Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
Miscellaneous - 59 SURREY DRIVE 4/30/2018
59 SURREY DRIVE 210/074.0-00040000.0 I I �I I TA Z DFPARTAfENTOFPUBLICSAFM Permit No. p7;?27Z VBOARD 0FFTREPREVEM0NRWUTAT10AN527CVfR 12-00 Occupancy&Fees Checked P TION FOR PERMIT TO PERFORM ELEOWCAL WORK /1-0A.P LICA � ALL WORKTO BE PERFORMED IN ACCORDANCE WITHTHE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date o '7--0 1-0.5 Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) S Owner r Tenant Pay w y .� Owner's Address Is this permit in conjunction with a building permit: Yes[Zf No a (Check Appropriate Box) Purpose of Building f&S i1CJ1,9 if", ( Utility Authorization No. Existing Service 100 Amps/010/ I-y6voits Overhead : Underground No.of Meters New Service AmpsVolts Overhead [= Underground Q 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 Pod Above Below Generators KVA and o�md No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burner 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 Tom KW Initiating Devices No.of Dishwasher Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryer Heating Devices KW Local Municipal Other Connections Of Water Heaton KW No.of No.of Signs Bailasis Hydro Massage Tubs No.of Motor Total HP R• PustutbdtetagtaarlatsaQVi�tsd�C�lt3allaws acsnatLial�t�ty6ls�ranePb6r.YndudnBCrn ah t�oca�ea'isstdOydnt YES NO %hniladM&p100fofs3W10dXOTW=-YES NO IfjwhaedmdaadYES,pimeado*the%x(ifa mmWby'dnd rgtlIe bm aa BaND o�x cis S't��e �,�•-� E*hdmD* _ Est¢n*dValued mftWwolk S bSlat O`7� r" 5 It>SpectiritDateRegll�lad Ra* G 7'D 7_d �— Fra! under�iePa>albesafpeljtry r,�" Ire,Jr i� 1° Li==Na �U ct 1 i NAME � I h csm ccKIM 1 LN BIlsimTd.Na L cx e 9f,I� ' .4TeLNa 'S1h15URAt10EW -Ianawaethat�eLioase $Ieinstianoeoa�eori�sfi�rt�dt�gli�etasce4sedbYMa�adn>s�sCeleallaHs e check one) Owner a Agent Telephone No. PERMIT FEE a i TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING ., rn BUILDING PERMIT NUMBER. DATE ISSUED: SIGNATURE: `�•" "'! Building CommissionedlngWor of Buildings Date SECTION 1-..SITE INFORMATION O 1.1 operty Address: 1.2 Assessors Map and Parcel Number: , � 74;b �D a Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area Fronts ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Recmired r54) de red Provided Re red Provided v 1.7 Water Supply M.GL.C.40. 1.3. Flood Zone Information: 1.8 Sewerap Disposal System: Public ❑ Private ❑ ZOOe Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record p6 � f "Do N ma a(Print) Address for Service .AI Signature Telephone (� 2.2 Owner rof Record: Name Print Address for Service: Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Su isor: Not Applicable ❑ S Licensed Construction Superviwc4�99 'CIL 0 License Number q,� " Address (Jv l i� ;; �i / / Expiration Did Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v G +���� e1 Company Name k� /j, � �j ,. / � 4 Registration umber r Address Expiration Date tr Signature Tel hone 3 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.......0 No.......0 SECTION 5 Description of Proposed Work(check.d apoRcabk New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition 0 Accessory Bldg. ❑ Demolition 0 Other ❑ Specify n e ! l .r. Brief Description of ProposedW rk: t `a Le O 0 a SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to beOFFICIAL USE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)x (b) 4 Mechanical HVAC 5 Fire Protection 3 6 Total1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION 40 BE COMPLETED WHEN _ OWNERS AGE-NT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as er/Authorized Agent of.subjec property Hereby authh to act on My beha ;i re Wive to work authorized b this building '`, ,� y g permit application. Si ature ofOwner" Date SECTION 7b"OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Signature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIlvIBERS i s 2' 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS D34ENSIONS OF G.MDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X — MATERIAL,OF CHININEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE ` Location 1U — Q, No. k Date NORTH TOWN OF NORTH ANDOVER F 9 Certificate of Occupancy $ �'�s'•^° '�� Building/Frame Permit Fee $ s�CHU Foundation Permit Fee $ _P Other Permit Fee $ TOTAL $ �- { Check # /??%S i }`Building Inspect,6r/ TPM CONSTRUCTION LLC • 20 WHEELER AVE SALEM,NH 03079 (603)898-0864 PROPOSAL St'BNIITTED TO: PHONE: 978-685-5996 Patrick Duffv 59 Surrey Drive Andover. MA Ol 845 PAGE: 1 OF 2 Date: 2/1105 We herebt,submit specifications and estimates for: KITCHEN REMODEL DEMO WORK: *Remove existing kitchen cabinets *Remove wall between kitchen and dining room 13' long Remove drywall ceiling in existing kitchen and hallway Remove door opening to family room and relocate Remove existing tile floor in kitchen, multi layers will add additional time at $55.00 per hour NEW CONSTRUCTION: Install new carrying beam 13' long Flush beam ost $2.000.00 ('j"d d to, Install new ceiling in kitchen— '/2" blueboard skip trowel finish47i1s#a,i _Nnwj Jpo06/in Re-frame door opening to new location indicated by homeowner \r'Jr Install new kitchen cabinets: Allowance $4500.00 Install new hardwood floor—3-coat finish - 2-'/4 white oak in kitchen area Approx. sq. ft. 210. = $1.995.00 After wall is removed between kitchen and dining room a cost w/ill be added to contract after review by flooring contractor to patch in floors ELECTRICAL ALLOWANCE = $2.500.00 We hereby submit specifications and estimates for: Electrical installation for the following: -Move switches and outlets after walls are taken down -Microwave and hood F Dishwasher& Refrigerator 4 -Garbage disposal -New counter outlets and island outlet -Light switching -' X pend dints over island (Owner to Supply fixture) -Centered light over kitchen and center light in dinning room (Owner to supply fixture) -Dimmer for kitchen cans -7'X4' recessed cans and trims TPM CONSTRUCTION LLC ` 20 WHEELER AVE SALEM,NH 03079 (603) 898-0864 Additional electrical add-ons $2100.00 r -2 X Ground rods WOr- + rewu 4AeA 4;, -6'X 6" old work recessed cans r n�cessi o wA cost-• -Dimmer 60 -Feeder panel 12 circuit 50 amp 120/240 volt PLUMBING ALLOWANCE = $2,200.00 Plumbing contractor will confirm allowance after review of scope of work NOT INCLUDED IN CONTRACT PRICE: *Painting of walls and trim *Kitchen cabinets and hardware TPM Construction will provide the necessary permits to complete this project. TPM Construction will dispose of all construction debris. We will have an onsite dumpster to do so. Please send $500.00 deposit to hold date. Thank you. Tom We propose hereby to furnish material and labor complete in accordance with above specifications for the sum of: Twenty three thousand seven hundred eighty five dollars ----------------------------- Dollars $23785.00 Payment to be made as follows: At Start of Job: S7928.33 Job Half Done: S7928.33 Upon Completion: $7928.34 .all material is guaranteed to be as specified. .all work to be completed in a Authorized workmanlike manner according to standard practices. Amalteration or deviation Signature from above specifications involving extra costs will be executed only upon s%ritten orders,and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond our control. Owner to carrn fire, NOTE: This proposal mai be withdrawn by us if not tornado and other necessarN insurance. Our workers are full,]'covered b%Workman's accepted within dal-s. Compensation Insurance. Acceptance of Proposal — The above price(s)specifications and conditions are satisfactory and are hereby accepted. l ou are authorized to do the Signature: work as specified. Payment will be made as outlined above. Any additions to the scope of work as outlined above after acceptance of this proposal will be billable at SS-,.00/hour. Signature: Date of Acceptance: - 3!to-5- �BOARD tOF BUI D Nc5 License: CONSTRUCTION SUPERVISOR Number CS 058632 Birthdate 06./0811962 I'I Exte5`06/08/2006 Tr.no: 25331 i Restrtcted. 00 s THOMAS P MCDERMQ7 20 WHEELER AVE SALEM, NH 03079`":. = Commissioner i I I I he Commonwealth of Massachusetts Department of Industrial Accidents 1 Office of Investigations 600 Washington Street Boston,MA 02111 www massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Le 'blv Name (Business/Organization/Individual): �f ~ Address: City/State/Zip: ` --/°� ,/ Phone #: s e Ile Are you an employer?Check the appropriate box: 1.❑ I am a employer with 4. ElI am a general contractor and I Type of project(required): employee's (full and/or part-time).* have hired the sub-contractors 6. ❑ New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. t 7• ❑ Remodeling ship and have no employees These sub-contractors have 8. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9, Building addition [No workers' comp. insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.El Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' camp. insurance required.] 13.[—] Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information: t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp,policy information. I am an employer that is providing workers'compensation insurance for my employee& Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins. Lic. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under theons andpenalties ofperjury that the information provided above is true and correct ;4x Signature: Date: Phone#: Official use only. Do not write in this area,to be completed by city or town ofcid City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person• Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. an employee is defined as"...every person in the service of another under any contract of,hire, Pursuant to this statute, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of au individual,partnership, association or other legal entity,employing employees. However the owner of a dwelling house having not more ns to do maintenancenconthan three apartments ad structioneorthrepair,work on such haor the dwelling house of the dwelling house of another who employs pr or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." chapter 152,§25C(7)states Additionally,MGL "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials h to Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bo tm of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the app ant Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit(license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would lice to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-N ASSAFE Fax#617-727-7749 Revised 5-26-05 www.mass.gov/dia TAORTly Town of over �.....w. .�. And 'k. No. o coC LA over, Mass., Hic 11 ORATED P'? C7 H BOARD OF HEALTH Food/Kitchen PER IT Septic System BUILDING INSPECTOR T D THISCERTIFIES THAT.................r.....Rpr................ ...................................... ................................... .................... Foundation has permission to erect .......................... buildl on...�r.r. - -1 --J .... Rough ............ ......... .....*.......... to be occupied as Chimney M."Oopso...... ............... ........................................ provided that the person accepting this permit sn every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings In the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR S gh.......................................... ervice C 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. REVERSE SIDE- Smoke Det. 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 at: .5 4 , 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 150 A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section I OA. The debris will be disposed of in: (Location d cility) ' J Signature of Permit Applicant Fire Department Si off: P � Dumpster Permit Date NpRTH own of E _ ,A , Andover71C 0� Coc ,� dover, Mass., 7�ADRATED PPa,`�5 S H � BOARD OF HEALTH PER IT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.................1P.....W7 ......... ........................ .................... Foundation has permission to erect... .................................... buildi s on ... . ............ Rough ,�14c�`.�.- gf11 to be occupied as ... Chimney provided that the %person accepting this permits I in every respect conform to the terms of the application on file in Final l�w 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. PERMIT EXPIRES IN 6 MONTHS EL 0::> ;6o�UNLESS CONSTRUCTION STARTS P 1 . .. � O .............. . .................................... . Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal No Lathing or Dry Wall To Be Done — FIRE Until Inspected and Approved by the Building Inspector. Burner DEPARTMENT Street No. SEE REVERSE SIM Smoke Det. GENERAL BUILDING NOTES/CHECKLIST-NOT LIMITED TO ITEMS BELOW POST ALL LOT NUMBERS,ADDRESS, AND PERMIT(COPY 0K)..or no inspections INSPECTIONS: (Minimum) Excavation , Footing, Foundation, Frame, Insulation, Final. FOOTINGS: Continuous Full 2x4 Keyway Continuous strip footings for interior columns FOUNDATION: Rebar as required Anchor bolts or straps - Damproofing Foundation drain-pipe/stone/fabric filter/cover and outlet connection. FRAME:Fireblock-over girts/plates between floor joist Penetrations for plumbing, heat,elec, etc. Walls at stair stringers. Windbrace corners and center bearing partitions. Size ridge to provide full bearing at rafter cuts. Hip and Valley rafters-watch bearing at walls. Ridge&Hip-Provide proper connections. Cathedral roof rafters provide proper connections and use"Hurricane Clips"tie to plate. Stair stringers-watch cuts and heal support. Joist hangers-fully nailed w/hanger nails. Sill plates 2-2X6(1 PT)w/sill seal. Girls-solid brick or steel plate bearing at foundations "air space at sides in foundation pockets. Lateral bracing at ends. Certified calculations. required for Beams/LVL's Trusses. Solid bearing support for Headers/Beams etc. Check headroom clearances-stairways, under beams Attic Access. (min. 22x30 w/3'headroom above). Crawl space access. (min. 18x24). }_- Bath exhaust fans to have metal duct to exterior(not in soffit). Firecode S/R wood frame of"0"clearance fireplaces&stoves .� �. Window Schedule or Every Habitable Room Must Have: Natural light equal to 8%of floor area. -4" %of required glazing shall be openable. - Bedrooms required min.20x24 egress window or door. Vent attic spaces-"proper vent", soffit and required ridge vents. Firecode under stairs if used for storage FIREPLACES: Separate permit required. Inspections at Footing-Smoke Chamber-Finish Smooth parging, clean joints, 8"solid @ combust. Surf. DECKS: Separate permit required: Lag to house, provide flashing. Rails min. 36" high, Baluster max space 5"on center. Over 8'above grade, use 6x6 posts w/lateral bracing. Lag all posts and rails. Pier footings down 48", Conc. pad at stair base. FINISH: Handrails returned to wall/newall post. Guardrails required alongside open cellar stairs. Exterior grading complete. Certificate or occupancy required prior to occupying structure. Temporary Stairs required for inspection. Re-inspection fee- $30.00(Be Ready). Certificate of occupancy required prior to occupying structure. Date. . ... . 1 HppTF, of TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION . y �,SSACHUSE�t This certifies that . . P�. . . . . �N /... has permission for gas installation . . . . . .?4"V. . . 4E. . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . ;?.q. � !�r�.�. L !'. .. . . . . ., North ndover, Mass. dee. .� ''yLic. No.2 z o? . . . .z! Q ^� GAS INSPE OR Check# 8� t 5165 MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS (Type or print) Date 7 OS' NORTH ANDOVER,MASSACHUSETTS s Building Locations �/ `� U rr C C Permit# Amount$ Owner's Name _ �� r New❑ Renovation Replacement ❑ Plans Submitted ❑ U � v� W W W U O F r" x to j P7 0.1 v� Wd O O O O z F v� a Z U a a W W/ a F W E (Q' Z d z WCW 0.Z� F". O W U a O x ;Z) A a OU. 00'. � � a F O SUB -BASEM ENT B A S E M ENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR 7TH . FLOOR STH . FLOOR (Print or type) /,-j� Check one: Certificate Installing Company Name— L J Address C, L `�� ❑ Partner. 04- 3 b usmess a ep one C7 O 3 F Z Firm/Co. Na-0e of Licensed Plumber or Gas Fitter G ✓ 4.J td/Z f o_ INSURANCE COVERAGE Check one:/ I have a current liability Insurance policy or it's substantial equivalent. Yes No❑ If you have checked yes,please ind' a the type coverage by checking the appropriate box. ❑ Liability insurance policy Other type of indemnity ❑ Bond Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner 1:3Agent 1:1 i hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations p ormed under Perini ued for this application will be in compliance with all pertinent provisions of the Massac se Stat as Code and }tap 42 of the General Laws. Signature of Licensed Plumber Or Gas Fitter By: ❑ Tit' , Plumber Z Z a 173 , City/Town ❑ Gas Fitter License Number ❑ Master APPROVED(OFFICE USE ONLY) ffr"Oumeyman Date. `. .. . . .... At "oRT TOWN NORTH ANDOVER p P IT FOR PLUMBING s o� •' a ,SSACHUS� � This certifies that . � . . . . . . .s0AJ ?1u1z b1. . . . . . . . . . l . . . . . . . . . . . . . has permission to perform . . . ?4vL`. . . . . . . . . . . . plumbing in the buildings of . . . v. !. .` . . . . . . . . . . . . . . . . . . . Y S� r e Y Y. . ` . . . . . . . ., NorthAndover, Mass. Fee <<. . . . .Lic. No.�Z t7t3. . . ... . . . . . 1)—? PLUMBING INSPECTOR Check K 6519 J Sy� u MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO P'UMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS � n Date r' f Building Location S� Sv �� 7 C '`f� Owners Name �J L/ ic ) Permit# Amount Type of Occupancy f New Renovation Replacement11 Plans Submitted Yes ❑ No FIXTURES 9[Bffi�lC BPii4�1VII�ir a�n>� 4M BLOat 5MH-CM 6M FU= 7MRDM 9MFI-(cn -t-,4 (Print or type) s e �) ✓� /1 �� Check one: Certificate Installing Company Name L J Corp. 192 ,� Address � � Partner. JBusiness Telephone ^�S— ,rJ G 03 6-2, �irm/Co. Name of Licensed Plumber. ' Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity El Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner 0 Agent El I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and iggakations perfo,Ffied under Permit Issue or this application will be in compliance with all pertinent provisions of the Massachu tts tate P1,idnibing Code hapt 2 of the General Laws. By: S-Ig—n—aMe Of ice arIUMDer Type of Plumbing License Title Z Z v'? 3 ` City/Town License f%4umDerMaster Journeyman 1 APPROVED(OFFICE USE ONLY L� Date...... ....................... NOR7M °�, °;•�"� TOWN OF NORTH ANDOVER ' PERMIT FOR WIRING This certifies that ......�- '. .c....................................... ............ ,./.................... / has permission to perform ° wiring in the building of......... .. Y.................................................. '^.` ........ .C"re-.may >Q ..... ,North Andover,Mass. a:�........ ................ ..... Fe . Lic.No. Z 3�.......? 11 v N�� .� i ELECTRICAL INSPECTOR Check # r DEPARTAiWOFPUBLICSAFETY Permit No. BOARD 0FMEPREVUM0NRECUL 770AS527CNR12:00 Occupancy&Fees Checked NFOR PERNIITTo PERFORMELECTRICAL W0000r �0/ APPLICATTO ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 �,_ EASE PRINT IN INK OR TYPE ALL INFORMATION) Date©'7-2 T of North Andover To the Inspector of Wires: The dersigned applies for a permit to perform the electrical work described below. Location(Street&Number) �` c, Owner r Tenant Owner's Address Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) Purpose of Building fi:1--S rRCJrn '/0-1 1 Utility Authorization No. Existing Service — Amps l�Volts OverheadUnderground M No.of Meters New Service Amps / Volts Overhead r--J Underground Q 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 Na of Lighting Fixtures Swimming Pool Above cl Below Generators KVA and ormd 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 Wtiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local a Municipal Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP 's OTHE hlstrarneCa►�a@e Pt>rstlatbt4letaglaana�scfh�seLLsC�alaalLaws Iha%eaamotLiabkhSM=Pcbyniu*gCrniplele aati critsstrbstsfdajuivalat YES NO Itmeahnnadvdidpoofofmnebthe0ffgr-YES NO Ify31haedvdwdYES,Pleas nbo*t ce WofwmaFbydwdalgthe EV:aimD* _ Esl¢n*dVahleafE6*W Wade S WcrklnSlat G 7 5 hrpectirnD�leRt d Rao �-D 7-C7 S^__ Final FIRMFIRM NAME la>da�ieP aofpa�uy.�m Ir-e-IrI '/G LlmiseNc cV C I Lion= 1 h0Mg C �Uj,G Sign� � Loalsel b 9-ag 79- _ Bts xssTd.Na Adikess ra it A 17 AILTdNa OWNER'SINSURANCEW •I.anawar &tftLia mdoesuat ttreirsl>rarnea orhs tale4dra�taslecllmadbyM s Ge3�(Laws andthatmys�s�aernlh'spm�[apphcabaiwaitcsthis rac�msnaf: (Please check one) Owner Q Agent Telephone No. PERMIT FEE� i i I I COMMONWEALTH OF MASSACHUSETTS ELE tS A REGOJOURNEYMANIANS ELECTRICIAN ISSUES THIS LICENSE TO d f kTHOMAS M BUJA im j 96 3RIDO"L ST I "'AL.Efl 14H 03079-7,104 2091JR 67/31/07 007078 Location No. Date MORTM TOWN OF NORTH ANDOVER 3? oL F A Certificate of Occupancy $ CMU s Building/Frame Permit Fee $ sA Foundation Permit Fee $ Other Permit Fee $ .- TOTAL Check # �' 7 6 4J' Building Ins ector The Commonwealth of Massachusetts State Board of Building Regulations and TOWN OF NORTH ANDOVER Standards BUILDING DEPARTMENT Massachusetts State Building code 780 CMR APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OF OCCUPANCY OF,OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING Building Permit Number: � � Date Issued �• Signature: Budding Commissionerihmpector of Buildings Date SECTION 1-SITE INFORMATION 1.1Prop" ` `59 Surrey Drive l2A�msll4t� Parosll�ber: ppL litapNomber Pawl 1.3 Zoning Into 1.4 Property Duarea�oas Lot Area(sq) Fcomage(ft) ZoningDhdrict PwposedUse 1.6 Building SePoack ft Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided 1 ! 107 WaterSWply 9M.G.LG40.4 54i 13. Flood Zonelafamsation 1.8 Disposal System Public 1,-- a Zone�f-1 O Q Id Flood tmic*l13OnSAeDisposal Sy+sbem 2.1 Owner of Record s Patrick&Sheryl Duffy 59 Surrey Drive Name(Print) Address: 978 685-5996 R Signalure Telephone 2.2 Authorized Agent: ANTOON-Boudreau Construction, Inc. 14 Bearse Ave. Methuen Name(Print Address Michael J. Ajitpon/ Kevin E. Boudreau S' Telephone 978 688-6272 SECTION 3 COMIRUCTPON SERVICES FORFROJECIS LESS THAN 3UN CUBIC FEET OF ENCLOSED SPACE 3.1 Licensed Construction Svisor: Not Applicable Q Licensed Construction Supervisor: License Number Michael J. Antoon CS 026645 Address Expiration Date 14 Bearse Aver,, /Methuen, MA 01844 11/25/2005 Signature ez4& TelephoQ78 688-627 3.2 Registered H Contractor: Not Applicahle 0 Michael J. Antoon Company Name Registration Number Mike Antoon Construction 102658 Address Expiration Date 14 Bearse Ave. Methuen MA 01844 07/02/2004 signatureZ�gj(lTelco— 978 688-b272 Revised 1997]trtc i ' SECTION l Ob-OWNER/AUTHORIZED AGENT DECLARATION Patrick & Sheryl Duffy I, as Owner/Authorized Agent hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury. Patrick Duffy Sheryl Duffy Print Name 10/29/2003 Signature of Owner/Agent Date SECTION 11 -ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollars)to Official Use Only be completed b permit applicant 1. Building (a) Building Permit Fcc Multiplier 2. Electrical (b) Estimated Total Cost of Construction from(6) 3. Plumbing Building Permit Fee(a)x(b) 4. Mechanical(HVAC) 5. Fire Protection 6. Total= 1+2+3+4+5 Check Number IL V W 1 1 VIF to.) I' , ctover 0 `- I74 A�� dover, Mass. , IAQ f—a79o'43 DRATED pPP\� 5 7 H E BOARD OF HEALTH Food/Kitchen PER T T Septic System THIS CERTIFIES THAT.......... �,...,... BUILDING INSPECTOR .. .. ..... .4 ................... "' ' Foundation has permission to erect........................................ buildin s on. � �.r�. Rough �...�.. ........ ... .. 00L a .42A t0 be Occupied as ..... �...... ............. .... ... Chimney ..... ............................................ .............................. provided that the accepting is permit shall in every respec form to the terms of the application on file in this office, and to the provisions a Codes and By-Laws relatin the Inspection, Alteration and Construction of Final 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 TARTS ELECTRICAL INSPECTOR 4#' Rough .... ................:................ Service BUILDING INSPEC.TOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous. Place on the Premises — Do Not. Remove Rough No Lathing or Dry Wall To Be Done Final Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT • Burner Street No. SEE REVERSE SIDE Smoke Det. I SECTION 6-DESCRIPTION OF PROPOSED WORK check all applicable)- New Construction J3 1 Existing Building E3 lRepairs 0 Alterations 13 1 Addition 13 Accessory BId . 13 1 Demolition 13 1 Other 0 Specify Brief Description of Proposed: Replace four(4)wood exterior door units with Therma-Tru Fiber Glass, insulated units of equal size. Install two (2)replacement windows in shed Replace four(4)wood exterior door units with Therma-Tru Fibre Glass, insulated units of equal size. SECTION 7-USE GROUP AND CONSTRUCTION TYPE USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly A-1 A-2 A-3 lA Q A-4 A-5 IB Q B Business 13 2A 13 E Educational 0 2B Q F Factory Q F-1 F-2 2C 13 H High Hazard IO 3A 0 I Institutional 0 I-1 I-2 I-3 3B 13 M Mercantile o 4 0 R Residential o R-1 R-2 R-3 5A 13 S Storage [3 S-1 S-2 513 13 U Utility 13 Specify: M Mixed Use 13 Specify: S Special E3 Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS. ADDITIONS AND/OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index(780 CMR 34) Proposed Hazard Index(780 CMR 34) SECTION 8-Building Height and Area I BUILDING AREA Existing(if applicable) Proposed Number of Floors or stories include basement levels Floor Area per Floor(sf) Total Area(sf) Total Height(ft) SECTION 9-STRUCTURAL PEER REVIEW(780 CMR 110.11) I Independent Structural Engineering Structural Peer Review Required Yes E3 No .Q SECTION I Oa-OWNER AUTHORIZATION-TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I Patrick & Sheryl Duffy As Owner of subject property hereby authorize ANTOON-Boudreau Construction, Inc. to act on my behalf,in all matters relative to work authorized by this building permit application. 10/29/2003 Signature of Owner Date revised bldg form/state JMC SECRON 4 WORIO+dtS'COMPENSATION INSURANCE AFFIDAVIT p14G.L a 152§25g6)l 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 AttachedY No El SECITONS- PROFFFSMONALDESIQVAND CONSEWDOWN SERVICES-FMBUH WG AND S1YUMMESSUWECPTOCON9MUCITON i CONTROL PURSUANT TO 780CMR 116 CONTAINING MORE THAN CY.OF ENCLOSED SPA 5.1 Registered Architect- No Applicable Name(Registrant): Address Rc atcationNmmber Expiration Date Si Tel 5.2 Registered Professional s Name Area of Responsibility Address Registration Number Expiration Date Signature Telephone Name): Area of Responsibility Address Registration Number Expiration Date Signature Telephone Name Area of Responsibility Address Registration Number Expiration Date • Signature Telephone Name Area of Responsibility Address Registration Number Expiration Date Signature Telephone 53 Gerd Conh*eter Not Applicable Company Name: NTOON-Boudreau Construction, Inc. Responsible in Charge of Construction Michael J.Antoon/Kevin E.Boudreau Address 14 Bearse Av . Methuen,M 44 978 688-6272 Si Telephone 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: Rick Lamarre & Sons, Inc. 23 ChestNut Road, Tyngsboro, MA 01879 (Location of Facility) ature of Permit A licant L11,a4C�t1- Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit 1 Please Print I Name: Michael J. Antoon/Kevin E. Boudreau Location: 59 Surrey Drive City North Andover Phone 978 685-5996 aam a homeowner performing all work myself. of am a sole proprietor and have no one working in any capacity 0 I am an employer providing workers'compensation for my employees working on this job. Company name: ANTOON-Boudreau Construction, Inc. Address 14 Bearse Ave. Cftw Methuen, MA Phone#: c 978 688-6272 Insurance Co. AIM Mutual Insurance Co. Policy,# 0055249 Company name: Address Cfir. Phone#. Insurance Co. Policy# i Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of abrortal penalties of a fine up to$1.500.00 i and/or one years'imprisonment as well as civil penalties in the forth of a STOP WORK ORDER and a fine of($100.00)a day against me. t understand that a copy of tris may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby car*under of pegwythat the information provided above is true and correct Signature �" Date 10/29/2003 Print name Michael �fntoonU Phone It 978 688-6272 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 FORW woarafa"CONUMsanoa --- - Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: 102658 Expiration: 7/2/2004 Type: DBA MIKE ANTOON CONSTRUCTION Michael Antoon 14 Bearse Ave ,,, ,- r Methuen, MA 01844 Administrator License: CONSTRUCTION SUPERVISOR Number: CS 026645 J Birthdate: 11/25/1957 Expires: 11/25/2005 Tr. no: 7883.0 Restricted: 00 MICHAEL J ANTOON 14 BEARSE AVE „ ,-� METHUEN, MA 01844 Administrator October 24, 2003 TO: Building Inspector, Town of North Andover FR: Patrick and Sheryl Duffy This letter will confirm ANTOON-Boudreau Construction, Inc. has permission to work at our home 59 Surrey Drive for modifying the existing roof overhangs, replace 4 exterior doors and replacing existing siding with vinyl siding. If you have any questions, please feel free to call me at 978-685-5996 • Patrick Duffy and Sheryl Duffy 59 Surrey Dr. North Andover, MA 01845 s � ry 14 Bearse Ave. Methuen,MA 01844-3409 =v PH - ONE/FAX: (978) 688 6272 CONSTRUCTION lad. E-mail:info(&AntoonBoudreau.com Formerly Mike Antoon Construction "Where Quality& Value is Peace of Mind" Contractor: ANTOON-Boudreau Construction, Inc. 14 Bearse Avenue Methuen,MA 0 1844-3 409 Phone/FAX: (978)-688-6272 Federal Tax ID Number: 02-0663379 Board of Buildings Regulation and Standards RegistrationN e Michael J. Antoon—102658 Kevin E. Boudreau— 127716 Customer: Name: Mr. &Mrs. Patrick Duffy Address: 59 Surrey Drive,North Andover, 18 5-f'817 Telephone No: (978) 685-5996 Fax No.: N/A i File No.: #491 (P_DUFFY'_01_03) Date of Contract: October Subject: Replace all a teriS ers &install vinyl siding to existing home. (See Scope of Work,Exhibit A) Date of Execu ' n act: October 27, 2003 Commenc �� e of Work: October 29, 2003 (Weather permitting) Date of Subs antial Completion of Project: End of November,2003 (Weather permitting) Total Contract Price: $29,500.00 (Twenty nine thousand five hundred dollars) Time Schedule of Payments as follows: S9,500.00 upon signing and return of this contract. Includes start Payment and exterior door order Payment $5,000.00 at completion of front and back overhang modifications $5,000.00 once doors are replaced $5,000.00 at start of siding work D $5,000.00 upon day of completion Invoices will be submitted in advance of payment due date,usually by E-mail,followed by a hard copy.All payments are to be made with a Bank or Cashiers check made payable to"ANTOON-Boudreau Construction,Inc."if they are not drawn on a local bank. Any deposit under this contract shall not exceed one-third(1/3) of the total contract price of the actual cost of any materials or equipment of a special order or custom made nature, which must be ordered in advance of the commence of work, in order to assure that the project will proceed on schedule. `v The Contractor hereby states that no final payment shall be demanded until the contract is completed to the satisfaction of the parties thereto. If there are any inquiries regarding this number or about this company, you should contact the Chief Administrator of the Board of Buildings Registration and Standards or his nominee for said inquiries. Cancellation Rights: You as owner have a three (3) day cancellations right under Section 48 of Chapter 93 of the Massachusetts General Laws and Section 14 of Chapter 255D, or Section 10 of Chapter 140D as may be applicable. Warranties: The warranties granted for said work I one(1)year from date of completion of project. All installed products warranties will be provided to the customer as the items are installed. Obligations: Under this Contract the Contractor shall be responsible for: 1. Determining whether any and all permits are necessary; 2. That it shall be the obligation of the Contractor to obtain said permits; and A 3. That the homeowner who secures their own permits will be excluded from t aratty fund provisions provided by 142A Massachusetts General Laws Chapte Extras: Any alteration or deviation from the Contract and/or specifica ' ivo vi g extra costs or man- hours will be commenced only upon signed charge orders detailing(the xtra charge and the date of completion. Payment will be due upon execution of the written ch-ftge order. � 0 Insurance: Customer will carry fire,tornado and a g a1�``l*` ili policy for the work. The Contractor will carry workman's compensation and general liabili. n DO NOT SIGN THIS CONTRACT IF EREANY BLANK SPACES. THIS PROPOSAL MAY BE WITHDRAWN BY THE 6lv. - k CTOR IF NOT ACCEPTED WITHIN FIVE (5)D Executed and accepted this � y of OCA , 2003 Contractor Owner(s): Michael J. Antoon Patrick Duffy Kevin E. Boudreau Sheryl Duffy Visit us on the Web: www.AntoonBoudreau.com ' EXHIBIT A Scope of Work PREPARATIONS for PROJECT 1. Will obtain all permits required for project and coordinate with local building officials for all necessary inspections. 2. Will provide 30 yard dumpsters for safe removal of all CONSTRUCTION RELATED debris. 3. Existing shrubs,plantings and trees must be trimmed and/or tied back to allow a minimum clearance space of 26"between them and the existing structure. This space is required so the pump staging can be installed and for ease of stripping the house. Additional labor costs will apply if clearances are not there. CONSTRUCTION DETAILS 1. Will prep front and rear of house so the pump staging may be set-up to work on� rear overhangs. 2. Overhang work consists of: a) Removing existing trim boards b) Framing facia plumb and planchard so it is level. c) Will make ready to receive new aluminum coil trim and pe orate vl soffit material. 3. Vinyl siding prep and materials as follows: a) Will strip existing house siding and install Tyvelc us over existing sheathing. b) Exterior window/door trim and existing pin iro will wrapped with"WHITE" aluminum coil. c) Will install"WHITE" Traditional come os d) We may install three(3)"WHITE" ' yl b vents if the existing ridge vent is not properly installed e) The siding color will be Certa'..t 5edA,4onogranfrm"Canyon Blend" f) Soffit color will be"WH g) Shutter style will be le e�d"BURGANDY" o�� h Will install" I 95li t Locks dryer/exhaust vents and utility blocks as required. i) Will wrap" of posts on upper level of screen porch with the same aluminum coil 4. New door ec s'follows: a) W' k r- 11 interior/exterior casings. See exclusions, 7a b) All .doors include new single cylinder deadbolt and key lock by Schlaige. All keyed alike. c) Front door: i) Therma-Tru SmoothStar embossed S754 ii) Side lights Therma-Tru SmoothStar embossed S750SL iii) Front door unit glass "CRYSTAL DIAMONDS" • iv) Front door trim- Sunburst pediment with fluted casings d) Other doors (3)—Therma-Tru Fiber-Classic flush-glazed 2150. Exterior trim will be 908 style. 5. Will install two (2)new vinyl windows, close to the existing size, at enclosed area under screen porch. 6. All labors necessary to complete project. 7. Exclusions a) The new interior trim applied to the new door configuration may not cover the same as the original doors. This may leave unfinished areas where the existing wall coverings/paint meet. Repairs to these areas are not included in this contract. b) Painting of any kind, interior or exterior. c) Wall coverings. d) Any new exterior lighting fixtures. e) Extras derived from unforeseen insect damage or poor structural integrity to existing structure. f) Other requirements not on the plan that the building/fire departments may require. .Y aDate........ ...'.. ............ f NORTH 1 TOWN OF NORTH ANDOVER PERMIT FOR WIRING SSACHUS� I This certifies that .......... ANA has permission to perform . f'� wiring in the building of.>......k.: f.. ... ................................................... V ......:....... ,North Andover,Mass. Fee.4 ............. Lic.Nod:.... ...... ;•�... ..:........................ CELECTRICAL INSPECTOR Check # x. 667 THECOMMONWF.ALTHOFMMSSACHUSETTS Office Use only ` DEPARTNIEVT0FPUX1CS9FEIY Permit No. BOARDOFFIREPREVENT70NREGUTAT70NS527CNIRI2:Q0 _ Occupancy&Fees Checked APPLICATTONFOR PERMIT TO PERFORMELE CAL WORK ( ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL COD S27 CMR 12:0DateVI G ,. U PLEASE PRINT IN INK OR TYPE ALL INFORMATION 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) 9 .s�rl,e y /)Riy e Owner or Tenant alk o .1 C merz y 46L(-4y Owner's Address Lf swIl e/0 -1),oy/e Is this permit in conjunction with a building permit: Yes M No [Ey (Check Appropriate Box) Purpose of Building Utility Authorization No. _ Existing Service Amps �Volts Overhead Underground M No.of Meters New Service Amps / Volts Overhead Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work _/,4hVIA4 0 E A U 6AI U�tlO /IQ L No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA round ID ground No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices `o.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal Other d Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER' hastuanceCoMNr-Rus<IatttothemgtuteIrMOfMWMdBlsetlSCtMWLaws IhawaamemLiabilityh>swmmPbkyin kdTCorMic CDm ageorit atsmhalegxvalent YES [21 NO Ibave advalidprwfofsameto#rOffiM YES F)wbavedrdodYES,please-mda&thetypeofoovwageby dWk'hgdiaqTrMWb0X ••• -- ••• 1� WSURANcBOND OTHER ?&aTSpa*) If Ali LL CN` EsWMt0dvake0f $ WaktoStart hW0C iMDateRegnested RW9h Final SignedrmderTr, ofpew.. FIRM NAME >ql&l E- 1 C Iia eecdtVSignahue 'y7? d Iiar�seNo S/ /l!t° 4-1 BusiImTelNo. Arlr— .2d hkA f y l/� . /�e77�r�P�; �l� d ldryy Alt Tel No. •n'g"�� OWNER'S INSURANCE WAIVEP,Iamawarethat theLmm does not haw the marrarre oomraW or its aksw0al equivakit as regmed by Nl%sadmscm Garoal Laws and that my signature on this permit application waives this req*etrellt (Please check one) Owner F-1 Agent Telephone No. PERMIT FEE$__ Signature ot Uwner or Agent Location / 5cj r , No. 0?6 Date NORTH TOWN OF NORTH ANDOVER 1- 9 . : Certificate of Occupancy $ Building/Frame/Frame Permit Fee $ a SSE 9 Foundation Permit Fee $ Other Permit Fee $ !' TOTAL $ y Check # / / JMf (� 15 '145 Building Inspector s K TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED. SIGNATURE: Building Commissio er/I for of Buildings Date z SECTION i-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 59 Su rft, 6<--,\,,e- IIf - N . 1 M a O t 6 I"1f C 7 Map Number Parcel Number Qj f> OV2� 1 ` 1.3 Zoning Information: 1.4 Property Dimensions: ^ , ZoningDistrict Proposed Use Lot Area sf) Fronta e ft �J�/� 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1 10 1.7 Water Supply M.G.L.C.40. 34) I.S. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ 3 + Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ a SECTION 2-PROPERTY OWNERSI3IP/AUTHORIZED AGENT M 2.1 Owner of Record V- ,L/ Na a(Print) Address for Service 685 a( 8tiS vv Signature Telephone 2.2 Owner of Record: Name Print Address for Service: � z � e! Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: 0 + License Number Address y Expiration Date Signature Telephone �. 3.2 Registered Home Improvement Contractor G .I V 2+fes Not Applicable ❑ �-l` k V\C)M2 S -T-v\�- . l Z� Pi 9 Company Name ^,��� Registration Number Address �t)-c 5Vtr !-`C', U�I�oU� Expiration Date ii nature Telephone — lj n r 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 buildinjpermit. Signed affidavit Attached Yes....... No.......0 SECTION 5 Descrition of Proposed Work check ail applicable) New Construction ❑ Existing Building ElRepair(s) 11Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Desc 'ption of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Itetn Estimated Cost(Dollar)to beFFICIALll SE Completed b permit applicant 1. Building f 7 q (a) Building Permit Fee l 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 12-1 $ q . Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BURDING PERMIT 1, ,as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZEfD' AGENT DECLARATION .I, PC-k %J V E V4 as Owner Authorized Agent o 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 Sip-nature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 sT 2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 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. n The debris will be disposed of in: i SS �ft(` YL,(sor, (Zcl� . AS1�I ,d, MC' . C)n �( (Location of Facility) C, _ Signature of Permit Applicant H( $• UI Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector i • I I I Board of Building Regulations and Standards 1 HOME IMPROVEMENT CONTRACTOR Registration. 126893 Expiration: 08/03/2002 i Type`Supplement Card Home Depot At-Home Services PAUL VENTRE 3200 COBB GALLERIA PKWY#26 � � ALTANTA,GA 30339 Administrator I i i I ' AUG-16-01 09 :40 PM P. 01 t *t �.,�, , yr t�iAbiLl J Y It URANW: kL1a cT�+ �"7f tfSlwliutYl f 'SHtPARD&SCOT-t CORP. Sefial A2027 THI$CtMFToCATCF IS RSSUEA A5 A +REFI OE 12r20fi1 352 SEVENTH AVENUE•SUlTE 805 ONLY Ak0 CONFERS NO RIGHTS UPON YHE C�Ognq T*N HOLDER. T1if5 CERTIFICATE APES NOT AML-ND, NEW YOfi,� NEIN YORK 10001 ALISR THE COVERAGE AFFoRt)EO BY THE pFXTgNO OR UCiES BELOW. + INSURERS AFFbRf7fNG CtJ`J ERACiE RMA Iit01y![ SE_RyICt.-S, INC. Ax'�7rPA AG�IIRAL 1NSL�fiANCE:GME'A,yY _.._... 32C*J CC)aU GALLERIA PARK'VVAYI LNsua�a a: _TRAVELERS iUbEMN1TY OF 1 INoiS ATLM{TA. GEORGIA 3033.9 R+StJR3tc_ CONTINENTAL CASUA41`Y INSUzgANdE co. -- L AMERICAN INTERNATIONS GR0Uf' - nIc Pouc+es or !„Hs rsmr;r USTE0 BELOW HAVE BEEN ISSUED T©TSE IFf$ •• ANY REUUIRLMEN T, C)Ft�[p Ep _ I,tA-Y PER TOJN,THE IkSURANCE AFFORTi�t)8Y THE PO�tIANY C L5 OESCfLgF.p>KERaN 15 SUfi�Ei�T 7�d pl�E TERMS.!•:7cCtU$1r�NSrp,NO CONDITIONS OHb TZ� pNSSO SDINC DOCU,AEtST YwTH R` PECT iQ VWIICII PHIS CCRT1FICATI;MAY BE ISSUeD OR POLICIES.r[S.,4GGREGATE i.NN11 S SHUNrV"AY HAVF&F-EN REDU4ED dY YAIU Ci/A15. .^L..:_ I_ 1'ratlRc.�+CE j -�_PS7L/Cr N4iti:acK -~�� ��ECTIVf POIfCY fJIPSucii W1' 141 ---- --- '-- _ GFJ47tAlUABILJ,YMM IA�rS 4 X'co Y_acvlccNExa LuoSTf iA01AC,10097 I FACtO=K 's 1` ,QpQ,004 _— CLAACi►w11E �X d C�l<I I MUM 21"28102 Omwc tmw hrj I i 5U,W0 1 I 1 E NEO E7LP(v.�w Twpr •7 _ _ I I�RsowuaEwuuuRr i 1,�00 ~� GATE F---,10 000 1 C[N1 AGcttEGTF LWMT AF•ru t R � t I !GiNfW14AGGilE t< t: L, _ , I f I OOVCTi•CUNPeOP ACC I A4f1'L'M081L-E I�AeIIfTY — �_ I ;A"AUIo IY810330Dg703-TIL I2118101 j 2t=2 i I *4 ow.?4lswp.L IT �s $1.000.000 . .. �5GtF�ULCO 41'OS �90t7IlYpUtn2r �i _ ' N62Fi7 ' �w'w'' ,+V,IT In ca+sAee t1Ai<tTTY I VIM e000 d) - �ANY Alftu I `AVTOOTaY:EAACCrt>CrrT 'b �_ _ I { I aTH£+t r rArt IEA AGC _ ,A,Jio Omy ESC ES LIAL11UTY �—I --'�" �•- ACla C . 0(XIA ( i CJA Ay-X rCUP 247893247 + 1 EACH olm",4.hCE s 10,000,000 2128fU1 212MZ u,GxzaAT> ��; 10,(00.000 nEUUCT'EiIL I I _. I t X IkETiNm)4--------------- EMPLOYCAS LLABUTY IWC s386oz7,bVC s3ar�Oze, 3/10101 3/10102 X S I I WN3860291F S . TflRr wlrs FR If I E F.L EACH Ar-cn HT 500.000)" � � I!L DrsEASE•EA EMPiort�� ---.SOO,P00 ::.x.f-no+•r or�y�p�y�,pG,ITtcwsv&.�a.�s�,ca,yxoNs AA�Eo ar LnUartsl�t�xi�rcaAt MaovtstGrla '. .�" T�LDFht X H %tT1FIQ'ATE ,a~� H oaONtu.I�ISVNEc:It4SURE'�LETRk CA NCFLIATIdN -- �.�. >i+rO KD ANY a rhe At VVr-DISC IUKO POUCES a4 CAAICEL."8(.-'.E 1'1*EtMITI l)rtiE rtlt]keOF,Testi ISSi1ttK.7rtaU�Tt vnu EnOEAYott 7'O MAJL p4Y3%*TrT-N WI CE TO'ME CEATIWAIM kOLM-AM M Yk:LEFT,a VT FAtLLIP—E TO 00 50 WtALL PROOF OF INSURANCE w ovur.AnoN oft uuu.°"or ANY k1No v"Twg It4$Vt4ER ITS AGE1115 OR AurmNz=RLpscsfNTATIv1:OF%MPEhOtHTN150RANCE^904N ' 1 OACORO CORPORATION 11911 NORTH T E D own of over No. a �o a - - - f7 0 dover, Mass., 0R47E Cl BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..... .......—D.U� .............. ......... . ... ...... .......... .... .................................................................................. Foundation -2 has permission to erect.....................................— buildings on .....6...Q ....6 . (-5 4e.. ..... .......... ......................... Rough to be occupied as �'P�0... ............W..."Ov...210 tv's 0 A.) sr 44-AD e%e Chimney .........................................................................I.... 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 ta the Inspection, Alteration and Construction of 74 Buildings In the Town of North Andover. 1 /— :� 8 y`— PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES N 6 MONTHS Final UNLESS CONSTRUCTION TARTS ELECTRICAL INSPECTOR Rough 00ea ...... ........ .. ................. ........00.......................................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in 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. Location ; No. S f� Date !►ORTh TOWN OF NORTH ANDOVER f 9 ` Certificate of Occupancy $ Building/Frame Permit Fee $ Kwu Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 64zS J Building Ins 6or TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLII/S��HA, ONE OR TWO FAMILY DWELLING . __ a;;.; 'r s : ;+s� fd�V►41R�['�7�G�1sa .. :_ .,`_ ._Fs BUILDING PERMIT NUMBER. DATE ISSUED: 3 -a -a SIGNATURE: C, Building Commissioner/I for of Buildings Date Z SECTION i-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: ��9 Srcrr�u D,r. N© Ada& 1` A*,, Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: o� N Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide RegWred Provided Reqttired Provided v 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 rn 2.1 Owner of Record 4- she4 leu ' i ✓S9 �� A/ > � Name(Print) Address for Service 1____9 / ? OcJ X) Signa re Telephone 2.2 Owner of Record: W Name Print Address for Service: O Z rn Signature Telephone SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: O License Number M Address D Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name rn Registration Number r Address r z Expiration Date ^ 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.......❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of ProposedWork: t// /Ul batl CtA�ye 4,,ovxd rgW o? J(�et�ve e SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by pen-nit applicant 1. Building (a) Building Permit Fee 6 300Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(e)X (b) _ 4 Mechanical HVAC /v 5 Fire Protection 6 Total 1+2+3+4+5) 1 Check Number ' SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, ✓ as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit applicatio ( , �/ Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Signature of Own er/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS in 2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHRVINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 02q ( Mote ° v FORM - U - LOT RELEASE FORM R� z 4 � 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 E&�k �- Ekeryl Au;& PHONE-1i 1j 9786�s5i�� ASSESSORS MAP NUMBER 7q LOT NUMBER SUBDIVISION LOT NUMBER STREET Swc t"Q-tA -Dr%v e- STREET NUMBER S I OFFICIAL USE ONLY RECOMNIENDATIONS OF TOWN AGENTS l..... ■...............■ ■...................■r............................■ DATE APPROVED O CONSERVATIONADMINISTIr DATE REJECTED CONMIENTS DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR-HEALTH DATE REJECTED CONIIAENTS t PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED CONMIENTS RECEIVED BY BUILDING INSPECTOR DATE • BAY STATE SURVEYING.ASSOCIATES INC. JOB# / 100 CUMMINGS CENTER, SUITE#316J, BEVERLY,MA., 01915 LOCATION . !vdRTH An��ojl,,�i2.•�/{� NOTES: •• """•""" 1)This is a mortgage inspection survey and not an SCALE : 1" =40 DATE :.........�. ,z�— �! instrument survey,therefore this plot plan is for ••, mortgage inspection purposes only.It is NOT to be used to establish boundaries or for the construction REFERENCE .r�...5:l7Z•,r��.:. g of any type of improvements. ..4u ....... 2)This survey is based on survey marks of others. '•"•""' "'�f'�'r 3)Bushes,shrubs,fences and tree lines do not ... ..................................................... necessarilyindicate property perty Ilnes. 3(> 4)Whenever an offset is 1'+-or less,an instrument TO:................J �;r, h,�„D1 'rC.,...N...,,•,....•,.., survey Is recommended to determine property The location of the building(s)as shown,either lines,and any possible encroachments. complied with the local zoning setbacks at the time of 5)Offsets shown are approximate,and are to be construction or is exempt from violation enforcement action used only for the determination of zoning,Not to under Mass.O.L Title VII Chanter 40A Section 7 be used to e8*.2h11sh Prose !I_ 0)In my professional opinion the building(s)are not located in the special flood hazard zone,as defined by H.U.D.MAP# 2 • Ol7 n� �t kba� F ,aA = 2? 2.7-7 'Zod tiM t N RR SIA • (� 40,3 SU��� NORTH ED ovm Of r Andover ' TIMs8z � ^ -4 ao y `' ,j C OC nIc dower, Mass. 46 a T O - l K 1I� 1 r I Ij-+ t ADRATED PP9'\- S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT..... A . . . ..k... .....5. .. ..r. ...1...........D..t ..( '.... ............................. BUILDING INSPECTOR Foundation p .91.................... g S°�.......r.0...�..r..It ......... R.I U.� Rough has permission to erecpt...... ... buildings .............. to be occupied as....... 0 V �. A bo is t G t-. o w A P•ot I � 1%6,1 P Chimney ............................................................................................................. provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-laws relating t the Inspection, Alteration and Construction of Buildings in the Town of North Andover. _ WOODPLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION S ARTS ELECTRICAL INSPECTOR C Rough ..........I*....... ................................ 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.