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HomeMy WebLinkAboutMiscellaneous - 44 ANDOVER STREET 4/30/2018 44 ANDOVER ST
2101059.000.0
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North Andover Board of Assessors Public Access Page 1 of 1
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North Andover Board of Assessors
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SSS"eMOS�` roperty Record Card
Click Seal To Retum Parcel ID:2101059.0-0025-0000.0 FY:2013 Community:North Andover
SKETCH PHOTO
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Summary
Residence
Detached Structure
Condo 44 AXWM ON ET "
Commercial
Location: 44 ANDOVER STREET
Owner Name: APPLEGATE,LETA&WILLIAM
Owner Address: 44 ANDOVER STREET
City: NORTH ANDOVER State: MA Zip: 01845
Neighborhood:6-6 Land Area: 1.24 acres
Use Code: 101-SNGL-FAM-RES Total Finished Area: 4245 sgft
ASSESSMENTS CURRENT YEAR PREVIOUS YEAR
Total Value: 781,600 719,700
Building Value: 571,200 511,000
Land Value: 210,400 208,700
Market and Value: 210,400
Chapter an Value:
LATEST SALE
Sale Price: 835,000 Sale Date: 08/16/2004
Arms Length Sale Code: Y-YES-VALID Grantor: WERNER,JONATHAN
Cert Doc: Book: 8993 Page: 239
http://csc-ma.us/PROPAPP/display.do?linkId=2253841&town=NandoverPubAcc 3/26/2013
!I
Residential Property Record Card
PARCEL_ID:210/059.0-0025-0000.0 MAP:059.0 BLOCK:0025 LOT:0000.0 PARCEL ADDRESSA4 ANDOVER STREET FY:2013
PARCEL INFORMATION Use-Code: 101 Sale Price: 835,000 Book: 8993 Road Type: T Inspect Date: 05/05/2011
Tax Owner: - - YP 9. - - - -. ---.... 512011
APPLEGATE,LETA&WILLIAM Tot Fin Area: 4245 Sale Tss' T Sale ate' P8l16/04 Certll7oc: 239 TrafficRd ndition M
Entrance: C5/0
Address: Tot Land Area: 1.24 Sale Valid: Y Water: Collect Id: RRC
44 ANDOVER STREET Grantor" WERNER,JONATHAN Sewer. Inspect Reas: C
NORTH ANDOVER MA 01845 Exempt-B/L% / Resid-B/L% 100/100 Comm-B/LP/o Indust-B/L% / Open Sp-B/L% !
RESIDENCE INFORMATION LAND INFORMATION
Style: CL Tot Rooms: 11 Main Fn Area: 1935 Attic: Y NBHD CODE: 6 NBHD CLASS: 6 ZONE: R3
Story Height: 2.35 Bedrooms: 6 Up Fn Area: 2310 Bsmt Area`. 1320 Seg Type Code Method Sq-Ft Acres Influ-Y/N Value 'Class
Roof: H Full Baths: 4 Add Fn Area: Fn Bsmt Area: 1 P 101 S 43560 1.000 208,621
Ext Wall: FB Half_Baths: Unfin Area: 180 Bsmt Grade: 2 R 101 A 0 0.240 1,824
Masonry Trim: Ext Bath Fix: 0 Tot Fin Area:- 4245 DETACHED STRUCTURE INFORMATION
Foundation: ST Bath Qual: M RCNLD: 549562 - Str Unit Msr-1 Mir-2 E-YR-Blt Grade Cond%Good P/FJE/R Cost Class'
Kitch Qua 1: M Eff Yr Built: 1980 Mkt Adj: B5 S 1452 0.00 1957 A A 50///50 20,400
i Heat Type: FA Ext Kitch: Year Built: 1827 Sound Value: PT S 210 0.00 1988 A A !/!85 1,200
Fuel Type: G Grade: VE Cost Bldg: 549,600
Fireplace: 3 Bsmt Gar Cap: Condition: G Aft Str Val1: VALUATION INFORMATION
Central AC: _Y Bsmt Gar SF: Pct Complete: 4 Att Str Va12: Current Total: 781,600 Bldg: 571,200 Land: 210,400 MktLnd: 210,400
Aft Gar SF: %Good P/F/E/R: /100/185 Prior Total: 719,700 Bldg: 511,000 Land: 208,700 MktLnd: 208,700
' Porch Type Porch Area Porch Grade Factor
S 392
E 16
SKETCH PHOTO
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432 q.Ft
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36 36
4 1V Sq.F 4
14-
FU-M75/FU/FM/ S
1320 Sq.Ft 392 5 q.Ft
30 Be 28
0
44 ANDOVER STREET
44
Parcel ID:210/059.0-0025-0000.0 as of 3/26113 Page 1 of 1
GIJILll U a Gas®
of Massachusetts
A NiSource Company
995 Belmont Street
Brockton,MA 02301
February 28,2013
Ms. Leta Applegate
44 Andover Street
North Andover, MA 01845
Dear Ms. Applegate:
During a recent visit, our service technician detected a safety problem with your gas
heating system at 44 Andover St.,North Andover,MA 01845—burn off from flue going
raight back into basement. Accordingly,we have issued a Warning Tag because of this
situation.
Under the circumstances,we strongly urge you to correct the code violation. In addition,
the Massachusetts code pertaining to the installation of gas appliances and gas piping,
established under Chapter 737,Acts of 1960, requires that the condition be remedied.
I
If you have any questions,please call our Service Department at 1-800-677-5052 and ask to
speak with the Service Supervisor.
Please disregard this notice if the condition has been corrected.
Sincerely,
Customer Service Department
Columbia Gas of Massachusetts
I
i
Date V�.,.�. . . . .
.-
� b�1'1LTsD
•. TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
` This certifies that . .Se.
has permission for gas installation . . �AvQ- J.A't-C_. ?�? �
f {
in the buildings of. � . , 4c . . . . . . . . . . . . . . . . . . . .
at . . . .�.�. . ..A,�CDNA-A. . ,North Andover, Mass.
Fee .- . . Lic. No. 1�aa
GASINSPECTOR
Check#_2-6P5
8593
J
MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK
CITY Q( An,c�nw�r- _ _ MA DATE PERMIT#
f
JOBSITE ADDRESS ! OWNER'S NAME L QT
GOWNER ADDRESS sp. TELr __,IFAX[ _ �
TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL® RESIDENTIAL49
PRINT
CLEARLY NEW:J RENOVATION:© REPLACEMENT:NJ PLANS SUBMITTED: YES Q NOE]
APPLIANCES Z FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14
BOILER
BOOSTER
�J
CONVERSION BURNER
COOK STOVE
DIRECT VENT HEATER
DRYER
FIREPLACE
FRYOLATOR
FURNACE �_j i !L- _- --
GENERATOR
GRILLE
INFRARED HEATER
LABORATORY COCKS
MAKEUP AIR UNIT _. _ I Il— .�_. ., L �I. G — -- - I
OVEN -
POOL HEATER
ROOM/SPACE HEATER _ I
ROOF TOP UNIT
TEST
UNIT HEATER
UNVENTED ROOM HEATER
WATER HEATER
OTHER
INSURANCE COVERAGE
have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES JER NO E
1 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW
LIABILITY INSURANCE POLICY Pg OTHER TYPE INDEMNITY ® BOND El
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 _i AGENT
SIGNATURE OF OWNER OR AGENT
hereby certify that all of the details and Information I have submitted or entered regarding this 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 compl' nce with all ertinent provision of the
Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
PLUM BER-GASFITTER NAME( LICENSE# ice? _ SIGNATURE
5r(
MP N MGF[ JP [ J� JGF LPGI CORPORATION Q# PARTNERSHIP # LLC[ k#
I
COMPANY NAME: Scor-. 1I�, I ADDRESS IO L-A _----__-_�.____
CITYac.e �j;( --- -- - _ STATE /x'1,4 ZIP
FAX __�T4 I CELLr----- =--- I EMAIL kIVS C-U` n•-T--- -._... - - ---
ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES
Yes No
THIS APPLICATION SERVES AS THE PERMIT ❑ ❑
FEE: $ PERMIT#
L' 2��� PLAN REVIEW NOTES
The Commonwealth of Massachusetts
Department of IndustrialAccidiints
Office of Investigations
600 Washington Street
Boston,MA 02111
UV www.massgov/dia
Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers
Applicant InformationII', Please Print Ledbly
Name(Business/Organization/Individual): r t1 ry )-fin 4.�
• i
Address: /o c vim. L Aix
i
City/State/Zip: Mezw,�,'U Phone#: 977 F94 004
Are you an employer?Check the appropriate box: Type of project(required):
1.❑ I 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.N I am a sole proprietor or partner- listed on the attached sheet.t �• E]Remodeling
ship and'have no employees These sub-contractors have 8. ❑Demolition
working for me in any capacity. workers'comp.insurance. 9. ❑Building addition
[No workers' comp.insurance 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions
required.] officers have exercised their
3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑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 outthe section below showingtheir workers'compensation policy information.
i Homeowners who submit this affidavit indicating they aie 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:.
i
Policy#or Self-ins.Lie.#: Expiration Date:
Job Site Address: City/State/Zip:
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-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
Investigations of the DIA for insurance coverage verification.
_ I
I do hereby cert un derfiik epains andpenalties ofperjury that the inform ation pro vided above is true and correct
Si ature: Date:
13 ,
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 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 cbapter 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
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
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 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 ciuestions,
please do not hesitate to give us a call.
The Department's address,telephone and fax number:
The COMM011weatthofMassachusetts
Department of Industrial Accidents
Office ofIavestigatim,
600 Washington Street
Boston,MA 02111
Tel,#61.7-727-4900 at.406 or 1-877-MASSAFE
Revised 5-26-05 Fax#617-727-7749
www-mass,govfdia
�4
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OF MASSAC ustz
I'LttIIIBEC;S AtV.0 MFITT.ERS
i( ENS D .AS 4.4NIASTERIPLUMBEC�
a =: ISSUES THE'�A80VE LICENSE TO- ,
�..
MA
tIAVERH;Ij_L_ y018;:, 72:0 _
f 0 /01/14 1725-05
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,._. .
Fold,Then Detach Along All Perforations
Date..................................
NORTH
0 TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
Thiscertifies that .............................................................................................
has permission to perform ....
L................................................................
j�qA)DLE 6:�47Z�7—
wiringin the building of...................................................................................
at.......................................................
North Andover,Mass.
A ..............d2i�
Fee.... ........ Lic.No.............. ................................................ .......Q...
ELECTRICAL INSPECTOR
Check #
7912
Commonwealth of Massachusetts Official Use Only
HELMDepartment of Fire Services Permit N°. ��1�
r 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(MEC),527 CMR00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: I Z I Z TO
City or Town of: NORTH ANDOVER To the Inspector of Wires
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number) 4-jcl &L dOLLe f' S }
Owner or Tenant _`•t;•f� �Qp I ECS�c Telephone No.
Owner's Address •5 or M c--
Is
Is this permit in conjunction with a building permit? Yes L] NoF Zzy— (Check Appropriate Box)
Purpose of Building r 4"44.0
p•P0 cQ a Utility Authorization No.
Existing Service Amps / Volts Overhead Undgrd❑ No.of Meters
New Service 2 Amps /20 /zy0 Volts Overhead❑ Und rd
g No.of Meters I
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work: E— FEE
E E p DEL Se-ryj ,r.e- t�
'
Completion 4rth,followingtable may be waived hy 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 KVA
No.of Luminaires Swimming Pool Above ❑ In- El
Emergency Lighting
rnd. rnd. BatteoUnits
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners No.of Detection and
InitiatingTo—taDevices
No.of Ranges No.of Air Cond. Tons l No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Total "" " - _._....._..__._............ Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local Municipal
El El Other
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water No.of No.of
KW Data Wiring:
" Heaters Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
No.of Devices or Equivalent
OTHER GLC e/V
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
undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: fNSURANCF6P1--BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application R true and complete.
FIRi14 NAME: Va r`O�Oh�' �l�I)-/c a f' G°c1r17` LIC.NO.: I I (o ce
Licensee: _6tf—p11.iPy\ -:Y Ncg Signature k%J, � p LIC.NO.•�- kS(
(If applicable,enter"exempt"in the license numb r line.) � — c N 7
us.Tel.No.- �
Address: _10 a W r r,,rin-p S'Ae/6 <! kIk Alt.Tel.No.:
*Per M.G,L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.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:$ 5 j S
Date.
Of 41 MORTM TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
SSACMUSE� /L
This certifies that . . .
has permission to perform . . . . . . . . . . . . . . .
plumbing in the buildings of . a . . . .
at . . . . . . . .:'-
orth Andover, Mass.
Fee a' . . . .Lic. No.�4 ,,a�J, �,' fcn
C �PLUM81NG-IvSPECTOR
Check #
6923
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER,MASSACHUSETTS IZ�v�Q
C� Date
Building Location /7 � U(/l- 'T/�2T Permit
Amount
Owner^�> [LL
i
New Renovation Replacement ❑ Plans Submitted Yes No
FIXTURES
i
SLSBM. /
RWNM
la HAOM
2ND FUM
4M KfM
5MFLOCR
6M»
7M F10M
9MFLO(R
(Print or type) Check one: Certificate
Installing Company Name / kl i (j ❑ Corp.
Address E Partner.
Business Telephone y _�,y �Firm/Co.
Name of Licensed Plumber:
Insurance Coverage: Indicate h type of insurance coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity D Bond ❑
Insura aiv : 1,the undersigned,have been made aware that the licensee of this application does not have any one of the above
thr
i
re Owner D Agent D
I hereby certify that all of the details and information I 2ha submitted(or entered)in above application are true and accurate to the
best of my knowledge and that all plumbingwork an latio performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Mas s ate lu��Code and Chapter 142 of the General Laws.
BY19
ig re o icense um er
Type of Plumbing License
Title 7
City/Town L License Master � Journeyman D
APPROVED(OFFICE USE ONLY
v
Date. .` : .� ..0�?.... .
N°RTM
pF .ao ,°1ti0
of TOWN OF NORTH ANDOVER
F .� P
• PERMIT FOR GAS INSTALLATION
• ° a
SACMUSE�Sy
This certifies that !. . . . . ��. . . . . . . . . . . . . .
has permission for gas installation . . . . . . . . .
in the buildings of . . . �J. . . . '/f. . . . � . . . . . . . . . . . . . . . . . .
.
at . �?'� . . . . . . . . . . . . . . . . . . .. North Andover, Mass.
Fee:3P,`�. Lic. No i? / ,.�.. . . . . . . . .
Cl GAS IN5EC R
Check#
5525
VIASSACHL SETTS LiNIFOMI APPUCATON FOR AMU TO DO GAS FT
NG
(Type or print) Date �Z
NORTH ANDOVER,MASSACHUSETTS
Building Locations wAf4fUer 5� Permit ff
Amount$
Owner's Name .A �T CC 6AT125/
NeW( Renovation Replacement ❑ Plans Submitted
U
> F
I F � G1
3 4 0 1 0
SUB •BASEM ENT
BASEM ENT
1ST. FLOOR
2ND . FLOOR -
3RD . FLOOR
4TH . FLOOR
5TH . FLOOR
6TH . FLOOR
7TH . FLOOR
8TH . FLOOR rF-F-I
(Print or typea/,� ,�L�`�� � v����I � � , �r`� C one: Certificate Installing Company
Name (�(/ /, i Corp.
Address T ❑ Partner.
Business a ep one y •gip -07- Finn/Co.
Name of Licensed Plumber or Gas Fitter
1NSLRANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑
If you have checked yes,please indicate the type coverage by checking the appropriate box.
Liability insurance policy Of-- 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:
Signature of Owner or Owner's Agent Owner 13—Agent ❑
t 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 installati s erfo d under Permit I tied for this application will be in
cc:mpliance with all pertinent provisions of the Ntassachusett State Gas ode 4 d Chapter 2 of the General Laws.
By:
Signature of Licensed Plumber Or Gas Fitter
Title ❑ Plumber
City/Town Gas Fitter 'License Number
. Iaster
Journeyman
APPROVED iCt•FICE[;SE 0,NLY,
Date......7. ..7..,&P-4
NORIH
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
SS US
This certifies that ....... .......1'f ���' ���`G o
has permission to perform �,bD�l 1 U�
.......... .......... ...................................................
f�pL G�%�
E wiring in the building of..�........................�..............................................
j at...... t � ..........5.�
. ...............,
North Andover Mass.
Fee...��.......... Lic.No. f 2 32,4
.......... .
... I.......... .
j ELECTRICAL INSPECTOR . .•
` {Check # `
- 6776
IS\ Commonwealth of Massachusetts Official Use only
_ Department of Fire Services Permit No. -7 74:�
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev.11/991 leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT ININK OR TYPE ALL INFORMATION) Date: '7-,19-06
City or Town of: IV* 8wr)aV&A� To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number) 4 -A),0191167L 37
Owner or Tenant W/ J/j/ A ,64k!D L,5TA jgP,01EGQ V Telephone No.
Owner's Address S�AA4 0
Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box)
Purpose of Building IRC-5JAt5k1jA L 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: 00•/,7'-1,61�/
r
�
L;-y--6K //OU A,1 S 0"eAd- j4*0 gw e I�5 T l-'alDor
Completion of the followin table may be waived by the Inspector of Wires.
No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans No.of Total
Transformers KVA
No.of Lighting Outlets g' No.of Hot Tubs Generators KVA
No.of Lighting Fixtures Swimming Pool Above ❑ e; ❑ ato.o Units Emergency Lighting
� rnd. rnd. Batte 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
(i� Initiating Devices
No.of Ranges No.of Air Cond. Total No.of Alerting Devices
Tons
No.of Waste Disposers Heat Pum Number Tons KW No.of Self-Contained
Totals " ' ... ................... Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other
Connection
No.of Dryers Heating Appliances Kir Security Systems:
No.of Devices or Equivalent
No.of Water , No.of No.of Data Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Ter
Wiring:
/ No.of Devices o or E uivalent
OTHER: , �—x N AUS-" r'Aw s ��7r/ 2G� 1
Attach additional detail ifdesi ,or as required by the Inspector of Wires.
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 cove age is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:)
(Expiration Date)
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: '7- 9 Q 4, Inspections to be requested in accordance with MEC Rule 10,and upon completion.
I certify,under the airs and penalties of perjutny,that the information on this application is true antfcomplete
FIRM NAME: Q (,J r Iq)AlIC 14L16IC.NO.:*fj�/3�
Licensee: SignatuIIC. NO.:
(1fapplicable,enter"exempt"in the license number line.) Bus. l"el.No. 79-f 5-1-
Address:
/-Address: Alt.Tei 1.No.:"7kI-$Z0-971Ag
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not hme the liability insuranhe coverage normally
required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner owners ent.
Owner/Agent
Signature Telephone No. PERMIT FEk-- $
��Q� Pp-zt,
Location �y
R No. �"oDate
t MopT:�h TOWN OF NORTH ANDOVER
o
N41
9
Certificate of Occupancy $
Building/Frame Permit Fee $
s�CHU
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
Check # /y3
18 68
Building Inspec
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REP RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING
BUILDING PERMIT NUMBER: DATE ISSUED.
26 X
SIGNATURE:
Building Commissionerfing=Wr of BmIdings Date Z
SECTION 1-SITE INFORMA'T'ION
1.1 Property Address: 1.2 Assessors Map and Panel Number: O
q� A.IU�DV�� 5i��ET+
Map Number Parcel Number
1.3 Zoning Information: 1.4 Propety Dimensions:
A- Re—it dr yuh AL-- D/'1 , Aod '
Zoning District Proposed Use Lot Fronto ft
1.6 BUILDING SETBACKS ft
Front Yard Side Yard Rear Yard
Reqtired Provide RMjirW Provided ReqWred Provided
Ia
0 30
1.7 water Supply MGd..C.40. 54) 1.5. Flood Zone Information: _ 1.8 sewerage Disposal system:
Public Private 0 Zone Outside Flood Zone ❑ Municipal On Site Disposal System 0
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes L---No M
2.1 Owner of Record
SII (14M4 A no�e�ai�e 44 ANboyE2 STREF-T-
Name(Print) Address for Service:
e
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service:
Z
M
Signature eepone
SECTION 3-CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor: Not Applicable ❑
W1 H Iw M PO&OYL Ge e9 L C0WtA0dlW&,5Qa(,G C S 6 9 3 q r7
Licensed Construction Supervisor: O
O tent A WQ ,/� License Number
Yv[J V
ddress
lj�/"
Eviration ETaic i
ignature Telephone r
j
3.2 Registered Home Improvement Contractor Not Applicable ❑ v
W1111om Pu b Gr we. c.Cy Kri r2AM►��,
Company Name 0?70/ m
/ Registration Number r
2turme
ssE Telephone Y I
i
i
s • L
SECTION 4-WORKERS COMPENSATION(1VLG.L.C 152 § 25c(6)
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result y
in the denial of the issuance of the building it.
Signed affidavit Attached Yes......Nit No.......0
SECTION 5 Description of Proposed Work check all applicable)
New Construction ❑ Existing Building A Repair(s) Alterations(s) ❑ Addition X
Accessory Bldg. ❑ Demolition `, Other ❑ Specify
Brief Description of Proposed Work:
5� kl-Jl' IM44yr kLd-s ' scLi�d1l L-.S
0
SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar)to be UFFIGIAti ISE(}NIY
Completed by permit applicant
1. Building (a) Building Permit Fee
Multiplier
2 Electrical (b) Estimated Total Cost of
Construction
3 Plumbing Building Permit fee(a)x(n)
4 Mechanical HVAC DA Da
5 Fire Protection .500
6 Total 1+2+3+4+5 azo Check Number
SECTION 7a OWNER AUTHORIZATI N TO BE COMPLETED WHEN __T
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
1, I U 1 N't ���li� W�Q ''1--f-*t er/Authorized Agent of subject property
Hereby authorize ( � (t/+Wt Q�{qy� to act on
My behalf,in all matters rela,}ve to work autho
2pad by this building permit application.
Signature of Owner Date
SECTION 7b OWNERJAUTHORIZED AGENT DECLARATION
1, W1/(144K TG0f4Z.6&► 1: (d!J
6VC,1-6-4C 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
Id bd belief
(t I 0 t�1y
P Nanr \J
/�(2�
e b '�'
a e O Ler/Agent Date
NO.OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TBMERS Isr2ND 3RD
SPAN
DIMENSIONS OF S1I.LS
DR ENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CHI1VMEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
�AORTH
Town of : 4 over0
-
No. _
LA E dover, Mass., - °
,q� COCHICKEWICK
7,9 A�'�A rE o APS` •(�
S E BOARD OF HEALTH
PERMIT T Food/Kitchen
Septic System
/ BUILDING INSPECTOR
THIS CERTIFIES THAT................................4b......*Ig
..... ....................... .............................................................. Foundation
has permission to erect...................................... ...... ..... ...... ................. Rough
Aaw mow
to be occupied ................7MlMi� Chimney
...... ................ ............... .
provided that the person accepting this permit shall in every respect conf o the terms of the application on file in Final
this office, and to the provisions of the Codes and By-Laws relating to th nspection, 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 CONSTRUCTIO STARTS ELECTRICAL INSPECTOR
Rough
............. � ... .. .... ... Service
.. ... .. .. . . ...... .........
BUIL ECTOR
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. Bumer
Street No.
SEE REVERSE SIDE Smoke Det.
a
Building Dept
North Andover,Massachusetts Friday,January 27,2006
Building Dept;
Attached Is the proposed plot plan for 44 Andover Street the building Inspector requested
as of our meeting at 1:00pm 1/27/06.He has one copy of the Architectural and structural
drawing along with another accepted Building secretary along with the permit and historical
society sign off and all other documents required to date by the Building Inspector.
Please call me to handle any question or requests. If you could provide a receipt for the Mr.
Godin I would appreciate It.
Cordi
William Po eneral Contracting Services,LLC
10 Lacy Stre
North Andover,Massachusetts
CC:applegate
4
I
I
f t i
CER77FIED PLOT PLAN
�jN OF MASS
PREPARED FOR:
WILLIAM & LETA APPLEGA TE *IS
AT R NO. 35773
44 ANDOVER STREET ��/ s
SAL LAS
NORTH ANDOVER, MA.
NORTH ESSEX REGISTRY OF DEEDS: BK. 8993 PG. 239
ASSESSOR'S MAP: 59, LOT 25 ZONING.• RES 3 i
SCALE-1"=50' DA 7E. DECEMBER 28, 2005
NOTE. SETBACKS TAKEN TO CORNERBOARD.
CAPPED
IRON ROD
FN D.
'I
300.00'
N05°32'30„E
J
b
()tcp O
� (Jt
LOT 1 r
0 54, 755 SF.
1.26 AC. SCRLEN
PORCH 22.6' rh
EXISTING o "1
DWELLIN y
N0. 44� p �y
_
POSED
J 21,6'y
G4
0-10
BARN
ILm
y
CSO J O i
J.— S13°29'52"W 133.20' VC' S12-52'15"W�A 155.88'
PREPARED BY.•
JOHN ABAGIS & ASSOCIATES, PROFESSIONAL LAND SURVEYORS
9 BARTLETT STREET, NO. 252, ANDOVER, MA. (978)-688-4899
JOB NO. 5383
CER77F/ED PLOT LLAAAA
PLAN
PREPARED FOR. OF
WILL/AM & LETA APPLEGA TES All S Enr
AT o N0. 35773
44 ANDOVER STREET ���a1VpLLAW
NORTH ANDOVER, MA.
NORTH ESSEX REGISTRY OF DEEDS: BK. 8993 PG. 239
ASSESSOR'S MAP: 59, LOT 25 ZONING. RES 3
SCALE. 1 x=50' DA 7E. DECEMBER 28, 2005
NOTE: SE78ACKS TAKEN TO CORNERBOARD.
CAPPED
IRON ROD
FND.
'
300.00
t405-3f 30„E
J
cncn O
Z v!
J N
U
LOT 1 Fli
0
54,755 SF.
`{ 1.26 AG. SCREEN
PORCH 22.6' r�
EXISTING 0o "1
b LLIN y
N0. 44� O
J 21.6'+
W
J v BARN
ca
L4 L4
!—
Sl 3-29'52"W 133.20' M -512'52'15"W” 155.88'
PREPARED BY
JOHN ABAGIS & ASSOCIATES, PROFESSIONAL LAND SURVEYORS
9 BARTLETT STREET, NO. 252, ANDOVER, MA. (978)-688-4899
JOB NO. 5383
i
'
ACQn~ CERTIFICATE OF LIABILITY INSURANCE DATE(MM
1 237
20/YY"06
PRODUCER THIS CERTIFICATE IS ISSUEDAS A MATTER OF INFORMATION
Circle Business Insurance Agency Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER.THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
247 Newbury St. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Danvers, MA 01923
978-777-7030 INSURERS AFFORDING COVERAGE NAIC#
INSURED William Pogor General Contracting INSURER A ESSEX INSURANCE CO
Services, LLC INSURER B:
10 Lacy St INSURER C:
North Andover, MA 01845 INSURER D:
978-685-2425 INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTEDBELOWHAVE 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
MAYPERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
POLICY EFFECTIVE POLICY EXPIRATION
LTR NSRD TYPE OF INSURANCE POLICY NUMBER DATE MM/DD/YY! DATE MWOD LIMITS
GENERAL LIABILITY EACH OCCURRENCE $ 1 OOO OOO
luHtNItU X COMMERCIAL GENERAL LIABILITY PREMISES(Ea ocanence) $ 50 000
CLAIMS MADE 1 X 1 OCCUR MED EXP(Any oneperson) $ excluded
A 3CS2317 8/19/2005 8/19/2006 PERSONAL&ADV INJURY $ 1,000,000
GENERAL AGGREGATE $ 2 OOO OOO
I
GEMLAGGREGATE LIMIT APPLIES PER: PRODUCTS-COMPIOPAGG $ 1,000,000
PRO-
POLICY JECT LOC
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMIT
ANYAUTO (Ea accident) $
I
ALLOWNED ALTOS BODILY INJURY
SCHEDULED AUTOS (Per person) $
HIRED AUTOS BODILY INJURY
NON-OWNED AUTOS (Per accident)
PROPERTY DAMAGE j
(Per amdent) $
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $
ANYAUTO OTHER THAN EAACC $
AUTO ONLY: AGG $
EXCESSIUMBRELLA LIABILITY EACH OCCURRENCE $ `
IOCCUR CI CLAIMSMADE AGGREGATE $
$
DEDUCTIBLE $
i
i RETENTION $ $
WORKERS COMPENSATION AND
X TORY LIMITS ER
EMPLOYERS'LIABILITY
ANY PROPRIELORMARTNER/EMCt1TNE T.B.D. 1-13-06 1-13-07 E.L.EACH ACCIDENT $ 100,000
B OFFICERIMEMBER ExCLI-DED? E.L.DISEASE-EAEMPLOYEE $ 100,000
Ifyes,describe under
SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $ 500,000
OTHER
I
I
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BYENDORSEMENT I SPECIAL PROVISIONS
PROJECT: 44 ANDOVER ST. NO. ANDOVER MA
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION
TOWN OF NORTH ANDOVER DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN
400 OSGOOD STREET NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL
BUILDING DEPARTMENT IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR
TOWN HALL REPRESENTATIVES.
NORTH ANDOVER MA 01845 AUTHORIZED REPRES AT
AXED 9-685-2425
ACORD25(2001108) ACORD CORPORATION 1988
SENT 81::.NORTH ANDOVER & FOSTER INSURANCE;9786866410; DEC-6-05 1 :54PM; PAGE 1/i
S•
MOW,. CERTIFICATE OF LIABIUTY'I,. ' URANCE ITE
oos
PRODOCER TMIS.• FICA •IS ISS,UED AS A MATTETION
NORTH ANDOVER INSURANCE AGENCY, ZNC ONL11i.` D CONFERS NO RIGHTS UPONCATE
MOII) THIS FrERTIFICA?E DpES NOT AOR
.9 WAVIERLY ROAD :Al CO E AFFORDED BY TM PW.
:NORTH ANDOVER NA 01845-2415S15URERS AFFORDING COVE
' I
INSURt p SURER Il: 1`ZONXX: GRANGE NIIJ?UAL
iSmall Electric iMFIER
9 Waverly Road dYBRIRER
North Andover MA 01845- R
COVERAGfS`�
THE POLICIES OF INSURANCELtSTEO BELOW HAVE BEEN ISSUED TO THE INSUI NAM dV'E FOR:1rIiE POLICY PERIOD INDICATED,NOTWITM ANI IING ANY
REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH R TO WHICH THIS CERTIFICATE MAY BE ISSUED OR AAY ERTAIN,
THE INSURANCE AFFORDED;SY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO A- E TERMS; EXCLUSIONS AND CONDITIONS OF S H OLICIES.
AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
MMI TYPEOF INSURANCE POLICY NUMEER PONCY VIDUUOY'i PIRATt011 LIMITS
LTR
QENERALLIABILITY / / / / EAr.HODCURRENCE t 1,P00,000
K COMMEJtCUIL GENERAL'IAEILrrY FIRE DAMAGE M 0"Ift) 000,000
A CLARAsMADE X occuR N"41596 09y13/2•. 5 :0911-'j/2006 MED EAP LAM are t 10,000
PERSONAL 6 ADV INJURY t 1' )00'000
GENERALAcc,REOATE t 2, )00,000
OENL AGGREGATE LIMITAPPLIES PER. PRODUCTS-COMP/OP AGG t 2, )00,000
FD POICv PR : LOC /
uTCM05U UANIUTY COMBINED SINGLE LIMIT
ANY AUTO
IES ecciJallJ i
A ALLOMEDAUTOS MGT41596 05125/2,• 5 05/95/2006
BODILY INJURY
X 6CHEDULEDAUT06 (Papereml LOO,000
X MIRED AUTOS BODILY INJURY DD 000
B NONdNMED AUTOS (PeT A0C10eM) _
,• I / / PROPERTYOAMAOE -
(Pn.eecteent t 00,000
OAl1A0B LUUItLITY AUTO ONLY-FA ACCIDENT f
ANY AUTO I I '•` / / OTHER TWIN EA ACC i
AUTO ONLY: AGG t
QIICME LIABILITY ! ! / / CURB f
OCCUR FICLAVAS MADE AGGREGATE f
LN:DLICTIBLE -
RETENTIONf
WOOKM AM
E.L.EAC"ACCIT t 100,000
DEN
M2T41596 60/13/;' 09/13/2006 E.L.DISEASE•EA EMPLOYEE! 100,000
E.L.DISEASE•POLICY LIMrt t 500,000
OTHER i
DESCRIPTION OF OPGRATIO11131LOCATIONS"NICLMUCLUS10NG ADDED BY 01I1ORdaLI{tI1TiOPECUI N6
FJULR 970-695-2425
CERTIFICATE MOLDER AwwmL INGUREa INSURER LETT : :CJI N
aNitU1 C�; :OF TIM! ABDWE DENRIM P'DLICIES EE OA! THi
tNPtRA DA7i T11BI12010. Wit156ulum INSURER WALL 8110 VMR TO MAIL
10IMdTTEI{%Vr"TO"M CEWWWATE HOLDER NAMED TH "",,BUT
WILLIAM POOR GENERAL CONTRACTOR -. .FAIWWP. 60 Eo am%"MIroQB ND OBuoA11DN OR upAOL• UPON THE
10 LACEY STREET IMRQrAQ Arnna
' :lNlTTtD,. R6FIIBBi►t�AIiYB
No ANDOVER HA 01845-
A4CORD 264(7197) IDACORD COR TION 1986
K..
Page 1 a z
INSO255(Bf101.o1 ELECTRONIC LASER FORM,INC.? pt7-050
• I
.DEC-G-,2005 02:37P FROM: TO:9786852425 P.2
ACORD• CERTIFICATE OF LIABILITY INSURANCE 6/2/06/20'
PRODUCER FAX THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
DeAngelis Insurance Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
283 Merrimack Street HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Metkuen, MA 01844
INSURERS AFFORDING COVERAGE NAIC III
INSURED David Wilson INSURERA: Nautilus Ins CO
627 Lake Street • INSURERS: Mass. Assigned workers' Compensation (WCRIB;
Haverhill, MA 01832 INSURER C:
INSURER 0:
INSURER E:
OVERAGES
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
POLrGIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS,
INSR kDD`L TYPEOFINBURANCE POLICY NUMBER FOUCYEFFECTR/E POLICY EXPIRATION mmmarfin LIMITS
GENERAL LIABILITY NC447824 04/16/2005 04/16/2006 unPC4ce s 11000,000
X COMMERCIAL GENERAL LIABILITY DAMAT S 5Q QQQ
CLAIMS MADE ❑X OCCUR E)(P(' S 5.0
A POWNAL&ADV€NJ RY s 1,000,000
OEN AGOREOATE s 2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AOG S 2,0 000
POLICY JECT 7LOC
AUTOMOBILE LIABILITY
COMBINED SINGLE LIMB S
ANY AUTO (Ea.Ment)
ALL OWNED AUTOS BODILY INJURY $
SCHEDULED AUTOS (Per parson)
HIRED AUTOS
BODILY INJURY E
NOWOWNEOAUTOS (Per am ident)
PROPERTY DAMAGE S
(Per Aeddent)
GARAGE LIABILITY AUTO ONLY-EA ACCIDENT 5
ANY AUTO OTHER THAN EA ACC S
AUTO ONLY: AGG S
EXCE88RIMBRELLAI LABIL ITY EACHOCCURRENCE S
OCCUR CLAIMS MADE AGGREGATE S
S
DEDUCTIBLE S
RETENTION $ S
WORKERS COMPENSATION AND CE TIFICATE TO BE ISSUED 09/OS/2005 09/OS/200S WD T 0TH-
EMPLOYERs'LIARILRY DIRECTLY BY CARRIER E.L.EACH ACCIDENT 6
B OFFICERIMEMBANY EREXCLUDED?ECUTIVE TO FOLLOW E.L.DISEASE-EA EMPL2YEF4 S
II yes,describe under
SPECIAL PROVISIONS below E.L.DISEASE•POLICY LIMB I S
OTHER
DESCRIPTION OF 9PERATIONS I LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT I SPECIAL PROVISIONS
e: 7 Harris Street, Wilmington, NA 01886
ertificate is issued in the interest of the named insured and Certificate holder listed below.
ertificate is subject to company conditions and exclusions.
EIRTIFICATE HOLDER CANCELLATION
I ;
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL
10 DAYS WRITTEN NOTICETO THE CERTIFICATE HOLDER NAMED TO THE LEFT,
William Pogor General Contracting Svcs LLC BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY
10 Lacy Street OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES.
No. Andover, MA 01845 AUTHORIZED REPREBENTATNE A+
David SegalMCe
ACORD 25(2001108) FAX: (978)6$S-242S OACORD CORPORATION 1988
Permit Number
REScheck Compliance Certificate Checked By/Date
Massachusetts Energy Code
REScheckSoftware Version 3.5 Release la
Data filename:C:1Program Files\Check\REScheck\44Andoverst.rck
TITLE: 44 Andover Street
CITY:North Andover
STATE:Massachusetts
HDD:6322
CONSTRUCTION TYPE: 1 or 2 Family,Detached
HEATING SYSTEM TYPE:Other(Non-Electric Resistance)
DATE: 12/06/05
DATE OF PLANS: 12/5/05
PROJECT INFORMATION:
Addition/Remodel
COMPANY INFORMATION:
William Pogor General Contracting Services,LLC
COMPLIANCE:Passes
Maximum UA=264
Your Home UA=255
3.4%Better Than Code(UA)
Gross Glazing
Area or Cavity Cont. or Door
Perimeter R-Value R-Value U-Factor UA
Ceiling 1:Flat Ceiling or Scissor Truss 841 30.0 0.0 29
Wall 1: Wood Frame, 16"o.c. 400 19.0 0.0 21
Window 1:Vinyl Frame:Double Pane with Low-E 8 0.350 3
Window 2:Vinyl Frame:Double Pane with Low-E 8 0.350 3
Window 3:Vinyl Framc:Doublc Pane with Low-E 8 0.350 3
Window 4:Vinyl Frame:Double Pane with Low-E 8 0.350 3
Window 5:Vinyl Frame:Double Pane with Low-E 5 0.350 2
Door 2: Solid 20 0.490 10
Wall 2: Wood Frame, 16"o.c. 128 19.0 0.0 6
Door 1: Solid 20 0.490 10
Wall 3: Wood Frame, 16"o.c. 128 19.0 0.0 6
Door 3: Solid 20 0.490 10
Wall 4: Wood Frame, 16"o.c. 436 19.0 0.0 20
Window 6:Vinyl Framc:Double Pane with Low-E 8 0.350 3
Window 7:Vinyl Frame:Double Pane with Low-E 14 0.350 5
Window 7 copy 1:Vinyl Frame:Double Pane with Low-E 14 0.350 5
Window 7 copy 1:Vinyl Frame:Double Pane with Low-E 14 0.350 5
Window 7 copy 1:Vinyl Frame:Double Pane with Low-E 14 0.350 5
Window 7 copy 1:Vinyl Frame:Double Pane with Low-E 14 0.350 5
1
Window 6 copy l: Vinyl Frame:Double Pane with Low-E 8 0.350 3
Door 4: Solid 20 0.490 10
Basement Wall 1: Solid Concrete or Masonry 400 0.0 14.4 18
Wall height: 8.0'
Depth below grade:7.2'
Insulation depth: 8.0'
Basement Wall 1 copy 1: Solid Concrete or Masonry 128 0.0 14.4 6
Wall height: 8.0'
Depth below grade: 7.2'
Insulation depth:8.0'
Basement Wall 1 copy 1: Solid Concrete or Masonry 436 0.0 14.4 20
Wall height:8.0'
Depth below grade:7.2'
Insulation depth: 8.0'
Basement Wall 1 copy 2: Solid Concrete or Masonry 128 0.0 14.4 6
Wall height: 8.0'
Depth below grade: 7.2'
Insulation depth:8.0'
Floor 1:All-Wood Joist/Truss:Over Unconditioned Space 800 19.0 0.0 38
Furnace 1:Forced Hot Air,78 AFUE
Air Conditioner 1:Electric Central Air, 10 SEER
COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans,specifications,
and other calculations submitted with thepermit application. The proposed building has been designed to meet the Massachusetts
Energy Code requirements in REScheckVersion 3.5 Release la (formerly MECchecl and to comply with the mandatory
requirements listed in the REScheckInspection Checklist.
The heating load for this building,and the cooling load if appropriate,has been determined using the applicable Standard Design F
Conditions found in the The HVAC equipment selected to heat or cool the building shall be no greater than 125%of the
design load as spe ified i S ons 780CMR 1310 and J4.4.
Builder/Designer A Date I L
f
�I
I {
I
i
NORTH ANDOVER OLDE CENTER HISTORIC
DISTRICT COMMISSION
Certificate of Appropriateness
I
This Certificate of Appropriateness is issued this
Fifth day of January 2006 to Leta and William Applegate
for 44 Andover Street in accordance with Chapter 40C of
the General Laws of the Commonwealth of Massachusetts
as amended and the by-laws of the North Andover Olde
Center Historic District Commission.
This will allow the renovation of the outbuilding
between the main house and barn with the plans and
n ative ap rov at this meeting.
G e H. Schr kr,Jr. Chairman
thleen S a
0 ieus
Martha arson
Leslie Hopki
H Aznotit
ichard Michae raly
Jo eph Piotte
r i
Kathy Brown
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The Commonwealth of Massachusetts
Department of Industrial Accidents
".,. Office of Investigations
9' 600 Washington Street
Boston MA 02111
~�r www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information l, , Please Print Legibly
Name (Business/Organization/Individual): W 1 ( P06.026_cGgX
Address: (0 L ray ST-
City/State/Zip:
TCity/State/Zip: r Wb (/ Phone#: T78 37616 7,5
Are you an employer?Check the appropriate box: Type of project(required):
1.❑ 1 am a employer with 4. 9 1 am a general contractor and 1 6. ❑New construction
employees(full and/or part-time).* have hired the sub-contractors
2.10 I am a sole proprietor or partner-
listed on the attached sheet.1 7. ❑ Remodeling
ship and have no employees These sub-contractors have 8. Demolition
working for the 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 10.54 Electrical repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL i LIZ 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' 131-1 Other
comp. insurance required.]
*Any applicant that checks box#I must also till 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.
*Contractors 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:
Policy#or Self-ins. Lic.#: ``'' Expiration Date:
Job Site Address: A-WOOV&t- 'g�;/ City/State/Zip: 041d
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-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
Investigations of the DIA for insurance coverage verification.
I do herebyertify it the pains and penalties of perjury that the information provided above is true and correct.
Sip-nature: Date: br
Phone#: 64 Q
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 confinnation 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 pen-nit 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
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
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
Revised 5-26-05 Fax# 617-727-7749
www.mass.gov/dia
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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:44 KVVDOVE2 5T. is that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as defined by MGL
11, S 150 A.
Also, note Permits are required under Fire.Prevention laws Chapter 148 Section
1 OA.
The debris will be disposed of in:
(Location of Fa ility)
Sijrbke of Permit Applicant
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Fire Department Sign off:
Dumpster Permit
//2- L04C T
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DEC-6-2005 03:46P FROM: 70:9786852425 P.2
bEC. 6. 2005 3.32PM ASSOCIATED INSURANCE NO. 4735_,..P. 2/3
CERTIFICATE OF INSURANCE
:DATS(Mwowm
WOQNONLYAND
PRODUCER CONFERS NO RICHT9 UPON THE CWAng
AbStTI 702 HOLDER T1D TE
DeAngelis]nsutance Agency Inc DOES NOT AMEND,UTEND OR ALTER a M COVMUM Asim.
ERAGE AF1rC»�ao uT
283 Merrimack Street
Methuen. nu 01844 C4MPANm AMRDI NG COVERAGE
INSURED
David WilsoD Plumbing&Heating 1 COMANY A AIM.Mutual IDsurance Co
6Z7 Lake 5t
Haverhill,MA 01832
COVERAGES
•THIS TO CERTWYTHAT THB POCK SOP INSURANCE LISTED BELOW HAVE DMMN ISSUED TO TIm2auRBD NAMED ABOVE POR THB POLICY PIRIOD
INDICATED,NOTWITTISTANDING ANYNT,TERIM OR CONDMN OP ANY CONTRACT OROTHBR DOCUMENT WITH RBSRECTTO WHICH WS
CERTW_ATE MAY BM ISSUED OR[NAY P AIN.THE INMMMCB APPORDED BY THD POLIC>BT DESCRMZD RMMW M SUBIBCT TO ALL T1C!TERMS.
EXCLUSIONS AND CONDMONS OF SUCH POUCIRS. LWI TS SHOWN MAY RAYS BEEN RMDUCSD BY PAID CLAIMS.
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PROJECT:44 Andover Sheet,North Andover.MA.
CIRTIRCATE HOLDER. CANCEUATION
SHOULD ANY OP THS ABOVE DSSCst>eED POLICIES BB CANC M=sMM THE
W1Wam Pogar WIRATION DATE THEREOF, THS IMV MG COMPANY WILL ENDEAVOR TO
"L_10 DAYS WRTTTMN NOTICE TO THS CRRT MCATS HOLDER NAMED TO THB
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N Andover,MA 01845 `
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r INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve
the applicant and/or landowner from compliance with any applicable or requirements.
APPLICANT FILLS OUT THIS SECTION
APPLICANTW l I &yVt�D(�0a &JARJ9, C Au Lh �k«CpHONE V 07� 087-5
LOCATION: Assessors Map NumberPARCEL��
SUBDIVISION LOT(S)
STREET 444WDOV�'l� S'T�,E E� ST. NUMBER
OFFICIAL USE ONL
RECO DATIOJkS OF JOWN AG
WNSERVATION ADMINISTRATOR DATE APPROVED
DATE REJECTED
COMMENTS .�
TOWN PLANNER DATE APPROVED
DATE REJECTED
COMMENTS
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FOOD INSPECTOR-HEALTH DATE APPROVED
DATE REJECTED
SEPTIC INSPECTOR-HEALTH DATE APPROVED
DATE REJECTED
COMMENTS
1N PUBLIC WORKS-SEWERIWATER CONNECTIONS
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DRIVEWAY PERMIT
FIRE DEPARTMENT
7ECEIVED BY BUILDING INSPECTOR DATE
Rovhwd 9%97Im
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BOARD OF BUiCbIidG� S
License:
Number: CS 083917
Birthdate: 06128/1957
Expires:06/28/2006 Tr.no: 83917
_ B Restricted: 00
— WILLIAM H POGOR _
79 JOHNSON ST
NO ANDOVER, MA 01845
Administrator
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WILLIAM POGOR GENERAL CONTRACTING
10 Lacy Street
North Andover,MA 01845
MA Home Improvement Contractor
License No.083917
MA Construction Supervisors
License No.139701
I
Inquiries may be made to:
Director of Home Improvement
Contractor Registration
One Ashburton Place
Boston,MA 02108
(617)727-8598
CONTRACT
Customer: Friday,November 04,2005
Will&Leta Applegate
44 Andover Street
North Andover,Massachusetts
Project Location:
Same as above
Nature of Work:
O Design/Layout/Concept Services
X General Contracting Services
This Contract relates to the above checked services that William Pogor General
Contracting,LLC shall provide to Customer. The services being provided are spelled out
in the next section. The Customer's Payment Schedule is provided for in the section
following that. This is a written binding contract. Do not sign if there are any sections or
spaces remaining blank. If the contract is not understood, please have it reviewed by an
attorney of your own choice.
1 1
C omen Initials Con ctor Initials
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Services to be performed:
I. General Description of Work
1. PERMITS
1.1. Building Permit. `f
1.2. Electrical Permit.
1.3. Plumbing Permit.
1.4. Gas Permit. k
1.5. Waste Removal Permit.
1.6. Occupation Certificate.
1.7. Fire Safety Certificate.
1.8. Notifications
1.8.1. As required by North Andover Massachusetts Building Department I
Form U.
1.8.2. Dig Safe.
2. DEMOLITION
2.1. Demolish existing structure according to plans.
2.2. Temporary Supports for remaining structures(barn&house).
3. WASTE&DEBRI REMOVAL
3.1. Remove all extra debris associated with the building process,all extra fill (soil).
4. FOUNDATION
4.1. Excavation
4.2. Footings,walls(any wall pining),terraced support for existing barn structure(see
structural plans).
4.3. Drainage
4.3.1. Install foundation perimeter drain line and terminate to appropriate
locations(dry well or city storm drains).
4.4. Backfill
4.4.1. %crushed stone to fill lower level surrounding drainage area,remainder of
the fill area to be filled with bank sand material within 4"of final grade.
Remainder to be filled with loam.
5. CARPENTRY
5.1. Framing
5.1.1. Exterior Wall Frame(2X6 KD spruce dimensional lumber).
5.1.2. Tyvek Home wrap or comparable material.
5.1.3. Interior Wall Frame(2X4 KD spruce dimensional lumber).
5.1.4. Floor frame(as specified by structural engineering diagrams).
5.1.5. Roof Frame(as specified by structural engineering diagrams).
5.1.6. Structural Steel(as specified by structural engineering diagrams).
5.1.7. Plywood Sheathing exterior wall(1/2"CDX Fir). f
5.1.8. Plywood Roof Sheathing (5/8" CDX Fir).
5.2. General Carpentry `
5.2.1. Siding(to match existing residence,pre-primed).
5.2.2. Soffits(Soffits vented with 2 1/4"white screen).
5.2.3. Facia (to match existing residence,pre-primed).
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Cm;m' Initials 6ntictor Initials
5.2.4. Exterior Trim(to match existing residence,pre-primed).
5.3. Finish Carpentry
5.3.1. Hardwood Flooring(customary red oak,or maple.All grades select or
better).
5.3.2. Door&Window Casing(popular paint grade).
5.3.3. Closet Shelving(paint grade).
5.3.4. Baseboard molding(paint grade).
5.3.5. Two vanities.
5.3.6. Built in cabinetry as agreed upon through interior elevation drafting for
mudroom.
6. INSULATION
6.1. Wall,ceiling and foundation insulation as specified energy efficiency certificate
found in building permit documentation.
6.2. Proper-vent all roof areas MGL.
7. ELECTRICAL
7.1. Rough Electrical
7.1.1. Sub Panel(100 Amp).
7.1.2. Rough Wiring
7.1.2.1.Switches(as appropriate for lighting needs).
7.1.2.2.Outlets including GFI as required by MGL.
7.1.2.3.Lights (total ten recessed lights).
7.1.2.4.Exhaust fans as required by MGL(one for each bathroom).
7.1.2.5.Exterior lighting(Three fixtures,two door lights,one set of floods).
7.1.2.6.One doorbell.
7.1.2.7.Wire HVAC electrical.
7.2. Finish Electrical
7.2.1. Switches(single pole,dual pole,three-way switches).
Dimmer switches if requested(extra).
7.2.2. Light Trims(white Baffles all recessed).
7.2.3. Outlet and switch covers(white or Ivory).
8. PLUMBING
8.1. Plumbing Specifications
8.1.1. Plumbing Fixtures are based on medium grade Kohler series suite.
8.1.1.1. Series suite incorporate(toilet,sink,fixtures).
8.2. Rough Plumbing(two bathrooms one full, %i half).
8.2.1. Sanitary Lines.
8.2.2. Water Lines.
8.2.3. Gas Furnace Lines.
8.2.4. All necessary mixing valves.
8.2.5. Install all vents&roof caps(asphalt roof shingles (aluminum)Cedar roof
shingles (copper)).
8.3. Finish Plumbing
8.3.1. Install all Porcelain Fixtures.
8.3.2. Install all Finish trims for mixing valves.
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9. HVAC(HEATING,VENTILATION,&AIR CONDITIONING)
9.1. Install 2.5 Ton Hydro-air pack(provides independent heating and air
conditioning.
9.2. Install all duck work and return air venting.
9.3. Install all gas hookups.
9.4. Install two thermostats.
9.5. Install two heating and cooling zones using electrical damper.
9.6. Install all HVAC vent covers(White or Brown).
10. HARDWARE
10.1.Finish Door Hardware
10.1.1. Interior finish hardware is based upon medium grade Baldwin Lock sets
(Passage and privacy lock sets).
10.1.2. Exterior Door hardware Baldwin medium grade(deadbolt,doorknob).
10.1.3. Bathroom hardware(two sets).
10.1.3.1. One two-foot towel bar.
10.1.3.2. One 30"vanity.
10.1.3.3. One toilet roll holder.
10.1.3.4. One 24"mirror/medicine cabinet combination.
10.1.3.5. One bathroom glass water barrier(shower door).
11. WALL FINISHES
11.1.Blue Board&Plaster(all walls&ceilings smooth coat).
11.2.Kerdi waterproof barrier for any wall tile affected areas.
12.FLOOR FINISHES
12.1.Hardwood flooring(sanded flush,one coat sand sealer,one coat of high gloss,
one coat of client's choice for finish(high gloss, semi-gloss, or satin).
12.2.Ditra waterproof barrier for any affected floor tile areas.
12.3.Mudroom floor tile(as required by client not to exceed$7.00/ft). ;
13. SIDING
13.1. Clapboards(grade A cedar,pre-stained to match existing house color).
14. WINDOWS
14.1.Pella windows(to match existing home double hung). _
14.2. Exterior Doors(to match existing home).
15. ROOFING
15.1.Asphalt shingles to match existing home.
15.2. Bay window roof standing seam copper or soldered seamed flat copper squares.
15.3. *Extra(Cedar roof shingles would be considered an extra would add to the
contract price).
16. GUTTERS
16.1. '/i round copper gutter&down spouts front and back.
17.PAINTING
17.1. Paint specifications(Based on Sherwin-Williams colors and products).
17.2.Exterior(one coat of paint will be applied to all exterior services).
17.3.Interior(one coat of oil based primer sealer all surfaces,two coats of color
customer choice. 4
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18.LANSCAPING
18.1. Rough grade affected soil areas.
19. MASONARY
19.1. Apply granite veneer to all visibly affected areas of foundation.
19.2.Reuse or replace front and rear granite entrance steps(reuse existing if
possible).
20. FINAL TOUCH UP AND PUNCH LIST
20.1.Upon substantial completion a punch list will be generated signed by both the
contractor and home owner for finish Items.
II. Dates of Performance (If Itemized Schedule, attach
and refer to it here):
Commencement Date: As Soon As Permitted
Substantial Completion Date: 6 months from commencement
Other Particularly Agreed Dates(if any):No workweeks, Thanksgiving and Christmas.
III.Work Changes
Any changes to this contract must be mutually agreeable and put in writing under a
Change Order Form. A blank Change Order Form is attached after the signature lines
below and shall be the form used for any changes to this contract. It shall be the
obligation of both parties to adhere to this provision.
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Cu s er Initials Co ctor Initials
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IV. Contractor's Conditions of Performance
All dates of performance are subject to reasonable extension(s), at the Contractor's
request, if request is made due to inclement weather, labor disputes, issues involving
acquisition of materials or permits from appropriate authorities, mutual dissolution of
contract by the parties, stop work order(s) by state or local municipalities, or act(s) of
God. Approval of such request(s) shall not be unreasonably withheld. No acceptance of
liability is expressed, assumed or implied due to any of these circumstances. Work may
be stopped, interrupted or ceased at the sole discretion of Contractor if payment(s) under
the terms of this contract, or any written amendment thereto, is not made by Customer as
agreed herein. Work shall be performed in an ordinary standard. It is understood that
certain portions of Contractor's consulting and drafting work is deemed artistic and/or
subjective in nature,and therefore, disputes related to subjective portions of Contractor's
work shall never be grounds for non-payment by the Customer.
Permits for Work
The type(s) of permits that will be required for the Contractor's work herein shall
include:
As stipulated in previous work specifications.
Unless otherwise requested by the Customer, the Contractor shall obtain all necessary
permits required to undertake and complete the project. If the Customer undertakes to
obtain their own permit(s) the Customer will be excluded from the guaranty fund
provisions of M.G.L. c. 142A.
Special Conditions of Services:
(If this section is intended to be left blank, state"none"):
I
None
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Customer Initials tractor Initials
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Customer Payment Schedule:
This Contract is:
X Agreed Fee
0 Time and Materials Invoiced
El Combination Agreed,Fee and Time and Materials Invoiced
i
Agreed Fee(If applicable):
Deposit(Ten(10%)Percent): _$15,000.00_
This sum is due at the signing of the contract
(Subject to Customer Consumer Rescission Rights)
First Installment(Twenty-three(24%)Percent): _$36,000.00_
This sum is due upon notification that the building
Permit has been obtained.
Second Installment(Thirty-three(33%)Percent: _$49,500.00_
This sum is due upon Contractor's notification of
50%completion of work
Third Installment(Twenty-eight(28%): _$42,000.00_
This sum is due upon Contractor's notification of
Substantial Completion of work
Final Payment(Five(5%)Percent)Final Balance: _$7500.00_
This sum is due no later than seven(7)days
After final completion of work by Contractor T
Total Contract Payment: _$150,000.00
Time and Materials/Labor Invoiced(If Applicable):
Initial Deposit: N/A G
Contractor shall be paid at a rate of $_135.00 per hour, plus all
materials and out of pocket expenses, including, but not limited to invoiced
subcontractors, consultants and materials suppliers. Contractor shall provide an itemized
entry of his time billed as part of his invoice together with copies of expense invoices.
Invoices shall be issued weekly. Payments due under invoice shall be made within seven
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Cu m r Initials ctor Initials
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III
(7) days of receipt of invoice. Receipt shall be upon delivery to Customer's address.
Contractor may suspend or cease work under this contract if payment is more than seven
(7)days overdue.
Special materials,or materials of a special order or
custom made nature,shall be separately invoiced and
require advance payment by Customer prior to order.
i
Description of Combination Agreed Fee and Time and Materials:
As specified by any extra work orders.
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Payment terms may not be altered
Unless expressly agreed by the parties in writing.
Deposit Terms
If there is an initial deposit, it shall be non-refundable. The Customer acknowledges and
agrees that the Contractor shall commence work in good faith upon receipt of said
deposit,utilize his time and that of contractors and/or consultants he may work with, and
that the Contractor shall be fairly compensated for such commencement of work and
dedication of time to this Customer that might otherwise be devoted to other projects.
The parties agree there is valid consideration for the non-refundable deposit. j
DEFAULT OF CUSTOMER
If the Customer defaults for any reason, the Contractor shall be entitled to immediate
payment of all monies owed as of the date the Contractor notifies the Customer in writing
that he deems the Customer to be in default. The Contractor's Notification shall state all
sums deemed to be owed and due from the Customer. Said sums shall be due and
payable within seven (7) days of delivery of said notice. Any sums due after such notice
of default shall be assessed an interest charge of 1 '/z%per month, or 18%per year until
all sums are paid in full. If the Customer defaults, and does not tender payment of all
sums due within said seven (7) days, the Contractor may record this contract in the
j registry of deeds and seek a lien on the property for the enforcement of payment. The
Customer shall be responsible and owe the Contractor all costs and expenses incurred in
the collection of monies owed under this contract, including,but not limited to reasonable
attorney fees.
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ALTERNATIVE DISPUTE RESOLUTION
The Customer and the Contractor mutually agree that in the event the Contractor has a
dispute with the Customer, the Contractor may submit such dispute to a private
arbitration service, of the Contractor's sole choosing; provided however, such private
arbitration service shall have been approved by the Secretary of the Executive Office of
Consumer Affairs and Business Regulations and which shall have been in business for
more than five (5) years, and shall be staffed with at least one retired justice of the
Massachusetts Court System. This provision is an election at the sole discretion of the
Contractor. This provision is in addition to any rights afforded the Customer under
M.G.L. c. 142A. The arbitration, if elected by the Contractor, shall follow the rules and
regulations of the American Arbitration Association. Nothing in this provision shall
prohibit the Contractor from initiating a civil action for any such defaults. The
Contractor may have the right to institute a civil action to obtain and enforce any
statutory liens rights the Contractor may have, while contemporaneously seeking
arbitration of the underlying disputed claims, which determination shall be conclusive as
to the amount, if any the Contractor may enforce through such civil action lien.
CUSTOMER RIGHT OF CANCELLATION
YOU MAY CANCEL THIS AGREEMENT IF IT HAS BEEN
SIGNED BY A PARTY THERETO AT A PLACE OTHER THAN
AN ADDRESS OF THE CONTRACTOR, WHICH MAY BE HIS
MAIN OFFICE OR BRANCH THEREOF, PROVIDED YOU
NOTIFY THE CONTRACTOR IN WRITING AT HIS MAIN
OFFICE OR BRANCH BY ORDINARY MAIL POSTED, BY
TELEGRAM SENT OR BY DELIVERY, NOT LATER THAN
MIDNIGHT OF THE THIRD BUSINESS DAY FOLLOWING THE
SIGNING OF THIS AGREEMENT. SEE ATTACHED NOTICE OF
CANCELLATION FORM FOR AN EXPLANATION OF THIS
RIGHT.
i h
This Contract shall be construed in accordance with the laws of Massachusetts.
This Contract may be executed in duplicate. Customer acknowledges receipt of copy by
signing below.
Ili
Cu omer Initials Co for Initials
y THIS IS A BINDING LEGAL DOCUMENT. DO NOT SIGN THIS CONTRACT
IF THERE ARE ANY BLANK SPACES OR YOU DO NOT UNDERSTAND ANY
TERMS HEREIN.
Executed as a sealed instrument this �� day of
A�
Cus omer 4Byl: eral Contracting,
Customer
E
I
l
I 10
Cust er Initials CoMictor Initials
NOTICE OF CANCELLATION
FORM
Date of Co tract
You may cancel this contract,without any penalty or obligation,within three(3)business
days from the date entered on the first page of this contract.
If you cancel, any property traded in, any payments made by you under the agreement,
and any negotiable instrument executed by you will be returned within ten (10) business
days following receipt by the Contractor of your cancellation notice, and any security
interest arising out of the contract will be cancelled.
If you cancel, you must make available to the Contractor at your residence, in
substantially as good condition as when received, any goods delivered to you under this
contract; or you may if you wish, comply with the instructions of the Contractor
regarding the return shipment of the goods at the Contractor's expense and risk.
If you do make the goods available to the Contractor and the Contractor does not pick
them up within twenty (20) days of the date of your notice of cancellation, you may
retain or dispose of the goods without any further obligation. If you fail to make the
goods available to the Contractor, or if you agree to return the goods to the Contractor
and fail to do so, then you remain liable for performance of all obligations under the
contract.
To cancel this contract,mail or deliver a signed and dated copy of this cancellation notice
or any other written notice, or send a telegram to William Pogor General Contracting, at -
79 Johnson Road,North Andover,MA,01845,not later than midnight of:
llko!�
(Date o 3` day.)
I hereby cancel this Contract.
Customer(s) Signature (Date)
i
11
Cu tomer Initials Contractor Initials
r
I
WORK CHANGE ORDER FORM
Will&Leta Applegate
(44 Andover Street/North Andover,Massachusetts)
Customer:
Contract Date:
i� D5
i
This Work Change Order changes only those items specifically addressed herein.
Nothing in this Change Order shall be construed to change any other term or condition of
the Original Contract.
Description of Change(s):
a- Wtrcl�
ZieXi>N
4
�•
I�4:p 4 ate.
rece�- t " f I�o�� fix-►�e. -
�Nl 99*1\ v �� fie, ►� - i n
12
Cust er Initials *Coactornitials
Commonwealth of Massachusetts Official Use Onl
Department of Fire Services Permit No.
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/99] leaveblank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527•CMR 2.00
(PLEASE PRINT IN INK OR TYfE L INFORMATION) Date: Cp_
City or Town of: Alr611 To the Inspectorl of Vires:
By this application the undersigned, ve.not' a of s or her' tenti n to perform the electrical work described below.
Location(Street&No r)
Owner or Tenant 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: Installation of Security system/,_ o. e6
Completion of the ollowin table maybe waived by the Inspector of Wires.
No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans No.of Total
Transformers KVA
No.of Lighting Outlets No.of Hot Tubs Generators KVA
AboveIn- o.o Emergency Lighting
No.of Lighting Fixtures Swimming Pool rnd. ❑ rnd. ❑ Battery Units-
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones
No.of Switches No.of Gas Burners o.o Detection and
Initiatin Devices
No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices
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:
r No.of Devices or Equivalent/2
No.of Water KW No.o No.o Data Wiring:
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 ifdesired,or as required by the Inspector of Wires.
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 coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:)
(Expiration Date)
Estimated Value of Electrical Work: p _ (When required by municipal policy.)
Work to Start: (r vp21nspections to be requested in accordance with MEC Rule 10,and upon completion.
I certify,under the haiins nd penalties of perjury,that the information on this application is true and complete.
FIRM NAME: LIC.NO.: 15-13C
Licensee: John S. Bassett Signature LIC.NO.: 1533C
(If applicable,enter"exempt"in the license number line.) Bus.Tel.No. 603 594 5928
Address: Alt.Tel.No.:
OWNER'S INSURANCE WAIVER: I am aware that the Licl9hsee 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: $
Location
Nd. Date
' "ORT" TOWN OF NORTH ANDOVER
I Ota+oto i�,'�•C
p Certificate of Occupancy $
Building/Frame Permit Fee $ 964
sAcMus Foundation Permit Fee $
Other Permit Fee $
Sewer Connection Fee $ o
Water Connection Fee $
TOTAL
gIII Building Inspect6r t`
10352
Div. Public Works
APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PACE 1
MA +40. LOT NO. 12 RECORD OF OWNERSHIP (DATE BOOK ;PAGE
ZONE I SUB DIV. LOT NO.
LOCATION a PURPOSE OF BUILDING 1
OWNER'S NAME NO. OF STORIES SIZE
�, I-�r
_ S \ a
OWNER'S l
ADDRESS •stT /'1 BASEMENT OR SLAB
caC c ✓
ARCHITECT'S NAME � � SIZE OF FLOOR TIMBERS IST7�"r�%7 4 N D i� 3RD a�
BUILDER'S NAME •�-ly�� ,y`- i�„I SPAN '"'''�� l•r+4
DISTANCE TO NEAREST BUILDIN , � DIMENSIONS OF SILLS
DISTANCE FROM STREET Il-G�x � '" Qx 7� POSTS
DISTANCE FROM LOT LINES - SIDES REAR "" dvk 16GORDERS
AREA OF LOT / I ,4/j rr FRONTAGE A0D HEIGHT/SOF FOUNDATION / THICKNESS @'f„/1-�
IS BUILDING NEW ( <'y SIZE OF FOOTING 1. X •..� ��J
IS BUILDING ADDITION MATERIAL OF CHIMNEY
IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND so
WILL BUILDING CONFORM TOR QUIREMENTS OF CODE •, IS BUILDING CONNECTED TO TOWN WATER y)/,-
BOARD OF APPEALS ACTION. IF ANY /7 IS BUILDING CONNECTED TO TOWN SEWER yl--
l ~
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS
3 PROPERfY INFORMATION
LAND COST
SEE BOTH SIDES
EST. BLDG. COST " �J Gn d
PAGE 1 FILL OUT SECTIONS 1 - 3
EST. BLDG. COST PER SQ. FT. 6
PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOMi
SEPTIC PERMIT NO.
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
DATE FILED
•UILDING INSPECTOR
SIGNAT AU RIZED. ENT
F E'E OWNER TEL.# a 3� U�0d
PERMIT GRANTED �l CONTR.TEL.
CONTR.LIC.M
H.I.C.a Z/ 3 7
i
�Lo O �
Q
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY S DRIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
MULTI. FAMILY _ OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA-
APARTMENTS I I RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
CONSTRUCTION
2 FOUNDATION 8 INTERIOR FINISH
CONCRETE 3 1 2 '3
CONCRETE BL'K. API
BRICK OR STONE HARDW D
PIERS PLASTER _
_ DRY WALL _
UNFIN.
3 BASEMENT 11
AREA FULL FIN. B'M'T' AREA _
'1, '1,
1 r/. FIN. ATTIC AREA _
NO B MJ FIRE PLACES _
HEAD ROOM MODERN KITCHEN
4 WALLS I 9 FLOORS
CLAPBOARDS B 1 2 3
DROP SIDING CONCRETE �_
WOOD SHINGLES EARTH _
ASPHALT SIDING HARDVJ'D
ASBESTOS SIDING COMMON _
VERT. SIDING ASPH. TILE _
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY ATTIC STRS. & FLOOR
BRICK ON FRAME
CONC. OR CINDER BLK.
STONE ON MASONRY WIRING
STONE ON FRAME
SUPERIOR 1___i POOR
ADEQUATE NONE
5 OOF 10 PLUMBING
GABLEHIP BATH (3 FIX.) _
GAMBREL MANSARD TOILET RM. (2 FIX.)
FLAT SHED WATER CLOSET _
ASPHALT SHINGLES LAVATORY
WOOD SHINGES KITCHEN SINK _
SLATE NO PLUMBING _
TAR & GRAVEL STALL SHOWER _
ROLL ROOFING MODERN FIXTURES _
TILE FLOOR
TILE DADO
6 FRAMING 11 HEATING
WOOD JOIST be RERELESS_FURNACE
REO HOTaAIR
TIMBER BMS. L COLS. T`A _
STEEL BMS. 6 COLS. NOT W T`R R VAPOR
WOOD RAFTERS AIR 1071 1
RAX .T 141—
#„IMT BEATERS
7 NO. OF ROOMS PoAs2nd Rf
lit 3rd EA'TI
PRRA1,:;4N0. APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1
MAP qq O. LOT NO. 2 RECORD OF OWNERSHIP JDATE BOOK ;PAGE
ZONE I SUB DIV. LOT NO. F.)
LOCATION PURPOSE OF BUILDING
OWNER'S NAME NO. OF STORIES SIZE
OWNER'S ADDRESS BASEMENT OR SLAB
ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD
BUILDER'S NAME SPAN
DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS
DISTANCE FROM STREET "' POSTS
DISTANCE FROM LOT LINES - SIDES REAR "" GIRDERS
AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW SIZE OF FOOTING X
IS BUILDING ADDITION MATERIAL OF CHIMNEY
IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS
3 PROPERTY INFORMATION
LAND COST
SEE BOTH SIDES
EST. BLDG. COST
PAGE 1 FILL OUT SECTIONS 1 - 3
EST. BLDG. COST PER SQ. FT.
PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY
• ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR '
DATE FILED
\ BUILDING INSPECTOR
SIGNATURE OF OWNER OR AUTHORIZED AGENT
F E E OWNER TEL.#
PERMIT GRANTED CONTR.TEL.N
19
CONTR.LIC.#
H.I.C.#
I
BUILDING RECORD -
1 OCCUPANCY 12
SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA-
APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
CONSTRUCTION
2 FOUNDATION 8 INTERIOR FINISH
CONCRETE _ d 1 2 I3
CONCRETE BL'K. PINE _
BRICK OR STONE HARDW
PIERS PLASTER
_ DRY WALL _
UNFIN.
3 BASEMENT
AREA FULL FIN. B'M'T' AREA _
1/1 1/1 3/ FIN. ATTIC AREA _
NO B M FIRE PLACES _
HEAD ROOM MODERN KITCHEN-
4 WALLS I 9 FLOORS
CLAPBOARDS B 1 2 3
DROP SIDING CONCRETE �_
WOOD SHINGLES EARTH
ASPHALT SIDING HARDIN D
ASBESTOS SIDING COMfACN _
VERT. SIDING ASPH. TILE _
STUCCO ON MASONRY _
STUCCO ON FRAME
BRICK ON MASONRY ATTIC STRS. & FLOOR _
BRICK ON FRAME
CONC. OR CINDER BLK.
STONE ON MASONRY WIRING
STONE ON FRAME _
SUPERIOR1---jPOOR _
ADEQUATE NONE
5 ROOF 10 PLUMBING
GABLEHIP BATH (3 FIX.)
GAMBREL MANSARD TOILET RM. 12 FIX.) _
FLAT SHED WATER CLOSET _
ASPHALT SHINGLES LAVATORY
WOOD SHINGES KITCHEN SINK
SLATE NO PLUMBING _
TAR & GRAVEL STALL SHOWER _
ROLL ROOFING MODERN FIXTURES _
TILE FLOOR
TILE DADO
6 FRAMING 11 HEATING
WOOD JOIST I E'ESS F17RNAt:E
�Ets T A.4
TIMBER BMS. &COLS.
WRAMSTEEL BMS. & COLS.WOOD RAFTERS 957 NO. OF ROOMS B'M'T 2nd 3rd
• OR
• Town of over
No.
dover, Mass., 191/
0 . LA
C0CWICHEWICK
0q41
BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT A.........0 0.4.......................................................... Foundation
has permission to erect ... . buildings on.........JJ......410,6..'a 4 ��.............................. Rough
........
#/90 . Z.�. ......................
0(-, 0 Chimney
to be Occupied as..................................... -7/j.7?.!-�..4.d-,f.k.................. ....... ....4�
Wit shall in every respect conform to the terms of the application on file in
provided that the person accepting this perm 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. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
PERMIT EXPIRES IN 6 MONTHS Final
UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR
Rough
..... .................... ..........................
..........................:v/....... .... ....... ....UILDING..INSPECTOR Service
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
00 Not Remove Rough
Display in a Conspicuous Place on the Premises Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
Smoke Det.
Or _
t �
MoaTw ANDOv�R, Mass
d✓%55'. PRlPAlX D FIM
JANE W141TEHI LL
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CONSERVATION LAND `
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ALtb `� �Gr<' ;r,.q.. r ry.,.ra G� .... i '� g2 �• J
mM. „✓Wit: I.EAtTQAL STRL•E�
01910
FORM U - VERIFICATION FORM
INSTRUCTIONS: This form is used to verify that all necessary
approvals/permits from Boards and Departments having jurisdiction
have been obtained. This does not relieve the applicant and/or
landowner from compliance with any applicable local or state law,
regulations or requirements.
****************Applicant fills out this section*****************
APPLICANT: '1.4eS-tf rPL eA Phone 6_0,S� ,�7'-y Dh�00
LOCATION: Assessor' s Map Number Parcel c
Subdivision d?o Lot(s) i?04"'If
Street daa ue_ r St. Number
************************Official Use Only************************
RECOMMENDATIO OF AGENTS: (�
b/ Date Approved
Conservation Administrator Date Rejected
Comments
Date Approved
Town Planner Date Rejected
Comments
Date Approved
Food Inspector-Health Date Rejected
Date Approved
Septic Inspector-Health Date Rejected
Comments
Public Works - sewer/water connections
- driveway permit
Fire Department
Received by Building Inspector Date
Q LJ
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REAL ESTATE •,Better1Homeso
SCHRUENDER DIVISION 73 Chickering Road(Rt 125/133),North Andover, MA 01845 508.685-5000 Fax: 508-685-5900
TSLZL"C"i7i6 ATTr SO4 TT YL 17:Cti'L":LT➢T.ty IIL i•C1Ti�Lf'"T i'7lLA L II 7YC`I C`I4 SLAT
le�'A1d 111'!1, vVEN1-1131` IAlu ME31WU1 %_V1V11d113J1'}._ iN
CERTIFICATE OF NION!-APPLICABILITY
This certificate of non-applicability is issued this 4th day of April 1997 to
The Stearn Company in regards to the property at 44 Andover St. in accordance with
Chapter 40C paragraphs 5 through '10 of the General Laws of the Commonwealth of
Massachusetts as amended and the by-laws of the North Andover Historic District
Commission. This will allow new windows and gutters on subtect property. The wood
frame of the windows shall remain and the windows shall be as shown to the
Commission.
George H. Schruender, Jr.
Chairman
i
. t III
CERTIFICATE OF USE & OCCUPANCY
Town of North Andover
Building Permit Number C200Z y ,� Date o /qR !y
THIS CERTIFIES THAT
THE BUILDING LOCATED ON
MAY BE OCCUPIED AS46e WC., IN ACCORDANCE
WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND
SUCH OTHER REGULATIONS AS MAY APPLY.
1 AORTN 1 CERTIFICATE ISSUED TO S4440 '
O • , y0
oroAiNaft p ADDRESS Are-,/[ NAye /� �I�
1,3444 HU Building Inspector
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F t4O R Town of Andover
No.2G'Z
* dover, Mass., s -19 ? 7
O'9LAKE -
4_COCK ICHEWI CK A-
Dq E D APP`y SCC
SS BOARD OF HEALTH
U
PERMIT T D Food/Kitchen
Septic System
_S2 4e �....... BUILDING INSPECTOR
THIS CERTIFIES THAT...................................................... ... ...........................,........................
"" Foundation
has permission to-erect-.-., .A.T� ,.. buildings on ........ ......... ./1.....�.d..v .�...........�,'T'... ough
to be occupied as........................................... "A).:7-0r'.iO..P............AAE44. ..14.774-1-42'>.AJ............... 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 Z40C / * ?ep
(Buildings in the Town of North Andover. PLUMBINGASPTECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
PERMIT EXPIRES IN 6 MONTHS
UNLESS CONSTRUCTION ST ELICAL INSPECTOR
TS RoughE
.............................................
�/
........................ ........... ...... ....... ...... Service" r
.
LDING INSPECTOR
to �
Occupancy Permit Required to Occupy Building RetacFLU e afe GAS sP OR
f g c �• /
Display in a Conspicuous Place on the Premises — Do Not Remove 7
No Lathing or Dry Wall To Be Done
Until Inspected and Approved by the Building Inspector. FIA DEPARTMENT
Burner
Street treet No.
�c-)9-5 --
Smoke Det.
I
1
•�e! 7DOa)t97t0.17.�CO�i/! p/�i'�%fYJJOCr/fIJP.//
r OEPARTNENT OF PUBLIC SAFETY
CONSTRUCTION SUPERVISOR LICENSE
Naa6er:
I Expires: .
CS 035146 0Birthdate:
1/02/1991 07/02/1959
Restricted to: 00
x VMr TIMOTHY N PERKINS
14 OLD FERRY•RO
s HAVERHILL, . Nq 01830
cwu.�itrda�l'a
HOME IMPROVEMENT CONTRACTOR)
Registration 10837
Type - 'INDIVIDUAL
r` Expiration 09/07197
i TIMOTHY PERKINS,
TIMOTHY N. PERKINS
` ADMINISTRATOR 14 OLD FERRY RD..
HAVERHILL MA 01830 ;
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Location ? �•''�u'�"'? �
No. Date
MORT1y TOWN OF NORTH ANDOVER
? �_ •BOOL
Certificate of Occupancy $
Building/Frame Permit Fee $
�Ssncmus � Foundation Permit Fee $
�. fs /I/ th 0xL l`iV---
`• Other Permit Fee $ �� -�
+ewer Connection Fee $
Water)"66hnection Fee $
IV
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G/70, . Building Inspector
Op
Div. Public Works
p
PEWAfff NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. r PAGE 1
MAP 410. LOT NO. 12 RECORD OF OWNERSHIP jDATE BOOK 'PAGE
ZONE I SUB DIV. LOT NO. �I
LOCA ION - w2 PURPOSE OF BUILDING
OWNER'S NAME �,/� / ,i j ` AI t t NO. OF STORIES SlZJE
OWNER'S ADDRESS Vji�; ,..{�r BASEMENT OR SLAB -
ARCHITECT'S NAME `r,$,)r SIZE OF FLOOR TIMBERS IST 2ND 3RD
BUILDER'S NAME ) d
�� S��' SPAN 44"
r—�
DISTANCE TO NEAREST BUILDING , � DIMENSIONS OF SILLS
leFG cy L. , I
DISTANCE FROM STREET POSTS -
DISTANCE FROM LOT LINES —SIDES REAR GIRDERS
AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICK SS
IS BUILDING NEW SIZE OF FOOTING X
IS BUILDING ADDITION Xf MATERSAL OF CHIMNEY
IS BUILDING ALTERATION f/ IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE y© IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION. IF ANY
LV,}b / IS BUILDING CONNECTED TO TOWN SEWER
PST /� '�.� o[` .
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS 3 PROPERTY INFORMATION
O J LAND COST
SEE BOTH SIDES / t /G- ��-'�`I ( O
✓✓✓ !ll��� / EST. BLDG. COST t"�© a
r s�✓
J
PAGE 1 FILL OUT SECTIONS 1 - 3 �OI/ 4-��1� e - /4( �L f EST. BLDG. COST PER SQ. FT.
PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY
C ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
4 DATE FILED
BOARD OF HEALTH
SIGNATURE OF OW R OR AUTHORIZED AGENT
FEE / V
PLANNING BOARD
PERMIT GRANTED
19
OWNER TEL # `' 4 3 BOARD OF SELECTMEN
CONTRACTOR TEL g d
CONTRACTOR LIC #Go 7 4 7
BUILDING INSPECTOR
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
MULTI. FAMILY oFFlces LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA-
APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
CONSTRUCTION
2 FOUNDATION 8 INTERIOR FINISH
CONCRETE _ B 1 2 13
CONCRETE BL K. PINE
BRICK OR STONE HARDWD
PIERS PLASTER .
_ DRY WALL _
UNFIN.
3 BASEMENT 11
AREA FULL FIN. B M'T' AREA _
'/. V2 '/. FIN. ATTIC AREA _
,`NO B M FIRE PLACES
HEAD ROOM MODERN KITCHEN
4 WALLS 11 9 FLOORS
LAPBOARDS B 1 2 3
'OP SIDING CONCRETE �_
DOD SHINGLES EARTH _
,SPHALT SIDING HARDNU D _
1,SBESTOS SIDING COMMON
VERT. SIDING ASPH. TILE _
STUCCO ON MASONRY _
STUCCO ON FRAME
BRICK ON MASONRY ATTIC STRS. & FLOOR _
BRICK ON FRAME
CONC. OR CINDER BLK.
STONE ON MASONRY WIRING
STONE ON FRAME _
SUPERIOR I� POOR
ADEQUATE NONE
5 ROOF 10 PLUMBING
GABLE IBATH (3 FIX.) _
GAMBQEL MANSARD TOILET RM. (2 FIX.) _
FLAT SHED WATER CLOSET _
ASPHALT SHINGLES LAVATORY
WOOD SHINGES KITCHEN SINK _
SLATE NO PLUMBING _
TAR & GRAVEL STALL SHOWER _
ROLL ROOFING MODERN FIXTURES _
TILE FLOOR
IN TILE DADO
6 FRAMING I 11 HEATING
WOOD JOIST PIPELESS FURNACE
_ FORCED HOT AIR FURN.
TIMBER BMS. & COLS. STEAM
STEEL BMS. & COLS. HOT W'T'R OR VAPOR
WOOD RAFTERS AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS
7 NO. OF ROOMS GAS
OIL
B'M'T 2nd ELECTRIC
1st 13rd NO HEATING
b a
S PLM1WING
ORTIy
Own o6 OLndover
No. 0-12
.......... . .. I I I
E
7 v' P'-?tM1 HE er,, Mass., 1 19
WEVV, 9 t
OA?
SS
PERMIT T LD BOARD OF HEALTH
THIS CERTIFIES THAT.../... .....Wf4Te.r49.bAj44.............................
BUILDING INSPECTOR
has permission to erect Alen W. ........ buildings on Rough
to be occupied as4.0 • � �.
Chimney
A*
*4�t_ Final
provided that the person accepting this permit shall in every respect conform to the terms or the application on file in
PLUMBING INSPECTOR
this office, and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough*
Buildings in the Town of North Andover. Final
VIOLATION of the Zoning or Building Regulations Voids this Permit.
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONST TION STARTS Rough
Service
Final
...TO,
................................
BUILDING INSPECTOR GAS INSPECTOR
Occupancy Permit Required to Occupy Building Rough
Final
Display in a Conspicuous Place on the Premises
Do Not Remove Burner FIRE DEPT.
No Lathing to Be Done Until Inspected and Approved by Smoke Det.
Building Inspector
j•
TOWN OF NORTH ANDOVER. MASSACHUSETTS
3
t+CNU�E
HISTORIC DISTRICT COHMISSION
i
Application for Certificate of Appropriateness
Application is hereby made for the issuance of a CERTIFICATE OF
APPROPRIATENESS under Chapter 40C for proposed work as described below
and on plans, drawings, or photographs accompanying this application.
CHECK CATEGORIES THAT APPLY:
1. Exterior Building Construction: ( ) New Building
( ) Addition
(x ) Alteration
Type of Building (X ) Home
( ) Garage
( } Commercial
( ) Other
a�
2 . .� d1✓ Z>6o,e �,��/�" G✓�i✓1z.J
3 . Signs or Billboards : � New sign
( ) Existing Sign
( ) Other
4 . Structure: ( ) Fence
( ) Wall
( ) Other
(Type or print legibly)
r
Address of Proposed Work: �2 Date:
Owner: / /�._ <�1 'Jt/�" G�/ff - /L�� _ Telephone
Home Address (if different from above) : A�
Agent or Contractor: wee— //\/dp i Telephone It
Address: a�{/ TZ / ST.. MOM- A44. CM944
Assessor' s Map n : Lot tt : ZS
7 1991
y. f
I
Detailed Description of Proposed Work: Give all particulars of work
to be - done (see 78 below) , including materials to be used, if
specifications do not accompany plans . In case of signs, give
locations of existing signs and ' proposed locations of new signs.
(attach additional sheet if necessary. )
�`�x/�7 ��/�' Alff ✓ �N,P��r.� 62, 7ftz- /i✓�71ViA/ ZEct57Zrl4 �'tc—
7 ids- klAtZ,� . 1-4Q4A7tV (70' ZWW-464f C04C,! fr 73 ASA/ Aft-q j
7--IMV ZF= YF,40Y "AlI a-W CAITom'/ �/ y97'
,�,�� ��,g�L,�_�t/�/, �t�jq-r 1��. �A/�i�!/�A-►. / ../[L L��" /Ill
//l/ 77�
AOw er nt, C tracto
DO NOT WRITE BELOW THIS LINE
RECEIVED FOR HISTORIC DISTIRCT COIIIfISSIOid:
TIME: �/','3d P
DATE:/Z ° 45-- YO
B Y: Z) 111A/iCucc/
APPLICATION 141r : Ga - f Q '
THISA LIGATION FOR CERTIFICATE OF APPROPRIATENESS :( APPROVED
( ) DISAPPROVED j
Reason for Disapproval:
I
( ) NO CERTIFICATE OF APPROPRIATENESS REQUIRED
I
A CERTIFICATE OR APPROPRIATENESS is 6211,z//-0 //13A/for work described
in .the application above and attached document . /9j
S��/GfC9j�i�1 %/1e3 � a &// ' fc?Tia
Chairman: Secretary:
Vice Chairman:
1 ' `
ADDITIONAL INFORMATION FOR 14AKING AND FILING AN APPLICATION j
Certificate of Appropriateness does not in any way supercede any state or
_oval codes or regulations . APPLICATION MUST BE FILED IN TRIPLICATE. Return
)ne copy to Building Department, one copy to the Town Clerk, and one to the
iistoric District Commission.
I
:'he four categories for which a Certificate of Appropriateness is required
ire:
EXTERIOR BUILDING CONSTRUCTION: (new or existing buildings) : An
application is required for any exterior of a building to be erected or
altered including windows, doors, siding, roof, light, ' parking lots, dish
ntennae, solar collectors, etc. , that will be visible from any public street,
,ay, or public place. The following scale drawings are required with
.pplication: plot plan, floor plan, and elevators where applicable. Also
-equired are photographs of existing buildings, where additions or alterations
.re to be made. No plot plan is required for addition or alteration which does
iot touch the ground.
DEMOLITION OR REMOVAL: Photograph required.
SIGNS OR BILLBOARDS: An application is required for any sign or billboard
:xceeding one (1) sq. ft. to be erected within the District, with the following
-xceptions:
a. Temporary signs for use in connection with any official celebration or
parade or any charitable drive as long as they are removed within three
(3) days of the termination of the event.
b. Real estate signs as allowed by zoning bylaws advertising the sale or
rental of the premises on which they are erected or displayed.
STRUCTURE: An application is required to build, alter, relocate or
emolish any structure whithin the District such as stone walls, gat
es,.
ences, etc.
i
-ENERAL REQUIREMENTS :
Work on projects requiring approval shall not be started until the
ertificate of Appropriateness has been filed with the Town Clerk by the
ommission. Approval is subject to the fourteen (14) day appeal period
rovided by the Act.
No changes shall be made from the original approval application without
dvance application filed with the Commission.
A separate application must be filed for each project requiring a
artificate of Appropriateness.
Under heading of "Detailed Description of Proposed Work" , give detailed
ata on all exterior architectural features: foundation, chimney, siding,
oofing, roof pitch, sash and doors, window and door frames, trim, and gutters-
eaders .
A complete and legible application will expedite action of the Commission.
Dpies of the Act establishing the North Andover Historic District and the
istrict Commission may be obtained at Town Hall .
I
�m
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sNf�OVER ST. N.ANDoVE RPI.A►.1 'I•H61-7. 60 r• '�a2sL,o�tc,5rV(Gj- �/a. S2" =1=O" pate 6
0GT.'90
I
Date. /�-'.f. /?'V
. . . . . . . . .
N2 45 7
NORTM 4, TOWN OF NORTH ANDOVER
0
PERMIT FOR PLUMBING
S CHUS
This certifies that
�� - . . . . . . . . . . .. .. . . . .
has permission to pe 4 . . . . . . i . . . . . . . . . . . . . . .
plumbing imthe buildings of . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . .
') 11
at."�&/ North Andover, Mass.
Fee. . . . .. . .Lic. No.. . . . . . . . . . . . . . .
L Gi�TOR
I U�61 G�INSPEC
Check #
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER,MASSACHUSETTS
1 // / / / Date
/ Sl-
Building Location Y Y Wnc�ol , sf' Owners Name Permit#
Amqunt
p / •/
11�/���`o. W jC/l o lam/ /-7/1 , Type of Occupancy
New Renovation Replacement Plans Sub Yes r No
FIXTURES
a a�
a
a F
w w g a a a x a -
FCC a z a H w w
C�
stRBsv>ic
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BE 11aR
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4IH FLOOR
SIfI FIOCit
61H ROM
71H HJ0CR
gm FIDCR
(Print or type) Check one: Certificate
Installing Company NameF, Corp.
i
Address ' ' ❑ Partner.
i av Ir
„,Business Teleph6he j — Firm/Co.
Name of Licensed Plumber.
ji3surance Coverage: Indicate the f insurance coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity Bond j
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 ent
I hereby certify that all of the details and information I have bmitted( Bred)in ove application are true and accurate to the
best of my knowledge and that all plumbing work and' ons p ed un ermit Issued for this application will be in
compliance with all pertinent provisions of the Mass in ode and Chapter 142 of the General Laws.
By: igna o rcense er
Type of Plumbing License
Title
City/Town ice se u er Master Journeyman ❑
APPROVED(OFFICE USE ONLY u
Date. `. . . . . . . .. . . . .... .. !
I
,4ORTIy
O� ma`s e•e O�
TOWN OF NORTH ANDOVER i
: PERMIT FOR GAS INSTALLATION
•`t6�
�,SSACHU5Et .
This certifies that . . �1 `. .'. : . . ��`. {. . . . . . . . . . . . . .
has permission for gas installation C
in the buildings of . . .1-4� .'.'. . . . . . . . . . . . . . . . . . . . . . . . . . . . .
at . . . ... . . . . . ..�.. . f. . . . . . _ , North Andover, Mass.
Fee�v . . . . Lic. No.��r J. . . . . . Y?. . . . . . . .
GAS INSPECTOR
Check it
35 . 3
z
iVIASSACHUSETSU�
P*AFPUCAT0fXF0RPMMW4
Type or print)
NORTH ANDOVER,M' A S TTS
Building Locations zJ
An
twner�s dame °t r r 2
"dw Renovation Replacement • P Suoraitt
z �
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J ,
a �
2
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t- :+3 a t
a�* i 1st
U t3 -B,% SE�t ENT a } t
SEM ENT �.a � , T
IS'r. FLOOR a .. MIM
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2N U . FLO U R b }z
3RD . FLUOR } zz
5rii . IF L t) U K ,. r
6 T II . F L U U K .° ', }
iT11 . FLUOK � Nt }
YT I1 . FLOOR
•C #L '�,YQ y,
Prim or rype)
an
+amr Andover lb & Ht k n �� TMt
Address 20 Agean Dr.,' Unit-10
Methuen. Ma�_�U 844
Business Telephone 978 685-8383
',ame of Licensed Plumber or Gas Fitter "fit
t�
INSURANCE COVERAGE
have a current liability insurance policy Or It'd subst�tlal"egatialet '
!'you have checked ve$ please l Icate IhC[� a �i�h1 thea pro ate . �s a
_i,biliryinsurancepolicy thee type of!Ad Wt+
13
()wner`s Insurance Waiver. I am aware that the Ia e the Itis e } a
Aass. General Laws,and that my signature on this permit applidadon waives this requirement
r
Oben one.
i;narure of Owner or Owner's Agent Owrt A
herebv certify that all of the details and information I have submitted(or entemd above 4p
: k
Orsi ut•my knowledge and that all plumbing w�and insz lad to Performed uad `permit Issued,,,,
_ompiiance with all pertinent provisions of the Massachusetts Mate Gets G and Chapter 142
Bv: Sapatu ofl, sed Plumb OrG�
Tille Plumber 0981,
(C:rv_iTown r¢as Fitter t t r
ivlttateA �
�PPP,O\,ED ioFFicF.USEi)NI.Y) oumeyrt srt k ;im
0
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