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HomeMy WebLinkAboutMiscellaneous - 557 BOXFORD STREET 4/30/2018 (2) 55 BBOXFOR SSTREET 210/105.0-0027.0000.0 L - March 29,2015 Inspector Of Buildings Town of North Andover 1600 Osgood Street North Andover MA 1845 Claim Number: 033557020 Policy Number: 49681400005 Company Name: Arbella Mutual Insurance Company Date of Loss: 2/19/2015 Insured: Sang Kim Property Location: 557 Boxford St N Andover,MA01845 To Whom It May Concern: Claim has been made involving loss,damage, or destruction of the above captioned property, which may either exceed$1,000 or cause Massachusetts General Laws,Chapter 143, Section 6, to be applicable. If any notice under Massachusetts General Law,Chapter 139, Section 3B is appropriate,please direct it to the attention of the writer. Kindly include a reference to the captioned insured, location,date of loss and claim number. Very truly yours, Stephen Laucella Crawford&Company 204 Second Ave Waltham,MA 02451 CC: North Andover Fire Department North Andover Heath Department Arbella Mutual Insurance Company Location 3 No. �� / ; ' Date NORTol TOWN OF NORTH ANDOVER C�,f• o , '�yG 3? 'y Ot ` Certificate of Occupancy $ �'�S'••" Eta Building/Frame Permit Fee $ s�CHus Foundation Permit Fee $ Other Permit Fee $ �� TOTAL $ Check # �� i f Building Insp�tor Location J No. Date NORTh TOWN OF NORTH ANDOVER 0��.� o ,•14•C F 9 a Certificate of Occupancy $ �'�s',••°•;��' Building/Frame Permit Fee $ JACMUS } ; Foundation Permit Fee $ Other Permit Fees, $ TOTAL Check # Building Inspector I . j TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION PO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONEORTWO FAMILY DWELLING gte•Z1 '$w.l �ni -�t; ,: £zx° a ..,::_ L", ..� F7Gbti :�Sv wJ�} a �,�'„,"�:+ d ,:sxt.�'°- � � { BUII,DING PERMIT NUMBER: /D/� DATE ISSUED: j l SIGNATURE: Building Commissioner/Inspedor of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: S"s77 .9o,14ed S-t- O S- Z 7 j Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: \ Zoning District Proposed Use Lot Area(so Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Regaired Provided 1813+- 100 L pp -t-- 1.7 Water Supply M.G.LC.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private 0 Zone outside Flood Zone 0 Municipal ❑ On Site Disposal System ❑ --q g SECTION 2-PROPERTY OWNERSIIIP/AUTHORIZED AGENT T M 2.1 Owner of Record Name(Print) Address for Service: cf` O Signature Telephone 1 2.2 Owner of Record: (\v r Name Print Address for Service: M Signature Tele hone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable Licensed Construction Supervisor: License Number 1 Address ' Expiration Date Signature • Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ oP% ��4�1 t`c 12_ T o lS �o r12 2 43 Cny Name z / Registration Number Addres �J ?7a-W7-zy?4 Expi— r h Date Si nature Telephone { • 1 t SECTION 4-WORKERS COMPENSATION(MG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......0 SECTION 5 Desch tion of Proposed Work check aII applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify uplO Brief Description of Proposed Work: ASSC(r►t��� Q 0L e �► F,-oL)1nd w t Wt V41 VICTaC" SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be NA'tSE ONS ` Q, Completed by permit applicant � ��: .. ,: ; •;:, 1. Building (a) Building Permit Fee dd© Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(.d)X tbl 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building pennit application. . Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, Bch k L I as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true,and accurate,to the best of my knowledge and belief ` '2 Print Nam Si at weer/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 sr 2ND 3RD SPAN D1IvIENSIONS OF SILLS DRAENSIONS OF POSTS DUAENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CIIIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. APPLICANT PHONE ASSESSORS MAP NUMBER /O�"C' LOT NUMBER 7 SUBDIVISION LOT NUMBER STREET C-I y-e eT STREET NUMBER ��7 OFFICIAL USE ONLY0 MEN 4SERE NS OF TOWN AGENTS ■ ■. ..........................................■■.■■. ■■.. ■■ woman DATE APPROVED 0 VATIONADM NISTRATOR r DATE REJECTED COIvrnN Ism ��"� a N�° lJ Q e) f CJ l v� welv DATE APPROVED TOWN PLANNER DATE REJECTED CON N4ENTS DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED p� DATE APPROVED SE TIC INSPECTOR-HEALTH DATE REJECTED COMMENTS G`�1 f<y C�4A PH<�-it1"7 YCU-5 06 6- be 1 V ,011)1 T ' `�C/�c� �i7l �s� ��,eC �ti •R�'�2 dF i�aysc - cc�cG� �i,�/ PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DAZE gP4 0 /i/ G�oN � f _J vl ;fyp61ASILT FENCE AND � HAYBAIF LINE TO `r' • BE INSTALLED AT LIMIT OF WORK WELL �o CASING �PG� ` } 100 �- PROPOSED / 16'x24 '.i U ABOVE W GROUND LL. POOL O � LANDSCAPING o ?1 � � BEDhggM��I�1�j { -:f •..�1 R rvNSG 4-A I '&S7Ep WADI ; C� I 9 10 #3B ' A. � 14/F '> o MacDONALD TOM P K I N S No.39M 4.64± ACRES BOXFORD ROAD 1. THE WETLAND BOUNDARY AS DEPICTED HEREON WAS DELINEATED BY WETLANDS & WILDLIFE, INC. ON SEPTEMBER 9, 2000. 2. THE LOCATION OF THE PROPOSED ABOVE GROUND POOL WAS PROVIDED BY GIBRALTAR POOLS. NO ENDORSEMENT IS MADE WITH RESPECT TO COMPLIANCE A OF SAID PROPOSED POOL WITH NORTH ANDOVER ZONING REGULATIONS. GRAPHIC SCALE 3. PROPERTY LINES AS DEPICTED HERE ON HAVE BEEN COMPILED FROM VARIOUS 30 0 15 30 so SOURCES AND DO NOT REPRESENT THE RESULTS OF A COMPREHENSIVE PROPERTY LINE RETRACEMENT SURVEY. CONSEQUENTLY, THE ENDORSING PROFESSIONAL LAND SURVEYOR BEARS NO RESPONSIBILITY FOR IT'S DEPICTION HEREON. ( IN FEET ) 4. CONTOURS DEPICTED HEREON ARE BASED ON AN ASSUMED DATUM. BENCHMARK IS I Inch = 30 ft TOP OF WELL CASING, ELEV=100,0'. WETLAND LOCATION PLAN 557 BOXFORD STREET PREPARED FOR: PREPARED BY: NORTH ANDOVER, MA 01945 GIBRALTAR POOLS WETLANDS & WILDLIFE, INC. DATE: SEPTEMBER 15, 2000 428A BOSTON STREET 55 SOUTH MAIN STREET REVISED: JUNE 17, 2001 TOPSFIELD, MA 01983 MIDDLEBORO, MA 02346 SCALE: 1"=30' T POST • /� '• 014 x 3/4 SMS STOP I _ 5/16 x 2 I - "THE GENESIS" SS BOLT WALL CHANNE RA/G TENSION ROD "C" 5/16 x 3/4 , MATERIAL SPECIFICATIONS IP/C/UTS, STIFFENER SS VERTICAL 4 �R/.� SPAC DECK JOINER - 16 ga. gale. stl plate w/ structural nails rated at PLATEO /� �iA j n 2280/sq. in. Q LIL�� FACIAL - 1-1/2" x 3-1/2" alum. channel section, paint finish. POST BASE STRAP - 1'1 ga. x 2-3/4" galv. steel. CORNER STRAP - 11 ga. x 1-1/2" galv. steel. i i WALL CHANNEL - 1-1/4" x 2-1/4" extruded alum. section. j/3 PONr'M'N ZEE BASE - 14 ga. x 1-1/2" x 7-1/2" x 1-1/2" galv. steel. �jpT DECK ASSY - 6" aluminum interlocking deck planks held in place xOrF Er. NOTc 4 �\ —COST with tabs, 4" facial and braced with tension rods. Z• �`j 2• � \\ WALL CORNER PLATE - 14 ga. galv. steel formed plate. I` CHAAlIVE CORNER VERTICAL - 3-1/4" x 3-1/4" formed section, 20 ga. gale. —'- pre-painted steel. POST S BRACES - 1-1/2" sq. alum. extruded tubing paint finish. ' 7 4 �i1�1 / NOTES - A) Main base corner S center straps include 1/2" 13 x 3/4" , ASC S/RAPS ROrER E' ^F r' screws S nuts, 4 ea. at corners S 2 ea. at strap ends. Corner BALL �� 0,>✓. M/lil. straps receive 3/8" s/m/s at each end. Ch'ANNFL B) All verticals are fastened 2/ 5/16" screws grade 5. DECK �' TENSION C) Tension Cables - Cold drawn C1018 steel, 70,000 - 85,000 �J ROD PSI, 1/2"1/2" dia. on end, 5/8 D. up to 24 feet, 3/4 - 32 ft. , D) Wall Channel - Aluminum 6005T5. 35,.000 PSI yield. TRAP �\ \ E) One base strap is used across the center of pools up \ � SAFETY GATE INSTALLATION WHERE REQUIRED i to Z4'. Two base straps are used on 24 pools. Three base straps Q' Z14 VER-TICAL are used on 32' pools. li Bc VERTICAL - 4" mod. channel, 20 ga. gale. pre-painted steel. Self Closing Latch I�� � !Q/rJ swing stair up to close WALL - 1-1/4" x 4 x 1-1/4" interlocking channel 25 ga. gale. pre- i painted steel. II \� BEAM - SaFecy Gate II I - 85 RAIL - 1-3/8" x 1" alum. extrusion paint finish. illi i ���_ osr Deck PICKET - 9/16" x 3/4" x .9/16" alum. channel paint finish. I',�(1_ I I I `r i �"A•'1O _ I I .=/✓�N�R STAIR - 1-1/4" x 4-1/2" x 1-1/4" side rails 1 x 1 tubular hand � ~- rails, 5" heavy extruded steps conform to National Swimming Pool Institute standards. U Handrail •� SWIM LADDER - 1.900 stainless tubular rails three cycolac moulded Hinge 2" down steps, stainless steel hardware. r Ili II Icencered between F I I posts nI i POOL LINER - Vinyl liner conforms to Natioal Swimming Pool 6A•�i�l I I; suggested minimum specifications for all season exposure. • ,\� ( , FACIAL FASTENERS - Include 4 ea. 5/16" stainless screws, 14 ga. i i I gale. place. _,thrr,•;!^a,. II Step t�✓PiYER VE.4T, `� (� 1� FENCE RAIL FASTENERS - Includes fence link and 3/16" rivets. NOTES: 1) All aluminum extrusions are 6063-T6 alloy, 31,000 PSI yield. All brackets plus angles S structural hardware are minimum 14 ga. hot galv. steel. 2) On hopper depth pools, base straps are removed to � E`!ti':S c� s7� REVISIONS _ �lr ,cr�a.a! ST UC UAL DETAILS allow for hopper depth and are supplemented with external concrete f:: \�N Rr~ VISIONS piers (8' O.C. Max). Pier size will be comparable to base strap r'0. 2PSIS c" "'-�• "': \ support. A pier will. also be placed at center of pool width on hopper end only. Depth of Piers will depend on soil condition. ON GROUND POOLS r `�S/olVAt ENG , i- - 71 W(LKFS POOL CORP. M1FFL[NVILLc PA. ,ORT, E Town of over 0 . , No. C'o 13 000/ COCHI , dowe > Mass.> �9S RATED OP-A H ` BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT......... ,,,III K�IV ....... Foundation .............. . has permission to erect.. ... . ., buildings on.... ... ....... Q ......17'.... Rough to be occupied as , ''... Q e n�.�,4� �O 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 rejpting to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. A0Vw � PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION START ELECTRICAL INSPECTOR 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. Burn Street No.. SEE REVERSE SIDE Smoke Det. �,..,...., �,•ya,s,`�— � ...>_... �,+(,yy.�,.Mr�::Yubuwvnewasae ervaie�.�.:aea.�+i.sr�a•••�..,...a..b.a+..,.t.,..�,,.v... -- .o.�...�.�..�................+..-...................a..»..,..d.. - y =l�.L'�9.�rRRI'220h�19Fia`C ... • i �,�w�„_ � ���� •rJaiitv�tuierucer.�l� u�.��l�r:l.lrrc�uacal�l 1 � oard of BUil.d.i.nf:) Rec)Ul_at.ion!:: E,ncl Standards cine Ashbui-t.cm i.?01. ���j• I BOat 011 , lila S`3aChllSEtf c. 02108 i Home ImFrovowc i-d- Cor-it i-OCL0r Re;cl.i si;1- 1:i.orl 'Regi.strat.ion - 1.29931. E>(P i rrii-A ori., 1.1/23/2001 TYhe ' Fr i v,_s Lc; (' .>rj:)o) ,i 1 i cal) HONE IHPROVENENT CONTRACTOR _rte Y Registration: 129431 GIBRALTAR FOOLS (ORP ! Expiration: 11/23/2001 DOMINIC DE BERNARD0 �" r. �'" Type: Private Corporatio 420A BOSTON ST TOPSI-IELD MA 01.903 GIBRALTAR POOLS CORP vS., ,P.QfiINIC DE BERHAROO ADPAIiI� iii 01I 418A B0:'. N ST 1 TOPSHEI.I t� NA 01983 1 I i I MCC 01,7MV "C5 000 I'Vashin;ton Street • -0`_ Boston, Mass. 02117 Wor;e;s' Compensation Insurance affidavit -n2fnC: r. :y i a:i I am a homeowner per or.:.in2 =ii wor'-. :sei% i am a scie crocretor,_nd nave m one wore ,Q i nv cat zcity am an _move-prov;di::_'xc:'te:., , Siwe^.SZi:ir1 :vC;.!:.7mlcvees -CIX::_cn _us Compinv ^t e- Gibraltar Pocls Corc. addre:s: L•?R Rnctnn S =v-- To-zisfield. K-. 01988 ne 978-887242L irapronct co: Public Service Mutual -riic 03-266101-98 am _ oie — *ep;:e:e: ,7Pcer2i :ont:-=or. Drell - G ::ie :JL'Cw'lii '.'/CC:C�.., _... _ LSa.:C' �Ci:..�°: �._ .. _ ..�... .C• ..- - 1adress: _ corat t)anv ^am-: sddre^; . c. } �^ane• ' in�annc-•eo. Failure to secure:ove Ie:zi r utrea oaaer pec on 'SA of.`:1Gi.15_can lend to the imtwstdon of c-mtnat oensttic of:!ine iso to SI_00.1,10 and/or one years'imonsooment zs•Neil as civii oersitic in the form of a ST OP WORK ORDER znd s fiaeoi 5160?0 zday zgzt at m� [undrr:tacd hat: coot'of:hn statement may be forwardea ;o the Oifce of Inve mgahons of the DIA for coverage veriGanon. !do herebv c unaerrhe Pai11r1s\1 and 1/J!\�JJtei es of Pe/rzri th�m:he fn_1ormadon Drmided above is ime-a7nd corrr= Print;arc Dominic DeBerna_do SOnC'- 978-887-2424 01Ttcial use only do not write m this errs to be co©oiued by cry or:t7srts o::: sl I city or;own: pe^it9ier�e K r9aiiding Depat-aeac [L;C=.-tng 3oara carx iC immeaiate r=oonse is r;am -n C:S iec=ea's OfGcr [fieztih Depat�ear cancer.-PC--On: none=; r'Ottrcr NAl SHEA0KELEMENT FILTER,SYSTEM _ 4/2.11 PORT`It"s Mem mming-Pool Features: Unique Ring-LAT`t access provide simple no tool access to filter element and strainer basket for cleaning. �Ma� war Built in tool on Ring-LokT',t allows you to easily disee lid from tank bottom. ngag Patented safety tab lock assures proper installation and safe operation. Filter element is constructed of durable Dupont' Reemay Polyester cloth. The coreless design allows easy cleaning from "inside-out" with a garden hose. Patented sediment catcher prevents debris from falling into the tank when element is removed. Floating eye seal between the closed impeller and diffuser maximizes pump efficiency for best flow and pressure. It's Elemental! Ease plumb pump/filter connector requires no pipe NSF. �L With 3 foot NEC twist lock cord. sealant or tape. 1-1/2" inlet and outlet ports on system tank. Patented air-cooled heat sink allows pump to run dry 1 without damage to the shaft seal. One year unconditional warranty against seal failure. Dimensions Built-in high efficiency diffuser for increased performance. Sturdy platform base provides an integrated elevated surface to support the pump and filter. i 12 year limited tank warranty. 7--I Easy conversion to DE filter. See page 28. Total Gallons Circulated 29„ i Model I Filter 6 Hours 8 Hours `o• I .Area Residential Residential MODEL A SHER80 180 Et. 18.800 I 38.300 - SHER80 128-3/4"' Note: If system is placed above water level.a check I I valve must be placed in the suction line below the i ater level to assure proper pump prime. J JACUZZI. "The Vmt Trutted.Vame in Nater"" } Ib RIVLZS 2 DIE) RAQ: YLII DRACr � ` t rAT 10 FACIAL BACK 114 x 3/4 I � ,I' I � � �� :�� ! �j�//.! SSS � �•�� 2- > 54I �. ;/� /.;i � i 1 \I IIS• 1 \ ! ` � ` / �_STAIR ---------------- /� CE 1SJHII9Ur70 AT COYllER �t\ N11111I Toy VI" I, --tACK MICE ISI&E , /16'flIVETS XIWF. 112 SPACER — _ STAKE RACK F-"CF ' BACK BRACCCC SIDE ?PUCE 1, Date.....7-.!z .6.... t NpRT„1 a e.`„`�•-+ a0 TOWN OF NORTH ANDOVER o p PERMIT FOR WIRING i _ • �SSACNUS� This certifies that ...... ................R+.f ........................................................ has permission to perform .......... .. ? � 1J,! T .......... wiring in the building ry buildi.ng of........... 7, .... ... .. , 1.�...................... at.......... 1.... o0SNorth Andover,Mass.. ..... ... 'y . . Fee.�j _ Lic.Noa? 7f ...... t ELECTRICAL INSPECTOR ' Check # j 2 � 6736 Commonwealth of Massachusetts Official Use Only • Permit No. b Department of Fire Services Occupancy and Fee Checked r BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/05] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(i EC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:_111/6(6 City or Town of: lV , A,;>oykyL To the In p ctor of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) 5 5 '1 3v C Owner or Tenant Telephone No. k-- Owner's Address �,jyvl E Is this permit in conjunction with a 4uilding permit? Yes ff— No ❑ (Check Appropriat Box) Purpose of Building 1_0 1#-i r Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity rr Location and Nature of Proposed Electrical Work: C414th >-f <v IZ�3 7C� -W I rue, l:C C:-S5, 1 ompletion of the following table may be waived by the Inspector of Wires. of No.of Recessed Luminaires No.of Ceil: TransSusp.(Paddle)Fans Tota Trsformers KVA No.of Luminaire Outlets 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 o.o -Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons g No.of Waste Disposers Heat Pump lNum. ber Tons I KW No.of Self-Contained Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ unicipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent t o.of Water K`,`, No.o No.o Data Wiring: Heaters Signs Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications firing: No.of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such cove ge is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE OND ❑ OTHER ❑ (Specify:) I certify,under the pai nd p aIt' of perjury,Heat the information on this application is true and complete. FIRM NAME: LIC. NO.: Licensee: f?:12M U44 Signature LIC. NO- (If applicable,en r " empt"in the lia a num a line.) Bus.Tel. NO.: Address: vrl) 01 F Alt.Tel.No.: *Security System Contractor License required/for tis work; if applicable,enter the license number here: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the(check one)❑owner ❑ owner's agent. Owner/Agent PERMIT FEE. $ Signature Telephone No. s r .. .DatA . . . .7�Q.� . -, o' "ooTM'�o TOWN OF NORTH ANDOVER ' PERMIT FOR PLUMBING a ;'SSACHUSf ..•�+; This certifies that .�. . . � !?!h�r`i. . . . . . . . . . . . . . . . . . . . . . . . has permission to perform !a.. .. .. .. . . . . plumbing in the buildings of . . . ...`. . .. .f( . . . . . . . . . . . . . . . at. Sfe�!4-17 .0.15�.. . . . . . . . . . . . . . . . . . . . . .. North Andover, Mass. Fee. /! . .Lic. Nd? .75�. . . . . . . . . . . . . . . . . . . . . . . . . . . . . �� PLUMBING INSPECTOR Check 7022 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MAySjSACHrU—SETTSC• g � / '� ��sf Date — ' Building Location s , Owners Named if G //'� Permit# Zy Amount /_ LO Type of Occupancy New Renovation ® Replacement Plans Submitted Yes No FA FIXTURES z H z U F a w z U Q w A z a Q �4 A A xd E" W C W a a ..7 F ►a G9 as F STS1fiVIC HA9 VEq IST:HDD M FL" r 3M KOOR 4W HDM 5M ff00R 6M HDM M Hf= SIH Rom -�E (Print or type) � �J Check one: Certificate Installing Company Name /YLA1-7 ❑ Corp. Address 20Q � d � Lr C/l G e� rl Partner. i Business 77 5 t- -y.- .l'7 Firm/Co. a � Name of Licensed Plumber: jt l'1 -. - La's A/ 4/9 Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy M Other type of indemnity 11Bond ❑ 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 r I hereby certify that all of the details and information 1 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 Massac usetts State Plumbing ode and Chapter 142 of the General Laws. Mau By: Signaure o kens a.rmmoer Type of Plumbing License Title City/Town tcense um er Master ❑ Journeyman APPROVED(OFFICE USE ONLY Iv Location 'Jr i6d2 Q Id. No. Date "ORTh TOWN OF NORTH ANDOVER `> O . o • M [.i 9 i Certificate of Occupancy $ Its Building/Frame Permit Fee $ / �CNus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # ' I \-Building Inspector ►, TOWN OF NORTH ANDOVER APPLICATION FOR PLANS EXAMINATION sb-7�-�cMu�� Date Received: permit NO: Date Issued: IN11PORT ANT: :1 licant must complete all items on this page LOCATION 58 7�0)(FO/'!� ST Print PROPERTY OWNER 6- 'e ? a4V-1 � �C/"�' Print INIAP NO.: D/ 5 C- PARCEL: �7 ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Non- Residential Residential =New Building XOne family Addition Two or more family = Industrial Alteration No.of units: _. Repair, replacement Assessory Bldg Commercial lic Demolition Moving(relocation) Other Others: Foundation only- DESCRIPTION OF WORK TO BE PREFORMED .Y.r/5.7Tcr// �j 77/e 1 G&V1t,S 411 7-4--i/ Identi kation Please Type or Print Clearly) Phone. OWNER: Name: Address: SS /��� S7� /�✓� o � CONTRACTOR Vartie:- ���5���1Y�lE�i�r�/�71r��f'�!� — Phone'-�'7.�• ;address: 0`�/G °� 0040� CO/1�cc nt Super%isor's Construction License: Exp. Date: Home Improvement License: 14113©7 Exp. Date-___d ,ARCHITECT.ENGINEER \amc: Phcne:— .Address: Reg. No. FEE SC'HEDL LE:BL'LDI.1 G PERMIT:510.00 PER$1900.00 OF THE TOT.IL EST1,6L-I TED COST 3ASED O�ti 31 J.S.HO PER S.F. Total Project Cost :$- • DIS x 10.00=FEE:$ _ Check No.: L() Receipt No.:L,I-_ lla:w 10'4 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits j Building Permit Application ❑ Workers Comp Affidavit a Photo Copy Of H.I.C. And/Or C.S.L. Licenses Copy of Contract Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application • Surveyed Plot Plan ❑ Workers Comp Affidavit Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydrau Calculations (If Applicable) Mass check Energy Compliance Report(If Applicable) New Construction (Single and Two Family) Building Permit Application Certified Proposed Plot Plan Photo of H.I.C. And C.S.L. Licenses Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned)to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) a Copy of Contract !Mass check Energy Compliance Report In all cases if a variance or special permit was required the Town clerks office must stamp the decision from the Board of 1ppeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application `(N:1`.SIq.<:'1'10\.11.SFIR\ICLS ORT lR'I'11F.\I:ill'FOR"" TYPE OF SEVa'ARGE DISPOSAL Tannin�:4 sage Body.1rt S"immin,Pools = Public Seuer - "'" Tobacco Sales Wel) _� ' " -- Food Packaging Sales _ == =n 16 — �'ermane'iit'a`��llmpster on Site _ PriNate(septic tank,etc. Electric deter location to project NOTE: Persons contrrrct'irg wish 1 Crgisler d enntractars rlo not have access to the guaru y fund R Signature of Agent Owner-- Signature of Contractor Plans Submitted Plans Waived Certified Plot Plan Stamped Plans THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SICK OFF-U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ I []Water Shed Special Permit CJ Site Plan Special Permit J Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION ❑ ;] COMMENTS DATE REJECTED DATE APPROVED f HEALTH �L- CUNDOE;riTS Loning Board of Appeals: ariance.Petition No: Zoning Dccisiomreceipt submitted cs ('tanning Board Decision: Comments ✓J 15l'1'�(lt Ctl L)Cta:'IUII --_f lilt lits 'Vater f S,:uLr--ornection i:;naturc&uatc imp Durnpster cn�itc yep_ no _ vire Department snatur,:date I Building Pcrmit Appro%cd and Issued by r: �� 14 Building Setback ( Front Yard Side Yard Rear Yard ReqUired ProNided Required Provides Required Provided � --'_'_'~^, Ntimber vrStories: Total square feet o[floor area, based onExterior dimensions. Total land area,sq. ft.: NOTES and DATA--(For department use) � � V40 TH 'q Town of No. o :F = o L&CIO t A o dover, Mass., �' • O� COCHICHEWICK �'X sRATED 0"? C3 7 BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System �+ THIS CERTIFIES THAT........ BUILDING INSPECTOR �L,�.................�. r........,�ir�Yl► .......... - Foundation has permission to erect........................................ buildings on .-s-r.�...4 /�.xr ..... Rough to be occupied as... /111. ...RA. A,t......... 4 i „! ...... .J..... .. 4 Chimney provided that the person accepting this permit shall ... every respect conform to the�erms of the appli4n on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRU STATS ELECTRICAL INSPECTOR Rough ......•• Service .. .. .. ...... . .. .. . ...... ....................... ...................... PECTOR 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 BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. UOWN OF NORTH ANDOVER OFFICE OF BUILDING DEPARTMENT 400 Os good Street North Andover,Massachusetts Ol 845 Ss+crause Gerald A. Brown Telephone(978)688-9545 Inspector of Buildings Fax (978)688-9542 HOMEOWNER LICENSE EXEMPTION Please print DATE: JOB LOCATION: SS 7 130k po p oc ST /O,S e 't 7 Number Street Address Map/Lot HOMEOWNER S4 e01-A- 90/V t-, 'q°t 979 7911-37?S Cj 7 17, - 93 i 2 Name Home Phone Work Phone PRESENT MAILING ADDRESS S-9 7 j3 o h Fa 1-T- AA A r' d IF City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings to two units or less and to allow such homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor). State Building (Code Section 108.3.5.1) DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family structures. A person who constructs more that one home in a two-year period shall not be considered a homeowner. The undersigned"homeowner"assumes responsibility for compliances with the State Building Code and other Applicable codes,by-laws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. IIOMEOWNERS SIGNATURE APPROVAL OF BUILDING OFFICIAL Revised 10.2.005 Form Honuriwners Exemption BGG OF APPEALS 683-9541 CONSFRVATION 633-'t530 HF..ALTH(M-9540 PLANNING o.�8- 05 35 Allr, The Commonwealth of,hlassachuselts Department of Industrial.lecidents Office of Investigations 600 Washington Street I. ;}` Boston, AL4 02111 t ., , i www.mass.go vId is Workers' Compensation Insurance ,affidavit: BuilderslContractorslElectricians/Plumbers Applicant Information Please Print Legibly NarnelBusiness,Orgall ii;diuniIIdividual): !N/ /7(/ � T Mdlress: 7 A ,Vc C- _ City:State;Zip:CONO !A Ma Phone 4: Vg:--g:--A6 Y F2.$ e you an employer?Check the appropriate box: Type of project(required): I am a employer with 4. ❑ 1 am a general contractor and I6. ❑New construction employees(Full and,'or part-time).* have hired the sub-contractors1 am a sole proprietor or partner- listed on the attached sheet.' '• ❑ Remodeling ship and have no employees These sub-contractors have g. ❑ Demolition working for me in any capacity, workers' comp. insurance. y, ❑ Building addition [No workers'comp. insurance 5. ❑ We are a corporation and its 10 Electrical repairs or additions required.] officers have exercised their 3.❑ 1 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.❑ Root repairs insurance required.]t employees, [No workers' 13.❑Other comp. insurance required.] — \oy applicant That checks hox:11 muss ASO 11111eat the section below showing their workers'compensation policy inti rmatii)n. I lomeowncrs who suhmit this affidavit indicating they are doing all work:md then hire outside contractors must submit a new artidavit indicating:arch. Contractors that check this box nursl attached an additional:,heel showing the mune or the sub-contractors and their workers-comp.policy inrermation. 1 am an employer Nrtit is providing workers'compensation insurance f i)r my emplgvees. Below is the policy end job site inf immalion. InsuranceCompany Name:- _-- - --------__._--- -----_ ---- Policy `or Self-ins, Lic. 4:-- —__.__ Expiration Date:________—__ lob Site Address: City:StatelZip: _— --_— — Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 35;1 of b1GL c. 153 can lead to the imposition of criminal penalties of a Fine up to 1i 1.500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP AA ORK ORDER and a tine Of up to$250.00 a day against the violator. Be adv ised that a copy of this statement may be forwarded to the Office of lmotivtions of the DLA for insurance coverage verification. I do herehy certyl n der the poins and penalties of perjun,that the in%ormation provided above is true and correct. tii n;lUlre: — `i-r l'iv� _ (tate: "'y !-ZCy-=C/a 9- ------- ----------------- --- ---- /ic-ied arae only. I`o ,it write rn/hiv rr."r.to be,.-ompleted hl; -W or towito i il, C;ty or T,>wn: " r,mit/L.icens�_ _ — Issuing,Authority(circle one): 1. Board of health 2. Building Department 3.C;g/T,iwdi C!erk A. E?eecrkal t nspector t lowhi.ng Inspec.or 6.other i Phone#: � a � �na8 O�xh S—ti �va�Q� B xh �l1ALc)dsh (' -a%f 24 ' � o Oo Q�X�► 3�y —� C:0 a Cent Qc' [�pa,M �jc�iogra CLasf r w Q � � r . tij r Al r Al, ro0ol Page# l of � pages Proposal Submitted To: Job Name Job# Address Job Location Gt,� �i8 y� Date /r7 7_ / Date of Plans v ler' U Phone If Fax# Architect We Zyu- submit specifications and e..stimates for: L410/'k 7"-0 S 5...... vd � 4� � C'C!CSri._ . .� � tib - - , _.. .... . .. _ .. _ _.. __. _.. A-enp we, �J' t� ✓r� to e ��e,v �/, i�� n 0' ,0( /trv�-r .ct �-i-c� _ ..... ... ' - --a - ' `P– /I WS If� � "� hwc G� �c /. off' 7A.-e-_..4 ovs-c ��f✓rdx/e .. 2�l _ e Zdi ` .vreJ 06ck�-, Q —OL 14"ter► oar ZO 7-X .. -- ,. e lQNi ......_c.� l ._ _ .-5!._ . , u^. _.. tee.. o_,q . ____._..__ ........ _______... `__ �...4 , .Id e ... � .7�_a.11 7". 06C-4" ._� t...._'JGt<✓i �f / ..,......� _(`'.. /l;y�l _.......... Q'V C(O( -e f'4"' 70(. M ... _.._ _7._. _ ._.. __ ..___ .......... ...._ ....... ... .._.. w1 -"dam✓ -f e e.?G _ dor '/-C � - ye s . ..........._.. 0......7`� �..��. d / a .<. 'im o�J - We propose hereby to furnish material and labor—complete in accordance with the above specifications for the sum of: $ Dollars with payments to be made as follows: Any alteration or deviation from above specifications involving extra costs will be Respectfully executed only upon written order, and will become an extra charge over and submitted above the estimate.All agreements contingent upon strikes,accidents,or delays beyond our control. Note—this proposal may be withdrawn by us if not accepted within days. Zcceptance of Propoot The above prices,specifications and conditions are satisfactory and are Signature hereby accepted.You are authorized to do the work as specified. Payments will be made as outlined above. Date of Acceptance Signature Com_NC3819 - Page# of pages Propont CO /A/C 0 lc/t r/�C." 0 i 7 V Z.. Proposal Submitted To: Job Name Job# Address Job Location ff ' u Date Date of Plans Phone# Fax# Architect We herebysubmit specifications sp'e._..cificationsa.......- nd estimates t7imZat.eGs,f.or: . ..... ....... ex Tfndr0,of— � /E Co.....................— �f12�Y/d TO ..........ofO G✓s r 7 Z 14.. e:_, d .......... / . ..... ........... ...................... ...... /lr c, --ia. doal ...__ ?.ac {- .r~._vl ��r...... ..... ._ ........ _ ....... ........_......... - . . ........ l /� / / s �•. --,� .t G,u r rlu,a t _ 7" C. tl7'� nCIC // _ _ ._.._..... ...... 11-6...l�..._.5.. ur ( . �a fvl w� - . Ti y f ti ._._._. .. _.. . G �f /lam ter_e 4< _� ...�, �Yv± A u.�/S �-�! L, v, �� �-0-� 7-77 r G✓cl / C a"V d+'t – JjP yr i_-vc l �a "r. L -�� °s- v� Gj�-v2.r/�/ ...... .... .. �.s �l . 5 is D. .,ma c lamed ..t. 74 e r� _s __.. _ -. ._ �' ____. . .. ..............._ ........ ........ r al �' Gl gyeLi- -. 7proposehereby to furnish material and labor—complete in accordance with the above specifications for the sum of: $ Dollars with payments to be made as follows: Any alteration or deviation from above specifications involving extra costs will be Respectfully executed only upon written order,and will become an extra charge over and submitted above the estimate.All agreements contingent upon strikes,accidents,or delays beyond our control. Note—this proposal may be withdrawn by us if not accepted within days. acceptance of Propont The above prices,specifications and conditions are satisfactory and are Signature hereby accepted.You are authorized to do the work as specified. Payments will be made as outlined above. Date of Acceptance Signature ::NC3819 Page# of pages Proposal Submitted To: Job Name Job# Address Job Location f Date Falef Plans Phone# Fax# Architect rrW;e hereby submit specifications and estimates for . ..... .... C�/'c� .y,��f r_..-►� G(fc4.v.v a •-L� �� T1�-o��s1 �� ✓-c_rtei� o C�ooY ,gyp . C'P../ ! c,,- �C_ � G'� e 0 Xe GD - /�___ %fie..-__-/�• �� _ ` � lrV le. /j // ....... __. _ _ _._.. ..7. IN � ' P tetf !/r'G YYl / 7/�e- e p��. i .11}'�'J ...4! n 1!(J� � ....._ .._ -_/�� 5 7`- 7�r y. !,'►sP . v f(i v/ Fi!�z Sfrf�� ... P..l� �ixSG�7A/ GJ i-•� � We propose hereby to furnish material and labor—complete in accordance with the above specifications for the sum of: $ Dollars with payments to be made as follows: Any alteration or deviation from above specifications involving extra costs will be Respectfully executed only upon written order,and will become an extra charge over and submitted above the estimate.All agreements contingent upon strikes,accidents,or delays beyond our control. Note—this proposal may be withdrawn by us if not accepted within days. 01cceptance of Propool The above prices,specifications and conditions are satisfactory and are Signature hereby accepted.You are authorized to do the work as specified. Payments will be made as outlined above. Date of Acceptance Signature i i NC3819 Page# of pages Propool Proposal Submitted To: Job Name Job# Address tA� Job Location Dale Phone —Fate Plans Phone# Fax# Architect rWebmit specifications and estimates for: ......... ......__. ...........Y. .. .zG[ �C-Gc 5._1 ,/^..._ .Ct t — �,� .i t/�dr? Gu Cr e-, �_ c•� /l // pro h� v's tl�, �.� ` '''G s � 5X0. 4 _'° ......... ......... ._....... _.. ........_ 13 !'r�e , �..''�/f .._U� S7�.i,ti...G.!./ �cr,.� wc►l/� a,,-f:.� �,-�.y� 7L,� j .1 .../.j.e G�....... _ OLG ......0-4...... S................ ...%..! ._. _.0 s,b `a __�A. • GC r 0/� ..-.... ....... �._e...... c....Na�_P.i(/ ...... ..y._.._ �,Y .QQr'LC ,-..__, U, 7�..s�/�� ��L/ y I ( o �r rte_ �Rt�vL�i ........��oc�/J� rz Lr �a �. ,�JeS__ ✓ r^��r� Q.._...G+ � � �S �i P�-r n� e5 Cir// �� r e l�,c> h %J ��SAMr,?/ _ �a _ -?.- �a r ... _Scc¢rlJ►yJ ._ ��_� I Gt�n. a..,ti ��� 7 FaoT SPc�-,aY► i. Grimy ro'vr '2r Cl— CUA D{ 600,oa /laid We propose hereby to furnish material and labor—complete in accordance with the above specifications for the sum of: $ 7711. with payments to be made as follows: Any alteration or deviation from above specifications involving extra costs will be Respectfully executed only upon written order,and will become an extra charge over and submitted above the estimate.All agreements contingent upon strikes,accidents,or delays brThe'above d our control. Note—this proposal may be withdrawn by us if not accepted within days. 01cceptance of j3ropool prices,specifications and conditions are satisfactory and are Signature hereby accepted.You are authorized to do the work as specified. Payments will be made as outlined above. Date of Acceptance Signature NC3819 . Page# —C' of � pages PCO ool l GS Proposal Submitted To: Job Name Job# Address Job Location if v Date Date of Plans Phone# Fax# Architect rWe hereby submit specifications and estimates for: ...... _ ...... ____.. _.. .......... /P ,V ! /1 cc f // v410 C/ r_ _. .. i1 ...... ............... ................... .... -_....._ - ............. . . ... .........._. _.... ..... ....... - ..-- .. . .. V v C� S 7'7 'Y�j �Q S f T_ �/ `f/cGY) /c^6L /s� / _T ..m._.. l- - ....:-.. .... ' .._..✓. _ ...__.. .......... .. _ ........_........ _........ __ _ ..........._.._. _ . ........... / ? _ _.11G rr/r - cc.. vz. _ ..-5%!v G _... 7proposeereby to furnish material and labor—complete in accordance with'the above specifications for the sum of: $ Dollars I with payments to be made as follows: Any alteration or deviation from above specifications involving extra costs will be Respectfully executed only upon written order, and will become an extra charge over and submitted jbey.�ndZr.w','tO,.l. v .All agreements contingent upon strikes,accidents,or delays Note—this proposal may be withdrawn by us if not accepted within days. acceptance of Vropogai The above prices,specifications and conditions are satisfactory and are Signature hereby accepted.You are authorized to do the work as specified. Payments will be made as outlined above. Date of Acceptance Signature NC3819 rOont Page# of pages Proposal Submitted To: Job Name Job# Address Job Location Date Date of Plans Phone# / Fax# Architect rWe hereby submit specifications and estimates for: _ _ ._. ..._ __ __ __ _ __ ,-r ..._. ........ ..... ......._ (�/ ''!�1!. 1 '.... "tJ... �t {I'7s�•� . .........�ftr f ...5 .!�/ .�'r S .__ Q..__. �4 i✓ J a ... L✓. 7-A--4 ....._.... .c2..�i>C.�........ C .. -fie ........... ..L.IG_S t"_7_ 'r"_ '' _ ..! _.`.-Jr.._._. '.._ . .`c-s.____t. /� Vii/ e.v, .. <�cw' .... s _ _a...__.. ,cw.-moi . wi '1. . _.T_dr ... .. T✓_.__. ate c, AZ Jnr .o ...... .... Cf teeW 7-_.. Al- _�//f ._.... _. ___ 07- 1__ s_ 7ffWeroposeereby to furnish material and labor—complete in accordance with the above specifications for the sum of: ` $ Dollars with payments to be made as follows: Any alteration or deviation from above specifications involving extra costs will be Respectfully executed only upon written order,and will become an extra charge over and submitted above the estimate.All agreements contingent upon strikes,accidents,or delays rbeyondour . Note—this proposal may be withdrawn by us if not accepted within days. 21cceptance of Proposal ,specifications and conditions are satisfactory and are Signature hereby accepted.You are authorized to do the work as specified. Payments will be made as outlined above. Date of Acceptance Signature ::.NC3819 – . roool Page#7—of O pages Proposal Submitted To: Job Name Job# Address Job Location � 1 Date Date of Plans Phone# Fax# Architect We=hereby specifications and estimates for ..... ._.......... . .......... l' pjf... 4ZI......._ .. 0... ... ......... .... .. _ �� . L'�' 1 _ - -- . .. . _ ...................... .... .. ' t �c°........... _ __._ fry .1'�-�v L.r1 y7?.t"/I. .............. . _. _... _. CK 1,11.k`�... _...... eq Z rvS7� �tQi�� s PX`jGt-✓ST.✓ ce� l� �i ✓+?l ' �7� / —a. 5 r-i o Gy� �X .5�, -�y vu,-�. �� 7We propose hereby to furnish material and labor—complete in accordance with the above specifications for the sum of: $ Dollars with payments to be made as follows: Any alteration or deviation from above specifications involving extra costs will be Respectfully executed only upon written order,and will become an extra charge over and submitted above the estimate.All agreements contingent upon strikes,accidents,or delays beyond our control. Note—this proposal may be withdrawn by us if not accepted within days. .cceptattce of Vropool The above prices,specifications and conditions are satisfactory and are Signature hereby accepted.You are authorized to do the work as specified. Payments will be made as outlined above. Date of Acceptance Signature NC3819 �V 0 � Page# of pages Proposal Submitted To: Job Name Job# Address Job Location (/zV Date Date of Plans Phone# Fax If Architect We=hereby specifications and estimates for. ,+ ...._ /Z r / , Lr � �.�✓ C- .Iv c.� LfG z�...... _................ ....` G.Z _y�. . ...__........ ._..... _ e 3 � f � � -r .,� . ._ _ __ . _............... ............. ...... ..... ............. _ 'eu.... .......................................... ......... ......... ...............__ i 7f, �o�r /e � S' Gvee LrS _. u's'e_.. C/�" .,.,c 4 � We propose hereby to furnish material and labor—complete in accordance with the above specifications for the sum of: $ 15-00,00 Dollars with payments to be made as followsA/-'5-00•C)C) j/ l%r' T 4yoa0.0y h��/f'u � jOo0.U6 P Any alteration or deviation from above specifications involving extra costs will be Respectfully f/ executed only upon written order, and will become an extra charge over and submitted L e the estimate.All agreements contingent upon strikes,accidents,or delaysnd our control. Note—this proposal may be withdrawn by us if not accepted within days. 01cceptance of jropogal The above prices,specifications and conditions are satisfactory and are Signature hereby accepted.You are authorized to do the work as specified. Payments will be made as outlined above. c Date of Acceptance 6 '—/'g—d Signature ��/ 76CEIVED rOWN u� hux l ►1 OCT 0 7 2005 SYSTI✓+m PoMPINU RP_C�OK TOWN OF NORTH ANDOVER HEALTH DEPART;,ENT -- ................ cSJ� Z- 7 DATT Op pVMNQ: —Z QUANTITY PUMPEC �'t�sPQUt.; Np Y�J ruKt Or sbxvlc e: K�v'rlNz Ub��A V�f'iUNJ. ► 000D mtN01'rIUN Nvl : IV t Cis ry, KMAYY 0UA58 B�YFI 83 IN PLAI-,, Rppr3 .. L8 CKFI81•.D KUNBn�.'F, ,Y4LCDCAMYpYUR � omen EXPLAM N2 2480 Date.�. '�.... NORTI{ °�<��`° '••'"o TOWN OF NORTH ANDOVER 3r �a,P ..... • OL p PERMIT FOR WIRING cHuSEt ,t This certifies that ..., . �'........... �r.. "' has permission to perform + wiring in the building of. _ ................... 63-7 /_'at................ . ._...................,North Andover,Mass. . Fee ..� ....... Lic.No 37-'�... : ...................... f/ v ELECTRICAL INSPECTOR Check # O WHITE: Applicant CANARY:Building Dept. PINK:Treasurer DEPARTAfEVT0FPUBLIG$4FLTY Permit No. � BOARD OFFREPREYEAWONREGM770AS527CIIR 12.00 Occupancy&Fees Checked APPUCAT'I®NFC)RPERdW TO PEUORM L,E=C,4L WORK ALL WORK TO BE PERFORMED IN ACCORDANCE W[TH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) 7 �C� Owner or Tenant L;f/ -,7-&N ^��y wis Owner's Address Is this permit in conjunction with a building permit: Yes[:] No (Check Appropriate Box) Purpose of Building , ; Utility Authorization Noe_01 Existing Service OU Amps/;�>/ 2 dVolts Overhead Underground ® No.of Meters New Service ..� Amps/pti�1�olts Overhead Underground No.of Meters / Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work SprUfce. No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA ground ground El No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.or switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FERE ALARMS No.ofZones Tons No of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW htiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.or Dryers Heating Devices KW Local ® Municipal ® Other Connections NeNof Water Heaters KW No.of No.of Signs Bailasis No.Hydra Massage Tubs No.of Motors Total HP OTHER Ir�rxtceCaaage Ptastm�tblhert�tmarralLs�Gala�alLaws 1hawaamatLmbilqInsLl=eP0kyirdidfftg mpkw Opwatiom Cuowagecritss e#�ala>i YFS NO Ihaw ahnittedvalidptoafofsmneiD M06fe YES'EJNO IfycuhmedaJWYES,pl=itdr&thetypeefwy=e ebydr datgthe INSURAT bo BOND® OT[1 R ® Ftasespac>iY) Expitim Esti r ValuedE1ecftWWcxk$ WaknSW D* FMW I� Cali Sigma tadeM Pialtte;ofpajtay. FIRM NAME �e_vw vt Lfllw•; So, c12., L Na 3 7 7 3 Q, SigT� L+amseNo y BusivssTelNa ea Ah l Ua��e � S /`�e�l. , �ot 4J�Sy Ai Td Na OWNER'SWSURANCEWAMIE,Iamaw"etbatheiimdomvd_ alegtma6tasm WbyMa mduxtG as!Laws and fie mysgtutte onft parni Wpficatimwmi ksthistwaettem I (Please check one) Owner LiAgent ® 0""' Telephone No. PERMIT FEE 2-2 � J , stem 114 Pleasant Valley St. Methuen,MA 01844 ` Fully 978-682-9050 4 Licensed&Insured FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. .........................................................��PSK.......... APPLICANT _x PHONE—6-17 6�T 2-9 ASSESSORS MAP NUMBER /O F C LOT NUMBER_ SUBDIVISION LOT NUMBER STREET © S STREET NUMBER -f— ...... OFFICIAL US ONLY RE OMMENDATIONS OF TOWN AGENTS . ........ .....5.......t ................................................. " 5 °�- DATE APPROVED CONSERVATION ADMINISTRATOR DATE REJECTED COMMENTS �✓ � IT DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS DATE APPROVED FOOD INS ECTOR-HEALTH DATE REJECTED j" DATE APPROVED WEPTIC INSPECTOR-HEALTH / DATE REJECTED 7Z d A a / COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT -- DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE -'� �X/S77�v'G i � � II L _ CLCISSIC cLea '-1 nq serzv1 Ce • o o - - o � 38_t-WORK AREA A 34' n �1 a _ 1 O, •._... -POOL LOCA110N Use Adjuslahle A-Imine —Snfely Line G 4 • Flrares Al Wali Joints ) "'Ila" A o Indicated t1y A. Digging Layout r•�.w ,,. , '�s ve t/ NSPI .,, See"Wall Corner tir'lnlr TYPE II DIMENSIONAL '^ - r0. 1,�, et■r• ep — --- (tYhicnl All Corners) '^ •�•sr�`* SPECIFICATIONS AS APPLIED TO 1 ► 1 ` WEATIIEfIKINt3 POOLS `—� — 1. �h Overhang nl diving board from edge A of pool is 2'-B 7/8" (±3 Inches).--- 2. Water depth Under lip of diving board ��• �t 1 4 is a minimum of 72" m point"A". t ; Plan Nnlr' �, . .• 'y\, �~ ;1. Maximum hoard length Is 0'-U". ^,Inlrrirss Slrel Will r Ovwhnrr 1)Islancrt 4. 20 Inches.board bright over water is 2' - 0 7/0" ( 3'� - y 1'nnel5 41"I Ifrlh. All 9 pipers 42."I ligh. 2U Inches. 4 - r - r I 5. ivirrg board nrrrsl be centered in width 2t1" Maximum I iciyht Above Water -- -- of pool. 1- A- 1 "'- fleler to L Minlimom Wntrr level *�•� •e _ — —_..._. for hrir.rum lot nllon9. 4" fle'low top Of Liner � r � I /. Snlriy Ilnr9 mull hn mechnnicnlly nl- lH+di..lurhrd I:mlh "A" Inrhed on orlrt 91r1rt 9ulrpnricd Iry See Nolo 2 /vim- vm.•t Liner Over buoys. 2" (; "r.pncird Sand 11, A step or ladder or other ripproved 1q'.p- 1O'-O" enn% Minh he- provided nI both the q'-p' 6'-0. I_ _I-- rnshallow and deep ends. Profile FOLLOW ALL APPLICABLE SAFETY AND BUILDING CODES, AS WELL AS INSTALLA- TION INSTRUCTIONS FOR TFIE POOL AND ALL EQUIPMENT AND ACCESSORIES. 16' 16' 161d 16vt' r-- CAUTION: DIVE FROM DIVING BOARD ONLY. l034 RECL _16.04 RECT 14' z ,4',SECTIONS 14r . z-15' SECTIONS WEATHERKING PRODUCTS, INC. 4. 16 SEC71ONS 15' 4-16vvVC110NS /5 4 11r.901 R0L 11-0 CORNL 175 /0-COPING CL PSNERS EAST GREENWICH, R.I. !0_ COInING CL l!5 onAw"AF/11 APP: J,P.P. -- --16, ---16----- 1Gr/? lGvt 16 x 34 x a BGT II DAM 12-82 Holiday Coling Layout Shap Strip Coping Layout RECTANGLE EMERGENCY AMENDMENT TO 5ECTION421.1O.1 SWIMMING POOL ALARMS At its June 9, 1998 meeting, the 136R5 voted to amend the above Section of the building code by emergency action to clarify the permissible audible alarm activation period. Delete the wording "rhe alarm Shall Sound continuously for a minimum of 30 seconds immediately after the door i5 opened" and replace with; "The audible warning shall commence not more than 7 5econd5 after the door and door Screen, if present, are opened and Shall Sound continuously for a minimum of 30 Second 5". Swimming fool Safety The Interpretive Mule of the Responsible serious danger that needs to be addressed by the Building Official building inspector. N-ery011e agrees that young children should There are really 0111), two ways to assure chip( not be able to gain access to swiululing 1001 safety whe11 the entry to the pool is ofl-Of the areas without adult supervisioll. i\ccidcntal sliding door. One way is to force the c011SMIctioll child drut�nings in house pools occur in significant of• a fe11Ce and gate between the llonle olid t11e pool. numbers. ��1.�ily 11un1cowncrs wish fur a heifer way to acco111- __ L'uilding codes address thn e issue by stating that plish seemingly cotradictory goals of safetyvisual swi111111ingpools mu must be srrou11dcd l� by f-ciicill� `' lleal, and conveniece. , r that gates need to be self l�ltclling and that latch A company in Cali10n1111a Manufactures all releases should be fu 0r.f00t high When all is built �lutolnatic sliding glass door closure and latching in accordance with code, these regulations provide (ICrVice that Conforms to t11e intent of the code. safety for children w110 live 111 neigllb0rh0ods « lth the latching device installed, the door serves where their family Or neighbors have access to the same purpose as a safety gate. Inspectors in swilliming pools. COnnecticut and New York have embraced the con- The trend in pool installation challges the 1101,111 rept and are permitting pools that can be accessed in a significant way. Pools are more and 11101-e thrOugh the sliding door as long as the door is accessible through the sliding glass doors off of the eelulppeel to close a11c1 latch automatically. fanlilY 1-00111. The area around the pool is t11c11 J-he device is manufactured by Glidestar sealed with cedar or chain link 1c11cing. Industries; for more illformatioll contact Gerald Cllildreil call often open the sliding door. It does Iathanl, at 209-226-6892. Oli the east coast-, call not sell' close and latch. The dour it presents a 860-677-0543. Aslc for Mike ILllehaS. TMC0A,M0 , LTHQFM4MC VSEM Office Use only DEPARTMENTOFPUBLICSAFETY Permit No. BOARD OF FIREPREVEN770NREGUlA770AS527CV1R 12:00 -� Occupancy&Fees Checked APPUCATIONFORPERMITTO PERFORMELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSAaiussTS 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) Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes[::] No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead 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 No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA ground 1:1round El 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. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.ofselfContained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal Other ED Connections No.of Water Heaters KW No.of No,of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER• — Irst.==Cc;wmW- Laws IhawanatatLiah*hsty=PbbcytncbdmgCa►>plete ComaWcritssksbnfi le*salad YES ID NO Itmeaftriodvalidptoofafsamelodle0ffm YES M 1,0 IfyutmedvdWYES pkmmk*theWofoojaaybydak gthe INSURANCE BOND GUfR O ftmSperify) EVirafmDale FAniedVakrdElecftxalWodc$ Weik>oStat Itsp"mD*Rap5wd Rao Final Signedundx*iePWalbmcfpetjtW HWTM AME LimiseNa Litz�ee Slg�ne .Lxla>SeNo BxkxssTdNTo. r.d ALTUNa OWNER'S INSURANCEWANFR;lam aw&eftftI.Ioasedoes not haw %bqital a*Aatas m#WbyNbmfiattsGaaalLaws andditmysigrat menttlspwdTpkMmwairesftmw'wrni (Please check one) Owner M Agent a Telephone No. PERMIT FEE$ Town of North Andoverof t%°07"qti Building Department 3? y6:' `.° °oma 27 Charles Street ° North Andover, Massachusetts 01845 (978) 688-9545 Fax(978) 688-9542 ^o�Q cac `y,0" �R4TED I'pP �SSACHUs�� SWIMMING POOL REGULATIONS NOTE: Permit card shall be posted in a visible and accessible location for obtaining the various inspectors signature. All swimming pools in excess of 2 feet in depth are required to have a building permit and conform to the following regulations: 1) Electrical: An electrical permit must be obtained prior to an application for a building permit to install a pool. 2) Zoning: Pools shall be located to the rear of the front building line of the house and no closer than 10 feet to the side of rear lot line. 3) Health: a) The Board of Health must approve location from subsurface disposal system.. b) Semi-public and public pools must have plans approved by the Board of Health prior to construction and must also have an annual operating permit from the Board of Health. 4) Safety: Pools must be enclosed by a suitable wall or fence at least 4 feet in height with a self-closing and latching gate that meets the approval of the Building Inspector. No water allowed in pool until fence/wall is erected. Pool cannot be used until inspected and approved by the Electrical and Building Inspectors. Fees Electrical Permit $35.00 Building Permit $35.00 minimum fee $6.50 per thousand on estimated cost TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING T I`his;Sectioi for 11cial_Use`OnI V BUILDING PERMIT NUMBER. DATE ISSUED rn X SIGNATURE: Building Commissioner/inspector of Buildings Date z SECTION I-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: O Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft) 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40.§34) 1.5. Flood Zone Infomutioa: 1.8 Sewerage Disposal System: D Public 0 Private p Zone -Outside Flood Zone 0 Municipal 0 On Site Disposal System -J SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record Name(Print) Address for Service Signature Telephone 2.2 Owner of Record: Name Print Address for Service: O z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: O License Number Address D Expiration Date Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ sv Company Name rn Registration Number r r Address z Expiration Date 0 Signature Telephone Y SECTION 4-WORKERS COMPENSATION(M.G.L.C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes....:..❑ No.......0 SECTION 5 Description of Proposed Work check all applicable) New Construction 0 Existing Building 0 Repair(s) ❑ Alterations(s) ❑ Addition 0 —J Accessory Bldg. 0 Demolition ❑ Other 0 Specify Brief Description of Proposed Work: z x � 0, move 6koo4b too SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be '� � pFFIiCI�i7SE{?NLY Completed b ermit a 'Yffll� „ � x 1. Buildingo (a) Building Permit Fee /3 7 0 Q 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) Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, A 1 AP /Q al t Pry{ as Owner/Authorized Agent of subject property Hereby authorize to act on My behal" .a Viers relativ nzed is building permit application. 18' a® Signature of Owner V Da� SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, as Owner/Authorized Agent of subject property Herebv declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Signature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINIBERS 1 ST 2ND 3 RD SPAN DIN ENSIONS OF SILLS DIMENSIONS OF POSTS DIIv ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CfflMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE cr" 76 y — 72-"1 y For Marketing Dept.Use Only y Gibraltar Pools"Corp. Where Buyer Heard About Gibraltar: 428 Boston Street 1. Buyer initials: U.S. Route One 2 1 Topsfield,MA 01983 (978) 887-2424 3•, 2. Date _2000 Buyer 1's Name and Phone Number Buyer 2's Name Mailing Address(Sired[,Town,9tate and Zip Code) Physical Address(Street,Town,State and Zip Code) 0 J�- &0- We hereby agree to sell,and Buyrtd=-Buyer shown above agree to buy in good faith subject to the terms and conditions set forth below and upon the reverse side h r Ilowing: Your pool has the features and accessories checked below: SWIM AREA OUTSIDE DIMENSIONS 66-90 Steel Buttresses and . Supports !�iluxe tration System: G �uum Equipment WithBaked Acrylic Finish High Rate Aywin Bottom Drain ©an erlocking G-90 Steel Side Panels UStandard minum Coping O Aldminurn Fence V'r in Vinyl Printed Liner 0"Pum 9 Y mp O.Ir4F,o rV adder �jash In-Wall Skimmer Qrl eluxe . CYStainless Steel �eck(Patio and Full Promenades) ❑,S•tandard ❑A uminum ,''Bottom Leveling Channel 319"It rter Chemicals tl�Skim Net L Aluminum Outside Ladder • • �ffApproximate 4'Wall Your pool includes only those features and accessories specifically stated herein and those included by the manufacturer unless otherwise indicated in writing in this agreement. ASSEMBLY:Your pool will be assembled by ❑you urus In:1111101:1261nivi • •' ultim UVOIN. LOCATION OF YOUR POOL:Your pool will be assembled at Buyer 1's address stated above or,if not,at 1.Price of pool $ / 3� a 0,0 00 2.Trade-in description,if applicable $ 3.Net price of pool $ O 4.Sales tax $ . Qu 5.Total price(3 plus 4) $ yq51 00 6.Initial deposit❑4,000 0 2,000 0 other $ ' h D Check El Visa D Master Card O Am.Express O Discover 7.Total Balance due(5 less 6) $ 0' 8.Amount due on or before delivery $ 5-,95 00(1..h.1.,71—$1000) 9.Amount due on completion and/or financed $ / &Do.00 tecaaneae,stoop) Sea associated finance dmuments,N ary,and the proviabn on the rwerse aide .. hereof entitled"Credit application and finance documerad. SOME OF BUYER'S RESPONSIBILITIES: You will supply water and electrical connections,and removal of excess dirt,sand,and pack- aging materials.You are responsible for obtaining,at your expense,all permits (including building permit), authorizations, licenses, appraisals,title searches and other documentation required by law,or any government agency,or any finance institution.You agree to reimburse us for any such costs paid by us on your behalf.Buyer(s)warrant the clear title of any trade-in,and warrant that it is free of all liens and encumbrances. By signing this agreement,you acknowledge receipt of a completely filled in copy of.this agreement,two Ompleted copies of the attached notice of cancellation and confirm that you have been orally informed of your right to cancel:,and that yo(i have read and understood completely the front tand,b4ck.of# is.agreemem, Signature-of Buyer 1 V Independent Salesperson Signature of Buyer 2 Signature of an Officer of Gibraltar Pools Corp. NOTICE OF CANCELLATION. YOU MAY CANCEL THIS TRANSACTION, WITHOUT ANY PENALTY OR OBLIGATION, WITHIN THREE BUSINESS DAYS FROM THE ABOVE DATE. IF YOU CANCEL, ANY PROPERTY TRADED IN, ANY PAYMENTS MADE BY YOU UNDER THE CONTRACT OF.SALE, AND ANY NEGOTIABLE INSTRUMENT EXECUTED BY YOU WILL BE RETURNED WITHIN 10 BUSINESS DAYS FOLLOWING RECEIPT BY US OF YOUR CANCELLATION NOTICE, AND ANY SECURITY INTEREST ARISING OUT OF THE.TRANSACTION WILL BE CANCELLED. IF YOU CANCEL, YOU MUST MAKE AVAILABLE TO US AT YOUR RESIDENCE, IN SUBSTANTIALLY AS GOOD CONDITION AS WHEN RECEIVED, ANY GOODS DELIVERED TO YOU UNDER THIS CONTRACT OF SALE, OR YOU MAY, IF YOU WISH, COMPLY WITH OUR INSTRUCTIONS REGARDING THE RETURN SHIPMENT OF THE GOODS AT OUR EXPENSE AND RISK. IF YOU DO MAKE THE GOODS AVAILABLE TO US AND WE DO NOT PICK THEM UP WITHIN 20 DAYS OF THE DATE OF YOUR NOTICE OF CANCELLATION, YOU MAY RETURN OR DISPOSE OF THE GOODS WITHOUT ANY FURTHER OBLIGATION. IF YOU FAIL TO MAKE THE GOODS AVAILABLE TO US, OR IF YOU AGREE TO RETURN THE GOODS TO US AND FAIL TO DO SO, THEN YOU REMAIN LIABLE FOR PERFORMANCE OF ALL OBLIGATIONS UNDER THIS CONTRACT.TO CANCEL THIS TRANSACTION, MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE OR ANY OTHER WRITTEN NOTICE, OR SEND A TELEGRAM,T7i GIBRALTAR POOLS CORPORATION, 428 BOSTON STREET,TOPSFIELD, MA'01983 NOT LATER'THAN. MIDNIGHT OF /n/9.1 �DDS (Date) I HEREBY CANCEL THIS TRANSACTION (Date) (Buyer's signature). TERMS AND CONDITIONS Meaning of some words.In this agreement,the words'you"and'your"mean anyone signing this agreement as Buyer.The words'wve","us" and"our"mean Gibraltar Pools Corp."Salesperson"means an independent salesperson under contract to us. Acceptance of this agreement and delays.This written agreement is binding and effective upon signing by the Buyer(s), subject to a condition subsequent,that is,confirming acceptance in writing by an officer of Gibraltar Pools Corp.If it is not accepted by an officer in writing, or if at any time we encounter ground conditions or other conditions which we,in our sole discretion,determine makes assembling your pool not feasible or prudent in the circumstances,we have the right to cancel this agreement,pick up any materials delivered to you,and our liability,if any,is expressly limited to the amount actually received of your down payment.We will have no liability for any delay beyond our reasonable control in delivering or assembling your pool.If any material that is part of your pool or used in assembling it is unavailable for any reason beyond our reasonable control,we can substitute material of equal or greater value or quality. Damages.lf,after we accept your offer to buy a pool,you wrongfully cancel this agreement,you refuse delivery of your pool,you breach your obligation of good faith,or we are unable,through your action or inaction,or other breach by you of this agreement,to assemble your pool,you will pay us for lost profit and out-of-pocket expenses.Our lost profit will be equal to 20%of the total price of your pool,unless a lesser amount is required by law. Guarantee.Any Buyer signing this agreement guarantees payment of all amounts owing under this agreement.This means any Buyer signing this agreement will immediately pay any amount owing under this agreement that becomes overdue,whether or not we try to collect it from anyone else. No notice of loss of rights.We do not have to tell you if any amount owing under this agreement is not paid by the day it becomes due.We can exercise any right against you or your pool without losing any other right against you or your pool.We can do any of the following without telling you or losing any right against you or your pool: 1.Accept a check or order marked"paid in full"or with similar language as a payment under this agreement. 2.Give additional time for payment of any amount owing under this agreement. 3.Give up or delay any right against you or your pool. Collection costs.If we use an attorney or collection agency to collect any amount owing under this agreement,you will pay us an amount equal to reasonable attorney fees and/or actual collection agency costs and any court costs we have to pay.The amount of the attorney fee will be equal to 20%of the amount owing unless a court sets a smaller or larger fee.Under this agreement,upon substantial performance by us, full and final payment becomes due and Buyer(s) are required to sign promptly the completion certificate form(s) required by the relevant financing institution and by us. No landscaping:We do not perform any landscaping or other forms of yard work,nor do we sell or provide related materials. Underground.In excavating your site,we are not responsible for any damage to lawns,pipes,wires,underground structures and materials and the like.SUCH WORK IS PERFORMED ONLY AT OWNER'S RISK. Ground Drainage.Although highly unlikely,it is possible that environmental conditions could cause frost damage to your pool.All cases are different.For example,the pool may shift or move or be damaged due to frost,which can be particularly severe where there is improper drainage or wet ground conditions in your yard and in the pool site area selected by you.Gibraltar disclaims any and all liability and responsi- bility for frost damage and/or for any damage in whole or in part due to frost,yard water,adverse topographical conditions,improper drainage, or homeowner's negligent landscaping. Changes.Any change in this agreement must be put in writing and signed by a corporate officer.We may correct obvious errors in this agreement,such as sales tax calculations. Continued effectiveness.If any part of this agreement is determined by a court to be invalid,the rest will remain in effect. What law applies.Any legal question about this agreement will be decided according to the law of the state where the contract is executed. Responsibility.You and everyone else signing this agreement as Buyers will be,individually and together,liable under ft.We can sue you under this agreement even if we do not sue anyone else. Excess material.Any material which we deliver but do not use in assembling your pool will remain our property, except sand and similar materials and packaging materials. Entire agreement.E=xcept for the written manufacturer's Limited Warranty delivered by us and financing documents used in connection with the purchase of your pool,this agreement is the final and complete agreement between you and us concerning your pool.ANY ORAL OR WRITTEN STATEMENT CONCERNINGYOUR POOL BY A SALESPERSON IS NOT A WARRANTY AND IS NOT PART OFTHIS AGREE- MENT,UNLESS IT IS SPECIFICALLY STATED HEREIN AND APPROVED BY A CORPORATE OFFICER IN WRITING. Warranties.We make no warranty concerning your,pool or any other matter,except that the swimming pool and accessories described in this agreement are the ones being bought under this agreement and except for the written manufacturer's Limited Warranty delivered by us.ANY WARRANTY OF MERCHANTABILITY AND ANY WARRANTY THAT YOUR POOL IS FIT FOR A PARTICULAR PURPOSE WILL BE LIMITED IN DURATION TO THE PERIOD OF THE WARRANTY MADE IN THE WRITTEN MANUFACTURER'S LIMITED WARRANTY.A "WARRANTY OF MERCHANTABILITY"IS A WARRANTY THAT PROPERTY IS FIT FOR THE ORDINARY PURPOSES FOR WHICH PROPERTYOF THE SAME SORT IS USED.IFYOUR POOL OR ANY ITEM IS MANUFACTURED BY SOMEONE OTHERTHAN US,ONLY THAT PERSON WILL BE LIABLE UNDER ANY WARRANTY MADE BYTHAT PERSON TOYOU OR TO US. Credit application and finance documents.In connection with any application made for credit for the purpose of financing your pool or any update,extension or renewal of any credit we extend to you as a result of any application,a credit report may be requested from a credit reporting agency and submitted to one or more financial institutions at our sole discretion.Upon request,we will tell you if a credit report was requested,and if so,the name and address of the credit reporting agency furnishing the credit report.To request information,write Gibraltar Pools Corp.,Credit Manager.If we expend effort at your request or with your consent to obtain approval of your credit for a loan to finance your pool,prior to and upon approval by any financial institution of your credit,you agree to cooperate in good faith promptly and fully as necessary to complete and/or correct and sign financing and related documents required by the approving financial institution and similarly cooperate in supplying such credit-related documentation and information requested by such institution.If you deliberately furnish us with untruthful or misleading information during the credit process,a financing approval could be nullified.In that case,payment would be due immediately. Our obligations If we assemble your pool.If we assemble your pool,we will level the ground on which your pool will be assembled,but our responsibility will be limited to a reasonable leveling of plain dirt only.We can level the ground by fill or grading,at our discretion.You are responsible for the complete removal of any trees and the entire stump(s)at your sole expense.We will assemble your pool and provide pool fittings to enable you to make any necessary electrical connections. Your obligations if we assemble your pool.If we are to assemble your pool,you will apply for and obtain,at your expense,all permits, authorizations, licenses, and appraisals required by law or any government agency, or any finance institution.You will be responsible for removal of any excess dirt,sand and packaging materials.YOU WILL PAY US FOR ANY ADDITIONAL EXPENSE OTHER THAN REASON- ABLE LEVELING OF PLAIN DIRT IN PREPARINGTHE GROUND ON WHICHYOUR POOLWILL BE ASSEMBLED.You will be responsible for correcting any existing or resulting violation of any zoning,building,electrical,plumbing or other code.You are responsible for providing adequate drawings of the pool site selected by you.You agree to obtain any consent for us to enter any neighbors property if we need to do so to assemble your pool.You are solely responsible for informing us of,and for satisfying,any and all setback(and related)requirements:and further,you agree to hold us,our employees and our suppliers and contractors harmless from any and all claims and liabilities in any way related thereto. If applicable, any extra fill, gravel, materials or labor beyond that required to perform a normal installation will be Buyer's responsibility. If you aro assembling your pool.You are responsible for leveling dirt,preparing the ground including any appropriate drainage work neces- sary,and obtaining and installing sand or other base material.We will deliver your pool materials to the location specified on the reverse side hereof. Doop ond.ft your pool includes a deep end where the depth is in excess of approximately four feet and we are assembling your pool,our responsibility for digging the deep end will be limited to digging plain dirt only.You will pay us for any additional expense associated with the digging of anything other than plain dirt.You are responsible for dirt removal and we are responsible only to pile the dirt related to digging the deep end at a location chosen by you on your property at a distance of not more than 20 feet from the location of your pool.If we encounter ground conditions or other conditions which we,in our sole discretion determine make digging the deep and not feasible or prudent in the circumstances,you agree to accept instead,a flat pool with a depth of approximately four feet. WE ARE NOT RESPONSIBLE FOR DAMAGETOTHE DEEP END AND THE POOL ITSELF WHICH OCCURS AS A RESULT OF DRAIN- ING WATER FROM THE DEEP END,GROUND SHIFT,SURFACE AND SUBSURFACE WATER,ICE,FROST,SNOW,LEACHING FLUIDS OR ANY ACT OF NATURE.NO DIVING.YOU UNDERSTAND THAT WE DO NOT ENCOURAGE DIVING AND WE URGE NO DIVING BE PERMITTED INYOUR POOL SERIOUS BODILY INJURY MAY RESULT FROM DIVING. 3= , ww � "lam•• , w a r' " r �-, •�< , . _ Why 4' O • �a Vil .�[o t I. •, %fP"""1.„„ Vis. - k°` '�! 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"�` :�..- .,..,.`�el;�.-_, ":.._.tom, t-�:d«f,°a, ,:.�•�t.a,.-- > .,� W'•n. .. .:..__.._ +_ .: �...��.�., ,s .r '� '..a,.: '0., woo-w!ansesn-Anr m IV aj!sgaM inp I!sIA Q fl I& Z3 a a PuOu3 mGN jnog6noayl Stood-Tlvjq! .f . .�...� 1, slle;aa pue uol;ewao;ul ao;AananS pae4we sai j* t1 77 st�r' . - �.fir• � � �-,.,. " ♦' n s £Y 4 W Y % Arr G 1 a , _ F•. , _ E GOOD HOUSEKEEPING N.S.P.IbESIGN WINNER XFZ_ . f Made in USA - `= REMEMBER...You can ONLY buy a genuine GIBRALTAR POOL-The Virtually Self-Cleaning ! r PODITM from Gibraltar Pools Corp.at 1-800-USA-SWIM.Trust the name and company that ....rte— . is the largest builder of pools in every New England state.Beware of imitations! SURFACE SUCTION ,,,, i CLEAN WATER HIGH TRADE-Ifs! PROGRAM RATE FOR EXTRA VALUE! FILTER TRADE IN THAT UNUSED CAMPER, BOAT,CAR, BOTTON DRAIN SUCTION SNOWMOBILE, OR JUST �- . ABOUT ANYTHING ELSE! ExlsT.wELL LOT # 3 4. 1 AW 57j �ENGNM' K GoN OF 3 p OWDO0 40 a. tll( zo W 7L 1 v 14 ,t w. 1 { !••�• �'� •'' '� �*'. j .:..1 s;Fa� ��."�S t �15 �`I ^e.�' is ° 3„ :_'• J ,,,� 1,:_ P�PPCSG�G:.:L .r 4-114 1'' 1 iI •1 + v r` d t SpfZ�� " a '1 EXIST.�51EQTIG f1 1 •� • .fir 1 "�� ,.r J t SQ �7YL:e-1 5 -� /� .i � � �j3 �.. �{ 1'J #� t� � 1st �^ •r I � '1'F:.i7�}�.1�� A 4 1 �j T :b tr `► I ' / rte' -(E5 j ��o , �• 1 1 �. .� - ,.•, � ,i�.,'� , � .1'71 �� � I ,� T. G a� pyt I � t • ( e • ✓ / � $ 4 t fix.,. \\\. ° i � r',tt` \ _ ,'• ti,\_ �9g '. � -, \ moi. 1 D . +F • x«1\ •J'xy.6i\, jn� \ S e ,� a< t A rr rx x err.'r +?K_ 9 F .xFt `U'.M 4v � ,'• y,- „tr as '"rl ` ` - r �� �..� �� ��: t'• . t�.� �F PAVEI'I�T �� �� -X%�#w'ixre•�r�� �h,-.,.;,..w ..�,,o ��-^.._•...••+.r.,�w;:c'+3..,+r".:::^- ..`F'r"�,.''._"c- Location�O Date 0.1 NORTH TOWN OF NORTH ANDOVER 4? •jjjjJjjj& Gw • ; Certificate of Occupancy $ Building/Frame Permit Fee $ U Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 5. Check 14 .r 16 j �._ Buildindlps�ector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING It BUILDING PERMIT NUMBER: "% ® DATE ISSUED: ®� SIGNATURE: ,Edilding Commissioner/1for bf Buildings Date S,A • SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: —' Number Parcel Ntimber 1.3 Zoning Information: 1.4 Property Dimensions: O Zonin District Proposed Use Lot Am(so Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided v 1.7 Water Supply MG.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private 0 Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT m 2.1 Owner of Record n ame(Print) Address for Service. Signature Telephone / 2.2 Owner of Record: Name Print Address for Service: O z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: License Number Address Expiration Date Signature Telephone r 3.2 Reg�istere'd Home Improvement/Contractor. Not Applicable ❑ Company Name j > Registration Number /SEt � Address j Expiration Date, Signature % � Telephone SECTION 4-WOREERS COMPENSATION(M.G.L.C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work(check all applicable) New Construction ❑,,, ;¢Existing Building ❑ Repair(s) ❑ Alterations(s)s q, Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of P;npggd % SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be FFII USFfIl�tI•Y CO feted by permit a lican >boUy, a t 1. Building �2p (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 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT Ix as Oie=/Authoizdfsubject property X Hereby authorize to act on cX My behal�ir�ll tters Iati or uthorized by this building permit appli at on. ¢4. Sig 8 of CKii,r ate SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief f Print Name Signature of Owner/Anent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR T19VMERS 1 Tr2 3 SPAN DFAENSIONS OF SILLS DEVIENSIONS OF POSTS DE\,ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CIMMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE a Town of North Andover NaRrh q 0 ,t4t0 �bt + �? yE',' ^' •6 0 Building Department o 27 Charles Street * ,� North Andover Massachusetts 01845 * s ` (978) 688-9545 Fax(978) 688-9542 ' 440.,A t`V Pp, ,Q �r0 S$ACHUgE DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit# the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, s150a. The debris will be disposed of in/at: Facilit location r Sig ature o Applicant D 7 NOTE: A demolitionP ermit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name: Location: City Phone am a homeowner performing all work myself. am a sole proprietor and have no one working in any capacity I am an employer providing workers'compensation for my employees working on this job. lCom an name: 1/710 Address cz Ci • S; Phone#:4i?-I)zez-,�?,2s Insurance Co ✓, �� !l a?� Policv# Company name: - Address Citi: 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 andtor one years'imprisonment as 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 statement may be forwarded to the Office of Investigations of the DIA for coverage ver cation. I do herby certify under ains and penalties of peduryMat the information provided above is hue and correct. Signature Date Print namea S Phone# Official use only do not write in this area to be completed by city or town official' ❑ Building Dept ❑Check I immediate response is required Building Dept ❑ Licensing Board ❑ Selectman's Office Contact person: Phone#: ❑ Health Department ❑ Other FORM WORKMAN'S COMPENSATION Page of ,. Owner - Robert Bolis Proposal Free Estimates (508) 687-3328 Bolis Construction Roofing, Seamless Gutters, Insulation,Vinyl Siding Aluminum Storm Doors, Windows and Replacement Windows PROPOSAL_SUBMITTED TO PHONE g ` _ DATE ti +��� .fit `,i.�i/C"�f•�1� `� �!., J �.� �'Y r/i,s'"..,! "" �.'.`-�•,t:;� .�+ STREET i ✓ + ^ ' JOB NAME CIN,STATE and'ZIP CODE tY� { JOB LOCATION q"'J sr'i,/f i''f.t'..+::_A'', ,fps✓ _�i-�fi+�"� ARCHITECT `" DATE OF PLANS "' JOB PHONE We hereby submit estimates for. Az ,.y a ✓ }'C�'� `f ` f '` f!*.-���" ,�^•.��4 K�w��_' • f -'�'' � .�,y/ � lit•- sr.1`' ,+J`',r !`r� w ..F�.'. —' `x I�P'�l .Jr Y -n + ..r 7 � 1.- .fi' ° lr�r gip• r !Y I�I�•�'`PP r-r�.� / ..bTi:::�`:��� j '�,.,,d�rd'!✓.SY�+��Ii.✓�_•- '�--- ,r',l..�{,� .+',rC !�'� L'' ,/�G�C Gam' F G:� a We Propose hereby to furnish material and labor= complete in accordance with above soecificationg,for the sum of- dollars' C� -).-- Paymdh�i,to be made as follows: All material is guaranteed to be as specified.All work to be completed in a work- Authorized manlike manner according to standard practices.Any alteration or deviation from Signature .t'•"�'"J y',` .'. above specifications involving extra costs will be executed only upon written — orders,and will become an extra charge over and above the estimate.All agree- , ments contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado and other necessary insurance.Our workers are fully covered by NOTE:This proposal may be Workmen's Compensation Insurance. withdrawn by us if not accepted within days. Acceptance of Proposal - The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized to do the work as specified.Payment will be made as Signature outlined above. Date of Acceptance: Signature `� Q C NORTIy '9 ovm Of6 ®ver ,. 380 7117 ;+ LA o dover, Mass., 7 o COCMICMEWICK 5 AERATED P � S BOARD OF HEALTH AN Food/Kitchen vERMIT , T D Septic System /' , BUILDING INSPECTOR THIS CERTIFIES THAT....——W—.'.`.'.-......... .........p . ............................... ...................�... � .. . ................. . ..... Foundation has permission to erect,.... .......... buildi gas on..S. v... .. * Rough to be occupied as �� Chimney :7. 1 1; provided that the person cepting this permit shall inrespect conform to the terms of the application on file in Final this office, and to the prov sions of the Codes and By-LWSI 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 CONSTRUCTI N S Rough .. .......4......... .......... rw... ..................................... Service BUILDING INSPECTOR - Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFina, 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. Location �`7 �x r'[. r T, No. ! / Date r NORT" TOWN OF NORTH ANDOVER Of�riao a,h I. •a Ooh . Certificate of Occupancy $ } Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee Sewer Connection Fee $ Water Connection Fee $ RECEIVED pAygtg - r.t MAYBuilding Inspector jCCf N®<And,vonr n—ie Div. Public Works PERM&NO. � SI APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1' � r MAP 4-40. I LOT NO. 2 RECORD OF OWNERSHIP (DATE (BOOK PAGE ZONE SUB DIV. LOT NO. 1 LOCATION ST ' PURPOSE OF BUILDING c> DG V/►p �Aj OWNER'S NAME // / t M �J// NO. OF STORIES 2f+ SIZE OWNER'S ADDRESS (/L�(,•+1,•�/ 1/�l/y���� lOeb s- [ A BASEMENT OR SLAB ` ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR GIRDERS AREA OF LOT 7 A- FRONTAGE HEIGHT OF FOUNDATION THICKNESS _ t IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY Be I (1n S BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND �1 }1 WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER o D '/ BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COS) jr PAGE I FILL OUT SECTIONS I - 3 EST. BLDG. COST PER 80. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG.COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED /�'!lr`7 �, �� BOARD OF HEALTH SIGN NER OR�TF�ZED AG * ��� �- / 8 3 FEE CONTR.TEL.#_ CONTR.LIC.# PLANNING BOARD P MIT GRANTED A4 I 19�� BOARD OF SELECTMEN BUILDING INSPECTOR p �\ F ti BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY _ SrORIEs THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS I RAGES, ETC. SUPERIMPOSED.THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION B INTERIOR FINISH CONCRETE 3I DRY WALL 2 I3 CONCRETE BLK. PINE _ _ BRICK OR STONE HARDW�D __ _ PIERS PLASTER _ _ UNFIN. 3 BASEMENT 11 AREA FULL FIN. B'M"TAREA _ 'h /1 % FIN. ATTIC AREA _ N_O BMT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDW D_ _ ASBESTOS SIDING COMMON VERT. SIDING ASPH.TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS.d FLOOR I_ BRICK ON FRAME CONC.OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I� POOR _ ON ADEQUATE NE $ ROOF 10 PLUMBING t GABLE HIP BATH (3 FIX.( — ! GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING I MODERN FIXTURES _ TILE FLOOR t ,� TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE , FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. &COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING ' RADIANT H'T'G UNIT HEATERS - 7 NO. OF ROOMS G19 L B'M'T 2nd _ ELECTRIC Ist 13rd I NO HEATING HN own o �� ? 6 ndover • 15 11 70 ENTRY PERMIT -- � � -= � N � 1 Ern er, Mass., 10L PERMIT T SSA BOARD OF HEALTH #� 4fA**1...� PAWMTHIS CERTIFIES THAT............ ....... O" ...: 'W •.040it. BUILDING INSPECTOR has permission to�■I�.. buildings on . b•.4 e Rough � Chimney to be occupied as...........�.`t-4Frs*. ..... ./ ..................... - Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR. UNLESS CONST Rough . Service T . Final ..... . .... .... .................. . BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Burner No Lathing to Be Done Until Inspected and Approved by Smoke Det. Building Inspector Location No. yam Date �n MORTh TOWN OF NORTH ANDOVER v 0 9 a , Certificate of Occupancy $ Building/Frame Permit Fee $ —L) Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # �' X70 1 lz-_ -Building In6pec 6r A N TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, .. RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING �y '.-- V BUILDING PERMIT NUMBER: LZ DATE ISSUED. � M SIGNATURE: Building MM1ssioner/I for of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Pr at Address: 1.2 Assessors Map and Parcel Number: X05.c . Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lal Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Regaired. Provide Required Provided Reqaired Provided 1.7 Water Supply M.GL.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT m 2.1 Owner o rd l,�m �r�k;n.S Name(Print) Address for Service Sign '-Telephone�� 2.2 Own of Record: Name Print Address for Service: O Z M " Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: License Number on Address Expiration Date ic Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name rn Registration Number r Address r ^� Signature Telephone Expiration Date Y' SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Description of Proposed Work(check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alteration ) . ❑ Addition. ❑ Accessory Bldg. ❑ Demolition`" ❑ Other ❑ Specify Brief Description of Proposed Work: LO SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be s OFFICIAL;t7SE(�NI:Y Completed by permit applicant x.a. 1. Building (a) Building Permit Fee ea Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)x(n) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGYAJ OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby aorize to act on My i ,i all maq o work authorized by this building permit application. 6! 00 S na e of Own r Date SECTION 7h OW NER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Simature of Owner/A ent Date 11-1111 ill 11111.11111111.1 I MI NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1' 2NU3Ku SPAN DIMENSIONS OF SILLS DM ENSIONS OF POSTS DIWNSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUU DING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE a t NOR7N� Town of North Andover o� "° Building Department p 27 Charles Street Y North Andover, MA. 01845 s�cHuse D. Robert Nicetta Building Commissioner (978) 688-9545 (978) 688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print DATE JOB LOCATION ��y�' / 7 �� . /06Cl 'C)= Number Street Address Map/lot "HOMEOWNER 45 G-- 0-400 Home Phone Work Phone PRESENT MAILING ADDRESS 56j City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings Of two units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. (State Building Code Section 108.3.5.1) DEFINITION OF HOMEWOWNER: Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two family dwelling,attached or detached structures ac- cessory to such use and/or farm structures. A person who constructs more than one home in a '. two-year period shall not be considered a homeowner. The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other Applicable codes,by-laws, rules and regulations, The undersigned"homeowner"certifies that he/she understands the Town of No.Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requir HOMEOWNER'S SIGNATURE • i APPROVAL OF BUILDING OFFICIAL NORTH ® of -- R over No. 4aa o z== A o dover, Mass., (299e4t � 2.000 COCHICHEWiCK �q ADRAT E D P P�,`�5 S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...... ......... ............................................... ..................... ............... .................. Foundation ............... ... V49 has permission to erect........................................ buildings on... ....... .... ....... ............ ......................... Rough to be occupied a ............ ....... .. O Chimney Aj . . .. . .................................................... provided that the perso ccepting this permit shall in ev respect conform to the terms of the application on file in Final this office, and to the pr visions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION S 'T'S ELECTRICAL INSPECTOR Rough .......... .. .... ... ... .:............................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises - Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det. Date.... .. v�Q � NORTH °f*•``° '°�"o TOWN OF NORTH ANDOVER ° PERMIT FOR WIRING SACHUS� Aa.rf C................................................This certifies that ..... ............. has permission to perform ........... f . S wiring in the building of......... .d /s.!?. ?............................................. S//^^//' ' �j ......�...... North,Andover . ..f...... ./.f..F. � ... ........ ....... .�1.... .. Fee.... Lic.No ,r3. ELECTRICAL INSPECTOR Check # A 'ZOrl Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. ZZ Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/991 leaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be perfonned in accordance with the Massachusetts Electrical Code(MEC)JAPM (PLEASE PRINT IN INK OR LL ORM TION) Date: City or Town of: o the Inspector fWires: By this application the undersigned gives nott a his o h inte on top rrn the electrical work described below. Location(Street&Nu era QL Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Installation of Security system Completion of the followin table may be waived by the Inspector of Wires. No.of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans No.of Total Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA Above In- o.o mergency tg mg No.of Lighting Fixtures Swimming Pool rnd. ❑ rnd. ❑ Batte Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones o Detection and No.of Switches No.of Gas Burners No. Initiatin Devices No.of Ranges No.of Air Cond. Total Tons o.of Alerting in Devices No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained p Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ElOther Connection No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No.of Water Kms, No.of No.o 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 ijdesired,or as requ r y t enspector o ires. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantiivl�t.� undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing o tce. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) i a Estimated Value of /lectrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify,under the pa ns and penalties of perjury,that the information on this application is true and complete. FIRM NAME: cesLIC.NO.: I r Licensee: John S. Bassett Signature LIC.NO.: 1533C (Ifapplicable,enter"exempt"in the license number line.) Bus.Tel.No., 60 594 S97$ Address: r, Alt.Tel.No.: OWNER'S INSURANCE WAIVER: I am aware that the Li , see does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑ owner ❑owner's agent, Owner/Agent Signature Telephone No. PERMIT FEE: $