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Miscellaneous - 55 HEATH ROAD 4/30/2018
55 HEATH ROAD 210/060.A-0025-0000.0 Date. Z. :.`. .1.... . . MORTM 3r °` TOWN OF NORTH ANDOVER O �^ 4 F PERMIT FOR GAS INSTALLATION SAC MUSEt� This certifies that . . .,!t . . . . . . . . . . ?. . . . . . . . . . . . . . . . . . . . has permission for gas installation . . . . . . . . . . . . . . . . . . in the buildings of . .n.I.�� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . .a !`. r--- /'l. .�?`�. . . . . . . . . North Andover, Mass. Fee. ?. . . . . . Lic. No.. . . . `. L. . . . . .. . . . . . . . . . . , GAS INSPECTOR Check# T 7j, t. 4450 MASSACHUSETTS UNIFORM APPLICATION FO PERMIT TO DO GASFITTING (Print or Type) Mass. Date V �� _ /� Permit # Building Loca(lon -S � E r Owner's Name Al - A t)0UType of Occupancy A f✓S iI) � �} New ❑ Renovation ❑ Replacement p� Plans Submitted: Yes[] No ❑ (n OC N W N X Z a: V1 cc I rX (n K W cc W x W CC O U I-' = 71 N FC Z .O Y O W < c: CC O _, w m N F- CI ur O of a C7 Yr •a S 7. I... N Q > N W W W � Cr J Z .t = W tX 1A G W W U X H X < W J i C ~ I•-• } N O ? <L = W J }. W < w S CC W 2. < Cc .( t O O a O tiro/ X ¢ 'X o 0 X U. :3 � o d J v tr Y o a F- o SUB—BSMT. BASEMENT 1ST FLOOR • 2140 FLOOR 3RD FLOOR t 4TH FLOOR STH FLOOR STH FLOOR 7TH FLOOR STH FLOOR Installing Company Name CAI LA 41.4-A,, (Qmp I-��l Check one: Certiflcate # Address_. `tl [3I LItoP-1 S2-- 3--Corporallon l ❑ Partnership Business Telephone Cj7�{ ('��' 9-1�� _ ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter _ Mia C141-(.x44 INSURANCE COVERAGE: I have a current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes l-T- No O If you have checked ves, please Indicate the type coverage by checking the appropriate box. A Ilablifty Insurance policy p'' Other type of Indemnity❑ Bond ❑ OWNER'S INSURANCE WAIVER: 1 am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Sign lure of Owner or Owner's Agent Owner❑ Agent ❑ 1 hereby certify that,all of the details and Information I have submitted (or entered)In above application are true and accurate to the best of my knowledge and that all plumbing work and Installations performed under the Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the eneral Laws. Te of Ucense: `n Title Plumber Sig a re o censed Plumber or Gas filer filler 9` X City/Town aster License Number u,f'iK)V(R- � G Journeyman i BELOW FOR OFFICE USE ONLY ^ PROGRESS INSPECTION FINAL IIISPEC-ION SKETCHES FEE NO. APPLICATION FOR PERMIT TO DO CASFIT71HO NAME & TYPE OF 13UILDING LOCATION OF BUILDING PLUMBER OR GASFITTER LIG. N0. i PERMIT GRANTED DATE - ZO GA31MSPECTOR Date:.:� -1 NORTH 3?��,<� •�;•.'�ooL TOWN OF NORTH ANDOVER ° p PERMIT FOR PLUMBING SACMUSEt This certifies that �. ��t ! !. 1�. . . . ► •1•�. • . . . . . . . . . . . . . . • • • • has permission to perform . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . . 0� /• • . . . . . . . . . . . . . . . . . . . . . at . . J..J7 qr I. . . . . . . . . . . . . . North Andover, Mass. Fee.?-�. . . . .Lic. No.. . ! .� .F. ! . . . . . . . . L WING INSPECTOR Check # / ) a 5735 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING Z (Print or Type) Mass. Datev1L 2D 03 Permit #��7J� Building Location�Jr / f}T# Owner's Name_ Y Type of OccupancyP I/D''=Lt,i New ❑ Renovation ❑ Replacement D-- Plans Submitted: Yes ❑ No ❑ B•P •rr SEWERrr FIXTURES SEPTIC# :L N Cn Z Y C N h O Z N LU Y J fn >- U Q' N Z > S1 �4 CO Z cc C x O z a. cn W y N = h f- U' w Y Q cn U. _ U Z w O ¢ y u! ¢ Q W O C N Z ¢ a ¢ O 44 W = ¢ i- F- d rn o y ¢ � _ p .s Q 3 w a -ju 3 o z = x a x F- a x c 0 s4 a y r- o N a WW o ? r � � Qm y o a 3 ta- �a a 3 m Q O SUB—BSMT, BASEMENT 71 — IST 1ST FLOOR r 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR r 8TH FLOOR Installing Company Name i G 1 - Check one: Certificate # Address L�' l) S� ❑ Corporation ❑ Partnership Business Telephone_9 7 ?-2-5- 13 (o� ' Pm/Co. `J-e Name of Licensed Plumber - �_ C�iC 1- INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements Of MGL Ch. 142. Yes 13-- No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box A liability insurance policy Cr Other type of indemnity p Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ 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 perfo e u der th a it issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Co ` ChaptEi 1 €neral Laws. Title Signatu nsed Plumber City/Town Type f License: Master E] Journeyman [�-- APPROVED OFFICE USE ONLY) Ucense Number ,).-t/ L o _/ BELOW FOR OFFICE USE ONLY FINAL INSPECTIONS SKETCHES PROGRESS INSPECTIONS FEE NO..._ APPLICATION FOR PERMIT TO DO PLUMBING NAME & TYPE OF BUILDING LOCATION OF BUILDING PLUMBER PERMIT GRANTED \ DATE 2Q PLUMBING INSPECTOR yyza dy OR! • o -t: �oRroA,l �o • r�;� . appeal shall b-�-,APAILM F. L f a • isas :g: (20) days after the ;SEs.:.; . A"•;ssqcHu5��.' gl@ of filing of this Notice ��►tvvwe FER, 50 p TOWN OF NORTH ANDOVER In tho Office o the Town MASSACHUSETTS ��@�� BOARD OF APPEALS NOTICE OF DECISION Date . . . . February Petition No..6-.'.8 4. . . . . . . . . . . . . . . Date of Hearing. .F e.b.r. u a r y. . 3., . 19 8 4 Petition of . . . . . . . . .J E A PJ E R E S. . . . . . . . . . : . :. . . . . . . . . . . . . . . . . . . . . . . . . . Premises affected ... .5 5. .H?.d t h. .R 0 A.d. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Referring to the above petition for a variation from the requirements of the . 7.0.n i.ri g" R y. .l a w . . . . S.e c t.i.o n. .7.,. .P ax a g.r a p.h .1-3. a n d. .T ab 1 e. .2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . so as to permit - r. e.1. i e.f. . f.r.om. .th.e . s.i.de. :ya.rd. .set.bac.k . r.gqu.i.remen.ts . .to. .al l.ow the . . . ..c.o n t.ir_n u.e d. -.e x i:s t e.n.c.e. o f.,.a: .d yr e.1.1 i.n g... . . . . . . . . . ... . . . . . . . . . . . . . _ After.=a=public=hearing-given-on-the-above-date;_-the Board of-Appeals voted oto.` .v.a-r-j-.a n c.e... . ... . . . . . . . . . . . . . . . . d rel��t o ec lxezBxzl ��In9peot�nc koc irssut a ;-_ _ : =- .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . __ _ . . . . . . . . . . . . . . . . . . . . Signed - Frank. Serio., . J.r-._,. .Ch.ai rman_ _ . . . Alfred E . F"rizehl"e , Esq; . ' ice _Cha--i-rman - - Wil.-1 i.a m.-.J S 0.1 i y.a n" . . .. . . . . . . . . . . . . . Augus.ti n.e . W".. . Ri, ck"ers"on. . . . . . . . . . . . Wal ter. .F . . Sou:l:e*..... . . . . . . I . . . . . . . . . . . Board of Appeals 14ORTH 0 Any appAp 0vim,0 Pi LF i within (20) 0 �Yg aj: H date of filing Pf this Notice FEB Z3 2 10 .in the .0fflC0 Of 41P Town TOWN OF NORTH ANDOVER -Clerk MASSACHUSETTS BOARD OF APPEALS February 23*, 1984 - Mr. Daniel Long , Town Clerk Jean & Lisa Vallieres Town Office Building 55 Heath Road North Andover , Mass . 01845 Petition No . 6- 184 Dear i1r . Long : The Board of Appeals held a public hearing on Monday evening , February 13 , 1984 upon the application -of Jean and Lisa -Va 11 i e res The hearing was advertised in the North Andover Citizen on Jan- uary - 19 and=-26 , -1984 and all abutters wer-e notified by regul ar mail -The--fol lowi-ng -:.members -were -present -.a.nd-.v-oting : , -Franke.:: Serio;--J,r- z-01-1-65- Esq ,,----- Vi ce -C-hal rma-n T 7 n- A TU s��7U15 F ��E W_-H�_- William 1 -.J-.. --SV 1Y-Ti' ---. i-c-.ke.r-s-.onandAsso.ci-..at-e-':Membe-r WaT'td_r17F-.'-rSod:1-e. The-. pet7-i-ti oners -seelc-Ta v a r i-a nc e- from=-=t-he '--provisions -=o f= S e c t i.-O.n;:---7 P a ra g r a.p h -7 . 3 -a--n d T a 0 e7.2 6 f___t h e-.LZ o n i ng --B y.-,L a w--s-o. -a-s -t o p e r e 1 i of from--.t h e .- s i de -y a-r d s e t b a t k- re q u i-r.e m e n t -A o-- p e r-m! t t h e y;-co n- _t i n ued- ex-i-s ten ce of d- s-ing.1 e---f a-mi.1 y_dwe]-1 i n g - o-n- prem i s-es-I-o_ca-_t_e_d=�_ at .55 Heat-h -Road . Testimony by the petitioners ' attorney revealed that thd 'dwelling was- constructed in -1950 -and a recent - plot plan ' drawn- for - conveyance purposes revealed the s_1 i-ght-, viol-a-tion .- - Den-ial - of the -vari-a-nce - woul-d- invol-ve a financ-j:al hardsh=ip to - the.- petiti one-rs-;--- Upon = a motion mad-e--by -Mr.- Frizel le and seconded by Mr--. Wid'kerson the Board -voted unanimously to -grant the-- variance as . requested- In granting the- variance , - the Board finds that Section - 10 . 4 -ofithe ied . Specifically ,ical 1 -Boa-rd--fi nds----. Zoning -By--Law- ha-s - been satisf y the - that - the -1 oca-ti on_of=the. dwe-1-1 i n-g --on the - lot - for several -years= wi th-.- its -slight deviation from--the-current requirements const-itutes a - hardship as , defined - in Section 10 . 4 of the Zoning By Law. Sincerely , Frank _Serio , Jr . , Chairman jw Recei-+red by Town. Clerk : Dute� � ,._._,,_ TOWN OF 14ORTH ANDOVER, MASSACHUSETTS BOARD OF APPEALS ;;;'... �,' Time L_ �� !' i SS1CMU5 r, J-Y: %0ti c : Thi s application must b-e typewritten . APHP�{ TC rwi.RM RELIEF FROM THE REQUIREMENTS OF THE ZONING ORDINANCE Applicant Lisa & Jean Vallieres Address 55 Heath Road, North Andover Massachusetts 1 . Application is hereby made ( a) For a variance from the"r'equi rements of Section 7 Paragraph 3 and Table of the .,Zoning By-Laws . (b ) Fora Special Permit under Section Paragraph of the Zoning By-Laws . ( c) As a party aggrieved , -for..rev,i.ew of a decision made by the Building Inspector or other authority . 2 . ( a) Premises affected are land and building( s ) numbered 55 Heath Road Street . ( b) Premises affected are property with frontage .on the North ( ) South_ ( x ) East - ( ) West ( ) side of . Heath Road *4rAm�b; and . known as N o.---. .55 Heath Road ( c) Premises affected are in Zoning District and the premises affected have an area of square feet and frontage of fleet = - 3. -_ Ownership { aa.- .name and address of '-owner----( if -joint ownership , 'give -a-1-1 --names ) : Lisa L. & R. Jean V allieres Date. of purchase 10/21/83 Previ-ousOwner. - Robert W. Steer W . If applicant is not owner , check- his interest -in the premises : Prospective Purchaser Lesee_ Other--(explain ) 4. Size of proposed building : front ; feet deep ; Height: stories ; feet. ( a ) Approximate - date of -erection : 1950 ( b) Occupancy or use of each - floor : ( c) Type of construction .: 5 .. Size -of existing --building : 82 feet -front ; 30 feet deep ; Height : 1 stories ; feet . (a ) ,. Approximate date o erection : .. ( b) Occupancy or use of each floor : single residence (c) Type of construction : wood frame dwelling -6 .- Has there been a previous appeal-, un der__zon.ing , :.on these premises.?._ . If so , when? 7. Description of relief sought on this petition Relief from the side yard setback zoning requirement. Said requirement is..20 feet, and the building is 19 . 3 feet from the neighboring parcel. 8. Deed recorded i n * the Registry of Deeds in Book 1737 Page 84 or Land',Court Certificate No . Book Page . r The principal points upon which I base my application are as follows ; ( Must be stated in detail ) Enforcement of the side setback requirement in this instance would result in substantial financial hardship to the petitioners as they would incur enormous costs in having to move their entire house and foundation a mere 7 feet. The allowance of this variance would not be ubstantially detrimental to the public good, would not affect generally J the zoning district, nor would it derogate substantially from the intent of the zoning by-laws . I agree to pay for in newspaper and incidental expenses* i ;1u . �1 je�,;�'1l,� � ;� ��G��'I!/Gi � � � Petitioner ' s Si nature Sec. 1 APPLICATION FORM _. Every application for action by -the Board shall be made on a fora_ approved by the Board. •Thes_e-'forms shall - be furnished by the clerk-- upon request . An.y communication purporting to be an application shall be treated as mere notice of intention to seek relief until such time as it -is made - on the official application form. All in- formation called for by the form shall be furnished by the applicant in -the manner -therein prescribed. Every - application shall -be submitted - with a list - of "Parties--in ' Interest" -*Which Jist-.s.ha-1-1 -include---the peti ti o-ner.,- abutters; owne.r:s of -land directly -oppos-ite on any public or private street or way , and abutters--to the abutters--within three hundred feet of- the property line - of - the .-p.eti ti o.ner as -they. appear on the most recent appl i cabl e- tax-.-l..ist , notwithstanding ..that the land of any such owner is located in another-- city -or -town , the .Planning Board of the city or town , and - th.e- Planning-_Board of-every --abutting--city .or town-- * Ever_y application shall - be submitted with -an application charge cost in the -amount`-of- $25.-00 . In addition ,- the - petitioner- shal-1 be respon - sible for -any and -all costs -involved- in .bringing the petition before the-.-Board : - Such. costs shall include mailing --and publication , but are - not necessarily -limited -to these ,;- LIST _-OF-PARTIES hese .-LIST -OF.-PARTIES IN - INTEREST Name---- Address._ "SEE SEPARATE SHEET ATTACHED HERETO" ( Use additional sheets if necessary) "PARTIES IN INTEREST" Frederic & Susanne MacDonald 69 Heath Road (16) North Andover, MA 01845 Anthony S. & Barbara V. Furnari 9 Heath Circle North Andover, MA 01845 John J. & Marian S. Gaffny 20 Heath Circle North Andover, MA 01845 Waldeman & Erika Arndt 30 Heath Road North Andover, MA 01845 Walter & Madeleine McDonough 85 Sutton Hill Road North Andover, MA 01845 Frank & Elizabeth Watson 101 Sutton Hill Road North Andover, MA 01845 v/ Alphonse & Sophie Didell 91 Heath Road North Andover, MA 01845 r ilk 1 o� I �. E."IORTGAGE PLOT PLAN 55 HEATH ROAD NORTH ANDOVER, MASSACHUSETTS (1 BUYER: R. JEAN VALLIERES - ��1- AND LISA L. KLEMMER VALLIERES — �/ SCALE: 1" 40' �h OCTOBER 19, 1983 1411 � R 35 R•2200' L•l0.90'_ . N 78041, 30 �S L01' 17A �\ • SDA' 102� '(.l. E.,C'.D. 0 38 5 of NOTE: THIS IS NOT A SURVEY AND IS TO BE USLD FOR MORTGAGE +� PURPOSES ONLY. N.B. - DO NOT USE OFFSETS FOR ESTABLISHING LOT LINES FOR THE �♦ w�l7ft Q ~ ERECTION OF FENCES, WALLS, HEDGES, ETC. 0P�' W I HEREBY CERTIFY THAT THE BUILDING ON THIS PROPERTY IS LOCATED AS SHOWN ON PLAN AND DOES NOT COMPLY WITH THE LOCAL ZONING SET BACK REQUIREMENTS. CYR ENGINEERING SERVICES INC. I FURT14ER CERTIFY THAI` THE ABOVE DWELLING IS NOT LOCATLD 300 CANAL STREET IN A FLOOD HAZARD ZONE. LAWRENCE,MASSACHUSETTS *'NOTE: SIDE YARD REQUIREMENT IS 20 FEET. Dat e. .�.. 1/.>Y"....... � 3 1 OF NORTh,� TOWN OF NORTH ANDOVER ° PERMIT FOR PLUMBING gBACHUS� This certifies that-AT/.. .... 16'7�0ey .,,...��..//............................................................................... has permission to perform..........' ✓.. r.... /4---.......................................... plumbing ' dings of.... Q.. ........................................................... mit at.... ......,t.... ............................... North Andover, Mass. Fee. .."'....Lic. No. l�72L1.�. .� ... . ...... . ........................................................... PLUMBING INSPECTOR Check# MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK ' CITY 7 i MA DATE 3 —/ ( PERMIT# ! JOBSITE ADDRESS OWNER'S NAME POWNER ADDRESS S/ d zr4 TEL[ FAX TYPE OR OCCUPANCY TYPE COMMERCIAL ® EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW: ]! RENOVATION:® REPLACEMENT:Iy— PLANS SUBMITTED: YES01 NOQ FIXTURES Z FLOOR- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OILISAND SYSTEM DEDICATED GREASE SYSTEM �€ _.__.1 € __J DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN FOOD DISPOSER FLOOR/AREA DRAIN INTERCEPTOR(INTERIOR) KITCHEN SINK I _ .__3 _.._ !--_-.-- I J i .._._�I .__.-j 'LAVATORY ROOF DRAIN -I I I I I M SHOWER STALL ! ! _..__l € J ! 1 � I _1 .-_- — ( € `SERVICE/MOP SINK ( TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER INSURANCE COVERAGE: 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YEN7111 No Ell IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY Nf OTHER TYPE OF INDEMNITY D BOND ] OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER —! AGENT I© SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in c mpliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME LICENSE# - i 07 z " - S GN TURE MP,4' JP Q CORPORATION F]#PARTNERSHIP E-1# LLC COMPANY NAME '7`i`Vf 'fADDRESS 2 /Vr`r4o1Wf CITY I�I t h �- - - J STATE �dl ZIP TEL FAX ; CELL . EMAILK /�-CoM- --- ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL JNSPECTIOA NOTES Yes No a� THIS APPLICATION SERVES AS THE PERR IT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES s � ,/ Date..... ,<..:.a..//..7'..................... OF NORT�y,h TOWN OF NORTH ANDOVER � � a PERMIT FOR GAS INSTALLATION Thiscertifies that .......................... ..................................................................................... has permission for gas installation ...(?` 1. . C��N4n inthe buildings o .......��....�. ..I................................................................................... at........-15;5 .. P ` ,:.....�/'/....................... North Andover, Mass. Fee.�.... �P... Lic. No.1K.7.1 b�..... /...�.�....................................................... GASINSPECTOR Check# 4 o&� 1 9150 �q�- p ` MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY _d s �� 'i' _ _ MA DATE 3-fy-fy PERMIT# JOBSITE ADDRESS _f OWNER'S NAME G .A OWNER ADDRESS TE �IFAX��f TfPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL PRINT RESIDENTIAL CLEARLY NEW:El RENOVATION: REPLACEMENT:ja PLANS SUBMITTED: YES D NO 0 APPLIANCES 7 FLOORS-- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER �— CONVERSION BURNER COOK STOVE _ _ � DIRECT VENT HEATER I DRYER I . FIREPLACE _ - [� - IILj FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT __ I TEST UNIT HEATER _a UNVENTED ROOM HEATER WWER HEATER OTHERl„ I. ........_. ... .........._.. ..... .... .. .... . ... - - --- 0[:: J1 1 I INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YESNO [� I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 5- OTHER TYPE INDEMNITY ® BOND OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER © AGENT ��l SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compli nce with all Perlin t provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME � 6 _ I`Tf_,�LTLICENSE# 107L SIGNATURE MP a MGF 0 JP ® JGF D LPGI El CORPORATION©# PARTNERSHIP[]#=LLC®# COMPANY NAME: EZ `/�,CS11ADDRESS CITY m^�_�!� -w' _ _ _ . _ � STATE �ZIP(�� TELCod 3 FAX �CELL EMAIL �-*FGCC(ZpG'NfIC-L- (�,� ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTIOIJ NOTES e Yes No 5 THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES n The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations kVJ 600 Washington Street Boston,MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers Applicant Information Please Print LeLyibly Name(Business/Organization/Individual): /Ot Address: /y 12 �/c r 9A City/State/Zip: l' 7 ,-G�,�j ��' Phone#: �'U �'�'Z /C S�Z_ 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 mployees(full and/or part-time).* have hired the sub-contractors 2 I am a sole proprietor or partner- listed on the attached sheet.# �• F1 Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers'comp.insurance. 9. F1 Building addition [No workers'comp.insurance 5. El We are a corporation and its required.] officers have exercised their 10.El 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.]r employees.[No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. T Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors that check this box must attached an additional sheet showing the name of the sub-contractors 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 requiredunder 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. Ido hereby certi under the pains nd enalties of perjury that the information provided above is true and correct. - Signature: `~^ 4 Date: Phone#: a 3 2— Official Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other - - Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not producedacceptable evidence of compliance with the insurance coverage required" Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or'-permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial.Accidents Office of Investigations 600 Washington Street Boston}MA 02111 Tel,#617-727-4900 ext 406 or 1-877rMASSAFB Revised 5-26-05 Fax##617-727-7749 www.mass,govfdia c0`MMONWEALTH OF MASSACHUSETTS =: PL;UMBERll AND CASFITTERS ' y;L{CENSi=D A:� A MAS'7ER PLUMBER ISSUES THE ABOVE LICENSE TO: JAMESK ;FLA- FERS co, 7 NICHOLAS Rid N% FLAIS`T0ow NO 03865 1;0724 05/L1/14 x171191 t Date........Z.77: OF NORTH TOWN OF NORTH ANDOVER PERMIT FOR WIRING 188'�CMUg�� / This certifies thatc,€ -T/�ma.........................f4'.t.. ......... l- ................................................................. has permission to perform ............... .l.! 4.... .. ............ wiring in the building of................................/J. ...t................................................... at ......... .......5.5................ -..T ��. ...................... orth Andover,Mass. ........................ O40' Fee.,�5..:,:. Lic.No. —17 ....................... ......... � -�....... Check# S-7-7'"'��S-7-7 E- `►ucni.IxsrEcrox�t ,. 2163 P. . Commonwealth of Massachusetts Official Use Only r Permit No. Department of Fire Services Occupancy and Fee Checked ,M BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/071 leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code C),527 CMR 12.00 (PLEASE PRINT ININK OR TYPE ALL INFORMATION) Date: Z q City or Town of: NORTH.ANDOVER To the Inspector Jf Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) A a AV Owner or Tenant J9r#2tjY n` a tr Telephone No. Owner's Address ZnP Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building ,5'j fl rlt, Dwt lvi� Utility Authorization No. - Existing Service ZOU Amps /ZU/ 2 Q 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: j qylqYbIldlia40 OU t14 C w tie Completion of the following table may Ce waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets r7 No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- ❑ o.o Emergency Lighting rnd. rnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating AppliancesKW LJ Security Systems:* 1 1 No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Ele trical Work: (When required by municipal policy.) Work to Start: Z / ' /q Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE CO RAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cove age is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE JJ BOND ❑ OTHER ❑ (Specify:) I certify,under thepains and penaltiesofperjury,that the information on this application is true and complete, ct FIRM NAME: Iyrvl / is LIC.NO.: Licensee: i Aql Signature LIC.NO.: (If applicable,enter "exe t"in,the hy�ense ber It ) > Bus.Tel.No.•T-2k-30 L Z k7 Address: Zii� , '/� !� Alt.Tel.No.: *Per M.G.L c. 147,s.57-61,Vcurity work requires Departmen 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 agent. Owner/Agent PERMIT FEE. $ Signature Telephone No. ❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance-with the provisions of M.G.L.c. 143,§3L,the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166,§32,an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall be limited as to the time of ongoing construction activity,and may be deemed by the Inspector of Wires abandoned and invalid if he or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008 and extending through August 15,2012. ❑ Rule 8—Permit/Date Closed: ***Note:Reapply for new permit ❑ ❑ Permit Extension Act—Permit/Date Closed: Trench Inspection Pass n Failed 0 Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: SERVICE INSPECTION: Pass F?1 Failed Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: PARTIAL ROUGH INSPECTION: Pass N Failed 0 Re-Inspection Required($.) ❑ Inspectors Comments: �1 Inspectors Signature: Date: ROUGH INSPECTION: Pass 0 Failed Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: FINAL INSPECTION: Pass Failed Re-Inspection Required($.) ❑ Inspectors Commen orJ Inspectors Signature: Q IV Date: DEB WEINHOLD ...TOWN OF MERRIMAC,MA. .......dweinhold@townofinerrimac.com r The Commonwealth of Massachusetts07 - Department of Industrlgl Accidents Office of Investigations VV 600 Washington Street Boston,MA 02111 www.mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): 4MI Ct f�-. IM , Address: , City/State/Zip: �vYit^�►l�� MV . Phone#:—q 4 3�7Z-/�6� Are,you an employer?Check the appropriate box: Type of project(required): 1.0I am a employer with 2 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet.# +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. El We are a corporation and its 10.F1 Electrical repairs or additions required.] officers have exercised their 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12.❑Roof repairs insurance required.] employees.[No workers' 13.[i Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. I Homeowners who submit this affidavit indicating they aie doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information. 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.#: &AL14 /0-3 26- 15�n Expiration Date: (p / Job Site Address: ��QR7 A .City/State/Zip- G[ty]ofr�, A? ? Attach a copy of the workers'compensation-policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder 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 cert under the rains and penalties of perjury that the information provided above is true and correct. Si ature: ��-t/ Date: —411F Al Phone#: 971" 36Z` Z/e-7 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#: y Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, or express implied,oral or.written." p An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance ofublic work until acceptable evidence of compliance p p with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of 1 insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial t Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and tinted legibly.p g ly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or h town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or'-permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The ConuAonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 604 Wasbington Street Boston.,MA.02111 Tei,#617-727_4900 ext 406 or 1-877:MASSAFE Revised 5-26-05 Fax#617-727,7749 www-mass,gov/dia Date. -7 .4 TOWN OF NORTH ANDOVER 3?O•�,�..o '�tiooL PERMIT FOR PLUMBING i s � �,�• a ,SSACMUS� J This certifies �•. . . . . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . f plumbing inn the buildings of . . . . . . �.' . . . . . . . . . . . . . . . . . . . . at.�? . .r`! . . . . - -- . , North Andover, Mass. Fee. Lic. No.. x .?.�. . . . . . ,.� a .. . . . . . . . . . . . . PLUMB 4 INSPECTOR Check # j� a 5393 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING k (Type or print) NORTH ANDOVER,MASSACHUSETT Building Location S �' ' ` Owners Name 15 cry L_,�atePermit# Amount Type of Occupancy New Renovation ri Replacement Plans Submitted Yes ❑ No ❑ FIXTURES z cr � a x x x w �ffiVIC BASM/ r IST Hi" M HJOOR M NIM 4M FLOOR 5M HDM 6M FIOM 7M RA" SM ILOC R (Print or type) f Check one: Certificate Installing Company Name l)fL C �fi 1 w olp. Address ^ Pit P-c C-) Partner. cs. VP Busin^Te ep one �ye2�1-4 S�_ S'0e+7 0 Finn/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy B- Other type of indemnity ElBond ❑. 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 Massachuss Sta Plumbin ode and Chapter 142 of the General Laws. igna By: ur icense um er Title Ty of Plumbing License - --? City/Town LICenSe,1911moer MasterJourneyman ❑ APPROVED(OFFICE USE ONLY Iwo 4127 Date ................................. HOR7M o °� TOWN OF NORTH ANDOVER PERMIT FOR WIRING CHU This certifies that ....... t. :::: .............................. has permission to perform.,....... -r,e-< twiring in the building of.....v. ............,........................................................ t at U.. ......... "t ....L. ........................707�--.-, dover,Mass. �j( � Fee. Lic.No.�`/. �'!4 - _.. .............. �............ -- .................... ELECTRICAL INSPEC�`rOR Check # //r,Z� 7HECOMMONWEALTHOFMASSACHUSETlS Office Use only DEPAR7N&\T0FPUX1CSAFL7Y BOARDOFFIREPREVEMONRBGULWONS527C -12.010 Permit No. Occupancy&Fees Checked APPLICARONFOR PERMIT TO PERFORMELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dates Q 0-7/0 0 1 .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) 55- P to Owner or Tenant Owner's Address } „� Is this permit in conjunction with a building permit: Yes Qn-�o (Check Appropriate Box) Purpose of Building 'S 1 to,,1 w Py,, Li Utility Authorization No/d7 Existing Service Amp Volts Overhead ED Underground No. of Meters New Service Amps 'L��--Volts Overhead ®�nder&ound No.of Meters Number of Feeders and Ampacity Location and 1,Tature of Proposed Electrical Work h ,) )O v 11. a. (Z7-,! 1. I 1 R J4 No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total No.of Lighting Fixtures Swimming Pool Above Below KVA Generators KVA round round No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No, f Ranges No.of Air Cond. G Total FIRE ALARMS L Tons � No.of Zones-� No of Disposals No.of Heat Total Total No.of Detection and G� Pum s Tons KW Initiating Devices y No. f 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 No.of Water Heaters KW Connections No.of No.of Si ns Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER• rl"MftCOVWW-rtua>9b the lequimmaUdM"d>umllsGard Um haveaalaaltLiabl7ityhmmooepolicyit>d gCorr>pW0 ErA M CoWrJgeOr&Atstff balegtuvalalt YE NO ham�validpoofofsamelooe theO� YES ffyoufxmdrekedYES,plea uxbc&thetypeofmvaageby � box L�1 VSURANCE BOND OTHER � (pl y) 1111���l111 folkto Stait � / I Estir 1&d VakE dE1wfiical Wolk$ igtedunderthi-Rnaltiesof MR� - I RMNAME 1XfflSeN6. censee ( ( Signahm LioamNo R&M Tel No. L-��eA AIL Tel No. NM R'SINSURANCEWAIVER;IamawarethattheLioemedoesnothavetl>eir%mncecoverageoritssubstantialequivalentasIequiledbyMa%xhusmGeneralLaws d that my siglah m on this pemm application wars this requiten>�It lease check one) Owner r-7 Agent Telephone No. PERMIT FEE lgna ure Ot Uwner or gen VIA CL r-� be s t"c / r c, a 3 , 3 "`VVV ��. c 3 1 L 5 Date.... NORTp TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSACMUSE� t This certifies that ........ n.. .t...... ..f....... ............... S....... \ has permission to perform ...: ( _., , {/,- ," f- ...... ... ...............................I.............................. Z, wiring in the building of �!.!.!...f.`� !!� Z�� ...........:. .... ..................... at..... `. ........ .. ............................... ................. .. North Andov�erMass.� F ��. r�Lic.No..) ';t �G�. - ' .^..�...... %.. ... �ELECTRICAL INSPECTOi Check # WHITE: Applicant CANARY: Building Dept. PINK:Treasurer IrmW1VJ1VJ"1Vrrr_A"1J17VL'LY!liJ1]HCL7U►]Gl LJ v111ce use only DEPARTAI ENT OFPUBLICSAFL7Y y Permit No. �� BCMD 0FFIREPRBtEEM70NRX47.4TIa-" 527CMR 12.�fi1 D Occupancy&Fees Checked APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL.INFORMATION) Date 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) ,} S Owner or Tenant Owner's Address �. Sce ryy e Is this permit in conjunction with a building permit: Yes m No M (Check Appropriate Box) Purpose of Building eM r .. Utility Authorization No. Existing Service ^_ Amps Volts Overhead M Underground No.of Meters New Service Amps / Volts Overhead Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work w r:w,/rb, No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total a I KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA and ground No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. f Total FIRE ALARMS No.of Zones l Tons No.of Disposals No.of Heat Total Total No.of Detection and Pins as KW In.itiattna 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 r--J Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis d No.Hydro Massage Tubs No.of Motors Total HP f OTHER Irst==Co,a RnsmttDthetagtffia and BdtsGaiedLaws Iha%eaamotLmbt1dyhxa==Pobcyml&gCarlpkte Cmetagea'ilssi driva{at YES M NO Ihaw stbxniWdvatidptx#ofs&ne1otheOlf=YES FJ NO r IfjcuhawdxdwdYES,pleaseindic*fhetAxofw&agebydrdkxIgthe IIstJRANCE BOND 01HER (PfeaseSparfy) EVita6mDale F.,sdrt�ed Vakte� ^-II4'i�a;:$ NVO&0Sit hqtectirnD*Re pc0d Rao Fbal SigneduttdaM Rmitiesofpeljtay. FIRMNAME Ves r o✓ ''1 5 LioaiseNa Lica 4�(opoca^ F �l eur _ Sigimle liarseNo >� 31 BusirrssTd.Na ��-370 =q 9'��� OWNER'S INSURANCEWAIVER;I.amawatethatthelia dmnut icstsaneoaaa�aAsst> z>tralegtriva)atastt�cluuedlryM BetlsGa>eralLaws andd-dmysoonflusptsappkEdirn thisra4Malna)t. (Please check one) Owner o Agent 4•L...-.�•�� � � Telephone No, PERMIT FEE i d C) .,.'.I Office Use Only V4t bmwnluealo of _ a00ar4n1Eftg Permit No. �E�TIIYt2itEIIt of tIb11L' iafEtg Occupancy& Fee Checked AL BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 1 3190 (leave blank) ��SIS APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date -<_"7'97 Qo* or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) Owner or Tenant Owner's Address ,-- / Is this permit in conjunction with a 9 building permit: Yes No ❑ (Check Appropriate Box) Purpose of Building ��' 4������ ��{-`�" �'`'45-- Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps Volts Overhead ❑ Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work M ©�� No. of Transformers Total No. of Lighting Outlets No. of Hot Tubs KVA No. of Lighting FixturesSwimming Pool Above In- grnd. ❑ grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets LO No. of Oil Burners ' Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones Total No. of Detection and No. of Air Cond. No. of Ranges tons Initiating Devices No. of Disposals No of Heat Total Total I Pumps Tons KW No. of Sounding Devices No. of Self Contained No. of Dishwashers ( I Space/Area Heating KW Detection/Sounding Devices 1. Local Municipal [:]Other No. of Dryers Heating Devices KW ❑ Connection No. of No. of Low Voltage No. of Water Heaters KW I Signs Ballasts Wiring No. Hydro Massage Tubs I No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Complete perations Coverage or its substantial equivalent. YES NO I have submitted valid proof of same to the Office. YES NO If you have checked YES, please indicate the type of coverage by checking the appro a box. INSURANCE BOND -_ OTHER � (Please Specify) J -�) / (Expiration Date) Estimated Value of Electrical Work S S"by ' Work to Start 7-� Inspection Date Requested: Rough Final Signed under tTe Penalties of perjury: pp /I FIRM NAME �JcJcCt;s LIC. NO.M^5� Y�— Licensee tG�t` �'�' ^� `� Signature LIC. NO. 7 7 &U 5 ki� Bus. Tel. No. �O 3 a2 ��t� Address �� �✓ JlY� Alt. Tel. No. OWNER'S INSU ANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE S (Signature of Owner or Agent) x-6565 Date.......-.a ..-..�1.7 I TJ 916 f '40 1 D 0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING g ,SSAC14USE� This certifies that ......... ..........0.1 ..... .......... ............. .` g has permission to perform ...... y(, ........ . . wiring in the building of .................. at. . , ..... .. .....`"t"' .................... .North Andover,Mass. Fee... Lic.No��.-7.St. .......................................................... (M !i ELECTRICAL INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Location No. - Date Nrar.,tio TOWN OF NORTH ANDOVER p Certificate of Occupancy $ ` Building/Frame Permit Fee $ .s a ; ,SSACMUSFoundation Permit Fee $ o Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector Div. Public Works -zo PER3IIT NO. ' A APPLICATION FOR PERMIT TO BUILD -- NORTH ANDOVER, MASS. PAGE 1 MAP f4O.aCt') LOT NO. // 2 ; RECORD OF OWNERSHIP JDATEBOOK 'PAGE ZONE SUB DIV. LOT Np. I I LOCATION �` EPUR77EUILDING t�l�� /1 1 'OWNER'S NAME S 1 SIZE r7(� OWNER'S ADDRESS -S- BASEMENT OR SLAB tt�In ARCHITECT'S NAME SIZE OF FLOOR TIMBERS fST�X 2ND 1 3RD BUILDER'S NAME \ \1 C`I�5 SPAN �,•/ DISTANCE TO NEAREST BUILDING _ DIMENSIONS OF SILLS DISTANCE FROM STREET ' POSTS DISTANCE FROM LOT LINES-SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING x - IS BUILDING ADDITION MATERIAL OF CHIMNEY c- 18 BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND , WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER 18 BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION SEE BOTH SIDES LAND COST EBT. BLDG. COST (/ �1 / �p PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. 1,l0 O(COST PER SQ. FT. PAGE FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM R ELECTRIC METEP6 MUST BE ON OUTSIDE OF BUILDING SEPTIC PERMIT NO. 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND OPROYED BY BUILDING INSPECTOR DATE FILED BUILDING INSFKCTOR SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE �` OWNER TELAE C1 Lig-a 8�� PERMIT GRANTED CONTR.TEL# IS 51 nn �(� CONTR.LIC.p V v H.I.C.# BUILDING RECORD ,NCY 12 RIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM ICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CTION INTERIOR FINISH ]J2 DW"D _ STER WALL —— - B'M'T' AREA — r ATTIC AREA PLACES _ TERN KITCHEN FLOORS B 1 2 3 iCRETE IH — DW'D b VdCN _ I.71LE C STRS.b FLOOR I_ WIRING PRIORPOOR ]DATE I� NONE - I PLUMBING _ 1 (3 FIX.) _ ET RM. 12 FIX.► ER CLOSET _ 4TORY _ HEN SINK PLUMBING L SHOWER _ AERN FIXTURES _ FLOOR DADO HEATING VFURN _ HOT AI i M W'T'R OR VAPOR - CONDITIONING ' ANT H'T'G HEATERS TRIC HEATING �fORT F Town of , _ 4: -= over No. ZD�o * _ - - _ - Ali - * dower, Mass. 19 9� LAKE COC141CHIEW cm yY'�• TED S E BOARD OF HEALTH PERMIT T Food/Kitchen Septic System BUILDING INSPECTOR THISCERTIFIES THAT........................................ .......... .!! . ................................................................... Foundation has permission to end.....! ���,......... buildings on ........��.... `........ ........................... �...................... Roup, to be occupied as........................................... .Qr�. .............. .f. G.ltd1�!....................................... ... himn y C e 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 Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST Rough .. .. ... .. ...... . . ... . .............. ........ Service...... ............. BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Budding Inspector. Burner Street No. Smoke Det. I 7 l - �e�arxono�eu o��/uaaaac�iude!!d HOME IMPROVEMENT CONTRACTOR Registration 108741 Type - INDIVIDUAL Expiration 08/24/98 DAVID R. SMITH 54 Main St egville _NH 03819 ADMINISTRATOR -• - _._. ._.. W $ LO co 00 r --_+ co 1 I I Cc co ASMI 3 � SrOi l V OD M I W (�) (� F N I M cli I I IN CCI m y I IrOi` I CC N � QO ¢ N III m I j _- I II II co aiN III ° f I ro � �I III I I of of M I yJ N III m col lI I Z _n LU I I I I co I O I HI} I I I I I co N I o O I II l I c6 m I LU I Y I III l li I I III I of C>. II I I X I II N i m l m l I 4t III C" IO �................: Cl) I N 0 1 -ia i i m Nr to _ .si/ 0 J \ I co 1 I I % m I rxCSU _......__C13 co.. _...... .._.. .. _ ............... I to I L-� SUmM I I rl � i Inti • I � I a 515— { 1 l I THE FLOOR PLAN AS CABINET LIST 't I MOYNIHAN LUMBER OF Pf AISTOW I Smith Scale:1/4'=i' Design: 11/01/96 Dwg no. WILL NOT 8E RELEASEOiTIL JOB ORDER 12 PHEASANT LANE Date 11/01/96 HAS BEEN PLACED ALLVENSIGNS& I PLAISTOW,NH 03865 D.S.BUILDERS SIZES ARE SUBJECTTQ VERIFICATION ON JOB TEL:1-603-382-1535 I Designer ShE AND ADJUSTMQf/TQ FIT JOB C/1ONr\DffIONS. v l FAX:1-603-382-1935 �5 l' , y � 1�..�1-�C. • ham-[y�/J (-� ^ ". o-w-�d6 ��.ern c�, �x�5���� �'��,i,v�-�. ��ply.. w i�� i�l�v N��� ��es�u/� �►�, " 9. k �iC IA%RI� N �w �{� 1�" � mri } �;(A�e SiN `7 ►� Sz+.� uN/l�" i is s I !L P(&<,L O tk4 61�414 I I SDN J I !f : ]D17 m U fJ QI _ _ _ - - i cJ tp Z!ill f I �j�n cs+mmy ---Y - :.. - - ------------ ------------- w _...._ --- - i - � I i o t 131 ii II ! ;I iii � - I! a I _ r r'. .-�, .� ��� - �� � �� � � �� ��� �� �---���� D.S. BUILDERS LIC. # 055816 54 MAIN ST. REG. # 108741 DANVILLE NH. 03819 603 832 6651 LAURA CRAIG-BRAY 55 HEATH RD. N. ANDOVER, MA 01845 (508) 689-2887 Kitchen Renovation: PLANS &PERMITS - The contractor shall be responsible for obtaining the necessary and required building permit for starting and compleating this proposal. All subcontractors hired by the contractor will obtain their permit(s) prior to starting their respective work. The contractor will be responsible for scheduling all required inspections. The contractor is not responsable in anyway for subcontractors hired by the homeowner. The homeowner assumes all responsibities for subcontractor including any financial expence to contractor for cost of delay(expensed by contractor), or rework costs. The contractor will supply adequate drawings needed to obtain such permit(s)to guide workers through the project. Any variances needed must be obtained by homeowner and is nessary for related permits to be granted Demo: Renovate existing kitchen as per conceptual drawings dated August 28, 1996 including removal of all cabinets, countertops, and floor covering. Window: Installation of new Andersen CR135-3 casement window with low-E glass and full screens. in place of existing window. Cabinets: Installation of Cbico frameless white square edge and Dal-Tile 6 x 6 ceramic tile backsplash, Swanstone KSLS3322 sink with Delta 174 faucet and installation of all client supplied appliances. Flooring: Install 2 1/4"red oak hardwood flooring (at same elevation as existing hardwood flooring) sanded and sealed with(3) coats of oil-modified urethane. Plumbing Install plumbing to include hook-up of sink, dishwasher and faucet, and installation of new FHW, toe space heater and removal of strip heat at bookshelf area. I Electrical Install electrical to include hook-up of all client supplied appliances, (6)Halo 75 watt recessed light fixtures, (3) halogen undercabinet lights, (6) outlets, and (1)telephone outlet at desk area. Plaster: Patch of wallboard/plaster on walls up to 60 square feet. Ceiling 6 Square foot I Clean-up Clean up debris and store in container to be hauled away off site. Job site will be kept as neat and orderly as possible on a daily basis. Remove all construction debris. Does not include interior or exterior paint, or appliances. COST FOR ABOVE JOB SHALL BE $ 16,265.00 d A04.•.. •—•• ••••••••••• �•• v��Irvr1M Mr'r'iJVAI ILII�1 f Vf1 f Ct1M11 l u IAV rt�u�y�u��.�.+ , 04 (Print a Type) 2 NORTH ANDOVER,, Maes. Date SZ � „10 /� 7 Building r� Locstlon `/ 24, permit S ��� Ownees ' • Name ��t �:��-c c� New ❑ Renovation ❑ Replacement ( Plans Submitted: Yes❑ No.❑ FIXTURES Ito Is 11 y J . 1~ V e44 44 a M D O t » t el rj r w 1 at el Ir ._. Is t r .01 s M eca s a " w sIL W J ` IN U ! 1 i w a o S j at � w Lr l e e !f tl�—•s 11T• eAe�YtNT —j L � IST FLOOR 2ND FLOOR 4 $110 FLOOR i 4TH FLOOR eTH FLOOR sTH FLOOR ITHFLOOR eTH FLOOR _ Check one: Certificate Installing Company NameO13 c . Address J 2- ❑Partnership v�. [Iflrm/Co. Business Telephone 7 •Name of Licensed Plumber 3 INSURANCE COVERAGE: Check one I have a current liability Insurance policy or Its substantial equivalent. Yes W No ❑ 11 you have checked y". please Indicate the type covenpe by checking the appropriate box A liability Insurance policy (�^ Other type d indemnity C] Bond 0 OWNER'S INSURANCE WAIVER: 1 am aware that the Ilceniee does not have the Insurance coverage required by Chapter 112 of the Masa. General Laws. and that my signature on this permit application waives this requirement. Check one: §Faafurs of Ownu of Owners Agent Owner ❑ Agent ❑ i 1 hereby milfy that all of the details and Information I have submitted for entered)In above tlorl are bus and&=mate to the best of my f knowfsd�a and that sl plumbing wak and Installations performed under the permit I this applkation will be In corMflana with all pa linen provisions of the Massuhusetts State Plumbing Code and Chapt&r 112 0l al Title 99natUrgol Licensed City/Town license Number J� A!'f'i10VED(OFFICE USE ONLY) Type of Plumbing lksnss: Master ❑ Journeyman ❑ Date. 3321 / c TOWN OF NORTH ANDOVER 3r , '• 0 4. to PERMIT FOR PLUMBING This certifies tha . . . has permission to perform . . . e.!L. . . . . . . . . . . . . . . . . plumbing in the buildings of . . .�'./? �. !.g. . . . . . . . . . . . . . . . . . . . at. . ./y�. .L �� . . . . . . . . . . . , North Andover, Mass. ; ('� N Fee.),�.r-. . .Lic. No.. .d.sF 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR c WHITE: Applicant CANARY: Building Dept. PINK:Treasurer f MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) _ l NORTH ANDOVER Mass. Date . .6 1 : _ tuildin Locat�'o/n �� /�C� �� Permit /V J /�%�' �✓�Y Owners Name Y r, K New Renovation II Replacement Plans Submitted n C � tts Os 1G r t» Q f. us us C7 ss c LU - C M C U V o'f La U1 tu W GI C 4 V I G �. Q o. SASEMEXT I IST FLOOR { I i t i L I I F { { { I I I I I I I - I-.. _I.,; zna FLooR j 3R4 FLOOR L I (( ..) ..I { I I { I I I { ( I ...I. --- r+--- 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TK FLOOR STH FLOOR (Print or Type) NO Check one: Certificate Installing Comp -iy NameAo A- ��/7—C� Q Corp. Address 146 Z - Partner. - - dG �—Firm/Co. Business Telephone: 6/ 2--f /7/7 Name of Licensed .Plumber or,-Cas Fitter Insurancr- Coverage: Indica--e ;tee type o, insurance coverage by checking the appropriate box: Liability..insurance .policy.- Ot^e. *vee 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 _coyerages,_-._. Signature of owner/agent of property Owner u -Agent I hc:chy certify that all or the details and information I have suhmit:ed (or entered)in&Love application are true and accurate to the best or my knoWtedre and that atI ptuatbin; work and tnsu4ttioos ;=far=ed urs::-t'-'rr.-tit i=utd ro: this sprd=tion will be comptiartca With all perttactt pro.isions ar ttte StassaQ4u&etts State Cas Cade and CZapter I43 c£t.:e G<_%=i Lars, _. 3v TYPE` LICENS— Ti.L.Ze I Gasiitter. Signa ure of License: C_tv/Tcwn: �,�:aster P1Mwft� asfitter Journeyman APPROVED (OFFICE USE ONLY] License Number Date. . . ..... a NORTry °F �' 3? 6 TOWN OF NORTH ANDOVER ILI PERMIT FOR GAS INSTALLATION •` h y,SSACHUSESt This certifies that .(-.'e . . . . . . . . . . . . . . . . . . . . . . . . . has permission for gas installation . . . . .,. . -. . . . . . . . . . . . . . . . . . . in the buildings of . . . :!. . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . . . . . . . . . . . .I North Andover, Mass. Fee.�'.}. . . . . Lic. No.. . . . . . . . . . . . . . . . *_.r-V.. . GASINSPECTOR Check# 4462 MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS (Type or print) G Date NORTH ANDOVER,MASSACHUSETTS " 2 Building Locations rormit# �I Amount$ Owner's Name New❑ Renovation ❑ Replacement ®/ Plans Submitted ❑ a ou On w z U H d w o z 0 x z x H x z G o w 3 A oao o cv z E. OaU z w N a' F o SUB-BA SEM ENT BASEMENT IST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH . FLOOR 5TH. FLOOR 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR (Print �'/ �- (� �� � � f ���� Check one: Cer ti� to J ailing Company NamCOP-D Address / (.%LM 6 h'� ❑ Partner. L LAD Business Telephone ") 3 ❑ Finn/Co. Name of Licensed Plumber or Gas Fitter C I LL A4,0- INSURANCE COVERAGE Check I have a current liability Insurance policy or it's substantial equivalent. Yes No❑ If you have checked M,please indicate the type coverage by checking the appropriate box. Liability insurance policy 13" Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ 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 instal tionspe4fmned under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachus State cod=of the General Laws. By. Si ature of Licensed Plumber Or Gas Fittr Title ❑ Plumber -3 4 y U City/Town Gas Fitter License Number [a-Master APPROVED(OFFICE USE ONLY) ❑ Journeyman i Y 2527 Date. . . ....... . i NORTH TOWN OF NORTH ANDOVER. F pE .�ao ,6,ti0 0 PERMIT FOR GAS INSTALLATIONg s o • �9SSACMUSEt4 M This certifies that . /�.� s���►.�. . . . .���. .��. • . . . . . , w has permission for gasinstallation . . . . . . . . . . . . . . .112. in the buildings of . 0 Aq. y . . . . . . . . . . . . . . . . . . . . at . . . . . . . . . . . .. North Andover, Mass. Fee. ./.3.,.7. . Lic. NoJ-.&.3 I:. . . . . . . . . . . . . . . . . . . . . . . . . . . . GASINSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File Locations t! e a! ��d G _ No. Date 7— MORT1y TOWN OF NORTH ANDOVER 3j � a OL N 9 X + y Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # r 1 56U' 7 , Building Inspector �� s TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED:~ Io - C oa SIGNATURE: Building Commissioner/IEECEtor of Buildings Date SECTION 1-SITE INFORMATION , . . 1.1 Property Address: X1.2 Assessors Maprd Parce_I Number: a ,, d' CR MA `84� Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: 3 33, 16612S Zoning District Proposed Use Lot Area Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Re red Provided 30 �� 9, 30 30+ 1.7 Water S Iv1.�L C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public Private ❑ Zone Outside Flood Zone 0 Municipal -e On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSIIIP/AUTHORIZED AGENT M 2.1 Owner of Record AV*k 'PP✓ay A Gotyon^ C✓aim 5111my SS 1-E� F4 . Wo, Amok m✓, NA tS� Name "tS f Pri ) Address for Service: a r Telephone pO 2.2 Owner of Record: Jv Name Print Address for Service: Signature Tele hone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Yyti111aA4 C. "eKVAy Licensed Construction Supervisor: 77'1 1'2�1 11, Dv, Avit4ovey-, M AO(Q� License Number wn Addr ss u Ii. ob• 0* �+ g p�� Expiration Date a® Sig ature. elephon.e 3.2 Registered Home Improvement Contractor Not Applicable ❑ A'.AjwG/ ee...4,,y,.h 1n 5I1fhGASr Vie- Company ieCompany Name (Z g Q I `p M 110 Wtv,4 St• W oSyyg . 1 lt DaA A ess O 1 aO t Registration`Number Ad C� • d OZ• I • Ory ;E l O 3? g Expiration Date p� Si nature Telephone �1" i o . 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 rmit. Signed affidavit Attached Yes....... No.......0 SECTION 5 Description of Proposed Work(check all applicable) New Construction ❑ Existing Building 0 Repair(s) 0 Alteral<iops(s) 0 Addition Accessory Bldg. 0 Demolition 0 Other 0 Specify Brief Description of Proposed Work: �(2—y 1.2,0 SCC do c� '� 1po� a>�c�d� tT✓� br 3ITINQ J, l7A-1 SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be I�FICI�IL U (}�j7E,y Completed by permlt a licant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)x(b) 4 Mechanical HVAC • 5 Fire Protection 6 Total 1+2+3+4+5) -901, 2,1 1 Check Number SECTION 7a OWNER AUTHORIZAT ON TO BE COMPLETED WHEN J�? OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT ~� I, fK� ✓ ,as Owner/Atshmi—d*geffl of subject property Hereby u o ' e &%Ao4a✓ -tKo�a't'�crN Cio�.a�lctvls �. G• �C�N act on a My b matter elative to work authorized by this building permi application. 1 ' l S ue of Own Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, 143 1 11 k A vH t✓ • ypC to N ,as 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 W-,IItaw• G 1Pevty� Print Nan . ` " • • Signature of 6barct'tTA ent Date.,, NO. 0 S SIZE 'ij{o Z$ Naw CASENMIUOR SLAB SIZ LOOR TIMBERS (D 1 2 SPAN * -O DIMENSIONS OF SILLS Z V y DD,4ENSIONS OF POSTS DMNSIONS OF GIRDERS HEIGHT OF FOUNDATION, THICKNESS Q SIZE OF FOOTING I X MATERIAL OFC Y IS BUILDING O OLID R FILLED LAND IS BUILDING CONNECTED TONATURAL GAS LINE o p.O A-�5 2 - L= L 84 c 5 Q 21.4' P,OA % fid, 2 N n 5TH ry N � W '61 Lo -r 17 33, 15,� X40• II �. a � L -rpLAN 0 --1 GA'�N off'.{� -( K A�b v� , rA A 55 I � bb '- 13 , 2c�02 JAN rx 24813 PLAN WAS OA- I� 5"C ��M E-H--( 5�����( gid, ` • .EDWARD FARRELL PROFESSIONAL LAND SURVEYOR 110 Winn Street Suite 207 Phone:(781)933-9012 Woburn,MA 01801 Fax:(781)932-1174 I r, i ENERGY CONSERVATION APPLICATION FORM FOR LOW-RISE RESIDENTIAL NEW CONSTRUCTION and ADDITIONS 780 CMR. Appendix J (effective 3/1/98) Applicant Name: Wtkk\uwd G. 'Pwlttl.` ._ Site Address: 5S JAeh-44 44 Applicant Address: ((O k),, vt S+. City/Town: �1_�, D�a4J' kI Z2 i m M A P%501 Use Group: Date of Application: b" 1+•OA Applicant Phone: -15I 4t-61 &40,S Applicant Signature:.. r& C_ . 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.I b): Heating Degree Days(HDD63) from Table J5.2.I a: (For items d. through i., fill in all values that apply from Table 15.2.1 b:) 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+a) % h. Basement wall R- d. Glazing U-value U- i. Slab Perimeter R- e. Ceiling R-value R- j. Heating AFUE Component Performance: "Manual Trade-Off" (Limited to wood or metal framed buildings only) Climate Zone(from Figure J6.2.2) (] Zone 12 [-] Zone 13 [] Zone 14 Attach Trade-Off Worksheet from Appendix J, [and HVAC 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 2O5je sq.ft. b. Glazing Area++ sq.ft. c. Glazing%(loo x b=a) 1.0-0/- ADDITION with Glazing % (c.) up to 40°lo may use 780`CMR Table 11.1.2.3.1 below: MAXIMUM U-value 'MINIMUM R-Values Fenestration Ceiling Wall Floor Basement Wall Slab Perimeter,Depth 039 R-37 R-13 R-19 R-10 R-10,4 ft El "SUNROOM" addition(greater than 40% glazing-to-wall and ceiling gross area) Attach"Consumer Information Form" from 780 CMR Appendix B. Official's Name: Official's Signature: Application Approved F] Denied Date of Approval/Denial: Reason(s) for Denial: (provide additional details as rieeded on back side) 1 ��e -�ammaonuiea� o�✓�aaaac�u.�aella � Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration ::,128016 Explration: 21:11103 =Type private Corporation ,i ANDOVER RENOVATION SOLUTI 9AL-Ib1tn`'PENNY tom;" 110 W I N N ST WOBURN,MA 01801 Administrator BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 079181 Birthdate: 11/06/1953 Expires: 11/06/2004 Tr.no: 79181 Restricted To: WILLIAM C PENNY 2 COPLEY DRIVE ANDOVER, MA 01810 Administrator L i The Commonwealth of Massachusetts Department of Industrial Accidents _ Office of Investigations Boston, Mass. 02119 Workers'Compensation Insurance Affidavit Please Print Name �1I� EX I�P�Vt�a so�J��1/tS �v1 c . ANT Location �S }fit t �'C► ►- City Np• &Ac�ww ISA Phone 12)( C(31 no (—� am a homeowner performing all work myself. �I am a sole proprietor and have no one working in any capacity i I am an employer providing workers' compensation for my employees worming on this job. Company name: c�a�/ o./o��U.yy>t a� OtitS tti c . Address A0 City Int fl 6✓✓vt AAA O 18O( Phone# `1 $t `f 31 S 96,E Insurance Co L 1�1'itf IMJ ly a� Policy# W G X31_tel' 7A 1 1_0 0 t 2+ 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$1,500.00 and/or one years'imprisonment well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. I understand that a copy of this stient may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify rider the pain a penalties of perjury that the information provided above is true and correct. Signature `' Date Print name Vy M 1 QAM C. vt Phone Official use only do not write in this area to be completed by city or town official' ❑ Building Dept ❑Check if immediate response is required Building Dept ❑ Licensing Board ❑ Selectman's Office Contact person: Phone#: ❑ Health Department ❑ Other FORM WORKMAN'S COMPENSATION OT Building Department a'� y '' " '6 ~ oc 27 Charles'Street North Andover, Massachusetts 01845' (978) 688-9545 Fax.(978) 688-9542 e �wKr 9` T ' .Q TE° FPa`L.tS CH DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and.a condition of Building per-mit-# the debris resulting from the work shall.be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl I s I50 a The debris-will be disposed of in/at: 7 c✓k�c?�e D1. osa� H e_ Facility c hty location Signature of Applicant Date NOTE: A demolition permit from the Town of .North Andover must be obtain project through the Office of the Building Inspector. ed for this or. P _ . I �- FORM U .- LOT RELEASE FORM a KD-& Clow- adetAtd-ij 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. F�\tb f- V A t+�- a2 —S q *****************************APPLICANT FILLS OUT THIS SECTION*******fc�,,-'*;�*�-'mac. APPLICANT W l It M C- l0C�"A PHONE 1��1 LOCATION: Assessor's Map Number �o©� PARCEL a5 SUBDIVISION LOT(S) STREET SS �C��` �• N o. A-1n clwe; M�' ST. NUMBER 5S *****************************************OFFICIAL USE ONLY**** ****************************** REC MENDATIONS OF WN AGENTS: CONSERVATION ADMINISTR R DATE APPROVED a DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED- COMMENTS-- FOOD EJECTEDCOMMENTSFOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS- SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT �— RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 jm . • Andover Renovation Solutions, Inc. 110 Winn Street, Woburn,Massachusetts 01801 781.937.8805 FAX 781.932-1174 RENOVATION SOLUTIONS Purchase Agreement Name: Art Bray and Laura Craig-Bray Address: 55 Heath Road, North Andover, MA 01845 Phone: 978 689-2887 Mailing Address: Same Work Description: 1 . We will furnish and install in a workmanlike manner the remodeling project according to the client supplied conceptual plans, scope of work, and terms and conditions attached and dated May 13, 2002 . 2 . Subject to Addendum "A" made part of this agreement. 3 . The final price listed below will change based on the final scope of work determined at the pre-construction meeting and will be adjusted by change order outlining additions and deletions . Cash Price: $142, 807 . 27 This agreement supersedes all conversations, statements, and agreements expressed or implied between the parties, their agents and representatives. Payments are to be made as work progresses according to the Payment Schedule attached and made part of this agreement. Homeowner: Do not sign this agreement if there are any blank spaces. ------------------- ------------------------------------------------------- ------------------------------------------------------------- Owner Dto ------5 !:� -------------------------------- ner Date `---=-- ��re�si�ent --------------------- =5- 13--=Q�--------------------------------- William C. Penny, Date Andover Renovation Solutions, Inc. HIC# 128016 ADDENDUM "A" To Purchase Agreement- Bray Dated May 13, 2002 1. Financing Contingency In order to assist or help finance the work set forth in the work specifications of this purchase agreement, you shall apply for a conventional bank or other institutional loan of$ payable in no less than 30 years at prevailing market rates. If despite your diligent and good faith efforts a commitment for such loan cannot be obtained on or before June 13, 2002, you may terminate this agreement by written notice to Andover Renovation Solutions, Inc., said written notice shall contain written evidence to us, as to your inability to obtain financing, whereupon any and all obligations of the parties hereto shall cease and this agreement shall be null and void without recourse to the parties hereto. In no event will you be deemed to have used diligent efforts to obtain such commitment unless you submit a completed loan application conforming to the foregoing position on or before June 13, 2002, to a conventional bank or other financial institution which is presently in the business and practice of making residential mortgage loans. Should you fail to notify Andover Renovation Solutions, Inc. in writing on or before June 13, 2002, TIME BEING OF THE ESSENCE of your inability to obtain such financing with written evidence acceptable to us, then it shall be conclusively presumed that you have obtained satisfactory financing and this contingency shall lapse, and you shall be bound to perform your obligations under this agreement. 2. References Contingency You hereby acknowledge receipt of a list of references from the Andover Renovation Solutions, Inc. You may on or before May 27, 2002, check the references furnished by us. You shall have the option of withdrawing from this agreement by written notice to Andover Renovation Solutions, Inc. on or before May 27, 2002, TIME BEING OF THE ESSENCE. Should you fail to notify us in writing on or before May 27, 2002, your wish or desire to withdraw from this agreement then it shall be conclusively presumed that you have checked the references provided by us and are satisfied with our references and qualifications and this contingency will lapse, and you shall be bound to perform your obligations under this agreement. Scope of Work May 13, 2002 Bray Page 1 of 3 1. Construct 30'-0" x 38'-0" second story addition as per conceptual drawings dated March 7, 2002 including removal of roof and roof structure, 2x4 wall framing, 2x10 floor and 2x8 ceiling joists with (6) sheets of 5/8" CDX plywood on attic floor, 2x8 roof rafters with 2x6 collar ties, 1/2" CDX plywood wall and roof sheathing, Tyvek air infiltration barrier, red cedar 3/4" x 12" clapboard siding to match existing first floor, #2 pine soffit and fascia boards, aluminum continuous soffit vent,;;Cobra ridge roof vent, 25 year asphalt fiberglass shingles with Grace Ice and Water Shield on all eaves, aluminum gutters and leaders, windows and doors as specified below, R-13 fiberglass wall insulation, R-30 fiberglass second floor ceiling insulation, blueboard with skim-coat plaster, 2-1/2" colonial casing, 3-1/2" baseboard moldings and all finish carpentry. 2. Extend existing chimney as required for new second floor. 3. Install the followin windows and doors: Quantity Manufacturer/Model No./Type Details 7 Andersen TW30310 double hung white grilles, screens windows 2 Andersen TW28310 double hung white grilles, screens windows 1 Andersen DE P42310 picture window white grilles, screens 1 Andersen A351 awning window white grilles, screens 1 Therma-Tru 5210 Smooth Star Schlage Plymouth polished fiberglass entry door 3068 wity fluted brass entrance set pilaster trim and head casing 8 Windsor molded interior doors Schlage Plymouth passage (Stucture-core) sets 1 Windsor bi-pass door unit wood knobs 1 4068 interior french door unit Schalge Flair H french door hardware 4. Install new door unit on first floor as listed above and plaster patch interior and patch exterior siding. Items listed above have been priced into the project.Only items described above or in subsequent changes orders are included in the project. Scope of Work May 13, 2002 Bray Page 2 of 3 5. Strip remaining sections of roofing and install 25 year asphalt fiberglass strip shingles with Grace ice and Water Shield on all eaves and valleys. Install Cobra ridge vent. 6. Construct stair system to second floor as per plan with poplar risers and skirtboards and oak treads. Install post-to-post open Coffinan railing at second floor landing and around skylight opening as per plan. 7. Re-install existing kitchen skylight with new flashing kit. 8. Install 2-1/4" oak hardwood flooring to all areas of new second floor and finish with (2) finish coats of oil based urethane. Sand and finish new hardwood stairs and coat with oil based urethane. 9. Install Brosco Imperial pull-down attic stair system to new attic. 10. Install shelf and clothes pole in each new closet as per plan. Install (4) 16" shelves in linen closet. 11. Construct master bath with Kohler Wellworth toilet, Cabico 60" VTF60/4 red birch/maple vanity with Boston Marble one-piece oval bowl top and (1)Delta 2530 chrome faucet, Lasco 6042-HWP 60" one piece whirlpool unit with Delta 2730 chrome roman tub spout, Dal-Tile ceramic tile shower with Symmons Temptro125-1-143-LR shower valve and shower rod, Panasonic FV-11VQL2 vent/light fan, Dal-Tile 8x8 ceramic tile floor, and installation of client supplied bath accessories. 12. Remove brick from front of house and install 3/4" x 12" red cedar clapboard siding as per plan. 13. Construct shed roof overhang over new front door with (2)Fypon arched brackets. 14. Install (2) 10" Solartube skylight systems in new walk-in closet and existing first floor bathroom. 15. Install plumbing to include hook-up of(1) new baths, and extension of existing vent pipes to new roof. 16. Install central air conditioning system for new second floor. Items listed above have been priced into the project.Only items described above or in subsequent changes orders are included in the project. Scope of Work May 13, 2002 Bray Page 3 of 3 17. Install FHW baseboard heat off existing system to new areas. Install separate zone to second floor. 18. Install electric to include relocation of all wiring in relocated or disturbed walls and ceilings, installation of(8) client,supplied light fixtures and furnish and install: Quantity Item (22) outlets (2) bath fans (2) telephone outlets (2) cable TV outlets (9) smoke detectors 19. Includes removal of all construction debris. 20. Includes permit application, and permit fees 21. Does not include interior or exterior paint, bath accessories, surface mounted light fixtures, and landscaping. 22. Assumes bearing wall in basement is adequate to construct second floor. Items listed above have been priced into the project. Only items described above or in subsequent changes orders are included in the project. Terms and Conditions: ........................................................................................................................................... ............. 1.Parties: "You"refers to the buyer or buyers. "We"or"Us" refers to the seller, Andover Renovation Solutions,Inc. 2. Access:You will permit us to go into the premises.the premises includes the land and the buildings.You will get any consent needed for us to go onto any other premises in order to do the job. You are responsible and hold us harmless and accept all risks for access through adjacent properties.If we are not allowed to go onto the premises and are prevented from completing the work,then we have no further duty to perform this contract. 3.Insurance:We agree to carry Workmans'Compensation Insurance and Public Liability Insurance.They cover the work to be performed under this agreement. 4. Warranties: We warranty all materials and workmanship for a period of one (1)year from date of substantial completion on all work and materials supplied by us.This warranty does not cover damages beyond our control such as misuse or failure to follow maintenance instructions or Acts of God.If a replacement product is unavailable will we provide a substitute of equal value.You may not withhold any portion of the final payment for guaranteed performance under this warranty.No service under this warranty is available if payments have not been made under this agreement. The only remedies for breach of warranty are stated in this paragraph. It is understood that we will not be liable for incidental,special or consequential damages in any way connected with the products or their installation whether for breach of warranty express or implied,negligence or other reason. 5.Changes and Alterations:No additional work will be performed without the prior written authorization by you.Any such authorization will be done on a written Change Order form approved by both parties. Corrections of existing building code violations not specified in the project description, or hidden structural, electrical or plumbing defects will be an addition to this Agreement and paid by you. Any changes requested by inspecting Public Authorities not covered in the Project Description will be billed to you as additional work.You agree that the duration of work and the scheduled date of completion may differ from the date as indicated on page one,because of changes,alterations, hidden conditions,inspectional delays,etc.which are unavoidable by us and shall not be considered to be a violation of this agreement. 6. Survey: You are solely responsible for the location of all lot lines and shall provide at your own cost a survey showing buildings and property lines. 7.Matching Existing:Where materials are to be matched,we will make every effort to do so,using standard materials, but we cannot guarantee a perfect match.We are not responsible for the existing conditions of the structure with regard to the level and plumb of walls, ceilings and floors and work to be done to existing conditions will be done in a workmanlike manner without re-plumbing existing conditions unless specified in the Project Description. 8.Landscaping and Ledge:This agreement does not cover the blasting or removal of ledge during excavation and will be billed separately to you. We will bring the grade back to a rough grade condition after excavation,which does not include loam,seed or sod.We are not responsible for damages to landscaping or grounds due to the use of vehicles or heavy equipment. 9.Payment Schedule:Payments shall be made by you as per the attached Payment Schedule.We have the right to stop work if payments are not made to us when due. We shall pay all invoices authorized by us arising out of the construction and will hold you harmless against any liens for labor or material filed against the property. 10. Owner Supplied Services:You agree to provide electricity, water,toilet and telephone as may be required by us to perform the work under this Agreement. 11. Advertising:You grant us the right to display a job sign at the property and take photographs of our work for the use in our advertising. 12. Complete Agreement: This contract is the entire agreement, and it is agreed by both parties that the entire understanding is contained in this written contract between you and us.It is further agreed that any subsequent changes to this agreement must be in writing and signed by the parties. No oral agreements not specifically stated in this agreement will have any force or effect.You are advised not to sign this agreement unless all blank sections have been filled in or marked as void,deleted or not applicable,and until all exhibits and related documents that are incorporated herein are attached. 13.Subcontractors:We have the right to subcontract any percentage of the work to be performed under this agreement. You will not during the course of the project hire any of our designated subcontractors for other or additional work. 14. Cancellation:You may cancel this agreement within three business days as required by law if this agreement is signed outside our place of business.We retain the same right of cancellation. Any deposit received from you will be returned. 15.Registration: All home improvement contractors and subcontractors engaged in home improvement contracting, unless specifically exempt from registration by provisions of Chapter 142A of the general laws,must be registered with the Commonwealth of Massachusetts. Inquires about registration and status should be made to the Director,Home Improvement Contract Registration,One Ashburton Place,Room 1301,Boston,MA 02108. 16.Permits:We agree to obtain as your agent the building,plumbing,and electrical permits necessary to complete the scope of work under this agreement.We shall not be held responsible for delays in the work described in this agreement caused by regulatory,permit granting or inspectional agencies,or authorities.Under Chapter 142A,homeowners that obtain their own construction related permits or contract with unregistered contractors will be excluded from the guaranty fund. 17.Copy of Agreement:This agreement in governed by the Laws of Massachusetts.It must be executed in duplicate, and an original signed copy will be given to you at the time of execution.No work under this agreement shall begin prior to the signing of this agreement and transmittal to you. 18.Arbitration:The contractor and the homeowner mutually agree in advance that in the event of a dispute concerning this agreement,the parties shall submit such dispute to a private arbitration service which has been approved by the Secretary of the Executive Office of Consumer Affairs and Business Regulations as provided in MGL c.142A, and the decision of the arbitrator will be final. 19. Cleaning: We will keep the job site broom clean. At the end of the job we will broom clean all disturbed areas. 20. Approval of these terms and conditions is indicated by your signature on the first page of this agreement. ®1TJA ® Payment Schedule Bray May 13, 2002 RENOVATION SOLUTIONS Payment Description Percent of Total Amount Original Order Amount $ 142,807.27 Design Fee Paid $ 0.00 Change Order 1 $ 0.00 Revised Contract Amount 100.00% $ 142,807.27 With Order Deposit 6.00% $ 7,140.36 (Due At Placement of Order) Materials Deposit 30.00% $ 42,842.18 (Due at Preconstruction Meeting) Upon Completion of exterior second floor frame 20.00% $ 28,561.45 At rough frame inspection 15.00% $ 21,421.09 At blueboard and plaster 15.00% $ 21,421.09 At installation of interior doors 5.00% $ 7,140.36 Substantial completion 5.00% $ 7,140.36 Completion of punch list 5.00% $ 7,140.36 Totals 100.00% $ 142,807.27 NORTH Town of . . _ 4 over No. f1 aL o == o dover, Mass., COCHICKEWICK V %p ADRATED P5 S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT..... ...�rA.. ...j...La.11.r.#..C,�!,�,!„ .�...3.r�, BUILDING INSPECTOR kit . ........................................ Foundation has permission to erect..a.lP�.y..3.�ir......... buildings on .. ............La. ............... ....................... Rough �..... .N.......�or �b rM. ...... to be occupied as..A�.iw.l .. I.....R 3.........,. 1� 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. ( 0 lA /A wT 4 9.1cl�� PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION T S cRough ..........................•................. 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.