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HomeMy WebLinkAboutMiscellaneous - 47 CRANBERRY LANE 4/30/2018 (2) i 47 CRANBERRY LANE i 210/059.0-0071-0000.0 Date .2, Cd'i,. . OR':1tia TOWNOFrNORTH ANDOVER of �`� , '• �� PERMIT FOR PLUMBING Ss US This certifies that .:f�t�QP.2 . . ��?'.`�. . . • • • • • • • • • • • • • • • • • has permission to perform . { .?` . .17.Y. -- - - - - - - - - - - plumbing in the buildings of . .Oren.6 dlx�j . .1,4. . . . . . . . at .**./( .0. . ��.,�.�-. . . . .C.1&fi4 . • • • •, North Andover, Mass. Fee§).�-O . .Lic. No.�. . 1G/�/. . . . . . . . . . . . . . . . . . . . . . .(� . . . . PLUMBING INSPECTOR Check !/ 7Ct45 Date.!-1/0- k. . ...... ,&ORTp TOWN OF NORTH ANDOVER • - PERMIT FOR GAS INSTALLATION s r • �9SSAC MUSE•( This certifies that . . 6.P.' z. .l . . . . . . . . . . . . . has permission for gas installation . . .t= t. A H.!? r. . . . . . . . . . . . in the buildings of . . . . P t: . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . . North Andover, Mass. Fee. . ? Lic. No.. ./Ju. GAS INSPECTOR � Check# 2- 6322 6322 MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS G (Type or print) Date S�Q NORTH ANDOVER, MASSACHUSETTS V Building Locations % ��/ T� U�2 ( x-14 C L Permit# l Owner's Name Amount$l.� `//., New❑ Renovation D Replacement Plans Submitted D U w U m F. O C F F+ Z a U x a w c z Q w a H > U m z 0 F �a o x fi 3 0 a o a > a F o SUB -BASEM ENT BASEMENT % 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR j 4TH . FLOOR 5TH . FLOOR 6TH . F L 0 0 R-- 7 T H . 7TH . FLOOR 8TH . FLOOR (Print or type) NameCheck onff. e: Cc, e Inst a11 Company . �`i�-LL � � l ertifi G.1 —o Address L-0011 S 11 QU El Partner. Business a ep one Firm/Co. Name of Licensed Plumber'or Gas Fitter �T��C INSURANCE COVERAGE Check one: I have a current liability Insurance'policy or it's substantial equivalent. If you have checked yes,please in ' te-fhe type coverage by checking the appropriatYes e box. No� Liability insurance policy Other type of indemnity D Bond Owner's Insurance Waiver: I,am aware that the licensee does_not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner p p thereby certify that all of the details and information 1 have submitted(or entered)in above ppl cation are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By: Signature of Licensed Plumber Or Gas Fitter Title 0 Plumber oY City/Town, Gas Fitter (cense Num er �l0faster _ APPROVED(OFFICE USE ONLY) Journeyman t MASSACHUSETTS UNIFORM APPLICATION FOR-PERMIT TO DO PLUMBING (Print or ype) Mass. D to Permit # 07 Building Location .Owner's Name yJ Type of Occupancy New❑ Renovations Replacement❑ Plans Submitted: Yes❑' Noli- 4v FIXTURES B.P. # SEWER # SEPTIC # . z Z Y Ic-n Y } 0 Q Z > w Ln Z1-4 N Q � U I- Z O (D to w W to �ri Z to I— U w to to u_ Z ? a I�— U Z m to w >_ ¢ I- z a U g Lo g ¢ z a O u- W = O W O 0 = J to. Q Q' . 0 _I F- U ¢ _ 6 2 a Z to Y n O z z W . LL Y D w a > a a 0 a ° o a L a 0 U o z g mcn O = to u_ 0 Q D ¢ m D O SUB-BSMT BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name P Check one: Certificate Address t ❑ Corporation Business Telephone 1{ ❑ Partnership Name of Licensed Plumber or Gas Fitter ❑ Firm/Co. INSURANCE COVERAGE: I have a cur ren lability insurance policy or its substantial equivalent, which meets the requirements of MGLCh. 142. Yes No ❑ 1 If you have checked ves, please indicate the type of coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURNACE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass.General Laws, and that my signature on this permit application waives this requirement. Signature of Owner or Owner's Agent Check one: Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapte /14nof t((he Genera La s. By Title Signature of Licensed Plu ber City/I'own APPROVED(OFFICE USE ONLY) Type of License: Waster ❑Journeyman License Number Date....1...e. ..`.....`............ f NORTH 1 3:°•_':�`' TOWN OF NORTH ANDOVER PERMIT FOR WIRING SS�cMus� This certifies that .14�........ ...i�-�. -............................................. has permission to perform ........ :.,.r: .�..... ':'.: :- ............ n wiring in the building of.......'.7� .. ......... .. ......i.:: ?'*.........:...1 .... - '-' ...... ......... 4r 1� ............ North Andover,Mass. Fee ........... Lic.No..-C3.; ......... ...� .. ��.�"` ............. ELECTRICAL INSPP'V * Check n V 6z � $ Official use On Commonwealth of Massachusetts Permit No. Department of Fire Services r e Occupancy and Fee Checked of r BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/051 (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: 712 t{ ro e City or Town of: 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) Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building A OS i-e1.V,4 Utility Authorization No. Existing Service 2_40 Amps Z-y07 t'Lr Volts Overhead ❑ Undgrd No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity If y Location and Nature of Proposed Electrical Work: ��A,'� / ���Y •t-- Completion of the followin table may be waived by the hzs ector o JVires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans o. of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs , Generators KVA No.of LuminairesSwimmin Pool Above n- o. o Emergency Lighting I g rnd. ❑ rnd. Battery Units No.of Receptacle Outlets AZO No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches 4 No.of Gas Burners o.of Detection and Initiating Devices No. of Ranges No.of Air Cond. I Tons "1,Total No.of Alerting Devices No.of Waste Disposers eat Pump Number Tons KW No. of Self-Contained Totals: I I I Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No. of ater KW o.o o.o Data Wiring: Heaters Signs Ballasts No.of Devices or E uivalent No. Hydromassage Bathtubs No.of Motors Total HP a ecommunications irmg: No.of Devices or Equivalent OTHER: .-I trach additional detail if desired, or as required by the Inspector o/'{9?res. Estimated Value of Electrical Work: cd (When required by municipal policy.) Work to Start: 7(1,%4 1O6 Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability"insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE e BOND ❑ OTHER ❑ (Specify:) /certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME- LIC. NO.: Licensee: 14py Signature���it C�, `„ LIC. NO.: (lfapplicabl, nt'r "ecempt"in the license number ine.) yr %-W-0 Tel. Nolr !� ,i•73 Address: yi' �• ic beg �('0 �►1.i Alt.Tel. No.: *Security System Contractor License required for this work; if applicable,enter tl a license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the(check one)❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ �' e r i 7 .S`�-as Date.............................. • yiORTIf TOWN OF NORTH ANDOVER O L t PERMIT FOR WIRING sS^CHUS� This certifies that ....... .Y/�/ . ..... e4 T, � ;. . .............. has permission to perform ......h OV/-/ ...................... wiring in the building of.... ..... / ........ ......... .1. .4.�?y� ................................... at o... .......... ............ ......•—�.. ,North Andover,Mass ................... s Lic.No. 7 ..��a. ............1 ........ ELECTRICAL INSPECTOR Check # 5 � x ;��eparrment of Fire Services Permit BOARD �? FIRE PREVENTION REGULATIONS Occupanc' d �1 d i y Fee Checked ev. 11/99 Leave blanld APPLICATI FOR PERMIT TO All workPERF{3 ' '�' . �o�in acco L W � K OLE SE PRI1vTINI ��with the Massachusetts��M�L � TRf GA G�►.�.; �R 7YP AL INF 1t 12.00 NATION) Date: I City or Town f� J B this ©�'� r! r-• .�� Y application the un�3 `s)gried gives notice of his or her intention to perfo the che t t d1'Wf res. ^' Location(Street&Numb rI described below, Owner or Tenant IV1nP: Lot: Owner's Address i'; Oe -"' phone No. Is thiseratt' un ' !! P in cont ra ith a b4ilding pe •t? Yes I; I, . Purpose of Building I' �t r � NO ❑ l3�ulil:ding Perinitff �• . Existing Service AUtility Authorizatio' 1o. ps / I :`i olts Overhead El Service I'fil,ps / V ❑ Undgrd� !I No.of Meters Nnmbeyc of Feeders and , act oils Overhead Q Undgrd I !'' No.of dieters I I.ty Location and Nature of + W Cx L -ice P oposed Electrical Work: I Com lesion o the ollowine table E "I :-- No.of Recessedf +/e waived by the I Fi�ctnre�s I '`No.of Ceil.,S ie�`ar Wires. + usp.(Paddle)Fans o•o Ii .- No.of Lighting Outlets Tranr:fo_rmers Z{�;a ~ !: No.of Hot Tubs No.of Lighting Fixture„ I! ' Gene tors . KVA Swimming Pool A dve ❑ - Q o.oI anergeney ting No.of Receptacle Oudets�l No.of Oil Burners Batterd 111nits Na of Switches . f , Gas Burners I ARMS No.of Zones r No.of rners o,o ;.�!tection No.of RangesItlii..ata Devices i No.of Air Cond. -Tom— Tons + Devices _. f Tons No.oa rein No.of Waste Disposers ons g Totals; o•o n "- No.of Dishwashers I Space/AreaHni'Alertin Devices No.of Dryers t I eating KW Local] Coectim.- Q Otfirr'- o.o ( I Heating Appliances gyy Heaters II q� o.o go.o No'df rieviCm orFes++-*valent' I Lg• Ballasts Data . ircag; No.Hydromassage B4tW11i No!of Devices or E uivaterit' . No.of Motors Total HP eco ' naicauons OTHER. ' No11 oot Devices or —mit II Attach z IINSURANP�iovides roo '''"� ''fess waived by the owner;no permit frn `r�arEctincal negr�ired bydre lnsperrorn!t1''ares the k p liability onauce incl the P ormance owork may tmder4 ed uding Ieied I tf y issue`uttlrss cetif=that c ct v a is in ford comp OPeratiOn cove-age i .sttbstan _- �I (+ ,and has exhibited proof of same to the e t.; tial equtvalcuL Xho CHECK ONE: IDI SARAN BOND Q O Q P, rssuing office. i (SP Y. Estimated Value ofEleeIWsak: . j Work to Starr I.'yld by municipal poli( .) MOPInspactions to be accordance with NEC Ru! t�l u pa ialties,�f far ivn on .wind upon com letion. FIRM NAME: ' ;MUC ,that the �tv app rue mtd comp S S' LIC. NO.:___ _ Licensee: swephw ,. r obi Lpnnwnberlate.) r�ture� -� I"5 !I•IC-NO..0.1'i4 - ` ]BUL rOegt ' aware that the �TeL No..976-5.'3.'i=6667 > censeedoesnothavedu . i !ITeLNo.:978-53?-0735 Owner/�' - By m .P lelow,I hereby waive this requirement. I am the vabil�. coverage IIot R11y`' S t {checkCSI ow= El ome s imt. t E TdePhone No. Ieparanent of Fire ServicesI -- ---' I Permit N� ' BOARD n�P FIRE PREVENTION REGULATIONS -©c, ! TIONS OcciPa ciy a�d Fee Checked �1 APPLICATI l lfle:rve b�anit1 ..._._. All work r FOR PERMIT TO PERFORM EL � ' TRI Peifofted in accordance with the Massachusetts MecWcnl Code , CAL WORK ,may '(PLEASE PRINT IN I R 7YP INF RM�ITION 5'� 12.00 City or To {f o�A ) -Date: 7 J By this application the un�l 4sFOed gives notice of his or her intention w performche electii (d ofres: Location(Street&Nu i rdescribed below. Owner or Tenant ( � ( hiap: Lot: Ownees Address i ;iaephone No. - Is this e p rniit in co un � •' f RI �' ith a ilding pe 't? Yes I� Purpose of Building i �- NO ❑ 13"u� ing Permitff i Utility Authorizado�i Existing Service . s o' l P. _Volts Overhead❑ Und d i ew Service , �' Q' 1' No.of bleters Ps _Volts ' Numbe�c of Feeders and I' acity �e �d❑ Undgrd ,I ' No.of Meters _ Location and Nature of Pi °sed ElectnicaiWork: Clr talNo.of Recessed FLctnrehi W waived -by the/"n' 'No.of Ceil.,Susp•(Paddle)Fans _ cr Wires. No-of Lighting OutletsIII ' Tra oruiers M No.of Sot Tubs KtiA Gene! tdrs KVA r No.of Lighting Fixtare II ? Swimming Pool A ve (� o,°' ' d' iii J,Lj d- ❑ Batteird 1:1nu�ts No.of Receptacle Outle No.of 017 Burners Na of Switches ; FARMS No.of Zones f i No.of Gas Burners o,o _ 'on No,of Ranges j No.of Air Cond. ons + ;. trap Devices -- �. No.of Waste TNo.of Devices I I i Totals: ° ori U.° No.of Dishwashers I I Space/Area Hen TDe 'Tera Dentes lYo-of Dryers I I t�N► �`''� ' mon�.r - Heating Appliances KW ystentir ,...� o.o stet i Devices or Seaters Ii SW °•S. 0.° DataBwLtsts g. No.Hydromasuge Bat I& I No,of Devices or _ - 0 of vlotons Total exit ec�b uinicatrons irmg; ; OTHER: I Noll of Illevices or Eaaivaterit;— Jlidensee SUUUNNCE provides r :•':unless waived by the owner; pest�� �° },�ni ui"d by A Weecror grWi'res P P habiliry insurance including" P�� Orman e�O4 tle�trical work may issue'mil..ss Oed ► _ �B sea certifies that Isr�c cdvetage is in fotix.and has exbi'bited proof of s�amcee i r}s subuantial equivaleat. Tht:CHEC . IdE: lNSURA . BOND ❑ pnn ❑ (SPS'.) to the Pe; I 'issuing office. i I1� Estimated Valu ofEl ! .-- ozk: to Start: (When mutticip Work ' 'i Inspections to be requested in Icy NAME: SM pikddea afP�3►�l4 drat tlu ire with ,end upon completion.; CPRIC fomratiaA on>Ytir aPP ii �ra arrd empkt4L Then S S I.s,• LIC.NO.: aPPl�abJaerrre,• �;�, �3 bll Lot+pall Pcabody,MA .�.,TeL No,.978-5:3!i=-ti 661 BVSLIREI'N AVER: I am aware that the Licensee does not have the ' I .�TeLNo.:9 78-5:3 3—0.733" BY mY below.I herebyiusu1 muco coverage - waive this erage normally int. I am the(ctuxk a [�owner owner's i t. Telephone No. i . l } Date. .,771—.r"du i � r i 40RTN 11 ��;. �ooL TOWN OF NORTH �NDOVER PERMIT FOR PLUMBING 'SSA us This certifies that ... . . . . . . . . . . . . . . . . . has permission to perform � ,�-JJ `-. . Y. .. . . . . . . . . . . . . J ►,�mss' plumbing in the buildings of . , . . . . . . . . . . . . . . . . . . . . . . w oti . . . . . ., North Andover, Mass. Fee. . . . . . . . .L1c. No,7?.6 � . . . GPLUMBI G .NSPECTOR F Check F a 6540 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS S ��- .47 c rpib-at Lf7' Date Building Location , . Owners Name �� ('/ Permit# �ft3 Te of Occu anc rL�s / U�LI Amount �t New Renovation Replacement Plans Submitted Yes No FIXTURES SZ.S)EIaVIC { 1S>C)HIDCR 3�D)HIDQt �)HIDQt 4M R" M Fl" 6M HDOCR 7M RiM SII3)HID(R (Print or type) n 1 Check one: Certificate Installing Company Name 'C LA'j ❑ Corp. oClo�e� v ��- 1�vy� mt4 � Address Partner. a� Fusin Tele one //``//��,, �/ ,p � Firm/Co. Name of Licensed Plumber: (S �// L f 1)h 4 Insurance Coverage: Indicate the type of insurance coverage by Ghecking the appropriate box: Liability insurance policy ❑ Other type of indemnity Bond Insurance Waive : I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insuranc igna ure Owner E Agent t i I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massach et St Plumbi C anc�( hap er 142 of the General Laws. BY ign ur o icense u � � Type of Plumbing License Title _I o City/Town is n em e'T� rr Master Journeyman APPROVED(OFFICE USE ONLY 4 ' Location "T 7 No. "7" Date ;T" ,y TOWN OF NORTH ANDOVER F R Certificate of Occupancy $ cMus Building/Frame Permit Fee $ s� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ J •� Check # 1856 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING Seed"Aw BUILDING PERMIT NUMBER: V rDATEUED: —_a (� _p7 v0 S� 1X, SIGNATURE: 40 t a Building CommissionefinveaSr of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property//Address: 1.2 Assessors Map and Parcel Number. .�e 6161� Od , v� Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: \ r Zoninjt District Proposed Use Lot Area Fronts 11 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided ReqWred Provided I.S. Flood Zone Infomutioa: 1.: SewaW Disposal system: Public ❑ Private 1.7 Water Supply vide ❑C.40. 34) 7.oae ❑ Mmicipal ❑ Oa Site Disposal System ❑ aaas SECTION 2-PROPERTY OWNS /AUTHORIZED AGENT C istf?Ct; \,i,S to rrY 2.1 Own of Record Name( t) Address for Service 91 Signature Telephone i 2.2 OwnjP4 Record: / /SOff - AlAyee / Nam P 'nt Address for Service: �2z L7, t store Tele hone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construe n Supervisor: Not Applicable ❑ 44 � ©� Licensed Construction Supervisor: C l - C, License Number Addros J (/1/o, Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ . Company Namem Registration Number 4 Address NEWS Expiration Date z Signature Telephone f SECTION 4-WORKERS COMPENSATION(MG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes....... No.......❑ SECTIONS Descrl tion of Proposed Work check avykabk New Construction ❑ Existing Building Er Repair(s) 0 I Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: e O-Al 641e �"UO� 04,1 irc . )'12rl�or ��P� cJyrlc SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL US ONLY Completed by permit applicant 1. Building (a) Building Permit Fee 12000 Multiplier 2 Electrical �D p p (b) Estimated Total Cost of Construction 3 Plumbing 0,Q 0 Building Permit fee(a)x (b) _ 4 Mechanical HVAC 5 Fire Protection �� U 6 Total 1+2+3+4+5) I Check Number SECTION 7 N TO BE COMPLETED WHEN OWNS GENT OR CONTRACTOR 6 PLIES FOR BUILDING PERMIT as Owner uthorized Agent o subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION ,as Owner/ uthorized A t of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Yame Signature of Own ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2' 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X — MATERIAL OF CHDANEY 1S BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 4 A W The Commonwealth of Massachusetts d Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 . Workers'Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for my employees working on this job. Com an name: Address f U City: Phone 2Y_ Insurance Co. Poli # Company name: Address City: Phone# Insurance Co. Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of.a fine up to a1,500.o0 and/or one years'imprisonment_as_vreli_as.civil,penaltiesinthe form da.STOP W9RKORDER..aid..afine of.(.$100..00).ajdWagainst-ma 1 understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the painsa d nasties of 'ury that the information provided above is true and correct. r Signature / Y Date Print name �C �� .lei Phone# Official use only do not write in this area to be completed by city or town official' City or Town Perm#/Ucensi ❑ ❑ Building DeptCheck if immediate response Is required ❑ VCenSlrr9 Board ❑ Contact person: Phone#: Selectman's Office ❑ Health Department ❑ Other ✓�ie �o7.vnw�zruea/,�C a�✓f/faaaac�uiae� � , BOARD OF BUILDING REGULATIONS i License: CONSTRUCTION SUPERVISOR Number: CS 087568 Birthdate: 08/06/1960 Expires:08/06/2007 Tr.no: 87568 i 4 Restricted: 00 KEITH C XU 5 BRIDLE PATH RD . ! ANDOVER, MA 01810 Acting CRs over , . t ...: :: DAT (MM/DD/YY).: : .: :::. ,o / 524 OS PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION • John T Burns Insurance Agency Inc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 803 Washington St HOLDER. THIS CERTIFICATE DOES NOT AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Newton Ma 02460 COMPANIES AFFORDING COVERAGE COMPANY 2020188 00 A MWCAU INSURED KEITH XU COMPANY B DBA GLOBAL CONSTRUCTION COMPANY PO BOX 1533 C ANDOVER MA 01810 ' COMPANY D o;THI..... _......._..........._..... SISTO CERTIFY THAT::::.: THE POLICIES OF INSURANCE LISTED BELOW H • AVE BEEN ISSUED TO TH E 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. CO POLICY EFFECTIVE POLICY EXPIRATION LTR TYPE OF INSURANCE POLICY NUMBER LIMITS DATE (MM/DD/YY) DATE(MM/DD/YY) GENERAL LIABILITY - GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG. $ CLAIMS MADE F OCCUR PERSONAL&ADV.INJURY $ OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ FIRE DAMAGE wy—w) $ _ MED.EXPENSE (An—Pn ) $ AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT $ ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS . BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT ANY AUTO / OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGATE EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM. AGGREGATE $ OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION ANDWC STA - 0TH- EMPLOYERS'LIABILITY TORY LIMITS ER ........................:.:::.::::::::: EL EACH ACCIDENT $ 100000 A THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT $ 500000 PARTNERS/1 :.UTIVE 3490480 05/24/05 05/24/06 OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ 100000 OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS .............................:;: :. ::�'...: :.:.:;::c::;.;.:;;•>:•::::::::::::.:�::::::::::::::::.:�::.............................. :::::.:::::................................... .::::::::.:::.....................:.:::::::::.::::.:...................::::::::::.::::::..................... .... :::::::::.................:::::::.: .. :::.:::: ::::.CA :.::::::.:::::::::.::::........::::::::::::::::::::............:.:::::::.:::::.............:::: .............:......:::;:. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE TOWN OF NORTH ANDOVER EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL • DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. N.ANDOVER MA AUTHORIZED RETATIVE : .':':':;'2: :: :i::2:i: :iii: : :;:i :i: ::>i:::ii: �:>::• :>:.»:.::.>:::::.::::::::::.:::::::::::::::.:::::Q. .:.............. :::::::::::::...::...........:....... ::i::i:`C::: ................................. ..........:.::::::.:.:�::::.::::::::::::::::>:.s:.»:;.>:.:.>::�»»:.>:;.::.:>:.>:.>;:.>:;;:::i'::'.:i:;:;:>;:ii::ii:tii::i:::::):i;:i;:i;:::::;:i i;i: .... .�i.'Q���.::.ey. '. ' North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Location of Facility) I' Signature f Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector LIST OF DRAWINGS A-0. GENERAL NOTES AND LIST OF DRAWINGS A-1 . ARCHITECTURAL 2ND-FLOOR PLAN A-2. ARCHITECTURAL ELEVATIONS S-1 STRUCTURAL FLOOR FRAMING S-2 STRUCTURAL ROOF FRAMING S-3 STRUCTURAL WALL FRAMING GENERAL NOTES 1 . ALL CONSTRUCTION SHOULD COMFORM TO THE REQUIREMENTS OF "COMMONWEATH OF MASSACHUSETTS BUILDING CODE", LATEST EDITION, THE NATIONAL ELECTRICAL CODE, AND ALL OTHER APPLICABLE CODES. 2. ALL CHANGES AND DEVIATION FROM THE DRAWINGS SHALL BE DONE IN CONSULTATION WITH THE DESIGNER. CADD DRAWING DO NOT REVISE MANUALLY NO REVISION BY CHK APP DATE �D ME: Y05-01.dwg PROJECT. ADDITION PREPARER K. Xu 5/19/05 CHECKER Ah CLIENT 47 CRANBERRY LN REVIEWER Global Construction NORTH ANDOVER, MA PROJECT NUMBER DWG NUMBER SHT REV Y05-01 Y05-01 A-0 0 I I I GRAND ROOM ABOVE GARAGE 0. WALL TO BE REMOVED I I 10'-0' I ) BATHROOM 11 BEDROOM AREA TO BE MODIFIED SECOND FLOOR PLAN AROUND AREA CHANGED O¢CHUMMAN �''° �� Xu ORUCTURAL NA1, DWG NO. SHT NO. REV NO. Y05-03 A-1 0 AREA TO BE MODIFIED i EW ROOF,WALL & FLOOR FRONT cu OOF TO BE REMOVED DWG NM SHT NO. REV NO. Y05-03 A-2 0 CROSS SECTION A-A 00 W X M N J 3 J ,,, W 0s M X ' � I N Q W P4 2X8 J❑IST @ 16' Lo z 1ST FLOOR EXTERI❑R xX WALL N OF lyq R` UNJIANxu ti SPRUCTIJRAL NAL NEW FLOOR FRAMING DWG NO SHT NO REV NO Y05-01 S-1 0 FV-4- 0 D � ro x �co n 10'-9' 2X8 RAFTER @16' (2) 2X6 TIE m m 2X10 JOIST @16' 1/2' PLYWOOD 10'-9' 4'-6" 21'-6' OVER EXISTING 10'-0" ROOF SECTION A-A RODE FRAMING OF NU < MUCTURA6 DWG NO SHT NO REV NO ,o C."3.€.,515 Y05-01 S-2 0 90 i�� f., s�OUA9.1rC>�'® w 2X6 TOP PL 1'-a'-- 61_0• (MAX) <2) 2X6 HEADER 2X6 WALL STUD (TYP) 2X6 WALL STUD � I 2X6 SOLE PL (TYP) TYPICAL_ WALL FRAMING WALL_ FRAMING AT OPENING P �A c` C►-ml I+ C; DWG NO SHT NO REV NO Y05-01 S-3 0 �AORTH Tovm-' of S'p — - - �0 &_ L q E dover, Mass., =a —CR o o " 'Q COC HICHEZCK V j. AD RATED P'P*' `L 5 S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THISCERTIFIES THAT....... ..g.A�!! ...... .. ......Ifi�.A..!V ...................................................................................... Foundation l J�PmornY47 ' &P t* .�. L.has permission to erect........................................ buildings on ....... ......... ......................... .............N................ Rough t0 be occupied as...... 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 relatinp to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 4—?/07/ PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR .....00.00 !.. .................. ...g........F.... . .......... . Rough ... . .... ....... ....... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. OL SEE REVERSE SIDEJ1 ' Smoke Det.