11 FLOOR (Print or type) Check one: Certificate Installing Company Name l Ar S a L. a of c(. Corp. Address -1�tJ-J 5 f _ Partner. Business Telephone (,b�.t ti b5 Fq/FrtniCo• Nzqne of Licensed Plumber or Gas Fitter S lo", 0"i 5 INSURANCE COVERAGE Check one I have a current liability Insurance policy or it's substantial equivalent. Yes No❑ If you have checked ves. please In cate the type cove�ge by checking the appropriate box. 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: Sienature of Owner or Owner's Agent 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 pertormed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachpusetts State Gas Code and Chapter 142 of the General Laws. Bv. Signature of Licensed Plumber Or Gas Fitter Title d Plumber 14q 6 CityiTown ❑ Gas Fitter Lictrise INumoer Master APPROVED(oi,i-lc:usF )NLY) r7 Journeyman N° 3 D HORTM °ft"`°:•�"� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING L -. . SSACHUSEA This certifies that ~" ............................................ has permission to perform .................�......................................................... wiring in the building of ............ ............................................................ North Andover Mass. Fee//- ..........L. Lic.No!.`.!/........ ...... .......... ........................... ELECTRICAL INSPECTOR Check # /%/, WHITE: Applicant ' CANARY: Building Dept. PINK:Treasurer a�0 The Commonwealth of Massachusetts Office Use Only Permit No. 1IR3 P22 a =r; Department of Public Safety ^� BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Occupancy & Fee Checked 3/90 (leave blank) 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 10-19- (Z) I City or Town of M0140110d (Z)" n Q To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) )-o+ #C (( lam G: ' I^� �7LT7 Owner or Tenant ('oRL, QUA IcI�S ,�7���� Owner's Address :Aoc) ���(�ST �a� '71bJ6Ue'r- C Is this permit in conjunction with building permit yes [� no El (Ch ;k Appropriate Box) Purpose of Building ,itJC` 4 NOWT Utility Authorization No. `' 1 Existing Service Amps / Volts Overhead ❑ Undgrd ElNo. of Meters 1r New Service '1QQ Amps / Volts Overhead ❑ Undgrd No. of Meters Number of Feeders and Ampacity n (� Location and Natu a of Proposed Electrical Work /l.C'�_J /Td T)e TOTAL No. of lighting Outlets No. of Hot Tubs No. of Transformers KVA Above In No. of Lighting Fixtures Go Swimming Pool grnd.❑grnd❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners oC FIRE ALARMS No. of Zones TOTAL No. of Detection and No. of Ranges L No. of Air Conditioners TONS Initiating Devices 1 HEAT TOTAL TOTA No. of Sounding Devices No. of Disposals y No. of Pumps TONS KW No. of Self Contained No. of DishwashersS ace/Area Heating KW l Detection/Sounding Devices Municipal No. of Dryers Heating Devices KW Local ❑ Connection ❑Other t No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. of Hydro Massage Tubs No. of Motors Total HP OTHER: 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 ❑ 1 heave submitted valid proof of same to this office. YES 10 NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE BOND ❑ OTHER ❑ (Please Specify) (Expiration Date) Estimated Value of Electrical Work $ d6d Work to Start 10r Inspection Date Requested: Rough , f Final Signed under the penalties of perjury: n a� FIRM NAME �J-1 5">ov LIC. NO. Licensee C f=( 5 /4 c� .kd Signature-4 - LIC. NO. p �d Address r C� 6 c, Bus. tel. No. DCi GSC �'�66a Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantiapequivalent as required by Massachusetts General Laws, and that my signature on this application waives this requirement. Owner Agent (Please check one) Telephone No. PF ZMIT FEE $�_ (Signature of Owner or Agent) I { NORTry ss�cHuee I CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER I Building Permit Number C) 3B Date /—,-5 THIS CERTIFIES THAT THE BUILDING LOCATED ON MAY BE OCCUPIED AS �S� 7,4x' ��' u IN ACCORDANCE WITH THEPROVISIONS OF THE MASSACHUSETTS s4rATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. /'IXOOMSi F�l� �a'� �3Arths, 3 57L,)// CERTIFICATE ISSUED TO --('ptV4Mfi6rdrV y1�ClCRs C Aly 411 ' AM c Building Ins ector t NvKiH E Town of Over �No. ~ '� i� C% � 0 -CoCH,,:P y dover, Mass., �� °RATED PPa��y S H � BOARD OF HEALTH PERMIT T Food/Kitchen Septic System THIScowi*,%Ppory �V 1I�t�S � '` BUILDING INSPECTOR CERTIFIESTHAT... ..................................................... ................................... Foundation • ' 11 has permission to erect..............1........................ buildings on.FQ.....b. ... .1........5 .�.1� ...... AY... . Rough to be occu ied as a?• IlA { �+�� Q A�1 S 3 Sia II ' Chimne�(Cr', 0 p ...R.,�Q.�n. .,................. .... ........... ,. ........................... .*�►..... .......... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in p;na�i this office, and to the provisions of the Codes and By-Laws relatin to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. rn to y Of PLUMBING INSPECTOR y VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough 6P v. PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION ST S ELECTR SC4,L SPEC R .�/. . ..%N ........ ................................ s BUILDING INSPECTOR / in Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughMR No Lathing or Dry Wall To Be Done FIR PARTMENT Until Inspected and Approved by the Building Inspector. Burner _*1\\s a �r Street No. �f4�V16z' . SEE REVERSE SIDE Smoke Det. Town of North Andover r1ORTy q O��T�to Building Department -�? ''���- M'b• 0 27 Charles Street o North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 Co[NICNWK N ACHUs�t�y APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS e A tA LOT NUMBER. SUB IVISION DATE REQUEST FILED DATE READY FOR INSPECTION d FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE ($25.)DOLLARS WILL BE CHARGED iF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OF IAL UA ONLY ROUTING CONSERVATION �f�// �% DATE -P.LANNINGC DATE < 2 D2 D.P.W. —W R METER 49L 4TH DATE d Z D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE fW AUTHORIZATION N2 3 r Date.................................. NORTH °f'"`° :•�"° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING USE� r w � This certifies that t .•, . c, L � has permission to perform .........:................. .....,.............................................. -I,' wiring in the building of . . . ........... :...'..................................... q � •.. , ............................... .North Andover,Mass. Fee,..-.-. ............... Lic.No.............. .....................:......................................... ELECTRICAL INSPECTOR Check # �. 7 WHITE: Applicant CANARY: Building Dept. PINK:Treasurer (at The Commonwealth of Massachusetts Office Use Only ' Department of Pubpc Safery Penin NO BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 O=umcy a Fee Chocked—,- � 1-17 �r90 Peeve plank) APPLICATION FOR.PERMIT TO PERFORM ELECTRICAL WORK M W""IN pefemue N merearxoe vAe1 ew YaaeerJNueas Oeeakai Cede.S27 4111 1200 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION Date /;I //-p d/ City or Town of /9 T� 6oy,5R To the Ins -The undersigned applies for a permit to perform the electrical work described below, peetor of Wkas: Location (Street 3 Number 3./9 &' //// um� Owner or Tenant _ !) EEE F/J L DyeI.0A,ff•PS ��1. /� ��/n/ �� � Owner's Address__ 200 P,9 R S7, 30/TF a D Is this permit In conjunction with a building permit yes ❑ no 19 (Ch-;k Appropriate Box) Purpose of Building/&�,� � ��p/d�j{�,,E —Utility Authorization No. Existing Service Amps_J Volts Overhead ❑ Undgrd ❑ No, of Mete New Service Amps f Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Name of Proposed Electrical Work Lpfer-arzry sy No. of Hghtlng Outlets No. of Hot Tubs No.of Transformers TOTAL No. of U htin Fixtures Above In KVA Swimmers Pool md.❑ rnd❑ Genentora KVA No. of Asceotacla Outlets No.of Emergency Lighting No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS - No.of Zones No. of Ranges TOTAL No.of Detection and No. of Alt Conditioners TONS 'Initiating Devices No. of Oisoosals TOTALHEAT TL o.of SfedcesNo. of Pumps TONSKW N *(Self Sounding No. of Dishwashers Soace/Area Hosting KW Datecdon/Sounding Devices No. of Dryers Heating Devices KW Municipal ` Local ❑ Connection ❑Other No. of Wator Heaters KW No. of No.of low Voltage Signs Ballasts Whirl 11 No. of Hydra Massae Tubs No.of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General taws I have a current Liability Insurance,Policy Including Completed Operations Coverage or Its substantial equivalent.YES NO O I has"submitted. valid proof oFsanle to this•offlce.YES O•NO O It you have checked YES, please.indicate.the type of coverage by checking the ippropriato box. INSURANCE ® BONO ❑ OTHER ❑`(Please Specify) (Expkadw Date) Estimated Value of Electrical Work = Work to Stan Inspection Date Requested: Rough, tonal Signed under the penalties of perjury FIRM NAME op UC. NO Licensee Signatur t' <:. LIC. 'NO' Address - Bus.. N H- --033-26- Alt. OWNER'S INSURANCE WAIVER: I am swaie that the Lcinses does not have,the Insurance covarage..or its bslanttW No Massachusens General Laws, and that my signature on this application waives this requirement.Owner 'Agenequivalm t as required by g (Please chock erre) Telephone No PERMIT FEE i (Signature of Owner or Agent) RIM 1 MQ Town of '`'' NORTH ANDOVER BUILDING PERMIT INSPECTION REPORT PERMIT NO.: � PROJECT: I ~ DATE: UNIT NO.: FLOOR: WING: B IUILDIN//G NO.: REMARKS: ®®YY�S o� 1-wis�<j is �JAse(1r1en�T� FSI) '�d .AdP 8,4A5 2 SA I A I I A.cA e d ffs;-� Cas,+ 4 a5- DCO Fm09 ( Q, ^- Excavation-depth and soil conditions Framing- Other: Date: Date: Date: Inspector Inspector Inspector Footings and foundations and drains- Insulation- Other: Date: Date: Date: Inspector Inspector Inspector Electrical-rough- Plumbing and/or gas-rough- Other: Date: Date: Date: Inspector Inspector Inspector Electrical-final Plumbing and/or gas-final Other: Date: Date: Date: Inspector Inspector Inspector `ire Dept- Iil burner,tank,stove,smoke detectors Final inspection Certificate of Use and Occupancy Date: Date: Date: -Cof 0# Inspector Inspector Inspector Form#995 Action Press,685-7000 1 Date. . .��• •G/ r~ N2 ; u �T:�� TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING sSACHUS� This certifies that • has permission to perform . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . .;l ;r . . . f`�!.�:. . : �. !> , North Andover, Mass. Fee Li c. No../?.Y<. ... . . . . . . . . ? . C r .'. . . . . . (PLUMBING INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMU-TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS "1 { ( _ t � � ` Date Building Location ,; [ ,�� �„Wa.� Owners Name [; lr-+�eerIg!Oa o/ �,/� Permit#� Amount Type of Occupancy S,'-" L Le l-eA on l„ I New Renovation Replacement Plans Submitted Yes No El FIXTURES r a � A SrRE VE ist FLOM I Ij t4la. 2M H= 3 S�4 FLOOR 4M FLOM 5M MM 6M R-om 7M FIOCR SII3 FIOQt (Print or type) (� Check one: Certificate Installing Company Name L G 4 Corp. Address. i✓ �_�'�" S 1 ElPartner. Business Telephone Fiim/Co. Name of.Licensed Plumber. S'4,-, : P ek �, S Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity E 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 i c Signature Owner Agent F 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 Plumbing Code and Chapter 142 of the General Laws. By: -�f� Riwuvc.t Type of Plumbing License Title ~�.-- City/Town License Number Master Journeyman APPROVED(OFFICE USE ONLY I � I N° 3 , -i ! Date...... f / pOR7„ 50 TOWN OF NORTH ANDOVER A PERMIT FOR WIRING ACHUS This certifies that ...............: c hasermi n to w P ssio perform .... w ,i �£ wiring ................... 8 in the building of, r' /�;,, ....................... ...................... ..... ..... �. tS( Lic.N /i5 ,North Andover,Mass. Check # 11 L/ ELECTRICAL INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer lClL'WIYILYLVIYYII;HLIII VI'I VJ/1a3dLJ1V&3r1I IJ Uiuce use omy DEPARTAMWOFPUBLICS4FE77 Permit No. BOARD OF FIRE PREVE WONRW UTATIOI KS 527 CMR 12-M UVAA Occupancy&Fees Checked PPUCATTONFOR PERW TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL.INFORMATION) Date Town of North Andover -/ / / To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. `I / Location(Street&Number) ) �j} fro {- vJ se (y sA : i L wig Owner or Tenant Corn�ernp Aa,/ 0".1�e� �C11C. Owner's Address ' d )( .5T ro,,r4K AJ.-A, d-A U 10 Is this permit in conjunction with a building permit: Yes No n (Check Appropriate Box) Purpose of Building Utility Authorization No.0=3 Existing Service Amps / Volts Overhead M Underground No.of Meters New Service /o C) Amps 00 /No Volts Overhead Underground ® No.of Meters _ 1 Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work' Mal Se r-U(4�- No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA _ No.of Lighting Fixtures Swimming Pool Above Below Generators KVA ground M around No.',,;fReceptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices Vo.of Dryers Heating Devices KW Local Municipal Other Connections ED u14o.of Water Heaters KW No.of No.of Signs Bailasis r'4o.Hydro Massage Tubs No.of Motors Total HP OTHER Tmu-arroeCo�aage Pt>astrlr�o�thetequaa>lallse�Ivlacsad>usr�Ga�a�alLaws I ha%eaax=tLmbihtyhmm=PchLYmdx&gCmvkieOpw&m Catacecrks sJostf W apmalat YES ® NO liva est> TwwdvA dptoefofsmmlotheOffi=YES Ifjcuhaeedr dWYES,pl� mk*thetAxofaa'agebydmkzrglhe IIVSURANCE BOND OTHER r-1 (PU awSpeafy) 5pirAmDalle CA) -(( Estin>etedvaluecfElecttiratwak$ 300 � WakiDSlat " �?' C?/ h�e�imUa�eRegt>�ted Rao t 1 cc �_ Feral Signed utxfa-e RMh es afpegtay. FIRMNAME/ 10 r -' 'I �s 7� C ti=MNa J l9� Lioa>9ee ��r "s L4 er C_b __ Sim Lioa>seNo D 6 S� �Q / / BusilmTd.No: 61/s- �6 on �nS(�a4+'�r J�l� d�5A1kTeLNo. �o���' e--'1`7t i OWNER'SDVSL ANMWAIVFR;I.amawmdxttheLioarsedomnQt r etkreaslr wwvmp rdsabutale*mala>tas byNtsmdxEmCaraalLaws and that my sig>�rn�pamrt app�Lat wanes lhls rac�matra>< (Please check one) Owner Agent `'3�U CJ,) Telephone No. PERMIT FEE$ �