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Home My WebLink AboutMiscellaneous - 430 PLEASANT STREET 4/30/2018 430 PLEASANT STREET 210/095.0-0022-0000.0 i OMNI 9985 Date.... NOR r" 40 TOWN OF NORTH ANDOVER °G PERMIT FOR WIRING SSAC US Thiscertifies that ........................... ................................................................ has permission to perform ........ ..... ... ......S .... ........ wiring in the building of............147....... ............................... ....... ...... ...... ........ at.... ................4 North Andover,Mass. ..... 5... ..... Fee.�. :70. ....... Lic.No.�.......... ............... ....... Check # l.ontmontueaR of//laesaclwetb Official Use Only Permit No. oCJepartrnent o�}ire�ervice9 '' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (lease blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC).527 CMR 12.(U (PLE.ISE PPYVT IV IfVK OR TYPEALL LVFOR-414T10N) Date: 312, 11 _ City or Town of: �Uor m Aid-ay-61 To the Inspector of TVires. By this.application the undersigned gives notice of hiso her intention to perform the electrical work described below. Location (Street& Number) k1_5 �L Owner or Tenant 2 0-) Telephone No. Owner's Address Is this permit id-conjunction with a building permit? Iles El No (Check.appropriate Box) Purpose of Building Utilitv Authorization No.. Existing Service amps / Volts Overhead ❑ Undgrd ❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd 0 No. of deters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: i i Completion o1 the following table may be ivaived br the InsDec o of ll fres. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans TransTota v Trsformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above In t o.o Emergency Lighting - No.of Luminaires Swimming Pool Er'nd. E] arnd. ❑ 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 g _ No.of Waste Disposers Heat Pum Number Tons KW No.of elf- ontained Total p Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW : Local El Municipal El Other No.of Dryers Heating Appliances KW ec -city stems:* ices or Equi valent No.of Water KW No.of o.of Data Wiring: Heaters Signs Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Eq uivalent OTHER: /7ro '? " Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: S6 (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with NEC Rule 10,and upon completion. INSURANCE COVERA E: 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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) Self Insured I certify,under the pains and penalties of perjury,that the ' ormation on this application is true and complete. FIRM NAME: ADT Security Services ,LIC. NO.: C -4/15, Licensee: Mark A. Brophy Signatu e LIC. NO.: C-45 Rf oppliedble-enter `'exempt•'in the license number line.) Bus.Tel.No.: 603_,a4-5928 Address: 18 Clinton Drive Hollis NH Aft.Tel. No.: _ *Per M.G.L. c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. 00953 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: $ �J y `Iii .i •- .x_. i�, In«dC II 1 _ f ucrr�rtii.I,nt Vr t'UtSUE. CSAFE Y h = '4V:rr" r.A:REGISTERED SYSTEM CONTRACTbR :�...• ;1. 4f:,4! Number. SS CO 000_•53 -- = ISSUES7HEABOVELICENSETO: '• '' Expires: U:07:101,1, Tr.no: 117.0 •SERV : aDTSECURIT-Y , - =..hEARK�=:A :BROPHY .,SR t� S-License: ADT SECURITY SERVICE VERSI7Y. AVE 4 -0;>U N•I i� kIARK A 9RLPHY SR MA. A90-2311. ':�< .. 111 F.1ORS-'ST ` 02 >.4lESTWOOD r.. a0R';7PJOO. ►•,tA 07/31/13 849174 commissioner oradons PeG �..:: •• FoIC.ThanDaaNalonq I r A • � to G ri- t'•4. n1 _ a �• r a � If Location No. Date No�Th TOWN OF NORTH ANDOVER 9 i Certificate of Occupancy $ t scMusEt�; Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ ��XS; �✓ Check # 19040 j/ Building Inspecto( 1 CERTIFICATE OF USE 4..00CUPANCY TOWN OF NORTH ANDOVER Building Permit NumW 38 T CER S THAT THE BUtLDIN L, �6 Pleasant Street. MAY BE OCCUPIED AS Sin 1,}„ a Family Dwell'addition IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSXTTS STATE BUILDING CODE AND SUCKOTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Timm.Carlson—Richard Radcliff 430_Pleasant Street NoilhAndover b4A,01845 • ..yJ'.es-rr-. Budding Inspector �4ORTH Town of over 0zs= �A E dower, Mass., 7-4f "•foo S� COCHICHEWICK V BORATED F'Y C2 BOARD OF HEALTH PER ..M IT D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT .... A^ a4N JpIC CIS Foundation AA1W - /y '�eZ� ' bui i son yid �4.t�N has permission to erect....... .............................. ........... ................... .M................... .................... .............. Rough . PW /Q rA r G0t1w Adefrrw w ',s '�/• f w�► &m to be occupied ash ...... ........... ....................... himney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in al this office, and to the provisions of the Codes and By-Laws relating to the Inspectio , Alteration and Construction of , Buildings in the Town of North Andover. / y YO y PN# G A/1• A f /f/Y& y ING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. m 04r� � PERMIT EXPIRES IN 6 MONTHS �1s i G� ELECTRICAL INSP CTO UNLESS CONSTRUCTION STARTS 3,f -a -- A J. A 10'0�1 ........ .......................... .. Service ..... .. . ... . ....... .. ........................ BUILDING INSPECTOR Occupancy Permit Required to Occupy Building GAS INSPECTOR Rou Display in a Conspicuous Place on the Premises - Do Not Remove Final 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. K Location No. Date b NORTol T0WN OF NORTH ANDOVER O�t.. o F 9 Certificate of Occupancy $ Building/Frame Permit Fee $ l� JAC IN Foundation Permit Fee $ d Other Permit Fee $ r TOTAL $ w Check # r 184u5 `` Building Inspector '1 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REfA. RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: fD DATE ISSUED: M SIGNATURE: [il Building Commissioner/1for of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: �a c�- Map Number Parcel Number /W 1.3 Zoning Information: 1.4 Property Dimensions: t `J v Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft _ Front Yard Side Yard Rear Yard Required Provide R red Provided R, red_ Provided I.'I Water Supply M.G.L.C.40. 54) 1.5. flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private ❑ Zone Outside Flood Zone 0 Municipal.•Z.� On Site Disposal System 0 - J SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENTDistrict: es N o M 2.1 Owner of Record Name(Print) Address for Service Signature Telephone Q 2.2 Owner of Record: •Name Print Address for Service: t Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: �� 5-4,0 License Number Address �ci►�` J. Expiration Date Sign re Telephone A 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name U 13 W//-7 / Registration Number Address (rte `7 Expiration Date.,/' ^� Si n re Tele hone w 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 all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: X. SECTION 6-ESTIMATED CONSTRUCTION COSTS k OFFICIAL USEQNLY Item Estimated Cost(Dollar)to be .. Completed by permit applicant ` 1. Building (a) Building Permit Fee 6 Multi lier 2 Electrical ®� (b) Estimated Total Cost of Construction 3 Plumbing — Building Permit fee(a)X (b) 4 Mechanical HVAC / 5 Fire Protection jure C) 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATRA TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, .--.-V 7-;;,o "O'-eite as Owner/Authorized Agent of subject property Hereby authorize to-act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, G��A�_ 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 Jell Si ature_611MAmerient Date IN NEW111111111, NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TTHERS 1 2 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS s DRAENSIONS 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 A0RTIy Town of And Ow�ni...w�.,., .�."��`� •rte. .q No. 9►9►D " = A E dover, Mass., W'd? COC NIC ME WICK ADRATED PPa�� `S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT.. ... . ... .rAP/50 N is Per � BUILDING INSPECTOR BUI ' ' ........................ . ..... Foundation .......... has permission to erect.. ,...... bui i s on �`3� / 'A't� r ugh ........ ................. t0 be Occupied 8S.kr!4 r Vtow /�..........�.....rw �*kV �h,/n /1A� �.' �� A�r himney .............................. ........... ...... .......................... ..... ...... ....................... 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 relating to the Inspectio , Alteration and Construction of Buildings in the Town of North Andover. /y )eA I/ ~ G q/►. Af. y DEQ' PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. 04 r* a r Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS• CONSTRUCTION STARTS ELECTRICAL INSPECTOR .. .� ough Service 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 FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. cQ�jtwo FORM, U - LOT RELEASE FORM I n�nVq- CsAMc� �� _-. INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from I�, b_ Boards and Departments having jurisdiction have been obtained. This does not relieve . the applicant and/or landowner from compliance with any applicable or requirements. -turtk APPLICANT 'FILLS OUT THIS SECTION APPLICANT 771�114 Zal-156,e) / �� Z01elllr PHONE LOCATION: Assessor's Map Number PARCEL SUBDIVISION LOT(S) y STREET �eQ, Se,-, ST. NUMBER � c OFFICIAL USE ONLY E OM EN 0 OWN TS: C E TION AD INISTRATO DATE APPROVED DATE REJECTED COMMENTS AXS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT ® L000, / 7 DUMPSTER PERMIT RECEIVED BY BUILDING INSPECTOR DATE FORM U-Revised 6.05 JMC NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: 30 Rk4? 117 1- %, 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. Also, note Permits are required under Fire Prevention laws Chapter 148 Section 10A. The debris will be disposed of in: ell. /Z' (Location of Facility) Signature of Pe t Applicant Fire Department Sign off: 4/4 Dumpster Permit Date SEP 30 2004 9:27 978 556 0285 p.3 CERTIFICATE OF LIABILITY INSURANC9,,odjj 1pj nqmmmm "MAIUCIEFt IM IE D ISKIEDAS A IMTIMOF eOORIA710H- OILY MIO OOWERB NO W9=UPONTtECERTWCATE Davis, Davis 6 mooft BOLDER.TRNN:CORIP CATE DOES NOT AMM EMM OR 40 FAMOZa tae ALTER UVTM FOUMN BELOW. Havorhili a®► 01830— AFF� CUMUM Thme:978-373-1347 Ptm-. 78—Ss8-0285 Dom 8mffm-i* 31 .-U ftotootUm Imo-w-.00 ' +ttt�e+a '�Iers tba�raace g�cs�� equ�tix PA Viox 3 o,e BIL 019458 ° � ttt�e COVEIMOM 7NEP0t7C--OF019litMMtMMMU1NNIlVEtttMlt M-M71EtAStllimH AMEFOR7MF=a NmKwtlmuofvATWVJCM AdYpommemm.iHlYM 1'. ail011OFANYCO rIM"G an*RUDWMffWMfMP Gr70WllQiltB UK%YgEg= ldt liMIrPHO'#^lW ItFF"4RMW rIiEPaUCMMMMWittl WMMB6i ICALVE7BME=MM ttpCafirt10N8OFSM P01CIE&.IEGKIE t10iS9101E1 YRY i W IE�I1 HflNlp QJII� Uum ewff"U"MME 161,000,000 $ n CoA 06/22/" as/=/03 FStEOI RjQElAA =loo'boo r�PCLAMMME M lm I I tlwr� aetl i 5 1090 tl13!�^Ymm 1.51,090 000 � _ i i j sa 04A 000 F-1� � � ' pna�crs-Oo��orAoo s g 008 000 m=m= PRO- n A�no�os�er au++r t3ffil�EDt o LW t A�rA1ra � is t I NAtrroa s .ARasgi�A�utY Aarot�r-r�+Atxmaar s AMM p Ap„ SACC i F ssumwm r it00plI tCE s 0=.R 17 cummm AGMEMM s s u�ncttetE - - s s t+s BUM s s wofn ma am g EW&OrWuMBUmr 6>�939NE15b004 09/18/04 09/18/05 MEfAiACCMMa 6100000 t GL -VAS $100000 mL l -P6tw liar t*500060 elm CN RUWATE IMUOt NOWROlt MORMttmtt MWnw CANCEU ATiOlwl g Jk t AffrcrwAm lOL10m� �@ 7�EIQIRIt M'MW .WE fE1Ri8t1HlLENGe1YM O=L -M—DAYSWUTM ern cw NOR= AIMOVM wwroTolaeu�aurrAasat:ronosoaw�u CI'!Y I�IZ _ OBt/IW.H!'OF�1►S>�.Wp1ifE�i1CAB®fTiCti AygxOVm ML MUW2"MR) AacoRo OORPORATIOB 1tfIN J/e�Josm,�uraxra�o�.�e�/ g��) gRs�iatbasasdSta�rrrds .. HOME IMPROVEMENT COMRACTOR -136779 8rzj=6 TWOMEY+LEGARE CONTRACTING SHAWN TWOMEY 61 PATMOTST.' -eAor ' N.ANDOVER.MA 01845. Administrator JR. ✓ gra o� BOAhb or= ILaMONW-7., .. ticense: CONSTRUCTION SUP Number, CS0675w ER1/ISOR �r 10!15f19®6 Explm:iorAFA},r Tr.no: 5180 SHAUN M 7WOMEY 61 PAT-RoIT ST •>—� N ANDOVER, MA 01845 - AdrtlinlsttaWr,.. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,AM 02111 °�M 5.•'' www mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information �/ Please Print Legibly Name (Business/Organization/Individual): �n � c! � 47a- Address: 155./ 4l' r City/State/Zip:, .-Odi 1"r, QPhone #: Are yoV an employer?Check the appropriate box: Type of project(required): 1. am a employer with_ 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 $ Remodeling ship and have no employees These sub-contractors have 8. ❑ D olition working for me in any capacity. workers' comp. insurance. 9. Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.E:1 Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.[J Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.]t employees. [No workers' 13.❑ Other comp. insurance required.] *Any applicant that checks box#/1 must also fill out the section below showing their workers'compensation policy information.' t Homeowners who submit this affidavit indicating.they are doing all work and then hire outside contractors must submit a new affidavit indicating such tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: /•/Gla/-�, ✓.� �/��t/:/Gr✓�Cc Policy#or Self-ins.Lic. #: 40 0 Expiration Date: s Job Site Address: 17 3(3 19��Ie_4Se.,.y c� City/State/Zip:, da 01q6e/!V-1W a/ T z/r Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-yearmprisonment, 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 Investigations of the DIA for insurance coverage verification. I do hereby certify un t pains and penalties of perjury that the information provided above is true and correct Signa e - Date: Phone#:_ 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 ah individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having notmore than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction of 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 F checking the boxes that 1 to our situation and,if Please fill out the workers compensation affidavit completely,by c g apply Y n phone numbers along with their certificates of necessary,supply sub-contractors)name(s), address(es)and p o ( ) g certificate(s) insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members orp artners are not required to carry workers' compensation insurance. If an LLC or LLP does have wised that this affidavit may be submitted to the D artment of Industrial a policy is required. Be ad y eP employees, p y q 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 r uired to Industrial Accidents. Should you have any questions regarding the law or if you are eq 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 fill out in the event the Office of Investigations has to contact you regarding the applicant. f the affidavit for you to g o Y p Please be sure to fill in the eru , t/license number which will be used as a reference number. In addition,an applicant that must submit multiple perrrt/hcense 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 bum 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 Fax#617-727-7749 Revised 5-26-05 www,mass.gov/dia TWOMEY & LEGARE CONTRACTING Professional Building / Remodeling P.O. Box 366 Shaun Twomey North Andover, MA 01845 Doug Legare 978-685-7447 978-556-1547 CONTRACT 1. Date of Contract Signing: . 2. List of documents part of this agreement: / A. Contras B. Specifications(see Exhibit B) C. Drawing(see Exhibit C) D. Payment Schedule(see Exhibit D) E. Limited Warranty(see Exhibit E) F. Notice of Cancellation 3. Parties to Contract: A. Contractor: Twomey&Legare Contracting Shaun Twomey/Doug Legare Federal Id#: 04-3610112 Address: P.O.Box 366 North Andover,MA 01845 Contractor Registration No.: 136779 B. Homeowner: Richard Ratcliff&Timra Carlson 430 Pleasant Street North Andover,MA 01845 4. Description of work to done and the materials to be used: See Specifications(see Exhibit B) 5. Total amount agreed to be paid for work to be performed under the contract: 6. Tune schedule of payments to be made under the contract,finance charges for late fees,if any. * See Payment Schedule(see Exhibit D) *Any deposit required to be paid in advance of the start of the work shall not exceed one- third of the total contract price or actual cost of any material or equipment of a special or custom made nature,which must be ordered in advance of the start of work to assure that the project will proceed on schedule.No final payment shall be demanded until the contract is completed to the satisfaction of all parties. 7. A.Date work is scheduled to begin: See No. 14 B. Date work is scheduled to be substantially completed: See No. 14 S. Notice: A. All home improvement contractors and subcontractors shall be registered and that any inquiries about a contractor and subcontrama shall be ze$istered and ihat any nngedres about acontractor or subcontractor relating to a registration should be directed to: Director,Home Improvement Contractor Registration One Ashburton Place,Room 1301 Boston,Massachusetts 02108 Telephone No.(617)727-8598 B.For contractor's registration number,see top of first page. C.Homeowners have a three-day cancellation rights under MGL c 93§48;MGL c 140D § 10 orMGL C 255D§14 as may be applicable(see attached Notice of cancellation). D.For owner's warrwty rights,see 780 CMR R6 and MGL c 142A. 9. There is no lien or security interest on the residence as a consequence of this contract. 10.Permit Notice: A.The following permits will be required in connection with the work to be performed on your property: Building-Electrical-Plumbing B.It is the obligation of the contractor to obtain these permits as the owner's agent. 2 C.Any owner who secures their own construction-related:permits or deal with unregistered contractors shall be excluded from access to the Guarantee Find. 11. Contractor reserves the right when he deems himself to be insecure to require as a prerequisite to continuing work that the balance of fiords due under the contract,which are in possession of the owner,shall be plate in a joint escrow account requiring the signatures of the home improvement contractor and the owner for withdrawal. 12.The parties agree that no work shall begin prior to the signing of the contract,transmittal to the owner of a ropy of the contract and the expiration of any applicable rescission period. 13.Arbitration Clause:The contractor and the homeowner hereby mutually agree in advance that in the event that the contractor has a dispute concerning this contract,the contractor may submit such dispute to a private arbitration service which has been approved by the Office of Consumer Affairs and Business Regulation and the consumer shall be required to submit to such arbitration as provided in MGL c 142A. 14.Other Provisions: A. Commencement of Work/Completion-Contractor agrees to proceed diligently with the agreed upon work,commencing promptly following: • Issuance of a building permit by the Town • Estimated date of completion. Completion date shall be automatically extended by the number of days equal to those on which contractor shall be prevented or hindered from completion due to weather conditions,other acts of God,inability to obtain materials or schedule work due to delays caused by homeowner's selection process or change of orders,and/or failure of homeowners to make timely payments as agreed. B.Ental payment shall be upon the satisfaction ofthe homeowner.The parties agree that the issuance of a certificate of occupancy shall be the objective standard that the contract has been completed and the parties are satisfied Any punch list items shall be reduced to writing,with a date of completion.The parties agree that no escrow will be held for punch List items. C. Late Payments/Defaults-should the homeowner fail to pay the contractor in the manner as agreed,the contractor shall be entitled to stop work until paid in addition to taking all legal steps including the placing,of a mechanic's lien on the property to obtain payment.Anylate payment shall accrue interest at the rate of 1.5%per month. Homeowner agrees to pay collection costs and attorney's fees for any payments due but not paid in a timely manner. 3 D.Insurance-Contractor agrees to provide evidence of liability,worker's compensation and other risk insurance.Owner agrees to provide copy of hazard insurance as is required by contractor to coordinate policies. Owner: Contractor: Notice: The signatures of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the contractor. The owner may initiate alternative dispute resolution even where this section is not signed separately by the parties. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. 2i_0 �L4 O er Date Contractor 0s /Z' Va er Date Co r 4 Payment Schedule-Exhibit D Job Total $1999300.00 Payment Balance 1st Deposit on signing $50,000.00 $149,300.00 2nd Completion of exterior demo $40,000.00 $109,300.00 &completion of foundation 3rd Completion of weather tight addition $40,000.00 $ 69,300.00 4th Substantial completion of all plumbing, $30,000.00 $ 39,300.00 electrical roughs, &insulation 5th Drywall&Plaster $15,000.00 $ 24,300.00 6th Installation of hardwood and 90%of $15,000.00 $ 9,300.00 finish work 6th Balance upon substantial completion of job $ 9,300.00 Sign Date P / a n o f L a n d / n North Andover, Mass. S h o w i n g Proposed Additions 430 Pleasant Street . Prepared For Timra Carlson & Rich Ra t cliff Scale. 1" = 20' Dote: March 31, 2005 Rev.• Apr17 20, 2005 )prox. Location Of Assessors Map 95, Parcel 22 ist. Dock Zoning District: W105 R-3.• Residence 3 District Exist. Conservation 0lacords (Typicol) No te: N° This Plan has Been Prepared To i ,nay A Notice Of Intent Application To 1 h" North Andover Conservation Comrr�is on Rip—nap Outfall SO, N° co, Proposed Foundation cf,O� 2O�e Orain L e g e n d Proposed Fieldstone Retaining Wall Lot 6 9� (3' High Max.) 87.2 X _ — N/F Compass Properties, Inc. Existing Grade Proposed • • • 92 Addition x Finish Grade . . . . o- ��tiono,e�ff 100' Wetland Buffer er One Zone . . . . . . . - -— E16, 160SF Continuous Row Of Staked Ha,y Bales - Backed With Filter Fabric JOHN K MORIN CML M. 0-tA/%^ The Neve - Morin Group, Inc. Note. Engineers — Surveyors — Environmental Property Line. Data Token From A Plan 'Of Land In North Consultonts — Land Use Planners Andover, MA As Surveyed For M. T. Stevens & Sons 447 Old Boston Road - U.S. Route 1 Compony Dated Nov. 15, 1951 (Plan #2631 N.E.R.D.) Topsfield, Mossachusetts 01983 978-887-8586 2419-SDF 1 pip Approximate Edge of F.E.M.A tS* Flood Ione A, As Shown On Flood Insurance Rate Map Community _ y Panel Number 250098 003 C, Dated June 2. 1993. ,jl s � Ao Fa WF 100 t Fob of 0 WF 101 Existing Sewer Manhole Rim Elev. = 111.7' (USGS Dotum) r0`� WF 102 /N ` e e r WF 103 WF 104 Proposed Conservation .>>¢ '••••� ��'� F o �� : �'''`� Placards �; •s 177 (Typical) Proposed Fieldstone Retaining WaII 1100 �`•to..>>2� (3 High Max.) `�• — Top = 119' Existing Stockade Fence Lot 4 Proposed N/F David & Charlo t to Gulezian Deck ��'6 —-22'-— ,r2 - - - - --51;\ — Proposed i\ Addition Existing Deck (To Be Removed) \ I Top of Foundation Flev. = 129.48' -20'- D --34'`-- Exist. conte Proposed I R�v�ee Be Garage � a Proposed Conc. Existing .17Z Pods (3) -20'-- Dwelling , W Locus Map #430 (No t To Scale) Exist. Paved I Driveway IN V - 10!ee78.29' ••.. 5 Stevens Pond Q�eos i _ oa � --Edge of Pavement —'-__— f'ox Nln ?10 g S n t 1 ea s tree lips X. S1 t e sfc gee o'�s a° (Public Variable Widths) e°yon � Q� , 6186 Date.... ....................... :�. ,10RT11 °f<<``° '•�"° TOWN OF NORTH ANDOVER �r. Gp PERMIT FOR WIRING ��SS�cHu E�•h f This certifies that ....... P/....— has permission to perform .......... ......C !4'.+7. ...tSySr/��2 .................... wirin in the building of.... i ! l !?!, ...!. "�. L�F=................. 8 S �• at.......... /A. ...../4 .. ...............,North Andover,Mass. i Fee..Y-5.-.� Lic.No..t 53.3 C.............. � . .. .�. LECTRICALINSPECTOR J �� '' Check #O-P-4 f bZ/ Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. / Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/05] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 j (PLEASE PRINT IN INK OR TYPIE ALL INF RMATION) Date: /0 —c� �7--e!9 5 City or Town of: 111MT11 41V610 V To the Inspector of Wires: ! By this application the undersigned gives notice of hi or her intention to perform the electrical work described below. Location(Street& er) U - 1 Owner or Tenant G F Telephon�No. Owner's Address Is this permit in conjunction with a building permit? Yes No X (Check Appropriate Box) I Purpose of Building Utility Authorization No. Existing Service Amps / —Volts OF rize r! ❑ IjrldgrCl ❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity 1 Location and Nature of Proposed Electrical Work: INSTALLATION OF SECURITY SYSTEM Coni letion ofthefollowing table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of CeilSusp.(Paddle)Fans No.of Total : Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA i Above In- o.o Emergency Lighting j No.of Luminaires Swimming Pool rnd. ❑ rnd. El Batter Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: "."'."'.. Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or E uivalen No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or E uivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 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 A undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE X BOND ❑ OTHER ❑ (Specify:) SELF INSURED EXPIRES 9/30/06 I certify, under the pains and penalties of perjury,that the information on this application is true and complete. �4 FIRM NAME: ADT SECURITY SERVICES NO.: Licensee: JOHN BASSETT Signature LIC.NO.: 1533C j (If applicable,enter "exempt"in the license number line.) Bus.Tel.No.: 603-594-5900 Address: 18 CLINTON DRIVE HOLLIS NH Alt.Tel.No.: *Security System Contractor License required for this work;if Wplicable,enter the license number here: 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: $ � 1 Date. . ... . . . � WN OF NORTH ANDOVER PERMIT FOR PLUMBING 49 SSACMUS� _^ This certifies that has permission to perform ;= : plumbing in the buildings of . .- -� - ,- :•. . . . . . . . . . . . . . . . . . . , North Andover, Mass. Fee, rsh. . . . .Li c. No.. .v/ \:- �t . . . . . . . . . . . . �� PL Mr4G- INSPECTOR KK Check # �Z /7 6600 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date -SQjP?,Z o2Da.- Building Location�3cp, 7-67A 7— Owners Name S m n Permit# Amount p Type of Occupancy New Renovation Replacement El Plans Submitted Yes No FIXTURES W. s[.a>aavi� B��vr 1SlC HDCR 3V]FIO(R �IHIOCR 4MR" 5'IIIR" 6M H-CM 7M fl" SIH RO(R (Print or type) Check one: Certificate Installing Company Name6iQ� eA a ' Jw Alr-b, P�torp. Address C� /�yiGlc L.+-n& 11Partner. O Business Telephone 5?7R—C --.,'�8 6-990 Frm/Co. r Name of Licensed Plumber: /�/C s A4, Insurance Covera¢e: Indicate the t pe of insurance coverag by checking the appropriate box: Liability insurance policy Other type of indemnity El 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 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 to Plumbing Code a=-tl r 142 of the General Laws. ./ /LLC--' 4'l7� i By: igna u o is nse u er Type of Plumbing License Title City/Town r-ic� Master El"� Journeyman ❑ APPROVED(OFFICE USE ONLY 6135 Date.................................. NORTH TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING CHUS This certifies that .......... ........ .......................................................... has permission to perform ...... . ............................ wiring in the building or ................................................................................... S. at........ 7............,North Andover,Mas .Fee.1$7......... Lic.NoJ9'9k�/ ............... ELECTRICAL INSPECTOR Check # DEDIII?I1G71f1'OFPUB[JCSMMY Pefndt No. (/ B04itDOFEMPREVFN1MR OULA1VMS17aom,am Occupancy&Rea Checked �•• APPUCAIIONFOR PERMITTO PERFORMELECTRICAL WORK ALL wORK To BE PRRRORMHD ON ACCORDANCE W[TH TM MASSACHUSSTS MACTRXAL CODE,527 CMH 12:00 (PLEASE PRWT IN INK OR TYPE ALL INFORMATION) Dai Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perforrn the electrical work described below Location(Street&Number) (� Owner or Tenant ;r Owner's Address is this permit in conjunction with a building permit: Y43-Wo-o (Check Approprism Boa) Purpose of Building Utility Authorization No. Existing Service Amps Volts Overhead Underground No.of Meters New SAmps. Volts Overhead Underground C3 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work G/r/<'E �'YJOl77av s — l✓/,�3i�L ,�irt �-, , at;�,� r No.of L&Vft outlet Na of Hot TObs No.Of Trmstbrmars TOW KVA Na of Usti s RiIsres 3 `1 srbnadnB Pool Above Babes Generators KVA Na of Receptacle Outlet ?7a No.of OU HOroen Na of Emapeocy U*Wna Battery Units Na of switch Outlet 30 No.of 011118 Na of Rama Na of Alf Cord. TOW FM ALARMS Na Of Zones Terra No.of Disposals Na of Had Total TOW Ton KW Na of Detacdoo nal raidedq Devk= No.of Dishwashas Space Ara Headna KW Na of Souodinj Devices Na Of SON Conta6bd No.of Drpars , Headuy Devices KW LealMunicipalpdw Canecdom No.of Water Heaton KW Na of Na of 3191111 ailals No.Hydro Muwaaa Tabs Na of Motor TOW HP OTHER, 4 het MCvMP P�su�ntbferts}iwsrleOdMeo d�se�C�ILavN lhp IDaueaars WLie*JissroeR�YincirdtBtbrr crJhshb la *aM ya ISA Ihunembinilladv0psmfdssttetodr Of z Y$41<y43uhnedmAWY>I,pksahtwhe%mcifwuerapby drsddngthe bole ALSURANCZ kC V ID am 13 rleeseSpe* >�giolicaroe WodcbSmtt z lispec�kilDileRazad PW* E dVal>caf�ecsfalWadcS EBtMNAME Pt3r�Ddpe�uy ��Gs�r C Lia =M IAO 3B�aue [ioaseNo Birirre mNa 97z UWI�ffR'SIIVSIJRAI�EWANFR;Ianawaed>atlhehaensd�,g��gg�heirls�oe Ak'IliNa �� °Di°'`�o��rsiieQiveblferret}iedby11�1a�cfisbGarrilLarit (Please check ane) Ownec Agent r Telephone No, FEE DEFAR1111WOFROKSAFM Permit No. J 5 BOARDOFFBTiMPRiSVEWWREGULA77M327aMl2i Occupancy&Fees Checked APPUCA77ONFOR PERMUTO PERFORM ELECTRICAL WORK AU,WORK To 9E PE FORMED IN ACCORDANCE WrM THE MASSACHUSM ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL II`iFOR1NA1I0N) Dete Town of North Andover / To the Inspector of Wires: a permit to perform the electrical work described below. The undersigned apples for pe pe Location(Street 3 Number) Owner or Tenant Owner's Address is this permit in conjunction with a building permit: Yes�o-[:3 (Check Approprime Box) Purpose of Building Utility Authorization No. Existing Service Arnps....L.olts Overhesd Underground No.of Meters New Service Ampg-...L.V olts Overhead Underground C3 No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work 's Na of Liandna Outlet Na of Hot Tube No.of'fraosturma TOW KVA Na of Ugbdq PG OM3 '1 30nmiq Pool' Above Balm agrmetan KVA No.of Rceptacla Outlet s Na of OB Hume Na of Emergency Ughdng Battery Unit. Na of Switch outlet 3 Na of Oes Bmreere No.of Ranger Na of Air Card. TOW FM ALARM Na Of Zones Tom No.of Dispouk Na of Had TOW TOW Na of Deacdon and PO Ton KW Initimirg Deices No.of Dishwuhen sPoce Ates Hewing KW Na of sounding Deviou Na of sem Coothnd No,of Drym Heating Devices KW I Oqd Municipd Ottm No.of Water Heston KW Na Of Na of Connection A0111 Bdlub Na Hydro Mwage Tabs Na of Moon Told HP OTHER' � ttsltraeComp HUW1DtheM=nm6afM=dz=ftCu=dLm Ihareaaasa,tLithr�jr�nczR>tyinri�dggtaorrrpkle aibst>l>�siYegivalsg ,� p p Itimes hni1bdvaWpoci(c( tmebh0foe YMNO>fyouhstecfnd�iYB9,PkaeidnttetlietYRdaotvagf�bl► NKRANCE BCND 1:3 ann o rm** WakdSlat �� it tDrleRe d Ra* BWT*dValzafBlctW%bik S ald mow ► FMMNANS ;i { c c LimnNa ,-- i — �� LiomseNo �- Ikj*dTd% 4rUM ,. _1 . s�*�7 Si� �i - � JG'�;r C1 AkTdNa { GWI WS14URANCEWAM3%ltmawaethetdle —tziraaaiaecnleageaittsu6r"qivakoNEgadbyMmiumCandLm irdthl my4panQ1dilspm V -fliiamiliums 1 (Please check one) Owner � Agtutt Telephone No, pgRHQj'FEE s Tv Location �� - -�- --� No. F�/� Date Zz -7--1.> MORTil TOWN OF NORTH ANDOVER 3?O�,,,Go . O Certificate of Occupancy $ • "off # b'••"''4�' Building/Frame Permit Fee $ �Ss,�cMusE Foundation Permit Fee $ Other Permit Fee $ TOTAL $ � r Check # 1430/ 8 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: Izz © ®� SIGNATURE: Building Commissioner/IEECEtor of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Num 1.3 Zoning Information: 1.4 Property Dimensions: !3� Zoning Distrid Proposed Use Lot Area(so Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide R red Provided Re red Provided 1.5. Flood Zone Information: 1.8 Sewerage Disposal 1.7 Water SupptyM.G.L.C.40. 54) System: Public 0 Private 0 Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT q 2.1 ner of Records no / 41 f lT F o a "4 S�t" Name( rin A dress for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: License Number M Address Expiration Date arm® Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number FM Address r Expiration Date Signature Telephone ou 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 rmit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work icheck all applicable) New Construction 0,, '%xistmg,B 'Iding ❑ Repair(s) 0 Alterations s) 10 N. Addition 0 Accessory Bldg. 0 Demolition 0 Other ❑ Specify Brief Description of Propose Work- .Lshre ork:.Lshre SECTION 6-ESTIMATED CONSTRUCTION COSTS {v y- eN Y� t OFFJCIAL,USE O� Item Estimated Cost(Dollar)to be ,5 3 � Completed by 2ennit applicant 4, 21 ;K f 1. Building (a) Building Permit Fee Multi Tier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a) X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5) Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT R CONTRACTOR APPLIES FOR BUILDING PERMIT at� , 0 as Owner/Authorized Agent of subject property Hereby authorize_ to act on My behalfii all ta�tiirk authorized by this building permit application � a— OC) Sig,nature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Si ature of Owner/A ent Date Bonn= Elm NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TMMERS 1 ST 2ND 3RD SPAN DRAENSIONS OF SILLS DM ENSIONS 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 a NORTFf Town of North Andover O L Building Department p 27 Charles Street ; x North Andover, MA. 01845 �,,'°•,,.°��{9 D. Robert Nicetta Building Commissioner (978) 688-9545 (978) 688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print DATE . 6 0 JOB LOCATION Q ��JuYI� Q Number Street Address Map/lot "HOMEOWNER I rV �! Q Name Home Phone Work Phone PRESENT MAILING ADDRESS City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings of two units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. (State Building Code Section 108.3.5.1) DEFINITION OF HOMEWOWNER: Person(s)who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling,attached or detached structures ac- cessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other Applicable codes, by-laws, rules and regulations, .The undersigned"homeowner"certifies that he/she understands the Town of No.Andover Building Department minimum inspection p ures and r uirements and that he/she will comply with said procedures and requirements HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Town of North Andover of NORTH .1�1-¢o 1 ti 6�6 0 Building Department o - M 27 Charles Street A North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 �'4°R4reo` TIO*? 9SSACHUS�t DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit# the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, sl 56a. The debris will be disposed of in/at: e Facility location t)AA- Sign ture of Applicant zo_ � " Od Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. r �.10RTi-1 o o 4Andover o „. .,v,.. ' °4 No. gi y T OO 'y_- LA E o dover, Mass. �A COCMICKEWICK�`y oRATED pPGt-`J 7�7 4` BOARD OF HEALTH Food/Kitchen T T Septic System PERMI D BUILDING INSPECTOR THISCERTIFIES THAT... w....... ....... . ...... ................................... ..... ............................................. Foundation 0 C) has permission to erect........................................ buildings on . ...... Rough Chimney to be occupied as .. nfor provided that the person a mg this permit shall in every respect co m to the terms of the application on file in Final this office, and to the prov ns of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION ST S ELECTRICAL INSPECTOR Rough .Al.* .............................. Service 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 FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det' Location x j U7 t) No. / Date / 2 /3-�0 MQR7M TOWN OF NORTH ANDOVER ' Certificate of Occupancy $ ° ss�cMuPermit Fee $ <sE Building/Frame Foundation Permit Fee $ I Other Permit Fee $ TOTAL $ Check #. I 14 4 l. $ Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: M SIGNATURE: �C Buildin Commissioner/I26ELWor of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 14 3o fZr,,9mAT S27 Map Number Parcel Number (� 1.3 Zoning Information: 1.4 Property Dimensions: \ Zoning Diattict Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.5. Flood In tion: 1.8 Sew l DrcPosa 1.7 Water S�p1yM.G.L.C.40. 54) d ZIie�8 System: Public 0 Private ❑ Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record KFl I;l y t Name(Print) Address for Service: (1 W Signature Telephone 2.2 Owner of Record: Name Print Address for Service: p� 181 Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licet�ed Construction Supervisor: �LJ CD g 17 ��;lbo & (./ ��j�u�� /� License Number 0 y` Ams o� 7t _ /C97,/- 9 yea �v Expiration Date nature Telephone 6 < 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name /o (p M Registration Number Address LAI/ �/,� Y7? 7Yil— 9�s o as Expira�on Dat /y Si na G) re Telephone 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.......0 4 SECTION 5 Description of Proposed Work check all 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 {3FFICIALUSE ONLY . Completed by permit a licant k ... 1. Building (a) Building Permit Fee C Do Multiplier 2 Electrical (b) Estimated Total Cost of y Co m O Construction 7 b 3 Plumbing Building Permit fee(a)x (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER A ORIZATION TO BE COMPLETED WHEN NER ENT OR T CTOR APPLIES FOR BUILDING PERMIT I, 1 as O er/Authorized Agent of bject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building pen it application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name 1". Signature of Owner/A I ent Date r r NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2ND 3RD SPAN DIMENSIONS OF SILLS DMIENSIONS OF POSTS DUAENSIONS 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 Department of Industrial Accidents ' Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name- C57 A/ 7i Location: d�0®�' C-5 71 City � � G/ %� ml/9` Phone ! -K" 7 2;: Q am a homeowner performing all work myself. EDt�am a sole proprietor and have no one working in any capacity I am an employer providing workerscompensation for my employees working on this job. Company name: --- Address City Phone#: Insurance Co. Policy.* Company name- Address City: Phone# Insurance Co Policv# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 andtor one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby cerfdy and t pains an ens of perjury that the information provided above is true and correct Signature DateW,I—C)O Print name Phone# Official use only do not write in this area to be completed by city or town official' Building Dept ❑Check if immediate response is required Building Dept p Licensing Board F1 Selectman's Office Phone#: � Health Department Contact person:_ p El Other FORM WORKMAN'S COMPENSATION f Town of North Andover f µoR Q �S ,2D 16 -g6 Building Department o 27 Charles Street North Andover, Massachusetts 01845 L CO m� (978) 688-9545 Fax (978) 688-9542 9 fOCfCWw(y caus�� DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit# the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, sl 50a. The debris will be disposed of in/at: Facility location j a i Signature df Applicant i Date i; 1 i i NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. PARAMOUNT VINYL SIDING. & CARPENTRY 7 School Street MA LIC#056858 Methuen, MA 01844 Re #1 9 08659 (508) 7949950 PROPOSAL SUBMITTED TO PHONE DATE VdRd , ?7• R1TO 'a- 6 9. !� � � ) STREET JOB NAME C-19 0 41;3o /01 ST CITY, tTATE AND ZIP CODE JOB LOCATION ARCHITECT DATE OF PLANS f JOB PHONE We hereby submit specifications and estimates for: f°/� Tib f� f6 ri 16 T 4L Sol All .0411 Y17-0/0 'rte d",4- Jin/ le,4zx 2p 7-V L rJ 'fit/ / ,j -Z �s' %1L "10r15r)e vc7:A-V a L v G eyC, /r r jj T �~il od 110U 5 i i I It shall be the obligation of the contractor to obtain all permits as the owner's agent;owners who secure their own construction-related permits or deal with unregistered contractors will be excluded from access to the guaranty fund. dollars($ 4 00, 00. ). Payment to be made as follows: All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices.Any alteration or deviation from above specifica- Authorized / tions involving extra costs will be executed only upon written orders,and will become an Signature extra charge over and above the estimate.All agreements contingent uponrstrikes,accidents or delays beyond our control.Owner to carry fire,tornado'and other necessary insurance. Note:This proposal may be Our workers are fully covered by Workmen's Compensation Insurance. Withdrawn by us if not accepted within days. l }.. 1 Araptattrit of 11rapajoal—The above prices, specifit:ations DO NOT SIGN THIS CONTRACT IF and conditions are satisfact ry and are hereby accepted. You are authorized LTHERE ARE ANY B SES` to do the work as specified P y nt will be made as outlined above. Date of Acceptance: 00 Signature `—� tA®RTly own of Andover M..4 ® No. L A o dover, Mass., Awl 13 too I� COCMICMEMCK ADRATED BOARD OF HEALTH PERMIT TFood/Kitchen - Septic System THIS CERTIFIES THAT.......4ff �vI1� � ��1� S S O BUILDING INSPECTOR ............................................................................................................................................ Foundation has permission to erect...#1�y1 buildings on 30 PAvoas lw4 S w g .. ............... ....... ............................... ............. Rough V if 040 0 V� . /'� Chimney to be occupied as..... ...............�..... .......................................... ...................................................................................... 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 relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. M a sft P a:IL PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST TS Rough ........q0M.�C...CIA ............. ' Service 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 FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det. Sandra Starr From: Tim Willett Sent: Monday, July 16, 2001 1:06 PM To: Sandra Starr Subject: SEWER CONNECTION AT 430 PLEASANT ST TODAY GRASSO CONSTRUCTION IS CONNECTING HOUSE 430 PLEASANT ST TO SEWER. SOME INTERNAL PLUMBING WAS INSTALLED TO BRING THE SEWER OUTLET TO THE FRONT OF THE HOUSE. THE PREVIOUS OUTLET WAS LOCATED IN THE REAR OF THE HOUSE, HEADING TOWARDS STEVENS POND. 1 ASKED KEVIN GRASSO WHERE THE OLD SEPTIC TANK WAS, HE SAID HE DIDNT KNOW. HE THOUGHT MAYBE THE HOUSE HAS A CESSPOOL. I TOLD HIM IT HAD TO BE ABANDONED UNDER TITLE FIVE REGULATIONS, BUT HE'S CLAIMING HE DOES NOT KNOW WHERE THE TANK OR CESSPOOL IS. HE MAY HAVE TO DO SOME EXPLORATORY DIGGING. I TOLD HIM I HAD TO NOTIFY YOU OF THIS SITUATION. THE BOTTOM LINE IS THAT HE HAS NOT PROPERLY ABANDONED WHATEVER SYSTEM EXISTS THERE. PERHAPS YOU HAVE SOME RECORD OF IT THAT COULD BE HELPFUL. i Date. . I-// "I/ ORTI, o= ° °� TOWN OF NORTH ANDOVER ti 9 • PERMIT FOR GAS INSTALLATION s i s s a n0+•Ip �SSAfHUSEt This certifies that../`> . . . 1. 1 . - r, ��. < .�:. `/ .' ... . . has permission for gas installation .. . . . . . . . . . . . . . t-"" in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . at .��' ^`'�. ' ?�. . . . . . , North Andover, Mass. Fee--.. ... . . . . . . Lic. No./'��/-'F . . . r, . . . . . . . . . . . . GAS INSPECTOR / u Check# "'6f1,3 37 ' 0 MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FflTNG r 9 (Type or print) Date NORTH ANDOVER,MASSACHUSETTS Building Locations _ 1130 \ t �'V��t tJ\ -- Permit# !� //''�� \c U ` —)YV t mj Owner's Name Amount$ A-4u,rll rAz.�(D New Renovation ❑ Replacement ❑ Plans Submitted ❑ U �a a a o z z x w G w w vr� H a U a°4 a a H o SUB-BASEMENT BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR 8TH. FLOOR (Print or type){ ` �_ CjLe4k one: Certificate Installing Company Name— kY)04 Li Corp. Address - ❑ Partner. cv Business Telephone 11Firm/Co. Name of Licensed Plumber or Gas Fittera�J,�t,�� i ��e 1.4LAz, INSURANCE COVERAGE Check o I have a current liability Insurance policy or it's substantial equivalent. YE No❑ If you have checked�,please irate the type coverage by checking the appropriate b Liability insurance policy i 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 ofthe r Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ t 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 perf der Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State s C d Chapter 142 of the General Laws. By: Signature of Licensed Plumber Or Gas Fitter Title ❑ Plumber 12 � ,2 1 City/Town ❑ Gas FitterIL cense Number Master APPROVED(OFFICE USE ONLY) Journeyman 3?e O F - A a n • 4SMNUS� CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER BuildingPermit Number � Date v' b THIS CERTIFIES THAT THE BUILDING LOCATED ON—'/3, 0 /��S•4 Qu`� MAYBE OCCUPIED AS 5 O A-2fe- y t.v-e xjr IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO tJ t n- r-�n il,4 S S C) ADDRESS C Building Inspector Town . o4Andover 0% _ t-.- L A*6 dover, Mass. COCMICMEWICK V �d A�RA7E D PPS\ -`y 4 BOARD OF HEALTH MIT T PER M Food/Kitchen Septic System m BUILDING INSPECTOR THIS CERTIFIES THAT... �....... .... ...................................1110010Foundation has permission to erect........................................ buildin s on ... ...... .4.406Rough, ef W , to be occupied as .. . .................................. Chimney . . . . ................. provided that the person aing this permit shall in every respect conform to the terms of the application on file in Fina1J/� �i C this office, and to the prov ns of the Codes and By-Laws relating to the Inspection, Alteration and Construction of t Buildings in the Town of North Andover. �PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. ��"`` PERMIT EXPIRES IN 6 MONTHS ' /C--/ s- G ELECTRI AL SPEC UNLESS CONSTRUCTION ST S ou ........................................... service BUILDING INSPECTOR Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough No Lathing �or D Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner FIRE DEPARTMENT Street No. SEE REVERSE SIDE smoke Det..� 1� N TM Town of over 0 VA No. 9 = _ - 11__ C1% 0 L A o dover, Mass., kY �Q COCHICHEWICK �t oRATED vv ` BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System �+ THIS CERTIFIES THAT BUILDING INSPECTOR V�N r.� s:0 Foundation has permission to erect... �................ ............ buildings on .Jo....... .................... ................04..... ............. Rough ...... .... t0 be Occupied as..... �~ r .... .<</V..............�ra �► �� 0 w� �'" Chimney ...... . .......... ....................................................................................... _ provided that the person accepting this permit shall in every respect conformito the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the insp ction, Alteration and Construction of Buildings in the Town of North Andover. M of Sft P ;1L a PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMEXPIRES IN 6 MONTHS Final IT UNLESS CONSTRUCTION ST T'S ELECTRICAL INSPECTOR V00( Rough . ... ' Service BUILDING INSPFTOR 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. F N�TH Town of _ over 'l' L No. * �� o� y " dower, Mass., COCKICKEWICK ORATED I"P�,`�� 3 H BOARD OF HEALTH PERMIT T Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..... .V.�................... fs O ""' �� Foundation has permission to erect..... P .. .... buildings on ..... � ..�. 14 .......... ........... ................................................. Rough to be occupied as � ��DO................ 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 relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. ^ 0150W jP PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST ELECTRICAL INSPECTOR CRough ... ........... .... .................. .... . ... . . ..... ........ Service 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. FIRE DEPARTMENT Burner Street No. SEE REVERSE SIDE smoke Det' r r'- Charles Walker Y! 408 Louisiana Trail Browns Mills, New Jersey 08015 ' 1 September 28, 2000 To the Board of Appeals and the Building Inspector of the Town of North Andover: I am the record owner of the real estate located at 430 Pleasant Street, North Andover (the "Property.") I hereby authorize Gerald I. Brecher, of.691 Great Pond Road, North Andover, to apply for a Special Permit, a Variance, and a Building Permit with regard to renovation of the Property. Yours very truly, ' J Charles Walker I i 'E i i f i i� s i k I I 3 t I 1 �f I I� Date. N° 4762 TOWN OF NORTH ANDOVER ! PERMIT FOR PLUMBING j i y SACNUS� This certifies that . .�.f.�?K 6J.�. . . . .I .�Z.6�!cL, c G r has permission to perform . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . . at . . . . . . . . . . , North Andover, Mass. Fee. 1 f . . . .Lic. No.. . . . . . . . . . . . PL IVIBING INSPECTOR Check # 3 `� WHITE: Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS ) i1 Building Location Vl�O (�l Owners Namei��N 1fa�Sl� Permit# Amount Type of Occuanc New Renovation Replacement Plans Submitted Yes No El �'� FIXTURES z z w a o z EA Q � E d' ►., �. d r4 ►a A A r� ra d � A l S(EI1IM M H-OCR M IFLOC R 3M RDCR 4IH HfXR 5'M)H fM 6M R OCIR Mi FLOM SIH PIDOR (Print or type) QU,-aia Check one: Certificate Installing Company Name\ Osam - \,9,OJ�AL Corp. Address lend ��'`� G�0'i e— Partner. \fie-`L\2,► e\ Business Telephone 79 S' E Firm/Co. Name of Licensed Plumber: �OrJ�t``� U\�l�\J u,,fLZ Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy c 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 subm' (or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installa' ns need under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachus S ing Code and Chapter 142 of the General Laws. a By: �gna o icen um er Type of Plumbing License Title A61 (0 City/Town License Number Master ® Journeyman APPROVED(OFFICE USE ONLY �No 2921 Date....` ... ..�.�.:°.......... '. HORTM - °ft"' TOWN OF NORTH ANDOVER ° 3 L O A PERMIT FOR WIRING CHU • This certifies that . �// :: ...... has permission to perform%f�:`..::.'� ......................................... wiring in the building of . ........ 1 ......................................... at..........................................................."?4 ..f.............`'r `......'. :.......�... ,North Andover,Mass. ................. fee..................... Lic.Nod ��,� ...........7r1\ �. ........................ / ELECTRICAL INSPECTOR Check # WHITE:Applicant CANARY: Building Dept. PINK:Treasurer DEPARTALENTOFPUBLICS MY Permit No. BOARD 0FFIREPREVEN770NRWU ATIONS 527CMR 12:00 Occupancy&Fees Checked UVPPUCATIONFOR PERMIT 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 „7`,�o 6 1 Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) Hao Las-nn-7 Owner or Tenant keuf,t\( C-Yi Zlq� LG�.�� Owner's Address Is this permit in conjunction with a building permit: Yes No M (Check Appropriate Box) Purpose of Building c F . F) Utility Authorization No./-212 4 Existing Service �� Amps O /D4OVolts Overhead Underground Q No.of Meters l New Service aL 0 Amps p�O�Volts Overhead ® Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work' No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA ground ground No.of Receptacle 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 No.of Dryers Heating Devices KW Local Municipal Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER tr>stra=Caaage:R ttbthecagt>gart afTvlassadxsetlsGaia�alLaws ItmeaamtLiabt1dyh>ua=Po yni&gCar�e��Co oritsskstfft lec�Mknt YES NO Ihaw abnftdNOW plu0f0fs3n1e10 eO&1-YES 1 ti iijNO r If}atha%edoJWYES,pkwee thetAxcfwmaWbydrd4gthe > � dBOND p OTI-IER p ftwe ) E*altimo��... Fs� dVahx o& vJ v WaktDSlatt I hq)ecdmDa�R��a F'aral F RM NAME O ItC) s'. t�C �-- LitenseNaLE-- 3S"6o2,1- L ffEm 1-U V�r J PA Y?-4/ s S so-a>tne Bt&MTel.Na 603 7 20- 3,M 1 Add�—C(o „�mA YQ 5-77 ��1 Z,G�. /l� - 3 a 7 9 AkTel.Na OWNER'SINSURANCEWAIV ;lamawmdrttleLiomdo txk vet;lehmamecaea@eorAsst>I 1 it'I- riva ntasm#rdbyMassadxs&Gaini Lam and fixtmys nr zeatthispami<t imVM*%sItistechteement. (Please check one) Owner a Agent v Telephone No. PERMIT FEE$ �;(,S Location �3L) McASA AJ No. Date NORTH TOWN OF NORTEK ANDOVER 0� .eo r ,ti h � 9 Certificate of Occupancy $ �SSACMUsBuilding/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 6 Z— Check # 14450 BOO TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING %�" BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: C Building Commissioner/I for of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Al,L ! AIA Map Number Parcel Number A 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area(sf) Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.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 Record Name(Print) Address for Service Telephone Signature Tele p Q7 �1` q- S-0 2.2 Owner of Record: / l D` Y 7 j`ajl Name Print Address for Service: z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ VE-W 4-s6_d-qz-z-L/1'c z- &Z2g Licensed Construction Supervisor: ` v/ / `��?1 4 ` O1 7T Wn (j License Amber Add (/ _ Expiration D to Signatu Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Regis ration Number 7'5�g Address7,9 Expir on Date Signature Telephone yY � 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. Si ned affidavit Attached Yes.......❑ No.......❑ SECTION 5 Descri tion of Proposed Work check all a h'cable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition 0 Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar) be ' ( )to ,F {FFICIr4 L C1SE ONLY M Completed by pennit a 11Cant ,,.•, .,. .�.... ,+, •,r,�•....« s:, .ter ., .,: : • ;a.._ 1. Building � � e17,15' (a) Building Permit Fee ONIX Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing .Building Permit fee(a) X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CON CTOR APPLIES FOR BUILDING PERMIT �f 1 1, as Owner/Authorized Agent of subject property Hereby authorize to act on r My behalf,in all matters relative to work authorized by this building penmit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, as Owner/Authorized Agent of subject property Herebv 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 of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1ST2ND 3PD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIIMENSIONS 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 NORT#q Town of over o o y dover, Mass. DO COC HIC KEWICK ORATED S H BOARD OF HEALTH PERMIT T Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT ........................ S� Foundation has permission to erect... "Sets, .. 0 buildin s on ......... U 14 p ..... g � �. .............. .................. Rough .... ....... .......... .... .. to be occupied as....Rap plA Cf1 ~d* WW' .................................... .............................................................. ..�.o .... 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 relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. M 0150W to PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STAIVaS ELECTRICAL INSPECTOR Rough \ C . .. ............. ................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in -a Rough Conspicuous Place on the Premises — Do Not Remove Final 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. NORTH � F T0" . o _ 4Andover • f'� rY No. " o " dover, Mass., COCMICHEWICK 7� ORATED S H BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT V r� I�......... S ......................� ... O �� Foundation has permission to erect..... ... buildings on .....x`30 . Rough to be occupied as Rt Pi �om �'�00Chimney .... .................. ................. ............................................................................................... ..................... 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 relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. M 0/50M P PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST \ Rough Service// ........... .........................................................40004 Service 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 FIRE DEPARTMENT Until Inspected and Approved by the Building .Inspector. Burner Street No. SEE REVERSE SIDE smoke Det.