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Miscellaneous - 451 ANDOVER STREET 4/30/2018 (4)
A Date.................................. f NORTH 1 ?°•';�``°:'�.."°O� TOWN OF NORTH ANDOVER ' PERMIT FOR WIRING ♦ �,(, � Y ♦ o�„'FF Z. �++ �,sSACMU This certifies that .L.. i:�� !!...Ti2o......'.............5�-...........:-. ......C— has permission to perform .... �2oG�� � �73v-L��5 ................................ ... .............................. wiring in the building of..../UW&'a at...Tzz-'r....................... .,North Andover,Mass. Fee.. .(2-n �. Lic.No�7s 5� 7.......... �-�� -,-P--,A...- ELECTRICAL INSPEa*R /y�� Check N f d ✓ r c 9359 M C lt�i Official Use Only om.monwea o��aeeachu�ett9 i °J -3 3 c� c7Permit No. 2L partment o/ }ire Jervice6 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS p y [Rev. liQ7] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK I!work to be performed in accordance with the Massachusetts Electrical Cody fMEC),527 CMR 12.00 1'Lr.-1.51=PRJ.VT LVIVA' OR TYP AL INFO :114TIO.N9 Date: Cite or To��n of: To the Ins ector of Wires: , \ B" :his application the undersigned gives noti of hi or her intention t erform the electrical work described below. Location (Street& Number) c �1. Owner or'Tenanrkwop 1�mavj V17- ON%ner's Address Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Purpose of Buildino Utility Authorization No. Lxistin- Service Amps i Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacit Location and Nature of Proposed Electrical Work: Completion of the follovt4no table naay be waived by the Ins ecror of tivires. No. of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No. of Luminaire Outlets No.of Hot Tubs Generators KVA above In- o.o EmergencyLighting No. of Luminaires Swimming Pool grnd. ❑ rnd. ❑ Battery Units No. of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No. of Switches No.of Gas Burners No.of Detection an Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No. of Waste Disposers Heat Pum \amber Tons KW No.of Self-Contained Totals .... ........................... Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No. of DrN ers Heating Appliances KW Security Systems:* d No.of Devices or Equivalent No.of 8A ater K"; No.of No. of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. HN dromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:No.of Devices or Equivalent OTHER: Attach additional detail if desired.or as required by the Inspector of b6'ires. Estimated \ aiue t Elecn-cal Work: h?Vv!/ (When required by municipal policy.) F \Vorl; to Starr. Inspections to be requested in accordance.with MEC Rule 10,and upon completion. INSURANCE ItTAVRAGE': Unless waived by the owner,no permit for the perfonnance of electrical work may issue unless ire licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undcrsiL ncd certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CI-IFCh 0\E. INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) 1 c•erl4j% under the pains and penalties ofpeijuiy, that the information on this application is true and complete. FIRM N:A,:\IE: grfl—r)-A-7L'5C1111 L1 —In KI LIC.NO.: Licensee: I C, Q6.1 c Signature IC.NO..17s 1l a�+pllrable. enter "esem t"in the lice se ra n?be•lite. Bus.Tel.No.. Address:,��� t�r t 4LZli�'� LII� /f > 111Y?1M Alt.Tel.\'o. r. 147.s. 5 7-61.security work requires Depart1rient 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 b_, law. By my signature Below,I hereby waive this requirement. I am the(check one) ❑owner ❑owner's agent_k 01%ner'A" nt T FEE: Telephone No. PERti1I _. LaMarche Associates P.O. Box 179 Natick, MA 01760 508-650-9777 Fax: 508-650-9870 May 16, 2011 Building Commissioner/Inspector of Buildings NORTH ANDOVER, MA 02459 Board of Health/Board of Selectmen NORTH ANDOVER, MA 02459 NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 3B Claim has been made involving loss, damage or destruction of the property captioned below, which may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If any notice under Massachusetts General 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, cause of loss and LA file number. Insured: DEVELOPMENT NORTH ANDOVER OFFICE PK CONDO TRUST Loss Location: 451 ANDOVER ST NORTH ANDOVER, MA 02459 RECEIV E® Policy Number: 1120M15720 Date of Loss: 5/12/2011 JAN 10 ZUIZ Cause of Loss: Water TOWN OF NORTH ANDOVER LA File Number: MA-2-20023 HEALTH DEPARTMENT On this date, I caused copies of this notice to be sent to the persons named above at the addresses indicated above by first class mail. Gregory LaMarche Adjuster LaMarche Associates,Inc.-800-349-1525 Page 1 of 1 Town of Forth Andover F NflRT„ � Office of the Planning Department o A Community Development and Services Division 27 Charles Street North Andover,Massachusetts 01845 9SS C USES Heidi Griffin Telephone (978)688-9535 Planning Director Fax (978)688-9542 Notice Of Decision Any appeal shall be filed Within (20) days after the Date of filing-this Notice � ons In the Office of the Town N > am Clerk —' r v.� CD Date: June 21, 2001 �,, Date of Hearing: April 12001, May 1,1001 & June 5, 2001 Petition of: Richmond.Realty Trust 451 Andover Street,North Andover, MA 01845 Premises Aff,"ted: located off Waverly Road Referring to the above petition for a special permit from the requirements of the North Andover Zoning Bylaw Section 11. So as to allow: for a four story 43-dwelling unit building. After a public hearing given on the above date, the Planning Board voted to APPROVE, the Special Permit for Planned Development District Special Permit, based upon the following conditions: Signed?berSto i ons, Chairman Cc: Applicapt Angles, Vice Chairman Engineae'r Richard Nardella, Clerk Abutters Richard Rowen DPW Alison Lescarbeau Building Department Conservation Department Health Department ZBA BOARD OF APPE.<ULS 688-9541 BUILD I`�G 688 954j CONSERVATI(iN 688-9530 HEAI TFI 688 J640 PLAN TING 68R-9531 Riverbend Cr?ssing-Greene Street Special Permit Planned Development District Conditional Approval The Planning Board hereby APPROVES the Planned Development District Special Permit for a 4 story 43-dwelling unit building. This building will be utilized by adults .55 years of age or older, known as Riverbend Crossing. This special permit was requested by Richmond Realty Trust, 451 Andover Street, North Andover, Massachusetts on March 29, 2001. Richmond Realty Trust submitted a complete application on March 29, 2001. The application was noticed and reviewed in accordance with the procedures for approval described in Section 11, 10.3 and 10.31 of the Town of North Andover Zoning Bylaw and MGL c.40, sec. 9. The area affected is located off Waverly Road in the I-S Zoning District. The Planning Board makes the following findings as required by the Town of North Andover Zoning Bylaw, Sections 10.3 and 10.31. 1. The specifiq. site is an appropriate location for a Planned Development District as it is located in the I-S Zoning District and the PDD plan meets the minimum requirements required by Section 11.4 of the Town of North Andover Zoning Bylaw. 2. The use as developed will not adversely affect the neighborhood as this site is located in the Industrial-S Zone and is adjacent to the Town of North Andover Housing Authority, and is a similar use as the property adjacent to it. 3. There will be no nuisance or serious hazard to vehicles or pedestrians. The applicant submitted a traffic impact and access study to the town's outside engineering consultant and the study was found to be accurate and sufficient for the proposed project. Furthermore, the Town of North Andover Fire Department has determined in their review that this proposed project will enhance the current life safety conditions presently found on the property(attached). 4. Adequate .and appropriate facilities will be provided for the proper operation of the proposed use. The project will be on town water and sewer and has been determined acceptable by the Department of Public Works as noted in their letter dated May 24,2001 (attached). The Planning Board also makes findings under Section 11.2 of the Zoning Bylaw that this PDD is in harmony with the general purpose and intent of the Bylaw, including Sections 11.2 and 10.3, and that the PDD provides for a mixture of land usage at designated locations at greater density and intensity than would normally be allowed. In particular, the Planning Board finds that this project: 1 a 1. Does not detract from the livability and aesthetic qualities of the environment — The building has been designed by registered architect and a community and fiscal impact analysis has been submitted; 2. Is consistent with the objectives of the Zoning Bylaw— The project conforms to the Town of North Andover Zoning Bylaw with the exception of variances granted by the Zoning Board of Appeals; 3. Promotes more efficient use of land while protecting natural resources, such as water resources, wetlands; floodplain and wildlife - The project contains approximately 38% open space which can be utilized for terraces, walking trails and other active or passive recreational uses; and 4. Promotes diverse, energy=efficient housing at a variety of costs. The property will provide housing for individuals 55 years of age or older, which is a Type of housing needed in the Town of North Andover. Finally, the Planning Board fords that the. Planned Development District complies with Town Bylaw requirements so long as the applicant complies with the following condition: i 1. The developer shall designate an independent Environmental Monitor who shall be chosen in consultation with the Planning and Community Development �taff. The Environmental Monitor must be available upon four (4) hours tlotice to inspect the site with the Planning Board designated official. The Environmental Monitor shall make inspection as determined necessary by the Town Planner to assure compliance with this decision. Tie monitor shall meet with the Town Planner at appropriate intervals and file monthly written reports to the Planning Board detailing areas, if any, of non-compliance with approved plans and condition of the site plan approvals. 2. It shat) be the responsibility of the developer to assure that no erosion on the site shall occur which will cause deposition of soil or sediment upon adjacent properties or public ways, except as normally ancillary to off-site sewer and other off-site construction. Off-site erosion will be a basis for the Planning Board making a finding that the project is not in compliance with the plap. 3. Prior to endorsement of the plans by the Planning Board and recording with the Registry of Deeds the applicant shall adhere to the following: a. The applicant shall post (per agreement with the North Andover Planning Board) a Site Opening Bond in the amount of five thousand ($5,000) to be held by the Town of North Andover. The Guarantee shall be in the form of a check made payable to the Town of North Andover escrow account. This amount shall cover any contingencies that might affect 2 a the public welfare such as site-opening, clearing, erosion control and performance of any other condition contained herein, prior to the posting of the Performance Security as described in Condition 6b of this Conditional Approval. This Performance Guarantee may at the discretion of the Planning Board be rolled over to cover other bonding considerations, be released in full, or partially retained in accordance with the recommendation of the Planning Staff and as directed by the vote of the North Andover Planning Board. b. Deeds and easements relative to the project (with the exception of the Master Deed referenced in condition ##6d) must bq supplied to Planning Staff and reviewed and approved by Town Counsel. C. The construction and placement of the North Andover Trails Committee standard 55" kiosk will occur near the cul-de-sac area .at the bottom of the street near the parking areas. Rqvised plans must be submitted reflecting this. The Planning Board Approves the following building designs as depicted. in the following plans: Plan Titled: Lower& 1"Floor Elevations 2nd, 3rd and 4b floor plans Elevations Architect: Joseph D.LaGrasse&Associates,Inc. One Elm'Square Andover,MA 01810 Dated: November 27,2000,revised 12/15/00 Sheets: A-1,A-2,A-3,A-4 4. Prior to Construction: a) A construction schedule shall be submitted to the Planning Staff for the purpose of tracking the construction and informing the public of anticipated activities on the site. b) Yellow Hazard tape must be placed along the no-cut line on as shown on the approved plans and must be confirmed by the Town Planner. The Town Planner must be contacted to review the marked tree line prior to any cutting on site. The applicant shall then supply a copy of a plan, certified by a registered professional engineer, certifying that the trees have been cut in accordance with the approved plans. 3 5. Throughout and During Construction: (a) Dust mitigation and roadway cleaning must be performed weekly, or as deemed necessary by the Town Planner, throughout the construction process. (b) Street sweeping must be performed, at least once per month, throughout the construction process, or more frequently as directed by the Town Planner. (c) Hours of operation during construction are limited from 7 am. to 5 p.m., Mondaythrough Friday and 8 a.m.—5 p.m. on Saturdays. 6. Prior to the issuance of a building permit: a) The Planning Board must by majority vote make a specific finding that the Erosion and Siltation Control Program is being adhered to, and that any unforeseen circumstances have been adequately addressed. b) A Performance Guarantee in an amount to be determined by the Planning Board, shall be posted to ensure completion of the work in accordance with the Plans approved as part of this conditional approval. The bond must be in the form acceptable to the North Andover Planning Board. Items covered by the Bond may include,but shall not be limited to: i)as-built drawings; iu7 sewers and utilities iii)roadway construction and maintenance iv)lot and site erosion control v) site screening and street trees vi)drainage facilities vin) site restoration Viii)final site cleanup c) The applicant shall adhere to the following requirements of the Fire Department and the Building Department: i. All structures must contain a residential fire sprinkler system. The plans and hydraulic calculations for each residential system shall be submitted for review and approval by the North Andover Fire department. Plans and hydraulic calculations fp each residential system must also be supplied to the . Building Department when applying for a building permit. ` d) A Master Deed which represents the following: (1) Each unit shall be occupied by at least one person who is at least 55 years of age or older; (2) All unit owners shall comply with the rules 4 issued by the SFcretary of HUD for verification of occupancy which shall provide four verification by reliable surveys and affidavits, which shall be admissible in administrative and judicial proceedings for the purpose of such verification; (3) Children under the age of 18 may not reside in a unit for more than six months(6) in any nine month (9)pe+d. e) The applicant must comply with the Growth Management Bylaw, Section 8.7 of the Town of North Andover Zoning Bylaw. If the applicant wishes to qualify for the exemption listed in Section 8.7.6.d the Master Deed referenced above in Condition 6.d. must run with the land. (f) An as-built plan must be submitted to the Division of Public Works for review and approval prior to acceptance of the sewer appurtenances for use. (g) The roadway must be constructed to at least binder coat of pavement to properly access the lot in question. Prior to construction-of the binder coat, the applicant shall ensure that all required inspection and testing of water, sewer, and drainage facilities has been completed. The applicant must submit to the Town Planner and the Department of Public Works an interim as-built, -certified by a professional engineer, verifying that all utilities have been installed in accordance with the plags and profile sheet. (h) The applicant is required to pay sewer mitigation fees fees in accordance with the current and prescribed policies at the Department of Public Works. These fees are based on the number of bedrooms. Proof of payment must be supplied to the Planning Department. (i) The open space, subject to the easement for the public to use the trails, shall be part of the condominium. . To insure that this condition is met, the Applicant shall provide to the Planning Board a copy of the Master Deed along with the Exhibit A property description uppn the recording of the Master Deed at the Essex North District Registry of Deeds. The Master Deed shall provide that the open space shall never be severed from the condominium nor shall the unit owners ever be able to vote to withdraw the open space land from the condominium. 7. Prior to verification of a Certificate of Occupancy. a) The applicapt shall adhere to the following requirements of the North Andover Fire Department and the North Andover Building 5 Department. All structures must contain a residential fire sprinkler system. The residential fire sprinkler systems must be installed in accordance with referenced standard NFPA 13D and in accordance with 780 CMR, Chapter 9 of the Massachusetts State Building Code. Certification that the systems have been installed properly in accordance with the above referenced regulations must be provided from both the North Andover Fire Department and the North Andover Building Department to the applicant. Thet applicant must then provide this certification to the North Andover Planning Department. 8. Prior to final release of security: a) The Planning Staff shall review the site. Any screening as may be reasonably required by the Planning Staff will be added at the applicant's expense. Specifically after the detention pond is completed, the Town Planner will review the site and any screening as may be reasonably required by the Town Planner will be added at the applicant's expense b) A final as-built plan showing final topography, the location of all on- site utilities, structures, curb cuts,parking spaces and drainage facilities must be submitted to and reviewed by the Planning Staff and the Division of Public Works. 9. Tree cutting shall be kept to a minimum throughout the project to minimize erosion and preserve the natural features of the site. If any tree cutting occurs- outside of the no-cut line as shown on the plan, a reforestation plan must be submitted as outlined in Section 5.8(6) of the Zoning Bylaw. 10. This special permit approval shall be deemed to have lapsed after ZeVY (two years from the date permit granted) unless substantial construction of roadway and utilities has commenced. 11. The provisions of the Special Permit shall apply to and be binding upon the applicant, its employees, contractors and subcontractors and all successors in interest or control. 6 Q 12. The developer shall implement and follow all requirements set forth in this decision (conditions 1-12) and the plans and reports, referenced below in conditions 13a-d. Failure to comply with all requirements therein and the conditions of this approval shall be the basis for the Planning Board, voting by majority vote, to stop all site work and construction until defects on the site are corrected and the development is put back into plan compliance. Plan compliance will be solely determined by a majority vote of the Planning Board based upon the developers written comments and the Fonditions contained herein. 13. The Town Planner shall approve any insubstantial changes made to the plans and reports described in Sections 3 and 13. Any changes deemed-substantial by the Town Planner shall be presented to the Planning Board for a determination by the Board whether such changes would merit a public meeting or hearing and/or Special Permit modification. a) Plan titled: Definitive Plan: Planned Development for Riverbend Crossing Dated: 3/28/01 Applicant: Richmond Realty Trust Civil Engineer: Christiansen&Sergi, 160 Summer Street Haverhill,MA 01830 Sheets: 1 of 7 Scale: l"=2D' b) Plan tined: Proposed Site Locus Plan&Landscaping Plan Dated: November 27,2000,revised 12/15/00 Sheets: C-1 &C-2 Scale: 1"=40' and 1"=20' Landscape Architect: Joseph LaGrasse&Associates,Inc. One Elm Square Andover,MA 01810 c) Report ruled: Traffic Impact and Access Study `` Riverbend Crossing Condominium Development North Andover,MA Prepared by: Vanasse&Associates,Inc. 10 New England Business Center Drive, Suite 314 Andover,MA 01810 Dated: May 2001 7 Division of Public Works Phone 978-685-0950 "384 Osgood Street Fax 978-688-9573 North Andover, MA 01845 S Q u ff'"IECEIVED Me o MAY P 5 2001 An ER 7MENT TO: Heidi Griffin, Town Planner From: James Rand, Jr., Director Of Engi CC: J. William Hmurciak, PE, DirectorStaff Engineer, Joseph D. LaGrasse, Architect i Date: May 24, 2001 Re: Riverbend Crossing—Site Plan Revisions Reference Plan: Site Plan for "Riverbend Crossing" an independent elderly housing community on Green Street in North Andover, Mass. Prepared for Richmond Realty Trust, scale: 1"=20', Date: November 10,2000, rev.: 12/15100. Christiansen & Sergi, Professional Engineers & Land Surveyors. Revised May 14, 2001 This Department has reviewed this revised plan and find all changes satisfactory. Just a reminder that item 3 of our Memo dated January 23, 2001 still applies. "As required, by the Town the applicant is required to pay sewer mitigation fees. These fees are based on the number of bedrooms. Please add this note to your approval to alert all future parties." C:/Riverbend/Memo 02 0 Page 1 Location mac' 7— No. Date NORTITOWN OF NORTH ANDOVER f ,; R P Certificate of Occupancy $ __Sem s�cMust� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ I Check # f Building Inspector L� t TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit N0: Date Received Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION �I I n 0 � Print PROPERTY OWNER A• Unit# Print MAP NO:a�_PARCEL:2KZONING DISTRICT: Historic District yeZno Machine Shop Village y 100 year-old structure y TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition El Two or more family El Industrial ❑Alteration No. of units: ommercial ❑ Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑ Other O'Septic O,Weh' (]Floodp1a O'Wetlands� Of.VWatershedDistncf D Water/Sewer A. DESCRIPTION OF WORK TO BE PERFORMED: (Identification Please Type or Print Clearly) Li .3 I OWNER: Name: JW CVA Phone: Address: e- CONTRACTOR Name 3'-- Ty►LPhone: 7 Z- `l O � Address: -:?"i — --I © C V1 r- S4_ Supervisor's Construction License: �7 b 5715` Exp. Date: 7 — Z " Z 0 13 Home Improvement License: Exp. Date: (� �� — Z 01 Z ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE.BULDING PERMIT.•$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: FEE: $--S 4 & — Check No.: I Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund . .. . ............ �Sgnature_of Agent/Owner Signature of confractor Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ TYPE OF SEWERAGE DISPOSAL Public Sewer ❑ Tanning/Massage/Body Art ❑ Swimming Pools ❑ Well ❑ Tobacco Sales ❑ Food Packaging/Sales ❑ Private(septic tank,etc. ❑ Permanent Dumpster on Site ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water& Sewer Connection/Signature& Date Driveway Permit DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT -Temp Dumpster on site yes no Located at 124 Main Street Fire Department signature/date COMMENTS NORTH Town 0Andover .. 0 ., lit AOL o o , lover, Mass., CORC HICt1E WICK AOAP��V S ATED '9S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR .......................... ........................................ ............. THIS CERTIFIES THAT......................................................................... Foundation has permission to erect........................................ buildings on ....... . ....�....:........ .... .... ........... .......W.. Rough I to be occupied as 1}....... .�1•�.d.. .. Chimney provided that the erson acce tin his permit shall in eve respect con i�im to the terms of the application on file in Final p P P 9 P every P this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR TI TART - UNLESS CONSTRUC Rough ................ ............................................ Service BUIL ECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIR_E-DEPARTMENT � Until Inspected and Approved by the Building Inspector. Burner -- Street No. SEE REVERSE S1 D E Smoke Det. f J•N•R y HIC#108503 All Types of Home Improvement wwwJnrgutters.com 38-40 Lancaster Street*Haverhill, MA 01830 Nf Haverhill,MA: (978)372-4088 Nashua,NH: (603)595-2272 Andover,MA: (978)475-3723 Portsmouth,NH: (603)433-1811 Woburn,MA: (781)937-4212 Manchester,NH: (603)666-5502 Natick,MA: (508)653-2200 Dover,NH: (603)740-3099 Boston,MA: (617)423-3559 Rochester,NH Lakes Region: (603)335-0068 Toll Free Nationwide:(800)966-9238 Fax:(978)372-0360 PROPOSAL SUBMITTED TO tt PHONE DATE 1 STREET 'l JOB NAME CITY,STATE and ZIP CODE JOB LOCATION e r1. e .� We��J' yoSr hereby to furnish material �and rlabor-complete in accordance with specifications below, for the sum of: l� 4 A VVJ�-C -�—�____moi. ollars($ Payment to be made as follows: I i Authorized / �a !�----- So to WM*may be Signature / withdrawn by us if not accepted within days. _Tarp and cover all areas at work area to -- nping --___ We hereby submit gpecilgtjffibapjifth4rYoofing systesm down to roof deck and dispose of in a legal fashion. o Check existing sheathing and replace and renail as necessary. o Install 2 rotvs of Ice and Water Shield along bottore, 3'along rakes, 3' in valleys and a minimum of 12" up all adjoining walls. o install new step flashing at all roof transitions. a Install 8" white aluminum drip edge to all exterior edges,then apply 6" strip of ice and crater shield over exposed edge of drip edge. o Install 3' Ice and water shield around all existing roof penetrations. o Install neer pipe flanges around all existing soil pipes. Install 150 felt paper to remaining roof surface. o install neer Certainteed 30 year architccturai shinglas to roof surface nailing in a hurrican3 nailing pattern. o Check ridge vent for proper ventilation and cut as necessary,&install a new shingle ridge vent. 4 Clean job site on a daily basis and run magnet around entire house to minimize nails left behind from roof removal. C ****ADDITIONAL CHARGE TO REPLACE ANY ROTTED SHEATHING WOULD BE AT A COST OF $4.00 PER SO FT AND ROTTED FRAMING MEMBERS E^.+OULD BE$12.25 PER BOARD FOOT. AND LABOR RATE FOR MISCELAKIEOUS REPAIRS WOULD BE$68.5tt PER MAN HOUR PLUS MATERIALS. G ***ADDITIONAL COST TO INSTALL 3 ROWS OF ICE AND WATER SHIELD WOULD BE O ***ADDITIONAL COST TO INSTALL ICE AND WATER SHIELD OVER ENTIRE ROOF SURFACE WOULD BE I~i ""ADDITIONAL COST FO t CERTAiNTEED 5-SURESTART PLUS COVERAGE V40ULD BE $ WHICH INCLUDES: 1007/ COVERAGE FOR 25 YEARS ON DURATION, MATERIALS &LABOR, TEAR-OFF, DISPOSAL AND WORKMANSHIP. 4-NA CUTTERS CANT gg HELD RESQO.'CABLE FOR Dr'9RIS Air Q QR DUST IN YOUR AMC EdF RCC( AC %Q RECIOVAL AND QR COVERING X4Y!!AU_BLES I Arreptanre of JJroposal - The prices,specifications and Do not sign this contract conditions listed above and on the back of this form are satisfactory and are if there are any blank spaces: hereby accepted. You are authorized to do the work as specified.Payment will made as outlined above. Three day cancellation rights under section forty-eight of chapter ninety three,sec- % s„ tion fourteen of chapter two hundred and fifty five,D or section ten of chapter one Signature �r�f hundred and forty D as may be applicable. Date of Acceptance: Signature 1.ACCEPTANCE.This agreement is expressly limited to and made conditional upon your acceptance of its terms and conditions.Any of your terms and conditions which are in addition to or different from those contained herein which are not separately agreed to in writing (except additional provisions specifying quantity,description of the products or work ordered and shipping instructions)are deemed material and are hereby objected to and rejected. You waive your objection to any terms and conditions contained herein if Contractor does not receive written notice of your objection within ten business days of the date of this agreement. You will in any event be deemed to have assented to all terms and conditions contained herein if any part of the products or work described herein are provided or performed. Please note particularly the Limited Warranty, Limitation of Remedies and Limitations on Actions and Liability provisions set forth below. You acknowledge that the prices stated are based on the enforceability of these terms and conditions, and on the limited Warranty, Limitation of Remedies and Limitation of Actions and Liability provisions below,that the price would be substantially higher if Contractor could not limit its liability as herein provided,and that you accept these provisions in exchange for such lower prices. 2. LIMITED WARRANTY.All work performed by Contractor is warranted to be free from defects in material and workmanship for one year from the date of completion of the installation subject to the terms below.Contractor makes no warranties regarding products sold but assigns to you any manufacturer warranties relating to the products.THIS EXPRESS WARRANTY IS IN LIEU OFAND EXCLUDES ALL OTHER WARRANTIES,WHETHER EXPRESSED, IMPLIED OR STATUTORY, INCLUDING IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE.This limited warranty does not cover damages relating to(a)accident,misuse, abuse, neglect,or,normal wear and tear; (b)failure to use or maintain the product in accordance with manufacturer's instructions;and(c)alteration, repair or attempted repair by anyone other than Contractor or its authorized representa- tive.You shall be solely responsible for the correctness of the plans and specifications and shall release and hold harmless Contractor from any damages resulting from improper, inadequate or vague information supplied by you.Contractor does not take on any obligation to inspect or evaluate the work of other parties in any manner or aspect.This warranty is not transferable. 3. INSURANCE. Contractor shall maintain workers'compensation (employer liability), as required by law, and$2,000,000 in general liability insurance while performing the work. Contractor reserves the right to be self insured to the extent allowed by applicable law. Contractor does not agree to name any other persons or entities as additional insureds. 4. LIMITATION OF REMEDIES.Your sole and exclusive remedy against Contractor for any and all claims for damages arising out of or alleged to have arisen out of the Work will be limited to the repair or replacement by Contractor,at Contractor's option,of any nonconforming work or to the issuance of a credit for such nonconforming work in accordance with these terms and conditions provided Contractor is given a reasonable opportunity to inspect the work and confirms such nonconformity.This exclusive remedy shall not be deemed to have failed its essential purpose so long as Contractor is will- ing and able to repair or replace the nonconforming work and, in any event, Contractor's maximum liability for any damages shall be limited to the total amount paid to Contractor for the Work under this agreement.This Limitation of Remedies clause shall apply to the parties to this agreement as well as to the current owner(s)of the project and its/their respective successors and assigns. If you receive a claim for damages by any owner arising out of or alleged to have arisen out of the Work, you agree to give written notice to Contractor of the claim and provide Contractor an opportunity to inspect the alleged damages within 30 days after Contractor receipt of the notice. If you fail to give the required notice and/or fail to pillow Contractor an opportunity to inspect the alleged damages within 30 days, you hereby waive any and all rights for damages and/or correction of work against Contractor. This Limitations of Remedies may be plead as a complete bar to any action in violation of this clause. 5. LIMITATIONS ON ACTIONS AND LIABILITY.All claims and/or lawsuits including but not limited to claims or lawsuits for indemnity and/or contribution against Contractor arising under this agreement must be made within 13 months from the date of completion of the installation. CONTRACTOR WILL NOT BE LIABLE FOR ANY LOSS, DAMAGE OR INJURY RESULTING FROM DELAY IN DELIVERY OF THE PRODUCTS OR FOR ANY FAILURE TO PERFORM THAT IS DUE TO CIRCUMSTANCES BEYOND ITS CONTROL.CONTRACTOR DISCLAIMS ALL LIABILITY FOR ANY AND ALL DAMAGE WHICH MIGHT BE SUSTAINED BY ANY PERSON WHO MAY BE ALLERGIC TO OR AFFECTED BY THE EMANATION OF PARTICLES FROM CERTAIN TYPES OF INSULATION.THE MAXIMUM LIABILITY, IF ANY,OF CONTRACTOR FOR ALL DAMAGES, INCLUDING WITHOUT LIMITATION CONTRACT DAMAGES AND DAMAGES FOR INJURIES TO PERSONS OR PROPERTY, WHETHER ARISING FROM CONTRACTOR'S BREACH OF THIS AGREEMENT, BREACH OF WARRANTY, NEGLIGENCE, STRICT LIABILITY OR OTHER TORT WITH RESPECT TO THE PRODUCTS,OR ANY SERVICES IN CONNECTION WITH THE PRODUCTS, IS LIMITED TO AN AMOUNT NOT TO EXCEED THE CONTRACT PRICE. IN NO EVENT SHALL CONTRACTOR BE LIABLE FOR ANY INCIDENTAL, CONSEQUENTIAL, LIQUIDATED, OR SPECIAL DAMAGES, INCLUDING WITHOUT LIMITATION, LOST REVENUES AND PROFITS,ATTORNEYS FEES AND/OR COSTS EVEN IF IT HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES.THE RIGHT TO RECOVER DAMAGES WITHIN THE LIMITATIONS SPECIFIED IS YOUR EXCLUSIVE REMEDY IN THE EVENT THAT ANY OTHER CONTRACTUAL REMEDY FAILS OF ITS ESSENTIAL PURPOSE. 6.PRICES,TERMS AND SHIPMENT.No cash discounts,back charges,set offs or counterclaims are allowed unless specified by Contractor. In addition to the prices specified,you agree to pay any federal, state or local excise, use, occupational, or similar tax now in force or to be enacted in the future, assessed against Contractor or you by reason of this transaction. No retention is permitted unless Contractor agrees otherwise in writing.Any past due payment will be,at Contractor's option, subject to interest at 1.5%per month (18%per annum)to the extent permitted by law.You agree to receive(or permit Contractor to receive) near the work site,any materials needed to complete the Work. You agree to protect such materials from damage or loss and provide Contractor, free of charge, with reasonable use of light, heat, water, power, storage space and use of available elevators and hoists as needed.Title to all materials under this agreement shall not transfer to you until Contractor receives payment in full. Contractor may charge you a fee and its actual expense if the job site is not ready for work on the date you specify. 7. FORCE MAJEURE.Contractor shall not be liable for any delay,failures,or default in performance of this agreement or otherwise, in whole or in part, caused by the occurrence of any contingency beyond the control either of Contractor or of suppliers to the Contractor.Such contingencies include but are not limited to failure or delay in transportation,acts of any government or any agency or subdivision thereof,judicial action,labor disputes,fire,accident, acts of nature, severe weather, product allocation or shortages, labor shortages,fuel shortages, raw material shortages, machinery or technical failure, or work that cannot be completed because of another contractor covering the pertinent portion of the building. If any contingency occurs,Contractor may allocate production, deliveries, and performance of work among its customers or substitute substantially similar materials, in its sole discretion, without liability for doing so. 8. CONFIDENTIALITY. If you visit Contractor's premises or you otherwise receive any proprietary or confidential information from Contractor,you shall retain such information as confidential and not use or disclose it to any third party without Contractor's written consent. 9. CREDIT APPROVAL. Shipment and delivery of goods and performance of work shall at all times be subject to the approval of Contractor's credit department and Contractor may at any time decline to make any shipment or delivery or perform any work except upon receipt of payment or upon terms and conditions or security satisfactory to Contractor. By signing this agreement,you authorize Contractor to check your credit and references. 10. CANCELLATION. This agreement, or any part of it, may only be cancelled with Contractor's written approval. In the event of cancellation of this agreement, any part hereof,you shall pay: (a)the contract price of all completed items; (b)that portion of the contract price that is equal to the degree of completion of products or work in process,effective on the date Contractor receives notice of cancellation;(c)the cost of any materials and supplies which Contractor shall have purchased to perform and which cannot be readily resold or used for other or similar purposes; (d) a restocking fee; and (e)any expenses incurred by Contractor(including legal fees and judgments)as a result of the cancellation of subcontracts or purchases related to this agreement. 11. DEFAULT.You may terminate this agreement for Contractor's default,wholly or in part,by giving Contractor written notice of termination as follows. You may give written notice of termination only if Contractor has received a written notice from you specifying such default, the default is not excus- able under any provision hereof, and the default has not been remedied within thirty(30)days(or such longer period as maybe reasonable under the circumstances)after Contractor's receipt of the notice of default. Delivery of nonconforming products or work by Contractor shall give you the rights set forth in paragraph 4 hereof but shall not be deemed a default for purposes of termination. In the event of termination for default, you shall be relieved of the obligation to pay for work not performed by Contractor prior to the effective date of such termination.A default on Contractor's part shall not sub- ject Contractor to liability,through payment by Contractor, set off or otherwise,for any other damages,whether direct, consequential or incidental, and whether sought under theories of contract or tort. If customer breaches this agreement the Contractor is entitled to reasonable attorneys'fees and litiga- tion expenses as determined by a"Court of Law." 12.ASSIGNMENT.You may not assign this agreement or any claim against Contractor relating to this agreement. 13.GOVERNING LAW.This agreement shall be construed, interpreted and the rights of the parties determined in accordance with the laws of the State of Contractor's address first listed on the front of this agreement. 14. DISPUTES AND MANDATORY MEDIATION. In the event that a dispute arises over the reasonableness of or entitlement to fees charged by Contractor,the prevailing party will be entitled to reasonable attorneys fees and costs. In all other disputes of any nature, each party shall pay its own fees and costs. Except as required to protect confidential information and to obtain preliminary injunctive relief to prevent irreparable harm,you and the Contractor agree that prior to the initiation of any legal action the parties will engage in facilitative mediation of any and all disputes in anyway related to this agreement. If the parties cannot agree upon a facilitative mediator within 30 days of when the dispute arose,one will be selected pursuant to the Commercial Mediation Rules of the American Arbitration Association. Each party will share equally the fees of the facilitative mediator and costs of the mediation. 15.Three day cancellation rights under section forty-eight of chapter ninety three,section fourteen of chapter two hundred and fifty five, D or section ten of chapter one hundred and forty D as may be applicable. 16.SEVERABILITY. If any provision on this agreement is not enforceable,that provision shall be effective only to the extent permitted by law and all other provisions of the agreement shall remain. 17. ENTIRE AGREEMENT.This instrument contains the entire agreement of the parties relating to the subject matter hereof and may only be waived, changed, modified,extended or discharged orally by a writing signed by the party against whom enforcement of any such waiver,change, mortification, extension or discharge is sought the terms and conditions of this agreement supersede any agreement to which it is attached. 18. INDEMNITY. Each of the parties to this agreement agrees to defend and indemnify one another from any and all claims, actions and/or lawsuits caused by the party's negligent acts or omissions.This indemnity clause and the obligations created herein shall control and take priority over any con- trary indemnity agreement entered into prior to this agreement. Furthermore,this indemnity clause and the obligations created herein shall control and take priority over any contrary indemnity agreement entered into subsequent to this agreement unless the subsequent agreement specifically refers to this indemnity clause and declares it null and void. 09/20/2011 12:42 FAX 978 532 2217 CROSS INSURANCE Cj003 a A ® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/Y 9/20/20111 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement A Statement on this certificate does not confer rights to the certificate holder in lieu of such andorsement(s). °RODUCER CONTACT Den3B9 Cimet ti Cross Insurance-Peabody PHONE (979)532-5445 FAx No,(57B)532-2117 139 Lynafield Street E-MAIL ,daimetti®crossagency.com INSURERS AFFORDING COVERAGE NAIC R Peabody MA 01960 INSURER 4erChant S Ins drou NSURED INSURERe:Commerce re Industry ins Co J4R Gutters, Inc. INSURERC: 36-40 Lancaster Street: INSURER D., INSURER E- 3averhill MA 01830 INSURER F- ;OVERAGES CERTIFICATE NUMBER:CL1192053826 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. JSR TR TYPE OF INSURANCEADD POLICY EFF POLICY amp POLICY NUMBER DD MNJ001v LIMITS GENERAL LIABILITY EACH OCCURRENCE 3 COMMERCIAL GENERAL LIABILITY A V IiIiiNTIZU PREM: R. 9 CLAIMS-MADE 71 OCCUR MED EXP ono arson) S PERSONAL&ADV INJURY S GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG S POLICY PRO- LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT I aacctdent 11000.0 0 A ANY AUTO BODILY INJURY(Por person) S ALL OWNED x SCHEDULED KCA7015134 6/21/20116/7.1/2012 AUTOS AUTOS BODILY INJURY(Per awldenL) S X MIRED AUTOS X NON-OWNED PROPERTY DAMAGE AUTOS q $ PIP-eerie S U6IBRELLA UAB OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE 5 DED RETENTION S $ 8 WORKERS COMPENSATION We STATU• OTH- AND EMPLOYERS'LIABILITY Y/N X ANY PROPRIETORMARTNER/EJ(ECUTIVE E.L.L.EACHACCIDENT�S 50U 000500 000 OFFICERIMEMBER EXCLUDED? NIA (MandatorylnNH) 0009774192 /20/2011 /20/2012 E.LDISEASE•EAEMPLOYE S 500 000 If yyeB,'sceiba under DESCRIPTION OF OPERATIONS below E.L DISEASE.POLICY LIMIT S 500,000 1ESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional RemerAB Schedule,I/more spaco Is rcqulrvd) tefOr to policy for exclusionary endorsements and special provisions. :ERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN SAMPLE CERTIFICATE FOR ACCORDANCE WITH THE POLICY PROVISIONS. INSURANCE PURPOSES ONLY SAMPLE COPY AUTHORIZED REPREGMTATtVS Timothy Tramonte/DC4 N LCORD 25(2010105) ®1868-2010 ACORD CORPORATION. All rights reserved. 4S025(20100S).01 The ACORD name and logo are registered marks of ACORD .. d.�e;aiaas.�apuR { O C ,.. 0£81.0 t/W `Illy ane{I — �� � '1S i31SVONVI 017 8£ )SIONVZi3 NIA3>1 _. OIVI isZ1311ns 2i N r 1 -- ��k' juawajddng i lOZ/6178 .uoyejldx3 I:ad/Cl £09,80.i.l�:uo1;ej;s160b a013"INOO 1N3W3n021dW1 3W0 uoyetn;lau ssauisng. ;s [eS;��auinsuoO 30?�3.{O \- '- i<`Iassachusetts- Department of Public SACC Board of Building Regulations and Standards Construction Supervisor License ° License: CS 80515 i KEVIN M FRANCIS 35 WANNALANCET RD drool, HAVERHILL, MA 01830 i Expiration: 7/21/2013 Commissioner '' Tr#: 16840 i Ob89L :#�l .tauo�ss�unu�J £l•OZ/lZ/L :uojlejtdx3 4 0£860 VVY 1-1IH213AVH CRI 130MdlVNNVAA 5£ SIONV?J3 W NIA3N 9L909 so :asuaorl asuaoi-j JoSIAaadnS uor;oni;suo0 sp.11-Pua'1S Pur suuiar.In��aa ;uTWIE1 jo Parbg iRWS o!lttnd.;o luatul.irdad -sllasnt{arssq.4i p� 92. � r \ Office of Consumer Affairs 3t Business Regu€atioi f OME IMPROVEMENT CONTRACTOR Registration:4108503 Type h. Expiratiort=.g%1-912.0,.12, Supplement G J N R GUTTERSI�INC=4 KEVIN FRANCISs�I�;; 38-40 LANCASTEWST . :`;: �- I . Haverhill, MA 01830 - '' 'Undersecretary- L - ACO CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYY1) `.� 07/11/2011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). CONTAPRODUCER 978-374-2500 866-494-4513 NAME: Daniel J. Seaman Daniel J. Seaman PHC No Ext:978-374-2500 A/ No):866-494-4513 229 Primrose Street E-MAIL SS:dan@seamaninsurance.com PRODUCER CUSTOMER ID#: Haverhill MA 01830 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURERA:Atlantic Casualty JNR Gutters Inc INSURER B:The Hartford 38-40 Lancaster Street INSURER C: Haverhill, MA 01830 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LTR POLICY NUMBER MM/DD/YYYY MM/DD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $1000000 A COMMERCIAL GENERAL LIABILITY PREMISES(Ea occcuence) $50000 CLAIMS-MADE 1:1 OCCUR MED EXP(Any one person) $55000 L18507 07/20/2011 07/20/2012 PERSONAL&ADV INJURY $1000000 GENERAL AGGREGATE s2000 00 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $2000000 POLICY 171 PRO LOC LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT ANY AUTO (Ea accident) $ BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS (Per accident) NON-OWNED AUTOS $ $ UMBRELLA LIABOCCUR EACH OCCURRENCE $ EXCESS LIAB HCLAIMS-MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATIONWC STATU- OTH- AND EMPLOYERS'LIABILITY YIN Y L I R ANY PROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBER EXCLUDED? N/A E.L.EACH ACCIDENT $ (Mandatory in NH) E.L.DISEASE-EA EMPLOYE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ B Business Property Equiptment Leased or Rented from Others 08MS HE3720 17/20/2011 07/20/2012 Limit $275,000 DESCRIPTION OF OPERATIONS]LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required) Siding, Gutters, Roofing, Windows and General Repair CERTIFICATE HOLDER and Additional Insured CANCELLATION Barer SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE t ©1988-2009 ACORD CORPORATION. All rights reserved. Dimension Number of Stories: Total square feet of floor area, based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— For department use ❑ Notified for pickup - Date Doc:.Building Permit Revised 2011 June/mi Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application L3 Workers Comp Affidavit ❑ Photo Copy of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products (VOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable-) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products EMOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg .Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Doc.Building Permit Revised 2008mi 1 0043 Date........ .. C1.'.. NORTH °f�"`°:•�"� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING A No SSACNU5� This certifies that ..... ..... �)/1 QZT U 5 ys , 7eL.. has permission to perform ............ .......541.j................ wiring in the building of ..L c s P at....... S."/.... .1�l1�c��-l�,.......5 North Andover Mass. ............... Fee....... Lic.No..7Q927� .............. .. . .. .... : (Z r.... Cj�� � ss /d^� LECTRICAL INSPECTO�' Check # Application Number: C.I.D.# Commonwealth of Massachusetts Of/ficial Use Only Department of Fire Services Permit No. l 00 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 4/14/11 City or Town of: North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number): 451 Andover St Owner or Tenant: First General Realty Telephone No. Owner's Address Same Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Location and Nature of Proposed Electrical Work: Completion o the ollowin table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ No.of Emergency Lighting rnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Hot Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Siens Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: f� No.of Devices or Equivalent OTHER: Installation Of 5 Smoke Detectors/3 Horn Strobes/1 Strobe/WO 88969400 Attach additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:)Ins Co Of The State Of PA 2/12/11 Estimated Value of Electrical Work: (When required by municipal policy.) (Expiration Date) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify,under the pains andpenalties of perjury,that the information on this application is true and complete. FIRM NAME: AFA Protective Systems LIC.NO.: Licensee: Joseph W.Donovan Signature IC.NO.: 7007 C (If applicable,enter "exempt"in the license number line) Bus.Tel.No.: 617-772- 900 Address: 200 High St.Boston,Ma 02110 Alt.Tel.No. *Per M.G.L.c. 147,s 57-61,security work requires Department Of Public Safety"S"License: Lic.No.: 001097 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ 50.00 - - -, uepurtmenr of lnaustrial Accidents 191 Office of Investigations ---� 600 Washington Street Boston,MA 02111 * ,r www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Aonlicant Information Please Print Lezibly Name(Business/Organization/Individual):_ -A I°w Address: S-4— V 1 J ~ City/State/Zip: IS C)d A32ZPhone#: Are you an employer?Check the ppropriate boy. 1. [0;-I am a employer with 4• [] 'i am a general contractor and I Type of project(required): 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. 7. ❑Remodeling ship and have no employees These sub-contractors have g_ ❑Demolition working for me in any capacity. employees and have workers' [No workers'comp.insurance comp.insurance.1 9• ❑Building addition required.] S. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself.[No workers'comp. right of exemption per MGL insurance required.]t c. 152,§1(4),and we have no 12.❑��//Roof repairs employees.[No workers' 13.b+06lher_/%LADD I_ t s_ t/S comp,insurance required,] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy infom�ation. 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 state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.polity number. ,ram an employer that Is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name:_ ��,� R ,�/J /.tJ S 0� A W/7 0— C d1 Policy#or Self-ins.Lic.#:_ �� C Cl'P 4/4,/-2a�� 0 Expiration Date: azl a /.�- Job Site Address: 7 k., �O'(1-P f-,- City/State/Zip: ` C,k 1 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 nd penalties of perjury that the information provided above is true and correct: Simature: Date: — 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#: a �.J Date zr..... ............... ,&ORTH °`t :•�"� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING 'M CHU A � This certifies that .t ::�'. " ... .-� . . � '— ...................................... ... ...... ....� ;... has permission to perform-;.. ' wiring in the building of ......................................................' � i ......... at......... ............................................................ .... ,North Andover,Mass. d ./ �7 ��..... Fee.:................... Lic.No........'.7t.!—�............ �� ! ELECTRICAL INSPECTOR j Check # h r 8421 Application Number: C.I.D.# Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. yA -� BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked_ [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 10/14/08 City or Town of: North Andover To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number): 451 Andover St Owner or Tenant: First General Realty Corp Telephone No. Owner's Address 93 Union St,Newton,Ma Is this permit in conjunction with a building permit? Yes ❑ No ❑ (Check Appropriate Box) Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters New Service Amps / _Volts Overhead ❑ Undgrd ❑ No.of Meters Location and Nature of Proposed Electrical Work: Completion o the ollowin 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- ❑ No.of Emergency Lighting rnd. grnd. Battery Units ` No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and 110 Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices 36 Tons No.of Waste Disposers Hot Pump Number 1.Tons J.KW No.of Self-Contained ° Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection t No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Installation Of A fire Alarm System/WO 70854000 Attach additional detail if desired, or as required by the Inspector of lVires. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:)Ins Co Of The State Of PA 2/12/09 Estimated Value of Electrical Work: (When required by municipal policy.) (Expiration Date) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. I cert,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: AFA Protective Systems LIC.NO.: Licensee: Joseph W.Donovan Signature LAO LI .NO.: 7007 C (If applicable,enter "exempt"in the license number line.) V Bus.Tel.No.: 617-772-5900 Address: 200 High St.Boston,Ma 02110 Alt.Tel. No.: *Per M.G.L.c. 147,s 57-61 security work requires Department Of Public Safety"S"License: Lie.No.: 001097 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE. $ 125.00 920 Date. Z////. . . NORT„ TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING 1SSACNUSE� This certifies that . C rr So. . . . . . . . . . . . . . . . has permission to perform 6 v` �D�S plumbing in the bu-ildings of ` . . . . . . . . at. . . ..S/. . . . /P/-. .� .�r No�h,Ann��ddover, Mass. Fee. .�7 00 Lic. No. ZZG C;G✓ / n. . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR f Check It Y5' r P MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Town: (Z't AlU U ek MA. Date: permit# Building Location:_ Owners Name: lSY Type of Occupancy: Commercial ZKEducationalEl Industrial❑ Institutional❑ Residential❑ New:❑ Alteration:❑ Renovation: Replacement: ❑ Plans Submitted: Yes❑ No❑ FIXTURES DEDICATED SYSTEMS 2 o h LU >LU U z a W z 'a �, U W o ❑ 2 cn 2 ¢ ¢ w z Q m vxi a w F- w f- v� 2 2 O Q ¢ x w o a F a LU Q 2 a Oa a z W d a ¢ H Q a he x o = zj - ❑ w N 3 z � x a w U F x c O 1- U 2 Q " � d w w a o5 O w Q Q y H O O F O O o Z 2 cn I— F- w w a m m o ❑ LL x g 5 �° N 3 a ❑ ' a y w 4 SUB BSMT. 0 4 0 BASEMENT 1sT FLOOR 2"D FLOOR 3RD FLOOR t 4T"FLOOR r 5T"FLOOR 6T"FLOOR 7T"FLOOR 8T"FLOOR InsC-ilii;;Crir �.1 t�a ���� C 3 ,,'_03',e Address: Ra f �1.Cerpbrationn �� City/Town: Stater El / Partnership Business Tel:• _)-y-_ '/–V941 Fax:���–��6�� ❑Firm/Company Name of Licensed Plumber: INSURANCE COVERAGE: I have a current lia_ bility Insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes N If you have checked Yes,please indicate the type of coverage b checking the _. g y g appropriate box below. A liability insurance policy. Other t ype of indemnity ❑ gond ❑ - ' 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 rn ignature on this permit application waives this requirement. Check One Only 5i nature of Owner or Ownet's A ent Owner E] Agent El hereby certify that all o lthe details and information I have submitted(or entered)regarding this application are true and Knowledge and that all p!!�mbing week and installation performed under the mit issued for this application will a in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapt 1 of the General S. a�""life to the best c;my Type of License: .le ❑Per Si nature of Lice ed lumbe — y/Town aster 'PROVED(OFFICE USE ONLY) ❑Journeyman License Number: a a 6 1 � - The Commonwealth ofMassachusetts Department oflndustrialAccidents Office oflnvestigations' 600 Washington Street Boston,MA 021-11 yY www,mass:gov/dia Applicant nformation Workers' Compensation Insurance Affidavit: Builders/ContractorsfElectricians/Plumbers _ I .'lease Print Le�lbly Name(Business/Organization/Individual): a ON Address: 'o- u u;e City/State/Zip: e vX Phone#: Are you employer?Check the appropriate box: _ 1• am a em to er with- t 4. 'pe of project(required): p Y ❑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. 7• modeling ship and have no employees These sub-contractors have g, working for me in any capacity. workers'comp,insurance. El Demolition [No workers'comp.insurance 5. ❑ We are a corporation and its 9. ❑Building addition required.] .officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL11.❑Plumbing repairs or additions myself.[No workers'comp. c.152, §1(4),and we have no insurance T re aired. , 12.El Roofrepairs q ] • employees.[No workers comp,insurance required.] 13.❑Other *Any applicant that checks box#1 must also fill out the section below sho Homeowners who wing their workers'compensation policy information. submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. lam an employer that isproviding workers'compensation insurance for my employees. Below is tltepolicy anf rm site information. Insurance Company Name; (� Policy#or self-ins.Lie.#:_ �f( nQ -- Expiration Date: Job Site Address:_ ] ANONy , City/State/Zip: l, d �U V,(4 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 ofMGL 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 7���U under the a' a fp ry pP alties o er'u that the informationprovidedabov istrue and correct. Si nature: Date: . 21aone FOV77'claluseonbl. Do not writein this area,to be completedby city or townofficial.n: Permit/Licenseority(circle one): , L Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5-Plumbing Inspector 6.Other Contact Person: Phone#: COMMONWEALTH OF�MASSACHUSETtS 1 � T °' L�B� �l��tb�-�'�►�f�iT-� LICENSED AS A MASTER PLUMBER ISSUES THE ABOVE LICENSE TO: GERALD J DALEY JR 19 BERKELEY DR CHELMSFORD MA . 01824-116 12264 05/01/12 7882 s i 1 .ocation 'No. Date gGRTN TOWN OF NORTH ANDOVER F ; Certificate of Occupancy $ t Building/Frame Permit Fee $ 1 ' i Foundation Permit Fee $ ti V�aP t r Permit Fee $ MAY ''S�,e�w//{{�eJ�O�dnnectlon Fee $ D 7 *,(k er Connection Fee $ N0 AndLVer TOTAL $ Building Inspector / Div. Public Works PER]HI No. I l APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP fi-40. ' LOT NO. 2 RECORD OF OWNERSHIP iDATE BOOK 'PAGE ZONE I SUB DIV. LOT NO. • LOCATION jq PURPOSE OF BUILDING OWNER'S NAME✓ ON- ivvervIrr �? T n„ ^ NO. OF STORIES SIZE I�WNER'S ADDRESS V C ' VCM2 VWL / BASEMENT OR SLAB ARCHITECT'S NAME lACC, C SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME t G a^ SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW /0 SIZE OF FOOTING X IS BUILDING ADDITION /V l/ t��� y� MATERIAL OF CHIMNEY IS BUILDING ALTERATIONOFf-7M IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE �/`� IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY / IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST _2,6 1000 PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. y ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS `YYYI PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE ILED p7Q L. BOARD OF HEALTH SIGNATURE O OWNER OR AUTHORIZED kGENT FEE 1 (&P r ` PLANNING BOARD PERMIT GRANTED WNER TEL.V CONTR.TEL.H 2 19 Q?/ CONTR.LIC.0 BOARD OF SELECTMEN � G � v G= I Pte:°L'• � , INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY _ SIOkIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES _ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS I RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE B 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ _ DRY WALL UNFIN. 3 BASEMENT 11 AREA FULL FIN. B'M'TAREA _ '/ 1/2 '/, FIN. ATTIC AREA _ NO BMT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDIIJ'D ASBESTOS SIDING _ COMMCN VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR I_ BRICK ON FRAME CONC. OR CINDER BILK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I� POOR _ ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE HIP BATH (3 FIX.) GAMBRELMANSARD TOILET RM. (2 FIX.) _ FLAT I SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE _ FORCED HOT AIR FURN. r TIMBER BMS. &COLS. _ STEAM STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING `- RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS ► OIL B'M'T 2nd _ ELECTRIC Ist 13rd I NO HEATING r� L�• i i l I i i DEPARTMENT OF PUBLIC SAFETY COMMONWEALTH 1010 COMMONWEALTH AVE. OF BOSTON,MASS.02215 MASSACHUSETTS ENCLOSE CHECK OR MONEY ORDER LICENSE D ORR�UIR 7 E, EXPIRATION DATE CONSTR. SUPERVISOR u LVJ �. ADE PAYABLE TO 02/28/1993 \alt: .I'` ' EFFECTIVE DATE LIC-NO. S RESTRICTIONS "CO ONE PUBLIC SAFETY" NONE X02/28/1991 040824 rI F JOHN W PROKOP (DO NOT.SE CASH). 23 PINE ST SS 9 029-42-3602 LYNNFIELD MA 01940 PI�;Ejlaw0 f%AZtREASE PHOTO(BUSTING-OPR ONLY) FEE: 100..00. E�FECTIVE FEB. 1.. ,1989 HEIGHT: NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY STAMPED-OR-SIGNATURE OF THE COMMISSIONER 1 DOB: 08/03/1956 D NOT DETACH LICENSE STUB THIS DOCUMENT MUST BE SIGNATURE LICENSEE SIGN NAME IN FULL-ABOVE SIGNATURE LINE CARRIED ON TME PERSON OF THE MOIOER WHEN ENGAG COMMISSIONER OTHERS-RIGHT THUMB PRINT ED IN THIS OCCUPATION 20OM-2-87-81429 Location p No. /--7/f Date NpRTq TOWN OF NORTH ANDOVER a O'�,`•o •,�O0 • i ; ; Certificate of Occupancy $ �' ",• t�'' Building/Frame/Frame Permit Fee $ - CHust 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ _ Check # lw-dl? � 359, 1 _ Building Inspector - ------------------ ............._. 1 1'I RMIT NO. APPLICATION FOR PEIRMIT 1'U 13UII,l)"" "NOR"1'11 AND0VI?R,' MA Ito\1'NI7. —__ � I:II I.NI),I�� L 2. IILt(mi?(it mwNI tt51111• - ------ -- DXI1 BOOK ---_---_—_PAGt: /I IN I. SI117 Ili\•. 1111 N11. 1 Dt t 1urN :2 Al ' ,t1f%s;/r9 ; III HIM ISE I x III III NING (I\\Nlik S NAML NO,Of.SIMIES SIZE - I)Wtkit'S AIA MI:S j` IIASEMENf CM SIAII 44 (ARCi IIII Ll-1 .S NAMI: SIZE(l: I t.(x)It 11101MRS 3 r .. III III DER'S NAME f� SPAN - — DISIAN(-li IUNLAHI 11)UI1.1)IN(i DIAIPNSIt)fJ5(l1 S11.IS DIS IAIJC-l:I'R(x.tS'IRIA;I' I71Al1:NSIlxJSt11 Pt)SIS 1)ISIAWEFROM 1.UfLINES-SIDES HEAR DIAIMSII)IJSOf.GIRDIAts -- ARI.A(x'Lur I WN-11 AGE n[Ran OI I:OttNDAlION TI IICKNFSS — — isUI111.01m;NEW SI/1UF I(x)1INCi x { IS BUILDING AI_TERATIC)N ^� IS UUILD11,100N SM11)(V FII 1 E1)1-ANb -----_---- - i %%II L OI)II-DING C(xJFOItM TD RI:V fIREMt:NI S CA-C(ll)E IS fit III DING CONNEC 11:1)111 It)WN WA1 FiH I - ................ .... .. r. r.rr ern ..r'o ' IS IIUI1.171 N(:C(x 1NLC-I LD It)NAI URAL GAS I.IIJL IN51 tl( l l()NS 3. 1'I(()1'Llt I V INFORN1A I ION I.AM)COG 1' ESI. 111-1x;.COST I'Mil: 1 F111.(xlf SEC ll()NS 1-3 ES 1. Ul.lx;.COSI MR SQ.Ft. _ES 1. U11x0.ILA)SI I'LItIII xX.1 EI FCf RIC I,If:I LRS MI IS"F BE ON Ol 11 SIDE OF DUII.DING SEPI IC PLIMII IND. AI-I ACI IEDGAR A(:I:SWIIS]CONUtXIMM5I'ATF1:1RERLH11I AI IONS a. ,A1,111tUI'1'.I)Ul: � --- PLANS MIIST 1I 111 ED AND APPROVE D 13 HIIILI)INCi 1N51'IiCll)It Utfll.l)IN(:INSI't:(:FOIL '---- I ! (1 DA 11:ill 1:1) / / l)wtJE1tS-11:1 (I)NIR.IIIU �V } ( 1 — � ut W41 R.l it •� b� \ItI12t:IM t)WIJI:Itt)IIAl Ift tI/1:1)A01,11 II.1.l'.p Itl_ b .QE4AR1AW OF PU3LiC Sfif `V fj. CONSiRUC?ION SUPER 9..rrhda`e: �' 11 a CS @59666 9312•,�� �, 111 Restricted To: @@ •�, �t 19 gslINSTER -N i f 4ERR.IMACK. IN O3@54 - =j The Commonwealth of Massachusetts _ Department of Industrial-Accidents Office of Investivations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Name Please Frint Name: Location: Cit'/ Phone aI am a homeowner performing all worts myself. aI am a sole proprietor and have no one working in any capacty I am an emp Byer providing workers' compensation for my employees working on this job. Comcanv name: C J ✓� ' y Address Cihr. lv�CA PPhone Insurance Co. Policy# I Comoanv name: Address Cihr: Phone Y, Insurance Co. Folic• T Failure to secure coverage as reauirac under Section 25A or MGL 152 can lead to the imposition dcriminal penalties of a rine up to 51,500.00 and/or one years'imoriscrment as,Neil as c:vii penalties in the norm cr'a STOP'NCRK ORCER and a fine cf(5100.00)a day against me. I understand that a copy ei'his statement may be fcrNarded to the Office of investigations of the CIA for coverage verification. I do hereby cert".t1nde he pains and penalties or perjury that the information provided accve is,true and correct. j Sianature 1 Cate / /� Print name ao 2i, Phone n OffPc:al use only do not write in this area to be completed by c:ty or,own crnciai City or Tcuvn P=emit/Ucensinc Building Dept [Check if immediate response is required p Licensing Board Selectman's Office Contact person: Phcre#: Health Department Other BUILDING DEPARTMENT DEBRIS DISPOSAL FORNf In accordance with the provisions of MGL`c 40 S 54,a condition of Building Permit Number Is that the debris resulting form this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150A The debris will be disposed of in: VL J cL Location of Facility - Signature klermit Applicant i Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector i - N � 7. r 1 `1I S ' NORTH Town ® Andover oTO over, Mass., ADD COC HIC HE W ICK ��• ADRATED 1s BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System D� Atok ze All BUILDING INSPECTOR THIS CERTIFIES THAT.. ........ �� Yr ..... . �r� ••• Foundation N i 0 r y �.......�N 6�� ks #= Rough has permission to emt....�...... ............... buildings on ...... . ....................... to be occupied as.....R+f ro.IG .......Corr I a(o r / 10*0 Me !'.*A1vN Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final A a g UNLESS CONSTRUCTION sTAjqrs ELECTRICAL INSPECTOR �� � Rough .............. ... ......................................................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wail To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det. I „ , i a • t , , ! ..�:. � :'... �Sr .. #, . r-� , > y .:.t'k. ,,, iF. x{ ..}•, ,t FfiC. rid. •:<�3 1 ,>. 3 t . v^a , , s..-. ,. .... .,..•,.r. ,:. ,. „rrr�a. > .,: ,. ...� -:P". ",Y:S-�'-. ..�r:. . {. 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SRT , >#� � r � 4 �� a• Y` .. .wit. 1 V f .. ._ - '*•L.y?r•y,.r.4•��.t,A..M• -.-��. , 'r r ^�O� F _:j' A� •+'X.�'},a�]•�.�1f ��• •l�'• S � �, • •t., " I', . i s. +f r cam?L}�1 W AP v lf' _ vu d v o' 'n , .:,...-t.: . .`�', v..n.-�:`_�3�,«. •..„. ._ _. �'b..,....,.r.•8:� .wi.,.-•.w. .£d.,.�.,«+-..xr-..,....�':w..,>4i. •r:: .,.-7L_1c'.r,,.,,..-.-.�:..t ,.,.-,s__,.,.F,• .a- .� r / � � /` F 1 �.i� �. !�1 ♦t '_ �� r 1' �. L- � � � - �. �, � l �� >� Location . tt y,Ao, c dzT 'No. f c. Date 40"7h TOWN OF NORTH ANDOVER 3? 0 p Certificate of Occupancy $ } Building/Frame Permit Fee $ ted. Foundation Permit Fee $ �Ss�cwuSEt Other Permit Fee $ Sewer Connection Fee $ Water Connection tFe $ TOTAL p $ 1S U •yU gwlding Inspector Ill 10/05/7 14:31 150.00 8832 Div. Public Works PER31IT NO. Y� APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP d40. LOT NO. 2 RECORD OF OWNERSHIP DATE BOOK "PAGE T Z8'NE SUB DIV. LOT NO. F— I LOCATION PURPOSE OF BUILDING \ " Q112 SJ r 1JBst�LG��/ idly of ZA)2402 OWNER'S NAME 1I�-"\V�£j � �, O. OF STORIES SIZE OWNER'S ADDRESS u,, ^ �Ov e/f -7; /�"' ( BASEMENT OR SLAB ARCHITECT'S NAME r, UC_. SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME Q 12 G CL /1 /�, - SPAN --- DISTANCE TO NEARESTBUILDING ((_,Q v �Q�liyJV5 7DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION Y5GJ IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE 7L�S IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY 7 IS BUILDING CONNECTED TO TOWN SEWER lye IS BUILDING CONNECTED TO NATURAL GAS LINE / INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. • PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED BUILDING INSPKCTOR SI NATURE OF OWNER O A THORI``ES�D AGENT C— Q F E E � . 0 OWNERTELJ r PERMIT GRANTEDhh CONTR.TEL.N • V 19 Q Af CONTR.LIC.# 0 H.I.C.# MGT " ck # r BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY �01` TORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY FICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE d 1 2 13 CONCRETE BL K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN. B M AREA _ 1/1 1/7 1/1 FIN. ATTIC AREA _ NO B M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDN!✓'D _ ASBESTOS SIDING _ COMIACN VERT. SIDING ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STIRS. d FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I-I POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I IP BATH )3 FIX.) GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT A SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR 8 GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. d COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1y1 13rd NO HEATING j h OFFICES OF: ; Town.of - -120 Main Street , APPEALS :+ .;�: NORTH ANDOVER North Andover, BUILDING *r.;`�:,••r4.� Massachusetts O 1845 CONSERVATION °"""'` DIVISION OF HEALTH Pt--\NNING PLANNING & COMMUNITY DEVELOPMENT KAREN H.P-NELSON, DIRECTOR In accordance with a provisions of liGL c .10, S 5s, a condition of Building Permit Number 0 is that the debris resulting from this work shall be disposed of in a properly lic:agcy solid waste disposal facility as dc;tncd by ,MGL c 111, S 150A. The debris will be disposed of in: l r� (LOM,ion of Facility Signa ure of Pcrmi Appli nt OCT , L zV Date .TOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. f t NORTH own of And o No. L}q,D 1or dover, Mass.,C C,f' `7� 19 acs COCHICHE WIC ? ��S°RATED 4 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT......121.R..tX...... ........ e........ ................................ / Foundation has permission to erect........................................ buildings on .......'x ....,.��'n.calr�v.C. ....c ..................... � Rough U„�„l Chimney to be occupied as........0,,0000.1 .�P..........�1�c�c..s.:� ....E.r+.�................C.J.C'wo...... � .)............*'6'. provided that the person accepting this permit shall in every-(espect conform to the terms of the app'fication on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings In the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough ...... . .......................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Fi Ugh Fnal No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner PLANNING FINAL CONSERVATION FINAL street No. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT Smoke Det. Location r ' No. Date 7 NaRTh TOWN OF NORTH ANDOVER „ Certificate of Occupancy $ + + Building/Frame Permit Fee $ / 4 viae .4cMuFoundation Permit Fee $ � ss s Other Permit Fee $ Sewer Connection Fee $ W Connection Fee $ R,ECEIVE01 PAYY AL — r EC 0 3 1991 Building Inspector Idover Collector Div. Public Works PERMIT NO. ' Y• APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP K40. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK ZONE I SUB DIV. LOT NO. — I ;PAGE - - F LOCATION ,[,�f'/ ynl��r( .S IzInd00er PURPOSE OF BUILDING cntic,e,� • OWNER'S NAME7i/J�/ //�„lC•'�Jer J /.� �C.�/�j/ '-T(.�s NO. OF STORIES / SIZE �1/,'�/u V-2/ OWNER'S ADDRESS V�rn p T BASEMENT OR SLAB OI IJ `/ ARCHITECT'S NAME J SIZE OF FJ�,/'SOOOrR OE! IST 2ND 3RD / BUILDER'S NAME j h� , o - SPAN .._ DISTANCE TO NEAREST BUILDING �C DIMENSIONS OF SILLS DISTANCE FROM STREET f 00 , 31 " POSTS DISTANCE FROM LOT LINES-/SIDES `L� REAR GIRDERS ���ol/x, AREA OF LOT V FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING / ���� X IS BUILDING ADDITION l Ar ©rMATERIAL OF CHIMNEY (� IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND 15 01;d WILL BUILDING CONFORM TO REQUIREMENTS OF CODE //X IS BUILDING CONNECTED TO TOWN WATER yes BOARD OF APPEALS ACTION. IF ANY iGJ IS BUILDING CONNECTED TO TOWN SEWER �eS IS BUILDING CONNECTED TO NATURAL GAS LIN16 e INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUT BE FILED AND APPROVED BY BUILDING INSPECTOR DATE ILS;D BOARD OF HEALTH SIGNATURE bF OWNER- rOR AUTHORIZED AG / OWNER TEL.# " F E E 3 or- CONTR.TEL.# 0W 01 CONTR.LIC.#�2.�.Qs.�—_ PLANNING BOARD PERMIT GRANTED BOARD OF SELECTMEN OCT - 2 BUILDING INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 , SINGLE FAMILY _ S�oulES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION _ 8 INTERIOR FINISH CONCRETE B 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT AREA FULL 11 FIN. @ M'T' AREA _ V, 1/2 '/, __jj FIN, ATTIC AREA _ NO BMT f FIRE PLACES _ y HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH _ ASPHALT SIDING HARDN'J'D _ ASBESTOS SIDING _ COMMON VERT. SIDING ASPH.MOW STUCCO ON MASONRY �— STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIORI� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLEHIP BATH )3 FIX.) GAMBREL MANSARD TOILET RM. )2 FIX.) _ FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ Cr TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOAD JT PIPELESS FURNACE I r OISO I S-F' FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. &COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING T RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC Ist 13rd NO HEATING F, E14 '310' H•13 moi+m.it & VY'% S 6 '46'9 V—a----- s t r11 9.0 �. I'd aid i ani S E Pu l W A T R FINAL tAo T owJLJL %yf6 OL ®ver )HIVE AYENTRY PERMIT � - er, Mass. e 1951 '"ENTRY B � C HI MEWICK oR ?a I P SS BOARD OF HEALTH LRMIT T LD THIS CERTIFIES THAT...l1.!!!I � v �+1R �. .................................... ............ .. .. ......... BUILDING INSPECTOR has permission to erect . +�.......... buildings on 4fl..A44.0.. ....$ ......... Rou h 9 to be occupied as...... , ' � .. � Chimney Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Rough Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR Rough UNLESS CONSTRUC ST R Service Final .... ................. ......... ............. ... BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the Premises Do Not Remove Burner FIRE DEPT. No Lathingto Be Done Until Inspected and Approved b STREET N;-.-- Smoke P PP Y Smoke Det. Building Inspector Of tAORt/�r O tt�ao r.q� °m NORTH ANDOVER FIRE DEPARTMENT * = CENTRAL FIRE HEADQUARTERS 124 Main Street SSgCHUS North Andover, Mass. 01845 WILLIAM V. DOLAN Chief of Department Tel. (508) 686-3812 To: Robert Nicetta, Building Inspector From: Fire Chief Dolan RE : 451 Andover St . - covered overhang Date: October 9 , 1991 After review of the plan for the proposed covered overhang at 451 Andover St . , the fire department would be opposed to kits construction without a corresponding elimination of parking spaces across from the overhang on the perimeter of the adjacent building. The construction of this overhang would reduce the fire departments present vehicle access and those vehicles using those spaces would create an obstruction to fire department vehicles . I have attached a copy of 527 CMR 25 : 00 . Please note in section 25 : 01 (b) Occupancies the definition and how that occupancy is addressed in 25 : 05 . with a local It should be noted that this building is equipped fire alarm system only which is not connected to the municipal fire alarm system, and that the building is not equipped with automatic fire suppression systems . These factors make fire department vehicle access of even greater importance . Please contact me if you have any questions regarding this matter . william V. Dolan Fire Chief �''(�a2uU7tL- cc , Lt . Lona �vew �G�t i OCT _ 9lor" "SMOKE DETECTORS SAVE LIVES" � r 527 CMR: BOARD OF FIRE PREVENTION REGULATIONS I 527 CMR 25.00: OBSTRUCTIONS AND HAZARDS IN CERTAIN BUILDINGS AND ON PUBLIC OR PRIVATE WAYS Section 25.01: Definitions 25.02: Public and Private Ways 25.03: Exterior Access to Buildings Designed for Retail Occupanc 26.04: Interior of Buildings Used for Retail Purposes (; 25.05: Commercial and histitulionai Occupancy Buildings 25.06: Buildings of Industrial Occupancy a 25.07: Buildings of Habitable Occupancy 25.08: Public and Private Property 25.09: Removal of Obstructions and/or Hazardous Materials FIRE 'S ET( 25.01: Definitions MARSHAL0"SAf pEpj OF PURI C_:�---- ASS For the purpose of 527 CMR 25.00, the following terms shall have the meanings respectively assigned to them: Approved. Approved by the State Fire Marshal. Building. Any structure used In accordance with the occupancies uuled In this regulation, such structure not to include one, two, or three-family dwellings. Occupancies. (a) Retail. Any building to which the public may have ready access at certain times for the purpose of purchasing goods or services but not including buildings having professional occupancies such as doctors, dentists, lawyers, architects, engineers, etc. (b) Commercial and Institutional. Any building used primarily for the conducting of one or more business enterprises to which the public has access but which are not primarily devoted to the sale of actual goods that may be carried away by the public. Such buildings may include schools, colleges, laboratories, restaurants, business offices, banks, warehouses, etc. Retail occupancy in one or more of the first three floors of a multi-story commercial building will be allowed without altering the commercial designation of said building. (c) Industrial. Any building used for the manufacture of products. (d) Habitable. Any building, institution, or residence designed to house more than three families where people regularly sleep. This includes dormitories, condominiums, hospitals, hotels, rooming houses, nursing homes, etc. Sections of a multiple residence structure that are separated by at least the equivalent of a six-inch (6") thick concrete block wall shall be considered single buildings in accordance with this regulation. Hazardous Substance. Any liquid, solid, or gas which is toxic, flammable, explosive, or reactive when combined with other substances within the immediate vicinity of the substance, or any substance which could increase the intensity or the spread of fire out of proportion to the normal materials present in the area. Obstruction. Any fixed object, such as but not limited to a fence, post, pole, wall, ditch, or any movable object such as but not limited to a gate, barrel, tank, motor vehicle or truck whether registered or unregistered, temporary structure of metal or wood, or other physical barrier which might prevent the access of firefighters or firefighting equipment. 25.02: Public and Private Ways If the head of the fire department determines that an obstruction exists or that there is a quantity of hazardous material stored on a public or private way or access area contiguous to any of the buildings referred to in this regulation which might prevent the access of fire apparatus or firefighting personnel to the contiguous building, he shall have the authority to have such obstruction or hazardous material removed by the owner: 5/27/88 527 CMR- 187 527 CMR: BOARD OF FIRE PREVENTION REGULATIONS 25.03: Exterior Access to Buildings Designed for Retail Occupancy The plan for any new retail building shall include an access for fire equipment on at least two sides of the building, such access to be approved by the head of the fire department on the plans prior to construction of the building. Access to present buildings shall be kept clear of hazardous substances and obstacles which may, in the opinion of the fire department, impede the proper placement of fire apparatus and personnel in case of fire. 25.04: Interior of Buildings Used for Retail Purposes The head of the fire department will inspect retail establishments and may direct the owner or operator of such building relative to maintaining clear aisles and exits free of obstructions and hazardous substances. The head of the fire department may also direct the operator of the establishment to locate hazardous substances in certain areas of the building so that there will be less danger to the public in case of fire. 25.05: Commercial and Institutional Occupancy Buildings. The head of the fire department shall inspect the outside access to such buildings to make certain that suitable areas are provided for the stationing of fire apparatus for rescue and fire extinguishment purposes and that sufficient unimpeded entrances and exits exist for the entrance of firefighting personnel and the evacuation of the building. The interior of the building shall be inspected by the head of the fire department to ascertain that all exits and main corridors are free of obstruction and that hazardous materials, if kept in such buildings,,shall be located in in a place designated by the head of the fire department. If the head of the fire department believes that obstructions or hazardous substances present an impediment to the evacuation of the building or the access of the fire department, he may have such obstacles or hazardous substances removed. 25.08: Buildings of Industrial Occupancy Access for fire apparatus shall be provided on at least one side'of every industrial type building, such access to be kept clear of all obstacles and hazardous materials as the head of the fire department may direct. The interior corridors and exitways of all such buildings shall also be kept clear of obstacles and hazardous materials as directed by the head of the fire department, who shall inspect all such buildings at least once each year at any time without prior notice provided it is during the normal working hours of such institution. 25.07: Buildings of Habitable Occupancy Each building built for residential occupancy after the approval of this regulation shall include a suitable paved access for fire apparatus on at least one side of the structure. In addition, a clear, unobstructed way shall be provided from such fire apparatus access point to all exits of such building. The head of the fire department shall inspect such access areas and order any obstacles or hazardous materials removed at his discretion. The head of the fire department shall also inspect the interior of such buildings at a reasonable hour and shall make certain that corridors, hallways, and other exitways are clear of obstacles and hazardous materials which might prevent the timely evacuation of the building or the efficient operation of the firefiRhting personnel in case of fire or explosion. 25.08: Public and Private Property Hazardous substances shall not be left unattended within one hundred feet (100') of any building without a permit from the head of the fire department. If, in his opinion, the nature of the hazard requires a greater separation from the building, the head of the fire department may so dictate. The head of the fire department may order hazardous materials to be removed from any public or private property if the presence of such material does not comply with this regulation or with other regulations of the Board of Fire Prevention Regulations. 10/2/87 527 CMR - 188 527 CMR: BOARD OF FIRE PREVENTION REGULATIONS , 25.09: Removal of Obstructions and/or Hazardous Materials If the head of the fire department determines that an obstruction exists or that there is a quantity of hazardous material stored that must be removed in accordance with these regulations, he shall have the authority to require such obstruction or hazardous material removed by the owner. If after an inquiry to persons within the building involved or within the contiguous building and after making obvious inquiries concerning the owner of such obstruction. such owner is unavailable, the head of the fire department may have the obstruction removed by others at his discretion. The cost of such removal will be borne by the owner if and when located. REGULATORY AUTHORITY 527 CMR 25.00: M.G.L. c. 22, s. 14; c. 148, s. 28. 10/2/87 527 CMR - 189 PER31IT NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE I MAP i-40. LOT NO. 2 RECORD OF OWNERSHIP JDATE BOOK 'PAGE ZONE I SUB DIV. LOT NO. (�-I I LOCATION L ' /� PURPOSE OF BUILDING v n� • OWNER'S NAME �(!�/ /1 �✓er L Jj� T,�s NO. OF STORIES / SIZE T J .. OWNER'S ADDRESS < p BASEMENT OR SLAB _ ARCHITECT'S NAMEAh � �/�f� SIZE OF FLOORIST a of 2ND 3RD BUILDER'S NAME _j17h� �_// _ (/„/� SPAN DISTANCE TO NEAREST BUILDING 7 YV !�U DIMENSIONS OF SILLS DISTANCE FROM STREET {OO 3 POSTS • DISTANCE FROM LOT LINES-SIDES GC REAR GIRDERS - AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION (O ^ THICKNESS • IS BUILDING NEW SIZE OF FOOTING / /��� X . - - IS BUILDING ADDITION nA� D�� MATERIAL OF CHIMNEY f� - IS BUILDING ALTERATION C IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE ///X IS BUILDING CONNECTED TO TOWN WATER />s' - BOARD OF APPEALS ACTION. IF ANY iGJ IS BUILDING CONNECTED TO TOWN SEWER ('C•eS IS BUILDING CONNECTED TO NATURAL GAS LINE 3 PROPERTY INFORMATION INSTRUCTIONS LAND COST - _ SEE BOTH SIDES EST. BLDG. COST .SoL PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS I - 12 -. ! SEPTIC PERMIT NO. 1111 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS I PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE ILEO -1 BOARD OF HEALTN SIGNATURE bF OWNER OR AUTHORIZED AG -^l OWNER TEL.# is ��" =?I3/q FEE •� CONTR.TEL.# ' Q - CONTR.LIC.#-0' PLANNING BOARD PERMIT GRANTED 19 BOARD OF SELECTMEN • OCT - BUILDING INSPECTOR r Ov y J { _ a o e r '7(1f� t l' '- �3�''^'•.� t�a� �4 t't '4R .t ; t§ .---..'.` /�t �1 _...-_ y^ ^�e ��4 �3't�J ' � �. •,.� �,ty �f�� `�cc � r-``t{(• � }. a � a - ,. �`" ! H�f 1 .. ,:� j !) �i ,,.r .'`• _ - �- 3 tom't r+s� .� _' ��' _ _ _ _ A-�:..�._.«;_..._;_____ .,,,�� = r • � � �, ,. ,, �'�•���' ��. F:V('Z--� e': 5:i .. .,, ... Y`c .a:.c.4,.,�...,._.�. �' _ '�� _ f- ' - � s �;� r �L E 1""^i f—•—t f � '^.. 1 �`� �,,,, t, Y, .°p.�•.S' - ~`^.,..4 t , _ - .I t �- _�. t s f a� ��t_'—�--„• t t `t?` f _ � _ 1 --,,.,�,�,. fl`✓!'�; '4:R'rl '«: "f' •" ., �i..�{.il.��f. „w- ," ,..CW?:,v _ ...« � .. i-..--+ni�'�t..wy' '' '• f w1."e - -E•„1'eYws..'-.�.MS/.=`iG .._R$:°F-.i•f=-e"�7'•` E�C`�" ,.. � �...q...'�` `•h .,_%» k....�... 4f' -. �,v.alr�..` ,.y.,a.a�,?w... ».",,,,,"'... , �"'^v+�-- �c� ..�. -.tY .e�,:�¢;""��. -i,�'.' ..;,.r,c-, 't`.'�,x♦ „�".,.h1'-...Y�Sr�.'"'a- •,-* '.,tr - �' - _ o F , e. s- -,. '..w. �. .' .. 4 :. Y .ele ,. •tia'` ~�'""' .. „ �,...3O—.• '��t.... ? --..r,x_,,. ��lf- r.-¢ �i �r' .. E'`�f', �.T a'1�'rs'�'t l�i.�,tc`�f% - � :. �N j�� ;x�� ✓l� r J .:. - -'•.-cam _ _ .. E ,E 1 �,Jt � `�""n�++�*.ei,(� � --e � '_-_ _....._ _.. ... -�_ ,,:�„, ..�Y r� ••.'ir.L` rj �. � � r►'�'!�N ,`,� { � �� '1� . ..�. . .,--`� .-. ._� ` � .,,_j ,' ' � -_L ? may_ .r.-... ' ..�• .`. �. t� _ ---� 6�r -37-- 01 ` - j y�Et� _w 7 L�� �� �/Y1 �f`��'� -=-�---• —3^V Ij�!!� ��0 © 1 u, Al� ,... S�?�►� ��� d b7 t _ _ � f a _ C'r-; �� c�• ���a ti�1!!�`� n(7� 1 +.z L� f`r0�ItO'JV 73 0-in U, 4C�XOZ G1�� O—.... it ti _ 7 C t Z" .— 'i�P.7!R'V-•c�'c-.0-��-.. �• a. t, f��l. . �' —,.1_w - 1 1 Od O�d - - 1, Fy - ---�- O S n _f. > ; F ; .'�'y--z'_'----- , r✓ - ��.�,1 _ � - �, 1 � -SCJ (� ('�� 7 1 �� .... ' /\�1 � S � �� c _ a N a ni. V4 11 vs . • , '..- .. �. .. A ..... n -. . _ ..p, ... .... ,. A . .. '. .,.r ,^•.c.. ..' t' ,*! _F� - v�' ..0*L.�::it. - ,.ar�ti3Y+c a'�.�...n'Raw..v -.. � - .-. 9.` ., h. __ ...... ..� . � .. j ,. . 1. .-vy .. '. . �.. ,•.I p 1_ .4, +i� •M vF. ...'.-'4.9-.•..e.—.-....�.�_ -- ••- f. e f--:v�..... - .. .. > �"°: .-- ♦. :v/ :. .-<::FL..� .:Y...i.'+.r.c.«...xr-.:..-..v- �r..eh..�_+-,. _s..�.... �.«.r .+-� 1i 11xe ..w�u�1a w . ., s•. ...a.�..._•.... i rk ' _ 4 f 7' SlN :1W__4dfr-lf):3N WfiWINIW ) I 1 OS t t I oc; ?IV )!1 l.._I fit.,I °�t tr '�;,-� fit' ! b--E) FIC) i?II(if! IN )w r(I NonTN.� KAREN H.P.NELSON TOWN Of 120 Main Street, 01845 Director * 508 682-6483 r NORTH ANDOVER BUILDING CONSERVATION B�CHUeE DIVISION OF PLANNING PLANNING & COMMUNITY DEVELOPMENT MEMORANDUM TO: D. Robert Nicetta, Building Inspector FROM: Christian C. Huntress, To ner DATE: November 29, 1991 RE: 203 Turnpike Street, Addition The property owners of the above referenced office building have asked for a carport to be constructed on the property. In doing so, the applicant has caused a previous Site Plan Review approval issued to Evergreen Associates, dated 7/21/90, to become invalid. I have addressed this issue to Town Counsel. Mr. Joel Bard informed me that any action on the property which changes a previously approved Site Plan will render that approval null and void. In this particular case, should the property owner want to construct the proposed addition as approved on 7/21/90, they would have to re-apply to the Planning Board for Site Plan review. Should you have any further questions with regard to this matter please feel free to contact my office. tl � NOV 2 91991 L�-- - BUILDING DEPARTMENT l� l/ I' f•f: � t P. • � r'''Y _ ;T :K,r '� 4 .iLLa'��. . :J t 4.1ia._�. ...� , .: . "r'"". •,.,,.. i , to COMMONWEALTH DEPARTMENT OF k0kk SAFETY or 1010 COMMONWEALTH AVE. ' s...,`. MASSACHUSETTS BOSTON,MASS.0215 ENCLOSE CHECK OR MONEY ORDER f f LICENSE MADE R R UIR E, 7 EXPIRATION DATE CONS TR :SUPERVISOR (� �. PAYABLE TO } 02/28I1,993t. lJ' I tr '•-� 8 EFFECTIVE DATE . LIC NO. . RESTRICTIONS , ;NONE?, 02/2811991i: '040824 "COfvt $�ONEl PUBLIC SAFETY" . h � .IOHN W ,pROKOP (DO NOT SECASH) 23 PINE ST'' 0 0294�-3602 I 'LYNNFIELV14A : 1940 PtoS5 M . REASE PHOTO(BLASTING OPR ONLY) FEE: .. E FECTIVE FEB. 1, 1989 HEIGHT: NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY STAMPED•OR•SIGNATURE OF THE COMMISSIONER N DOB: 1 1 t 08/03/'1956;1 D NOT DETACH LICENSE STUB CARRIED DOCUMENT THE MUST ,OE 4 SH3NATURE LICENSEE THISSIGN NAME IN FULL-ABOVE SIGNATURE LINE CARRIED ON THE PERSON OF �.• THE HOLDER WHEN ENOAG'�. 1 r OTHERS'•RIGHT THUMB PRINT ED IN THIS OCCUPATION. COMMISSIONER - 200M'2.81.8ie29 a 'A , '. 4 ', ''',A'd#?�x.'r•y.'�wp,4•sQ,. t l:ef'S� r.;St. a +' .m,.Y .+ .. ... t`.. .{ .. ..r{'{Yz �.'3b't ? 4 .. ... �. .ct ,�' ... , The Titled Corporation 21 Custom House Street, Suite 500 Boston, MA 02110-3525 (617) 737-8787 November 15, 1991 Mr, Christian Huntress Town Planner Town of North Andover 120 Main Street North Andover, MA 01845 RE: North Andover Office Park 203 Turnpike Street Expansion Permit Dear Mr. Huntress: The owner of North Andover Office Park, The Titled Corporation, Trustee of 451 Andover Street Realty Trust, is hereby requesting the Town of North Andover to consider the existing approval for the building addition at 203 Turnpike Street as null and void. Sincerely, , HE T TLE C, PO TIO Hu h M. Beckett, as its President MW 2 51991 i r-vi,-DING DEPARTIVIED' C ti Date (��:.. .. ...... i NORTI� TOWN OF NORTH ANDOVER ,(, � PERMIT FOR WIRING ACMUS� This certifies that ........`/ -................................... has permission to perform,.-.--`.:- ....... wiring in the building of -IP 0 at ..................... orth Ando er,Mass. ,r Fee...rS. .... Lic.lvof1aj............ 1........................ ... . ELECTRICALINSP R Check # 901, 3 Commonwealth of Massachusetts official Use only ' Qv .3 Department of Fire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. 1/07] (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WO All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CM 12.00 R (PLEASE PMT IN INK OR TYPE ALL INFORMATION) Date: 0 2-� 1 V . City or Town of: NORTH ANDOVER To the By this application the undersi a gives notic of his o her intention to perform the electrical trical wk dlesc ' below. Location(Street&Number) r--- Owner or Tenant Telephone No. Owner's Address tr– Is this permit in conjunction wi � permit. Yes No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Und d �' ❑ No.of Meters New Service Amps ____/_Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Logia 'on and N ,titre of Proposed Electrical Work: Com letion of the follo table may be waived b the Ins ector o Wires. No.of Recessed Luminaires No.of Ceil:Sus No.of Total p.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above In- o.o mergency ig g d• ❑ ted• � Batte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones N::::Wl tches No.of Gas Burners No.of Detection and No.of Ranges InitiatingDevices g ANo.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Disposers Heat Pump I Number Tons KW \ T - ...........-.. o.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW IAcal❑ Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems: No.of WaterNoKW . o.of No.of Devices or Equivalent of Heaters Si s Ballasts Data Wiring: No.Hydromassage Bathtubs No.of Devices or Equivalent No.of Motors Total HP Telecommunications Wiring: OTHER: No.of Devices or E uivalent Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of 4ectrigal Work: (When required by municipal poIicy.) Work to Start "—NInspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: 'Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability ins a including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cove is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER I certify, under t e aims and enal&es o ❑ (Specify:) . � P perjury, the information on this application is true and comple FIRM N' ��� ` Licensee: Signature LIC.NO.: � (If applicabl t"in the :cense number linej�� LIC.NO.. Address: ElkIz. ," Bus.TeL No.: ' + *Per M.G.L c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Alt.L l.No. cI OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the Iiability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one) ❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE. $&-15— °^ � s_. •- -v' � 0 7�� ��- �� � � � . �� The Commonwealth of Massachusetts U, ! Department of Industrial Accidents Office of Investigations 600 Washington Street ,U a Boston, MA 02111 www.nuws gov/dia . Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/plumbers Applicant.Information Please Print Legibly Name (Business/Organization/Individual): Address: City/State/Zip: Q'hone#: . ,k-7���� _i� A4you p oyer?Chec th appropriate box: 1. a em to er with 4. Type of project(required): P Y * ❑ 1 am a genera[contractor and I 6 0 onoyees(full and/or part_ e). have hired the sub-contractors 2.❑ I am.a.sole proprietor or partner_ listed on the attached sheet. 7. :e7 modeling ship and have no employees These sub-contractors have o 8 ❑Demolition working rking for mein any capacity. workers, comp.insurance. g• El Building addition workers'comp,insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11-ED Plumbing repairs or additions rrayself. [No-workers'comp. c. 1.52, §1(4),and we have no 12. Roof insurance required.]t employees. ❑ repairs [No workers' comp. insurance required-] 13.❑Other Any applicant tinctchecks bore#l must also fill out the section below showing their workets'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then him outside contractors must submit a new affidavit indicating such. ;Contractors that check this box must attached an additional sheet showing•the.m±me tithe sub-conttactots and their worker;'comp.policy infornmado I am an employer that isn. .prgwding workers'compensation insurance for my employees: Below is the policy and job site information. Insurance Company Name: ' Policy 4 or Self-ins. Lic.#: t� Expiration Date: 2��Job Site Address: S � S 1 � � CIty/State/Zi Attach a copy of the workers' compensation policy de'cfaratiou 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 t$ 50'500.00 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 here i y nder the pal pe alties of per' the information Provd ove is true and correct SiJ natur 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): I. Board of Health 2.Building Department 3.City/Town Clerk 4. Electrical inspector 5. Plum 6.Other, bing Inspector r Contact Person: Phone*: r" Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the'foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or tnastee Lof an individual,partnership,association or other legal entity,employing employees. 'However the owner.of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business of to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence.of compliance with the insurance'coverage required" Additionally, MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority" Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to cavy workers'compensation insurance. if an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of industrial Accidents for confirmation of insurance coverage.. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,notthe 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 tine. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department hes provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating-current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts De ,partmcnt of Industrial Accidents � Office of Investigations 600 Washington Street At Boston, MA 02111 Tel.#617-727-4900 ext 406 or 1-8.77-MASSAFE Fax#617-727-7744 Revised 5-26-05 vvww.mass.gov/dia 9 t 47Date.�o/ .7/ ��. . . TOWN OF NORTH ANDOVER A PERMIT FOR PLUMBING 'SSACMUS� i This certifies that . . . . . . . . . . �.Ce has permission to perform Ae ,*-r ��a-..S s� plumbing in the buildings of /J ne✓�f `�� � . !�PP . . . . . at�S/ /�!z ?vQrSr . . . �/°off �Adqve Mass. Fee /�,a. . .Lic. No.� � !� . . . . . . . . . . . . . . . PLUMBING INSPECTOR Check # f f t 'M I MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING 4 City/Town: MA. Date: 2 l� Permit# i Building Location:_ �Tl kN�q�Gc �l(�/ r _ U Owners Name: S/ eAl Type of Occupancy; Commercial Educational(❑ Industrial❑ Institutional❑ Residential New:❑ Alteration: Re ❑ ❑ Renovation: placement:❑ Plans Submitted: Yes❑ No❑ /� V FIXTURES �'v •v DEDICATED r� z z SYSTEMS LU O w Z V y ❑ v7 to O Z a w Z ar' Z - cn _� Q Q w (7 a �� Z a O m vxi a Ln >. to Q w ❑ LL Q H ❑ Q Z ce 0 Z h O u a X `/ Q , FW- < d x p m T O I ❑ w m � —r— x = Q � a a Q o o > > o 0 o z z P W .e I w ¢ m m o ❑ LL x vxi n 30 3 u -SUB BSMT. Q BASEMENT 1sT FLOOR ND FLOOR y 3RD FLOOR a { 4'FLOOR $T"FLOOR 6T"FLOOR 7T"FLOOR 8T"FLOOR Instaiiing C®,Irp•s:r,}t ftiame: Address: City/Town: a StL orAoration Stater BusinessTel:- 97,S�—�f�. (��� Fax: Q L ��/n` ��D Partnership _ 7�O — .1 ❑Firm/Company Name of Licensed Plumber: INSURANCE COVERAGE: 1 have a current fiab�lnsurance policy or its substantial equivalent which meets the requirements of MGL.Ch,942 Yes If you have checked Yes,please indicate the type of coverage b checking the g Y 9 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 b Chapter Massachusetts General Laws,and that my signature on this permit application waives this requirement. Y p r 942 of the Check One Only Si nature of Owner or Ownet's A ent Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)regarding this applicafion are true and rr,ir fo � r Knowledge p and that all plumbing hA:or k and Installations pert'ormed under the permit issued f his application will be in compliance with all provision of the Massachus s State Plumbing Code and Chat a-� .a, to the b�sL o,my p 42 of the Ge r L ws. 3y Type of License: ❑Plumber Signature of Lic se Plumbe Ity/Town �'19t'dster PPROVED(OFFICE USE ONLY) ❑Journeyman License tdumber; The Commonwealth ofMassachusetts Department oflndustria(Accidents Office of Investigations, 600 Washington Street Boston,MA 02111 yY www.mass govldia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le ibI Name(Business/OrganizatiorAndividual): Address: e� k�,e City/State/Zip: e l lea({ Phone#: g711 - Are yo an employer?Check the appropriate box: 1•�am a employer with 3 4. g T yperoject(required): ❑ I am a eneral contractor and I employees(full and/or part-time).* have hired the sub-contractorsw construction 2.❑ I am a sole proprietor or partner- listed on the attached shget. tmo ling ship and have no employees These sub-contractors have working for me in any capacity, workers'comp.insurance. El molition [No workers'comp.insurance 5. ❑ We are a corporation and its ilding addition 3.❑ required.] .officers have exercised their 10.El repairs or additions I am a homeowner doing all work right of exemption per MGL bing repairs or additionsmyself. [No workers' comp. c. 152, §1(4),and we have noinsurance re uired. r f repairsq ] employees.[No workerscomp,insurance required.] er *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 anew 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.#: I/ p Expiration Date: Job Site Address: t S( A4'vJG- �� City/State/Zip: /U� lJ d i/el 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. fP J r1' do hereby certify nder the ai n e Ities o er'u that the information provided above is true and correct. Si nature: . Date: /0Zz // ?hone#: K4 FOVf7cialonly. Do not write in this area,to be completed by city or town official n: Permit/License# hority(circle one): . L Board of Health 2.Building Department 3.City/Town Cleric 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: ' Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required" Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance t 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 certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,;please call the Department at the number listed below. Self-insured companies should enter their ,self-insurance license number on the appropriate line, amity 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/liceuse applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town,may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: T he COI-n,.uonweaith oa Ylassachusetts Department of Industrial Accidents Office Of Investigations _ 600 Washington Street Boston}IYIA,02111, Tel.#617-7274900 ext 4406 ox 1,-877-MASS FE Revised 5-26-05 Fax#617-727-7749 WWW.mass.l;0v1dia r COMMONWEALTH OF MASSACHUSETIT S LICENSED AS A MASTER PLUMBER iSSUES THE ABOVE LICENSE TO: GERALD J DALEY JR 1-9 BERKELEY DR CHELMSFORD MA . 01824-116 12264 05/01/12 788 i. a I i { S r t' `e< t `t l MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING �S !Print or TWO NORTH ANDOVER, , Maas•, Data Bunding 4 N©k-fi W "0,jln,2 S-r Permit *- G Y 1) Locstlon Owner's No" ANdbt� ©BICE Name New (tr Renovation ❑ Replacement ❑ Plans Submitted: Yes❑ No ❑ FIXTURES ......... st w = W < » ~ w M o s ►- s • r >e J 0 M O e1 y at Y 10- r • N V V = O t 1/ ` O < s ac L Z O O V > a M S O u x It tis 1 w s ►t- f s i o sua—asMT. +H aAttMtflT IST FLOOR IND FLOOR 3110 FLOOR f 4TH FLOOR J. aTH FLOOR !TH FLOOR, TTHFLOOR aTHFLOOR — Check one: CartNlcate Installing Company Name �Gulm ❑Cori. Address (6GcI=i Q-�N tvE D Partnership r�6-t t(d- O1Zo I Virm/Co. Business Telephone S Of Q)-i of_ 9 6q3 .Name of Ucensed Plumber. W JE l2�Z�A� INSURANCE COVERAGE: Checx one I have a current Ilabilty insurance polcy or No substantial equtvalenL Yea ❑ No ❑ It you have checked ISI. please Indicate the type coverage by checking the appropriate box A Ilabllly Insurance poilcy Cther type of Indemnity O Bond ❑ OWNER'S INSURANCE WAIVER: I am aware %at the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on thla permit application waives this requirement. Check one: slonOwner ❑ Agent ❑ attxe o Owner a Owner s ant thereby cwtity that&A of the details and Information I haw submitted lor entendy In above appFkatlort are true and accurate to the best of my knowledge and that aA plumbing wait and Installations performed under the, pertinent proAslons of the Massachusetts State Plumbing Code and Gyaptar',1 ,�� e�' rn7 be h cort�pBanp with alt THN gnatu• pp CRY/Town Ucenu Number ( C)CIP)Vi Mr'riClVf t)(OFFICE USE ONLY) Type of PIumbing �nze: Master Journeyma 0 �.r Date 2643 NORT►r <.��° •��o TOWN OF NORTH ANDOVER a PERMIT FOR PLUMBING �SS.tC14US� This certifies that .�.Iy.v!-. . . . .�. .a.K. . . . . . . . . . . . . . . . . . . . has permission to perform . . Re,w.v'�r. !P.PL.-1. . . . . . . . . . . . . . . . . plumbing in the buildings of . !: ?1 t?'Ac y�.i�. .1./:r!C r . 4?rt: . . . at. .V.47/ R . . 5.�. . . . . . , NortoYer, Mass. Fee. a.f- . .Lic. No.Al.` F) . . . . . . . . . . . . .'� -y . PLUMBING INSPECTOR 10/12/95 11:53 95,00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File ,y MASSACHUSETTS U141FORM APPLICATIOWFOR PERMIT : O ll (Type or Print) ; i O PLUMS D NORTH ANDOVER ,Mass. _ :� ..Date: Building Location �� /% G� s�� Permit I 6 or Owners Name d-�C New D Renovation Replacement [] Plans Sybmitted FIXTURESw. % z m intw N c0i 4 H cs "' � a 'evii N z 0 a to a r X: 00C •i OF- U YdWr trX- ~ ai a zo 1— txn cO= a• $ 4!6 z < inW cc 0. O wadWQ x p C ' ;iW46° W ac � .4 aw ac K. Xaxp ~ zz x Y O Nus xO Q "A{ Occ it cc 0 V X Q SUB-,BSMT. V • BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR TTH FLOOR 8TH FLOOR t . (Print or Type) Check one: Certificate Installing Company Name Q Corp. -.. Address �j~7 /�Li l LYS M_Partner. Firm/Co. Business Telephone Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the • appropriate box: Liability insurance policy Other type of indemnity [] Bond Li Insurance Waiver: I, the undersigned, have been made aware- that the licensee of i this application does not have any one of the above three insurance coverages. ,• I Signature of owner/agent of property Owner AgeneN 0 ) II hemby ccltifr that all of Ute details and inforntalion i lave submitted(ot en(cmd)in atwevc applicalion aite tont zente to the bail tti Mr �•- knowle ftc and that all plumbing work and installations 11crfnrnicd under Permit issued fat this appliealioq will be bt cotlytljatpot r nll peitltKM�,,� tdtioiti of Ute Maisaaltuselti Stale Plumbiat Code and Cluplet 142 of llic Gmcial laws. ail By i Title . Signature of �Licensed Plumber Tye of Plumbing License City/Town: M AooRnVFr1 7oF:F,rF USE ONLY1 LlcenSe Number Master [] Journeymap Date. . v= 3604 NORTH ��•°„•.',�o° TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACHUS� This certifies that has permission to perform a.p.lx-i c. . . . . e!V? . . .�G.�. . . . plumbing in the buildings of /.-: o. . .D.f /`lC T. . at. . '�!4.1 Ah clo.L,cm . . . . . . . . .. North Andover, Mass. Fee G3, . . . . .Lic. No.`.`�7 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR 02/04/98 09:02 65.00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Date. N° t,. 3 7 NOR7M TOWN OF NORTH ANDOVER 'y o PERMIT FOR PLUMBING ,SSAGMUS� i This certifies that . . .�� . "!:. . . . . . . . . . :. . . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . : .`.`: .�. :. . .1 1.�. .'. .`. . . .�. . . at . . . . . . . . . . . . . . . . . . . . . . . . . North Andover, Mass. Fee. . . .Lic. No.. . . . : . . . . . . . . .� . . .-�.-1 { !x/!�. . . . . . . PLUMBING INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS _ Date Building Location ��5 1VC(dy Owners Name �ti' ✓ V EPermit# a 7 Amount C. Type of Occupancy C) New Renovation Replacement Plans Submitted Yes No FIXTURES rA w F w w °" a drA MZ x5 a d A w w w H ' SW>lRM W1VFM ISI:H M zrn FlDat 3MFUM 41HROR SIH ROCR 6I HfM 'TIS FiOCR 91H ROOR (Print or type) Check one: Certificate Installing Company Name+�1_�!��-P/zy oze C 0 Corp. Address ��� %3L) Fe) Partner. ?10 , Business Telephone Firm/Co. Name ofLicensed Plumber. Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy �/ Other type of indemnity Bond ❑ Insurance Waiver. I,the undersigned,have been made aware that the licensee of this application does not,have any one of the above three insurance rgnamm Owner Agent El 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 installa' s p ed under Permit Issued for this plication will be in compliance with all pertinent provisions of the Massachus�te P bin Code an hapter 142 of Gene ws. BY: S-10MM 01 Licenseaum er --._ Type of Plumbing License Title 036 City/Town icense Numoer Master 0- Journeyman ❑ APPROVED(OFFICE USE ONLY NORTH Town of North Andover f , OFFICE OF 3�0`t �ao hO0 ' COMMUNITY DEVELOPMENT AND SERVICES p i oq • 146 Main Street KENNETH R.MAHONY North Andover,Massachusetts 01845SgAGAr •'\`�� , MUSES Director (508)688-9533 r December 13 , 1995 North Andover Office Park 451 Andover Street North Andover, MA Attention: Patti McMahan, Property Manager Dear Ms . McMahan: We thank you for your prompt response dated December 11, 1995 regarding plumbing, electrical and gas maintenance permits . We wish to advise that even though you do not employ in-house repair and maintenance personnel, it is the property owner' s responsibility to ensure that outside contractors and vendors apply for any and all permits prior to performing work at your office park. Yours trul , D. Robert Nicetta, Building Commissioner DRN/gb BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Jute Parrino D.Robert Nioetta Michael Howard Sandra Starr Kathleen Bradley Colwcll NORTHANDOVER OFFICE PARK December 11, 1995 Mr. D. Robert Nicetta Building Commissioner Town of North Andover 146 Main Street North Andover, MA 01845 Dear Mr. Nicetta: This is in response to receiving an application for repair and maintenance permits for plumbing, electrical, and gas fitters. We do not employ any of these types of trades on our payroll. We contract through outside vendors/contractors for any work needed at the office park, and it is up to the independent contractor to apply for the necessary permits. Sincerely, Patti McMahan Property Manager 1 ' 2 451 Andover Street, Suite 210 North Andover, Massachusetts 01845-5070 Telephone 508/685-8535 Facsimile 508/687-6043 Location A AI rI,,z4l ' No. 7 - �� Date 7 i, TOWN OF NORTH ANDOVER 9 * : • . Certificate of Occupancy $ s�CMt� Building/Frame Permit Fee $ _ E� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 24 1 61 A wilding Inspector TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO. 7 Date Received Date Issued: ORTANT:Applicant must complete all items on this page LOCATION Ve i 'r nva1el M4010,1— � Print PROPERTY OWNERA Print MAP NO: �2 61' PARCEL: -�,P- ZONING DISTRICT: Historic District yes no Machine Shop Village yes no TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building ❑ One family ❑Addition ❑Two or more family ❑ Industrial [I Alteration No. of units: commercial Repair, replacement ❑Assessory Bldg ❑ Others: ❑ Demolition ❑Other yWatershedlDistrI t ®ASfeptic tOWellti , .t ❑Floodplain f a ��Water/Sewer - • �' - - - - - - -- DESCR TION OF WO'DK T 1�BE PERFORMED: c% /OYt Idn. Reationlease Type or Print CIearly) OWNER: Name: [L. Phond: Address: 7-0 CONTRACTOR Name: U,S &101t T 5�r v�`a s� L r.5 a 1 D Y► t S Phone: Address: f L© ,fie>'I ST Supervisor's Construction License: /O 75 0 Exp. Date: 0)d/� Home Improvement License: Exp. Date: ARCH ITECT/ENGINEEjO -�� ��SS Phone: Address: m 471 V&?/ Reg. No. V153 FEE SCHEDULE.BULDING PERMIT $92.00 PER$9000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. Total Project Cost: $ (ZO` 00 FEE: $ Check No.: �0 1 Receipt No.: 2 NOTE: Persons contracting with unregistered contractors do not have access to the fund - -------- .-f;=_ -- --- - ------ ----max :---;— =-- -.. -- - --- <:Si nature of. ntra :: - a I Signature:o_f=Agenf/Owner•: - - - - - .._-9:..____._—_.—.____— --- - - Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ [Well PE OF SEWERAGE DISPOSAL blic Sewer ❑ TanningWassage)Body Art ❑ Swimming Pools ❑ ❑ Tobacco Sales ❑ Food Packaging/Sales ❑vate(septic tank,etc. ❑ Permanent Dumpster on Site ❑ i THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments — C ConE�Qrvation Decision: Comments Water & Sewer Connection/Signature&Date Driveway Permit DPW TOW],Engineer: Signature: FIRE DEPARTMENT - Temp Dumpster on site yes Locatedno384 Osgood S et Located at 124 Main Street Fire Department signature/date COMMENTS F ORTH ToNvn o ; ° rn No. f }. Andover WV: . A K O �` dower, Mass. ul-/' /� 7 •pA COCHICMEWIC K 1 ORATED PERMIT T D 7SS BOARD OF HEALTH FoodKitchen Septic System THIS CERTIFIES THAT / BUILDING INSPECTOR . .�. . ... ... ......`.. ..!�...................................................................... ........................... has permission to erect....... buildings on .S� �/ Foundation g .... . ..�..................... h to be occupied as...........�l lltp.... :} C.... .....e5- f�ie Ca. Rough ug .<�,�`� Chimney provided that the person accepting this permit shall in every respect com t e terms o e application this office, and to the provisions of the Codes and By-Laws gelatin to pp on fi inFinal Buildings in the Town of North Andover. y 9 Inspection, Alteration and Constru ' n of PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations'-Voids this Permit. [Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTI ARTS ELECTRICAL INSPECTOR Rough Service DING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS uvsPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove FFinal h No Lathing or Dry Wall To Be Done :.t Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. IF SEE REVERSE SIDE J1 Smoke Det. Architects JDLaGrasse & Associates, Inc. Joseph D.LaGrasse,AIA Architects, Engineers & Land Planners Thomas F.Galvin,ALS Julianna E.Hoch,RA CONSTRUCTION CONTROL AFFIDAVIT PROJECT NUMBER: 2161 W PROJECT TITLE: North Andover Office Park PROJECT LOCATION: 451 Andover Street 2nd Floor NAME OF BUILDING: Building I SCOPE OF PROJECT: Demolition and construction of 3 2nd floor common bathrooms. In accordance with Section 116.0 of the Massachusetts State Building Code, I, Joseph D.LaGrasse,AIA MA. Reg.# 4153 being a registered professional engineer/architect hereby certify that I have prepared or directly supervised the preparation of all design plans,computations as specifications concerning: Entire Project X Architectural Structural Mechanical Fire Protection Electrical Other For the above named project and that, to the best of my knowledge, such plans, computations and specifications meet the applicable provisions of the Massachusetts State Building Code, all acceptable engineering practices and all applicable laws for the proposed project. I further certify that I shall perform the necessary professional services and be present on the construction site on a regular and periodic basis to determine that the work is proceeding in accordance with the documents approved for the building permit and shall be responsible for the following as specified in Section 116.2.2: 1. Review of shop drawings, samples, and other submittals of the contractor as required by the construction contract documents as submitted for building permit,and approval for conformance to the design concept. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Special architectural or engineering professional inspection of critical construction components requiring controlled materials or construction specified in the accepted engineering practice standards listed in Appendix 1. Pursuant to Section 116.4,I shall submit periodically,a progress report together with pertinent comments to the Building Inspector. Upon completion of the work,I shall submit a final report as to the satisfactory completion and readiness of the project for occupancy. Joseph D.LaGrasse,AIA Signature of Archit V ngmeer Date One Elm Square N&4153 T 978.470.3675 1420 Celebration Blvd. Andover,MA 01810 ANDOM F 978.470.3670 Celebration,FL 34747 MA AA26001333 OF M www.lagrassearchitects.com The Commonwealth of Massachusetts r i Department of Industrial Accidents 1 �pM.AU1. J Il Office of Investigations • ii Y'U t_� 600 Washington Street If 11.1 %s Boston,MA 0211I www.mass gov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print'Leaibiy Name (Business/Organization/Individual): C/ PI-0iK v/.1� Address: /5 LO i.,ve l� City/State/Zip: -�G•�O Phone.4:�� Are/y u as employer?Check the appropriate box: Type of project(required): 1.E I am a employer with_ 4. ❑ I am a general contractor and I 6. ❑New construction einployees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. # � ❑Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its rd.] officers have exercised their 10T]Electrical repairs or additions equire 3.❑ 1 air a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.[No-workers'comp. c. 152,§1(4),and we have no 12.0 Roof repairs insurance required.]t employees.[No workers' 13.❑Other comp. insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors acid 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:r 'Yt% 4 e 1-n j 01�2 2 / Policy#or Self-ins.Lic.#: lz��Z,K?1__/ � Expiration Date: //— ©J —�d/%( Job Site Address:(/U V a,- Sr City/State/Zip:/60✓►'°t /I rlOo✓01 14 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ile I do hereby cergt jy u. et lie . s and penalties ofperjury that the information provided above is true and correct.' Si ature: Date: O — �l( Phone 7� �b Zz0� Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1. Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or.on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s) of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. AIso 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 pen-nit/license number which will be used as a reference number. In addition,an applicant that must submit multiple-pen-nit/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 pen-nit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Briton,MA 02111 Tel. #617-727-4900 ext 406 or 1-877MASSAFB Revised 5-26-05 Fax#617-727-7749 www.mass.govldia 04/05/2011 TUB 12:03 FAX 978 683 0028 FRAYEL INSWGB AMY 002/002 /CORD„ CERTIFiCATE OF USABILITY INSURANCE °ATE4/3/111 PRODUCER,- THIS COMMME IS ISSLED ASA MATtEROF INFORMATIOAI l=vwl insurance.Ag=cy CIM TAND=NMW K616151M UP0NT MC6RTEiCATB 231 Sutton Street HOLDER TH1SC@WROATEDOE5NCTAMMEXODOft Suite 28 ALTER TtECOVERAGEA ORDERSMEPOUCHS SELL W. North Andover, NA 01845 RGURMAFFORDINGCOVE7ASE__ NAtG j IRMO INSUMA-.zurich US Property Services MMHURM Grapste Stas ins Co Lisa M. Games DBA DISUMutc 40 Highland Street INSURHID. Peabody, MA 01960 wsuastl= -- —� CCNMGES THE 1?OLICtES OF INSURANCE.LISM BELOW HAVE BEEN ISSUED 70 THE INSURED NAKED ABOVE FOR THE POLICY PERIOD INDICATED.NO WITHSTANDING a_.^v o^r.��,^�..��r aou eta On•wn -off aw»emutwaOr nc nre�ne veGUn ra�tM7F1 RR�s t!fTe�W411�1�RiIS f.F_RTiFif_A7F MAY SE IMEn OR MAY PERTAIK THE1NSURRANCE AFFORDED BY 114EPOUCIES DESCRIBED HEREIN IS SUHrECT70 ALL THE TERMS.MCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. m—m W lywop gmamPDLr-y POUCYEF TIVE fOtILY N taft9 GENERAL[IJBRIT4 EACH OCCUARMCE S 1,000 000 A X cD► tCu6k rlEwu uAmulY scp04305964 10/27/10 10/27/11. Ia IS 1,000'.000 CLAmghADE i=A I OtCtlR PERSONALd ADVINIURY 5 a.'000 000 GENERALAG6REGIRE 3 21000,000 GEM MGGMKfELlWTAPRMFM moDucm-COMPAma s. 2,000 000 I mucY Fl, IAc 4 AUMOBILELMLITY C!?M INEDSEIGLELIM1T s 4 „r.rnvry � 4•w�at� r MLOVMAUTOS BODSYraitiaY S SCHEDUIEDAUT08 IIoPmI HREDAUTOS eoDrtrrrruRr s NON-OWNWAUM 1 Ips GARAGELIJBLITY iii AUT00_NLY-FAACCV9fr 1 S ANYAUTO OMERTHAN EA1tCC 5 AUTDONLY- AGG S EMM30AMISRELLALtABRtn BCH OCCUMINCE S C&MAQ aADG aG3kl3wsE s .. S DIDUCTIBLE _ � S ROW= S 5 w08KgtsimurBls9 mmill X W"UmaCSM - DTI} 8. EMR.OTEIc;CIMUFY WC 006371982 11/3/10 12/3/11 FwYFRORtiETORIPi�RTt ltIEXECUTc1E - EL.FACHACC INT S 100,000 CFFIC ONtei�tDOQ1IDfiCl L'i01.SrJLI�•t*1►E61FlDYEB S 1DD,0Dif u afaalceU>aa •• si aALpRovisaNsee i EL DlsErsE.POIJGYLNIIT S 500,000 MER,t - 1lt OMCItr=NOFQFERATlONSILOCAMMSIVEMCtMIM(CLUSIONSAOMMOYMMOtMENTISP'Cc IA FROVISO S !`�ttGf_aTCGi�]Ll1Cfl uw.oa�L-eio`vi SHOULD ANYOFTHEABOVEDESCRIM FOUL SUR8ECARCELLIDSEEORETiIED�I4{AT10H DATETMMF,THEt$$UINGItMRERWTLLOMEAVORTOMIL 30 0AISWA1T1EN NAOF, LLC. H(MCETOTHEC6t7iEYCATEHOLDi•RKAtMTCDMLE SUTFWIARE70D0MMML 451 Andover S `zvet nVoSENOOBUGAT1oNORLM=Y0FANYK= RMSURl!&DSAMWS0R IT? North Andover, I OI84.5 AUTHORMR5WSWTAnW - -- — i Proposal 9452 U.S. Property Services Page 1 515 Lowell Street, Suite 3 Date 05.03.2011 Peabody, MA 01960 I I. General Information Proposed by* U.S.Property Services Telephone: (978)836-1206 515 Lowell Street,Suite 3 Peabody,MA 01960 Submitted To: First General Realty Corporation Work Performed At: 451 Andover Street 93 Union Street,Suite:315 Qn floor bathroom renovations Newton Centre,MA 02459 H. Work Description: We hereby propose to furnish the materials and perform the necessary labor for the completion of the work described herein in each of the three bathrooms located on the 2nd floor only: Remove vanity and mirror Demo walls,ceiling and floors Demise shell of space and perform fire blocking where needed Install new walls as noted on the architectural plans Install new 2x2 drop ceiling Install curved soffit above the sink Install new 12x12 ceramic tile floor Install 4x4 ceramic wall tiles roughly 4 feet high Install new wall hung sink and mirror Install supplied baby changing stations Install grab bars were needed Install supplied paper towel,toilet paper and soap dispenser Supply new electrical wiring to bring the space up to current code requirements Perform plumbing needed to accommodate the new layout III. Exclusions: Dumpster to be supplied by FGR W. Terms: All material is guaranteed to be as specified and is to be completed in a substantial workmanlike manner for the sum of: Fifteen Thousand Dollars($15,000.00) Payments to be made as follows: 1/3 deposit, 1/3 progress payment and 1/3 final payment *Any alteration or deviation from the above specifications involving extra costs will be executed ed only upon written order, and will c m be o e an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. **Note—This proposal may be withdrawn by us if not accepted within 30 days Respectfully submitted on behalf of Frank Gomes,US Property Services By signing below you accept all to cond' ' f this contract: 0 r Authorized Si 1 1lassacbusetts- Department of public Safeth Board of Building Regulations and Standards Construction Supervisor License License: cs 104350 LISA GOMES w-' 40 HIGHLAND ST PEABODY, MA 01960 Expiration: 9/1/2013 irnmri.vinncr• Tr#: 104350 i Dimension Number ofStories: Total square feet of floor area based on Exterior dimensions. Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine ^ NOTES and DATA— For department use i I ® Notified for pickup - Date Doc:.Building Permit Revised 2008 -_ r Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. (Roofing, Siding, Interior Rehabilitation Permits uilding Permit Application orkers Com Affidavit davit hoto Co O Copy f H.I.C. And/Or C.S.L. Licenses /Copy of Contract Ioor Plan Or Proposed sed Inte rior Work Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Ener Compliance Re Energy p port (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) E, Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products DOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit a all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals iat the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording Lust be submitted with the building application Doc: Doe.Building permit Revised 2008mi 10,097 Date...-�............................... i ,aORTH °tt"`°;•�"° TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SS�tcMUSf c ,� This certifies that ��'� w ../I............X............has permission to perform �' " f�r`"'`7 ........................... .... ............................................ wiring in the building of... %.lf. ... �f ��` ................................ ....... �......... sem........... North An er, f Fee . lj3 d1'�" Z}..'......... Lic.No.............. ........ ........ .................. ............ ......... /*LEcrRICAL INSPECTOR tCheck # Ay70 C®lF9iq On wealth of massachusettsFOccupa Official Use only Department of Fire Services /o 0 y BOARD OF FIRE PREVENTION REGULATIONS nd Fee Checked APPLICATION � qq y� p' ® ®gyp °per �'i��LIC/`°1,1 I®1� FOR PEI�IillI 1 TO PERF®R1Y1ELECTRICAL ' Ieaveblank All work to be performed in accordance with the Massachusetts Electrical Code ���'� 1 (PLEASE PAMTM WK OR TYPEALL INFO (ME ,5 7 CMR 1 .00 City or Town of: TION Date: By this application the undersi eWA To the Insp or of ares: ves 40' e of his or her' tention to perform e e ctr' Location(Street&Number ork dtscFjbe4,beloW Owner or Tenant nor Owner's Address a one No. Is this permit in conjunction with ng permit. Yes No [� BLDG PEANUT# Purpose of Building Utility Authorization No. Existing Service Amps / _Volts Overhead ❑ Undgrd No.of Meters New Service Amps _Volts Overhead Number of Feeders and Ampacity Undgrd No.of Meters ocation d ature of Proposed E t Completion of the following table may be waived by the Ins ector of Wires. No.of Recessed Luminaires No.of Ceil.-Sus . No.of p (Paddle)Fans Total. No.of Luminaire Outlets Transformers p�rA No.ofHot Tubs Generators KVA No. of Luminaires Swimming pool A nd e [] In- o.o mergeney ig tmg No.of Receptacle Outlets rad. Bao Units No.of Oil Burners No. of Switches � FIRE FARMS No.of Zones No.of Gas Burners No.of Detection and No. of Ranges Total Initiatin Devices No.of Air Cond, No.of Alerting Devices No. of Waste Disposers Heat Pump Number Tons Rns I6'4' Totals: ......_.._... ............ ................................_... No.of Self-Contained No. of DishwashersDetection/Alertin Devices Space/Area Heating IAV Local❑ Municipal r Connection Other No. of Dryers Heating Appliances NKW Heaters KW No. Systems: No, of Water No.of No.of Devices or E uivalent o.of g' W Data Wiring: ' Si s Ballasts Da No.Hydromassage BathtubsNo.of Devices or E uivalent No.of Motors Total HP ' Telecommunications Wiring; OTHER: No.of Devices or E uivalent Attach additional detail if desired, oras required by the Inspector of Wires. Estimated Value of;lec ical Work: Work to Start: l l (When required by municipal policy.) Inspections to be requested in accordance with AMC Rule 10,and upon completion. INSHe2Aee pr CO GE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is . orce,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ND [❑ OTHER Xcert , under t ,e in nd penalfies o e 'awry,that the information on this application is trace and cora le FIRM N t`1 � '��� �.�1,� .---� p t Licensee: LIC.loTQ,;Al r K Signature � (If dyes able, er,�:�xe "in th®ense n b r�i LIC.NO,; Address: (J xPer M.G.L. c.147,s.5 -61,security work requires De ! 0 « „ Tel.I�To., V"UQ7 OWNER'S INS partment of Public Safety S Licen Alt.Tel,. INSURANCE WAIVER; I am aware that the Licensee does not have the liability LIC,NO.: required g law. By my signature below,I hereby waive this requirement. I am the(check one ty insurance coverage normally Owner/Agent )❑owner ❑owner's agent. Signature Telephone No. pRMIT FEZ ,� /Z�— ELECTRICAL PERMIT 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 INSPECTION; Passed—[ Failed—[ ] Re-inspection required($50.00)-[ j Inspectors'co ,ments: (Inspectors'Signature-no initials) Date ' s EUNDER ROUND INSPECTION: Failed—[ ] Re-inspection required($50.00)-omments: (Inspectors'Signature-no initials) Date 4.INSPECTION—SERVICE: DATE CALLED NATIONAL GRID: NAME: Passed—[ ] Failed—[ ] Re-inspection required($50.00)-[ ] Inspectors' comments: • 1 (Inspectors'Signature-no initials) Date 5.INSPECTION-OTHER: 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 IS NOT ACCESSIBLE AND A RE-INSPECTION OF$50.00 IS TO BE CHARGED. The Commonwealth of Massachusetts Department ofXndustrial.Accidents Office oflnvestigations 600 Washington Street Boston,MA 02111 Uvww.mass.go-p1dia Workers' Compensation Insurance davit: 13nilde�rs/Contractors/JElectriciansJPlu ntberrs A �47licant Information. Please Prim Legib Name(B.usiness/Organizatio dividual): Address: PO City/State/ V \ Phone#: -7-7 q q�O Are y an employer?Che c f ropriate box: Type ofproject(required): 'L �Tama employer with 4. ❑ I am a general contractor and I 6. 0 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.i 7. C]Remodeling . ship and have no employees These sub-contractors have 8. []Demolition working forme in any capacity. workers'comp.insurance. 9. E]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.❑Plumbing-repairs or additions myself.[No workers'comp. c.152,§1(4),and we have no 12.E]Roof repairs insurance required.]t employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box4l must also fill out the section below showing their workers'compensation policy information. 7 Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new-affidavit indicating such. fcontractors 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'coin information. pensation insurance for my employees Below is the policy ancZjob site Insurance Company Name:cJ / Policy#or Self-ins.Lic.#: Expiration Date: rob Site Address: A6aW 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 RUO 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 maybe forwarded to the Office of Invstigations of the DIA for insurance coverage ver eification. I do Herebyer i uncles•the pains a enaldes ofpeY' That the information provided above is Prue andcar, eet. Si atur Date: Phone#: Official use ors y. Do not write in this area,to be completed by * or town official. City or Town: PermitUcense# Issuing Authority(circle one): I.Board ofHealth 2.Building Department 3.City/Towyn.Clerk 4.Electrical Inspector 5.Plumbinghspector 6.Other c`�'ontactPerson: Phone#: QO S18 .......................... f NQRTH r 1 "ooh I v / fiOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSACOM4 c�i� Lr/17 / tB Z This certifies that ......J .. ....................�.{.......�........... ....................... has permission to perform ..f' .........,1- +./�f: ' .........�................ wiring in the building of at....y5........... .............`..`......?.............5 ......... ,North Andover,M Fee.12.......... Lic.No./4//513...... /.....I. . ............L...... ..........:..... ELECTRICAL INSPECTOR Check # Commonwealth of Massachusetts Offtcia 1 Use Only Department of Fire Services PermitNo._ y YI BOARD OF FIRE PREVENTION REGULATIONS OccupancyaudFee Checked APPLICATION Yy qq qq'' [Rev. 1/07] f°9���1�i6►T�®1�f F®R PERMIT �'® PERF ORMELECTRICAL Ie�avebIank All work to be pedormed in accordance with the Massachusetts Electrical C de Q,527��00 WORK ' (PLEASE PRINTININK OR TYPEALL INFO City or Town of: TION) Date: To the Inspector of iy es.- By this application the undersi ed ives no ' e o his or r intention to perform a electrical work described e Location(Street�&N mber) low. Owner or Tenant � 4r— Owner's Address Telephone No. Is this permit in conjuncts ith a building permit? Yes Purpose of Building U22— No ED] BL G PERMIT# Utility Authorization No. Existing Service Amps _/ _'�ro Nlts Overhead ❑ Undgrd❑ No.of Meters er'c--- Service Amps /_�rol{s Overhead Number of Feeders and Ampacity ❑ Undgrd ❑ No.of Meters Loc ature of Proposed Electrical Work: 0 u r— No.of Recessed Luminaires Completion of the following table maybe waived by the Inspector of Wires. + No.of Ceil:Susp.(Paddle)Fans No.of Total. No.of Luminaire OutletsTransformers KVA No.of Hot Tubs No. of Luminaires Above Generators KVA Swimming pool ❑ In- o.o mergency ig tmg No. of Receptacle Outlets nd' rnd. ❑ Batte Units No.of Oil Burners No. of Switches FIl2E FARMS No.of Zones No.of Gas Burners No.of Detection and No. of Ranges Total InitiatingDevices No.of Air Cond. No.of Alerting Devices No. of Waste Disposers Heat Pum Tons p p Number. •Tons KW No.of Self-Co Totals: ....................... "' "' No. of Dishwashers Detection/Alertin Devices Space/Area Heating KW Local❑ Municipal No. of Dryers Connection El other ry Heating Appliances KW Security Systems:* No. of Water No.of No.of Devices or E uivalent Heaters �' No.of Si2s BaData Wiring: Ilasts No. No.of Devices or E uivalent Hydromassage Bathtubs No.of Motors Telecommunications W,rin Total HP ' g OTHER: No.of Devices or E uivalent tt Estimated Value of Electrical Work: �0��-/ `4ach additional detail if desired or as required by the Inspector of Wires. Work to Start: (When required by municipal policy.) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insur e including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cover is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER d cert, under thg pans a d penalties o er'u that th information on this application is free and cora Ie FIRM N K fP 1 rJ'� S ����� P Licensee: LIC.NO.: (IfappZicable, r "exe t"in he li e e mber line. Signature LIC.NO.. Address: �c'' F Iv — -� t Bus.Tel.No.: *Per M.G.L.c.147,s.57-61,security ork requires Department of Public Safety"-tS°'Licen� Alt.Tel'No.: OWNER'S INSURANCE yVAIyER: I am aware that the Licensee does not have the liability ins LIC.NO.: required by law. By my signature below,I hereby waive this requirement. I am the(check one o ty urance coverage normally Owner/Agent )❑ weer ❑owner's agent. Signature Telephone No. PERMIT FEE: � ZS ELECTRICAL PERMIT NO. INSPECTION REPORT: Q ELECTRICAL INSPECTOR-]DOUG SMALL 1.ROUGH IN ECTION. Passed—[ Failed—[ ] Re inspection required($50.00)-[ ] Inspectors' comments: (Inspectors'Signature-no initials) Date 4---/3P -17 2.FINAL INSP ION: Passed—[ Failed—( ] Re-inspection required($50.00)-[ ] Inspectors'comments: A (Inspectors'Signature-no initials) Date 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—[ ] Re-inspection required($50.00)- [ ] Inspectors' comments: (Inspectors'Signature-no initials) Date 5.INSPECTION-OTHER: 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 IS NOT ACCESSIBLE AND A RE-INSPECTION OF$50.00 IS TO BE CHARGED. The Commonwealth ofMassachusetts Department of Industrial.Accirlents Office oflnvestigations 600 Washington Street Boston,MA 02I11 ipww.mass.govfclia Workers' Compensation Insurance Affidavit: Builders/Contractors/EIectxiciaxas/Plumbers A licant Information Please Print Legib Na1T1a(B.usmess/ anization8adividual): Address: PO 0 b City/State/Zip: 0 4\f C,Phone#: l0 F mployer?Check f appropriate box: Type of project(required): a employer with. 4. ❑ I am a general contractor and I 6. ❑New construction loyees(full and/orpart time).* have hired the sub-contractors a sole proprietor or partner- listed on the.attac&d.sheet.z 7. ❑Remodeling . and have no employees These sub-contractors have 8. []Demolition ing for me in any capacity. workers'comp.insurance. g, ❑Building addition workers'comp.insurance 5. ❑ We are a corporation and its red.] officers have exercised their 10❑Electrical repairs ox additionsa homeowner doing all work right of exemption per MGL 11.❑Plumbing-repairs or additions lf.[No workers'comp. c.152,§1(4),and we have no 12.E]Roofrepairs ance required.]i employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box41 must also fill out the section below showing their workers'compensation policy information. 7 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 insr�rance for my employees Below is the policy and job site information. Insurance Company Name: t`(�(`�Q11 C- 01 Policy#or Self-ins.Lie.#: ! Expiration Date: fob Site Address: Lf%s-( ��( x. City/State/Zi 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 fne Of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. X do liereb i under the pains andpenalties ofperj r that the information provided above is Prue ancteort eet. Si ature: Date: Phone#: 04 Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Tssuing.A,.uthority(circle one): X.Board of$ealth 2.Building Department 3.City/Town Clerk 4.Electrical]Inspector 5.Plumbing Inspector 6.Other ContactPerson: JPhone#: 10099 NORTFI °ft"`°:•,"° TOWN OF NORTH ANDOVER � 9 PERMIT FOR WIRING sSACMUS� This certifies that .�''.�?.........`.. //e .................. ,.n.................. has permission to perform .' c!.^ .......1,��/..�! ........... ................. ��� / h y /� wiring in the building of..�.c./..1I. f' _i e'-~ at... ........ .:.. ........... :e7:7 ... ,North Andover,Mass. Fee.`:Za.......... Lic.No,, /.�'�..V......., ..... ..........ir.... ....::^.uy^'91...... LECTRICAL INSPE' R Check tt 1�s�f COiF MOnwOs' lth ®f MassachusettsF1/071 Off Bial Use Only •� Department of Fire Services UC/ BOARD OF FIRE PREVENTION REGULATIONS d Fee Checked • APPLICATION qq ®® PERMIT ®�1 p �,°� �y ---- �'iI��L��f•i,��®� �®I� 1`"�Rlvl� l 1'® f�'���®R1�1ELECTRICAL leaveblank All work to be pertormed in accordance with the Massachusetts Electrical Code ),527 CWORK (PLEASE PRINT RINK OR TYPEALL INFO 1 City or Town of: TION) Date: By this application the undersi ed ives no ' e of ' or her" tentioo perform th e tri WrA To the Inspec °f YTrires: Location(Street�&Number) rk descri ed w. Owner or Tenant 7-Y)S" Owner's Address one No. Is this permit in conjuncts a building permit? Yes Purpose of Building No ❑ BLDG PERMIT# Utility Authorization No. Existing Service Amps _ / _Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps ---�_'Volts Overhead Ej Number of Feeders and Ampacity Undgrd ❑ No. of Meters Loc tion an afore of Proposed EIe T Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Sus . No.of p (Paddle)Fans Total. No.of Luminaire OutletsTransformers KVA No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Arnd.e ❑ In ❑ o.o mergency ig tmg No. of Receptacle Outlets rnd. Batte Units No.of Oil Burners No. of Switches FIRE ALARMS No.of Zones No.of Gas Burners No.of Detection and No. of Ranges Total InitiatingDevices No.of Air Cond. No.of Alerting Devices No. of Waste Disposers Heat Pump Number Tons ns Totals: ..............................._. ..............K�?6'........... No.of Self-contained No. of DishwashersDetection/Alertin Devices Space/Area Heating KW Local❑ Municipal No. of Dryers Connection El Other rY Heating Appliances KW Security Systems: No. of Nater No.of No.of Devices or E uivalent ' Heaters Si2s Ballasts ts BData Wiring: No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Telecommunica ions Wirin : Total HP ' g OTHER: No.of Devices or Equivalent Estimated Valu Of lectri 1 ork: "� Attach additional detail if desired oras required by the Inspector of Wires. Work to Start: (When required by municipal policy.) Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RA E: Unless waived y the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability' ance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such ov ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER I cert, adder t. s nd penalties o er'u that the information on this application is true and come le FIRM N JrP J rJ', .C P u l� Licensee• /�u/ C e ignatur LIC.NO. (I.T pplicable,(e�e, r, x G� LIC.NO.: r" v "i a licens n r line.) Address: � � �',f�•� 2 us.Tel,l�To.: "Per M.G.L. c.I47,s.57-61,security wor requires Department of Public Safety``S"Licen fit'Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the li n LIC.NO.: 1 required by law. $ m signature below,I hereby waive this requirement. T am the check One )El Y gn liability insurance coverage normally Owner/Agent ( )Elowner ❑ Signature � owner's agent. Telephone No. PERMIT FEE. $ ti ELECTRICAL PERMIT 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 INSPECTION: Passed— Failed—I ] Re-inspection required($50.00)-[ ] Inspectors'c mments: (Inspectors'Si ature-no initials) Date - 3.UNDER GROUND INSPECTION: Passed—[ ] Failed—I ] Re-inspection required($50.00)-[ j Inspectors'comments: (Inspectors'Signature-no initials) Date 4.INSPECTION—SERVICE: DATE CALLED NATIONAL GRID: NAME: Passed—[ I Failed—[ ] Re-inspection required($50.00)-[ ] Inspectors' comments: (Inspectors'Signature-no initials) Date 5.INSPECTION-OTHER: 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 IS NOT ACCESSIBLE AND A RE-INSPECTION OF$50.00 IS TO BE CHARGED. The Commonwealth ofMassachusetts Department of Industrial.Accidents Office of Investigations 600 Washington Street Boston,MA 02111 1vww.massgov/dia 'D6rorkers' CompengationlasuranveAffiidavit: BuLUdeirs/ContractorsAFIectxicians/Plumbe�rs A licant Information Q Please Print Le 'bl Name(Business/Organ ization/Individual): Address: �--' 1 '� City/s tate/Zi V lJ [Phone#: G `�Z Are yo n employer?Che the appropriate box: Type of project(required): 1. am a employer with 4. ❑ I am a general contractor and I 5. New construction _ig� employees(full and/or part-time).* have hired the sub-contractors ❑ w n traction 2.❑ I am a sole proprietor orpartnex- listed on the attached sheef.s 7. E]Remodeling . ship and have no employees These sub-contractors have 8. []Demolition working for me in any capacity. workers'comp.insurance. g, ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and it, required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑.I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself.[No workers'comp. c.152,§1(4),and we have no 12,❑Roof repairs insurance required.]i employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#i must also fll out the section below showing their workers'compensation policy information. 7 Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. lam an employer that isprqXrding workers'compensation insurance for my emptoyees. Below is the policy and job site information. Lo(r, Insurance Company Name: ^(` O Policy#or Self-ins.Lic.#: Expiration Date: fob Site Address: � V v� Ci ty/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 WORD ORDER and a fine ofup to$250.00 a day agaiustthe violator. Be advised that a copy ofthis statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. .X clo 71erehy ce�d .un r•the pains and penalfies g4perju.py that the information provide bore is true ancleorr eet. Si ature: Date: Phone#: 77 Official use only. Do not write in this area,to he completer)by city or town official. City orTown: l'erxnit/License# Issuing Authority(circle one): X.Board ofHealth 2.BuiidingDepartment 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact person: Phone#: op o-ff MASSACHUSETTS UNIFORM APPLICATION F OR PERMIT TO DO PLUMBING City/Town: MA. Date: Permit# Building Location: IT/ AA �vls-K- � / ���i�(Ji'O -� wners Name:1S/ �}-et/�,� Type of Occupancy: Commercial Educational V ❑ Industrial[❑ Institutional ❑ New: Residential❑ ❑ Alteration:❑ Renovation: Replacement:❑ Plans Submitted: Yes❑ No0. ❑ 00 FIXTURES LU LU ¢ � � m X � a a � `� 47 Date. . . . . . . . . . . . . 0 0 ¢ LU o ►- ¢ ! a Ln o a w, " '' X IL o° -SUB BSMT. BASEMENT &ORTM TOWN OF NORTH ANDOVER o�t,..o ISTFLOOR °cp 2ND FLOOR ` PERMIT FORPLUMBING 3RD FLOOR • 4T"FLOOR fiT"FLOOR sswcNuS� ei 2 . . . . . . . . . 7H FLOOR �j-r� �• 7T"FLOOR This certifies that /� j en0�� /�, S 8T"FLOOR has permission to perform / 'list.ilingC' ; �.r plumbing in the buildings of - • / � ! "° Andove , Mass. Address: q at�5� �7.UPf . . . . . . � City/Town: g �IW 1?� PLUMBING INSPECTOR Fee. . . .1 . . . .Lic. N o.�. .J 3usinessTel:• 9��_a•�f� �,fa Fax: Y lame of Licensed Plumber- C Check # d VSURANCE COVERAGE: have a current iia,bili{�lnsurance policy or ifs substJntia'equivalent which meets I .,._ You have checked Yes,please indicate the type of coverage bychecking the appropriate requirements of MGL.Ch,942 Yes liability insurance policy pp prate box below. Other type of indemnity ❑ • Bond ❑ ' VNERIS INSURANCE WAIVER:I am aware that the licensee does_ no_ t have ftie insurance cover Issachusefts General Laws,and that my signature on this permit application waives this requirement. age required by Chapter 942 of fhe nature of Owner or Owners A ent Check One Only hereby certify that all of the details and information 1 have submitted(or entered)regardig this a ❑►icati Agent ❑ Brtmen ge and that all p!un,bi„g work and i,^,stalfatio,�s Performed under the permit issued f =rtinent provision o the Massachuse”State Plumbing Code and nd r t 42 0;the Ge PP on are true and ccu.r to .r his application will be in compliance eo�vith all c ei ry ' r 'L WS. Type of License: "own ElPlumber Signature of Lie sed Plumbe LO1( kMster VED(OFFICE USE ONLY) []Journeyman License Number: jKlPfuA - -- /'�-/6 -/- MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City/Tow n• Cr4d �0(C)U��, MA. Date• �f' � Permit# Building Location:_ el l All) ll?ti�A&�1 Owners Name: If/ `rflNL'lu,1 kesuy CU Type of Occupancy: Commercial ZKEducationaIF1 Industrial❑ Institutional❑ Residential❑ New:❑ Alteration:❑ Renovation: Replacement:❑ Plans Submitted: Yes❑ No❑ FIXTURES DF.nirATC- 2 w � z 1 r a Date. . . . . .'• a O2 01 LU Q Ln vii a o LL 2 a LU a a o o F d Se SUB BSMT. aORTM, TOWN OF NORTH ANDOVER o BASEMENT 3r •`" °` PERMIT FOR PLUMBING MLR RR ioR � SsAcMus . . . . . . . . . . . . . .This certifies that has permission to perform /sy aP . �� r� in the b ildings of . . jam/ 1 r plumbing `-S �� MI's. ns• `l; s . . . . . . . ;No h;A over, as at. . �ZZ(w /!!tlr�r (((YYY�///'�..,n . . . . . . . . . . Iddress: a fp?.tlU Lic. No.. . . . . . . . . . . CIN nwn: Fee. . . . . . . . PLUMBING INSPECTOR iusiness Tel:' 7� f—l/�� Fax: y Check # _--�— tame of Licensed Plumber: _ i- .� >j-- VSURANCE COVERAGE: have a current lia_ bility insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes�j N you have checked Yes,please indicate the type of coverage by checking the appropriate box below. liability insurance policy.&/�Other type of indemnity ❑ Bond ❑ WNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the assachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only naiure of Owner or Owner's A ent Owner ❑ Agent ❑ 'hereby certify that all of the details and information I have submitted(or enfered)regarding this application are true and acc:irzte to the hest of my nowledge and that all pi!rnt,inn :crk and instalfatio;,s performed under the mit issued forfhis application will he in compliance with all ertinenf provisio of the Ma s'a usstts State Plumbing Code and Chapt 9 of the General s. Type of License: e ❑PIPJaber Si nature of Lice ed lumbe mown EeMaster PROVED(OFFICE USE ONLY) ❑Journeyman License Number: a 6 9 9 �) 4 Date.���'/1/. . . TOWN OF NORTH ANDOVER . o PERMIT FOR PLUMBING ,SSACHUS This certifies that C. 0 I ^ has permission to perform . ��,�. .4414h. .eL". .a.��,..�. . . . . . . . . . plumbing in the buildings of . . ; . . ./.V2110V14.r. .117-. . . . . . . . . at . . . . . . . . . . . . . . North Andover, Mass. Fee.QaS . . .Lic. No.. . .7.V.V, ,6!' . . . . . . .11.8 . PLUMBING�INCTOR Check # 6� o�.(o 1715 + y9•(-b MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING � � e City/Town: f MA. Date: CQ C� G Permit# Building Location: � C � v1120�Q/� S� ' Owners Name: 6W,p/Al lv�a , Type of Occupancy: Commercial Educati alE1 Industrial❑ Institutional❑ Resid tial❑ New:❑ Alteration:❑ Renovation: Replacement: ❑ Plans Submitted: Yes No❑ FIXTURES DEDICATED F z SYSTEMS z W Y0 N W z H Z a w Z F- Y Q -J U Uj R . o: z z a QUl LU m CC m to OC C F } '=' R in Y 0 ii N N W F- ❑ LL Q W ❑ Q Z CC w Z N y U a X Q ~ Q Q U. 3 Q = W W C: S� 06 0 W Q Q H y 0 ~ FV- > > O 0 ° z Z of F- F-. w �— � ❑ � Q � N Q Co m o o i 2 �e g g H O Q it Q -SUB BSMT. '" Q C7 C7 C7 BASEMENT 1'FLOOR 2ND FLOOR l , 3RD FLOOR 4'FLOOR ST"FLOOR 6r"FLOOR 7T"FLOOR 8r"FLOOR Installing Company Name: (1-•oYA Check One Only Certificate# Address: �j 2A,l G ElCorporation City/Town: State �'" Business Tel: Fax: (p( �Zlrm)Company ership Name of Licensed Plumber: INSURANCE COVERAGE: I have a current liability insurance policy o its substantial equivalent which meets the requirements of MGL.Ch.142 Ylfs No❑ If you have checked Yes,please indi a the type of coverage by checking the appropriate box below. A liability insurance policy. Other type of indemnity ❑ Bond El OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only S Inature of Owner or Owner's Agent . Owner ❑ Agent ❑ 1 hereby certify that all of tfie details and information I have submitted(or entered egardi this application are true and accurate to the best of my Knowledge and that all plumbing work and installations performed under the pe u issue for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Ch er of the Ge ral Laws. By Type of License: Tit►e. ❑ umber Signat e o Licensed Plumber Citylfown Master APPROVED OFFICE USE ONLY) ❑Journeyman License umber: I ?, 74k ` I N-03-2011 13:03 From: 7812969007 To:171316653�3 Pa9el:2'2 1 I 4 CERTIFICATE OF LIABILITY INSURANCE 6/3/2011 THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE MOLDED THIS CERnFiCATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE:AF rOIRDED BY THE P (CIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING IN3URER(B), ,4UTHOIRIZED REPRESENTATIVE OR PRODUCER,ANDTHE CERTIFICATE HOLDER. IMPORTANT: 11 the certificate holder Is an AOOITIONAL INSURED,the policy{ies) must be endorsed. If SUBROGATION IS WAIVED,subact to the U)"ns End conditions of the Policy,certain policies may require an endomemem A statement on this certificate does not Confer right to the Certificate holder in lieu of such endorsomenl4a)- PRODUCER cONTAC Maria Nixon NE: Strata ie R@aourc® Group PHOME ITI1124b-rD T 5 P (781)246-9002 27 Water Street, Suites 107 I .wn3Laon0Itsategiozesource roup.net j PRO CUSIAMM"00000011 Makef field MA 01880 INSURE AFFOROINOC*VEaAe AIC F NSURED INSURER A:7rj1kV6-10x`6 Oesum a IAmtruat North AmeiL a Catfish, Inc., DHA: Cronin Plu®bing HQat.Lng INSURER C: 952 Main Street Rear IwaLIRIeILo: IMSURER 2: Melrose MA 02176 INSURFAP: COVERAGES CERTIFICATENUMBER;CL116300127 REVISIO, N MBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAME A OVE rOR YNE POLICY FERIOD INDICATED. NOTWTHSTANDINO ANY REQUIREMENT. TERM OR CONOITION OF ANY CONTRACT OR OTHER DOCUMENT Ii ATH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, TIME INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN,15 SUBJECT TO ALL THE TERMS, EXCLLI3ONS AND CONDITIONS OF SUCH POLICIES.LIMITS SMOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS_ NLA TVPE OF INSURANCE JM ADO SUa. POLICY NUMBER POLICY EFF MPOLICY QP LIR,IITS OrNlAALUI1biUT' EACH OCC RR NCE S 1, 100,000 X COMMERCIAL GENERAL LIABILITY TIED 5 s Ee oaurrence s 3j40,0,001 A CIAIMSMADE QOCCUR Iae07E22$495COI'11 /11/2011 4/11/2012 MEOERP A t arson 6 j 5,000 PERSCINAL;bA E110PAGG JURY S 1, 00,000 rGENERAL AGG TE S 21 00,000 GEN'LAGGREGATELIMITAPPUESPER ODUCT$-C S 2, 00,000 X POLICY PELT L00 b AUTCUORIL1 UILBIUITY COMBINEDI;SIN LE LIMIT f (Ea NlUftnt) ANY AUTO BOOILV INJURY Pevpermq S ALL OWNED AUTOS BODILY INJURY(Peraoeiderlq s SCNEOLA EDAUTO$ PROPERTY AGE f I HIRED AUTOS leer Bootdenl) NON.O WNQD AUTOIS s S UMSRiLLA ULBOCCUR EACH OCCURRENCE f EXCEbS UAB HCMMS'%ADE AGGREGATE DEDUCTIBLE s RETENTION S S g WORKERS COMPENSATIONWC STAT OTM. AND EWPLOYaS'LIABILITY VIM X ANY PROPRIETORiPARTNER*XECU tM E L EACH ACCT Nr S OFFICEKNEMBER MUDDED? ~IA 0202000206502 /1OJ2011 /10/2012 300.000 E L.DISEASE• EMPLOYE E 00 000 If Eypas dvsrmbs ---40-1-000 DEBCRIPT(ON OF OPERATIONS bEtOW E L.DISEASE• OLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Atlaen ACORD 10I,A6dIUBnB)RemeTkl9eeNUte,h IIIBro Been IB redLATBdI CERTIFICATE HOLDER CANCELLATION i SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CAIMCI-ILEO 1EFORSE THE EXPIRATION GATE Tt1ENEOF, NOTICE WILL BE DELIVEJED IN Catfish, Inc. ; DELA: Cronin Plumbing ACCORDANCE WITHTHE POLICY PROMS k7N G Heating 952 Main Street Rear AUTHORLtEDREPRISENTATTve rselroee, HA 02176 Jody ftowther/IOW �' C""' '• ACARD 2612000109) 0 198$•.2009 ACORD CORP RATION_ All rights r-4wved. INSOZS Izood T hs ACORD name and logo are registered marks of ACORO T 'd 1 ESE-S99- T 8L Xdd 1317NEISb1 dH WdLS :6 T T 02 60 unC i N Q � I I ' �f m Ln m In cn co COII MM,&tTff-a "AS-SgUHUSkTTS W . , .. LIC LASEDVA- AS A• ASTER PLUM9E ISSUES THE ABOVE LICENSE To. R i JOSEPH P CRONIN a (f° 33HOWARD STREET i� x MELROSE MA 02176=1917 w 12743 + 05/01/12 794285 w • w — m — J E O N In W O N W O C I II 1 JUN-03-2011 13:03 From: 7812969007 To: 17616653, 31 P se:2/2 A CERTIFICATE OF LIABILITY INSURANC °"'�' �'D°'M 6/3/ 011 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON T E CERTIFICATE NOL R,THIS CERTIFICATE DOES NOT AFFIRiYIATIVELY OR NEGATIVELY' AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSVRANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSU NO INSURER(S), AU HORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is so AODITIONAL INSURED,the poliey(iss)must be endorsed If SU GATIDN IS WAIVED,subject t0 the ferma and eolediti0ns of the policy,�e►tain Policies may require an endorseenorm A statement on this cartificste does not confer ril his to the ce1U11CMe holder in lieu of such endot oment(a). PRGOLrCER C NEA' Maria Nixon Strategic Resource Group ►++DME (783)246-9002 27 Water Street, Suite 107 AI ac I7YII7ea EaoT 9Mmn'IML+strato91c"I sour group-net 00000011 Wakefield MA 01990 (Mau acrogolNocdvE DE INSYRED NAIL a INSURER A:Trave lora CatfiBh, Inc, , DAA: Cronin Plumbing s Heating INSUIURO Amtrust North Amari a 952 Main Street Rear INSURER C: INauw o t elrose MA 02176 INSURER E: INSURER i COVERAGES CERTIFICATE NUMpER.CL116300127 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW KAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR YME POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMEN LMTN RESPECT TO ICH THIS CERTIFICATE FRAY SE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL T E EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TERMS, #NSR AWOL SUB TYPE OF INSURANCE POLICY NUN@6 MP�DY errM(FLI EAP LI) ITL GENERAL LIABILITY EACHOCCu REHCE 1,000,OOD X COMMERCIAL GENERAILIABILITY A-9M RENTED 9 S aoOdJRIeAC! 6 900,000 A CLAiM9+AADE OCCUR IG6979y2X495C0;11 /11/2011 /11/2012 MEOE/(P Dnaalsan E 5,000 i PERSONAL ADVINJURY A 1 DOQ,00o GENERALA GREGATE S 2 DO0,000 GEN'L AGGREGATE UNIT APPLIES PF-It X POLICY LOC DROOUCTS COMPIDPAGG S 2 OOO,QOD AUTOMOBILE LIABILITY 1 C00WONIED NMI!LIMIT S ANY AUTO tee ee 4m) ALL OWNED AUT08 BODILY INJU Y(Perpenw) S SCI+BOULEOAUroG 801xLLYI.NJ Y(Perawcranll S HIRED AUTOS PROPERTY C AMAGIf (per eoaeenl) NON.OW"Q0 AUTOS s s UMBRELLA UABOCCUR EXCESSLIAa CLAIMS-MADE EACH 0 CU RENC6 t AGGREGATE S DEDUCTIBLE RETENTION 9 B NORAERS COMPENSATION i AX0EMPLOYERS'LLLBIUTY YON X TAU- DTH. ANY PRCPRIETOWPARTNEW"ECUTIVELIN FR OFFICe"rIVIDER EXCLUDED7 ❑ NIA EL.CACMq IDENT S 300 0DO iMbnderory:n NN) 02000206S02 /10/2011 /10/2012 "k 1 a,daa�IbuOK ELD15fAE EA EMPLOYE 1 500 000 CR I OF RATION E L DIS SE POLICY LIMIT S 3001000 DEBCRIPTIONOFOPERATIONS#LOCATIONS)VEHICLES lAttaenACOR0191,A"UonaRemerkescoodu)e,irmeree0e¢elsre"red) CERTIFICATE HOLDER / CANCELLATION SHOULD ANY OF TI4E ABOVE DESCRIDED POLICIES BE CANCU FO BEFORE THE EXPIRATION DATE THEREOF, NO CE WILL 89 DELIVtt EP IN Catfish, Inc. ; DEA: Cronin Plumbing ACCORDANCE WITH THE POLicy FROVp s. & Heating 952 Main Street Rear AUTHORIZEDREPREaeNTATLVE Melreee, HA 02176 Jody Csowt:Ael:/mm INS025(2 cogoo)(20091 ACORD 49) 0 leve-2099 ACORD CORP RATION. All rights r efved. The ACORD name and logo are registered marks of ACORD I -d TESE-S99- T6L XUA 13CN3Sb1 dH Wd00 =6 TTOE 60 U17C i Date....�D... . - //.. i Of NO RT:,�0 : --, C� TOWN OF NORTH ANDOVER o p PERMIT `FOR WIRING 'ss�cHusEi This certifies that .............. I has permission to perform ��/�1;..'l�i7� ...... fmo. //l �;- It wiring in the building of. ..... . T ..- at... �>r� ! /�. ................... ... . .North Andover,Mass. F . .. .��'`.:Lic.No. s 1 �.... ... . .. .. . ....... .. . .. r ., 1 ELECTRICAL INSPEVOR t Check # 1?0..71 10429 Common-wealth of Massachusetts Official Use Only Permit No. Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave bik) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(1, C),527 MR 12.00 (PLEASE PRINT MINK OR TYPE ALL INFORALM011) Date: City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or er intention to perfotm the electrical wo+described beloy. Location(Street&Nimber) C— ��f" � (z3c) (o 1-7 S_�'2_(.40 Owner or Tenant Telephone No Owner's Address Is this permit in conjunction Rh building permit? Yes 3xgh a No ❑ (Check Appropriate Box) Purpose of Building_ 0 C_a___ . Utility Authorization No. Existing Service Amps Volts Overhead E] Undgrd F No.of Meters New Service Amps Volts Overhead❑ Undgrd D No.of Meters Number of Feeders and-Ampacity Locy-tion and NaWe of Proposed Electrical Work: I J _� ONY-\3�\ Completion of the following table may he waived by the Inspector of Wires. doll No.of Total No.of Recessed Lumi—in--fres No.olrefl.-Susp.(Pad 6)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators ICDA No.of Luminaires Swimming pool Above o In- IN 0.of Emergency Lignting grna. ❑ grnd. El Battery Units No.of Receptacle Outlets No.of OR Burners FIRX ALARMS JNo.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 Hes f Self-Contained Totals: ..K]J�M IOW No.c No.of Waste Disposers ................ Detection/Alerting Devices No.of Dishwashers Space/Area Heating XW Local E] Municipal Connection ❑ Other No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: . Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs lNo.of Motors Total HP Telecommunications Wiring: No.of Devices.or Equivalent OTHER: V\(:%V5A_ 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: [ 0 1� I I ( Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability ins ance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cove is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE liability El OTHER F] (Specify:) I ceiWfy, under t e . ins andpenalties ofperjury,that the in ormation on this application is true and completc. FIRM NA� LIC.NO.: V� LicenseeS* Signatures OL..�_ LIC.NO.: (1fapplicablepr"exem t in e ic nse number line) BUS.Tel.No.•r =70 Address: omc),J 9 C) C--:2 W_� (D2�_m Alt.Tel.No':L01 -Per M.G.L c.147,s.57-61,seciiiity work requires Department of Public Safety"S"LicenseLic.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) El owner EJ owner's agent Owner/Acypmf ?' Corrzmorzai ealth Of�assachusetts 4r ! Department of Industrid Accidents y W1 Office of Investigation 600 Washington Street Foston, MA 02111 www.hzass gov/dia . Workers' Compensation Insiurance Affidavit: Builders/ContractorsXlectric Applicant Information Please Print Leguibl Name (Basin /t)rganization/individual): S Address: jr City/State/ZipJ '�1�������j'S �--I l lPhane#:.� Are you employer?Che .the appropriate-box: ' I. am•a employer with 1�_ 4, Type of projec]dd : ❑ I am a general contractor and I , employees(full and/or part-time) have hired the sub-contractors b• ❑New con 2.❑ I am.a.sole proprietor.or partner_ listed on the attached sheet.I 7• ❑Remodelt ship and have no employees These sub-contractors have 8. [J Demoliti ' working for me,in any capacity, workers' comp.insurance. (No workers'comp. �. 9• ❑Building P ❑ We are a corporation and its required.] officers have exercised their 10-El-Electrical ditions 3.❑ I din a homeowner doing all work right of exemption per MGL 11.0 Plumbing ditionsmyself.[No•workers'comp. c 152 §1(4);and we have no insurance-required.]# 12.❑Roof repai .employees. (No workers' comp. insurancerequired_] 13.❑.0ther *Any applicant that checks bob#t mustalso If out the section below showing their workers'compensation policy information. t Homeownerp who submit this affidavit indicating they am doing all work and thea hire oulside contractors must submit anew affidavit indicating such. Contractors that aherlt this box mustrttaohed an additional shsat sho:vi5rg the r.�ne of the sub contractor grid thedr�verka 'temp,potic/infa,;.at oa. I rrr%L 26a�3p�ller thgt pr,?Vi 1kz9:WD lXFS compevsador2&SdBMMe ? a to ee& �leloav is the olle andjob site information f Y P Y ! Insurance Company Name:�`�1 Policy#or Self-ins.Lie.#: • � Expiration Date: t•� I � �,' t Job Site Address: U'�/ 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 e. 152 can lead to the imposition of criminal penalties of a- fine up to$1,500-00 ancYor one-year imprisonment;as well as civil penalties in the form ofa 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. Ido hereby cel,' oder the pains rand penalties of perjury that the i>�foPnzation pP0vided raliove is true and correct. Signature:• C Date - Phone � C:1 Phone#: L� ` official use only. Do not w•rite i Mis ar e.7,to be com,pleaed by cu y or town ofjicia� City or Town: Permit/License# Issuing Authority(circle one): I.Board of Health 2.Building Department 3.City/Town-Clerk 4.Electrical inspector b.Other 5.Plumbing inspector Contact Person: Phone#: Date...... 'Y NORTH TOWN OF NORTH ANDOVER PERMIT FOR WIRING 14 C"U'j C-- This certifies that .... ....... CC............................ TX.................. ..... has permission to perform ..........4.... ........................................I............... wiringin the building of................................................................................... at...... ............................ North Andover,Mass. ..�ic. .............. Check # 10495 Commonwealth of Massachusetts Official Use Only f Permit No. y 44 Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code( C),527 CMR 12.00 (PLEA SE PRINT IN INK OR TYPE ALL INFORW TION) Date: City or Town of: NORTH ANDOVER To the Inspec or ol Wires: By this application the undersigned gives n lice of his or her intention to perform the ele trical wo described be Location(Street&Number)4• 1 Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with a buildin permit? Yes No ❑ (Check Appropriate Box) Purpose of Building ' ` Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Nnmber of Feeders and.Ampacity Location and Nature of Propos d Electrical Work: VQ ➢C Completion of the following table may be waived by the Inspector of Wires. Recessed T umin�i m ! '1 S )r No.of Total No,of__._ess _�_�.._._re No.of. eia. mousy.(I'audlet Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators K VA No.of Luminaires Swimming Pool Above ❑ 'In- E] IN o.o Emergency Lighting nd. rnd. Battery Units --• No.of Receptacle Outlets No.of Oil B���ners FIl?E� ?��IS No.of ones No.of Switches No.of Gas Burners No..of Detection and lWtiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices ' Tons j No.of Waste Disposers Heat Pum Number Tons KW No.of Self-Contained Totals:p ' . ..'......... .. ........... Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW ` Local ElMunici al F-1 Other Connection Heating Appliances Security Systems:* No.of Dryers g pp ' No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: . Heaters Signs Ballasts. No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: .�gttach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: SJ3 (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverag in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE OND ❑ OTHER ❑ (Specify:) I certify, under thp ins and penalties of perjury,that the information on this application is true and complet FIRM NAME• I 1�C'�r1 �zIP .� �/S '-- -'Vt,�_ LIC.NO.: . Licensee: ��(� `�\ �if ef\ Signature LIC.NO.-. (If applicable,a "exe "in the liqqn umber line. © Bus.Tel.No- Address: Alt.TelNo.. 17 *Per M.G.L c.147,s.57-61,secunty, work requires Department of Public Safety"S"Lice e: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one) ❑owner ❑owner's agent. Owner/Agent PERMIT FEE:S a _441 .� he� Commonwealt o Massachusetts� h f Department of Industrial Accidents Office of Investigations tt600 Washington Street ai:r ;' g Boston, MA 02111 www hzass gov/dia . Workers' Compensation Insiurance Affidavit: Bu.iIders/ContlractorsXlectricians/Plumbers A lieant Information Please Print Leoibl Nana (Business/Organization/individual): Address: `� V City/State/Zi V vl��\ Phone Are u an employer?Check the ropriate box: Tpe of project(required): Ilam*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 t Remodeling ship and.have no employees These su&contractors have J.[.7--Y� . []Demolition working for mein 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.ElI ain a homeowner doing all work right of exeinption per MGL' 11.❑Plumbing repairs or additions Myself[No•workers'comp, c. 1.52, §1(4);and we have no 12.[] Roof repairs insurance required.]t employees. [No workers' camp. insumcerequired.] 13•❑.Other *Any applicant that checks bot'#l must also fill out the section below showing their workers'bompensation policy information. t Homeowners who submit this affidavit indicating they am doing all work and then hire outsid $Contactors that ehec?c e contractors must submit a newaftidavit indicating such. this box must attached an additional sh>et showing the name of the sub-contmator and their�vcrke s'camp,pclic;info,;,adoa. I art an.employer that E',jp7jLftvW ` �riePi coMpel radon iftsddPance for my.eiWloyees. Belaev is tlaepolicy and job site information. Insurance Company Name: Policy#orSelf-ins.Lie.#: ® !m Expiration Bate: Job Site Address:Lf City/Stafe/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 tine 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 cern nder the pains and penalties ofpe that the information provided above is true and correct. Sienature: Dat • e. Phone#: �-__7 4 lay L on,l. Do not w.Pite%i t Us area,to be cannpfgtid by cky or town.official n: Permit/License# hority(circle one): Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plu3inspedor son: Phone#: 4 r' 3r C'NO nT TOWN OF NORTH ANDOVER _ OFFICE OF ; COMMUNITY DEVELOPMENT AND SERVICES 27 CHARLES STREET �ss^Cs NORTH ANDOVER,MASSACHUSETTS 01845 William J. Scott Director FAX(978)688-9542 (978)688-9531 December 30, 1998 Andrew Consoli PO Box 5187 Bradford MA 01836 Dear Mr.Cosoli: Per our conversation of this morning regarding the continuing education requirements for Real Estate Agents,I have reviewed the North Andover Zoning Ordinance and the Massachusetts State Building Code. Enclosed please find a copy of the pertinent section of the MA Code. Please be advised that the proposed continuing education courses to be held at the Remax Preferred office located at 451 Andover St is allowed as it would be considered an accessory part of the existing business,as long as the occupancy stays below the 50 person threshold. Respectfully, Michael McGuire, Building Inspector Nmjm cc: file attachment r r BOARD OF APPEALS 688-9541 BUILDINGS 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 Ek f r . 780 CMR: STATE BOARD OF BUILDING REGULATIONS AND STANDARDS USE OR OCCUPANCY 780 CMR 304.0 BUSINESS USE GROUP manufacturing occupancies. The term "Use Group 304.1 General: All buildings and structures which F" shall include Use Groups F-1 and F-2. are occupied for the transaction of business, for the rendering of professional services, or for other 306.2 Use Group F-1 structures: Factory and services that involve stocks of goods, wares or industrial occupancies which are not otherwise merchandise in limited quantities which are classified as low-hazard, Use Group F-2, shall be incidental to office occupancies or sample purposes. classified as a moderate-hazard factory and shall be classified as Use Group B. industrial occupancy, Use Group F-I. The manufacturing processes listed in Table 306.2 are 304.2 List of business occupancies: The indicative of and shall be classified as Use Group F- occupancies listed in Table 304.2 are indicative of I and shall be classified as Use Group B. Table 306.2 Table 304.2 MODERATE-HAZARD FACTORY AND BUSINESS OCCUPANCIES INDUSTRIAL OCCUPANCIES Airport traffic control Fire stations Aircraft Film,photographic towers Florists and nurseries Appliances Food processing Animal hospitals,kennels, Laboratories;testing and Athletic equipment Furniture pounds research Automobiles and other motor Hemp and jute products Automobile and other Laundries:pickup and velticles Laundries motor vehicle showrooms delivery stations and Bakeries Leather and tanneries,ex- Banks self-service Beverages,alcoholic cluding enameling or Barber shops Police stauons Bicycles japanning Beauty shops Post offices Boat building MachineryCar wash Print shops Boiler works Millwork and woodworking, Civic administration Professional services;attor- Brooms or brushes wood distillation Clinic,outpatient nev,dentist,physician, Business machines Motion picture and television Dry-clearing,pickup and engineer,etc. Cameras and photo equipment filming''? delivery stations and Radio and television Canneries,including food Musical instruments self-service stations products Optical goods Electronic data processing Telecommunications Clothing Paper trills gr products equipment building Condensed and powdered Plastic products milk manufacture Printing oepubhshing 780 CMR 305.0 EDUCATIONAL USE Construction and agricultural 'Recreatiopal vehicles machines• Refuse incinerators GROUP Disinfectants shoes 305.1 General: Dry cleaning using other than Soaps and detergents flammable liquids in clean- Sugar refineries '- tng or dyeing operations or Tactile trills,including other than classified in 780 canvas,cotton,cloth. CMR 307.0 bagging,burlap,carpets Electric light plants and and rags 'Exception: A room or space occupied for power houses Tobacco educational purposes by less than 50 persons,five Electrolytic reducing works Trailers years of age or more, and which is accessory to Electronics Upholstery and manufacturing another use group shall be classified as a part of Engines,including rebuilding shops the main use group. 306.3 Use Group F-2 structures: Factory and 305.1.1 Day care facilities: A child day care industrial occupancies which involve the fabrication center which provides care for children more or manufacturing of noncombustible materials that, than two years nine months shall be classified as during finishing, packing or processing, do not use Group E contribute to a significant fire hazard, she be classified as Use Group F-2: The manufacturing 305.2 Business or vocational training: Structures processes listed in Table 306.3 are indicative of and occupied fo shall be classified as Use Group F-2. Table 306.3 LOW-HAZARD FACTORY AND 780 CMR 306.0 FACTORY AND INDUSTRIAL OCCUPANCIES INDUSTRIAL USE GROUPS Beverages,nonalcoholic Gypsum 306.1 General: All structures in which occupants Brick and masonry Ice are engaged in work or labor in the fabricating, Ceramic products Metal fabrication and Foundries assembly assembling or processing of products or materials, Glass products Watcr pumping plants shall be classified as Use Group F-1 or F-2. This includes,among others, factories, assembling plants, industrial laboratories and all other industrial and 2/7/97 (Effective 2/28/97) 780 CMR-Sixth Edition 49 Date...CEJ, /' "'.. . ...8C4? .. ....... f ,4ORTH ti 3?;•,� ``° TOWN OF NORTH ANDOVER PERMIT FOR WIRING SS�CHus� This certifies that ............. ..� ...... 5l. /�?.. ................................. has permission to perform �!�-�. y7` S..YSj !✓l . ................ ..... ...:.. ................ wiring in the building ......................... .. ..... ..... .,� �.rl �I N6o v�2- S.7 . ........... ,North dover,Mass. at........................... .......... ...... ....... } Fee..................... Lic. ...... .. ..... ,,, .. . .. ELECTRICAL INSPECTOR Check # �.� / rl Commonwealth of Massachusetts ;;;i; ✓' , VL , Department of Fire ServicesOccupancy and Fre Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. �� Oi ' 1 leave Mink) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK UI %. ork to he pertrnmed in accordance%5ith the I lecu•icil Code ti'_"(AIR 12.00 !'LE:(.SE PRI,\T l.\ UK OR TYPE,I LL 1.\FOR.11,I TION) Date: 16oyl_l Cih' or Town of: �,� � IVNIeFIL,411C [UNIVOOP t!/ BY this application the undersigned gives lioticc of his urh/er illmittun to perform the electrical work described below. Location (Street& Number) �J Afod14�,� CSC ' (honer or Tenant ��� if As-r cy7a L ��� .GAt�l Telephone No. Owner's Address Ls /L/Alts S'�— Is this permit in conjunction with a building permit? Yes ❑ Vo ❑ (Check Appropriate Box) Purpose of Building�l✓(.' Ltility authorization No. Existing Service Amps I 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: ('.;nr petioli)/1/14 ;(,,/I!nii!,v lah/e meat I,e wall-1 the l:is;c.tar,)/ IN,. No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle) Fans No.of Total r Transformers KVA No.of Luminaire Outlets No.of Hot'Tubs v Generators KVA No.of Luminaires Swimmine Pool :Nbove ElIn- ❑ o.o Emergency Lighting o t rad. rad. Batter knits No.of Receptacle Outlets No,of Oil Burners FIRE ALARMS �No. of Zones No.of Switches No. of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Tonsl No.of Alerting Devices No. of Waste Disposers Heat Pump Number Tons KW No.of Scl -Contained Totals:1 Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal El Other Connection No.of Drvers Heating Appliances KW Security Systems:* No.of Devices or E uivalcut No.of Water No.of No.of Heaters KW Data Wiring: Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs No.of Motors Total tip telecommunications Wiring: - - No.of Devices or E uiti alent OTHER: �' �/� Illll._'il.../..hllUl7U,:/t'1.lli!/,L'SdZtl, •d'.,,PI'i�1111'Cil/%1 .IlCl/,Tl.t.-l.,r. .'i,. F:,timated lv"alue of Electrical Werk; I kt hen required by municipal policy.) %�urk to man: if //jL Inspections to be requested in accordance with EIEC Rule i0, and upon completion. INSLRANCE C'(1�' R;1(.:E: (. nless waived by (he 0wnc1% no permit fur the perlormance; Ofclectrical work ma) i'.Aue unlc file licensee prop ides proof of li,thility insur:mcr includin-,",_,omplctcd(iperation•'cover pe ur its ,ul-aantial <quiv:ilcnt. h. ndec i lwd c;Coilic: that :oeh co%cral."e i:. in Ii rcr, :md hnti<'.hihih,d prootct:;,lrle to the permit is min." olticr. I IF(-K 0 ; ;��;(R ,1�:t.'1 � i3l;�:1) �_� i.i I tll.R ❑ I.`ip<rily:l •"110" !"Ider llle 0!7.'71.1'.!fill 10;1,111.4"4 1 )e/ 771'', u , 1 �1 ! ► 'r 77 Ire:r7%ur:►,ll.''1n.,:!.171.5' !171J1.'/71�1!,'l l <9RNI NAME: address: 3 �� ,ins. Tel. `lo.:_ '';;eC,urity cv.,tetn C)ntractor f.icen;r feLluuvd for this w(,rk; if upplic.ible.rntcr Lilt: license number here: ?9W.NIER'S INSI'It,�NCE ��,alti'ER: I ;nn aw,ire that the I,i':rn ec J!;,. lil;l hut.-• (hc Ii,Abilit, inaur;Ill ce 1111a , tcquired by law. By my :acnature below. I her<('y waive this, rcquirunent. I ;;m the!Check enc)❑ .;vvner ❑ uvtetcr':, t_..;nt. Owner/Agent iyai:ltui'4 < PF'.R.911T i Date/0 8764 },1 HORT/{ TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING SA US This certifies that40.S . . .�'-. .:�. ��. . 1 . . . . . . . . . . has permission to perform . . .R.v. . . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of .A:,. ti .� °.` .(.° . .V- C'(,.2 � s r.,. . . A �. '.`. . . . .C-( . . . . . . . North Andover, Mass. Fee.�b . . .Lic. No..l./7� )._ . . . . . . . . .��. �-/�. . . rPLUMBING INSPECTOR Check # 'MASSACHUSETTS.UNIFORM APPLICATION FOR PERMIT TO'DO PLUMBING (Print or Type) Massa Bate I �! t / 1 Permit# Building Locatlon `l.' l �A L�,(k OJT Owner's Name JV SCK AVLJM r- WdIU& l�/I IIC Type of Occupancy. by New ❑ Renovation Replacement ❑ Plans Submitted: Yes❑ No FIXTURES m o z =_ > y W Y J y t 'y F y 7 D a ¢ I Q 93 z oc_W h w Q s y Z W z a h V► rf� Qt- U y 0 z a m 44 W r < h y x c d O < x = O a .4 W Q < W a < ce .� h O0. O y F• Q 0. y h Y 0 'oN = _ ,{ U. 7C W a x r m y n in -+ s }. vs u. cs c < 3 m Q r SUB—BSMT.' BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR FS4TH FLOOR TH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company NameCheck one:. Cerfrtt&2te NG• q Address �/ Corporation Z. 1 ❑ PartnWil 04- ership Business Telephone -1 # ?Mj$4y}®® ❑ hmvco Name of licensed Plumber 1 . f41(.feA0 INSURANCE COVERAGE: I have a current.liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes %01" No ❑ If you have checked yes, please indicate the type Coverage by checking the appropriate box. A liability insurance policy Wo-W' 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. Ch-ck one: Signature of Owner or Owner's Agent Owner ❑ Agent[] 1 hereby certify that all of 4he details and information I ha au ed entered in ve application are true and accurate to the best of my knowledge and that all plumbing work and installations ti the pe it' for this application will be in compliance with all pertinent provisions of the Massachusetts State Plum ' te�1 of neral taws. Title i nature of umber Gty/Tov�rr Type of License:Master Journeyman (O I NL License Plumber ,f BELOW FOR OFFICE USE ONLY FINAL INSPECTIONS $ICE'1'CIiESjf PROGRESS INSPECTIONS FEE l NO. APPLICATION FOR PERMIT TO 00 PLUMBING NAME A TYPE OF BUILDING LOCATION OF BUILDING PLUMBER PERMIT GRANTED DATE to PLUMBING INSPECTOR Office Use Only ,y 01 ��4t �>lmmanlUr# If 5=55caOIIS&S Permit No. Occupancy&Fee Checked �C}iF[tfA1PA2 Of plt�)),tt �'FI)� BOARD OF FIRE PREVENTION REGULATIONS 521 C?JR 12:00 iso peeve blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 10%0 Air or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 41SI . AIDDU T2 r,7* Owner or Tenant &anrw .Os✓aod LI o F/a i c e m/C Owner's Address Is this permit in conjunction with a building permit: Yes 71e No U (Check Appropriate Box) Puroose of Buiidino n40ft4A24. . L Utility Authorization No. Existing Service Amps _� Volts Overhead '� UndgrndIa No. of Meters New Service Amps __l Volts Overhead ❑ Undgrnd a No. of Meters Number of Feeders and Ampacity ee Location and Nature of Proposed Electrical Work Re.voL.w.f.a ct{ .14a— Total T No. of Hot Tugs - No. of Lighting Outlets i I No. of Transformers KVA Lighting Fixtures Swimming Pool Abcver— fn- No. of Li 9 9 grnc. - grnd. .—. Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners I Battery Units No. of Switch Outlets I No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Conc. Total No. of Detection and 9 I tons Initiating Devices No. of Disposals No.of Heat TTotal Pumps Ton s KW No. of Sounding Devices No. of Self Contained No. of Dishwashers Scace/Area Heating KW Detection/Sounding Devices No. of Dryers ' g Municipal Heating Devices KW Local I! Connection ❑Other No. of No. of Low Voltage No. of Water Heaters KW I Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of `„lassacnusetts general Laws I have a current Liability Insurance Policy including Como tein Operations Coverage or its substantial equivalent. YES NO = I have supmitted valid proof of same to the Office. YES •_'` NO = If you have checked YES. please indicate the type of coverage by checking the appyqpriata box. INSURANCE BOND —_ OTHER = (Please Soec:ty) (Expiration Date) Estimated Value of Electrical Work S Work to Start Inspection Date Recuested: Rough Final Signed under the Penalties of perjury: / FIRM NAME ev �- Gr LIC. NO. Licensee �A �i Ln)&1J�9L�- Signature LlC. NO. 6 O Bus. Tel. No. CXS S8 2-- Address -"JOSS Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does ret have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws. and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telednone No. PERMIT FEE S U (Signature of Owner or Agent) x-5565 �� X361Y rDate.. . .... . /.... T- 2593 i NORTH 1 Ottt``D s t4. TOWN OF NORTH ANDOVER PERMIT FOR WIRING . i ,SSACMUS� O I �/ , �c. This certifies that .....C.T./�.�.sP.l/.......t`........................................................ `. has permission to perform ......Tl."'..W..k9.oz.T t't..cA.- ..................... . CU wiring in the building of....../!!.. ........ /... .lc. ...... i1� .................... at.....? ..................... .North Andover,Mas�'C.' I Lic.No.llv{ .-.............ESEi�`a`. .....`.,...T � ,��It�l1�Sl4lt /8"" WHITE: Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File . q;:5�{ PERMIT NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP NO. I LOT NO. 2 RECORD OF OWNERSHIP DATE BOOK PAGE - ZONE SUB DIV. LOT NO. I I LOCATION S PURPOSE OF BUILDING OWNER'S NAME -� NO.OF STORIES ,c-� SIZE OWNER'S ADDRESS /WvJ^ BASEMENT OR SLAB lY� ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME SPAN - DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET G "' " POSTS DISTANCE FROM LOT LINES-.SIDES 'REARMV "" GIRDERS AREA OF LOT FRONTAGE` HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REAUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER - IS BUILDING CONNECTED TO NATURAL GAS LINE 3 PROPERTY INFORMATION INSTRUCTIONS LAND COST SEE BOTH SIDES EST. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED A&i3 v BOARD OF HEALTH SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE . C�a PLANNING BOARD PERMIT GRANTED d �3 1 BOARD OF SELECTMEN BUILDING INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY _ S'ORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY _ OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA. APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION _ 8 INTERIOR FINISH CONCRETE _ 3 1 2 13 CONCRETE BL"K. PINE BRICK OR STONE HARDW'D PIERS PLASTER DRY VJALL UNFIN. 3 BASEMENT AREA FULL FIN. B"M'T" AREA _ y, 1/1 1/1 FIN. ATTIC AREA _ NO B M'T FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH ASPHALT SIDING HARMWID - ASBESTOS SIDING COMMCN VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STIRS. & FLOOR (_ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR (� POOR _ ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE HIP BATH (3 FIX.) _ GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT I SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY _ WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. &COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS GAS 7 NO. OF ROOMS OIL B'M'T 2nd _ ELECTRIC tst 13rd I NO HEATING PERMIT NO. APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 MAP NO. LOT NO. 2 RECORD OF OWNERSHIP (DATE BOOK PAGE ZONE I SUB DIV. LOT NO. �— LOCATION / PURPOSE OF BUILDING r OWNER'S NAME ,]Z_ NO. OF STORIES IZE S 7zr- OWNER'S ADDRESS BASEMENT OR SLAB Q �` ARCHITECT'S NAME S7 SIZE OF FLOOR TIMBERS •IST✓V 2ND 3RD BUILDER'S NAME j^w� q_ ('� ett-. SPAN \ 4�� +- DISTANCE TO NEAREST!BUILDING � �(•/�,[,!-3� DIMENSIONS OF SILLS\ J v DISTANCE FROM STREET /�� POSTS \ DISTANCE FROM LOT LINES—SIDES REAR GIRDERS AREA OF LOT V FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND Q WILL BUILDING CONFORM TO REQUIREMENTS OF CODE per' IS BUILDING CONNECTED TO TOWN WATER ✓ BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS,BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION ' LAND COST or SEE BOTH SIDES �,/� EST. BLDG. COST V v 0-6.0 i PAGE 1 FILL OUT SECTIONS i - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FI D , / BOARD OF HEALTH SIGNATURE OWNER OR AUTHORIZED A NT FEE PLANNING BOARD PERMIT GRANTED J 19 BOARD OF SELECTMEN BUILDING INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES I_ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS, WITH PORCHES, GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION $ INTERIOR FINISH CONCRETE B 1 2 3 CONCRETE BL'K. PINE BRICK OR STONE HARDW'D PIERS PLASTER __ DRY WALL __ _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ 1/. 1/2 1/4 FIN. ATTIC AREA _ NO B'M'T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE _ WOOD SHINGLES EARTH __ _ ASPHALT SIDING HARDW'D ASBESTOS SIDING COMMON _ VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR I_ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR POOR ADEQUATE I� NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH 13 FIX.) GAMBRELMANSARD TOILET RM. (2 FIX.) FLAT A SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY _ f WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING II 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. &COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd I NO HEATING Is k Date3.�, ��v r' °f,',`°o 4, TOWN OF NORTH ANDOVER o41 PERMIT FOR PLUMBING SSACNUS� ,, This certifies that OroelIel p/ . .?F `�l.� has permission to perform . ,D—. rld 4/-,74�G . . . . . . . . . . . . plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . . . . . . . . . .. North Andover, Mass. Fee �! !.�� Lic. No.. . !. . . . . . . . . . . . . . . . . . . . . . . . . 1 PLUMBING INSPECTOR Check it ___.�_ 85t �MASSACNUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print at Type n �o ..� Maa.- oate J Bundin Location d Locatiermlt lon (,, �Mri, wo, Names - •/ New O Renovation Replacement O Plans Submltt4Z: Yea❑ No FIXTURES y ZY < f- y .yi y O 2 F y W W Y J y } v < y W <fOF y YY yOa !� V yY < y < YW Wz O2y <� rtHO- r n W K WW O � = W < X O 9z a J J V < a, Y 3e O W Y W y Z OOjz O< < 6 mOY '3 - <r j 3 sus—BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH'FLOOR STH FLOOR 7TH FLOOR STH FLOOR Installing Company Name ro M"h Check one: Certificate Address 2— O Cortn.etahip m/CBusness Telephone -13 ( o.ZQ Z Name `. of Licensed Plumber INSURANCE COVERAGE: I have a current liability insuranc Icy Or its subsfantW c N Y�have checked vim, pleas indicate the �ttvdant. Yet No ❑ type coverage by checking the appropriate box A Iabllty insurance policy cher type at Indemnity O Bond ❑ OWNER'S INSURANCE WAIyER:1 am aware that the Ikensee does not have the insurance coverage required b Chapter 142 of the Mats. General Laws. and that my signature ,�this Per"appllcallon waives this requirement. y Check one: • • a Owner ❑ Agenl ❑ kw*Weby cw y that all of the delta .and Information 1 htw !h 'n' t Prosbni of tin• work and IniiaNallons p�torm� POMaPDhca an Irw anA aoatrate to Ih•bed MauachupHa Stale Pkm+bin0 Oade and Ch No 41 2 al Cavil. atbn ance with AN Me • fe um w City/To" Men$e Number APfft+0 o(OFFICE USE ONLY) TWO of PMT"v Memo:Master Journeyman ❑ r , BELOW FOR OFFICE USE ONLY PROGRESS INSPECTIONS FINAL INSPECTIONS SKUC- FEE NO. APPLICATION FOR PERMIT TO DO PLUMBING NAME &TYPE OF BUILDING LOCATION OF BUILDING PLUMBER PERMIT GRANTED DATE 19 PLUMBING INSPECTOR