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HomeMy WebLinkAboutMiscellaneous - 49 GREENE STREET 4/30/2018 49 GREENE STREET 210/043.0-0005-0000.0 i OMAPFRE The Commerce Insurance Companysm Citation Insurance Company" Commerce " Gore Road,Webster,Massachusetts 01570 INSURANCE- 508.949.1500(www.commerceinsurance.com September 26, 2013 BUILDING COMMISSIONER or Board of Health or INSPECTOR OF BUILDINGS Board of Selectmen TOWN/CITY HALL Town/City Hall NORTH ANDOVER MA 01845 RE: Our Insured: SEAN J MCADAM/MARY ELLEN MCADAM Property Address: 49 GREENE STREET Policy#: BCGZYT Date of Loss: 09/07/2013 File#: HKXN98-YVVWW88 Claim has been made involving loss, damage, or destruction of the above captioned property which may exceed $1Massachusetts 000 or cause General Laws,s, Chapter 143, Section 6 to be applicable. If any notice under Massachusetts General Laws, Chapter 139, Section 3B is appropriate, please direct it to my attention. Please reference the above captioned insured, location, policy number, date of loss, and file number on any correspondence. SUSAN JOHNDROW Telephone: (508)949-1500 Ext: 15193 Sr Claim Representative, Property Toll Free: 1-800-221-1605, Ext:15193 On this date, I cause copies of this notice to be sent to the persons indicated above, at the address above,by first class mail. September 26, 2013 mold from water leak in AC unit CIC 254 (Rev.4/95) MAIL 506 Location qq No. 6? 9 8 Date 8 r C9.- NpRTry TOWN OF NORTH ANDOVER F to 9 Certificate of Occupancy $ CNUS Building/Frame Permit Fee $ Foundation Permit Fee $ s Other Permit Fee $ TOTAL $ d Check # t °� 16021 Y Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING s eclt�oa f6Cvowel, BUILDING PERMIT NUMBER. DATE ISSUED: M 8 8 I/%. far *, DIAL SIGNATURE: Building Commissioner/1for of Buildings Date Z SECTION 1-SITE INFORMATION 0 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided ReqWred Provided v ' 1.7 Water Supply M.G.L.C.401.5. Flood Zone Information: 1.8 Sewerage Disposal System: . �?E � Public 0 Private- ❑ s 'Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System 0 q SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record ,,!�Afr/�2 >C rP�,� Z����d�� <' 'P7- Name(Print) Address for Service: Signature Telephone 2.2 Owner of Record: Name Print Address for Service: O Z M Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: O �^�p License Number leA1 C/Z e,1 wn Address 2oe:Z3 '9 7 lv PL'Lo 7? Expiration Date ic C-s-ignatiffa Telephone r 3.2 Registered Home Improvement Contractor Not Applicable 0 v Company Name f D -0 rn Registration Number r Address 4/y - Z9 - Z od f/ Z Expiration Date ^ Signature Telephone V I SECTION 4-WORKERS COMPENSATION(M.G.L.C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work(check all applicable) New Construction Existing Building ❑ Repair(s) Altesl,. ❑., Addition ❑ t!f'° �a + Accessory Bldg. ❑ De olrtion ❑ Other ❑ Specify Brief Description of Proposed Work: 'e'o^v�� 77/e- F ZM/e zoo-'w e SECTION 6-ESTIMATED CONSTRUCTION COSTS Itern Estimated Cost(Dollar)to be . UF)FIGAAL-USE'.OIL Completed by permit applicant 1. Building (a) Building Permit Fee 4 Doff• Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)X (b) 4 Mechanical (HVAC)O ! 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, ,as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf.in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Prim a e Si ature of Owner/Aent Date 1 13:11031 NO. OF STORIES SIZE BASEMENT OR SLAB r SIZE OF FLOOR TIlvIBERS I ST 2 3 PID SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BU LDING CONNECTED TO NATURAL GAS LINE 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) `ter _ Signature of Perm Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector F. r T ✓��/OO�I77/IIZO'II.C!/P,Q.GLiL 6�i/L�4dCLCitUGP.l�6' , �\ Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 101846 Expiration: 6/29/2004 Type: Individual STEPHEN M.KEISLING Stephen Keisling 68 Glenncrest Dr. N.Andover,MA 01845 Administrator � ✓fie tDar�Urrzaozcue� a�:/�aa:rac�ivaelta BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 027489 Birthdate: 07/16/1953 Expires: 07/16/2003 Tr.no: 12035 -�nncTnnfinn_I`C'� Restricted To: 00 STEPHEN M KEISLING 68 GLENCREST DR KI nk1nnvC0 RAA n4oec Farm DECLARATIONS PAGE 1 CONTRACTORS ADVANTAGE SPECIAL Family Casualty Insurance Company POLICY NO. 2005XO431 ® Gienmont,New York NAME OF INSURED AND MAILING ADDRESS: AGENT NO. 2591 OFFICE NO. 2591 STEPHEN KE ISLING JAMES W UGONE 68 GLENCREST DR FARM FAMILY INSURANCE N ANDOVER MA 01845-1315 10 S MAIN ST STE 208 TOPSFIELD MA 01983-1832 978-887.-8304 RENEWAL TRANSACTION EFFECTIVE 03/21/02 POLICY PERIOD FROM 03/21/02 TO 03/21/03 12:01 A.M. STANDARD TIME AT THE LOCATION THE NAMED INSURED IS: INDIVIDUAL OF THE DESCRIBED PREMISES - BUSINESS,OF THE NAMED INSURED: CARPENTRY—NOC LOCATION OF DESCRIBED 68 GLENCREST DRIVE PROTECTION CLASS IS: 04 PREMISES NO. 01: N ANDOVER MA 01845 CONSTRUCTION- IS: FRAME PREMISES 01 BLDG 01 BUILDING MATERIALS / EQUIPMENT STORAGE BUSINESS PROPERTY COVERAGE: LIMITS OF TERM ADDL/RTN INSURANCE PREMIUMS PREMIUMS BUILDING 0 0 0 BUSINESS PERSONAL PROPERTY 5,000 46 46-- BUSINESS INCOME AND EXTRA ACTUAL LOSS SUSTAINED NOT EXPENSE EXCEEDING 12 MONTHS INCLUDED INCLUDED BUSINESS LIABILITY COVERAGE: BUSINESS LIABILITY - PREMIUM IS SUBJECT TO AUDIT BODILY INJURY/PROPERTY DAMAGE 500,000 PER OCCURRENCE 1,000,000 AGGREGATE 500,000 AGGREGATE FOR PRODUCTS - COMPLETED OPERATIONS HAZARD MEDICAL EXPENSE 5,000 PER PERSON FIRE LEGAL LIABILITY 50,000 PER OCCURRENCE CODE DESCRIPTION PAYROLL TERM PREM ADDL/RTN 91342AA CARPENTRY—NOC 20,000 379 379 THE LIMIT OF INSURANCE FOR THIS BUILDING SHALL BE AUTOMATICALLY INCREASED BY 5% ON AN ANNUAL BASIS DURING THE POLICY PERIOD. ACTUAL CASH VALUE (ACV) — BUILDING OPTION DOES NOT APPLY. DEDUCTIBLE: $250 DEDUCTIBLE APPLIES EXCEPT WHERE NOTED IN THE POLICY OR ENDORSEMENTS. COUNTERSIGNED BY: BF 30 05 01 98 INSURED COPY PROCESSED DATE: 02/15/02 O OED f over No. CP - oma S 0 L COCHICA over, Mass.,. ORATED P' CD BOARD OF HEALTH Food/Kitchen PERMIT T Septic System THIS CERTIFIES THAT....A"ot..*:'a..114.......2... 61%ow BUILDING INSPECTOR ........................................................................ Foundation has permission to erect-Row'.411.10#4010**1*.. buildings on ......14--ct.........&^4A.W. ...........so.*.m...... Rough ...... 14 . Chimney to be occupied as..... 1Z..A.w*.4\........t. . ......... . . .........C 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 B La �s relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. s4 i 7,r 4 e' s-"0000W 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 Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Date. A ti 4.0�T" , TOWN OF NORTH ANDOVER 3� •, �Z. 40 a PERMIT FOR PLUMBING ,SSACNUS� This certifies that . . . H. . . . . . . . . . . . . . . . . . has permission to perform . . . . . .R.'� . . `. . . . . . . . . . plumbing in the buildings of . . . .�. .. .t.. . . . . . . . . . . . . . . . . . . . . L( 4' at. . . . . .7. . . . . . . . . . . . . . . . . . . . . . . . . . . . ..I North Andover, Mass. Fee. Lic. No.. . . . . . . . . . . . ... . . PLUMBING INSPECTOR Check # 5438 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date Building Location y Cf G2 ---' -ey- 5-t— Owners Name f ' w Permit# ti/ �.-'` Amount '; p Type of Occupancy New Renovation Replacement [Er", Plans Submitted Yes No ❑ FIXTURES F* Cn o z W w a o a x �.. W W �, Z 0* 00 H w w A a a z A O z w w `" a o � SLRME 1V Nr ],S]C Frit MIMM e M FLOOR 4M FLOOR 5M FIDOR M FLOOR I MID 7M HA" SIH FLOOR (Print or type) r Check one: Certificate Installing Company Name f S Y/2�-nt e � ' Corp. Address .51/ Go 'x F6 h - ! Partner. '--,1�0 rl',4) D .'-SIL- `iLr'i/a Business Te ep one 0—Firm/Co. Name of Licensed Plumber: 60 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 . Signature Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installatio s performed under Permit sued for this plication will be in compliance with all pertinent provisions of the Massac-h�tts to PIumbing,lde andC pter 142 e General Laws. By: i a re o 1ce113QU I JUJIJUP Type of Plumbing License Title City/RO icense um er Master Journeyman ❑ APPROVED(OFFICE USE ONLY Date. . ' N� 45 � � 7 i E � �.<"o T �4,0 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSAcmUS� This certifies that . .�.*. . . . . . jthat . . . . . . . . . . . . . . . . . has permission to perform . . . . . . .;. . .p. . �.,� plumbing in the-buildings of . : �--✓z� !- -''�. . . . . . . . . . . . at . 1. . .� . . . . . . . . . . .„North Andover, Mass. Fee . . . . . .Lic. No.. . . . • • • • • �Pcunnel INSPECTOR Check Check # WHITE: Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date ©� Building Location GreaK-R, Owners e. v Permit# _ Amount Type of Occ an New Renovation Replacement Plans Submitted Yes No El FIXTURES FLna >4 0 9 w x a a Cn ►- W H W H � r., �., H U W w w a a A x Ha A x a loo. E• d w w d x a A a a d SLRBM %SE" T J MII'1m —ZDR9R FLOOR 4IH RfXR SIH FLOOR 6IHRfXR 7IH FLOOR SIH HD(R (Print or type) �j Check one: Certificate I istalling Company Name �',' r► + Wq Corp. Address 4111 �artrier. mm, oz/To Business Telephone Firm/Co. Name of Licensed Plumber. &'71clae) S- er � Insurance Coverage: Indicate'the type of insurance coverage by checking the appropriate box: Liability insurance policy El------' Other type of indemnity ❑ Bond Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature , Owner Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of;3;pa, us State bing Code and Chapter 142 of the General Laws. By: icense um er p Plumbing License Title City/Town icense u�i ear Master Journeyman APPROVED(OFFICE USE ONLY Location AjC- i NO. ��� Date 1 '� NORTI� TOWN OF NORTH ANDOVER 1 i * i ; . Certificate of Occupancy $ r �SSACH <�' Building/Frame Permit Fee $ F Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # I l 15584 Building Inspector PERMIT NO. 013 APPLICATION FOR PERMIT TO BUILD********NORTII ANDOVER, IVIA ,. AIAPNO. ® 4/3 LOTNO. C)6&_6-- 2. RECORDOFO\1'NERSIIIP DATE BOOK PACE "LONE ,.571111 DIY. LO'ENU. LOCATION S'�PNe T PURPOSE OF BUILDING OWNER'S NAMEv� NO.OF STORIES SIZE OWNER'S ADDRESS i/9 6;e-e,-)e- BASEMENTORSLAB ARCHITECT'S NAME T SIZE OF FLOOR TIAIDER$" 1 2ND 3 Illlll_IIER'S NAME kms' Ke Ls t�� SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET DIMENSIONS OF POSIS DISTANCE FROM 1.0T LINES-SIU ES REAR DIAIENSIOHS-OFGIRDERS AREA OF LOT FRONTAGE HEIGHTOFIFOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING l IS BUILDING ADDITION AIATERtALOFC111A1NE1' IS BUILDING ALTERATION IS BUILDING ON SOLID Olt FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS DUI-DWG CONNECTEh TO TOWN WATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER i' IS BUILDING CONNECTERTO NATURAL GAS LINE INSTLI&IONS I PROPERTY 1NFOliNIA"TION LAND COST t EST. BLDG.COST Saoo. 00 PAGE 1 FILL OUT SECTIONS 1-3 EST.BLDG.COST PERS . FT. EST.BLDG.COST PER ROOM ELECTRIC METERS MUST DE ON OUTSIDE OF BUILDING SEPTIC PERAII'f NO. i ATTACIIEI)GARAGES MUST CONFORM TO STAI'F FIRE REGULATIONS 4. APPROVED Ill: C PLANS MUST BE FILYD AND APPROVED 01'BUILDING INSPECTOR D111l.DING INSPECTOR DATE FILED' OWNERSTELII Dial_ CONTR.TELN (o2- ZO 7 Z .. k s CON"fR.LICw 0 .; 7 qF9 \V SIGNATURE OF-ONER OR AUTHORIZED AGENT FEE $ ��. ILLC.11 /O/,:P qr!D PERM IE GRAM ED Revised 5/5/99 JAI DECLARATIONS PACE 1 arm CONTRACTORS ADVANTAGE SPECIALY , Famil Casualty Insurance Company POLICY NO. 2005X0431 ® Glenmont,New York NAME OF INSURED AND MAILING ADDRESS: AGENT NO. 2591 OFFICE NO. 2591 STEPHEN KEISLING JAMES.W UGONE 68 GLENCREST DR FARM FAMILY INSURANCE N ANDOVER MA 01845-1315 10 S MAIN ST STE 208 TOPSFIELD MA 01983-1832 978-887-8304 RENEWAL TRANSACTION EFFECTIVE 03/21/99 POLICY PERIOD FROM 03/21/99 TO 03/21/00 12:01 A.M. STANDARD TIME AT THE LOCATION OF THE DESCRIBED PREMISES THE NAMED INSURED IS: INDIVIDUAL BUSINESS OF THE NAMED INSURED: CARPENTRY-NOC LOCATION OF DESCRIBED 68 GLENCREST DRIVE PROTECTION CLASS IS: 04 PREMISES NO. 01: N ANDOVER MA 01845 CONSTRUCTION IS: FRAME PREMISES 01 BLDG 01 BUILDING MATERIALS / EQUIPMENT STORAGE BUSINESS PROPERTY COVERAGE: LIMITS OF TERM ADDL/RTN INSURANCE PREMIUMS PREMIUMS BUILDING 0 0 0 BUSINESS PERSONAL PROPERTY 5,000 74 74 BUSINESS INCOME AND EXTRA ACTUAL LOSS SUSTAINED NOT EXPENSE EXCEEDING 12 MONTHS INCLUDED INCLUDED BUSINESS LIABILITY COVERAGE: BUSINESS LIABILITY - PREMIUM IS SUBJECT TO AUDIT BODILY INJURY/PROPERTY DAMAGE 500,000 PER OCCURRENCE 1,000,000 AGGREGATE 500,000 AGGREGATE FOR PRODUCTS - COMPLETED OPERATIONS HAZARD MEDICAL EXPENSE 5,000 PER PERSON FIRE LEGAL LIABILITY 50,000 PER OCCURRENCE CODE DESCRIPTION PAYROLL TERM PREM ADDL/RTN 91342AA CARPENTRY-NOC 15,600 276 276 THE LIMIT OF INSURANCE FOR THIS BUILDING SHALL BE AUTOMATICALLY INCREASED BY 5% ON AN ANNUAL BASIS DURING THE POLICY PERIOD. ACTUAL CASH VALUE (ACV) - BUILDING OPTION DOES NOT APPLY. DEDUCTIBLE: $250 DEDUCTIBLE APPLIES EXCEPT WHERE NOTED IN THE POLICY OR ENDORSEMENTS. COUNTERSIGNED BY: BF 30 05 01 98 INSURED COPY PROCESSED DATE: 02/02/99 � HOME bR `OVE�I�NT SON,Iz�r;OR e ist'rati4 10'184: , Ex r��TNDIVIDUA �6/29J00 STE HE .:M. K€IIILIN6' �{ �- 68 Glen�,nc�res Dr�. TiD1iAINISiRATOR' _ l— ��N s•qi--JY^w��)s . lee{ooirtinaMvea�/i o �/�aaoac�ivae!!a ' BOARD OFBUILDING REGI ATIONS Licetue CANSTRUCTION-SUPERVISOR m 027489 uber Bi M. 953 Expires:0719612001T >Tr no:( 1.1.352 c x1 W 5 , STEPHEN�MICEIS[ NO '68�GL•ENCRE57"DR`�;:'��.,�i '' a ,t,,,...-.�.�. x:- N ANDOVERMA�01845; s z �Admmistrator � R• ,S tR' �Y i'�.-.. "..�..�'?�.f�..�.��-�r.1 JR R,7.: P { . i l Page No. of Pages STEPHEN M. KEISLING D Building & Remodeling 68 Glencrest Drive NORTH ANDOVER, MASSACHUSETTS 01845 MA Lic. 027489 Home Impv. 101846 Phone 682-2072 PROPOSAL SUBMITTED TO PHONE DATE c ' STREET Q r JOB NAME el/ CITY,STATE and ZIP CODE JOB LOCATION ARCHITECT DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: stl..�, R.�'M2yJ......_`...C,r,�L~ —Q..... CX���J2� �C ....._ '_�vw�C . C����......... �................. ... /- ......................�,...................... _ �.................... c9rn. / Gt S OT (IYJ O( ........!^._ ....-c. ........... /'�•��"' Cz-r`.......................................... o s .........................._ ..... =...........-.............. .......... .................................................. ............................... . ........... ........................... ............................................. .. ............................ 6141-e- ...............P.............................................:-._ a-e '. ...,, ..._ ..................................... ...........'..._..c, .......... Q .. u .............. .................. �.._................................. ...... ......................................................................... r d'a,41 w– x"130, °O .........._.._ ul... `crr - ............� .0 c � . -� 1f. L , ............ ........................,...................... ............ *,-,*-*3, .._ .... ..., -..� .......�� -;... - ..................................................................................................................................................................................................... ..............................................---........................................................................................................................................................................................ ............................... ........................................................................................................................................ &.t a ...�-a, - -,�- _-... 4 ........................................" 2. ..ti........................... ............................................................................................._............ ............._..___....._...........J................................ ......... ........................................ ....................................................2�.................. .v.............................................................................................................................................................. We pr0P089 hereby to furnish material and labor—complete in accordance with above specifications, for the sum of: dollars($ ). Payment to be made as follows: �a13 0, o a�� 1 All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices.Any alteration or deviation from above specifications Authorized involving extra costs will be executed only upon written orders,and will become an extra Signature charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control.Owner to carry fire,tornado and other necessary insurance. Note:This proposal may be withdrawn by us if not accepted within days. Our workers are fully covered by Workman's Compensation Insurance. 3y da . />rAcceptance of Proposal —The above prices,specifications and conditions are satisfactory and are hereby accepted. You are authorized Signature to do the work as specified Pay nt will be made as outlined above. 611) Date of Acceptance: Signature riroCKWay-.-f0mnn company . nde!'Sen Brosco Architectural Group C. Indo alis Serving Greater Northeast Architects since 1890 jTj if�P vv Office and Exhibit Area: 146 DASCOMB ROADe (Route 93-Exit 42) 800-225-7912 , ANDOVER,MA 01810 FAX (24 hours) 800-242-4533 COMMERCIAL - RESIDENTIAL DATE JOB # , E I i i f i 1 i I { � l ; ..__......j-..�._..I # i� � i , '� 1 � f j —L�11 f t } 4 i v E # f } mm S V E # S E 1 i E ! e t aiJk'. .2 10 s. r_u.e u w4iiA6 � .o49e1 rJ r�.c.e. .,.__ 1 .cG je e7 �n9�a�.0�—.VP.�.0 �11f113�� I I ENTRY DOOR SYSTEM Andersen "Rain Sensitized" I ( I Wood and Steel Automatic Closing Hinged French Patio Doors ROOF WINDOWS NORTH Town of Andover O ,..,.i.W TO No. (00 dover, Mass., O 0700 O C OC HICHEWICK k4 RATED pPP\��CC BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT....... ....... V.........�...l..t.o..4. �.................................................. .......... Foundation has permission to w0kM6� ..I.... buildings on .........�.1.....G.1%.%.T.".1p...........�.�...... Rough to be occupied as...n1A s � ..r`0 ..... .. 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 y 3 PERMIT EXIR PES IN 6 MONTHS Final P UNLESS CONSTRUCTI N AR- ELECTRICAL INSPECTOR SC Rough ...... Service . .......A3 1 .4 BUILDING INSPECTOR Final Occupancy Permit Required t0 Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det. 663 NORTH 3? �� TOWN OF NORTH ANDOVER o PERMIT FOR WIRING ,SSACMUS� co �` . r This certifies that .......:.J...a...�.�1. P .� .......+ .?..`..... .......:. .....: ........ ." has permission to perfor> ..v e .4.e..... ..G<<4.... �. wiring in the building of .4n.t.f,C' ... .......................... .... ,North Andmer,-Mass: Fee..SA.::..0).. Lic.No. ;. ELECTRICAL INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer ' The Commonwofttee use onlr ealth of Massachusetts � �_ ►er•ee so. Dcpart cnt of Public SajdY �. Ocwpaner t fee amekd BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12003/90 (leave blank) 'i APPLICATION FOR PERMJT-.TO PERFORM ELECTRICAL WOR All Work to be performed In accordance with the Ma"achusetu Dearieal Code,527 CMR 12:00 (FLEA-SE. PRINT IH INK 0)1: Date City or To,= of V To the Inspector of Wires: . the undersigned applies for a petit to perform the electrical, work described below. Location '(Street b R=ber)_ / /i2eP�1/ 0-mer or }Ienant Owner's Address ,SQ✓►ee- Y 9 Qi/l(�il/ S 2P�f Is this permit in conjunction with a building permit: Yes ❑ No ❑ (Check Appropriate Box) r 6 Purpose of Building_ S/ ( �/�/ (� Utility Authorization NO. �C? `f /,•, �•/L� Existing Service Arps / Volts Overhead ❑ Undgrd❑ No, of Meters Fev Service Ames / Volts Overhead ❑ Undgrd ❑ No. of Meters N=ber of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of LightinK Outlets No.,.of Hot Iubs No. of Iransformers Total RVA No, of Lighting FixturesSvicming'Pool Above In- grnd. ❑ grnd, ❑ Generators KVA No. of Receptacle OutletsNo'. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch OutletsNo. of'Gas"Burners FIRE ALARMS No. of Zones No. of RangesNo.`'of Air Cond. Total No. of Detection and tons Initiating Devices r No. of Disposals Ho..of,Heat Total Total Puays T s No. of Sounding Devices No. of Dishwashers Space/Area•Nesting KW No. of Self Contained Detection/Sounding Devices- No. of ers (,Municipal Heating Devices KTJ Local�-+ Connection❑Other No. of Water Heaters Sig sf Ballasts LOW voltage +' " trine ! , No. Hydro Hassage Iuba `lo. cf.Motors Iotal HP r nr-n f - INSlinANCE CCVE.RAGE: ihrsuant to the requirements of eassachusetts General Laws I have a current Liabilit Insurance Policy including Completed Operations Coverage or its substantial equivalent. . YES(] NO I have submitted .valid proof of same to this office. YES❑ HO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE QTBOHD ❑ OTHER❑ *(Please Specify) Esti=ted Value of 'lec_;ical Work S piration accl Work to Start )a I a O Inspection Date Requested: Rough� 1 � C a I �. Final tA?r I (Ch li r Signed under the penalties of perjury;,.`:, ., FIRS NArmeS� R o �3os 1� e� � CdNZ24�7�yrf s LIC. NOAZA02192 n Licesee S, 1 VIOAKn Signature;�grrd �, u - LIC. NO.E 3, Address R b ani )) � nn ;/.. YW3 SS bal�'3 Bus. Tel. Ho.�7d�- 77V Alt. Tel. No. H2,39s-3a8Q itznt $ IHS `UivaleLANCZ WAIF✓ : Z asa.avace`[hat the Licensee does not have the insurance coverage or its suo- scarst:al equivalent ss required by.Ma}sachuaetta General vs, and that my signature oil this permit application waives this requirement. '.0vner Agent (Please check one) ":telephone ''.o. "CT®i i/CJ Date. . N° + 259 TOWN OF NORTH ANDOVER ° p PERMIT FOR PLUMBING � o •"a This certifies that -_•�-'^' �'� r has permission to perform . . . . �?. . . . . . . . . . . . . . • • . . plumbing ing buildings of . . . . >-' "?' ".. . . . . . . . . . . . . . at . /. . . .. .... .. . . . . . . . . ... . .. North Andover, Mass. FeeNor. . . .Lic. No Q26. . . . . . . . . : . .. G! . .'. . . . . . . . . . . "PLUMBINGINSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBINGF.__.._.,__-_ .-(Type or print) - NORTH ANDOVER,MASSACHUSETTS v � �- 22 ! Date �- .� /'Owners Name �� �J I` d Permit# ' Building Location � �2- - �- Amount T e of Occupancy New ❑ Renovation Replacement ❑ Plans Submitted Y - No -® - FIXTURES - Ln Ln z z F ra — W � x U z <W W d W Cn a � W q a q a a SLREM ISE FlaR - 2PII FIOQt 4IH F19R 5M H_00R M FLOCK 7IH FIOQ2 8IH FLOQ2 - (Print or type) fi Check one: Certificate Installing Company Name =�1 r- /� �L ❑ Corp. Address ,..r�i� 1 �yz- J Partner. Business Telephone j _4' �-��� Finn/Co. `< Name of Licensed Plumber. Insurance Coverage: Indicate the type of insurance coverage by checking the appropnate 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 - rgnature 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�u7settsleffijfhbkgC s p ed under P it Issued for th' applicati will be in compliance with all pertinent provisions of the Mass tode an Chapter 142 o e Laws. By: M—gn=ot Licenseaum er Type of Plumbing License F Title �p City/Town license urn er Master Journeyman APPROVED(OFFICE USE ONLY s 366 ? G Date . ./ .....�.... f 3?�. r``° a"o,� TOWN OF NORTH ANDOVER PERMIT FOR WIRING t. �,SS^CMUS� r This certifies that 3..iA has permission to perform X 1. ©. ... . �c. .......................................... s wiring in the building of....... ... 7.'..` `1............................................ at....... ...... �.P!1..... .: ...................... .North Andov�_ ass. Fee3..(.�.0..... Lic.No ,1 y ... ....... ....... ELECTRI AL IN ECMRf Check # -- -� �- - =� (.,ommonweafk ol) addach dej/1 OCficial.Use Only 5 N-09 2eparintenj o`,}ira Servicae Permit No. BOARD OF FIRE PREVENTION REGULATIONSOccupancy and Fee Checked . Rev, 11199] ticave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be pert'ormed in aecordance with the Massachusetts Electrical Code(rimEC),527 ChIR 12.00 (PLEASE PRINT IN INK OR TYPE:iLL /t f ORLL 1770N) Date:- le, Z City or Town of: /(wA d, To the Inspector of FYu es: By this application the undersigned gives notice o ti Location (Street S Number) s or h intention to perform the electrical work described below. rcen" Owner or Tenant 21hA n Telephone No. Owner's Address O-YYN t Is this permit in conjunction with a buil ing,permit? Yes ❑ No C (Check appropriate Bos) Purliose of Building - • Utility Authorization No. Existing Service Amps / 1'oits Overhead ❑ Undbrd ❑ No.of Meters . New Service Amps / Volts Overhead❑ ❑Undord b 1'0.of,Meters. Number of Feeders and Ampacity r Location and Nature of Proposed Electrical Work: IL) �- 11h 6G !�J t Cont letion o(dte follouill table nzav be waived by the Ins cctor of I vices. No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans of Total- Transformers "Total Transformers KVA No.of Lighting Outlets No.of Mut Tubs Generators KVA No.of Lighting Fixtures Swimmino Pool Above ❑ In- ❑ t o.o Emergency ig tang ornd- rnd. Battery Units No.'of Receptacle Outlets No.of Oil Burners FIRE ALARt1IS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. TotTons No.of Alerting Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Sclf-Contained Totals: Detection/Alertina Devices No.of Dishivashers Space/Area Heating KW Local ❑ tilunicipal ❑ Other Connection No.of Dryers Heating Appliances I{1�; Security Svstems: No.of iVater No.of No.of No.of Devices or Equivalent HeatersKiv Data.✓iriug: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No. of Motors Total IIP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. INSUR. NCE COVERAGE: Unless waived by the o,.vner,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 iil force,and has exhibited proof of same to the permit issuing office CHECK ONE: INSURANCE ,� BOND ❑ O'I'LIER ❑ (Specify:)�-a, — lxz�sr� �;Z/ D3 Estimated Value of E. cirical Work: (When required by municipal policy.) (Exiration Date) Work to Start: !� Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certifj,, ander the it •and penalties ofperjury,that the information on this application is trite and complete. FIRM NAME: � �c�cJ 7-101'C LIC.NO.: 33 Licensee: S, /�. fc//�,;� �/2 Signature L1C.NO. (/f applicable, enter "er nrpt"in the license number line.) Bus.Tel.No.: Address: Shy /,L/C��2//j'(b /Ce/1Z� A�A/pDdC2 - OWNER'S INSURANCE"WAIVER: I ani aware that the Licensee docs not7rdie the liability insurance coverage normally required by law. B% my signature below, I hereby waive [his requirement. I am the(check one)C] o«mer ❑ owner's assent. t. Signature •I•elcphore No. Pi:R:1fIT I'L'L: S