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Miscellaneous - 440 CHESTNUT STREET 4/30/2018 (2)
1 .� 0 Safety insurance Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Board of Health or Inspector of Buildings Board of Selectman City Hall City Hall NORTH ANDOVER, MA 01810 NORTH ANDOVER, MA 01810 RE: Insured: CHUNG-KIT CHAN and LAI-YIN TSENG Property Address: 440 CHESTNUT ST., NORTH ANDOVER, MA Policy Number: HMA 0323591 Claim Number: BOS00031986 Date of Loss: 9/19/2012 Company: Safety Indemnity Insurance Company Claim has been made involving loss, damage or destruction of the above-captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass. Gen. Laws, Chapter 139, Section 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim number. Allan Leavitt Claim Examiner 9/21/2012 Safety Insurance Company Homeowners Claims Unit P. O. Box 55098 Boston, MA 02205-5098 Phone: (617) 951-0600 EXT 3213 Fax: (617) 531-8891 Email: AllanLeavitt@Safetylnsurance.com y 0 L 46 Date....lp NORTH TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ,SSACNUSE` This certifies that ......f 5.l � . y has permission to perform ..... ......... ..... ... ... r wiring in the building of /L!."°2.......1.5,f �G .... ..... ......................... ..................... at......`/y.�...,..� ts7�iv� >` 5 ..... ,North Andover ass. Fee.... ... Lic.Noi,�3r�r3rr?�...... ....W/I . .. EL RICAL INSPECCO Check 0 ��� r i Commonwealth of Massachusetts official use Only / Department of Fire Services Permit No. G Yb BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ----------- APPLICATION 1/07j (leave blank F®R PERMIT TO PERFO�R®M�p ELECTRICAL E All work to be performed in accordance with the Massachusetts Elleecht�rica'C de(MEC),527C��Q0�®I�R+ (PLEASE PRWLVINK OR TYPE ALL INFORMAT IO City or Town of: NORTH ANDOVER NI Date: � _ ( F; � 20 � l By this application the undersigned gives not' e of his or her intention to erform the ele tri al woector frk described be Location(Street�&Number) L q LA 1i3 J N L + low. Owner or Tenant � � � � Owner's AddressCL 1,1.Cs Telephone No. Ts this permit in conjunction with a bj�ding permit? Purpose of Building_ `� �(f(( , Ni Yes ❑ ty (Check Appropriate Box) Utility Authorization No. Existing Service APs _ _Volts Overhead ❑ Undgrd❑ No,of Meters New Service Amps r _Volts Overhead❑ Undgrd[J No.of Meters Number of Feeders and.Ampacity Location and Nature of Proposed Electrical Work: { Com letion of the followin table may be waived by the Irra ector of Wires. No.of Recessed Luminaires No.of Ceil.-Sus No.of p.(Paddle)Fans Total No.of Luminaire Outlets Transformers KVA No.of Hot Tubs Generators KVA. No.of Luminaires S Above ❑ �- �'imming Pool o,o mergency ig g --, No.of Receptacle Outlets d• nd. Batter Units No.of oil Burners FLRE AI.ARMru No.of Zones c ���a No.of Switches No.of Gas Burners No.of Detection and No.of Ranges Initiatin Devices . No.of Air Cond, Total No.of Waste Disposers Heat Pump NubTons Tons N sNo-of Alerting Devices -........ No.of Self- No. elfNo,of DishwashersDetection/Alertin Devices Space/Area Heating Imo' Local❑ Mumcipal No.of Dryers Heating A Connection 0 Other Appliances KW Security Systems:* No.of Water No.of No.of Devices or E uival Heaters ' No.of entData Wiring: Si s Ballasts. No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Telecommunications Wiring: Total HP OTHER: No.of Devices or E uivalent �C� Estimated Value of Electrical Work: rV Attach additional detail if desired,or as required by the Inspector of Wires. Work to Start: G • t G _ � 0 if (When required by municipal policy.) INSURANCECOVERAGE: Inspections to be requested in accordance with MEC Rule 10,and upon completion. the licensee Unless waived by the owner,no permit for the performance of electrical work may issue unless .provides proof of liability insurance including "Completedoperation" coverage or its substantial eq undersigned certifies that such cove ge is in force,and has exhibited poof of same to the permit issuing officeuivalent The CHECK ONE: INSURANCE LY BOND ❑ OTHER I certify, under the pains and penalties of er u .(SPecify:) . FIRM NAME: ry, at the information on this application is true and complete Licensee: �t LIC.NO.. 3 7 (If applicable,enter."exempt"in the 'cense number lin ) Saga a �� LIC.NO.: Address: i . (o �� k S Bus.TeL No. *Per M.G.L c 14c 147,s 57-61 security rk re cues D kAV TeI.No.: OWNER'S INSURANCE ' 1 am aware that�ecens a does not haveublic Safety 'the liability Lic.No. required bylaw. By my signature below,I hereby waive this requirement. I am the(check one) 11 owner coverage normally Owner/Agent ❑owner's agent Signature Telephone No. PERMIT FEE:$ 3 S ELECTRICAL PERART NO. INSPECTION REPORT: ELECTRICAL INSPECTOR-DOUG SMALL 1.ROUGH INSPECTION: Passed—[ ] Failed—[ ] Re-inspection required[($50.00)-[ ] Inspectors' comments: (Inspectors'Signature-no initials) Date 2.FINAL INSP ION: Passed—[ Failed—[ ] Re-inspection-required($50.00) Inspectors'comments: (Inspectors'Signature-no initials) Date —l17 3.UNDER GROUND INSPECTION: • Passed—[ ] Failed—[ ] Re-inspection required($50.00) Inspectors' comments: ' (Inspectors'Signature-no initials) Date 4.INSPECTION—SERVICE: - DATE CALLED NATIONAL GRID: NAME: Passed—[ ] Failed—[ j Re-inspection required($50.00) Inspectors'comments: (Inspectors'Signature-no initials) Date n' 5.INSPECTION-OTHER: j Passed—[ ] Failed—[ ] Re-inspection required($50.00) Inspectors' comments: (Inspectors Signature-no initials) Date DOOR TAGS ARE TO BE FILLED OUT AND LEFT ON SITE IF THE AREA TO BE INSPECTED B NOT ACCESSIBLE AND A RE-INSPECTION OF$50.00 IS TO BE CHARGED. w The Commonwealth ofMassachusetts ' Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibl Dame(Business/organizationandividual): 0 S ��. Address: U t NC, City/State/Zip: h(0�4cly Phone ' I q Are you an employer?Check the appropriate box: 1.❑ I a employer with 4, F7. e of project(required): ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors E]New construction 2.❑ I am a sole proprietor or partner- listed on the attach # Remoded sheet. ❑ elm shipand have Remodeling no employees These sub=contractors have.insurance working for me in any capacity. workers'comp8. ❑Demolition.9. Bu' addition [No workers'comp.insurance 5. We g n ❑ a corporation and its required.] officers have exercised their 10. lectrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL I L[❑Plumbing repairs or additions myself. [No workers'comp. c. 152, §1(4),and we have no in required.] t employees. [No workers' 12.❑Roof repairs comp.insurance required.) 13.❑ Other " Y az glicant hat checks box 4l m:st also fill out the section below sho;=.,n� b .heir workers'compensation policy info Watton. 1 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.#: ( j �[ Expiration Date: 1 ✓ ( l Job Site Address: –1 `(� � ��S' 1 N��--E-- �--�- N rr'�� City/State/Zip: N .A VCS Ur c/ e-M� 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby7fyue pains and penalties o perjury that the information provided above is true and correct Si ature: _ O /d' — ( Date: 1 Phone#: ""l. �5f �6 Official use only. Do not write in this area,to be completed by city or town officiaL City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6. Other Contact Person: Phone#: 9555 ........................... Ot T TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSACMUSEt This certifies that .......... - has permission to perform ............... ....... wiring in the building of....... .......... .�b.................................... . ............. . ...... ............................... ..North Andover,Mass. Fee.qS....M- ...... Lic.No..1C1.7A�. ...... .... Jlz Check # r6 . N VV//////V/IWCQIIII V/ I'IdDJQl.1ILIJCl�.7 --- - -- - Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank M APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC), 27 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 7 W /0, City or Town of: NORTH ANDOVER To the Inspect r of fres: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Owner or Tenant vq+J rd- v N q 4 Telephone No. "7?/-6 y0^J ee-1 Owner's Address �yy rakJ d,,,i- .$ d' /Vi&d4` i+1rg Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building OL ml 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: i Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA )Y No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ N-0—.0-T mergency Lighting rnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained .. . ....................................................... Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security f Systems:* evi es or Equivalent No.of Water No.of No.of Data Wiring: Heaters KW Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications No.of Devices or Equivalent OTHER: eo 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: /D Inspections to be requested in accordance with MEC Rule 10,and upon completion. C INSURANCE V RAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance includmi g"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 7❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: ':Z—Ac- L-r-Je%c-eJ Y `"'l cQ 1 LIC.NO.: Licensee: —ilea Signature LIC.NO.: 117 1 (If applicable, enter "exempt"in the license number line.) Bus.Tel.No.:!®o3—Z-3r 723 n Address: S�"VQ- 4" -e,, ►,J Alt.Tel.No.: *Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑ owner ❑ owner's Owner/Agent PERMIT FEE. $ Signature Telephone No. r a Ic The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 s� www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): J AC_ aea"J c Address: ? or+_ City/State/Zip: <�N" N4 03c-? Phone #: 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.�I am a sole proprietor or partner- listed on the attached sheet. $ E]Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition 'comp.working forme in any capacity. workersp•insurance. 9. ❑ Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑ Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.El Plumbing repairs or additions myself. [No workers'comp. c. 152,§1(4),and we have no 12.❑ Roof repairs insurance required.] i employees. [No workers' 13. Other Q�� ��q a.. comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $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. r Insurance Company Name: Policy#or Self-ins.Lic.#: 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$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: Date: Z0 /,9 Phone#: Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Illy Date. .. .. . . .. ... . Of NORTHto F= °p TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLAT ON �,SSACHUSES This certifies that .f"f9 . . . . . . ..... . ... . . . . . . . . . . . . . . . . . . has permission for,gas installation . . .� c. n&/1 . . . . . . . . . . in the buildings of . TG . '.`h/ . . . . . . . . . . . . . . . . . . . . . . . . . . at . . ��D �`�. S.�" U. .4. . . . . . . N rth Andover, Mass. Fee. l. . Lic. No../A). � - . . . GAS 1N CTO Check# 2 ) 73-19 MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS RTTING (Type or print) Date 016 NORTH ANDOVER,MASSACHUSETTS �'— Building Locations C/DOY _S1,101-11e. o ��/�fl/7(/7 Permit# 3 j /�,,/�CF/( Amount$ L '►�° L(/0✓ /�/II��/ /�� Owner's Name�. �� /✓11 �J✓�(/I1.t Q . New Renovation Replacement Plans Submitted U �a o W o U M Ck 'd o a z z c x w . H z �Tk g t , z 0 H o 3 a ° ° > 0 W SUB-BASEM ENT H o BASEMENT 1ST. FLOOR 2ND. FLOOR 3RD . FLOOR l 4TH. FLOOR { STH. FLOOR 6TH . FLOOR 7TH . FLOOR 8.T-H . F L O 0 R (Print or type)Y&L-4 / Check one: Certificate Installing Company Name /d /� �/ Lri ,('W.L '❑ Corp. Address ❑ Partner. 30 4P Business Telephone /, Z S' 7—d/3.3 qFirm/co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check on I have a current Iiability L-isuran. policy or it's substantial equivalent. Yes DO Nor If you have checked3Lqsplease in -' ate the type coverage by checking the appropriate bol--,- Liability o .Liability insurance policy Other type of indemnity Bond 1 Owner's Insurance Waiver: I am aware that the.licensee does not have the Insurance coverage required by Chapter 142 ofthe Mass. General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner 0 Agent 0 I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts S # G d d pter 142 of the General Laws. BY: Signature of Licensed Yumber Or Gas Fitter Title Plumber, ss 7 y City/Town 0 Gas Fitter License Number Master APPROVED(OMCEUSEONLY) rj Journeyman The Commonwealth of Massachusetts . .� Department o fIndustrial Accidents Office of Investigations ..600 Washington Street Boston, MA 02111 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le6ibly Name(Business/Organization/Individual):_lo.4$t 1 IAN(f _ eLl� Address: City/State/Zip: A: Phone#: 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 employees(full and/or part-time).* have hired the sub-contractors 6 New construction 2,❑ 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 me in any capacity. workers'comp.insurance. 9 ❑Building addition • [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 1 L❑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' comp,insurance required.] 13.R Other ':-ny applicaat that checks box#1 must also flI crit the section below showing thCL iso;=;•_s'compensation policy i^t'or...a.tcon. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a neer 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.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 do hereby certify under the pains and penalties of perjury that the information provided above is ------ true and correct Signature: Date Phone#: FOther only. Do not write in this area, to be completed by city or town official n Permit/License# hority(circle one): Health Z.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector son: 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 t1 ae 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 Iocal 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 coxnpliance 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 fillout the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if + necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their cerdficate(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 maybe 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 pernaitor License is being requested,not the Department of Industrial Accidtnts. Should you have any questions regardiu.g 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 thanit 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 ofMassachusettts Department ofIndustrial Accidents Office of InvesfibatiQng 600 Washington Street Boston,MA 02111 Tel. # 617-727-4900.ext4-06 or 1-877-MAS.SAFE Fax#617-727-7749 Revised 5-26-05 wvm,.mass._govfdia r .-• Date.. 113D22 of"°RT," , TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING �ss�c►+us�t f This certifies that.......r..fo ... ......... � ................................... ...... . . - has permission to erm....xl °`9 .. .. �'d�✓. ?- ICA plumbing in the uildings of......... .5 ,. .:......................................................... at.. ." •• .... .........:-S. u. ... ......... North Andover, Mass. Fee(,�9.4..'.......Lic. No.1.,'�...b yS... ................................................................................. PLUMBING INSPECTOR Check# M� ItQtMASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK ' CITY MA DATE -zy- ���PERMIT# JOBSITE ADDRESS OWNER'S NAME POWNER ADDRESS z-I td5� ��- TEL may-Z AX TYPE OR OCCUPANCY TYPE COMMERCIAL Q EDUCATIONAL EQ RESIDENTIAL PRINT CLEARLY NEW: � RENOVATION:® REPLACEMENT: ]I PLANS SUBMITTED: YES® NODI FIXTURES'l FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB _._( �..,.1===j=1 CROSS CONNECTION DEVICE I DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OILISANDSYSTEM ___ 1 -_. __� _ I _ ____f __ _( __-. 11-11 --J1 DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM i DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN I ! --.— FOOD I .-____-P ----.._ FOOD DISPOSER -J1--AL I== FLOOR/AREA DRAIN I ____.._1 .___-_! __._J _____! __..__.1 -____J ___ _C ____! INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY I -___J _-.___! ______ _�I .--_____I __.___( ___ 1 ______P ___.__1 ..:�� ___.._� ! 1 __._.__► \ ROOF DRAIN ! y ! .____.! .__^I __.( ___.J ._ __( .__._! ._...__ __^I ..______f SHOWER STALL SERVICE l MOP SINK TOILET l ___.._ l -____! _—_(_._ - _ { __! _..-J1 I .-__-1 _-_ URINAL .J WASHING,MACHINE CONNECTION i ( _.._ _ __.. ___. ! - ._.....__1 ____ i __ 3 ___.._( ____ _.__.._- WATER HEATER ALL TYPES WATER F °ING -_ 1 ! __{ OTHER �l INSURANCE COVERAGE: 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES f NO IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW r4-1 LIABILITY INSURANCE POLICY j OTHER TYPE OF INDEMNITY Q BOND P]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 Q AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with 11 Pertin nt provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME �� I LICENSE# /� 5�S-": SIGNATURE (VIP QI JP Q CORPORATION n#PARTNERSHIP _i# LLC -J COMPANY NAME _ 5 ; ADDRESS Dr i CITYvy '/�----_...._...__..__I STATE ZIP f ���G� TEL�Ke s-y EMAIL FAX _ � CELL _ -�.Y�--=� ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES 1 ,i The Commonwealth of Massachusetts Department of IfidustrialAceldents 1 Congress Street,Suite 100 Boston,MA 02114-2017 o�r www mass.gov/dia �7M SJ.V Workers,Compensation Insurance Affidavit:BuildexslContractors/Electricians/Plumbers. G AUTHORITY. TO BE FILED WITH THE PERMITTINPlease Print Le 'b1 A ••licant Information �-^ Q,� Sa xie y Name(Business/Organization/lndividual): G Address: °l p/ Phone#: �'7�_ 3 7 City/State/Zip: �... . • : Type of project(required): Axe you an employer?Check the appropriate box: employees(full and/or part-time). 7. ❑New'constraction 1.Q I am a employer with___ 2. I am a sole proprietor or partnership and have no employees Working formic in $. Remo dellrig any capacity.[No workers'comp.insurance required.] 9, ❑Demolition 3.❑I am a homeowner doing all work myself[No workers'comp.insurance required] 10❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 11❑Electrical repairs or additions ensure that all contractors either have workers'compensation insurance or are sole JZ.[f Plslinbing repairs Or additions , r,. proprietors with no zemployees. 5-❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 11[]Rbof repairs These sub-contractors have employees and have workers'comp.insurance.t 14.a Other 6.QWe are a corporation and its,officers have exercised their right of exemption per MGL c. 152,§1(4),and we.'. I 1 .1 employees:[No workers'comp.insurance required.] *Arty applicant that checks box#]must also fill out the section below showing their workers'compensation policy information: i Homeowners who submit•this affidavit lied an additional sheett showing he name of the-work and then hire oing all sub-contractors and state wtside contractors must h th now or not hoseentities have h $Contractors that check thus box must attae employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. employer that isprovidingworkers'compensation insurance for my eynployees. Below is thepolicy andjob site jam an • information. Insurance Company Name: Expiration Date:. Policy#or Self-ins.Lic.#: PIA Job Site Address: Z/ ! �tjon I 5 � —City/State/Zip:A/ Ald9 te-4Attach a copy of the evoxkers' compensolicy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL a.152,§25A is a criminal im OPiWORKp RDER1and a�Of p to $250.00 a and/or one-year imprisonment,as well as civil penalties in the form o day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. X do hereby certify under'thepains and penalties ofperjury that the information provided shove is tru�a�correct. –• Date: ISipatur Phone#: 3 3� t 3 FFfonly. Do not write in this area,to be completed by city or town official Permit/License# n• ssunghority(circle one): 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 1.Board of Health 2.Building Department 6.other Phone#• ContactPerson: . � c Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their enipl6yees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of tile, 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 b6 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 applicaritwho has'not produced-acceptable evidence of compliance with the insurance coverage req'u`ired." 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'contractors)name(s),address(es)and phone number(s)along with their certificates)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. B e 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(ifnecessary)and under"fob 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 Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 Tel.#617-727-4900 ext.7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass-gov/dia i Date &ORT#1 OF 0 x TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION s`rACHU This certifies that .................................................. ... /Z— ...................................... has permission for gasinstallation .................. .... . ...... in the buildings of .......................................................... at ......... ........... North Andover, Mass. Fee.2!;?............ Lic. No. 3G.............. ..................................................................... GASINSPECTOR Check# MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK I ICITY ( —A ncb\lcy MA DATE � PERMIT# 1 JOBSITE ADDRESS „`J`IO C11eS f�� Si--=OWNER'S NAME *G OWNER ADDRESS j C _�F 0' S t . __ _ TE S - 2-o -_- _�.FAX _ p�T OCCUPANCY TYPE COMMERCIAL E] EDUCATIONAL ® RESIDENTIALP CLEARLY NEW:0. RENOVATION:D REPLACEMENT: PLANS SUBMITTED: YES D NO APPLIANCES Z FLOORS--> BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER - - - CONVERSION BURNER COOK STOVE .. . . . DIRECT VENT HEATERI �— DRYER FIREPLACE TJ( � _ I ._ J FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER _ ( �- UNVENTED ROOM HEATER WATER HEATER OTHER N L INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES [I NO El IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 01 . OTHER TYPE INDEMNITY Ej BOND OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER 0 AGENT [��I 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 compliance with all P rtinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. r PLUMBER-GASFITTER NAME LICENSE# S— SIGNATURE MP J J MGF JP JGF© LPGI CORPORATION 0# PARTNERSHIP 0#=LLC D#= COMPANY NAME: ADDRESS CITY w v_r v _L� . _ STATE ZIP ITEL Ylj'--? 3 3 FAX I CEL yL SYSJ�EMAIL _ _ _ i ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION.D TES r— Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES i i t� COMMONWEgLTH OF M ' d o�ASSACHUSETTS BOARD:'01= PLUMBERS pND GASFI:TtERS ` y I S$U>ES THE FOLLOWf NG' L I ' LICENSCENSE ED AS A MAS'TER%PLUMBER� s °kt R GAUTH I ER — 039 LAND 39 W00D PARK bR VE '.f',-_�.. 4�` W HILLF1A 01830 2262 Date. . . . . . . . 4 . . TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING SSACMUSE� This certifies that .,.-ce�c'c� :�-s���. f'. . . .� has permission to perform . %#' . �..•. . . . . . . . . . . . . . . . . . plumbing in the buildings of . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at. . !� a. -X'11 -..� . , North Andover, Mass. Fee.',` .Uc. Nd . � '1 . . . . . . . . . . . . . . PU-M�BING INSPECTOR Check # A") 8183 414/° MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/TMn:f 1 C rA 6 W&V 41 ,MA. Date:FS-1?'— 09 Permit# Building Location: `Y �10 C.6,CnA S+R&J Owners Name:b Type of Occupancy: Commercial❑ Educational❑ Industrial❑ Institutional❑ Residential New: Alteration:❑ Renovation: Replacement: PlansSubmitted: Yes N Ff RIES c 2 v► O W Z J - _ W. CO 4 Z #�- Y Q al V 0 it Z W fA W Z t- W Z h N O KE F'- 9 M W o: n. W rd i ami o v i% x OJ M Q W D q' a Z � O p W W Z u. CO lu IL ~ g O 0 ¢F- % 2 2Q' U. D. Y' Q = W W W Y = MA Q 2 vt 9 Q O H 5 > O Z 2 Q' Q 3 a 3a H Q to to O o .u. a x Y 5 5 a m 0 �-' X 9 ' O. SUB BSIWT. BASEMENT 1 1 151 FLOOR -YorFLOOR Sw FLOOR 4 In FLOOR -5w-FLOOR 6 FLOOR 7 FLOOR 8 FLOOR Check One Only Certifcate# �nstailin9 Company Name: yCb. // ❑Corporation Address:22 �®Y/YIS* �,6;W Town• gypr State.1, d, Partnership Business Tel: 1,'03- y3-2^ 0/33 Fax: e;0.3 991— 0/.9(0- MirmlComparty rk^0,7- Name of Licensed Plumber: INSURANCE COVERAGE: I have a current liabilityinsurance policy or Its substantial equivalent which meets the requirements of MGL Ch.142 YesNo If you have checked Yens please indicate the type of coverage by checking the appropriate box below. ////// ``����� A liability insurance policy D9/ Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I ane aware thatthe ffen.eC�din � mf-:--_ Massachusetts General Lem,and that my signature on this permit application wairc5 Fls oe a iae a arL r s Check One Only Owner D Agent ❑ Si nature of Owner or Owner's Agent - -3. ---- �_. an are true,and accu e m d{r wire any mei alI plumb a work sr.=iMtailadotts perfe-r-mm;under the pansy issued for this application will be In compliance with all Pertinent provision of itee fttssachusetts State Plumbing Code and C;hapier 962 of iite Genetai Laws. By Type of License: Ttlle umber Signature of Uq6nsedPlumber Cit'fro`"n ❑Journeyman License Number: ?/ APPROVED OFFICE USE adt. - Date.. .-.Z.a.'�� ... ~"t f NORTH 1 TOWN OF NORTH ANDOVER Wall PERMIT FOR WIRING �,SS�ICNUs� ....... &T .............. 1 This certifies that ..# 7 �(�l.....`�(......... . has permission to perform ........ wiring in the building of..............." �, v��jQ... .. .................................. C� �� !�/// 5. at...........................::._.........� ,North Andover,Mass. .. Fee.jff.- ��"�.... Lic.No. .......... .... .. . .... ...... j ZRICAL INSPECMR �t Checkit /S99 G°i97r 8044 t..onsmonwaa o� ai�ar alft _- Official UseOnly Permit No. _ 11sPerE�na,sE o�Jir.Sarvica! 7"�-- Occupancy and Fee Checked BOARD,OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leave,blank) APPLICATION FOR PERMIT TO PERFORM',ELECTRICAL WORK All wor(c'to be performed in accordance,.with.the Massachusetts Electrical Code(MEC),527 CMft112 00' (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) `'D ate'' City or Town of: ^ ` A'�Now w To the Inspector'of,Tires.t al By this application the undersigned gives notice of his or her intention to perform the e!ect�ical work described below. I Location(Street&Number) tip C,_es lNo t G l Owner or Tenant ,VRN FohhNliilb -� Telephone No. i Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No L/\j (Check Appropriate Box) Purpose of Building Utility Authorization No. i Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of r4eters New Service Amps / Volts Overhead❑ Undgrd No.of Meters Number of Feeders and Ampacity 1 Location and Nature of Proposed Electrical Work: �•��)-�Ij y, CL C-;C-n a CGU.r t o r� FIM Lar t)7 I_rJ lRC�`t55 Ccm letinn of the following table m be waived by the Insaector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Faddle)Fans r c ota Transformers KVA No.of Luminaire Outlets No.of Hot Tabs Generator-, KVA Above n- c..oI emergency ag rng j No.of Luminaires,. Swimmins Pool grnd. ❑ arnd. ❑_113atteEyUnits No.,.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No o Detection an .No.of Switches _ No.of Gas Burners 1:itiatina Devices ' No: - Total of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers eat um um er ons o.o e - ontatne P Totals . ........__•_ Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ CMunicipal onnection ❑ Other Heating Appliances KW Security Systems:* a,o No.of Dryers No.of Devices or Equivalent No.o atero.o o.o Data Wiring: .%!eaters KW Signs Ballasts No.of Devices cr E uivnlent No.Hydromassage Bathtubs No.of Motors Total HP a ecommunicati.ons trim-: No.of Devices'or E uivalent OTHER: / -0 s attach additional detail if desirec4 or as required by the Inspector of Wires. Estimated Value of Electrical Work: a '� (When,required by,municipal policy.) { Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERA E: Unless waived by the owner, 10 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 Z BOND ❑ OTHE1? ❑ (Soecify:) .I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: P�-T S��-Uri—rN �{ LIC.NO.: Licensee: -- Signa'wr� _ LIC.NO.:(-e L (If applicable,enter"esen(pt"in the � !icer num er line.) / Bus.Tel.No.: Address: . 1 0 ,L_/Ili _ its , ' a�� 9 Alt.Te*No.- 75 *Per M.G.L.c.,1 47,s.-57-61,security work requires Department of Public Safety"S"License: Lic.No. G l9 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)C]owner E]owner's agent. Owner/AgentPERMIT FEE: $ Signature Telepho�ae No._ ••� V Department Of Public Safety - _ One Ashburton Place, m 1301 Boston, Ma 02108-1618 License: CER T IFICATE OF CLEARANCE Number: SS CC 001975 Expires: 10/09/2009 Restricted To: 00 KENNY WONG f `- 18 CLINTON DR HOLLIS, NH 03049 Tr. no: 439.0 Keep lop for receipt and change of ada•-,- DPS-CAt 0 SOM-07/07•PC8490 COMI✓(D"W /EALT:". OF fvIASSACHUSE:i S 1fz �IC -EpOfIr4/101!!/M.?llI O�ii/�.OdJ?C�IIJCI� -- DEPARTMENT OF PUBLIC SAFETY LEC IA ' CERTIFICATE OF CLEARANCE REGISTERED SYSTEM TECHNICIAN Number: SS CC 001975 ;SU_S 1!i!S L!:'Er;SE TO Expires: 10/09/2009 Tr. no: 439.0 KENNY Q WONG rI jj S-License: ADT SECURITY 22 FIELDSTONE DP. IVE I KENNY WONG r 18CLINTON DR BURLINGTON MA 01803-42-13 iOLLIS, NH 03049 �_� _ I Commissioner %'G SAFE CALL CENTS R: (888)344-7233 5_9 6`6 �D 6 'J7/t a/10 28 4 07 2 NUMBR DRIVER'S LICENSE 8 1 • 58291 E� .� DATE OF BIRTH CIASG REST - HEIGHT SES fi 10-09-1969 D soz. M EXPIRES / G-09-2009 00NG KENNY OIU _ _ -- 22 FIELDSTONE DR _ BURLINGTON,MA 01803-4213!% „ v t/J C)'� J .r 4 I. Date. . . . . ...0. ._rT Q NORTH TO.W-N'OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACMUS� This certifies that . J ff-'. �•� ` has..permission to perform—, :fir?. . . 1. . : `: .. .. .. .. •. ... plumbing in the buildings of . -�:: ��. -r. . !�!. . . . . . . . . . . . . at . . :'' ' � - . . . , North Andover, Mass. Fee n--,P�..�. .. . .Lic. No.-�•!t /. . . . . . . . . . . . . . . . PLUMBING INSPECTOR Check # 8066 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town4Of ids MA. Date: 5- 009 Permit# �U�4 Building Location: y�/(� f �5�1"�(/ Sr. Owners Name:G/e //Z� 11i' n a Type of Occupancy: Commercial❑ Educational ❑ Industrial ❑ Institutional❑ Residential New: ❑ Alteration: ❑ Renovation: ❑ Replacement: Plans Submitted: Yes❑ N FIXTURES i z rn o Y to m v rn iii z U) y N a le z ia- Y U) Q Q N U :ac 3 QQ H U) O m N W o a COZ 9 Ix z M rn t7 v a LL W z wr Y = 9 0 0 3 x z Q 0 3 a Y a x 1u W W O a m m a a W a x Y 3 3 01 1 SUB BSMT. BASEMENT 1 FLOOR 2 FLOOR 3HO FLOOR 4m FLOOR 5 FLOOR -i'FLOOR 7 FLOOR -i'FLOOR ��� � {�f ///f/6K'i�fCt.� Check One Only Certificate# Installing Company Name: 79 Add, Y'xn ❑Corporation Address: �r City/Town: State: � ❑Partnership Business Tel 66 Fax: x¢63) /9� o rm/Company N�2'D �07 Name of Licensed Plumber: OL INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes /yNo❑ If you have checked Yes.please indicate the type of coverage by checking the appropriate box below. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement.. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I 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 compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By Type of License: Tale .Plumber Signature of Lic sed Plumber Cityrrown ❑Master APPROVED OFFICE USE ONL �burneyman License Number: .7 tco CERTIFICATE OF LIABILITY INSURANCE OP ID CA DATE(MMIDD/YYYY) HAT1rI-1 1 05/04/09 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Santo Insurance - Manchester HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 1065 Hanover Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Manchester NH 03104 Phone: 603-890-6439 Fax:603-890-0315 INSURERS AFFORDING COVERAGE MAIC# INSURED INSURER A: Nationwide Companies 23787 Hatfield Brothers Mechanical INSURER B: Travelers Insurance Company Robert Hatfield INSURER C: 78 Norman Drive INSURER D: Derry NH 03038 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REOUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NsRN TYPE OF INSURANCE POLICY NUMBER DATE(MM/DD/YM) DATE(MMIDD/YYW) LIMITS GENERAL LIABILITY EACH OCCURRENCE $1,000,000 A X COMMERCIAL GENERALLIABILITY ACP GLGO 540382959 01/13/09 01/15/10 PREMISES(Eaoccurenee) $100,000 CLAIMS MADE I—XI OCCUR MED EXP(Any one person) $5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE s2,000,000 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s2,000,000 POLICY JE LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $1,000,000 A ANY AUTO ACP BA 5403829593 01/15/09 01/15/10 (Ea accident) X ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) X HIREDAUTOS BODILY INJURY $ X NON-OWNED AUTOS (Perecddent) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR EICLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ WCL" $ WORKERS COMPENSATION X TORY LIMITS ER AND EMPLOYERS'LIABILITY B �IPROPR�IETORiPBER�1 DR/EXECUTIVE 6S62UB0368N15809 02/10/09 02/10/10 E.L.EACH ACCIDENT $500,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $500,000 If yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $SOO,000 OTHER OESCMPTION OF OPERATIONS!LOCATIONS I VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION TOWNNOA DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL DAYS WRIT I N NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO$O SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. TOWN OF NORTH ANDOVER AUTHORIZED 146 MAIN STREET AUUTHORIZED REPRESENTATIVE O ANDOVER MA 01845 1 Kendall J Turner ACORD 25(2009/01) ©1988-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Date.... . .. .. ... .. ...... .. &ORTk 1 1 ,ao .h° o? TOWN' OF NORTH ANDOVER • VOW PERMIT FOR GAS INSTALLATION ,SSACHUSEt This certifies that . . . .Z -z%-. . . . . . . . . . . . .�4` . . . . . has permission for gas instillation . . .. . . . . . in the buildings of . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . at , North Andover, Mass. .°1 Fee:!'?. . . . . Lic. No ©. . . . . . . . . . . . GAS INSPECTOR uU Check# AP,.-3/ 6775 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING CitylTown: N014 6'GGfOSI� MA. Date:S G-,,7-O A 9 Permit# Building Location:V/0 0 L.4JIlIUll- Owners Name: 1 117 a-�® Type of Occupancy: Commercial❑ Educational❑ Industrial ❑ Institutional❑ Residential New: ❑ Alteration: ❑ Renovation: ❑ Replacement-�c Plans Submitted: Yes❑ Nox FIXTURES Tin LU W Z ~Q U) V = m = O W ce W 0 Tin H O = 19 W Z 1- t9 J } Z W O Q 0 W CA) W Z m 0 ~ d FW- G 0 W K W > W Z F Q W = 2 4' H N U W W w Z = W I— Ili � Q xztuww z W } r�ii a~a aQ m w O z 0 ~ H w w V G G W t9 �U' _ _ 51 O a H > > > O SUB BSMT. BASEMENT i FLOOR 2Nu FLOOR -i'FLOOR 4m FLOOR -i'FLOOR FR—FLOOR 7'm FLOOR 8 FLOOR , 1 ` / Installing Company Name: 1 UF,e- �/� �'n.Y'd Check One Only Certificate# tel' �G �/ ❑Corporation Addres<2 ,� /10�✓azza Dr.city/Town: State: ❑Partnership 611 iness Tel:/oG 1 01120 Fax: P y/�!a �1� g Firm/Com an Name of Licensed Plumber/Gas Fitter: INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes��lo El If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. !! `"' A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this box❑;I 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 compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Type of License: By umber Title El Gas Fitter Signature of Licensed PlumberlGas Fitter ❑Master Citylrownoumeyman License Number: -31013 APPROVED OFFICE USE ONLY ❑LP installer Hate � .�. 4, TOWN OF NOR . H AN , OVER ' PERMIT FOR PLUMBING �SSACHU This certifies that . . . l°'. . ..'009 . .�. `. . . . . . . . . . . . . . . . . . . . has permission to perform . . ..D. t :'. . . . . . . . . . . . . . . . . . . ... . . . . . plumbing in the buildings of . . . . . ... . . . . . . . . . . . at. 4�.1�. .4t-fit �. �. I. . . . . . . . . . . . . . .. North Andover, Mass. Fee.2U.. . . . .Lic. No.. .24 .t ..4 . . . . . . . . . . ,. . .. . . . . . . . . . . . . PLUMBING INSPECTOR Check # �O 7942 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS J Building Location q10 O helknJ �i f- Owners Name Date_ /� `�(1'(l Permit#_____?5 Y L Type of Occupancy Amount New Renovation M Replacement / Plans Submitted Yes No FIXTURES 0 � O +� q ? - G U &�g1VII�' ]S); a M17+ IR I. 33ML II2 � 4IIiIIf� I x SMFLOCR 6gi IILICIt s�FLOM ) 4. (Print or type) Check one: Installing Company Name , il, �% j�� j �� L� Certificate L� Corp. Address I <t � f r�f v1nev,j n c 01 '4. ❑ Partner. usiness lelephone M iF m co. Name of Licensed Plumber. /�h J v'r 7� Fly Insurance Coverage: Indicate the e of insurance coverage by checking the appropriate box: Liability insurance policy emnity Other type of indBond fff�...11l ri F Insurance Waiver: I, the undersigned,have been made aware that the licensee of this applicati three insurance on does not have any one of the above Signature Owner ❑ ❑ Agent I hereby certify that all of the details and info7naave submitted(or entered) above application are true and accurate to best of my knowledge and that all plumbing work .dins ations perfoizned under ernut Issued for this application the compliance with all pertinent provisions of the Mass h setts tate G will be in Plkrmb� e Code d Ch pier 142 of the General Laws. By. �g c se�( u er Title Type of Plumbing License City/Town cense umber APPROVED coFFicE USE ONLY Master Journeyman (� Geotechnical Engineering Environmental Studies . Materials Testing Construction Moniioring RECEIVED June 9,2004 Law Offices of Ralph R. Joyce JUN 15 2004 PO Attn: Mr. Ralph R. Joyce NORTH ANDOVER 121 Collins Landing CONSERVATION COMMISSION Weare,New Hampshire 03281 RECEIVE re: SLOPE STABILIZATION RECOMMENDATIONS JUN1 5 2004 REAR OF LOTS 1 THROUGH 4 CHESTNUT STREET BUILDING DEPT. NORTH ANDOVER,MASSACHUSETTS GSI PROJECT NO. 202175 Dear Mr. Joyce: Geotechnical Services, Inc. (GSI) has visited the referenced site on May 18, 2004 and observed the conditions of the earthen slope which has been subject to erosion and local sloughing failure. Based on our review we offer the following recommendations with respect to permanent soil stabilization.To assist in our review of the slope conditions we were provide with the results of a topographic survey performed by GeoAmbient Engineering,Inc. (GAE) as well as a Drainage Analysis and Sediment&Erosion Control Plan dated 9/29/03 also by GAE. SLOPE TOPOGRAPHY AND EXISTING CONDITIONS There were two areas of localized slope failure observed at the time of our visit. Between stations 1 and 2 referencing the GAE topographicplan,there are downgradient and upgradient,shallow seated slope failures, of approximately 20 by 50 feet. These failures are characteristic of a sloughing of the surficial soil fill resulting from an instability at the fill/parent soil interface. The resulting scarp is 12 to 18 inches deep and exposes a profile of the fill soil unit which appears to be a fine to medium silty sand with some to little gravel (reworked glacial till). Groundwater was observed to be seeping from the scarp/parent soil interface. Parent soils are Parton series glacial till deposits. Frequent rill erosion was observed throughout the slope. The occasional topsoil veneer possesses negligible tilth and fertility and the extent of topsoil thickness is insufficient to support the vegetation which is composed of sparse perennial rye grasses. Upland of the affected portions of the slope,the area is generously vegetated with a mix of deciduous and coniferous trees and underbrush. There are no signs of slope instability in the naturally vegetated areas. Based on the topography provided by GA Consultants, Inc. the earthen slope ascends at the rate of 2H:1 V from the existing"Redi-Rock"retaining wall to a narrow,2 feet deep drainage swale running square to the slope. From this point the slope further ascends on a 2:H:1 V slope to the crest of the hillside at roughly elevation 190 feet.Che swale shows severe guHy erosion and the crushed stone lining has been transported downgradient towards the swale terminusl 12 Rogers Road, Haverhill, MA 01835 978/374/7744 FAX 978/374/7799 18 Cote Avenue, Goffstown, NH 03045 603/624/2722 FAX 603/624/3733 s Chestnut Street Earth Slope Recommendations GSI Project No.202175 June 9, 2004 Page 2 SOIL SLOPE STABILIZATION The parent soils are dense glacial till deposits which are inherently stable, in terms of global or deep-seated stability, in natural slopes as steep as 1 H:1 V. Such soils possess a great deal of silt and clay which render them prone to erosion. In the cf�hispre}ect,�ie shallow slope failure is the result of external erosion of the reworked glacial till fill as well as internal instability induced due to the effects of_groundwater seepage Our recommen ations with respect to slope stability improvement are twofold;subsurface drainage to relieve seepage forces and "bio-structural"erosion control incorporating hardy vegetation. Subsurface Drainage To obviate the groundwater seepage and thus enhance slope stability,it is recommended that the interceptor drainage swale be undercut with an underdrainJThe underdrain may be 4-inch ADS, Hancor type slotted drain pipe set within a 2 x 3 feet trench and enveloped with 3/4 inch crushed stone. The entire-perimeter.of the trench should be wrapped with filter fabric, Mirafi 140N or equal product. The underdrain will serve to intercept groundwater andinduce a egression in the phreatic surface;the result will be enhancement of the overall slope stability. The underdrain detail is depicted on the attached sketch,. The drain may enlaced along the alignment of the existing swale and.it's insert ray A4yl ight into the swale at a distance downgradient in advance of the proposed retention pond Once thhe.drain._is installed the interceptor swale should be reworked to the-geometry shown of the attached detail The swale should be lined with Mirafi 50OX stabilization'fabric and then lined with rip-rap-mie—ing the requirements of Massachusetts Highway Department, M2.02.4, Modified Rockfill. Bio-structurai Erosion Control Surface erosion may be countered by the establishment of deep-rooted,hardy vegetation along the slopeside. The beneficial effects of vegetation on the slope would include mechanical stabilization of the surficial soils by the root and stem structure and modification of the subsurface hydrology by the processes of evapo- transpiration. Secondary effects include a marked retardation and velocity reduction in stormwater run-off. GSI recommends that the slope be covered with a minimum of 6-inches of humus of such nature and organic content capable of sustaining vegetation. GSI further recommends that an'erosion control mat such as North American Green S150 or equivalent be mechanically affixed to the slope immediately after humus placement. One supplier of the above-referenced mat is Jennian Enterprises of Melrose,Massachusetts.-The mat provides erosion protection and slope stability'prior to establishment of vegetation. Subsequent vegetative cover may be established by using a hardy mixture of.grass and legume seeds including annual Rye grass and Crown Vetch. Crown Vetch is a legume that possesses a fairly deep root system and grows to a height of about two feet. The legumes are desirable for nitrogen contribution via transportation processes and subsequent inoculation into the tilth layer. A distinct advantage of the Crown Vetch is that it does not require mowing so there is virtually no maintenance involved with the slope protection. The Crown Vetch should be applied at a rate of 20 lbs/acre; an innoculant is required and is typically provided by the supplier. G S I Chestnut Street Earth Slope Recommendations GSI Project No.202175 June 9,2004 Page 3 Crown Vetch will not establish on acid soils therefore it is necessary to check the topsoil for pN and incorporate lime as required. It may be necessary to broadcast from 2 to 4 tons of ground limestone per acre to reduce acidity. Because the Crown Vetch exhibits slow seedling vigor,we recommend that a nurse crop be planted to germinate quickly and provide some degree of protection. The nurse crop may be 10 lbs/acre of annual Ryegrass and 50 lbs/acre of Red Fescue. The humus may require the application of fertilizer to enhance growth and promote root structure. Our preliminary recommendations is an application of 10 parts nitrogen-10 parts phosphorus-10 parts potassium at a rate of 100 pounds per acre.For best establishment,lime and fertilizer should be worked into the top four to six inches of soil. Seed germination will be facilitated with mulch cover provided by the erosion control mat. Construction Monitoring It is recommended that GSI be retained to observe construction procedures for conformance with contract requirements,documents and design concepts. � 1 We trust that the contents of this report is responsive to your needs at this time. Should you have any questions or need further assistance, please do not hesitate to contact our office. Very truly yours, GEOTECHNICAL S VICES,INC. Harry K. Wetherbee, P.E. Principal Engineer G S I Chestnut Street Earth Slope Recommendations GSI Project No. 202175 June 9,2004 Page 4 LIMITATIONS Explorations 1. The analyses,recommendations and designs submitted in this report are based in part upon the data obtained from preliminary subsurface explorations. The nature and extent of variations between these explorations may not become evident until construction. If variations then appear evident, it will be necessary to re-evaluate the recommendations of this report. 2. The generalized soil profile described in the text is intended to convey trends in subsurface conditions. The boundaries between strata are approximate and idealized and have been developed by interpretation of widely spaced explorations and samples; actual soil transitions are probably more gradual. For specific information, refer to the individual test pit and/or boring logs. 3. Water level readings have been made in the test borings under conditions stated on the logs. These data have been reviewed and interpretations have been made in the text of this report. However, it must be noted that fluctuations in the level of the groundwater may occur due to variations in rainfall,temperature, and other factors differing from the time the measurements were made. Review 4. It is recommended that this firm be given the opportunity to review final design drawings and specifications to evaluate the appropriate implementation of the recommendations provided herein. 5. In the event that any changes in the nature,design,or location of the proposed areas are planned,the conclusions and recommendations contained in this report shall not be considered valid unless the changes are reviewed and conclusions of the report modified or verified in writing by Geotechnical Services, Inc. Use of Report 6. This report has been prepared for Mr. Ralph Joyce in accordance with generally accepted soil and foundation engineering practices. No other warranty,expressed or implied, is made. 7. This report has been prepared for this project by Geotechnical Services, Inc. This report was completed for preliminary design purposes and may be limited in its scope to complete an accurate bid. Contractors wishing a copy of the report may secure it with the understanding that its scope is limited to evaluation considerations only. G S 1 6" TOPSOIL 6" RIPRAP 2 l MIRAFI 50OX �1 STABILIZATION FABRIC r'1.5 ' 3/4" CRUSHED STONE ET 4 DIAMETER HANCOR ADS SLOTTED DRAIN PIPE 18" "PAXTON SERIES" GLACIAL H:, TILL PARENT SOIL HNOTES: 1/2 # / 1000 SO. FT. CROWN VETCH HARD FESCUE AS NURSE GRASS — 1# / 1000 SO. FT. EARTH SLOPE CROSS SECTION G GEOTECHNICAL SERVICES INC. S 16 COTE AVENUE, UNIT /11, GOFFSTOWN, NH 03045 I TEL (603) 6242722 FAX. (603) 624-3733 SLOPE STABILIZATION RECOMMENDATIONS Drawn By: J.L. Date: 6/9/04 Figure CHESTNUT STREET Checked By: H.W. Scale: 1/4"=1'-0" �V>` o• 1 NORTH ANDOVER, MASSACHUSETTS File Name: Project No.: TOWN OF NORT 'VANDOV.S'.ROffik- cof the Building Departinent �ORTp� 2.7 Charles Street NdrthAnE]VBVpn% 0.845 o9gacni:.a`me a � 7��SSACttU5�i4� April 22,2004 Mr. Ralph Joyce 121 Collins Landing Weare N.H. 03281 RE: Retaining Wall problems 440,450,460 Chestnut Street,North Andover, MA. Dear Mr. Joyce: Please be advised that upon an inspection of the above noted properties it has been observed that there is washout occurring at the top of the slopes down onto the top of the wall and into the yards of the properties. This situation is in need of correction so that there is no further washout or damage to the homeowners properties. Please contact me so that we may begin the process to remedy this issue in a timely manner. My office hours are 8:30— 10:00 AM @ 978-688-9545. Respectfully, Michael McGuire Local Building Inspector TOWN OF NORT.F.1 ANDOVER AORTN 1,10 Office of the.Building Deparbuent0 1 4 0 Coninizinity Development and. Services 27 Chirles Street Nfulb Awhi Us 01845 #Arlo SACHUS D, Robert Nicclta, 1'eleph(me(97 )688-9i45 Baddipeg Cominhul'oner FAX 0)"781;6V-9542 May 21,2004 Mr. Ralph Joyce 121 Collins Landing Weare N.H. 03281 RE: Retaining Wall problems 440,450,460 Chestnut Street,North Andover, MA, Dear Mr. Joyce: Per our conversation during the week of 5/17—22 at which time you informed me that you were meeting with the engineer in regards to the washout problem at the above referenced sites. I am writing this letter to inform you that this issue needs to be remedied as soon as possible and that I will need the engineer's recommendations and your plan of action. I will also need the timeline of when work will commence for the corrections and the approximate completion date. Please contact me so that we may begin the process to remedy this issue in a timely manner. My office hours are 8:30— 10:00 AM @ 978-688-9545. Respectfully, Michael McGuire Local Building Inspector Certified mail r3 60_� t 11) THE BOUNDARY ,NFORviAII ON SHOWN HEREON WAS TAKEN EP4V A PLAN ENTITLED "PLAN OF L41D LOCATe D IN NORTH AiDMR �iA PREPARED aR MAP S8C �Q'i b` KENNETH W. IZE.A BCA+E, ��', +DATE: 4/s:/99 _ (rev. to 7/12,99) BY CHR?STI,'SON & SERGI, C rkr _ SQ7.03r4$"t NORTH ESSEX REGISTRY CF )EEOS PLAIN #11353,81. +24,86'—. i 2) THE INTENT OF THIS PLAN IS TO, SHOW THEAS— ) SUILT LOCATION Or THE FO;!1'1100CN ONLY. Ov ._ VL inn V06 , P; MO 98C LOT .1 r ' 25,307 StI.R. 0,$81 Ac.f MAP 9 S LOT 110 ( x' YAP 98C LOT 2 Y1 CONCRr,E p FC(INDAT 0.4 x CIV 00 f a+ i -,,406'29*40,. F 126.85` SCALECHESTNUT E0 20 40 (IN MET) I inch - 40 !t. I HEREBY CEPTi[=`/ THAT TFIIW I=OIlNGA7ON SHOWN HEREON CERTIFIED PLOT FLAN IS THE RESULT OF A FIELD Si RVV MADE 6N. MAP 98C LOT 1 OCTOBER 3"; 2001. CHESTNUT STREET NORTH ANb01'ERr MIASSACHUSETT PARED FOR JOYCE RALPH R. 85 MAIN STREET p C`R1�TJ?W:��3• NORTH ANCOVER, MASSACHUSE I P`Ss` 01945 f �ng, . "r ri;•;f,!gF} -4 eb£ SHIM had. 4ullr Dns (son Aos-cmo Sait�> Mts HaralceRfn CbC7p Nb t���vti--� t t i* N Deoigr �ur.luliant�. Irc. F _ 40 JADE: NOVEMBER S. 2DC1 N��!E 3 ., -. ' I _ _� _ DRAWN 9Y: CH�ECKEP E.. P.OJ>C'r N0. L{:>rh{SIC ` NIj SJR _,OF _ DATE Ja'A+ _ CMF 11490i 1rA;CFPt.zvrc .— Town of North Andover OORTh Building Department �� gt: ».•6 o 27 Charles Street o North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 q1TlD p�`y.�� �SSACHUS�t APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS % C/ S I1/(/ % 5 LOT NUMBER SUBDMSION DATE REQUEST FELED DATE READY FOR INSPECTION FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE-INSPECTION FEE OF TWENTY-FIVE($25.)DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFI IAL USE ONLY ROUTING CO ATION DATE PLA ...:, DATE D.P.W. —WATER METER L DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO.THE INSPECTION REQUEST DATE. SIGNATURE//DPW AUTHORIZATION pgR7q at «so, 1G F L P # Y s E S.#C�S CERTIFICATE 4F USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number a 01 % Date Y-3 -a 3 THIS CERTIFIES THAT THE BUILDING LOCATED THE BUILDING LOCATED ON MAYBE OCCUPIED AS IN ACCORDANCE WITH THE AlfilrISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY"PLY. - - CERTIFICATE ISSUED TO / �'N'4'yG`Gy ® c.;(G -e, Building Inspector Town . of ®ver No. �ol 0/ o� �o�H,� dover, Mass., V �d ADRATED S H u 4 BOARD OF HEALTH PERMIT T D . Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........ ...... ....................... ..Ct.. ........................................................................................ Foundation has permission to erect................1.................... buildings on .CD � yD e� tivcS� Rough✓'T`�� -- .... . ......... ........ . ............... .. .............. ... to be occupied as t.................. .P�� 09 6 4 . ..vl.. .. �!l..!e/�' J / ...1.�-.p Chimney provided that the person accepting this permit shall in every respect-conform to the terms of the application on file in Final'Hjk( this office, and to the provisions of the Codes and By-Laws jelating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. / D �/ P3 I D, PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. `f 6 �1—�� PEP kAIT EXPIRES IN 6 MONTHS 1 ` UNLESS CONSTRUCTIONS ARTS ELEc I- , INSP ....... .......... .��'��................................................. .... .. .. . . . . BUILDING INSPECTOR final Occupancy Permit Required t0 Occupy Building GAS INSPECTOR c-1 Display in a Conspicuous Place on the Premises — Do Not Remove _ C O P 1 PY s NO Lathing Or Dry Wall TO Be Done FIRE DEPARTWNT Until Inspected and Approved by the. Building Inspector. Burner - Street No. SEE REVERSE SIDE smoke Det. 7/? Date. ./ .. .I. ... . '-... �e S 1/ WORTH �Oye ..to ,e,41 TOWN OF NORTH ANDOVER O ..._. D • PERMIT FOR GAS INSTALLATION �,SS�CNUSEt This certifies that �.. . .. ... .`. . . . !`. .': . 4::--. . . . . . . . . . . . . . . . . has permission for gas installation . . . . . . . . . . in the buildings of . .%. . `"=. . . . . . . . . . . . . . . . . . . . . . . . . . . . at . �!�`.f L' . . �. . . . . . . . . . . . . .. North Andover, Mass. Ffe:�. . Lic. No.. . . . . . . . . . . . . . . . .{. G!r.:- . . . . . . . . GAS INS E TOR Check# � h U 3676 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) SMA Date/ 201 - Receipt# Permit# Map: Building Location �/f�o C T,�.vTs� OwneesName Lot: Zone: Type of Occupancy J'✓iv�J� �/3 •�� New Renovation ❑ Replacement❑ Plans Submitted: Yes❑ No ❑ Fee: wcn y . W W ¢ y ¢ O ¢ N H r .•• w ¢ O U H N U) LU Z ¢ F. i Q LU W Q ¢ Q Z O H ¢ m NH W W Q ¢ Q c7 w Q > N ¢ Z W y W Q ¢ c F W W W N N U_ Q ¢ ¢ 0 ¢ W W C1 y ¢ (S H Z J H Z r W W O > W H W J H W Z Q W J Q ¢ �- H > N m Z O Z ¢ O y T Q W > ¢ W z Z Q ¢ Q Q O O W — O W �' ¢ 2 0 a x W O 3 c C71 J 1 o ¢ > IC a r- O SUB-BSMT. BASEMENT 1ST FLOOR v ZND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name EASTERN PROPANE & OIL, INC . Checkone: Certificate 131 WATER ST DANVERS � 01923 Address Corporation Estimate Vaiueof Work: ❑ Partnership Business Telephone 800-322-6628 ❑ Firm/Co. Nameof Licensed Plumber orGas Fitt INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes 9--' No ❑ If you have checked ves,—pleaseeiindicate the type coverage by checking the appropriate box. A liability insurance policy�l/ 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. Checkone: Owner C3 Agent❑ 1 Signature of Owner or Owners Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed underthe permitissued for this application ill be* cc pliancewith all pertinent provisions of the Massachusetts State Gas Cade and Chapter 142 ofe Gene By Type of License: Plumber Signature of Licensed Plumber or Gas Fitter Title Gasfitter Master License Number City/Town Journeyman APPROVED (OFFICE USE ONLY) Revised OV17= i BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE NO. APPLICATION FOR PERMIT TO DO GASFITTING NAME A TYPE OF BULIDING •r: LOCATION OF BULIDING PLUMBER OR GASFITTER LIC. NO. PERMIT GRANTED DATE 20 GASINSPECTOR Date. f ��<*��°T• 40 TOWN OF NORTH ANDOVER F PERMIT FOR PLUMBING 'q US This certifies that D( 1,7 . . . . . . . • . . . has permission to perform . . . . ..K, :-:�. . . . . . . . . plumbing in the buildings of . . . .J . . . . . . . . . . . . . . . . . . . at. .y. Y.�%. .L . . . . . . . . .. North Andover, Mass. Fee. .3 Ulf. Lic. No.././* ?- . . . . . . . . . . PLUMBING INSPECTOR Check # 5068 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH AND E�,MASSACHUSETTS / JS`61 y � C�es�i�v S'�""' PrY G c 6 Date o� Building Location Owners Name #Permit# Amount ,?U O, Type of Occupancy New Renovation Replacement Plans Submitted Yes No FIXTURES cr � a c w w x ° zZ z d x x a x a z W O U a A a 3 C110 H O G�7 9z --t a mill —SM-EWE &�g1VII�iI' BE M HDOR c� M M)HIIM 4IH FLOOR 51H MOOR 6Hi FIDOR 7M MOOR SIH Ma R (Print or type) Check one: Certificate Installing Company Name /C)W V\, r El Corp. Address ���" El Partner. AJN a2e)7? . Business Telephone & P / Firm/Co. Name of Licensed Plumber: �/'I r( yi0 V4, -- Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 0 Other type of indemnity ❑ Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work anp nista i ns performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Mass ch eSt Plumbing Code and Chapter 142 of the General Laws. By: gna ure o ice se um er r1P4 Plumbing License Title City/Town icense um er Master Journeyman ❑ APPROVED(OFFICE USE ONLY DateN2 3412 ........................... + TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING SACMUS This certifies that—. ......... ................................................................. .has permission to perform ';,A!��............... ................................... wiring in the building of... ................................... ...................... .............. ............... ............... .North Andover,Mass. Feet)�......... L i c.No ELECTRICAL INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK:Treasurer THECVMMONWEALTHOFMAMCf USE77S Office Use only DEPARTMWOFPUBLICS4FETY Permit No. BOARD OFMEPREVEM70NRWUL4TIONS 527CMR 1100 Occupancy&Fees Checked PPLICATIONFOR PERMIT TO PERFORM ELECTRICAL WORK VAK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date /0,;70 Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) /-orr / CwrsT A/c7- sy— 7 Owner or Tenant 7 2 t,�-/yC:iff 4JT)y C- Owner's Address P A i Pt-( DZ Is this permit in conjunction with a building permit: Yes[:] No © (Check Appropriate Box) �a -3 - Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead Underground a No.of Meters New Service Amps / Volts Overhead ED Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA ground El ground No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners +. No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local a Municipal Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP �1-.- O OTHER �a 72� hmr4=Co�aage Pt tYbthetactl]rana�afTvTas�d GtrealLaws Iha%eamn tLiatnlityhMrMWPCbCYMch&gCa#AM Co�e'�gea•As >4 quyalert YES El NO hmstbrrilledvalidprodofsametotheOffmYES n NO lfjwha%edm*WYES,plea9 mdc*thetypecfmvwWbydakirgthe -�- II CE M BOND OTHER M (P1eweSpecify) Estm*d Vaht dUec>riral Work$ WoikbStart �B_3o �_hgpactiwD*RaWesbad Rough Final FIRM Aut� el'bofpay� Lim= Sigralre q BusirmTd.Na Ate. So 5'r--- 45 AIL Tel% 9 21 OWI 'SRWRANCEWANFR;Lamawm hsttheLiarwdo r. themstrax:ecomg "wbs r iala*m4attasmgLzWbyMxsahB&CauWLam andfatmysi n&nonrhspamhamtwaimsthis tt*miurat (Please check one) Owner Agent 00 Telephone No. PERMIT FEE$ —SO r,r-.�-� Date./ . .. ..... . . WORTH • 3= °`' 4. TOWN OF NORTH ANDOVER O 9 k' • - PERMIT FOR GAS INSTALLATION SSACNUSEt This certifies that . . . . . . . . . . . . . . . . . . has permission for gas installation . . . .,.n.-f. in the buildings of . J,�' �. ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at l/ . t - :. . .j. .: . 7. , North Andover, Mass. Fee. . ��. . . . Lic. No..//). CTAS INSPECTOR r Check# 3 �'.3 49 MASSACHUSE IS UNIFORM APPUCATON FOR PERMIT TO DO GAS�FTl D% (Type or print) Date NORTH ANDOVER,MASSAC USETTS !� .2L � Building Locations .5 (JPermit 11 /— Amount$ Owner's Name New Renovation ❑ Replacement ❑ Plans Submitted ❑ U w w a a U � x x v, Pa F O O O W F © . W ¢¢�+ Wz F v� O W CW7G z EW+ z E+ z C4 W �+ W w W F a o x 3 a 0 o0 °a a H 10 SUB -BA SEM ENT B A S E M ENT 1ST. FLOOR �... 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR (Print or type), Check one: Certificate Installing Company Name �` & �Uh U � � ❑ Corp. Addre e d o d El Partner. Business Telephone 3 g 7 3 V'116, Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑ If you have checked Les,please indicate the type coverage by checking the appropriate box. Liability insurance policy Ea 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 ❑ 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 d i ]la'ons peArmed rmed under Permit Issued for this application will be in compliance with all pertinent provisions of the M a tts to G ode and Chapter 142 of the General Laws. By: Signature of Licensed Plumber Or Gas Fitter Title ❑ Plumber City/Town Gas FitterceiLT nse Number Master APPROVED(OHICE USE ONLY) Journeyman N2 3 511 Date.................................. NORTq TOWN OF NORTH ANDOVER !? •`-^' ... ,-,a °t _ p PERMIT FOR WIRING SCHU E�h This certifies that .........................:...::......��.................................................... X1., �>!4as permission to perform � wiring in the building of.........:.......................................................................... J1� ' ......... ......;...�� ........ ,North Andover,Mass. Fee:. .r''''...../... Lic.No C.�'.-1?,�............ .........................' `.:..l................. .. / ELECTRICAL INSPECTOR Check # , WHITE: Applicant CANARY: Building Dept. PINK:Treasurer ThE 60W0NWE4LTH0FA SSACHVSEI7S Office Use only DEPARTMEL TOFPUBLICSAFETY Permit No. �V BOARD OFFIREPREVE1MONREGUT4TIONN527CIUR 12:00 Occupancy&Fees Checked APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Datg�_. Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) ill-119 c" ���� Owner or Tenant %e--/� G Z-7 Owner's Address rwr Is this permit in conjunction with a building permit: Yes® No o (Check Appropriate Box) Purpose of Building �w4--ol'114 Utility Authorization No. Existing Service Amps Volts Overhead E3 Underground M No.of Meters New Service ) ©d Amps /fib/ a 70VOlts Overhead r771 Underground ® No.of Meters Number of Feeders and Ampacity. Location and Nature of Proposed Electrical Work No.of Lighting Outlets No.of Hot Tubs / No.of Transformers Total 70 KVA No.of LightingFixtures Swimming Pool Above Below Generators KVA 01 ground ground No.of Receptacle Outlets n No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets L- I Q No.of Gas Burners I No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals 1 No.of Heat Total Total No.of Detection and . �� Pum2s... Tons KW Initiating Devices NFb.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained l Detection/Sounding Devices N .of Dryers Heating Devices KW Local ® Municipal Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHE ' I ur,V=CO,t a RIISU2ftbJt11e1FS IIfQ11f31S0 1Ii 3tSr$C �1ILSws Ihawaa>tIi2hli<yhmsa=PO[Lymch&mgCarrpl�e�A.MCO�ug crtaksta lCqL� YES © NO Ih�szicntt dvabdproofofmmiDtheOffim YES I � ' No IfycutmedvckedYES pleenhc*thety c)f byd�Cgihe El IN�`CE BOND F-1 OTHER F-1 mm Spiny) � � Expaarbrt Estm&d VahaecfFmftical Wcrk$ WotkriS!st l�-1 G ��� Ir ,�� Rough 0411 .� >,r,all C�fJ signedtaxl�'ihePanitiescfp�y' _ q FIR,MNAMEdZlL 1 u>s � Bun rvssTeLNa AiTe1.Na OW-N-ER'S LRAI EWAP/r Z I:amawaeit�tihel e tett thea oaa cc3ss��tiva� aste lbyt, C allaws aodiatmys onthsp�n# iwai�cs mre i > (Please check one) Owner Agent Telephone No. PERMIT FEE$:..��• ,,,� TOWN OF NORTH ANDOVER c� VtoarH Office of the Building Department o? Community Development and. Services A 27 Charles Street '�o r North Andover, Massachusetts 01845 �ryo^ x ss�CHU D. Robert Nicetta, Telephone(978)688-9545 Building Commissioner FAX(978)688-9542 January 23, 2002 Mr. Ralph Joyce 121 Collins Landing Weare N.H. 03281 Dear Mr. Joyce: Please be advised that as of today's date this department has yet to receive any documentation and application for the retaining wall(s) at the Chestnut St.job location. This is an important part of the ongoing construction at this site and needs to be addressed in a timely manner, as no further permits will be issued. Under the Mass State Building Code Chapter 1 Section 116 a certified professional engineer's certified drawing and calculation's is required for retaining walls over 10 feet in height of unbalanced fill from footing to top of wall. Please contact me so that we may begin the process to rectify this situation in a timely manner. I may be reached between the hours of 8:30— 10:00 AM and 1:00—2:00 PM at 978-688-9545. Respectfully, Michael McGuire Local Building Inspector Michael McGuire,Local Building Inspector James Deeola,Electrical Inspector James Diozzi,Gas/Plumbing Inspector Planning Department 688-9535 Conservation Department 688-9530 IIealth Department 688-9540 Zoning Board of Appeals 688-9541 TOWN OF N0RTR ANDOVER � NORTH� Office of the Building Department ��46��`go,ems�ooL Community Developinent and Services � A 27 Ch,)rles Street e North Audo-er,Massachusetts SSnciau5 D. Robert Nicelta, Telet)honc(97 8)688-9545 Rail/finRailifing commissioner FAX(91-9)688-9542 February 14, 2002 Mr. Ralph Joyce 121 Collins Landing Weare N.H. 03281 Dear Mr. Joyce: Please be advised that as of today's date this department has yet to receive the engineered drawings and calculations for the retaining walls on the rear of lots 1 through 3 Chestnut St. This is a very important safety concern to this department and needs to be addressed ASAP. Please be advised that until such time as the appropriate paperwork is submitted and reviewed there will be NO OCCUPANCY PERMITS for the lots noted above. Pleasecontact me so that we may begin the process to remedy this life safety issue in a timely manner. Res ectM P Y, Michael McGuire Local Building Inspector MichaelMeGuire,Local Building Inspector James Deeola,Electrical Inspector James Diom,Gas/Plumbing Inspector Plalining Departmeait 688-9535 Coayservation Dcpantmeirt 688-9530 Heottla Depaatnumt 688-95.10 7oning Hoard of Appeals 688-9541 Location �4-+ ( -A-' t( q0 C Gt,,.�jti,4 S+- No. 'C�'�c Date 1 a- 10-0 t NORTH TONIN OF NORTH ANDOVER � P ` Certificate of Occupancy $ 5 ••�° Building/Frame Permit Fee $ cNusE Foundation Permit Fee $ Q Other Permit Fee $ TOTAL $ —t 1 6" Cheek # ,ON 15206 / Building Inspector Vzor / a TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING, OTHER THAN A ONE OR TWO FAMILY DWELLING This Section for Official Use Onl Y= BUILDING PERMIT NUMBER: �� DATE ISSUED: / d / -4 _ 7 z SIGNATURE: A.1v C fJ Building Commissioner/I or of BuildingsDate SECTION 1�:5 A� b :y r �J ' � (f�: L2 Assessors Map and Parcel Number: `n d �11J Sr tel' qqc --63 /001, 19-1L) Map Number Parcel Number V V , 1.3 Zoning Information: 1.4 Property Dimension 62530�7 zonin Nh rid LYMosod I Ise Lot.Area s1 Frontswft 1.6 BUILDING SETBACKS(ft) Front Yard Side Yard Rear Yard Required Provide Required Provided R red Provided 1�t 1.7 Water Supply M.Gr..C.40... 54) 1A 11ood'lane tnfornution: 1.$ Sewerage Disposal Systc= Public 0 Private ❑ Zone Outside Flood Zone ❑ :Municipal On Site Disposal System ❑ st MON '-:M{ P. RTY f1Wt 1A 'Cif7R1 lk `lI<` T 2.1 0weer of Record Name(Print Address for Service: 76 7 e,' 3� m Signatur Telephone N 2.2 Authorized Agent —hqz N �i- Y� _ o? / fir, LL,iUS L��V it j > Name Pod— Address for Service: Z S ature Telephone go 3.1 Licensed Construction Supervisor Not Applicable ❑ Address� License Number 0 Xignatume nstructio pervisor: — 1J Z'7/ 3 Expiration Date _ % �P / r Telephone ,..� 3.2 Registered Home h513rovement Contractor Not Applicable v Company Name Registration Number m l^ Address r Expiration Date Zz^ Signature Telephone — — LI n SECTION 6 DESCRIPTION OF PROPOSED WORK (check all applicable} New C'nnstruction _ L'Xisling Ruildin� : Etc}�arnsl - - Altcralion�al 1�iditian Accessorn Bldg Demolition ! Clther SpecrtN Bricf Description of Propos&d Work r- SECTION 7-t3St GROUP AND CONSTRUCTION TYPE _ USE GROUP(Check as applicable) CONSTRUCTION TYPE -- A Assembly i i A-1 A-2 A-3 1 A --- _ A-4 i A-S 113 13liusiness� - 2A C vclucational - 213 b Factor F-2 2C 11 1li}Jh I laiard i - - - 3A I Institutional 1-1 l-2 i_3 3U M Mercantile --- — - ; -- - — K r �--- R-1 �: R-2 R-3 _ -- 5,A S Slorake S I--'� S-2 I 1 --- 513 tJ Utility i _ 4pccify: -- _ M.Mixed Use Specify: S Special Use Specify: COMPLETE THIS SECTI DN IF EXISTING BUILDING UNDERGOING RENOVATIONS, ADDITIONS AND OR CHANGE IN USE 1Aisting Use Group.-- _-- �'/9- _---_ Proposed Usc Group: _ Existing Hazard hider 780 CMR 34: — � Proposed I lazard Index 790 CMR 34: SEGTI4N�BU1�fIltiC 1f3E;1GT "A1�4�1kP,A ,. '� 13UILDINCT ARIA _ f XISTING(if appiicablel _ PROPOSED --- Nwnber of Floors or Stories Include Basement levels I-'loor Area per l loor(st) Total Area(sf) "1'okd l Leight(11) z�� SE2I0I"��'��"R1C���lF � t1►+��1�.11� Independent Structural Engrinecring Structural Peer Review Required Yes 0 No SECTION 10a.Owner Authorization- TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT i, as Owner of the subject property Hereby authorize_— _v/–r# K �Yer to act on My behalf, in all .atters relative two workauau h novo zed by this building permit application I /"7 o/ Signature of Chimer Date I .as(honer/Authorized { Agent ` hereby declare that the statements and information on the foregoing application are true and accurate.. to the best of my knowledge and belief. Signed under the pilins and penalties of peijury 1 ! Print Name c Sigitature of Charier/Agent Date SECTION 11 -ESTIMATED CC NS 'RUCTION COST Item F."Wilated Cost Q.killan)to be OFC~']itC T USE t}NLY Completed by Ix-rmit applicant I Building (a) building Pennit l,ee A57 j}00 Multiplier 2 Electncal �s _ (b) Lstimated Total Coast of Consiniction from(6) -- - - - 3 PlumbingBuilding Pcnnit l:ec w , tt=7 --- - -- - 9 Mechanical(IIVAC) DU0 - Fire Protection ( h Total (1+2+3t:}+j)-- �--- --_ - -- � © 6i-0 Check Number NO. OF STORIFS BASEMENT OR SLAB SIZE'OF FLOOR 11MBERS 1 rr 2 jrl_j!�3ND -3�--- SPAN DF.MFNSIONS OF SILLS UI?M , SONS Ol - DIMF.NSIONS OF GIRDERS IiF.IGIIT OF FOUNDATION T]IICKNESS SIZE OF FOOTING / l - -% X ---- -- MATF.RIA1,OF CIIIMNEY i IS BUILDING ON SOLID OR FII.I,F.D LANI) SDG IS BUILDING CONNECTED TO NATURAL GAS LINF. � � _ /Co7" / TOWN OF NORTH ANDOVER BUILDING DEPARTMENT j APPLICATION TO CONST RUC r REPAIR,RENOVATE.,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING Section for Official Use Onl x >.Y le'j gd+4 �x."': d�' F�-il}'S •Ex!M`t BUILDING PERMIT NUMBER: rya DATE ISSUED:jV SIGNATURE: Buildin CommissioncrAnspedor of Buildings Date 1 P'operty Addrqss 1.2 Asmsors Map and Parcel Number: C/ S7R" - qq (f /Q) Map Number Parcel lvumher - 1.3 Zoning httormation: 1.4 Property Dimatsion 7 f /�21 Zoning nis r ci --- Proposed Use Lat Area st - Fruntage(ft) � rn 1.6 BUILDING SETBACKS(ft) Front Yard Side Yard Rear Yard - Required Provide Required Provided Required:] Provided 02_' jx41D - -7 7Z7D - 1.5. Fkx)d% f nm laomntion: 1 A Sefv a al S _ am 1 7 Water Sc�s`i`?f G 1..^..G(3 SL) �$ D�Ix= Y° h Public ❑ q{Private ❑ Zone / Outside FFlood Zone ❑ Municipal On Site Disposal Systtm ❑ 2.1 (honer of Record -- -�/lwl 1- ----- \J;A- 577oU O Name(Print) - Address for Service --}—�' --' Signal'u Telephone 2.2 Authorized Agent9 ,P-y qZ ~- Z Name I' Address for Service: Z r vim-Rzr b 69--s � O S ature Telephone z Z M 3.1 Licensed Construction Supervisor Not Applicable ❑ lz--OC06�7 ��/�� CS ©Z/3 ?G Address � C�(1J " ------ License Number --- O �- •1I,f Di D cJ � r9. Dim/ _ _ _ba �_��� Li nstructio 'upervisor: u Z 74; 'a'� Expiration Date - ignature Telephoney _ r 3.2 Registered Home frIfRovement Contractor Not Applicable -14-11v Company Name --- -- Registration Number -- rn r Address ----- - r Expiration Date Z G) Signature Telephone I _ SECTION 6 DESCRIPTION OF PROPOSED WORKa tcheek all applicable) Neu Construct toil Fxisting Rluldii Iicpmrtsi \]ta;r,ttr�nu>> Adctttiot 1c�cssor Hide. t a,l tior Olhcr sjxccifv I 13ricf Dc rripunn of Prolx-tscd Work i I ITT ---- —��' SECTION 7-USE GROUP AND CONSTRUCT10NTYPE USE GROUP(Chak as applicable) CONSTRUCTION TYPE A Asscnrbt� fl A-1 A-2 - A-3 - lA --- ---- A-4 A-51 B F3 Business ----- — _ 2A --- - - C iiducational : 2 F factory F-2 _: 2C II High I lw_ud - --- -- ------ —..3n t I Institutional-- -- I-I — 1-2__._ — I_? ----- -- 3B M Mercantile —_— -- R re J R-t i. R-2 _: R-3 5A - I S Storage S-1 - S-2 i1 513 t l Utility _ I Specify -- -— M Mixed Use S Special Use t Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND OR CHANGE 1N USE _ F,xistin Use C;rou vT? ` t P _-- -- - —_ I Proposed Use Group: I I ! Existing V1ward Index 780 CMR 34: -- _ —_-- Proposed Hazard Index 780 CMR 34: i I I l3U}LllINCi AREA — I.XIS'fTN(;(if a) licable) - PROPOSED Ntuutkr of Floors or Stories Include Basement levels _ }Moor Area per Floor(sf)- - — -- --— -- �j Total Area(s --- Foutl t IeiYht(11) ----- ---- --- -- z Q -- -- S How - _ Inde t! nt StructuralEnl ineering Structural Peer Review R fired — Yes UNo r SECTION I0a Owner Authorization- TO BE COMPLETED WHEN -- OWNERS AGENT OR CONTRACTOR APPLIES FOR BUtLD1NG PERMIT as Owner of the subject property i f Iereby authorize_ ,Q !(>� _ to act on i I My behalf, in all atters relative two work authorized by t113-s-building penuit application — I Signature of Owner Date i i (_ _ — •r l�'�� G G as C M,ner`Author,:<ed � Agcnt I Ierett declare that the statements and information on the foregoing application arc true and accurate. to the nest of my knowledge and belief. Signed under the pains anti penalties of per ury I . I'ritrt Name `signature of Owner/Agent tate I � i ! Item (Estimated Cost(Dollars)tobe GI1+LUSE UNI.I' Completed by }xrmit applicant t._– -- ----- – ._ ------- _ I. Building ` (aj Fiuiiding Permit f ee .: Multiplier E.lectncal (b) li�tmafied'Jutel Cost -s— t of -- � J-5 dr Constncction ti-om(6) - ' ? Plumbing Mtildit,g Pennit tet: .1 Mechanical(I IVA') 1. Fire Protection L —_--- - – -- - - - — �---—_— 6 Total ('1 Q 3+4+5) c� � � Check Number ---------- NO. OF STORIES c2 Sul; f3ASF..MF.NT OR SI.AF3 SILIE OF FLO()R'IINMERS �,/Ul`� -2 / )Nu - - - -------�— — - i SPAN I)EMENSIONS OF SILLS ?X1 1✓T DFtMIiNS[ONS(?F YUS'I'S Z Z ! DIMENSIONS OF GIRDERS X --- --� IIF.IGf IT OF FOUNDATION c� i "I'l IlCKNI SS SIZE OF FOOTING � X % X MATFRIAL OF C110vTNEY /y- -t5 fit11LDING ON SOLID OR FILLED LAM) —�----- `�ISBUILDING CONNf CTED TO NATUR U,CTAS I, iNF. 7�HEM'! :NFCRVATl0N SHOWNH=REON WAS V A tL-r<►�'+ ENTITLE`D "PLAN, bF LAI0 "SORT:;; ANC"dEF. ,ihA PREPARED r4R /'! } ry R, -V4/27/991 MAP 9EC 1OI A2 KENN!�fr K. RGA, ` SCALE: O'; DATE: :' /rev. to 7,/12,199 2Y CHR3STI.AhSmr & Sz.PGI, 114C, i� - SC7'O3'48"E NORTH ESSEX RE.^,ISTR`! CF CEEOS 01-AN #13538. j 2ti 8 ' 2) THE INTENT O—r THIS PIAN IS T" SCOW THE AS- LOCATION OF THE F(k"IDAMN ONLY. (IV PC r o/ 9 r r r DHAP 98C LOT 1 25,307 Sq.R. C _r 0.r-81 Ac.f ASAP 98C La# 140 x' 'v.AP 98C ,-OT 2 � I.OLt.NDAiiC!V x,' �, CJf � r v� y,, —h�6 29'40"W 128.855' -,_ CHESTj'y UTS�� GRAPHIC SCALE w ' o 20 + i (IN F'EE'T) I inch - 40 ft. I HEREBY 'CERTIFY THAT THE FQUKDA"T,ON SHOWN HEREON. CERTIFIED PIAT FLAN iS THE RESULT Or A FIELu SURVEY MADE ON MAD 98C LOT 1 OCTOBER 3", 2001. NORTH STREET vORTH ANDOVE? MASSACHUTFTTS pqvNic FOR q4 pe d`* 1"H R. JOYCE 1 1, E 93 MAIN STREET NORTH ANDOVER MASSACHUSE"'m OIS45 ( / Ct`?4 i� wFr� I Frirtr , � j le" sing had. SAN Dn+ So9tm. r!R 4w,ua�2n Ob97p �' •�� •> fhft!h66tS+flhMNftS'.fYlK�'9K: erlgr, Cor,11111LIM9, IM SCALE 4,11 DATE: NOVEMBER 5. 20Ci MAMNG eY: I ChECKEd 6Y: PPJECT No. NAME w,CENSED :AND S' RVrop, DATE C,M F ��49C i Sldi�FPt.LWG • y ' ✓ �� FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. IO *****************************APPLICANT FILLS OUT THIS SECTION********* ********* *** APPLICANT PHONE 97V LOCATION: Assessor's Map Number PARCEL_p 3 SUBDIVISION V < (rl LOT (S) STREET ����s�/y LIT ST. NUMBER `?f� ****************************OFFICIAL USE ONLY*** ** ** ****** ** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION AMINISARATOR DATE APPROVED 11-74 'OI DATE REJECTED COMMENTS T WN PLANNE DATE APPROVED 1 DATE REJECTED COMMENTS a41-1-14 FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS -SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECT DATE Revised 9197 jm 67 i Growth Management Bylaw Exemption Statement Town of North Andover Building Department This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the Town of,North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information as requested below. Name of ApplirAunt on Building Permit(below) Address of Property for Permit(below) Map and Parcel: Purpos of Application (check below) Phone Number of Applicant: Single Family Two Family I the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 of the North Andover Growth Management Bylaw. 1 also understand providing this form does not absolve me or any parry to this permit from the requirements of obtaining other permits required prior to the issuance of the Building Permit. Further I understand that my interpretation of the EXGMPT10N status is subject to review by the Building Department and is only officially accepted when the Building Permit ig issued . Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building permit application and associated attachments,complies with one or more of the following sections as indicated by a check mark. This is an application for a building permit for the enlargement,restoration,or reconstruction of a dwelling in existence as of the effective date of this by-law,provided that no additional residential unit is.created.: The lots)weretwas created prior to May 6, 1996 are exempt from the provisions of this Section 8.7 of the Zoning Bylaw. This application is for dwelling units for low andfor moderate income families or individuals,where 211 of the conditions of 8.7.6.care met and/or,represents Dwelling units for senior residents,where occupancy of the units is restricted to seniorpersons through a properly executed,and recorded deed restriction running with the land. Ford purposes of this Section"seniors shall mean•persons-over the age of 55: This applicatlon is a part of a development,project which voluntarily agreed to a minimum 40%permanent reducttcn in density,(buildable lots),below the density,(buildable lots),permitted under zoning and feasible given the environmental conditions of the tract,with the surplus land equal to at least ten buildable acres and permanently designated as open space and/or farmland.The land to be preserved shall be protected from development by an Agricultural Preservation Restriction,Canservation Restriction,dedication to the Town,or other similar mechanism approved by the Planning Board that will ensure its protedion.. - This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. omThis apptiption represents a lot which is ready for buitding.permits.(i.e.all other permits from all other boards and missions have been received and the project is in compliance with those permits),and the Development Schedule does not accommodate issuing a building permit in that Year,one building permit will be.issued per Year per Development until such time as the Development Schedule accommodates issuing building permits. Applicant must supply approved form U with this EXEMPTION.. Please provide any and all information that would assist the Building Oepartment in snaking a determination` that your application is allowed one or more of the above EXEMPTiONS. By signing below I attest to the accuracy of the information provided and that the attached building permit is allowed an EXEMPTION as cited above. Further i understand that the submittal of misleading and or ' inaccurate information, or the checking off of an.above item which does not comply,whether done to my knowled a at,is grounds fo y the Buitdiog Department to issue a Building Permit. ign tune of Owner or Authorized epewhqOlsigned the Attached Building Permd Date This form must be attached to tfmMuildlng Permit upon application for such permit. �1f4 ��'r" E ,���1, CMIIIG//CCII.(IN;UUlf l� ILfI lJIU"'I(Iw-GW BOARD OF BUILDING EGULATIO43 J. • £ License: CONSTRUCTION.SUPERVISO ,; Number: CS 043769 „ ,: } A4 Birthdate; 11/19/1948 Expires: 11/19/2001 Tr. no: 11776 Restricted To: 00 TERRENCE JOYCE 50 SECOND ST L.�..•v r ! NO ANDOVER, MA 01B45 Administrator M dor u The Commonwealth of Massachusetts c Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affdavit Name Please Print Name. , Location: bT City " 157yFO Ve,�7, - 112 Phone # I am a homeowner performing all work myself. ®' I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Company name: Address City: Phone#: Insurance Co Policv# Company name: Address Com• Phone#: Insurance Co. Policv# 1111 Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. /do hereby certify under a pains and pen erjury that the information provided above is true and correct. Signature Date Print name TFrg41t/L,F Phone# 78' 6.92 703 Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing ❑ Building Dept ❑Check if immediate response is required ❑ Licensing Board ❑ Selectman's Office Contact person: Phone#: ❑ Health Department ❑ Other • I I �d MAScheck COMPLIANCE REPORT I I Massachusetts Energy Code I Permit # MAScheck Software Version 2.01 I I I I I Checked by/Date I I I CITY: North Andover STATE: Massachusetts HDD: 6322 CONSTRUCTION TYPE: 1 or 2 Family, Detached HEATING SYSTEM TYPE: Other (Non-Electric Resistance) DATE: 10-29-2001 DATE OF PLANS: )ctober 14, 2001 TITLE: Lotl, 440 Chestnut St. PROJECT INFORMATION: 3000 sq. ft.,28x40 main box,16 family, 2 car under COMPANY INFORMATION: Terrance Joyce COMPLIANCE: PASSES Required UA = 592 Your Home = 526 Area or Cavity Cont. Glazing/Door Perimeter R-Value R-Value U-Value UA ------------------------------------------------------------------------------- CEILINGS 1380 30.0 0.0 49 CEILINGS: Raised Truss 136 30.0 0.0 4 WALLS: Wood Frame, 16" O.C. 2977 11.0 0.0 265 GLAZING: Windows or Doors 407 0.320 130 DOORS 40 0.350 14 DOORS 30 0.490 15 FLOORS: Over Unconditioned Space 1500 30.0 0.0 49 HVAC EQUIPMENT: Furnace, 86.0 AFUE HVAC EQUIPMENT: Air Conditioner, 10.0 SEER ------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design described here is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The heating load for this building, and the cooling load if appropriate, has been determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall be no greater than 125% of the des' ad as specified in Sections 780CMR 131 d J4.4. Builder/Designer Date nMAScheck INSPECTION CHECKLIST Massachusetts Energy Code MAScheck Software Version 2.01 Lotl, 440 Chestnut St. DATE: 10-29-2001 Bldg. 1 Dept. 1 Use I I CEILINGS: [ ] I 1. R-30 I Comments/Location [ ] I 2. Raised Truss, R-30 I Comments/Location Insulation must achieve full height over the exterior wall. I WALLS: [ ] I 1. Wood Frame, 16" O.C., R-11 I Comments/Location I I WINDOWS AND GLASS DOORS: [ ] 1 1. U-value: 0.32 I For windows without labeled U-values, describe features: I # Panes Frame Type Thermal Break? [ ) Yes [ ] No I Comments/Location I DOORS: [ ] I 1. U-value: 0.35 I Comments/Location [ ] I 2. U-value: 0.49 I I Comments/Location I FLOORS: [ ] I 1. Over Unconditioned Space, R-30 I Comments/Location I I HVAC EQUIPMENT: [ ] I 1. Furnace, 86.0 AFUE or higher I Make and Model Number [ ] I 2. Air Conditioner, 10.0 SEER I I AIR LEAKAGE: [ ] I Joints, penetrations, and all other such openings in the building I envelope that are sources of air leakage must be sealed. When I installed in the building envelope, recessed lighting fixtures I shall meet one of the following requirements: I 1. Type IC rated, manufactured with no penetrations between the I inside of the recessed fixture and ceiling cavity and sealed or 1 gasketed to prevent air leakage into the unconditioned space. 1 2. Type IC rated, in accordance with Standard ASTM E 283, with no 1 more than 2.0 cfm (0.944 L/s) air movement from the the I conditioned space to the ceiling cavity. The lighting fixture I shall have been tested at 75 PA or 1.57 lbs/ft2 pressure I difference and shall be labeled. I A 1116 APPLICATION FOR WATER SERVICE CONNECTION North Andover, Mass 9� Application by the undersigned is hereby made to connect with the town water main in �� Street, subject to the rules and regulations of the Division of Public Works. The premises are known as No. A40 Street or subdivision lot no. 7p �[p✓��-c�tcP Ccsto OwnerAddress Contract r Address Applicant's Signature L� YU PERMIT TO CONNECT WI H WATER MAIN J The Board of Public Works hereby grants permission toGlc -� to make a connection with the water main at Street subject to the rules and regulations of the Division of Public Works. Board of Public Works By Inspected by Date See back for rules and regulations ' 1745 APPLICATION FOR SEWER SERVICE CONNECTION �I law � North Andover, Mass. t9L� Application by the undersigned is hereby made to connect with the town sewer main in Street, subject to the rules and regulations of the Division of PublicWorks. /1 The premises are known as No. 44 [ e�47y Street or subdjxjsion lot no. ��' '✓/ XPi � chi / �' /' ��IGi Owner Address C tractor Address Applicant's Signature PERMIT TO CONNECT WITH SEWER MAIN The Division of Public Works hereby grants permission to erl;�Z�ce 6 CE�— to make a connection with the sewer main atStreet subject to the rules and regulations of the Division of Public Works.. Division pf Public Works By Inspected by Date See back for rules and regulations TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET, 01845 J.VVILLIAM HMURCIAK, P.E. Telephone(978)685-0950 DIRECTOR Fax(978)688-9573 F tIORTh q to yt, t,y'10. 0 L F A o9Pfo.PP' (J SSACHuset DRIVEWAY PERMIT DATE —0( LOCATIONC� Plat J BUILDER phone OWNER1/,zae-e, T'Joevce phone THE NORTH ANDOVER SUPERINTENDENT OF OPERATIONS MUST BE NOTIFIED OF THE GRADE AND SETBACK FROM STREET . CALL THE SUPERINTENDENT'S OFFICE BEFORE FINISH GRADING AND SURFACING FOR APPROVAL OF SUCH ENTRY. FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT. X A Pr L cA nrr 3 S«NA-r uzE • � ORTIy 6 Town o s1� � : Andover Or.M..ww 4`r4 No. / ~ r A y CNA . _ - 0 ndover, Mass., f'/-o? � '0?04 / T Q - l A K E COC MICHEWICK A OOATEO PI? �C.) 9SSAC HUS�� I. T FOR EXCAVATION AND FOUNDATION THIS CERTIFIES THAT .........f.:e/`/!!Q. .C. '.:....... .1..©.. .C...'. -.................................................................. ,Lf n L has permission to excavate and pour foundation at ....Ap�/.......... f.. . ... !.!e4��!VV�.....�............ for the purpose of... O/y1 02 Ute, J9- O� sTel �G��e/' s.. : ...... . ........ ....... ............. ........................... ........................... . ............ ............ The person accepting this permit must return to the office of the Build70-3 Inspector a certified plot plan show of building thereori before Foundation will be inspected. eye C VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS The holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS assurance that a permit for entire building structure will be granted. Ag BUILDING INSPECTOR xAORT#q E Town of over ON.M'�.w.Ml` '44•y'` •f` `ern' 0 No. C:�?oJ► 9-02 Loel dover, Mass., f DRATED P*' C7 S H E BOARD OF HEALTH PERMIT T Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........ � r.,.9wc�. ........' /....m y. %el .... ...........,../.7�.....(................./UU�.........� Foundation has permission to erect................./.................... buildings on ....�D.......... ` '.................... ..............5.... Rough to be occupied as.... ..... aJf !.. O� .� n� / Ifs �I" �N� /�G L�c�/ Chimney ..............: .. ........ ... .,x .. ..... ...........45... (....... .......... 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 elating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. T 8 C P3 1014 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTIONS ARTS ELECTRICAL INSPECTOR Rough ............................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in Rough a Conspicuous' Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det.