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Miscellaneous - 50 BRIDLE PATH 4/30/2018 (2)
50 BRIDLE PATH 2101103.0 01140000.0 9766 Date.. Th TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING AC This certifies that ...... ....ez ...`-r,........z-;/—..4. ..... has permission to perform ..........&ILA.14�he..M�k4��fl wiring in the building of.... ....................................... at............ ........ North Andover,Mass. �Fee.—I..... ......... Lic.No. .7;.................A�. .......... ... ... ........ RICAL NSPE , R Check # -7. •`' � 6,UJJJJ71(1'11VVVa1&11 UR Permit No. �7 - Department of Fire Se9'vffces Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leaveblank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL, WORD All work to be performed in accordance with the Massachusetts Electrical Code(7c),527 CMR.12.00 (PLEASE PRINT WINK OR TYPE ALL INFORMATION) ]Date: �Da 9/� D 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) �(� rr��e 1 ccv 1 Owner or Tenant A V q i g 1 i f O �i G�o.t r,! Telephone No.9 21-ase-�oW2. Owner's Address Is this permit in conjunction with a building permit? fires ❑ No (Check Appropriate Box) Purpose of Building 1`eS t d e Utility Authorization No. Existing Service-ADD Amps / a4-(Volts Overhead❑ Undgrd No.of Meters New Service a40 Amps 1.10 / 1E10 Volts Overhead❑ Undgrd Ll-�No.of Meters Number of feeders and Ampacity A Location and Nature of Proposed Electrical Work:' Replace lst: &ty-e V,,la ,- ry nb R de..C.!' TrnS�t 1x new PVC P1 PQ f yr * Co'Auc--lora - "J 4PPre-A3GO Completion of the followtng table may be waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA Above El In- o.o mergency ig ing No.of Luminaires Swimming Pool rnd. rnd. Batter Units No.of Receptacle Outlets No.of Oil Burners FIREALARMS No.of Zones No.of Detection and No.of Switches No.of Gas Burners Initiating Devices Total of Alerting No.of Ranges No.of Air Cond. Tons No. g Devices HeatPump Number Tons.,, .KW .__. No.of Self-Contained No.of Waste Disposers Totals: Detection/Alert Devices Municipal No. of Dishwashers Space/Area Heating KW Local❑ Connection El Other Heating Appliances Key Security Systems. No.of Dryers g pp No.of Devices or E uivalent No.of Water No.of M.of Data Wiring: Heaters KW Sins Ballasts No.of Devices or E uivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total IIP No.of Devices or Equivalent OTHER: -Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: p2 (When required by municipal policy.) /0IZgl' Work to Start: /I 1 o Inspections to be requested in accordance with MEC Rule 10,and upon completion. I' INSURANCE COVE 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 cooveraa is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE tf� ttOND ❑ OTHER ❑ (Specify:) I certify,under thepains andpenalties ofperjury,that the information on this application is true and complete. Ad FIRM NAME: O LIC.NO.: aQ�l 7.3 e. Licensee: fey Gauo� "� Signature LIC. S0.1Z E (If pp STS7-SOy-agss' a Izcable,a ter"exe z t' in the license number line.) Bus.Tel.No.: �-_ Address: .37 ArO"+y <d aver I i `i+#1g 0 MA 61803 Alt.Tel.No.: *Per M.G.L c.147,s.57-61,security work requires Department of Public Safety"S"License. Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's Owner/Agent PERMIT FEE. $ Signature Telephone No. d �� �' - 1G - C sl � The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 600 Washington Street Boston,MA 02111 wk 5�•. www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le i�b� Name(Business/Organization/Individual): &ya, C(, Address: PM City/State/Zip: 6uf 1lMAtA nthyl$U-s Phone#: —3 1 Sd Are yo employer?Check the appropriate box: Type of project(required): 1. am a employer with —3 4. ❑ I am a general contractor and 1 6. 0 New construction employees(full and/or part-time).* have hired the sub-contractors 2 ❑Remodeling 2.❑ I am a sole proprietor or partner- listed on the attached sheet.I ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its 10.0 Electrical repairs or additions required.] officers have exercised their right of per MGL 11.❑Plumbing repairs or additions exemption 3.❑ I am a homeowner doing all work g p p myself. [No workers'comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]t employees.[No workers' 13.0Other comp.insurance required.] *Any applicant that checks box#l1 must also fill out the section below showing their workers'compensation policy information. I Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and jab site information. Insurance Company Name: Policy#or Self-ins.Lic.#:A(a —k1 EG— TLl— 7:7 Expiration Date: � ( �.Dl r' '-- A Job Site Address: S C) 16 r r i P /PG} �+ City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DTA for insurance coverage verification. Ido hereby certify under the pains and enalties of perjury that the in oration provided above is true and correct. Signature: Date: LD '9 Phone4: 7 ^ Lo Q �(3 r- Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License i 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#: Location -j r�ele /�x A No. (p Date MOR7M TOWN OF NORTH ANDOVER f 4 y �° ;s Certificate of Occupancy $ Building/Frame Permit Fee $ " +tNus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 6 Check # C U 6450' /Jq& f Building Inspector -f I� TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY G DWELLIN . � N ��p BUILDING PERMIT NUMBER: DATE ISSUED: _ �a.. ® 3rn � M SIGNATURE: C(� Building Commissioner/InspecTor of Buildings Date Z SECTION i-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: ap Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: i Zoning District Proposed Use Lot Area 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.40.§54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private 0 Zone Outside Flood Zone ❑ Municipal D On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT m 2.1 Owner of Record f E7ER O`/x`6/4 50 IFRIAOU-5-- PAS � Print) �y Address for Service: Si re 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 0 Z ,Plzov /I')4zl wo (o ff Licensed Construction Supervisor: O W// n 10 JoAl Y1 Ve L-k-F Mo�ai License Number y'7 �'f � �-9 Ge/f7V TI dress 97f--4f6--,3037 X71 9b2-3 by Expiration -®� xpiration Date Si re Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name m Registration Number 16 lrL)01&Aj ` r 4f!ft1 15J" r 9-11-63 11_63 wry Expiration Date ^` Si G) n e Telephone 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......Ar No.......❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition Air Accessory Bldg. ❑ Demolition Other ❑ Specify Brief Description of Proposed Work: fioolnoN 11\✓C44S1A16- J/Zc 6F &�X4T4Ki6 ,WZY-�&v .., SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be UFFICI I:.USE ONIS' Completed by permit applicant 1. Building ( )(a) Building Permit Fee Multi lier 2 Electrical � (b) Estimated Total Cost of Construction 3 Plumbing ae Building Permit fee(a)X(b) 4 Mechanical HVAC g �q© 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, DIVEIL ,as Owner/Authorized Agent of subject property Hereby authorize MAATJ1tk to act on lf, all matter rel e to ork authorized by this building permit application. 21-0� Si i of Owner Date SECTION 7b OWNEIVAUTHORIZED AGENT DECLARATION I, !,>fiX1t61,l 1A417,TIA10 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 Print e " L Si nature Owner/A ent Date s OR MM NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TUVMERS 1 2ND 3 SPAN / DlfvTNSIONS OF SILLS DMNSIONS OF POSTS DIIvMNSIONS OF GIRDERS FIEIGHT OF FOUNDATION TFIICKNESS SIZE OF FOOTING —7 f AswX MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION APPLICANT LD,q21?F-,'J /YI{}TLT//lZ PHONE �71f-6�5-303T LOCATION: Assessor's Map Number--/-v--3 PARCEL SUBDIVISION LOT(S) STREET R�'0 ST.NUMBER�® ************************* *********OFFICIAL USE ARECMENDATIONSO OWN AGENTS: I CONSERVATION ADMINISTR OR DATE APPROVED lS fI DATE REJECTED COMMENTS 5 s� A/ViC4 z TOWN PLANNER TE APP VED ATE REJECTE d s _� S, PR 1 X003 COMMENTS OZ ��/ N 'C,, ER _ I/VI �l� ni► IN f�N ! reF✓F� {Tlulhr FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS-SEWERAVATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 im RECEIVED Town of North Andover NaR*M Office of the Planning Department JUN 1 0 2003Community Development and Services Division t _ 27 Charles Street NORTH ANDOVfa Ra`" �ysS,CH PLANNING pP-ARTMENT North Andover,Massachusetts 01845 "5 Planning Director. hn://www.townofnorthandover.com p (978) 688-9535 J.Justin Woods jwoods@townofnorthandover.com F (978) 688-9542 June 4,2003 C. Peter&Caroline O'Neil —� 50 Bridle Path z No Andover,MA 01845 > �? �rgo47, CD RE: 50 Bridle Path Waiver of Watershed Special Permit Assessor's Map 103,Lot 114 ," 7�? Dear Mr. &Mrs.O'Neil: C On Tuesday,June 3,2003,the Planning Board voted on the following motion: Andes motion to grant a waiver per Section 4.136(8)of the Zoning Bylaw,last amended December 2002,to Peter&Caroline O'Neil to convert an existing three-season porch to living space at 50 Bridle Path,as approved by the Conservation Commission on November 22,2002. 2nd by White. Discussion:None. Motion carries 4-0. The Board found that the project met the conditions of Section 4.136(8)of the Zoning Bylaw,and accordingly,you must agree in writing that: 1) The Town Planner can perform a minimum of two inspections during the construction process to ensure proper erosion control is established during construction;AND 2) The Town Planner can stop construction if the proper erosion control is not in place. Kindly sign this form in the space provided below to acknowledge acceptance of these two conditions and an original copy to office. i � A eter O'Nei Caroline O'Neil Thank you in advance for our prompt return of the signed copy and please feel free to call me if you have any additional questions. Sincerely, ti 0 m OOds c JC3v: Community Development Dir. Health Administrator Applicant co > T r Conservation Administrator PI Board Engineer �r.2l'M1 Planning ngin -D .rrr,o Director ofPublic Works Police Chief Assessor <E Building Commissioner Fire Chief Clerk > w BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 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: N/f (Location of Facility) Signature of 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 The Commonwealth of Massachusetts 9 � Department of Industrial Accidents Office of investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Name Please Print Name: 7 A U6AJ Location: 50 ;3/Z/04t PA171 /U. /9/JO 6 u I City Phone # I am a homeowner performing all work myself. 1 am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for my employees working on this job. Company name: Address City: Phone#- Insurance.Co. Policy# 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 s1,5op.op and/or one years'irriprisonment-as_vte[Las_civil,penaltiesin2helbrnrfa_STQP.W—ORK-ORD.ERand-afne�f_�$1- DD)�riay�gair�stme I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. l do hereby der the pains and penalties of p 'ury that the information provided above is bye and correct. Signa# a Date Print name � IZ�L�iU /I�JT�/l�t) Pbone# Official use only do not write in this area to be completed by city or town official' City or Town Permit1lkensing . , .� _ ,... _ . . _ , _ ., ,` ;,','�. _.:. c . ❑ Building Dept OCheck if immediate response is required Licensing Board • p Selectman's Office Contact person: Phone#. E] Health Department ED Other i _ e �f f Mgcti PROFESSIONAL P.O. BOX 958 i ALv ORE J. G,r STRUCTURAL ENGINEERING E. HAMPSTEAD, NH 03826 o M CCIIq DESIGN SERVICES R CTU (603) 329-5540 No 33287 FAX (603) 329-6406 RESIDENTIAL• COM o SS CIBC /ONAL TITLE � � ��.`. l `S i»��1C, EST •�j 2 `d l ` , A � JOB NO . lk tie- J SUBJECT ! - ' 6A.me;w-Te~ SHEET N0 . DESIGNED BY DATEe.1&43 CHECKED BY DATE__ 1S1�-1�c„ i w1.,w� `TrL��� 'Y"<'I�-�''I�`�,. �...0� I tam. -��.��►�.. ��'!1 Z! -TTI C ri.aarlQ. r �� nPLP IFL72� 4 aAc$ lbxt XF ,[. 40 =x 1U �O X USI tt� �c ° S K = S 1. i 7L, 1"I�;� j �4 �/'04 S OF SA ATOc� PROFESSIONAL P.O. BOX 958 0 IA .� STRUCTURAL ENGINEERING E. HAMPSTEAD, NH 03826 ST RAS y DESIGN SERVICES (603) 329-5540 33287 FAX (603) 329-6405 9E IST ER �C. ',® WUVLt' A"7 H RESIDENTIAL• COM ER F6 wa �� a , Meq TITLE , �� d � . JOB ) NO SUBJECT `F�c. w.� 'T SHEET NO . DESIGNED BY ATE 2 NECKED BY DATE__ Ir I C'� > 11 j ale-. Aj- ?V�,b 0 L 9 f_ ZX16�16 4C. - NF►� �,�-rc.h�-tea WIQ4I-EN rL�s �Lt� ar w OF J9'LC• cy PROFESSIONAL 5 VATORE J. STRUCTURAL ENGINEERING P.O. BOX 958 MOCCIA 4 DESIGN SERVICES E. HAMPSTEAD, NH 03826 " STRU U (603) 329-5540 AA N� O � FAX (603) 329-6406 RESIDENTIAL• COMMER I S/ONAI TITLE __ � ) IJ4_�� ��-${�6�C-lq EST •1 NO . •{ JOB SUBJECT � � � SHEET NO . DESIGNED BY DATE-Lb CHECKED BY DATE_ �Z /*'% --tv4sq ��.�.-c-�..� �acs Gn,-r�n►� ?Avl A�� S 11x`1 ?t�6 t S � 1 "' eT�J'd.0• tH OF A PROFESSIONAL STRUCTURAL ENGINEERING P.O. BOX 958 LVATORE J. DESIGN SERVICES P� E. HAMPSTEAD, NH 03826 CjQ1 N (603) 329-5540 (ll t 0 %fLl-p`L rd FAX (603) 329-6406 No 3 287 RESIDENTIAL• COMMERCIAL• D SAUALER�O\���� 4SS1pNAl TITLE — { �►i___i_ I� -- I C� EST .) N JOB NO . . SUBJECTIr. {A:-(rer:+ i., SHEET NO . DESIGNED BY -- DATE ` 6 CHECKED BY DATE iFn(LLA L.11r.s 8 311 t� t� l � l , �, Z�. 110�r " �1 ET 4-A Ma a WG.e�T`C 2 l0-11' dim �, rr 14k d�, _F 'rVj ICS' ,zS'` L y 51 2zx�0�' \T�l �L.rL(c1o�TM L Lop pi iACA , °"' `` 1Z,Q 4�{1V�= i:�C�{.°'f' 1 I,�G► "�`b �11*°0 � V4�' •� t" �'�4"� tl'P'dC. tw OF PROFESSIONAL qc STRUCTURAL ENGINEERING P.O. BOX 958 DESIGN SERVICES E. HAMPSTEAD, NH 03826 3AL ATORE J R, (603) 329-5540 MOC IA FAX (603) 329-6406 " RESIDENTIAL COMMERCI D Sild� TITLE �L�— 1 (mi4A L FSSIONAL Nc� EST .) NO . C1 pQ JOB 3 SUBJECT �r'L ,,1��1 -7 f'C7 `Ic.. 1' ,MpC-jj'I � .r,.,SHEET NO . DESIGNED BY ATEZ iQ CHECKED BY DATE— 1�! Pl A fk �k 5 «f1?-\, �G Q�„ �i,a ►l G�►L RR "`rte t 2'R I I�,8 � Tn c�a �a�°T� 31 8-01)A IP L� r� °Tri La Iia �STbH le Construction Building with the QUkLITY and Chfincterof yesteryear. 44 Addison Ave Ext. 1 Methuen,MA 01844 1 (478)685-3037 1 Estimate Submitted To: Peter and Caroline O'Neil 50 Bridle Path N.Andover,MA 01841 We hereby purpose to furnish the materials indicated and perform the labor necessary for the completion of: Renovation and expansion of kitchen/'/sbath/laundry room. Misc. home improvements. (See Site plan and Order of Conditions from NACC-DEP File#242-1171) All material is guaranteed to be as specified,and the above work to be performed in accordance with the drawings and specifications submitted for above work and completion in a substantial workmanlike manner for the sum of: One hundred twenty six thousand six hundred forty dollars-$126640.00 Payments to be made as follows: $10000.00 when work begins Remaining payments as work progresses. Respectfully submitted: Darren M ino_L _ Any alteration or deviation from the ve specifications involving extra costs will be executed only upon written order,and will become an extra charge over and above the estimate. All agreements contingent upon accidents,or delays beyond our control. Note-This proposal may be withdrawn if not accepted within 10 days. Proposal Date 03/26103 ACCEPTANCE OF PROPOSAL The above prices, specifications,and conditions are ' factory and are hereby accepted. You are authorized do the work as specified. P ymen will be v ' l ('- as o ' ed above. D �' Signirture: 1` FF10E COPY �jj�tF.�OVATION a nns sheet Scope of work:Removal of existing sunroom. Construction of an addition expanding existing kitchen. New powder room and laundry room. Installation of new windows and doors in family room. Completion of several items required by conservation. Permits-The price of the following permits required are included in this estimate: building, electrical, and plumbing. Any special permits needed are not included. Demolition-The existing sunroom will be razed and removed. The existing kitchen,powder room, and laundry area will be gutted as deemed necessary. To ensure a clean work site a dumpster will remain on site for the duration of the project. Framing-The addition and interior will be framed as outlined in submitted blueprints. Siding-The addition will receive siding to match the existing conditions. The back wall of the family room will receive siding to match as deemed necessary. The underside of the addition will be finish with exterior grade plywood Roof-The addition roof as well as areas tying;into the existing roof tines will be shingled to match the existing conditions. lee and water shield will be applied to the entire roof of the addition. Due to age, the elements, and different lots of roofing„ there will possibly be a difference in color from old roof to new. Insulation-The addition will be insulated as outlined in submitted blueprints. Drywall-The addition as well as any interior walls disturbed will receive %a"blueboard and a skim coat of plaster. Ceilings will have a said swirl finish. Painting-Walls and trim to receive a coat of primer and 2 coats of finish, colors to be determined. Family room walls where disturbed will be paint to match existing color. The living room wall where patched will be painted to match existing color. All new exterior siding and trim will be primed and receive two coats of finish to match existing house colors. All paints to be Benjamin Moore or California. *Note:Due to the nature of wood and the drastic temperature and humidity changes in our region,you may notice the movement and shrinking of interior and exterior trim. This is typical of the region and is not defective. Q20 IENQYA33ON Sms cadons sheet Plumbing-Demolition of all old plumbing flxitures in the kitchen and I'floor %zbath. Provisions for new fixtures as outlined in submitted bluearints. Installation of all necessary drains, water lines, and vents. Provisions for and installation of Kitchen—I Sink(not in the island), 1 faucet, 1 garbage disposal, I dishwasher, and I refrigerator w/ice maker. 1/ Bath-1 pedestal sink 1 faucet, and i toilet. Laundry room-I washing machine w/a washer pan draining to the cellar. (The cost of all plumbingfixtures and their associated accessories is covered under an allowance)(The cost of all appliances and their delivery is the responsibility of the homeowner) Note:Due to the addition not having a foundation,the water lines in thefloor of the addition will be insulated and heat taped so as to avoid the possibility of frozen pipes. Heating-Demolition of any baseboard heat as deemed necessary for the renovation. Installation of new high output baseboard heat in kitchen. Installation of one kick space heater under kitchen sinks Cut and reroute baseboard heat in family room as deemed necessary for installation of new slider. The expanded kitchen will remain on the existing zone. The boiler will be drained and the system will be fllled with antifreeze. The antifreeze level must be check yearly when the boiler is cleaned Electrical-Demolition of all old wiring and f fixtures deemed necessary. Installation of new receptacles, GFI circuits, and switches as required by code. Installation of all lightfixtures. Wiring as required for following appliances: Electric cook top w/downdraf i, double oven, garbage disposal, trash compactor, refrigerator w/ice maker, microwave, dishwasher, washing machine, and electric dryer. Replace existing 28 circuit panel with a new 42 circuit panel. Replace existing 40 amp feed to sub panel with a 100 amp feed. (The cost of all light fixtures is cover under an allowance) *Note:Installation of recess lighting is covered under the lighting future allowanc. HVAC-Extend and relocate existing diffusers as deemed necessary. Relocate small condenser servicing family room wall mounted AC unit. Tile Floors designated for marble/tile will be prepared as necessary. Marble or the will be installed as noted in room by room specifications. A the back splash will be installed. This estimate includes standard installation. Diagonal,patterns,features strips, etc. will incur extra cost. The cost of all tile/marble is covered under an allowance. Hardwood Flooring--New 2 %"red oak flooring will be installed as noted in the room by room specifications. The hardwood will be sanded'and receive 3 coats of polyurethane. Finish All new interior doors will be 6 panel solid core masonite with a smooth finish. All new window/door trim and baseboard will match!existing trim. A set ofpocket doors will be installed between the family room and kitchen, these doors will be 15 lite solid pine doors. QINEILptFNM AT ON S aligns shee# Cabinets Kitchen cabinets, moldings, and the;r associated hardware will be installed. The cost of all cabinetry, moldings, and their associated hardware is covered under an allowance. Countertops-The cost of all countertops and their associated template and installation costs are covered under an allowance. Appliances All appliances will be installed The home owner is responsible for the cost of all appliances and their delivery. Miscellaneous A slider and two casement windows will be installed in the family room as outlined in submitted blueprints. There are no provisions in this contract for exterior stairs servicing the new family room slider, however stairs will be needed for a frnal inspection. If the stairs have not been determined by the final inspection date a temporary set of stairs will be constructed to satisfy the building inspector, and this will incur additional costs. Only the highlighted iterns, in the order of conditions for the special permit, are included in this estimate. The homeowner is responsible for carrying out the remainder of the conditions in a timely manner so as not to hold up construction. If the NA CC or any other authority revises or changes the order of conditions this could incur extra costs. Gutters/downspout will be installed to new addition as required. DM Construction is not responsible f�r any landscaping including grading, seeding, planting mulching, etc. The homeowner is responsible for the cost of all accessories. (Towel bars, mirrors, toilet paper holders, etc.) DM Construction will install these items. Q'NEIL MNOVATIONN &"MAKES The following allowances are included in this estimate. The allowances exist to cover the purchase of materials only, unless otherwise specified Any amount in excess of an allowance will incur extra cost. Any amount less than the allowance will warrant a credit. Upon completion of the project any extra cost or credits will be issued Plumbing Fixtures-$2500.00 This allowance includes all plumbing fixtures in the kitchen and bathroom. Including faucets, sinks, toilets,pedestals, etc. Lighting Fixtures$2500.00 This allowance includes all light fractures, specialty switches(dimmer, timer, low voltage,etc)and recess lighting The cost of the installation of recess lighting, in cabinet lighting, or low voltage lighting is covered in this allowance. F100409$850.00 This allowance includes the cost of all tile/marble and grout. Windows/Doors-$5600.00 This allowance includes all windows(included. screens, grills, hardware, ext.jambs, or any other specialty trim needed). This allowance also includes any exterior door units and their associated hardware. Cabine*,$20000.00 This allowance includes the cost of ail cabinets, appliance panels, and their associated hardware. Countertops-$10000.00 This allowance includes the cost of adl countertops and their associated template and installation costs. 0►ENOy TA IQN Room 1 Roo�„�cifica�ons I. Kitchen A. Walls-painted B. Trim- painted C. Ceiling-Sand finish D. Flooring-hardwood E. Installation of recess lighilug(allowance) F. Installation of under counter lighting(allowance) G.Kitchen windows Uramed countertop height 2.Bumped out 4%" H. Installation of new cabinets(allowance) I. Installation of new count wtops(allowance) J. All necessary provisions:for the following appliances and fixtures: 1. Electric cook top ry/downdrafL(ln island) 2. Doable oven 3. Garbage disposal 4. Trash compactor 5. Refrigerator write maker 6. Microwave 7. Dishwasher S. Sink/faucet(Not in,island) K. Toe kick beater L. Change existing heat to high output M. Install 15 lite pocket doors entering family room. N. Installation of a tile backsplash(allowance) H. %,Bath(Powder Room) A. Walls-painted B. Trim-painted C. Ceiling-sand finish D. Flooring-Marble(allowance) F. Installation of an exhaust fan(allowance) F. Install pedestal sink/faumt/tollet(allowance) G. Install accessories(towel bars,mirrors,etc) � i Q'NEIL RENOVATION Ream kiy Ra)m Specifications III.Laundry Room A. Walls-painted B. Trim-painted C. Ceiling-sand finish D. Flooring-Tile(allowance) E. Installation of recess light(allowance) F. Installation of washer and electric dryer. G. Installation of washer pan and drain. IL Installation of wire shelving above appliances. IV. Family Room A. Walls-painted to match where disturbed. B. Trim-painted to match where disturbed. C. Installation of a slider and 2 casement windows. D. Reroute heat as necessary. E. Relocate electrical as necessary. F. Install coach lights(alloweace) G. Relocated electrical as necessary. IL Patch in old door location. I. Relocate condenser for wall mount AC unit. J. Exterior stairs not included. V. Living Room A. Walls-paint patched wall to match existing conditions B. Patch in baseboard trim and faint to match existing conditions. VI. Exterior A. Installation of siding and trim to match existing conditions. B. Paint new siding and trim to match existing colors. C. Install exterior grade plywood to underside of addition. D. Excavate/pour new footings. E. Install gutters and down spout on new addition. VII. Basement A. Patch/paint areas openkl to expose necessary pipes. VII. Miscellaneous A. Installation of white wirc,shelving in broom closet. B. Highlighted items in order of conditions. ENERGY CONSERVATION APPLICATION FORM FOR LOW-RISE RESIDENTIAL NEW CONSTRUCTION and ADDITIONS 780 CMR Appendix J (effective 3/1/98) Applicant Name: 'D491161'jEnA1KT1A1J, Site Address: 50 PAN Applicant Address: i�2 A2/7Jrf 6A rt 25r City/Town: AVo)t/��? Al, /1,4 a/6?` Use Group: 1?1!�J'1�/.at- _ Date of Application: Applicant Phone: Applicant Signature:r—__ Compliance Path(check one): [] Prescriptive Package(Limited to 1- or 2-family wood frame buildings heated with fossil fuels only) Package(A through KK from Table J5.2.Ib): _ Heating Degree Days(HDD65)from Table J5.2.1a: (For items d.through i., fill in all.values that apply from Table J5.2.Ib:) a. Gross Wall Area sq.ft f. .Wall R-value R- b. Glazing Area` sq.ft. g. Floor R-value R- c. Glazing%(100 x b j-a) % h. Basement wall R- d. Glazing U-value U__ i. Slab Perimeter R- e. Ceiling R-value R- j. Heating AFUE ['i Component Performancei i6Manual Trade-Oir" (Limited to wood or metal framed buildings only) Climate Zone(from Figure J6.2.2) 7 Zone 12 E Zone 13 ® Zone 14 Attach Trade-Off Worksheet from Appendix J, [and JYPAC Trade-Off Worksheet,if applicable] MAScheck Software Attach Compliance Report and Inspection Checklist printouts. [] Systems Analysis OR Renewable Energy Sources Attach Mass Registered Architect or Engineer Analysis ALTERNATIVE FOR ADDITIONS ONLY: a.Gross Wall+Ceiling Area b oq sq.ft. b. Glazing Area`,5p sq.ft. a Glazing%(100 x b T a)_fj,5 % ADDITION with Glazing % (c.) up to 40% may use 780 CMR Table J1.1.2.3.1 below: MAXIMUM U-value MINIMUM R.values Fenestration _Ceiling all Floor Basement Wall Slab Perimeter,Depth _ 039 R-37 R-13 R-19 R-10 R-10,a ft i Glazing Area may be either Rough Opening or Unit dimensions. 2 Based on NFRC listing. Applies either to every unit,or to area-weighted average of all units. 3 R-30 ceiling insulation maybe used in place of R-37 if the insulation achieves the full R-value over the entire ceiling area (i.e.-not compressed over exterior walls,and including my access openings.) [� "SUYROOM"addition(greater than 40% gludng-to-wall and ceiling gross area) Attach"Consumer Information Form"from 780 CMF.Appendix B. Official's Name: Official's Signature: Application Approved ❑ Denied [] Date of Approval/Denial: Reason(s) for Denial: (provide additional details as.needed on back side) rAORTlq Town of 4Andover No. 4 IS 4K 0coCHC CQ dover, Mass., 3 I 0RA T E 0 H BOARD OF HEALTH Food/Kitchen PERMIT T Septic System ....... fBUILDING INSPECTOR ............ THIS CERTIFIES THAT .................... *0 Y1 *.......... ....!1 ............................................... #0**Y*................. Foundation has permission to erect........................................ buildings an.....574 ;5* ........................... Rough to be occupied as... d Cf. A ale,I #/a,*"* 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. /043/ //y X 860 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR Rough C ............ ........................................."••••• ............ ................... 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. IrSEE REVERSE SIDE71 Smoke Det. .. Date. . . . . . . . . . . . . TOWN OF NORTH NDOVER 0 r PERMIT FOR LUMBING ,SSACHUS� This certifies that . . .AMh.a!►^. . . . . . . . . . . . . . . . . has permission to perform . . . . . . .R. e>il" � ^5. . . . . . . . . . . plumbing in the buildings of . . . . .oA f I. . . . . . . . . . . . . . . . . . . . . at : . ,. . . . . . !'.( . . . . �. . . ., North Andover, Mass. FeQ. . eG .Lic. No. PLUMBING INSPECTOR Check # 3sy� 7344 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS O� � W Date Building LocatiorUCJ � �� Owners Name dy/ Permit# Amount Type of Occupancy /��� New Renovations Replacement Plans Submitted Yes No FIXTURES cf cf. SUM» lMWElff M Rfm 20 FI M -40 FLOCR 4MFLOOR 5M FIDCR 6M FIO(R 7M FLOCK SIH HDCR (Print or type) J� � �.e���t:J'w {� hec ne: Certificate Installing Company Name /Ll�! 'TiY�_0 Corp. Addres Partner. usmess Telep one �Q Firm/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the ype of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity a 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 the s tts State Plumbin hapter 14,2qf the General Laws. By: I na ure of Licenseam Type of Plumbing License Title City/Town rcense Numver Master Journeyman APPROVED(OFFICE USE ONLY Date..... �...... f NORTH 1 r°.��`` "�o� TOWN OF NORTH ANDOVER o p PERMIT FOR WIRING CHU f� T,�` ��cT Thiscertifies that .......................,. ..,.................................................................. has permission to perform .....!.?F"!b: ..... p° ...................... wiring in the building ofQ....................&2....©.�?�.r�..l.�.............................. at... f�?.. ! .L��?:�. )0,07.:el................................North Andover,Mass. A !' Fee..X " ... Lic.No.. .Q Z I<.�'4.......... 1 '. ,... 1 ELECTRICAL INSPECTOR I t Check 7289 a.u111#f1JJ/WCalln or ridssamuserrs u mciai use kinry d 77, Department of Fire Services Permit No. 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(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: L1,5 - U9 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) 50 BA4 P 9, Owner or Tenant ?Acy- ( te;l Telephone No. Ji7? d$)- )t)`1 Owner's Address S,,,,—e Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building Ho--,it Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity ii II Location and Nature of Proposed Electrical Work: i�t,,e l 001XI.-t &Iyi,-Il5 + 131,Ws Completion of the following table ma be waived by the lns ector of Wires. No.of Recessed Luminaires 3 No.of Ceil:Susp.(Paddle)Fans o,of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires 9 Swimming Pool Above ❑ n- ❑ o.of Emergency Lighting rnd. grnd. Battery Units No.of Receptacle Outlets `) No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches a No.of Gas Burners o.of Detection an Total Initiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers eat Pumerp um Tons No.o e - ontaine Totals: Detection/Alertin Devices No.of Dishwashers Space/Area Heating KW Local❑ M unicipa ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No.o aterKms, o.o o.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No. Hydromassage Bathtubs I No.of Motors Total HP Fellecominunications Wiring: No.of Devices or Equivalent OTHER: Estimated Value of Electrical Work as00.64 Attach additional detail if desired, oras required by the Inspector of Wires. (When required by municipal policy.) -b� Inspections to be requested in accordance with MEC Rule 10,and upon completion. Work to Start: t{- 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:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: E)QLA'r1C, LIC. NO.: Licensee: at9����/J' r �_ Signature LIC. NO.: loaf S-13 (Ifapplicable,enter"exempt,"in t license number e.) '` Bus.Tel. No.: 977 SOO'I�I Address: _ �1atr, )� w_ Y`@�,�le r Alt.Tel.No.: *Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S" License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, 1 hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE. $ 1 '� m� �1��or7�� 1 wr � per- 7-Z-oz � / ,. ., >r The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Informationt'J'II n Please Print Lep-ibly Name(Business/Organization/individual): A'a, ( ,f, Address: 'S1 mou�.,t Utj DV City/State/Zip: 2�Je., f )-0 aliM Phone �bd -ISIV I Are you an employer?Check the appropriate box: Type of project(required): 1.❑ I am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2..1 am a sole proprietor or partner- listed on the attached sheet.+ 7• Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 Plumbing repairs or additions myself. [No workers'comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.]t employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#I must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. ,Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains andpenalti%es ofperjury that the information provided above is true and correct Signature: �'/ l_�— Date: Phone#: -7p S2i U — 1 v y 1 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#: Date.2 ....17.013.... NORTH 3r°,,�`'°-:•.�"°°� TOWN OF NORTH ANDOVER � F PERMIT FOR WIRING s 6, . .. ... +�• ,SSACHUSf This certifies that ...... f.. .............................................................. has permission to perform .......:.; ............................................. wiring in the building of.......................................� .:......................................... at..� ..........................................C -� ,North Andover,Mass. ....... . Fee.L. ........... Lic.No.............. ..... Z .................................... �ELECTRICAL INSPECTOR r Check # r 4796 i Commonwealth of Massachusetts Offi ial Use Only Department of Fire Services Permit No. Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/991 leaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),51.7 CMR 2.00 (PLEASE PRINT W INK ORT ALL FO ATION) Date: Q Q City or Town of: To the Inspect r of Wires: By this application the undersigned gives` ice o is or he i teqioyi to perform the electrical work described below. Location(Street&Nui er) ITtA / Owner or Tenant ' ! Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps 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: Installation of Security system Completion of the folloudn table may be waived by the Inspector qf Wires. No.of Recessed Fixtures No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA Above In- 0.0 mergency Lighting No.of Lighting Fixtures Swimming Pool rnd. ❑ rnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones o Detection and No.of Switches No.of Gas Burners No.Initiating Devices No.of Ranges No.of Air Cond. Tonal No.of Alerting Devices No.of Waste Disposers . Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems: No.of Devices or E uivalent No.of Water KW o.o o.o Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: y b No.of Devices or Equivalent OTHER: 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:) (Expiration Date) Estimated Value of Ele trical Work: 13 — (When required by municipal policy.) Work to Start: V Q Inspections to be requested in accordance with MEC Rule 10,and upon completion. Tcertify,under the ains nd penalties of perjury,that the information on this application is true and complete. FIRM NAME: ces LIC.NO.: 153�C Licensee: John S. Bassett Signature LIC.NO.: 1533C (If applicable,enter"exempt"in the license number line.) Bus.Tel.No.: 603 594 592$ Address: Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Lic, see 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: $ , �1 Location No, �y v Date pORTN TOWN OF NORTH ANDOVER 041 n Certificate of Occupancy $ bis'•^ Eta' Building/Frame Permit Fee $ p �ACMUS Foundation Permit Fee $ Other Permit Fee $ • TOTAL $ Check # Building Inspector lei 14 .0, TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING 11 ME BUILDING PERMIT NUMBER: xt DATE ISSUED. 2; SIGNATURE: Building Commissioner/I for of Buildin Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: .s6 &(,, It. P't �-k 103 . / /V . 4,1 ¢,/ _ Map Number Parcel Number .fJ✓yrs �� � t�f � \� 1.3 Zoning Information: 1.4 Property Dimensions: v Ss e. S ltie Zonm District Pr osed Use Lot Areas Frontage ft V.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard R red Provide R 'red Provided R red Provided 30 -:(o 3 r t 1.7 Water SupplyM.G.LC.40.1 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 'JaL Private ❑ Zone Outside Flood Zone 11 Municipal On Site Disposal System 0 _J SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT m 2.i Owner of Record ame ri t) Address for Service: K1 L • Si tore Telephone 2.2 Owner of Record: ° Name Print Address for Service: m Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: License Number -- Mn Address l Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address rM Expiration Date Signature Tele hone 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 athdavit will result in the denial of the issuance of the building rmit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description oiProposed Work(check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ '. Accessory Bldg. Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: �S/Dra /D�XI(c � vf i i SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost Dollar to be 't , .Completed b 1. Building tz, (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbin Building Permit fee tat X(b) 4 Mechanical HVAC 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 1, 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 71h 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 Print Name Signature of Owner/A ent Date ' NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TRVIBERS 1 ST 2 3M 7771 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DRvIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING - X MATERIAL OF CHPJNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE " FORM - U - LOT RELEASE FORM . 1STRUCTIONS: This form is used to verify that all-necessary approval/permits from ° Boards and Departments having jurisdiction have been obtained.This does not relieve the applicant and or landowner from compliance with any applicable requirements. APPLICANT -P N��l 1 PHONE ASSESSORS MAP NUMBER b@R''NUMBER SUBDIVISION LOT NUMBER STREET a l f �� STREET NUMBER 5~� "........—......................rrrrr.rr.rrr.r.r.rrr.rr.r.r.■ ............... OFFICIAL USE ONLY 9,.�,� "r.....r..rr...r.......■.r..rr'...r.rrrrrrrrrr.rr.rr.■ ■.r■ ....:..�.....r . RECONIl�IENDATIONS OF TOWN AGENTS I.. err.■ MEN Now.■r■rr..■r.■■r..■r.■■rr.rr■■..rrr.rrr.r.rr�rrr�r�rr.0 rr.r I DATE APPROVED �' G CO SERVATION ADMINISTRATOR DATE REJECTED COND&-NTS 1 t' DATE APPROVED A) / TOWN P a' DATE REJECTED COMMENTS DATE APPROVED FOOD INSPECTOR—'HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR—HEALTH DATE REJECTED COMMENTS PUBLIC WORKS—SEWER/WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED • FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE Q llflkg 1 fJNR�'CIST,d'RId'D L4)VD DptlR1'; DESD Soak PA��4+- DR1i:4j, 'J, F�Q �,Y tL�W 80aK: PAGS;_.�,_�_ 9�:> ....r. ._...__ SR'.����' .�ALTY TRUcr Pf:Atl -�--•-�...,,_ pT ABARA .1 J'OISTl9'R!I•D L14ND �-� >SCALB; •- amtBTR loN mr. PAG RL00D 1� CtRTQ10A1! Dr "aZARD MrOPXATION PUS Numm '---- .lss�'SSORs MAPDAM: MO.R'TGA GE INSPECTION PLAN 50 BRIDLE pA THp NORTH ANDD VB'B, �A OWNERS UNKNOWN ` rW,9�°pj0poa� � a 0T J.4 f.0 LOT 32 /Vf JIV/ n l 1 1. r BRIDLE PATH ry M Soy fESULT OF TAPE MEASUREMENT, NOT THE RESULT 'VENT SURVEY AND IS CERTIFIED TO THE TITLEDE , ,A WPANY AND ABOVE LISTED ATTORNEY AND LENDER. 40 �+� S ' DEEDED EASEMENTS IN THE ABOVE REFERENCED KTEL.:(800)247 CIRCLE, F X�(50BL52B 4VA 0 0J? 3B 'OACHMENTS WITH RESPECT TO SUILDINCS SITUATED ) 'a 'XCEPT AS SHOWN. NORTIy Town of Andover O .., No. 170 o LA dover, Mass., RATED H 4 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System P , BUILDING INSPECTOR THIS CERTIFIES THAT........ ��4 e^ ..��/ ..................................... ................................. .... Foundation �X ... buildings on ....... 0 /`� /� /* .....IAVt Rough has permission to erect.....�Q........�.� g �.............�............................... to be occupied as...... L�......5. ... .... .!v........r'. ►.......�. . .......... chimney provided that the person accepting thWpermit 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. M ' D a P PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION START 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 T No Lathing or Dry Wall 1 o Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE a - Smoke Det. 4245 Date.... ....�.�`.... O� MO oTM 1ti 3? a t���•�+�!e � TOWN OF NORTH ANDOVER vo* 9 PERMIT FOR WIRING ,SSACKUS i This certifies that ........D U.... e ax v.......,F- l . ................................... has permission to perform ...... z '��n. 1ki0�e Lt" ^� ...................... ......................`!......... wiring in the building of.. C"� r.... .. .. ...................................... at.....S.0 ..... R C. ....I..A .....'........................ .North Andover,Mass. Fee...a0.. ..... Lic.No.`z' 5..Y....... :..;.!.o�c� t.� ..�t"`-...... ELECTRICAL INSPECTOR Check # 3 a ThEC0MNI0NWEALTH0FyWS4CHUSEM Office U c o ly DEPA9rAfiAT0FPUX1CS9FL7Y BOARDOFFIREPREVE7MONR�,MHONS527CRI2.-M P ermit No. 11 ccupancy&Fees Checked AI'PLICATTONFOR PERMIT TO PERFORMELECFRICAL WO ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Inspector of Wires: The undersigned applies fora pemlit to perform the electrical work described below. Location(Street&Number) d 13a f 1. n Owner or Tenant n Owner's Address Is this permit in conjunction with a building permit: YesJM No (Check Appropriate Box) Purpose of Building 444 ��j 5Y,,,, Utility Authorization No. Existing Service Amps Volts Overhead Underground — Sr' No.of Meters New Service Amps / Volts Overhead Under and rNo.of Meters Number of Feeders and Ampacity — Location and Nature of Proposed Electrical Work ,6,46gY"gi-i r No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total No.of Lighting Fixtures Swimming Pool AboveBeloµ KVA Generators © KVA No. o No.of Receptacle Outlets No.of Oil Burners und No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pum s Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal other Yo.of Water Heaters gWED Connections No.of No.of Si ns Bailasis do.Hydro Massage Tubs No.of Motors Total HP [HER*_ J /V A 6— Pte" � t ^�a >ranceCoraage PtnuarttotbelD4mmlff&ofA4a%adneMCaleralUm m aamaDliabdptcofud<�rep tDt1 Brh um YES C0mageerilsmb6WntWeq iiv*t YES ® NO �submVmdvafidploofofsametothet�tfice YES r—T ffyouhaveYESpl= thetypeo(m by *ingthe box Lam( URANCEE BOND OMER ftascs'pocify) Da1e . kroStart ti EMmAadValteof13DchicaiWork$ xlmdAeRnakies0fpe1iW. Rao Fma1 �� LnameNo. Sigrohae /G ) �� LmwNo CJ" ! M ✓ y (�L'1�/ [/�( jr4/f7��--fir l� d Sara j_ Btlst>essTel No. 7QZ S INSURANCE W At Tel No. AIVI R Iamawa�ethatthelioeri9edoesnothavethem%l nceoovetageoritssoulePvalentasegluedby lBZGe)eralLaws atmysignatueonthopamitapplicap®thisreq«errent se check one) Owner Agent Telephone No. *oo Igna ure o caner or gent PERMIT FEE$ The Commonwealth of Massachusetts d Department of Industrial Accidents Office of Investigations Boston, Mass. 02119 �M Seo Workers'Compensation Insurance Affidavit Name Please Print Name: Location: CI!y Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for my employees working on this job. Company name: Address City: Phone# Insurance.Co. Policy# Company name: a Address Clfi/: 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$1,5oo.00 and/or one years'imprisonment_as_weA_as.civil.penaltiesinlhelmniofa_STOP.WORK_ORDERartd_a.fine.of.($iDo DD).arlaY againstme. 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 c r e d penalties of perjury that the information provided above is true and correct Signature Date / Print name rze 7' 26 Phone# Ry&y Official use only do not write in this area to be completed by city or town official' City or Town Permft/Ucensinq Building Dept []Check ifrmmediate response is required it Licensing Board E] Selectman's Office Contact persona Phone#. E] Health Department Other Date. �' ".��T:'4, TOWN OF NORTH ANDOVER 3a °°c o PERMIT FOR PLUMBING SAC/IUS� This certifies that has permission to perform—. plumbing in the buildings-of . -: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ., North Andover, Mass. r tc. Fee v.. . . . .Lic. No.. " ",! -. . . . . . . . . . . PLUMBING.1 SPECTON Check # �� � � (/ 5436 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type print) NORTH ANDOVER,MASSACHUSETTS Date Building Location 5 G t P/q-nA Owners Name mal Permit# � �f 7 Type of Occupancy 4'5"� Amount New Renovationri Replacement Plans Submitted Yes ❑ No ❑ FIXTURES H H w rx a a a a w z a SIBS%E M Hfm 2�D H" 3MHDQt 4M WM M HD" 6M 11" M Fit= 81H HIM (Print or type) n Check one: Certificate Installing Company Name VALL A100 2j j y 1AJ6 ❑ Corp. Address I—) RD Partner. AL MICA 0/552— El Business Telephone 417 —GSF G Firm/Co. Name of Licensed Plumber: Z0466423 In�yirance 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 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 installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts u bing ode anc, a er 14 the General Laws. a By: ure o icense T-17157, Type bf Plumbing License Title City/Town icense lNumDer Master Journeyman ❑ APPROVED(OFFICE USE ONLY Location S' op/c//e ,94 No. a9 Z Date °2 MORT1y TOWN OF NORTH ANDOVER 3? . 0 � ; 9 Certificate of Occupancy $ CM tt�' Building/Frame Permit Fee $ s� us Foundation Permit Fee $ Other Permit Fee $ TOTAL $ -- Check # V�a t 16027 /Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING Ma ,a .z9- 4 i 7,7 77 BUILDING PERMIT NUMBER: B DATE ISSUED: t � SIGNATURE: Building Commissioner/In for of Buildings bate SECTION 1-SITE INFORMATION 0 1.1 Property Address: I 1.2 Assessors Map and Parcel Number: IMap Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zonin District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Y44— Side Yard Rear Yard Required" O OV A Required Provided ReqWred Provided 1.7 Rater Supply M_G.L_G40. z54) .� 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private 0 Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record Name(Print) Address for Service: Signature Telephone Q� 2.2 Owner of Record: 1r Name Print Address for Service: O Z M Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ t` o, Weir' a 9X03 p Licensed Construction Supervisor: o t 1' j r / .S r, e /J License Number aan Add e 09/ b i ' q?,?-9-P 7-9-587 Expiration Date S Sfgnature Telephone r 3.2 Registered Home Improvement Contractor L_ / Not Applicable ❑ _ r Company Name /20,560 R1 J` Registration Number r Add r s !� rf ! I i r 3 a Z Expiration ate ^ xP d Signature Telephone 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.......0 SECTION 5 Description of Proposed Work check au applicable New Construction, ❑ q E)�sting(Buildn'W ❑ Repair(s) ❑ Alteratic#n s) ❑in Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other 04, Specify .! 04. * Brief Description of Proposed Work: _ SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be ;` FFiIAhi3E E} Y ,_ Completed by permit applicant 1. Building (a) Building Permit Fee 52 1000 Multiplier 2 Electrical (b) Estimated Total Cost of �� '31000 Construction 3 Plumbing 000 Building Permit fee(a)X(b) �O O 4 Mechanical HVAC 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 Y. I, as Owner/Authorized Agent of subject property LIereby 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, ua, " d © , w e.54— 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 Print me t � C)2— i afore of Owner/ ent Dat T NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS IsT2m 3 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 BUILDING CONNECTED TO NATURAL GAS LINE BOARD OF BUILDINGJREGULATIONS s ". ii:ense: CONSTRUCTION SUPERVISOR i Number CS 059803 is Birthdate 08122/,1970 Exres 08122/2004 Tr.no: 2034 ` — _ estricted 00 ---------- DAVIDO CHEST a 80 HAVERHILL ST TOPSFIELD, MA 01982 Administrator l—` ✓fie 'oo�vrrw�uaealll a�/�iaaoaclauaelyd Board of Building Regulations and Standards � License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: I Board of BuildingRegulations and Standards Registration: 120560 g One Ashburton Place Rin 1301 Expiration: 1/30/04 I Boston,Ma.02108 :Type: DBA ii MEADOWVIEW CONSTRUCTION DAVID WEST 92 LAMOILLE AVE BRADFORD,MA 01835 Administrator Not valid without signature bJ-b:-cbbd b 3r 3:f f"1 fKIJI'I UtUKI`t I UWN 11NbUKH(*-t HL&N 111 117 fllDd IDU r7 r•./ii ACO D, CERTIFICATE OF LIABILITY INSURANCEDATE os 0s 02 FROWCEA THIS CERTIFICATE S ISS S OF INFOR114ATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Georgetown ImaUrarep Aaeney, Inc. HOLDER. THIS CERTIFICATE DOES NOT AMEND EXTEND OR 10 West Main Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, INSURERS AFFORDING COVERAGE Georgetown -NMA. 01833- _ I —_-- ,NSJRED I IhF.3URER A.COXk=C$ INSURANCE COMPANY Meadowview Constzuctien INSL•RER5SAFETY INSURANCE COMPANY 92 Lamoillia Ave., INsuRERG: 19 R . Bradford NFL 01835- INSURER e CO E ES THE POLICIES CIP INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANOING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY SE ISSUED OR MAY PERTAIN, THE INSURANCE AFPORDEL BY THE POLICIES DESCRIBED HERCIN 13 SUBJECT TO ALL THC TERMS, EXCLUSIONS AND CONOITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCEO By PAID C;AIMS, Flt TYPE OF INSURANCE POLICY NUMBER PGLICY EFFECTIVE POLICY EXPIRATION LIMITS CATE'MhY00 DAT£NWDLHY A GENERALLIABILRY I UNMING 03/09/200203/09/2003 EACI;C'COURR6NCE I 1,000,000 x GfiwmnCLALGENEFlt LLIP.BIITY FIRE DAMAGE(Aly orm 111% 6 50,00C CLAIMS MATE II OCU-JR i / / I / MED EY,91(An wtv perwil 6 5,00.- PERSOMAL8_AO_YINJ)RY 6_ 1,000,000 CENERAL AGGREGATE jE 2,000,OOC 3EN L A'30R63ATEUMIT APPLIES PER'•. - PROO'•I.'TS•CCL4F*P AGG Is 1,000,000 POLICY 47L ! 7'0; BAUTOMOBILEUABILITI :1609794 06/2-5/2001 06/2512002 ^oMpIN6�swGL6uMIT ANY.4 II"� AUTO ��'''"��'� ; (Ea ANaccldaR) {S ' 1 ALL I CANED AUTOS 1 / / BODILY INJURY I .�X��SCNEDULEDAUTOS (Pat P—) S 100,000 f H!RED AU`OS f',.'DILY INJURY lPeleawe300 000 WOrdOVrNED.4UTOS rl0 s , 1 / / � FP.OPE3TY CANAGE j (PatAm'dent) 6 100,.^QUO GARAGFLIABILITY I 41iTO0NLY-EAACCIDENT 6 rAtJYAUTO •:T HER THAN EA ACC S f 4:TOCTILY: A3G i¢ CESS LIABILITY / / 1 1eACM OCCUP.RE�CE _ F OCCVR Cl•JM5 MACE f 4GGR�ATE S 5 _ DEDUCTIm WOAfC I EMPLOYEP.S UABlt.11'•� I I EL.EAI`-i AC.^aD�? 3 °1.DISEASE-EA EKIPLOYEE S I _L.DIC•EASE.POLICY Utd:T 6 OTHER f f DESCRIPTION OF OPERATIONSRGCATIONSNE-IICLESMXCA.i:SICNs ADDED BY ENDORSEMENTWCCIAL PROYISION5 OPERATIONS USUAL TO THE HANED INSUASdD CERTIFICATE HOLDER ADDIVONAL INSURED•INSURER LetTER! CANCELLA'IICMI SHOULD ANY OF TME ABOVE MSCRIBEO POLICIES EE CANCELLED BEFORE THE EXPIRATION DATE TM02EOF; THE ISSUING INSURH'i PALL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO WE CERPFtCATE HOLDER NAMED TO T49 LEFT.EUT FAkUP.,E TO DO SO SMALL IMPOSE NO OBLIGATION OR LIAMLITY OF ANY 9fNO UP64 TME INSURER.IT9AGENTSORREPREBEtJTATryES. AUTHORIZED REPRESENTATIVE ACORD 26-S(710T) Q ACORO CORPORATION 1885 INSOT5S(Bmf O).Df ELECTROXC LASCR FORMS,INC.-(SM)2.27-0545 Pay*I d 2 6 TOTi1L P.O1 ACORD,,, CE-RTII=ICA ��E CSF LIASILIT�f IIVSUMNCE A M DTE IMM/DD(YY) �_— - — 3/4/02 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE BARROW GROUP,LLC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 110 E.CROGAN STREET ALTER THE COVERAGE AFFORDED-BY THE POLICIES 891DW. LAWRENCEVILLE,GA 30045 COMPANIES AFFORDING COVERAGE (770)338-4578 COMPANY A ASSOCIATED EMPLOYERS INSURANCE COMPANY INSURED RESOURCE MANAGEMENT, INC. COMPANY 281 MAIN STREET;SUITE 5 B FITCHBURG,MA 01420 COMPANY C COMPANY D ,j VERAGES 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 B Y 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 LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION DATE(MMIDD/YY) DATE(MMIDDIYY) LIMITS __- -_ --GENERAL LIABILITY- -- —_._..,._�_.__.__._.__ _ _. "' -GrNEtuL AGGREGATE $ COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG $ CLAIMS MADE ❑OCCUR PERSONAL&ADV INJURY S OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ FIRE DAMAGE(Anyone fire) $ MED EXP(Anyone person) S 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 S EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM $ WORKER'S COMPENSATION AND..._.__5001791.01.2002 03-01-02_....._.....03-01=03--. X T %is ER A EMPLOYERS'LIABILITY EL EACH ACCIDENT 'S' 1,000,000 v P EX X INCL EL DISEASE POLICY LIMIT $ PARTNERSINERSI E)CECUCUTIVE - 1,000,000 OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE S 1,000 000 OTHER DESCRIPTION OF OPhRATIONSILOCATION ITEMS COVERAGE IS EXTENDED TO THE LEASED EMPLOYEES OF ALTERNATE EMPLOYER: MEADOWVIEW CONSTRUCTION,92 LAMOILLE AVENUE,BRADFORD, MA 01835 CERTiFI AT�HOLD�R '- - ;.•CANCELt:A'1'tON' , SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE MEADOWVIEW CONSTRUCTION EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 92 LAMOILLE AVENUE 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BRADFORD,MA 01835 BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY RS AGENTS OR REPRESE ATNES. AUTHORIZED REPRESENTATIVE tf i� a..IA.Y IFs smitiRtiri +Mti-w.,.r�.:,.. 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: fvLtC� lia r -+0W (Location of lity) Signature of Permit Applicant 1! y 2_.-- Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector I i I i, CONSTRUCTION AGREEMENT CONTRACTOR'S NAME: David West and Meadowview Construction ADDRESS: 80 Haverhill Rd., Topsfield,MA 08983 PHONE: 978-887-2587 FAX: 978-887-2586 DATE: 11/07/02 OWNERS'NAME: Peter& Caroline Oneil ADDRESS: 50 Bridle Path Way North Andover,MA 01845 1. PARTIES This Construction Agreement (hereinafter the "Agreement") is made and entered into on this 7th day of,November by and between Peter&Caroline O'neil(hereinafter, the "Owners"), and David West and Meadowview Construction (hereinafter,the "Contractor"). In consideration of the mutual promises contained herein, Contractor agrees to perform the following work at the Owners'Property of 50 Bridle Path Way, North Andover, MA (hereinafter,the "Property"): 2. GENERAL DESCRIPTION OF WORK The Contractor shall perform and complete the following work at the Property (the "Work") in a highly professional manner: Without limiting the Specifications below or Construction Drawings incorporated herein, the Contractor will convert unfinished basement into living space. (hereinafter, the "Project"). The Project will add approximately 550 square feet to the interior living space of the existing house at the Property. The Contractor will obtain all permits needed to perform the Work. The Contractor will completely finish and/or install all framing, windows, doors, closets,paint,trim, carpet flooring, finish work, heating,plumbing, lighting, electrical work, insulation, plastering, and tile work. The Contractor will perform required demolition and clean-up/trash removal. The Work means and includes the construction and services required by the Contract Documents, whether competed or partially completed, and includes all other labor, materials, equipment and services provided or to be provided by the Contractor to constitute the whole or a part of the Project. 1 3. DATE OF COMMENCEMENT AND SUBSTANTIAL COMPLETION A. Commencement The date of the commencement of Work shall be on or about November 12, 2002. The Contract Time shall be measured from the date of commencement of Work. B. Target Date for Substantial Completion The Contractor and Owners agree that the Work is scheduled to be Substantially Completed in approximately 5 weeks from the date of commencement of Work, Le, by December 13, 2002(the "Target Date"),and the Contractor agrees to use best efforts to substantially complete the Work by such date. However, Contractor shall not be responsible for, and the Target Date may be extended by reason of, any delay caused by Owner;adverse weather conditions not reasonably anticipatable;accidents not caused in whole or in part by the negligence of the Contractor or its Subcontractors; additional time required for performance of Change Order work(as specified in each Change Order); and other delays caused by Acts of God beyond the control of the Contractor. C. Substantial Completion Substantial Completion shall constitute that stage in the process of the Work when, (1)the Work is sufficiently complete in accordance with the Contract Documents so that the Owner can use and occupy the Work for its intended use;(2)the appropriate authorities have approved the Work and have issued a permanent certificate of occupancy; (3) the labor and material costs of any remaining punch list items do not exceed$3,000; and(4)the remaining punch list items are of the type that completion of such items will not unreasonably interfere with the Owners'ability to use and occupy the Work. 4. CONTRACT SUM The Owners shall pay the Contractor the Contract Sum in current funds for the Contractor's Performance of the Agreement. The Contract Sum shall be Forty Thousand Two Hundred and Sixty dollars ($40,260.00) The Contract Sum includes all labor and materials necessary to complete the Work described above in the Contract Documents,unless expressly excluded elsewhere in this Agreement. 5. PAYMENTS A. Payments on Contract Sum 2 The Owner shall make payments on account of the Contract Sum to the Contractor as provided below and elsewhere in the Contract Documents: First Payment/nonrefundable deposit (Due when Agreement is signed and returned to Contractor): $10,000 Second Payment due upon start of plumbing work: $10,000 Third Payment due upon start of finish work/molding& doors: $10,000 Fourth payment due upon start of painting $5,000 Fifth payment due upon substantial completion $2,260 Final payment due upon final completion of project $3,000 The Contractor will provide the Owner a running tally of the Progress Payments. Final Payment shall not become due until (1)the Final Completion of Work; and (2) Contractor provides the Owners with final release of all claims; (3)Building officials have issued an occupancy permit Final Payment is scheduled to be $3,000. However,prior to Substantial Completion, Owner and Contractor will conduct a walk-through of the Project to develop a single punch list. When all items on this punch list are complete, release of claims is issued, and occupancy permit has been obtained, Final Payment will be due. Owner and Contractor will both sign off on punch list, and any further items that are later discovered will be completed after final payment is made and will be considered warranty work. B. Payments on Change Orders Contractor will write up a change order for owner to sign authorizing any additional work before any additional work can begin. With respect to Change Orders, 100%of the agreed upon sum for Change Order work is due prior to commencement of Change Order work. 6. CONTRACT DOCUMENTS The Contract Documents form the Contract for Construction. The Contract Documents represents the entire and integrated agreement between the parties hereto and supersedes prior negotiations, representations or agreements, either written or oral. Any future amendments and modifications of the Contract Documents must be executed in writing in order to be valid and binding upon the parties. In the event that any provision of this Agreement is at any time held by a Court to be invalid or unenforceable, the parties agree that all other provisions of this Agreement will remain in full force and effect 3 files a petition to take advantage of any debtor's act or reorganization under bankruptcy or similar laws; or(5)otherwise does not fully comply with the Contract Documents. When any of the above reasons exists,the Owner may, without prejudice to any other rights or remedies of the Owner and after giving the Contractor and the Contractor's surety, if any, seven(7) days written notice,terminate the Agreement and take possession of the site and of all materials, equipment,tools, and construction equipment and machinery thereon owned by the Contractor and may fmish the Work by whatever reasonable method the Owner may deem expedient. When the Owner terminates the agreement for one of the reasons above, the Contractor shall not be entitled to receive further payment until the Work is fmished. To the extent the costs of completing the Work, including compensation for additional professional services and expenses, exceed the costs which would have been payable to the Contractor to complete the Work, Contractor shall pay such excess to Owner, and this obligation for payment shall survive the termination of the Agreement. Such costs will be determined by the Owner and confirmed by the Architect. 12. ARCHITECT'S ROLE—Not applicable The Architect, as a representative of the Owner, will visit the site at intervals appropriate to the stage of the Contractor's operations(1)to become familiar with and to keep the Owner informed about the progress and quality of the portion of the Work completed, (2)to endeavor to guard the Owner against defects and deficiencies in the Work, and(3)to determine in general if the work is being performed in a manner indicating that the Work,when fully completed, will be in accordance with the Contract Documents. The Architect will neither have control over or charge of, nor be responsible for,the construction means, methods,techniques, sequences or procedures,or for safety precautions and programs in connection with the Work, since these are solely the Contractor's rights and responsibilities. The Architect will have the authority to reject Work that does not conform to the Contract Documents. ri Z D to ICONTRACTO 'S SIGNATURE 0 Date OWNER'S SIGNATURE 14 i I U 1 IN i IV ► r l�jt I � I � ----------- icAL NORTH ® ofAndover0 0% .... ...... . dover, Mass., -Al- aA Q T CC E o OCMIwCR � %p AORATEO i'? C5 S 4 BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT......f..�. .r..........0 BUILDING INSPECTOR .......................................... ....... . .. . ..... . Foundation has permission to erect.. . . . �N. $h........ buildings on ..... 0 /Ql 14 '� Rough f ........._ .........................1. ............ . to be occupied as....... . ......R001!M.......1 N......13.•�. .l.y11 40 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- ws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. / d3 ,��/ ApoPLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST T ELECTRICAL INSPECTOR C , Rough ............ .. ...................... .... ......... ..................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RouFinagh 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. /. .....`-. . . . . . . :��, TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING Y • S�CMUS / f f This certifies that . . . . . . .. . . . . . . . . ?'!'°�''`'.° . has permission to perform, �. . . . . . . . . . . . . . . . . . . . . plumbing in the buildingsof . . .j at.41 'C fi. . . . . . . . . ., North Andover, Mass. Fee/(-,V7 .. Lic. No:-�.o PLUMBING I P TOR Check # 117,3f 5657 + MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) �� C6�✓ NORTH ANDOVER,MAS HITS Date - Building Locations, Permit # Amount /Z. Owner's Name New Renovatio Replacement ❑ Plans Submitted n FIXTURES wV. Iz F F x w a m Q w w A 414 F a SZSBSMC &Ag1V)X M HD(R �II RDQt 3M FUM 4[R RDOR 5M FLOOR ti 6111 RIM 7M R" SIH ROM (Print or type) Ch Cor n r orC 'ficate Installing Company Name Cp. AAArAce ❑ Partner. Business Telephone Firm/Co. c Name of Licensed Plumber: Insurance Coverage: Indic a the a of insurance coverage by checking the appropriate box: ❑ ' Liability insurance policy Other type of indemnity Bond Insurance Waiver: I,the undersigned,have been mddefaware 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 a ication are true and accurate to the best of my knowledge and that all plumbing work d instal I ns performed under Pe it ssue . application will be in compliance with all pertinent provi ' tate Plumbing Cod d a 14 the General S. By: nsed rium Type o Plu ing License Title City/Town License Numner Master Joumeyrn n APPROVED(OFFICE USE ONLY Date.... ...Q`U 0 o! HoaTM�ti 3r �.t�``�-.�•�Qom TOWN OF NORTH ANDOVER o 9 PERMIT FOR WIRING ai, + CMUS� This certifies that P� + �� f? /IrC ...........................�.............�.... ............. ..... has permission to perform ..........�"�...� . .. e.4!?.....►`.. "-f "we ........................... wiring in the building of........... ............................................... at.............. ......!�%!R.<.. .�`?.... .. ............. orth Andov r;M Fee.. /T....... Lic.No.... �� ....... .,........ ...Y ... ..:..... / EC7RICAL IN ECTOR v Check # / S 464 r THE COMMONWEALTHOFMASSACHUSEm office Use only DEPARTNIEIIVT'0FPUX1CS4FETY Permit No. BOARDOFFIREPREVEMONRFGUL4UONS527CAMI2 00 Occupancy&Fees Checked APPLICATTONFOR PERMIT TO PERFORMELECMCAL Wi ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 1 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date_ a D- O Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) 5-0 —Ra 1 t) e- PA-rH Owner or Tenant flEmEer cot m i e LL Owner's Address - SAv✓t G� Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building CS('�-Cp J f Utility Authorization No. _ Existing ServiceO Amps /a fl Volts Overhead Underground [^ No.of Meters New Service Amps / Volts Overhead M Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work C topj �,� C s —No.of Lighting Outletsr-- No.of Hot Tubs No.of Transformers Total J KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA round1:1 ound No.of Receptacle OuXts No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers ry Heating Devices KW Local Municipal Other Connections No.of Water Heaters KW No.of No.of Si s Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER' L>SLrtanXCoWrage RustranttDdreMgtutMrMofMffimdmscBGer>`aallaws IhawaomerltLiabaifyku==PblicyinckxbgComplei ODw agecritssubs9ar&equivaleilt YES NO IhaNewbmitledwhdpfoofofsunetodieOffim YES ( FycuhavedrdodYFS,plea nKhmie hetypeofoc)wrageby dieddrrgdre box t7 LJ INSUM:�- RANCEOND EM r7 (PIe&*cify) WorktDStlt InspadionDateRMpe&d Rough °7 Esdrr dVahleofFbaricalWork$ ,?VO LL Signedurtdaaie peov- Cf�-1�— FIRMNAME E L-- 1ec LiO seNo. !'�11'1-�/1�,.7� /Aq Licen9ee r.Jl�!I�w 1 7C ,Tl�_ Signahue LA lice=No _ co /A B11SdcssTCINo. fit` AltTUNO.?d OWNER'SINSURANCEWAIVFR,Iamawatethattheliamr-doesnothavedlcinstr&Xc0owageoritsmbsUnUequivalattaswquredbyMassacht>Se ckri alLaws and thatmysignahtteontbispamitapplicah0f)WaiWSthisieg*enUj ' (Please check one) Owner Agent M , /•v C/ Telephone No. PERMIT FEE o signature or Owner or Agent