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Home My WebLink AboutMiscellaneous - 60 ASHLAND STREET 4/30/2018 (2) 60 ASHLAND STREET 210/017.0-0003-0000.0 r 1 I Date- 10454 w T TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that.. !!� ../..1'f.. (* -e....................................................... has permission to perform-41.4....41.4?#."U?..y`".............................................. plumbing in the.buildings of............................................................................................. at....4 U / .... .......................,.�......... ort Andover, Mass. Ir .... .............. j Fee.Y6.,. q.Lic. No.0 l...7 ..�1. .... ./... ............. .. .. .. . ... . ............................... LUMBING INSPECTOR a Check# ' i MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK t � CITY i MA DATE!4 (PERMIT# _ _... JOBSITE ADDRESS OWNER'S NAM v �.�:, r._ P OWNER ADDRESS € ? TEL FAX / _.... TYPE OR OCCUPANCY TYPE COMMERCIAL w EDUCATIONAL µ RESIDENTIAL(„C PRINT CLEARLY NEW:k RENOVATION:{ REPLACEMENT: I PLANS SUBMITTED: YES,. NQ FIXTURES 1 FLOOR BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE W _ I ( DEDICATED SPECIAL WASTE SYSTEM .. DEDICATED GAS/OIL/SAND SYSTEM € - ' ' :.li _ m mm ' T"` DEDICATED GREASE SYSTEM { I i DEDICATED GRAY WATER SYSTEM ?_ DEDICATED WATER RECYCLE SYSTEM R DISHWASHE _— _. .. i` DRINKING FOUNTAIN .... ~ FOOD DISPOSER77t _ _ .. ....._...... _..-E FLOOR I AREA DRAIN I INTERCEPTOR(INTERIOR) 3 . KITCHEN SINK , ! -.-::. _._... LAVATORY ___ ROOF DRAIN , € I SHOWER STALL SERVICE/MOP SINK TOILET __.._ URINAL WASHING MACHINE CONNECTION ,I 1 r WATER HEATER ALL TYPES W.. _:_ WATER PIPING.. rF OTHER II it E i i 33 _� r..��_,I f INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES;. NO L. IF YOU CHECKED YES,PLEASE INDICATE THE PE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW 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 Massachuse t I L s,and that my signature on this permit application waives this requirement. ' CHECK ONE ONLY: OWNER 'sAGENT SI NATURE OF OWNER OR AGENT __j I hereby certify that all of the details and information I have submitted or entered regarding this application are true andaccurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance w. all P i provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME i LICENSE# !� SIGNATURE MP'- CORPOROPARTNERSHIP LLC'.' S#JP1#,__,-..._.........__ , ..y,� _ COMPANY NAME�mm�� '✓!�.. � lLP/rjr( ADDRESS CITY / � / "I (/(�`'� STATE ZIP _..a;. ,TELYl 'f/ . .,..._....,:' FAX i CELL, EMAIL f »___� s , �_,, i 4 , permit Maspsaenusetts lecidealCodeAmendments527 CMR 12.00§Rule 8: In accordance-with the provisions of MG.L.c.143,§.32.,the aplication form to provide notice of installation of wiring shall be uniforin 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 he 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 maybe deemed by-the Tnspectox.of_Wires abandoned-and.inxalidaf-he—. • or she has determined that the authorized world has not commenced or has not progressed during the preceding 12-month period.Upon written t 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 j&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 otherwis a 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. Pule 8—Permit/Date Closed: ***,Note:Reapply for new permit J A(&rmit Extension Act—Permit/Date Closed: AV 1 Date...�.:..�`..��....... �. HORTI{ °! 1 TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,SSACMUS� / This certifies that .-- —�-*—'........., - ........... ... ............. has permission to perform....... ................................. wiring in the building of. .... .......y Z.*. �... ............................................ .......... o ..: ................ .North Andover Mass. _... .. V :!� . Fee--b................ Lic.No.&s-?-2 ELECTRICAL INSPE Check # 81 ?2 Commonwealth of Massachusetts official use only Department of Fire Services Permit No. P7.1- BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checkedva [Rev. 11/99] leave blank f�- APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC);527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: City or Town of. 0&4A. AiddY 1. To theIn p or of Wires; By this application the undersi ed gives notice of his or her intention to perform the electrical work described below. Location(Street&N b w) Map: Lot: Owner or Tenant Telephone No. �. Owner's Address (p(,) Q S Is this permit in conjunction with a building permit? Yes ❑ No Building Permit# 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: Completion o the ollowin table may be waived by the Inspector of Wires. No.of Recessed Fixtures No.of Ceil:Susp.(Paddle)Fans No.of Tota Transformers KVA No.of Lighting Outlets No.of Hot Tubs Generators KVA No.of Lighting Fixtures Swimming Pool Above ❑ In- E] No.of Emergency Lighting rnd. grnd., Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS N:;.o;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 g No.of Waste Disposers Heat Pump Number Tons KW No.of Sel- ontained Totals: "'''"""" .........."""""' Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Systems: No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: { Heaters Si ns Ballasts No.of Devices or E uivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: a 0 AttaJi additional detail if desired, or as required by the Inspector of Wires. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANC� BOND [:1OTHER E] (Specify:) (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. I certify,under t .pains and penalties of perjury,that the information on this application is true and complete. FIRM NAM E: LIC.NO.:77(4 Nk K Licensee: _115Signature. C�.oN�bAn �Y,7IC.NO.:I (If applicable,enter " xem t"in the license number li .) Bus.Tel.No.• �3 Address: ` Alt.Tel.No.��1(1�c3�1.� `�. 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 a ent. Owner/Agent PERMIT Signature -Telephone No. FEE: $ d Inspection Record Date Inspection P/F Inspector Notes a y w a f Date.. .V.. .. �. c`�.. . . RTIy 3r TOWN OF NORTH ANDOVER • - PERMIT FOR GAS INSTALLATION �,SSACMUSE4 171- This certifies that . . . . . . . . . . . ` . . . . . . . . . . . . . . . has permission for gas installation . . `. ..... . . . . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . at ° .. . .....:"�.'.'...�. . . , North Andover„Mass. Feep�?. . . . . Lic. No. . . �} 19 . . ! . GAS 1.S 'ECTOR Check# A�j 9/ 6423 MASSACHUSETTS UNIFORM APPLICATON FOR PRRMff TO DO GAS FfrrlNG (Type or print) Date NORTH ANDOVER,MASSACHUSETTS Building Locations a Permit# ya� j�Amount$ ro- Owner's N me New❑ Renovation ❑ Replacement Plans Submitted ❑ � a U04 W a W O UO E+ Z O W N6 E» a Z �" O Z F G� O O A O W (i r'G z f v2 p x a, W L� F..' W �a a cnG � � U v� A E+ W w v� � W W O O z U O v� >+ O 7w.' A C�7 a A a F O [BATS. B - jASEM ENT BASEMENT LOOR D . LOOR 3RD . FLOOR L4TH . FLOOR 5 T H . F L O O R 6TH . FLOOR 7TH . FLOOR S T H . FLOOR (Print or t - Chec one: Certificate Inst ng Company Name Corp. Addres ❑ Partner. Business Telephone�� / ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter/o ',(��.G�, L�f�C1 t" INSURANCE COVERAGE Ch k ong/. I have a current liability Insurance policy or it's substantial equivalent. Yes No❑ If you have checked y_es,please i icate the type coverage by checking the appropriate box. y 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 ❑ Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and i Mations performed under Perini sued for this application will be in compliance with all pertinent provisions of th Massachuset S a Code and Ch p r 142 of the General Laws. Signature of Licensed Plumber Or Gas Fitter By: ❑ Plumber Title ZQZLe City/Town Gas Fitter License um er Master APPROVED(OFFICE USE ONLY) Journeyman '\ A ,: t ,'�•' �,. i Location No. 4/z/ Date — MQRTq TOWN OF NORTH ANDOVER � w a + ; ; Certificate of Occupancy $ �ss.►cNusE<�' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ '� Check # 17945 ; ' ....8uilding Inspector/ t i CC// I ` TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING .-_;-i v _ -, aF'K .. .,.fnii£' w;,iAai' YV�1 ` ! '• '" T• .. BUILDING PERMIT NUMBER: DATE ISSUED.' SIGNATURE: Bui d1 ommi si or of Buildings Date SECTION 1-SITE INFORMATION IO 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number `U6 rJrv,Joy �Z 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area Fronta ft 1.6 BUILDING SETBACKS ft - Front Yard Side Yard Rear Yard Required Provide Required Provided R 'red Provided v 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zona Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ �I: i:�if SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT ii; 'iiSti iCt: Yes NO m 2.1 Owner of Record ame(Print) Address for Service Signature Telephone .2 Owner of Record: 0 Name Print Address for Service: z M Signature Telephone Aw SECTION 3-CONSTRUCTION SERVICES 7� 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: 0 'A License Number Im AMress _ Expiration Date we Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v o u� ��h ,1-7_� `26 / Company Name 1;,7 Registration Number Address Expire' n D G) Signature Telephone i SECTION 4-WORKERS COMPENSATION(N.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 as a Ilcable New Construction ❑ Existing Building ❑ Repair(s) 0 P terations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: t y e`nu o 5/1'h It �l i 5/✓y"W do� SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed b 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 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1,_ as Owner/Authorized Agent of subject property Hereby authorize�AY �F�4-�/''C,J to act on My behalf,in all matters relative to work authorized by this building permit application. ........... Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, 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 TIMBERS 1' 2 3 RD SPAN DIlVIENSIONS OF SULLS DIMENSIONS OF POSTS DIMENSIONS OF G.MDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY 1S.BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE w • 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: all, S- (Location of Facility) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector a ' 0RTjj Town of Andover No. dover, Mass., 0 LAKE coc KICHE WICK ATED BOARD OF HEALTH Food/Kitchen PER Septic System • BUILDING INSPECTOR THIS CERTIFIES THAT...... . ......................... ............ Foundation has permission to erect................ Am- - oP buildings o ............................. ... ... .................104#007......... Rough occupied ase. ,,OA� ....... .......... to be occ Chimney wpii shall in every respect conform to the terms of the application on file in provided that tIW eiio� accepting this MR ....... ...... ....* Final this office, and to the provisions of the odes and By-Laws relating to the Inspection, Alteration and Construction of Buildings In the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION Rough ................................fvx��........ .... Service ............................ BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR R Display in a Conspicuous Place on the Premises — Do Not Remove Finalough 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. . U 6477/IJ20�u/f X Board of Building Regulations and Standards { =_ -= HOME IMPROVEMENT CONTRACTOR - = Registration: 120131 ..=` Expiration: 10/22/2005 Type: Individual ROBERT R.BELANGER ROBERT BELANGER 1278 BRIDGE ST GG ' DRACUT,MA 01826 Administrator I j Location- No. ocation No. t ,/ Date NORTH TOWN OF NORTH ANDOVER 3? � . 00 10- F Certificate of Occupancy $ Building/Frame Permit Fee $ s�c14 Foundation Permit Fee $ Other Permit Fee $ rr/ TOTAL $ Check # �lCo 16136 ��' -- f -Building Inspector i . 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 Commissioner/Inspector of Buildings Date —� SECTION 1-SITE INFORMATION IO 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 0 Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide R red Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zane Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zane Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT F m 2.1 Owner of Record LGUIS MkQZTK_ � v A5 H (,^" b sem' Name(Print) s— Address for Service: Signator Telephone ? 7 8 / U f^(cam ^ -5- a 3 2.2 O of Record: kj Name Print Address for Service: O Z M Signature Telephone _SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ 'Licensed Construction Supervisor: License Number Address Expiration Date ic Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name rn Registration Number Address GOy2- Expiration to � Signature Telephone I P^ ) i SECTION 4-WORKERS COMPENSATION(M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes......Ar . No.......❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building 1 Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify / L Brief Description of Proposed Work: I SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFTCI VSE ONLY Completed by permit applicant 1. Building0� (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(e)X(b) 4 Mechanical HVAC G'y 5 Fire Protection 6 Total 1+2+3+4+5 �CA Check Number SECTION 7a OWNER AUTHORIZA ION TO BE COMPLETED WHEN OWNERS AqgNT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, I � as Owner/Authorized Agent of subject property . Hereby authorize �znZ7� !L- fc� � to act on 1 My b f i all n e la e to work authorized by this wilding permit applicatiot i nature of Owner Dat SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, 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 1p Signature of Owner/Agent Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2ND 3 SPAN DIMENSIONS OF SILLS DM/IENSIONS OF POSTS DiNIENSIONS OF GIRDERS DIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CH NINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE E � Town - ot Andover No. 37/ o� -OCHIC �? lover, Mass., • ADRATED S H � BOARD OF HEALTH PE IT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT. ....i&.. .. ........ ... ........................................................................................................................ Foundation i 4 L has permission to erect........................................ buildings on ...�.0.........W...... ..... .. ....... .......�: , J it.4 .4. ..:.:. Rough to be occupied as .. ..... .......... ..:.:.. .. ............................................................................................................................ Chimney , provided that the person accepting t ' mit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of t des 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 CONSTRtJCTiO ,. T'S ELECTRICAL INSPECTOR A Rough JW...............................................j.... ....................................................... 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. Vropooat R. Belanger Roofing, Inc. 1278 Bridge Street Dracut, MA 01826 (978) 454-8918 P PAL MITTE(1� F DATE STREET / PHONE F! fi C TY,STAT AND PLOCI N WE HEREBY SUBMIT SPECIFICATIONS AND ESTIMATES FOR: �� .�7 .Y- /�-- JL I��Y vsi�s {f I Y Y�• !�/ ��Yy Y d Ve 3prop&gC hereby to complete in accordance with above specifications,for the sum of: dollarsq( � brt)bei J J I° J�JJ t�j l' N'� Gr'/•�' � l //�!� / "'�7/� i/) h"_ f All material is guaranteed to be ass(cified.All work is to be completed in a work- Authorize manlike manner according to standard practices.Any alteration or deviation from Signatur specifications including extra costs will be executed only upon written orders,and will Note: This proposal may be become an extra charge over and above the estimate.All agreements contingent withdrawn by us if not accepted within days. upon strikes,accidents or delays beyond our control. /17 Acceptance of J)ropogal-The above prices,specifications and conditions are satisfactory and are hereby accepted.You are authorized to do the work as Signature specified.Payment will be made as outlined above. Date of Acceptance [ _ 03 03 Signature i � � ✓lze �arn�nza�uuea,�i o�✓�aaaac�uael�a Board of Building Regulations and Standards HOME IMPROVEMENT CONTRACTOR Registration: -120131 � Expiration: .10122/03 Type: In ROBERT R.BELANGER ROBERT BELANGER 1278 BRIDGE ST 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: &jZI (Location of Facility) Signature of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through.the Office of the Building Inspector 3