The URL can be used to link to this page

Home My WebLink AboutMiscellaneous - 56 CANDLESTICK ROAD 4/30/2018 56 CANDLESTICK ROAD i 210/106-A-0094-0000-0 -------------------- 1 r ' I f I \ o 41-914 76./ 6joo 931 I i i 1 I r 1 I 1 X1 4 �0�vh° 0 4g, 38(O ; \ vl� \ � I � � � s SYo Y 1 1 , 3 Z I � � _ 0 TO THE Deo bad/f�lz 6A\/106/;7 AND ITS TITLE INSURERS L HEREBY CERTIFY THAT I HAVE EXAMINED THE PREMISES AND ALL EASEMENTS, ENCROACHMENTS MORTGAGE INSPECTION PLAN AND BUILDINGS ARE LOCATED ON THE GROUND AS SHOWN. I FURTHER CERTIFY THAT THE BUILDING SHOWN CONFORMED TO THE ,,IZIONING LAWS AND LOCATED IN AMENDMENTS, L*.I FRONT,,SIDE AND REAR YARD SETBACKS ONLY) OF L4,Q0 DOVE IZ WHEN CONSTRUCTED I FURTHER CERTIFY THAT THIS PROPERTY IS NO� LOCATED IN THE ESTABLISHED MASSACHUSETTS FLOOD HAZARD AREA. NOTE ,THIS CERTIFICATION IS BASED ON THE LOCATION OF SURVEY MARKERS OF OTHERS, AND DOES NOT REPRESENT A PROPERTY SURVEY.- EXAMINATION OF THE RECORDS IS MADE ONLY SUBSEQUENT TO THE RECORDED DATE OF THE,LATEST DEED AND DOES NOT INCLUDE VERIFYING THE ACCURACY OF THE DEED DESCRIPTION PREVIOUS TO ITS DATE OF. RECORD. THIS COMPANY IS NOT RESPONSIBLE FOR ANY INDENTURES MADE SUBSEQUENT TO THE 1300K Irllo PAGE I26i RECORDED DATE OF THE LATEST DEED OF RECORD. PLAN No.7124 u. WHENEVER BUILDINGS ARE SHOWN LESS THAN ONE FOOT FROM THE PROPERTY. LINE IT IS PC ADVISED THAT A MORE PRECISE SURVEY BE MADE TO VERIFY THESE MEASUREMENTS. �C(ER'T.1NO. TMS CERTIFICATION TO 0E USED fOR M011 TOAOC PURPOSES ONLY V UIJ. 7 , 1986 : 1� . ' �ZN OF �1q BRADFORD ENGINEERING CO. SCALE L�.0' �* P.O. BOX 1244 HAVERHILL,MASS.01831 lames 1V: BOUGIOUKAS R ,S 9529 JAMES W. T•I• 373 2398 U BOlIG10UKAS 9829 l (GIST E�`�� SUR�Fj i i r Z4�27 19 's L C 6e„ li.0 raoq�e ail/cr'`I,171: ae,�� /1711 1 i n 4/ .4 � UIZ 7 ' . -4 624ow&�w : Altllll-17�IVY 7Zee2cZZI Z JT "A k VZ 6- 71'C,e e&'A249 X0eI1Y AUA�2V,4cej IXA 55. fJF f Y,E' t�'ri" + t� '/qtr , ' F;:' f, /90 EDMONDJW eX<1W r CYR ` -�'f'�, Na.379;��? �. :� L./`lIY��G/��G �'.� ♦ � = .��E /J a Providing Insurance and Financial Services Stade� �. -tome Office, Bloomington, IL + April 24, 2015 Town Of North Andover Building Department State Farm Claims Bldg 20 PO Box 106110 1600 Osgood St Ste 2035 Atlanta GA 30348-6110 North Andover MA 01845-1057 CERTIFIED MAIL: RETURN! RECEIPT REQUESTED RE: Claim Number. 21-6191-1-782 Our Insured: James P Martin Date of Loss: March 15, 2015 Loss Location: 56 Candlestick Rd, North Andover, MA 01845-3236 Tax Block: NA Tax Lot: NA To Whom It May Concern: State Farm Fire & Casualty Insurance Company writes to provide notice as required by Massachusetts law in connection with the matter referenced above. State Farm®received notice of loss or damage in excess of$1,000 at 56 Candlestick Rd, North Andover, MA 01845. We hereby notify your office pursuant to General Laws c. 134, §313 that State Farm intends to make a payment of$1,000 or more in connection with the above referenced insurance claim. Further, the applicable amendatory Policy Endorsement informs the insured of the Massachusetts requirement by stating the following: "We are required by Massachusetts law that we must notify the local inspector of buildings or Board of Health at least 10 days before we make a payment of$1,000 or more for loss to a building or structure. We must also give notice if there is damage which makes a building a health or safety hazard or dangerous or unsafe for occupancy regardless of the amount of our payment. If, prior to payment, we receive official notice of a pending or existing lien against your premises, we must delay payment until the matter is settled. If we are required to pay all or part of the amount of the lien, we will not be obligated to pay that amount to you." If you have questions or need assistance, please call (800)406-8543 and leave a voice mail message. We will return your call as soon as possible. Our centralized claim operation is also available to provide assistance. They can be reached at 877-783-1200. �JI�II� A' 21-6191-1-782 Page 2 April 24, 2015 Sincerely, Teresa J Bergh Independent Adjuster (800) 406-8543 State Farm Fire and Casualty Company `'� � �ti� ��' �_� 2� � ~�Rt SIF _ _�' - fi�ff qtr=- �,.r IL rr }r r r��rf�arm r,�� 's � �I�i �• f ��1 1 1 7 f�:. .+4� �� 1��4rF4r �y '1' r. '• :• 1. 1 � �� , �.,� � ,�r'yr,,�'r ,� �,, t ti �i r .ra ms's�""��'',�.v '"+�f -r ��. •h ,r`' lj+rx� v,� ,,�e��£�r r�� h�:��ti kyr h' yu rrY�.J'Nr.r a r�8�fE+y �Y`�r�� yisS 'rr. r ''ry�y;.."c �'.�'�E�h"� r r �?t."yf�l �� .y'`'+ �r a"••." `',rr �r ..� ..�f �� 'ti 1 �,'fy +�4s1"rr}' .,rrr.rfi Y�ir �� r t`�*rs4 a,S� y�; �'�`r...�. t i Y�,/d rJ.''SS tr'Y��+ra.'1 i �t�r•�I .rrf �y��1� < ,t?l rr ♦i i L,h. � f'� r� r r'�.�'r'f• �'`.� d .�vra+er�"'",y x tixi�r n s+��,�'u�y� �� fi'�r f��Mr Rie��r` f��+. �+ yrrr. �1�'�+,//��,r r'' r r r fF.S''r�}l}r�. rrt�� r sr� sy .•' r Eh.a Y r�y' "r*�r4,+�,,,"'�'�yE� }'�j. r�' � t+''E'i*`A �.�.�y ti;'� � r r,7r,"✓� r ar r ry`rr,.`'kS'�.*'�✓ . s ti j4�,�r ti� Y j1'�'fY .«r, s-try�Mar�4�r r �.4�d�' �e'ttf,. �� ;�.F�y'".��;,• � F- iVr,.rrs+r'..��q.r �sy-0ty rrq jrEr S}fit ��rr`�v f'i� ,+r -R r :� r 4 ` � - i I t I 7 t } _......_. �• r �� 00 1 � I �� ., i UNITED STATES POSTAL SERVICE First-Class Mail Postage&Fees Paid USPS Permit No.G-10 w 18 1 Sender: Please print your name, address, and ZIP+4®in this box* SENDER: COMPLETE THIS SECTION'� COMPLETE THIS SECTIOJvON DELIVERY o Complete items 1,2,and 3.Also complete A. Signatur item 4 if Restricted Delivery is desired. gent ■ Print your r,-;me and address on the reverse X - O Addressee so that we can return the card to you, g iv d by inte N ) C. Date o eliv 1111Attach this card to the back of the mailpiece, a or on the front if space permits. D. Is delivery address different from item 1? 13Yes 1. Article Addressed t : If YES,enter delivery address below: No T0)n [3 o F forf� -nd�rer "5 Bid �a9 o �d 3. Service Type 40rIia m�- d�� `� C3 Certified Mail® 13 Priority Mail Express'" D Registered 0 Return Receipt for Merchandise 13 insured Mail i3 Collect on Delivery 4. Restricted Delivery?(Extra Fee) p Yes 2. Article Number ( 7014 3490 0001 8828 1064 transfer from service label) PS Form 3811.July 2o13 Domestic Return Receint Providing Insurance and Financial Services -ml StateFarw Home Office, Bloomington, IL March 26, 2015 Town Of North Andover State Farm Claims 120 Main St PO Box 106110 North Andover MA 01845-2493 Atlanta GA 30348-6110 CERTIFIED MAIL: RETURN RECEIPT REQUESTED - RE: Claim Number: 21-6191-1-782 Our Insured: James P Martin Date of Loss: March 15, 2015 Loss Location: 56 Candlestick Rd, MA 01845-3236 Tax Block: **TAX BLOCK** Tax Lot: **TAX LOT** To Whom It May Concern: State Farm Fire & Casualty Insurance Company.writes to provide notice as required by Massachusetts law in connection with the matter referenced above. State Farm® received notice of loss or damage in excess of$1,000 at 56 Candlestick, North Andover 01845. We hereby notify your office pursuant to General Laws c. 134, §3113 that State Farm intends to make a payment of$1,000 or more in connection with the above referenced insurance claim. Further, the applicable amendatory Policy Endorsement informs the insured of the Massachusetts requirement by stating the following: "We are required by Massachusetts law that we must notify the local inspector of buildings or Board of Health at least 10 days before we make a payment of$1,000 or more for loss to a building or structure. We must also give notice if there is damage which makes a building a health or safety hazard or dangerous or unsafe for occupancy regardless of the amount of our payment. If, prior to payment, we receive official notice of a pending or existing lien against your premises, we must delay payment until the matter is settled. If we are required to pay all or part of the amount of the lien, we will not be obligated to pay that amount to you." If you have questions or need assistance, please call us at (800) 803-9089 Ext. 6103614744. i M 21-6191-1-782 Page 2 March 26, 2015 Sincerely, Monte Davis Independent Adjuster (800) 803-9089 Ext. 6103614744 State Farm Fire and Casualty Company 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance-with the provisions of M.G.L.c.143,§3L,the _ permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166,§32,an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall-be limited as to the time of ongoing construction activity,and may be.deemed.by the.Inspector_of_Wires abandoned-and.invalid_if_he— or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008 and extending through August 15,2012. ule 8—Permit/Date Closed: 0 2-Ll— lk ** Note:Reapply for new per 0 Permit Extension Act—Permit/Date Closed: 9813 Date.....1.Z.�.3.:..�. ..... JN NORTH 1 3?°.,�``°.;•:"�,� TOWN OF NORTH ANDOVER o ' PERMIT FOR WIRING ,SSACMUSE� Thiscertifies that ............A.a.- .............................................................. has permission to perform ........ 4/ '/?....... j!/; 7 ...................... q wiring in the building of............. �� -r,/....................................... 4 t� at.... .S..?`........4.6..............�..Mrth Andover,Mass. Fee...................�^.... Lic.No....e. S l�1 ,�� '... ELedffiAA.IMPWMx V Check # �� t (fommonwea&of/YlaJ4ac4u6etb Official Use Only cc Permit No. 4Y132epartment of-7ire Seruice6 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC) 527 CMR 12.00 (PLEASE PRINT OR TYPE ALL INFORMATION) Date: � I � )o City r Town f: N14 j��UV� To the In pec or of Wires: By this applica ' ndersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) �., Owner or Tenant 14�� (�t'�n Telephone NO (per Owner's Address S�m� Is this permit in conjunction with a building permit? Yes ❑ No R9 (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: ��JUI �jJ � n�- Gln ,eY10117! d 5� ' Completion of the ollowin table may be waived by the Ins ector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above [I In-rnd. rnd. ❑ Bat—Oo ter Units cy ig ung No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices Tons No.of Waste Dis posers Heat Pump Number Tons KW No.of Self-Contained r p Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Loc Ot Connection 1 No.of Dryers Heating Appliances KW Security Systems:* No.of Devices or Equivalent No.of Water No.of No.of Data Heaters KW Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: / '�l Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: 4(1 (� (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 coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) Self Insured I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: ADT Security Services Inc. LIC.NO.: C-45 Licensee: Mark A. Brophy Signature �C -�� _ LIC.NO.: C-45 (If applicable, enter "exempt"in the license number line.) Bus.Tel.No.:7 81-3 5 5-5 619 Address: 155 West Street, Suite 6 Wilmington, MA 01887 Alt.Tel.No.:781-355-5500 *Per M.G.L.c. 147,s. 57-61,security work requires Department of Public Safety"S"License: Lic.No. 00953 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ —11162"60 a Location t No. Date 4P-a -,)j „pRT" TOWN OF NORTH ANDOVER 40 10. 9 Certificate of Occupancy $ Building/Frame Permit Fee $ tCMUs Foundation Permit Fee $ Other Permit Fee $ TOTAL Check # �yX r ,( 65- 8 0 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING - 3 ... __�:.' ...�^�,'�„� . . � �'��• �dl�`;_ I�� v�TflG � .,zh`cmr.a,�E,r, �''.a',,, ' :'i"� BUILDING PERMIT NUMBER. DATE ISSUED. 1-18oZ /a-- UD SIGNATURE: X/M(6"'," Buiflng Commissionerfl for of Buildings Date SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: e( lc)( A 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 R 'red Provided 1.7 Water Supply M.G.L.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 of Record Name(Print) Address for Service: t Sijiature Telephone 2.2-Owner of Record: W X 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 n J—�T,^ l� q� ej7�S ' y 0-1- �{gC4S c e 11 0 —1 W, ` 'l J-t A 1$3 U 13 CO—.3-N"Co Z'S-G Expiration Date Sign re Telephone r 3.2 Regi er ome Improvement Contractor Not Applicable ❑ v 1ML G. Company Name m Registration Number A dress 1 0C2$ 11 r l Expiration Date /1 Sign to a Telephone !! SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes........❑ No.......0 SECTION 5 Description of Proposed Work check a Kcable New Construction ❑ Existing Building V Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Propos_e1d.Work: r P, \Uta C3,reG �✓i e.,.) S!CC u nN •�LVLY. L) ro 0 was 4 -se-co-'a ��o SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be QFFCIAUSE{',y z Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Z(.00 . 0 V Construction 3 Plumbing C1 V Building Permit fee(a) X(b) 4 Mechanical HVAC 3 5 Fire Protection d U 6 Total 1+2+3+4+5 p p t.� Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property Hereby authorize to act on %beh lf,in all tters relative to work authorized by this building permit application. Signature of Owner T� Date o SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, O��U, GA� b a.\ b U&"- yA ,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 \-A r-- Ca�1 Print N r Signa e o wn /A ent Date t NO.OF ST SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DEVIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 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. tarar•■rssrssssrrsssrssssrsssrrssasssrasa!■■rrsrssssassrsa■lsssssssaarserss/■ 2(-APPLICANT /APPLICANT !"l� l SSC. /"+ `� *PHONE 9 7 SCFS 1 9 �- ASSESSORS MAP NUMBER LOT NUMBER l `( SUBDIVISION LOT NUMBER STREET- i a` / STREET NUMBER �ssslstar■sssrsss!'assssrlssssssasafaaa■sssaal.■rlsrsasrrrsssssssssassaas■ass■ OFFICIAL USE ONLY �ssrsssaasrsaaa.■rusrrs.■salrrsssrrs■r■ss.■sassasssaasrssssssssssssasaslrrsss■ RECOMMENDATIONS OF TOWN AGENTS 1■•■■r!■tarter.■r■rarer!■ratraa•■!!laraaalar!!a!r!rlaf r■■!ar!■■aaal.ralrrr!!!■ DATE APPROVED CONSERVATION ADMINISTRATOR DATE REJECTED COMNIENTS J DATE APPROVED TOWN PLANNER DATE REJECTED CONWIENTS DATE APPROVED F INSPECTOR-HEALTH DATE REJECTED L DATE APPROVED lc VSE C INSPECTOR-HEALTH 04 DATE REJECTED pp qq COQ P v� Alx J-- PUBLIC WORDS-SEWER!WATER CONNECTIONS DRIVEWAY PERM[I� DATE APPROVED FIRE DEPARTMENT DATE REJECTED CONRVIENTS RECEIVED BY BUILDING INSPECTOR DATE w The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensatbri.Insurance Affidavit Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity, 12fI am an employer providing workers'compensation for my employees working on this job. Company name: 1 Address l 1 ciEv: rine* COU 3 7�-(- 6 Z S Insurance:Co._ A16 Policy#1NC.0-0-7E7-5 S.-7 SO O Company name: Address Phone* Insurance.Co. Pblicv# Failure to sears coverage as required under Section 25A or=152can lead tathe kq=Wm cf crW*faf penalties a.wfihe i to$1 1'. and/or one years'hnpdsonnwmt-as_ _:ho Qenatimin fine�f( iQAODl��ajf�9�stme. understand that a copy 0 F this statement may be forwarded to the Office of Investigations df the DA for coverage veracatioir. 1 dlo hereby cerwy wx1er penaihes ofperjury that the frffa madbrr provided above is true and correct; Signature pate 21118)0 3 Print name Pbone.i C17i"3-7 4-1�,2-S% Official use only do not write in this area to be cornpleted by city or town officiar City or Town '.Femro7/Lux�sirw.. BW74 nc„7 Dept Check d immediate uired13 is response re'9 Lim-On31f71�BAa1 Selectman's o Contact person: Phone# 0 Health Uepartr E] Other North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150A. The debris will be disposed of in: ' (Locatio f Fa ili i na re of Permit Applicant ate NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector Home Energy, Inc. Building Contract This contract, dated December 2 ,2003 , is by and between the following owner and contractor. Owner: James & Melissa Martin Telephone: Days978-681-9862 Eves Mailing Address: 56 Candlestick Dr., No. Andover, MA 01845 Contractor: Home Energy, Inc., 14 Edgehill Rd., Haverhill, MA 01830 MA Home Improvement Contractor license certificate #127191 Fed. I.D. #04-3355584 Telephone:978-374-6256 1. GENERAL This contract is for the following work and materials to be performed by the contractor (or new construction) on the property address above. The project is generally described as follows: Build two new rooms with closets in 12' x 28' vaulted ceiling area of main house according to attached estimate. Rooms will mirror existing bedrooms in rear of house. Install two new skylights in main roof and two new Andersen casement windows for room egress. The contract consists of this document, any plans or specifications or exhibits referenced herein, and the General Conditions following the signature page. Change orders and modifications shall be in writing and shall become part of this contract. 2. PRICE The total price for the work agreed upon is$33,842.30. Payment terms are set out below, in Paragraph 6. 3. STARTING AND COMPLETION PROVISIONS The work will begin on February 12th, 2004 , and will be completed, absent unusual circumstances, on April 28, 2004. 4. PERMITS AND APPLICABLE CODES; COMPLIANCE WITH LOCAL LAW a. All work to be done under this contract will be in accordance with the building codes presently in force in the Town of No. Andover, MA. The contractor shall obtain all necessary permits and pay all required permit and plan fees. b. The contractor shall at all times comply with the laws of this state regarding mechanic's liens. 5. SPECIFIC REQUIREMENTS FOR MATERIALS AND WORKMANSHIP This contract will be completed by the contractor in a good and workmanlike manner, using good quality materials. The parties agree upon the following materials specifications and work description, together with any plans or specifications incorporated herein. 6. PAYMENT a. Timely payment by the owner of all sums due under this contract is of the essence to thi< contract. The parties agree to the following schedule of payments: PAYMENT SCHEDULE DATE EXPECTED AMOUNT Initial deposit 12/08/03 $1000.00 windows & doors ordered 2/01/04 $3000.00 lumber delivery 2/12/04 $5000.00 frame complete 2/28/04 $3000.00 windows installed 3/06/04 $3000.00 rough electrical 3/13/04 $3000.00 insulation installed 3/20/04 $3000.00 blueboard delivered 3/27/04 $3000.00 plaster finished 4/04/04 $2000.00 trim & doors installed 4/11/04 $2000.00 flooring installed 4/15/04 $1000.00 finish electrical 4/21/04 $2000.00 occupancy permit 4/28/04 $2180.67 $33180.67 The contractor shall provide the owner with his own waiver or cumulative subcontractor's waivers equal to the amount paid for any progress payment. b. The contractor may cease operations if any progress payment is not made by the owner as required herein, and proceed to collect any balance due with any legal remedy. Alternatively, the contractor may continue operations, as set forth in the attached General Conditions. 7. SIGNATURE Attached hereto are General Conditions governing the rights and obligations of the parties to thi! contract. The parties are further subject to the laws of this state governing contracts and mechanics' liens. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES. IN WITNESS WHEREOF, we have hereunto set our hands and seals this day of , 2003 . owner contractor r GENERAL CONDITI These General Conditions are part of the contract betweenlames & Melissa Martin and Home Energy, Inc. for work at 56 Candlestick Drive, No. Andover MA 01845 1. CONTRACTOR'S DUTIES-GENERAL a. To direct and control the work contracted for in accordance with the terms of this contrac and all applicable codes, laws, and regulations, and as the building permits, if any, issued for this project require. b. To inspect the site, examine the plans and specifications, if any, and supervise all of contractor's employees, and to direct the work of all subcontractors selected by contractor. c. To maintain the work site in a safe and clean condition, to the extent consistent with the contract. d. To advise the owner promptly if concealed conditions are ascertained which require additional or different work, and to proceed in such event in accordance with this agreement. 2. OWNER'S DUTIES-GENERAL a. To provide adequate utilities for the work agreed upon. b. To advise the contractor of any condition of the property which affects contractor's ability tc perform. c. To provide secure storage areas for materials delivered to the work site. d. To execute in a timely manner all permit applications and other documents necessary for the work to proceed. e. To perform no work on the project without a written agreement with the contractor.f. Tc avoid interfering with workers. g. To make no agreements with any tradesperson, subcontractor, or contractor's employee outside the scope of this contract without the written consent of the contractor. h. Owner shall be entitled to make periodic inspections of the work site when accompanied by representative of the contractor, provided such inspections do not interfere with the work and can, in the sole judgment of the contractor, be made safely. Any other entry onto the construction site shall be at owner's risk. i. Owner shall notify his insurance agent of the execution of this Agreement and obtain any necessary Riders to his current coverage or any locally customary forms of coverage, such as Builder's Risk, to cover owner's interests and liabilities during the construction process. 6. MATERIAL SUBSTITUTION Contractor reserves the right to substitute other materials, products and/or labor, of similar, equal or superior quality, utility, or color. The Contractor reserves the right to make alterations to the heating and/or cooling system, provided any such substitution or alteration has comparable durability and performance characteristics. In the event of the substitution of any appliance or heating equipment, the warranty terms of the substituted materials shall be equal to those originally specified unless the owner otherwise agrees in writing. 7. DELAY Contractor shall not be responsible for delays caused by events beyond the control of the contractor, including but not limited to: strikes, war, acts of God, riots, governmental regulations aned restrictions. Delays caused by owner's failure to make allowance materials' selections or caused by the performance by contractor of extras or necessary work (as described in Paragraph 9) shall likewise be excusable delays. 3. 8. INSURANCE Contractor agrees to maintain all necessary forms of insurance to protect the owner from liability for any occurence arising from the performance of this contract. Contractor agrees that he shall cover his own employees for worker's compensation and carry general liability, and that all forms of insurance carried hereunder shall be with reputable companies licensed to do business in this state. Owner agrees to carry full coverage on the subject property covering owner's risk of loss during the construction period, together with all special forms required by reason of the performance of this contract. Specifically, owner shall contact owner's insurance agent and secure any necessary Builder's risk coverage prior to the commencement of the work. 9. HIDDEN, CONCEALED and UNFORESEEABLE CONDITIONS The parties agree that in the event contractor discovers a condition requiring an extra cost that they shall proceed as follows: The contractor shall notify the owner verbally at once to expedite agreement as to the charge to correct or cure such condition, and provide a written estimate aF soon as practicable. The parties must agree to such extra charges, or agree to a resolution method, or this contract may be canceled by either of them. For purposes of this section, a "hidden, concealed and unforeseeable condition" shall mean 4 condition not readily observable to a prudent contractor inspecting the subject property for the purpose of performing this contract. 10. EXTRAS Any extra work or materials desired by the owner shall be agreed upon in writing and such extras shall become a part of this contract. Unless otherwise agreed, extras shall be paid for as performed. Failure of the owner to sign an extras order shall not preclude recovery for same by contractor, and acceptance of said extra work or materials shall be presumed, unless there is written notice to the contrary. Contractor shall advise owner at the time of agreement on an extra as to any additional tim required to perform this contract. 11. SUBCONTRACTORS a. Contractor shall select subcontractors as required to complete this contract. Owner acknowledges that various portions of the work will be done by subcontractors. Any subcontractor selected by the contractor shall have all requisite licenses for the work to be done by such subcontractor, and the contractor shall issue subcontracts in writing whose specifications are consistent with this agreement. b. It shall be the duty of the contractor to use reasonable care in the selection of subcontractors Absent objectionable performance by any subcontractor, the selection of subcontractors shall be with the contractor exclusively. The contractor shall require all subcontractors to have such types of insurance in force as are required to hold harmless and indemnify the owner from any claim for injuries of property damage by any agent or employee of any subcontractor. c. Contractor shall pay subcontractors on a timely basis and obtain from subcontractors any necessary documentation required to release their lien rights, if any, as the work proceeds. d. Contractor shall exercise reasonable care in the selection of materials used by subcontractors, but shall not be responsible for later discovered materials' defects or damages from installation methods, not reasonably ascertainable at the time of installation. e. All home improvement contractors and subcontractors shall be registered: Any inquiries about a contractor or subcontractor relating to a registration should be directed to: Director, Home Improvement Contractor Registration, One Ashburton Place, Room 1301, Boston, MA 02108, Tel. (617)727-8598. 12. TERMINATION and CANCELLATION The contractor may terminate and cancel this contract if any payment called for hereunder is not received as scheduled, provided that notice is given to the owner as provided below. Upo such termination, the contractor shall have all remedies provided by law, including such lien rights as then apply. The owner may terminate this contract upon the following conditions: a. Failure of the contractor, or his subcontractors, to pursue the work contracted for, absent excusable delay, as provided in Paragraph 7 above, for a continuous period of seven days, without a written agreement permitting same, which may be satisfied by a simple notation to this agreement. b. Failure of the contractor to rectify any condition regarding which building code enforcement authority has issued a citation or violation notice, within seven days' notice of such violation, unless owner and contractor otherwise agree. c. Any other failure to perform this contract required by the terms of this contract. d. No termination shall be effective unless 10 days notice of owner's intent are given as provided below, during which time the default may be cured by the contractor. 13. WARRANTIES a. The work of the contractor including materials and labor, shall be guaranteed for a period of five years, during which period contractor shall at its own expense correct any defect arising from its work unless Paragraph 11 (d) of these General Conditions applies. This provision is in lieu of all other warranties, express or implied, and owner has no action at law or in equity against the contractor after said date . b. Any and all warranties for appliances or mechanical systems shall be delivered to owner when contractor's final payment is received. c. Notwithstanding any manufacturer's warranty of any component, appliance, or system, no action may be brought against the contractor on this contract, for the performance of this work, except as provided above. 14. NOTICES Notices may be sent to either party at the addresses shown above, or mailed by certified or registered mail. Any mailed notice shall be deemed given as of the date of mailing. 15. SEVERABILITY if any portion of this agreement is found invalid or unenforceable by any court, the remaining provisions shall remain in force between the parties. 16. ARBITRATION The contractor and the homeowner hereby mutually agree in advance that in the event the contractor has a dispute concerning this contract, the contractor may submit such dispute to < private arbitration service which has been approved by the Office of Consumer Affairs and Business Regulations and the consumer shall be required to submit to such arbitration as provided�n MGL. c. 142A. ,1 Owner_ 43 � -t_� :; Contractor______ NOTICE: The signature of the parties above apply only to the agreement of the parties to alternate dispute resolution initiated by the contractor. The owner may initiate alternative dispute resolution even where this section is not signed separately by the parties. 16. ENTIRE AGREEMENT This contract consists of the documents defined above, and constitutes the entire agreement the parties. It can be modified only by a written document. IN WITNESS HEREOF, we have hereunto,pet opr.hands and.deals this day of 2003 , at owner--', S-0411 2= Contractor—________ 1 ✓/re 7�o�x�no�r�aeaCl�•a�✓j�alJccdiute� . i Board of Building Regulations and Standards i F HOME IMPROVEMENT CONTRACTOR Registration:. 127191 Expiration: 9/17/2004 Type. Private Corporation s HOME ENERGY, INC JOHN CALL 14 EDGEHIL•L RD y -HAVERHILL,'MA 01830 Administrator �� 3 � fie t,am-tnvn•rceccl�i o�✓��.aesac�u�e�ta BOARD OF BUILDING REGULATIONS 3 License: CONSTRUCTION SUPERVISOR Number: CS 036866 Birthdate: 03125/1956 Expires:03/25/2004 Tr.no: 18580 r Restricted: 00 JOHN J CALL 14 EDGEHILL RD HAVERHILL, MA 01830 Administrator I , j Cover Page/Fax Transmittal From: 241*1"MADCO Jfome/Gifestyfes Melissa Martin 56 Candlestick Road North Andover, MA 01845 Voice Mail: 800-206-2096 xt. 243 Home Office Fax: 978-258-0152 melissamadco@hotirnail.com TO: Town of North Andover Dept. of Health FAX: 978-688-9542 DATE: 10/10/03 Attn: Brian PAGES: 1 including cover COMMENTS: Dear Brian, Thank you very much for reviewing our plans for our addition and calling me back tojt me know they look good. I very much appreciate the time you took to work with us. Have a good weekend, Melissa I I r s s NORT#q Town of No. 43k iy4� - - v . o- lover, Mass., /•2 / 9� o? D 3 O LAKE COCHICHEWICK V �,p ADRA TED P' C 7`S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT.... BUILDING INSPECTOR �,�. .�.�.�5......�... .. .....��......../��/�.......... ........... ......... Foundation has permission to erect.... ............ buildings on .....�7-4........C.I.4.I.V.. « ... Rough to be occupied as..op. CP 4P ........Ir *A Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-laws rel 'ng to the Inspecti , Alteration and Construction of Buildings in the Town of North Andover. /D / dyy � doom, PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION ST ELECTRICAL INSPECTOR S Rouge, .................................................... 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 Until Inspected and Approved by the Building Inspector. Burner FlRE DEPARTMENT Street No. :1 SEE REVERSE SIDE Smoke Det. ...-.r-•..-,--�.t�..wi'J?r+';�--el•'..r`•-;7.�.�.a.-�Ya.:.--4:K�.."`�- .••-s'�-.._ ._..�..___ _ -,.- .F -<. r No.: Date 0 NORTH r- °�'"`° "°1"° V9R TOWN OF NORTH ANDO ° A BUILDING DEPARTMENT S 39` *•° "�h Building/Frame Permit Fee $ SSAC14US� Foundation Permit Fee $ � O� —k&th€r Permit Fee 0 o Inspector t� PERMIT NO. 0-9 APPLICATION FOR PERMIT TO BUILD — NORTi ANDOVER, MASS. rncE MAP 410, LOT NO. 2 REgO.RD OF OWNERSHIP [DATE BOOK iPAGE ZONE I JB DIV. LOT NO. ( — i I 1 LOCATION io PURPOSE OF 9151ttT1'Ff•G .. ... ,. -. ' OWN[R'S NAME '..... _...._..:..,; � NO. OF STORIES 81ZE OWNER'! ADDRESS /' r//' BASEMENT OR SLAB ARCHITECT'S NAME SIZE dF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAMEXf SPAN ` DISTANCE TO NEARES B'JILDING DIMENSIONS.OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES — SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT,O'F,.FOUNDATION THICKNESS IS BUILDIyG NEW J�Irk_ SIZE OF FOOTING x 18 BUILDING ADDITION 7 oo MATERIAL OF CHIMNEY IS BUILDING ALTERATION l•�� IS BUILDING ON BOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST 7. SEE BOTH BIDES EST. BLDG. COST / OO PAGE I FILL OUT SECTIONS 1 - 2 * - s EST. BLDG, COST PER SQ. FT. PAGE.2 FILL OUT SECTIONS 1 - 12 } EST. BLDG. COST PER ROOM ELECTRIC METEpS MUST BE ON OUTSIDE OF BUILDING SEPTIC PERMIT NO. ' 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FFIL D AND PPROVED BY BUILDING INSPECTOR I '� DATE FILED �UILDINO INBP1tCTp/ ;.� 6IGlIAr 4WN AUTHORIZED AGENT /V s. FEE `OWNER TEL I PERMIT GRANTED CONTR.TEL I QP y �7 CONTR.LIC./ : :' .: H.I.C.I BUILDING RECORD 1 OCCUPANCY ES " SINGLE FAMILY SroRl THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. fAMIIY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES GA " APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION: Z FOUNDATION 8 NTEj110R FINISH CONCRETE CONCRETE BL K. PINE BRICK OR STONE HARDW'D PIERS i'LASIEIt- DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN. B'M'V AREA _ 1/1 %1 1/1 FIN. ATTIC:AREA _ NO B M'T FIRE PLACES _ HEAD ROOM MODERN KITCHEN ' 4 WALtS 9 •FLOORS S. CLAPBOARDS B DROP SIDING CONCR.IE WOOD SHINGLES EARTH _ ASPHALT SIDING HARD_:/'O ASBESTOS SIDING COM6.UN. _ VERT. SIDING ASPH• TI ,. _ STUCCO ON MASONRY STUCCO ON FRAME ATTICSTRS..B FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR I� PCGOR ADEQUATE . NONE 5 ROOF 10 PLUMBING GABLE NIP BATH 13 FIX.1 _ GAM83EL MANSARD TOILET RM. 12 FIX.1 FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY ; _ WOOD SHINGES KITCHEN SIkK SLATE NO PIUMBIhG _ TAR 6 GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES TILE FLOOR' TILE DADO,' g FRAMING 11 "WATING WOOD JOIST PIPELESS FURNArE FORCED HOT.AIR FURN. TIMBER BMS. A COLS. STEAM STEEL BMS. 6 COLS. HOT WJI'OR VAPOR WOOD RAFTERS _ AIR CONDITIONING s. RADIANT H'T'G UNIT HEA ERS 44 .. .. ....:. .i... :. GAS ' " .., :" ' .. ...':`........ .; .._... ..:..�: �.::.' 7 NO. OF ROOMS OIL T 1Ind I_ ELECTRIC 9 �I 3rd NO HEATING �.�-- 4 x 76./0 41.93 _ �7T ' 1 I \ I I I I I I \ Olt dol 4 a 49, 38 ' I � its -®r3o\ 1 ul I I S Y I +, I ' � .47q• g9 TO THE ,&O DDS/fi v_ 6QY I O6h gQOiL AND ITS TITLE INSURERS L HEREBY CERTIFY THAT I HAVE EXAMINED THE PREMISES AND ALL EASEMENTS, ENCROACHMENTS MORTGAGE INSPECTION PLAN AND BUILDINGS ARE LOCATED ON THE GROUND AS SHOWN. LOCATED IN 1 FURTHER CERTIFY THAT THE BUILDING SHOWN CONFORMED TO THE ZONING LAWS AND AMENDMENTS. L G.(FRONT,,SIOE AND REAR YARD SETBACKS ONLY) OF d.A0 DO\I E IZ WHEN CONSTRUCTED - K I FURTHER CERTIFY THAT THIS PROPERTY IS PD1 LOCATED IN THE ESTABLISHED MASSACHUSETTS FLOOD HAZARD AREA. II NOTE _THIS CERTIFICATION IS BASED ON THE LOCATION OF SURVEY MARKERS OF OTHERS, AND DOES NOT REPRESENT A PROPERTY SURVEY.' EXAMINATION OF THE RECORDS IS MADE ONLY SUBSEQUENT TO THE RECORDED DATE OF THE,LATEST DEED AND DOES NOT INCLUDE VERIFYING THE ACCURACY OF THE DEED DESCRIPTION PREVIOUS TO ITS DATE OF, RECORD. BOOK 1510 PAGE I Q(i THIS COMPANY IS NOT RESPONSIBLE FOR ANY INDENTURES MADE SUBSEQUENT TO THE PLAN NO. 712(} OK. _. RECORDED DATE OF THE LATEST DEED OF RECORD. PG WHENEVER BUILDINGS ARE SHOWN LESS THAN ONE FOOT FROM THE PROPERTY LINE IT IS CERT.NO. ADVISED THAT A MORE PRECISE MS CERTIFICATION TO BE USED FOR MORTOAGE PURPOSES ONLY SURVEY BE MADE TO VERIFY THESE MEASUREMENTS. ILIO. /17 ioGG T SCALE: 1" . 40. . BRADFORD ENGINEERING CO. Of BRADFORD P.O. BOX 1244 HAVERHILL,MASS.01031 ✓' TCI.' 373 2396 James W ROUGIOUKAS _R ,S9529 JAMES W. BOUGIOUKAS 1% 9829 C/STER�� SUR��j FORM U - VERIFICATION FORM INSTRUCTIONS: This form is used to verify that all necessary ' approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***********�73 ****** APPLICANT: �� '�"`� Phone 7� LOCATION: Assessor's Map Number zQ w Parcel Subdivision c ° n Lot(s) Street ✓� �`��"`�'C St. Number ************************Official Use Only************************ REC DATIONS TOWN AGENTS: Date Approved Cc ervatio Administrator Date Rejected ` Comments Date Approved Town Planner Date Rejected Comments Date Approved - _. Fond Inspector-Health Date Rejecter? Date Approved o2& �O ep is Inspector-Health Date Rejected Comments J- Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date r Date.. �.�?�....... t NCRTM q 3r;•'4 ° °- "°oma TOWN OF NORTH ANDOVER p PERMIT FOR WIRING ,SSACMUSEt /)) This certifies that --tti �1 ' - ....,............................................... ....................................... / f has permission to perform C wiring in the building of at.... . �`-- � '_�-- ,North Andover,Mass. ^`......{................. Fee� ........... Lic.No 1`S ,... .......................................... - ELECTRICAL INSPECTOR Check # �7�f 5Utj9 Official Use Only Permit No. k5�6 ?D%axud o�pu6l[e Satietyp- Occupancy&Fee Checked_5� BOARD OF FIRE PREVENTION REGULAT NS 527 CMR 12:00 APPLICATION FOR PERMIT TO ERFORM ELECTRICAL WORK All work to be performed in accordance ith the assachusetts Electrical Code 527 MR 1 .00 (Please Print in ink or type all information) Date2—/IdId To the In apeC r of i"vires: Town of North Andover The undersigned applies for a permit to perform the electrical wqA describeij below. Location(Street&Number ko S I /ck Owner or Tenant IFIL Owner's Address Is this permit in conjunction with a building peYes No 0 (Check Appropriate Box) Purpose of Building ti Utility Authorization No. Existing Service Amps Voits Overhead 0 Undgmd 0 No.of Meters New Service Amps r� 1n �Voiitts� �p Overhead 0 Undgmddf 0 o.of Meters Number of Feeders and Ampacity 2 /r`(/r rC�` C��` �t° Z / \�jmCJ Location and Nature of Proposed Electrical Work Total No.of Lighting Outlets No.of Hot fuse No.of Transformers KVA �) Above 0 In 0 No.of Lighting Ftd%ves / Swimming Pool gmd 0 gmd 0 Generators KVA 4 `l No.of Emergency Lighting Np.of Receptacles Outlets (J/ No.of Oil Burners Battery Units No.of Switch Saft1s C1 No of Gas Burners FIRE ALARMS No.of Zone Total No.of Detection and No.of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No.of Diposal No. Purno Tons KW No.of Sounding Devices Nol of Self Contained No.of Dishwashers S ce/Area Heating KW Detection/Sounding Devices• + 0 Municipal 0 Other No.of Dryers Heating Devices Z KW Local Connection No.of No.of Low Voltage No.of Water Heaters KW Signs Bailases Wifinct No.Hydra,Massage Tuds No.of Motors Total HP OTHER: IN�1YRAN5VERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I hav urrent Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES= NO - aubm valid proof af same to the Office YES= NO �7u ve ch lease indicate the type4f by checking the appropriate box. NSUl ANCE BOND OTHER (PI S ify) ) 04/ ed Value of.Electrical Work$ (Expirat e). Work to Start Insp n Pate Flesquested Rough Final Signed under the Penalties of perjury: J FIRM NAME'(` � LIC.NO S5 33 Licenseo�,W (U h-� (� b4 Signature LIC.NO. � Bus.Tel No. s Address 4 .L 1i- d Alt Tel.No. OWNER'S INSURANCE WAIVER: I am q%yfiri that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws.And that my signature on is permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMIT FEE (Signature of Owner or Agent) 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. I am a sole proprietor and have no one working in any capacity I am an employer providing.workers' compensation for my employees working on this job. Company name: Address City Phone#: Insurance Co. Policy# Company name: Address ' City: Phone#: Insurance Co. Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment 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 verification. I do herby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature Date Print name Phone# 4 Official use only do not write in this area to be completed by city or town official' ❑ Building Dept ❑Check if immediate response is required Building Dept ❑ Licensing Board ❑ Selectman's Office Contact person: Phone#. ❑ Health Department ❑ Other FORM WORKMAN'S COMPENSATION N° 1916 Date,. ......................... a NORTF� TOWN OF NORTH ANDOVER p PERMIT FOR WIRING 40 �7SSACMUSE� This certifies that ..... ...:................... .....::..... has permission to perform .............. �� l wiring in the building of..,. ;......... .......................................................... - -� ................. .North Andover,Mass. ............................................ ^ Fee:`r,5......'�.d....... Lic.Noe/,5%�l. ..... \ :!.....................J............... j---ELECTRICALINSPECTOR 10/12/9912:24 35.00 PAID WHITE:Applicant CANARY: Building Dept. PINK:Treasurer ul.�.%V � �- The Commonwealth of Massachusetts p,,n offi�.No. _ 7 occupancy & Pec Check.d Department of Public Safety 3/90 (kaw blank) I BOARD OF FIRE PREVENTION REGULATIONS S27 CMR 12.00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed In accordance with the Massachusetts Electrical Code, S27 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORHHATION) Date qT�Qq City or Town of (�� To the Inspector of Wires: REG CPY The undersigned applies for a permit to performs ((t''he electrical woo k described below. F1CT ACT Location (Street b Number) �(a �(/'1�IG5'16t �2U Ae„ O.rer or Tenant J Owner's Address Is this permit in conjunction with a building per=it: Yes ❑ No (Check Appropriate Box) Purpose of Building F—e-Std dC/ L t ►C� ' Utility Authorization NO. Existing Service Amps / Volts Overhead ❑ Undgrd❑ No. of Peters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Metes N;r—ber of Feeders and Ampacity Location and Nature of Proposed Electrical Work t No. of Lighting OutletsNo. of Hoc Subs No. of Transformers !oral KV A No. of Lighting Fixtures Swimming Pool Above❑ In- ❑ grnd. grnd. Generators KVA ' No. of Receptacle Outlets No. of Oil Burners (No. of Emergency Lighting Batte Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total No. of Detection and tons Initiating Devices No. of Disposals No. of Heats Total Total No. of Sounding Devices Tons KW No. of Dishwashers Space/Area Heating KW No. ,of Self Contained Detection/Sounding Devices _ r No. of Dryers Heating Devices KW Local❑ Municipal ❑Other Connection No. of Water Heaters KW No, of No. os ILow Voltage Signs Ballasts Wirin f"1 No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES Fj NO C] I have submitted valid proof of same to this office. YES❑ NO If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE S1 BOND ❑ OTHER ❑ (Please Specify) ' lExpiracion Date Estimated Value of Electrical Work S Work to Start Inspection Date Requested: Rough Final Signed under the penalties of perjury: FIRM NAMEA T1 ks N a.,,�•� SG LIC. NII.—Cls" Licensee m e'r-k .Yy Iye-s ie-P Signature LIC. NO. C�— Address S5 W S !�` Bus Tel. No. `[j.fr -(�S -o4yiij_ GS � S A- —Az+e— S !enw�' � v� � 4 Alt. Tel. No. .502'— Fr(.4- 0.5 k OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE S Signature of Owner or Agent BC-44A Location C, No. Date 3'd D-3 NORTH TOWN OF NORTH ANDOVER � 9 :fix s • ; . Certificate of Occupancy $ �•�a'•^" utBuilding/Frame Permit Fee $ s Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # �i 6 z 6 j- j`Cc.�----- Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEM�iOLIISHH A ONE OR TWO FAMILY DWELLING rn BUILDING PERMIT NUMBER: DATE ISSUED. 3 :2F-03 i SIGNATURE: Building Commissioner/1for of Buildings Date , Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: I Cr Map Number Parcel Number 1" 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS 00 , Front Yard —*' Side Yard Rear Yard Required Provide R 'red Provided R red Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Infortation: 1.8 Sewerage Disposal System: n Public ❑ Private ❑ Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSIIIP/AUTHORIZED AGENT rn 2.1.Owner of Record Name rint) Address for Service:m QG 1�J e Si nature Telephone 2.2 Owner of Record: I I ' A-e�kl"55;,:z CGt..c�e—S �c O Name Print, Address for Service: z Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: O 114 i) l,�A M$ o VE 3 e License Number Ll on Address . � - 1 Q ` ` 3 (D 2 Expiration Date Signa U Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ ` � 'L-7iq t Company Name rn G Registration Number Address -1 ,7L,-7/o 1I ` � -42-Z Expiration Dae � �1 Si nature 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.......❑ SECTION 5 Description of Proposed Work chec applicable New Construction ❑ Existing Building Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Descriptionof Proposed Work: & 3 SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL:USE-ONLY Completed by pen-nit applicant 1. Building # 2 q 6(S D O (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)x(n) 4 Mechanical HVAC 8 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, !"t G�l�is� &G M ,as Owner/Authorized Agent of subject property Hereby authorize J0IAA Cal I to act on My behalf.in all matters elative to work authorized by this building permit application. � Si nature of Owner �— Date SECTION 7b OWNER/AUTHORIZED A T DECLARATION I, JG V,-, : ' as Owner/Authorized Agent of subject property Hereby declare that the statements an "at, on the foregoing application are true and accurate,to the best of my knowledge and belief Printe Si nat e o O er crit Date —1— -01RANWINIUMM - —11—Mull— NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2ND 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHTT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHDANEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE r / 76./0 41.93 6100i off 37 /iy.o3 -------------- 60 i �fF 49, ti 1 \ a The Commonwealth of Massachusetts Department of Industrial Accidents Office of investigations Boston, Mass. 02111 SvO�, Workers'Compensation Insurance Affidavit Name Please Print Name: Location: Citv Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity I am an empl oyer providing workers' compensation for my employees working on this job. Company name: t74 aIV, y7 C. Address `W Ci - Phone#: Insurance Co. Poli # u 7 6 Company name: Address City: Phone#: Insurance Co. POlicy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of,a fine up to$1,500.00 and/or one years'imprisonment_as_virelLas_civil.penalties!nlbelorm-da-STOP WORK ORDER.,and_a.fine_of_($1DO.OD)atlay.againstme 1 understand that a copy of thi atement may be forwarded to the Office of Investigations of the DIA for coverage verification. !do hereby cert n pal and penalties of perjury that the information provided above is true and correct. Signature— Date Print name v�A CCL i P_hone.# Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing. Building Dept E]Check if immediate response is required [] licensing Board E] Selectman's Office Contact person: Phone#: Health Department Other i North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A.. The debris will be disposed of in: S� (Location of Facility) gnr of Permit Applicant Dat NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector V .':. - ', , 1r�� ..\p, YID_ x 9 `��• �f��d�' �.�, 'y �f L.i�sf.. � t, \ \ J 7 Yt�ib��bj x�-, 5 1e 1 - t1 � 1 yif J �•11�7: i r,. �„ - Ae a 1p��w •'.,;� r pA k r;r e 4 � �1 x I x x � ROW gk+Av;, ,oi I I tiZ,t1 lz_ to qokxz SIN t+f2 1� i 0. v, ; C- >� %AV BOARD OF BUILDING REGULATIONS eta License: CONSTRUCTION SUPERVISOR _ Number: CS 036866 Birthdate: 03/25/1956 de Expires:03/25/2004Restricted: 00 Tr.no: 18580 �' - JOHN J CALL 14 EDGEHILL RD HAVERHILL, MA 01830 Administrator �� ✓sfe 'rpomvma�ua��6ja.��.alGell is F Board of Building Regulations and Standards i HOME IMPROVEMENT CONTRACTOR Registration: 127191 Expiration: 9/17/2004 Type: Private Corporation HOME ENERGY, INC JOHN CALL 14 EDGEHILL RD 'HAVERHILL,'MA 01830 Administrator >. -T TAORTI, 0" . O E - Andover 0 'j0 No. Ll 4 � z — h � • p1g "' o1V0 o over, Mass. cocHicTt' SRATED p5 I BOARD OF HEALTH PER.,, M IT T D Food/Kitchen Septic System ��*T AA*+to 0141 tS w 144 at BUILDING INSPECTOR THIS CERTIFIES THAT........ . ................. .............................. ..................N....... C Foundation . . .. .. . ...... 0 has permission to erect.. ...........3. . ...... buildin s on .... .... ..... ......4�........................................... Rough to be occupied as 1)* �� 0 t' ps Chimne�CIPC o ........................................................ ........ ......... .................................................. y provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 6 / 14 $ so � PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT' EXPIRES IN 6 MONTHS Fina' UNLESS CONSTRUCTIONS ART ELECTRICAL INSPECTOR Rough .......................................................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove F nagh 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.