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HomeMy WebLinkAboutMiscellaneous - 63 FOXWOOD DRIVE 4/30/2018 JL63 FOXWOOD DRIVE 0/065,=0000.0 �I l it .� Date.......77. .:d ... U TOWN OF NORTH ANDOVER p PERMIT FOR WIRING SSACMUS� Yr ,r y:. . This certifies that ,,..<.. \ Commonwealth of Massachusetts Offilcial'J,C only Permit No. Department of Fere Services — �' _ Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 9/051 (leave blank) — I APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to he:performed in accordance with the MassachuSetlS Electrical Code(h-IEC).527 CNIR 12.00 (PLEASE PR11VT hV hVh OR TYPE ALL Ii TORMA110iV) Date: 0( _ City or Town of: /U - 1+iot0-zz_e_4 _ /t'�To llie Inspector• of•GYires. By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 3 �pG GQ Owner or Tenant _ ( dt. G� >✓f— ephone i 7 ](o Owner's Address 63 vxc, od T� _ is this permit in conjunction with a building permit? Yes. ❑ No VU (Check Appropriate Box) _ Purpose of Building Utility Authorization No. Existing Servi.ce _ __.._ Amps ` ! _Volts Overhead ❑ Undgrd ❑ Nr, of R;teter; New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: fy� Completion of the jolloirinQ table may be waived by the Inspector ol•lVires. No. of Recessed Luminaires No. of Ceil.-Susp.(Paddle)Fans No. of Total Transformers KVA No of Lumiriaire Outlets No.of Hot Tubs Generators KVA:. No of Lumino.ires Swimming Pool-Above '❑ l _ ❑ t o. o�mergency ►g ttng_ grnd. arnd. Batte units No.of Recep'tacle'.Outlets : No..of OiLBurners FIRE ALARMS No of Zones ��_-- No. of Detection and No. of Switches No. of Gas Burners Initiating Devices i No. of Ranges No. of Air Cond. TonaTotal No. of Alerting .Devices No. of Waste Disposers Heat Put-tp Number elf- Tons KW No. of SContained Totals: I Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection Heating Appliances Security Systems:* No. of Dryers b pp KW No.of Devices or Equivalent No. of Water No. of No. of KW Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent .r --- - 1elecommunications 'Wiring: INo. Hydromassage Bathtubs No.of Motors Total HP I No. of Devices or Equivalent OTHER: l Much additional eleunl ij desired. or us required by the lnspec•tar u/ Wires. Estimated Value of Electrical Work: I► t!o (When required by municipal policy.) Work to Start: AsAil Inspections to be requested in accordance with NI EC 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:) _._. . 1 certify, tmtier the>pttins ztnd penalties of perjury;that the i formutiotr on this upplicatiott is trite a d complete. FIRM N.ANI`%::,ADT Securitv Services,-Inc: LIC. NO.:``1533 C Licensee <P f/,�y 2 !� }�rC2C.L Signatur LIC. NO.: (J/'.app'liccible, enter "c.remnl"in the license number line.) Bus. Tel. No.: (,0 S94-S9OO _ Address: I2"Clinton Dri,✓e-Hollis N.H. 03049" Alt. 'i e!. No.: 603-i94- 90 "Security System Contractor License required for this work; if applicable,enter the license number here:-< OWNER'S iNSURANCE WAIVER: I am aware that the Licensee does not huve 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. PER/LIIT FEE: __ � _ _ _ � { � t f +�,.. ii Date.. .,:! ... .!............. 1 rjORTN 3:0 �.:'e`�o �ppL TOWN OF NORTH ANDOVER o PERMIT FOR WIRING �SS�cHUSE� / I This certifies that ...... .................. t�......... .................. has permission to perform ............................ -'�> ................ wiring in the building of............................... .................................................... at..f-3........ �? -gym ,. ............... l/ ....................::.::.��t.-.-�.:::. ,North Andover,Mass. �G Ae 1 Fee. ................. Lic.No.4//O A ..U.. ..........:...... �....................... ��ELECTRICALINSPECTOR Check # 112 4930 vu(uai ��e Permit No. 3d /SIS —! a�4 pa&zl s Occupancy&Fee Che( BOARD OF FIRE PREVENTION REGULATI, NS 527 CMR 12:00 APPLICATION FOR PER iT TO RFORM ELECTRICAL WORK All work to be performed in accords with the Massachusetts Electrical Code 527 CMR 12:00 (Please Print in ink or type all information) Date i` S To the frispecfor of Wires: Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number Owner or Tenant_��y !// Owner's Address Is this permit in conjunction with/a building`permit Yes No 0 (Check Appropriate Box) Purpose of Building /re,S I,d ria Utility Authorization No. Existing Service Amps Voits Overhead 0. Undgmd 0 No.of Met( New Service Amps Voits Overhead 0 Undgmd 0 No.of Met( Number of Feeders and Ampacity, Location and Nature of Proposed Electrical Total No.of Lighting Outlets No.of Hot fuse No.of Transformers MVA Above 0 In 0 No.of Lighting'Fixtures Swimming Pool grnd 0 gmd 0 Generators KVA No.of Emergency Lighting ti No.of Receptacles Outlets No.of Oil Burners Ba"Units No.of Switch Outlets No of Gas Bumers FIRE ALARMS No.of Zone Total No.of Detection and No.of'Ran No of Air Cond Tons Initiating Devices 'Heat Total Total 'No.of Diposal No. Pumps Tons KW No.of Sounding Devices NoJ of Self Contained --- No.of Dishwashers Space/Area Heating KW Detection/Sounding Devices 1 0 Municipal 0 Other No.of Dryers Heating Devices KW Local Connection NO.of No.of Low Voltage ry No.of Water lHeaters KW S' ns Bailases Wiring d ^,9-t-,/ P �^ No.Hydro Massage Tuds No.of Motors Total HP 1 OTHER: C/lY.bt o2 D E C eir r e d �yp/ INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES ANO have submitted valid proof of same to the Office YESs"NNO - If you have checked YES please indicate the type of coverage by checidng the appropriate box. INSURANCE BOND - OTHER - (Please Specify) Estimated Value o•.N rical Work$ (Expiration Date) Work to Start 6 D Inspection Date R uested Gcf�/ r' Rou �9 J �!/ gh Final Sighed under t e Pe attie of u : 1rY _/ . FIRM NAME C r ` "d ��eG�TzG I/tLC LIC.NO.��� Licensee_ (C 6j�/'Q! alit ��SQ Signature LIC.NO?2 3f/ / n / Bus.Tel No�S3 02 3 Address 6-6 ar,1 t 1v C ! ' t Clr d `/-U3� Aft Tel.No. 4:5'; 301 OWNER'S INSURANCE AIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Mass II General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) i (Signature of Owner or Agent) Telephone No. PERMIT FEE $�6vI �i MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date Building Location S I�GgXGP�G'�GG( �� Owners' Name" Permit#� ; 3 .-- Amount Type of Occupancy L,:$, New 0 Renovation Replacement Plans Submitted Yes El No El FIXTURES d O W U W 3 q as s� aENr i { SIM T HB 3M FLOOR 4M 1'1" � {. 5M 111M 6M MM {9] 7M 3 � � 1�1'1.lryAd\ _ til (Print or / Check one: Certificate Installing Company Name �!� iiL� GAG//�Lf� '� V✓� `� Corp. Address [lL.' Partner. Business Telephone Finn/Co. Name of Licensed Plumber: �f 111:: / Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy a Other type of indemnity ❑ Bond Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above threeinsurance i Signature Owner Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performeete r;Permit I ed for this application will be in compliance with all pertinent provisions of the Massach�ate P °bi and apter 142 of the General Laws. By: Signature Of icense um er Type of Plumbing License Title City/Town Mcense Numner MasterElJourneyman APPROVED(OFFICE USE ONLY I.._I MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS � �,/ Date Building Location G S r�'XG GA�.�( A4 Owners Name'/ y' / Permit# ` r Amount •.. G `� Type of Occupancy New E' Renovation Replacement 13 Plans Submitted Yes No ❑ FIXTURES i I � wz U O �7 p, Z W � O 3 as � �a51v� BASEU ' Date!.. . ... .. a O�"O oT:rho TOWN OF NORTH ANDOVER ° : PERMIT FOR PLUMBING SS�cNus�t 6 Check one: Certificate Corp. This certifies that . !.. . . • • • • . • • • . i,. Partner. has permission to perform . . . . . . :1'';'%: � -- . . • • • • • • • • • • • • • • • .f plumbing in the buildings of . . . . . . . . . . . . . . '.":''`.`' . . . • • • • • • • • Firm/Co. f at . . . . North Andover, Mass. _ it f r riate box: Fees .`. . . . . . .Lic. No.. . . . . . . . . :.._:_., . . . ., Bond ❑ PLUMBING INSPECTOR Check # -% ` application does not have any one of the above gent above application are true and accurate to the I„u,i,u,i,g wum auu installations performed u d Permit I ued for this application will be in compliance with all pertinent provisions of the Massachuslate P 'bi e and apter 142 of the General Laws. By: Signature o tcense um er Type of Plumbing License Title {��ty %al��1 City/Town ),cense um er Master ❑ Journeyman APPROVED(OFFICE USE ONLY �/ Location _ No. Date f 40RTol TOWN OF NORTH ANDOVER ►O' - 9 Certificate of Occupancy $ �7ssNus9 •" Building/Frame/Frame Permit Fee $ wct Foundation Permit Fee $ Other Permit Fee $ TOTAL y _ Check # f - 16 816 �y1 tic. ✓ Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING Ww BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: li4 ( V( Building Commissioner for of Buildings Date SECTION 1-SITE INFORMATION I z 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: M2 Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide R red Provided ReqWred Provided 26 1Z 1 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private 0 Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No 2.1 Owner of Record Name(Print) Address for Service Signature Telephone Q 2.2 Owner of Record: W Name Print Address for Service: O i z Si naxure Telephone M SECTION 3-CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ V/W Licensed Construction Supervisor: �Y� License Number Address A/ Aam,4 1t ����� Expiration Date Signature Telephone 3.2 ,.ggistered Home Improvement Contractor Not Applicable 0 Company Name Registration Number r Address Zz T Expiration Date Signature"" Telephone G) 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 a licitile New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition Ae Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify \ Brief Description of Proposed Work: -17 SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be �3FFICtAL USE O1+ILY ' Completed by permit applicant k , 1. Building (a) Building Permit Fee (1 Multi Tier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbin QAC Building Permit fee(a)X (b) °76 4 Mechanical HVAC / 5 Fire Protection 6 Total ;J` .• U O CP I Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUH DING PERMIT as Owner/Authorized Agent of subject property i I Hereby auth / V to act on My behalf, ers relati o work authorized by this building permit application. Signature of Ar Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, ,as Owner/Authorized Agent of subject a 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 Q�¢ BASEMENT OR SLAB — SIZE OF FLOOR TIMBERS 1 s, 2ND 3RD SPAN s DIMENSIONS OF SILLS �C DIMENSIONS OF POSTS Sf DtIMENSIONS 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 J - FORM U - LOT RELEASE FORM 8-/ o INSTRUCTIONS: This form is used to verify that all necessary approvals/permits frorr " Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *APPLICANT FILLS OUT THIS SECTION APPLICANT PHONE 9, --� moi/ LOCATION: Assessor's Map Numr 6 PARCEL SUBDIVISION � 04 LOT(S STREET__-JWQ,�� ST. NUMBER___/,� USE _Z;;; REC ENDATION. O TOWN AGENTS: CONSERVATION ADMINISrOR DATE APPROVED O DATE REJECTED COMMENTS s� TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE-REJECTED COMMENTS PUBLIC WORKS-SEWERANATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT ,:; / .___ .- X03 RECEIVED BY BUILDING INSPECTOR DATE Revised 9W jm Town of North Andover Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. FOR ROOFING, SIDING, INTERIOR REHABILITATION PERMITS 1) BUILDING PERMIT APPLICATION 2) DEBRI REMOVAL FORM 3) WORKERS COMP AFFIDAVIT 4) PHOTO COPY OF H.I.C. AND/OR C.S.L. LICENSES 5) COPY OF CONTRACT 6) FLOOR PLAN OF PROPOSED INTERIOR WORK FOR ADDITIONS /DECKS 1) BUILDING PERMIT APPLICATION 2) FORM U 3) MORTGAGE PLOT PLAN (MINIMUM) 4) DEBRI REMOVAL FORM 5)WORKERS COMP AFFIDAVIT 6) PHOTO COPY OF H.I.C. AND C.S.L. LICENSES 7) COPY OF CONTRACT 8)FLOOR/CROSSSECTION/ELEVATION PLAN OF PROPOSED WORK WITH SPRINKLER PLAN AND HYDRAULIC CALCULATIONS (if applicable) 9) MASCHECK ENERGY COMPLIANCE REPORT (if applicable) FOR NEW CONSTRUCTION (SINGLE AND TWO FAMILY) 1)BUILDING PERMIT APPLICATION 2 FORM U 3) GROWTH MANAGEMENT BYLAW 4) CERTIFIED PROPOSED PLOT PLAN 5) PHOTO COPY OF H.I.C. AND C.S.L. LICENSES 6)WORKERS COMP AFFIDAVIT 7) TWO SETS OF BUILDING PLANS (one to be returned) TO INCLUDE SPRINKLER PLAN AND HYDRAULIC CALCULATIONS (if applicable) 8) COPY OF CONTRACT (if applicable) 9) MASCHECK ENERGY COMPLIANCE REPORT In all cases if a variance or special permit was required the Town Clerks office must stain the decision from the board of appeals that the appeal period is over. The p pP pP applicant must then et this recorded at the Registry of Deeds. One co and roof of recording PP g g rY copy P g must be submitted with application. .�� , — — - ,�—�"—�•— .ion ( DETENTION i J POND, OUTLET` d \ ;r .t r `' ra 24 CP PIPE f / NDPIPE i �/ �c-�. f / STRUCTURE � �y � .r/ ` T" INV.:=150 STA r "9a \ f -VV. r` 1 Y K ^w f f Pi TOP EL=155.x'3 ,�h INV: EL=15(.25 IIJ ` } ,rte � . Y° // /`s 4��J� Zyr :� � `� F .F /, �.y .A�1• %.+ •r -.� 1 s •'♦ 7 .eu y4� 3 . + fry f��- r ,�^ 4 ' (=•t r`5r,;� Tk� .rk tr d� t,+ t-1¢��'.•tt -„ �/�• ,./Y 'fd ,P'YM# , fr-. RIMA q BUILT CONI OURS' P.}y. ' r °r* r INV; IN 7 42 p, ',#> - l 11, A / �. •4t i,-r' v - ; / r t Q a K•E, t �,f �. i .3 ,+ l / `:.y &S Fs rF /� y >„� t.�X# `e s* it Yti,¢X.•' 3 .X'g d$� .fy7 �* f °„ RECOR6 ,100 FT ° /ell aX YYIDE i�,RETfINING"/ / f rn AAb-BUIL UMIT ,� r * BUFFER;ZONE ,., $s tYi + �t Py Of-;..W n'�t11r�, j _ t .. q; t S b ,y•/r *r /� �fri yY tryor!,* t r. 1 - � s /c a !� c,� t(1"}, t"ryf�.� ''!`�; �� 7�]”] '",'�t .,.7 �� r�,�.� .<�e.:.:f{r� '� cfi•• .i � sR ` � ., �/ �'` w� r .. i � it'f a'r 7C� b 4q•'a,.. rG ���K ;A, 4 ro4si{'r`se ,y.. 1 � d ,�� / e;.4+ .J!„S ,$ �./t �tY'� '1 i�r• � s 1�,�,,ns '�Y qtr '�. �' fit ,i;rk r. ;t y4 � itv •-J��, ^ts�^ ..fit ,"9t- xe i"r r { * s., i 3' ` 4ss?� t r r �r] '. i.i+' 4 y+ e v �+.. . t J w" .x� r 0% rr • f�s_a a� PROPOSEb UMl1' r r l ,�j' s.e.�if��? � cin ,.. ' �:r r � 3:-3< v (� K (T'�s) •° �'' 3. "Y I441xw r T61 'WAL`t t L 4 xI r , ¢x ;F �o av fs s ttt s ' - , rr" 5•.,. dA / � t cf. .�;� any try 'd 2 3C, Y ;.,,-.g,�yy,�;$la+�) � f i. • , • A.} T f�1 _:..F �: 14 4 I i"Y • F£ 4N•."q .� �1•S:�� y rF•'" S.�q v`� ? ,' 1 rJ I J,t �.if AS fi .".�s ? d�*I+RFiE``..v"�� f A ;2r .c' pt rr '' ,'"t.,' \s., t.' r ��x x *s•' c ^y, Ai+`3' a •.. r i' ,,;. F �a 'ert, a .. � _ v�j•1� 6,aF u � {a ?` t rad k cy'a,E* ����� �\ ^�N�.rd�t�r��^��t s+ 4 ., t FrN.' rr. ?-G't' � �•r((�'��F.r�.']�Y� # N. 1 d" 1✓ i 1 �'i-+�vl P f. . i �` �CY 2 •�S, trv. e� hr '�'dr �.- �4 � +a # f P b, I + . LOT*:. A', E t rt "r i) ♦f' v l S�±'r I r.. :X'k i'f *, S-'".}s i r� !.: t .''f�yy..pp � t.. y, a7 r l •fit -'+at dJr 1 w/ 4zx�bt a %,+1 \ r #. ,!''` '' � ],f,� }^�, _',',L 'd'.� � •s. .��`; r. ` i :�'�w '�� a�,,+"'��'• � #�.s,xr>� �,�it�" r Y l r'r�`a, � t 6X, '`•' '.✓ g° -AMp �ti4 S `- \ ' r 4+�'�.L0TsF4l a r• � _ hXIP.: � ' '�W ut a<-s:;A fj- - .,_ 4 �v. � yy •; r �' ;14 1 R I . Vis. - .4. .••' '•L S f .. •. *s j{ '�''r� f ° ,n?Ln 4 M a LAMP,- ~= EE w r L`C. _ t X - 1,tGFY, •tik S `aYa.�. .r 'a M: # !a z r. $� t '!v. v TEL SIONWALK ,r, � yyr w f' �f.`lY ,f;tit .,. f ,•,c ''�k f � 7.T :N� j X'Y¢t r t'.C, ht 'a' i P' _ - PARCEL B �.� AS-•11il11LT L16AIT __ _ ,. � �•� -. AC.®RD CERTIFICATE OF LIABILITY INSURANCE OP ID DATE(MM/DDIYYYY) CDIBU-1 07/14/03 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION O J McCarthy Ins Agency, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE A Hub International Limited Co HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 229 Andover Street ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Wilmington MA 01887 Phone: 978-657-5100 Fax:978-658-9185 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: National Grange Mutual Ins. Co INSURER B: Associated Employers Ins.Co. CDI Building & Remodeling Inc. INSURER C: 10 Commerce Way INSURER D: North Andover MA 01845 1 INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER P L FF TIVE OLI MM/DDIEXPIRATION DATE MM/DD/YY DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1000000 A X COMMERCIALGENERAL LIABILITY TO BE ISSUED 07/14/03 07/14/04 PREMISES(Ea occuurtuence) $ 50000 CLAIMS MADE R] OCCUR MED EXP(Any one person) $ 10000 PERSONAL BADV INJURY $ 1000000 GENERAL AGGREGATE $2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG $2000000 POLICY FX7 PRO- JECT LOC AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $lOOOOOO A ANY AUTO MBH94260RENL 06/26/03 06/26/04 (Ea accident) ALL OWNED AUTOS BODILY INJURY $ X SCHEDULED AUTOS (Per person) X HIRED AUTOS BODILY INJURY $ X NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO EA ACC $ OTHER THAN AUTO ONLY: AGG $ EXCESS/UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR CLAIMS MADE AGGREGATE $ $ DEDUCTIBLE $ RETENTION S $ CT WORKERS COMPENSATION AND X TORY LIMITS ER B EMPLOYERS'LIABILITY WWC5003699012002 10/20/02 10/20/03 E.L.EACH ACCIDENT $ 100000 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes,describe under E.L.DISEASE-EA EMPLOYEE $ 100000 SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $500000 OTHER A Commercial Applica MPS19826 07/14/03 07/14/04 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS EVIDENCE OF COVERAGE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING INSURER WILL ENDEAVOR TO MAIL 20 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR REPRESENTATIVES. AUTHORIZED PRESENTATIVE ACORD 25(2001/08) c ACORD CORPORATION 1988 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02911 Workers'Compensation Insurance Afdavit Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. 1 am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Company name: Address • % city: 1 `• l� Phone# Insurance:Co. Poli, # 44iC ea b Oa®L Com•pname: ane Address Citi? Mom* Insurance.Co. Poli # cy Failure to secure coverage as required under Section 25A or MGL 452 can lead lathe imposition of criminal penalties of a fine ■ andlor one years'imprisorimentas_weLas_c iW penaltiesjol6el n-da.STOP f ejcf4$lMM)aidW __gaiosime understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for caveme veriiflamon. I do hereby certfy under a 'ns and penalties ofipedury that the irdom7atiarr provided above is hue and correct. Signature pate Print name �'� �J Phone. � �✓ Official use only do not write in this area to be completed by city or town official' City or Town ; P_mnMJcensing Q Bfifding []Check if immediate response is required p Selectman's Contact person: Phone# Health Depai Other .'iILail.• t��.,,�„��,,,,�<Zlr! ��, l/�;���1,�,.��r '' BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR ^” 1 Number: CS 069505 Birthdate: 03/26/1973 r' Expires: 03/26/2003 Tr. no: 9692 Restricted To: 00 VINCENT J GRASSO _, // 274 MIDDLESEX ST (.�.•.�e. :� N ANDOVER, MA 01845 Administrator 7w r7("lCil.AUJCIiu..e��' - HOME IMPROVEMENT CONTRACTOR E Re9istratioo: 129011 Expiration: 6/28/02 Type: Private Corporatio Construction i Developlent -Vincent Grasso >= +�= 104 Castlesere Place N Andover MA 01845 1 I I I I 1 I Go 1 Q i I I I I I I I a 0 rutr uU cuul) IUC ro ;l) rut C11443U Ob U1 ' i Q �1(NCS^ l "AV o ¢ROM: XLW. AR M g�LWAA U- �V \ \ 9 rr' / l �' ' G• ✓D;AC �• 0, W 1 oe Ct tIlA v p , \Fz CZC-771-Y T. J"IYe T/TSE/l/S!/� .OND �L V 7- ,P4 i c"J rlve G•�kt'Z 4 7' �'E.o.-Ee[.:Ns /S Gocf+i ca o✓ :.sre'cor.��.stiory�� ras.y�raoas c�,rcerr /N ol Flj,�►l'iY� CE,PT�FY T k'.�T T�✓/Q G.r'SdL�N6 /S.vOT rot.4rE,a J,✓ r�� FE.=�.raG �aaP ,4sazetD .e.�t,a. .�J,PA:✓iV �d,2 S�fewn�O,V FL'M�f' C MM!/it/I�Y P.�f.VGl '� SH OF arm 6/S/�? f�Q SURv� Bcccvo,v ey/,v�,pitl �E•?P/M. Gt`�.vG.:c�EE.P/.(/a SE.Pi'/C'S ,A,cGDYE.C, �fs'aSS,aG�✓SE�T.S Oi.�iO NORTH E Town of .. Andover No. r7 ocH,C �� dover, Mass., ORATED S � BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System ��jj l BUILDING INSPECTOR THIS CERTIFIES THAT........ '0.M.A�....R.............�1��.�.04..OA.....!..�.............................:................:.......... Foundation has permission to erect... � `a 9 on . .. ........... ................. 'R,buildin s ...........................v... ... . Rough ,ee z . ................. .. .. ... .................... .... ....... . ..................s............../3....A....1....A./..h...e....N.. Chimneyto be occupied as......................... .... 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 In pection, 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 Fina' UNLESS CONSTRUCTION START ELECTRICAL INSPECTOR aA Rough ✓vC ` 00 0 ..0'.............:....................................... .......... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RoughFina, No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. _Location k . No. � Date ,Y.. .. Q Cr ;,oRTM TOWN OF NORTH ANDOVER oar p Certificate.of Occupancy $ o • �� ; . Building/Frame Permit Fee $ fI 10 A; Foundation Permit FeeAC $ Other Permit Fee $ Sewer-Connection Fee $ 1 :Water Connection Fee $ TOTAL $ to Building Inspector l( ti .4 7985. Div. Public Works Location X WOC3 Q. t No. C3 Date I ` - N°"'" TOWN OF NORTH ANDOVE � p Certificate of Occupancy $ Sp ' Building/Frame Permit Fee $ y 'Ss�c►+ugEt Foundation Permit Fee $ _ .. Other Permit Fee $ L / Sewer Connection Fee $ __ Water Connection Fee TOTAL C 1� r Building Inspector 7951 Div.Public Works. -fi.rwT�..,.+""'+a„X;v.. ,,,or,�,i�i...�,�,�,�.. ,...,,� .—.,,v--v'+3:N-...•r�aX 'Location "f.�xu� �_ No Date N°RTM TOWN OF NORTH ANDOVER or �a ° Certificate of Occupancy $ k Building/Frame Permit Fee s�cMusEt Foundation Permit Fee $ Other Permit Fee $ A/.0 Sewer Connection Fee $ t lZ _ Water Connection Fee $ 77. `aw . TOTAL $ ZU'?1,1-b i uiid'-g Inspector, p Div. u lic Works No 807 PEWMIT NO. y AP CATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP 4-40. LOT N ?' 2 RECORD OF OWNERSHIP :DATE (BOOK :PAGE — ' -'DNE I SUB DI T NO. �— /.� LOCATI&� ®X' '�© / ��I I,� PURPOSE OF BUILDING f , 1� c �l1'1 IPdNtc�y SicaP(�r.C,2 OWNER'S NAME NO. OF STORIES sf L SIZE X ClD To a �_ r/z _�_ d �— Oy.;�NER'S ADDRESS _ 1 S BASEMENT OR SLAB PQ^�t,v"-e ze(Q g L, ARCHITECT'S NAME SIZE OF FLOORTIMBERS IST I�� j0 2ND �/.f © 3RD a BUILDER'S NAME a f^ Ida [J aL / a � /' - SPAN DISTANCE TO NEAREST BUILDING Al® IF DIMENSIONS OF SILLS t l x DISTANCE FROM STREETPOSTS �[3�/vi� ' S DISTANCE FROM LOT LINES—SIDES REAR GIRDERS X AREA OF LOT or? /1 0 FTFRONTAGE //!7� HEIGHT OF FOUNDATION 1 THICKNESS �i - !oD �a IS BUILDING NEW SIZE OF FOOTING .9aA r" X n� IS BUILDING ADDITION 1 /�/V O MATER;AL OF CHIMNEY IS BUILDING ALTERATION �+� ® IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE 'o IS BUILDING CONNECTED TO TOWN WATER Yr BOARD OF APPEALS ACTION. IF ANY /I) IS BUILDING CONNECTED TO TOWN SEWER eD �V IS BUILDING CONNECTED TO NATURAL GAS LINE J,{S INSTRUCTIONS PERMIT FOR FOUNDATION ONLY 3 PROPERTY INFORMATION REGULATED 8Y PARA. 114.8,& B. LAND COSTBLDG. -1 -� SEE BOTH SIDES EST. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 - 3 � fP EST. BLDG. COST PER SQ. FT. 43'D DATE EE PAID l `^ EST. BLDG. COST PER ROOM i*71-s 1 PAGE 2 FILL OUT SECTIONS 1 - 12 s 116 SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ''ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULT IT FOR FRAMUBUILDING PLANS MUST BE FILED AND /JAPPROVED BY BUILDING INSPECTOR •'DATE FILED DATE : *�F-FEE PAID I«o OUILDING INSPECTOR 81GNATURE N ORA HORI ENT (�4� .0 OWNER FEETEL.N 0� �"2 zoo /_ PERMIT GRANTED CONTR.TEL.N. L" �3 19 CONTR.LIC. . 0 Bm11'S1w fa eAv- DM FRAME PERMIT$ rJ tw A BUILDING RECORD 1 QCCUPANCY t� > 12 SINGLE-.F.AMtLY ,- STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS DISTANCE FROM MULTI FAMILY': OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS WITH:PORCHES, GA- APARTMENTSRAGES. ETC. SUPERIMPOSED. THIS REPLACBS:P,LOT CONSTRUCTION 2 FOUNDATION I 8 INTERIOR FINISH Y ti — 1 CONCRETE __ d1 2_ 3_ r - CONCRETE 8L K. PINE BRICK OR STONE HARDW D PIERS PLASTER —�-- ` _ DRY VJAIL �`' I--• �_ � Taw ` �' 3 BASEMENT AREA FULL -FItT,B M T' AREA '- _ r �• �' y, 1/1 1/1 FIN, ATTIC AREA y NO B M T FIRE PLACES'- HEAD ROOM ;M(DDERN KITCHEN ` `, '•._S 4 waus FLOORS CLAPBOARDS x B 1 2 3 r=`•`4;`, DROP SIDING CONCRETE �— WOOD SHINGLES < ;EARTH ASPHALT SIDING HARDW D ASBESTOS SIDING _ COMtACN �• ' } f VERT. SIDING AS PH. TILE t STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY b ATTIC STIRS. 8 FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. ..Z STONE ON'.MASONRY WIRING STONE ON FRAME _ SUPERIOR I--i POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE IHIP BATH 13 FIX.( GAMBREL I MANSARD TOILET RM. (2 FIX.( e FLAT I SHED WATER CLOSET ASPHALT SHINGLES X LAVATORY WOOD SHINGES KITCHEN SINK ,• _ - - SLATE - NO PLUMBING _- TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES _ TILE FLOOR X NILE DADO 6 -,FRAMING I, 1 1 HEATING WOOD JOISt'i PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. SCOTS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 04, �. y�� f { 7 NO. OF ROOMS GOIAL 04, B'M'T 2nd _ ELECTRIC ist 13rd I NO HEATING NORT#j Tow 0. of Andover No. ©18 C . f. O - LA E rt dower, Mass., 19 qS COCNICHE WICK A0RArEO ".P�\�'�� H BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.. c?kwcacx�....Q-!�AUM ....�P� ' ............................... ........................ ................ .........1 "" Foundation has permission to erect.. .... iyAk buildings on .. ? .....�cs�cwcx>>......!K ,....... �-°`f'..'4'J.... Rough to be occupied as.. Chimney provided that the person accepting this perMit shall in every hspec 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. PERMIT FOR FOUNDATION ONLY PLUMBING INSPECTOR h VIOLATION of the Zoning or Building Regulations Voids this Permit. REGULATED BY PARA. 114.8-S. B.C. Rough �� a + � FEE PAID Loi; Final PERMIT EXP N 6 MONI s L ELECTRICAL INSPECTOR UNLESS CON TR Rough ....... Service Final ��A,`t►�gu1���G BUILDING INSPEC OR Occupy Building PERVlo AS INSPECTOR k Occupancy_Permit Required to O py g c a` FEEDisplay in a Conspicuous Place on the Premises — Do Not Remove DA'• Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT_ I 4 y FORM U - IAT R=ME 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***************** APPLICANT: f O xLj o a a" (0 V Phone LOCATION: Assessor' s Map Number Parcel Subdivision f b X IndOO Lot (s) L{ Street St. Nu-mer 43 *�e�t�k�c�ci *ic*�k�k�kic**�c�c�c�t�F�ir**OfilCial Use Ont.y***************icicic*Wic*** RECOMM.ENDA IO S FTOWZAG- S: Date Ann.-roved Conservation Ad inistratcr Date Resected Cc=e: r I �-� Date Approved Town P'_annerate ; D Re ec ze.. ccI1T.'ien,:s kJlh Date Approved Fcod =^=_P.ector- ealth Date Reiec-ed Date Apprcved Se=-::.c Ir._;.ec- - ea_t~ Date Rej ectc_ Co � a Wc,ks - sel.-er/water ccnnect-ons - drivewa_: Permit- Fire ermitF're Derar--.:pert J Received by Building Inspector pat` 3 I 1 6�j 1D �f Z// 782 i Sy�bo w � S N P \ pAk v i L Zp• � S f1EREBY CETT/FY TO Tye T/TGE 1A/SU.POW ANO RL or 1,:,4 4.,v TtJ T.'�E B.4N,N Tf/gT THE OwELLlu6/S COCATEO ON TiyEGOT.IS S.f47I►'NANO Tir/.4T?OGSES CO.t/FGZPiY! /N !Y/Tf/ T.+/E ��"�✓ OF�G.N.voo vG�,ZON/.vG ,c�EGvGAT.fJ.t/,•$' h�6rI.P0/.c/G SETBAC.t'S FE0�1 ST�EET,3'� LOT L/�✓ES.'' /vO,e r,{/ �,vG,p ,C�! �q 3 S• Xf LOG4FTE0 /.y T ETFEOE AL FGG�DO H ZA OSA PE aT O.PAil�/V FOP �Sf/GwN OiV ifi�+�' L' MMt/N/TY!�.•INGG 'R OFMA'S` 47-tFO G/L/93 3 � P r�SS`O� lq�O SURV�OP BOl�,voq esu�,vFo.Q,is- �E.P,P/�1.4Gt'E'.vGis�EE,P�.t�6 SE.?/�/l'ES .4riov rA,rE,y ,�,Po� isr�,vc .eEcoeos. G� �-4.P,(� .ST,PEET A.t/OOYE.� A'1.4SS,4C,///SETTS O/8/O Ja/Ty"'�✓'�,�eG'T"i!'t_.Ys�� - wW'e.�r.,.. s_.�---�=5� �.'.s1 ^`�'"��V� Y � _ Location No,. —C? �. Date a *ORT►, TOWN OF NORTH ANDOVER 3?0.1,,** ,.�tioo� o . ' p Certificate of Occupancy $ WITP�o ,• Building/Frame Permit Fee $ ACHU Foundation Permit Fee $ 71 ZS N Other Permit Fe��`'"1 $ j .r Sewer Connection Fee $ Water Connection Fee $ ' TOTAL $ 7-4� uiiding inspector Div. Public Works KAREN H.P. NELSON or' ° Town of 120-Metin Street, 01845 Dirrcmr ;. (508) 682-6483 BUILDING ;,.a.;.e,..,y NORTH ANDOVER CONSERVATION ss,°" 5` DIVISION OF HEALTPLANNI NG PLANNING & COMMUNITY DEVELOPMENT PL:1\KI CHIMNEY APPLICATION AND PERMIT DATE PERMIT LOCATION OWNER' S NAME �jy G�'l,Gll�v BUILDER' S NAME MASON' S NAME MASON' S ADDRESS MASON ' S TELEPHONE MATERIAL OF CHIMNEY >�.. INTERIOR CHIMNEY Com• - ,A1 EXTERIOR CHIMNEY I NUMBER AND SIZE OF FLUES THICKNESS OF HEARTH o� Will chimney or fireplace conform to requirements of the code and have rules and regulations been received:. .iz DATE SIGNATURE OF MASON ,�� �_ 0NTR. LIC. EST. CONSTRUCTION COST CONTRACT PRICE �� PERMIT GRANTED 4 2-A 9 S- FEE J f ROBERT NICETTA, BUILDING INSPECTOR INSPECTED REMARKS } SOLID BRICK REQUIRED THIS PERMIT MUST BE DISPLAYED ON THE PREMISES v NORTH `. own of over 0 No. 0-18 c) : A _E dower, Mass., A- COCMICMEWIC N '7 ORATED PPa\y'L� BOARD OF HEALTH ! H , Food/Kitchen Septic SystemPERM . IT T i i BUILDING INSPECTOR THIS CERTIFIES THAT . Qkl ?DC.X�....21 !41 . .. Q'.'•�........................................................ Foundation buildings on . ................. .�-° ..4 ... Rou ,, ►'� has permission`to orect..�....4 ?41) g . .tK1t�iwl n. 1�.Gt 1 .. .' : Chimney.. to be occupied as. .t.hl► tlE. ..................... In provided that the person accepting this per�iit shvery lespec conform to the terms of the application on file of n of the Codes and By-Laws relating to the Inspection, Alteration and Construction of provisions g this office, and to the p Y Buildings In the Town of North Andover. PERMIT FOR FOUNDATION ONLY PLUMBING INSPECTO11 REGULATED BY PARA. 114.8-S. B.C. ug �.;��_s VIOLATION of the Zoning or Building Regulations Voids this Permit. OGS �- Trial PERMIT EXPIRE 6 MONI FEE PAID LOQ 5 ELECTRI AL SPE R S CON TR PERMIT FOR FRAME/ !k . .. ... . .. C 3 za FEE PAID' << ' BUILDING uvSPEC ORDA Occupancy Permit Required to Occupy Building GAS INSPECTOR 1 Rough Display in a Conspicuous Place on the Premises — Do Not Remove na 0 (6- ZL— c No Lathing or Dry Wall To BeDoneFIRE EPARTMENT Until Inspected and Approved by the Building Inspector. Burner PLANNING ��I SINAL CONSERVATION ►�`�'� 6�1� FINAL Street No. '. cr- Smoke.11 Det. `CQ SEWER/WATER-77 Cd -FINAL DRIVEWAY ENTRY PERM IT /" f t, d. _ .�'OCt t CU_ PANCc YYa,CERTIFICATE OF USE & fkTown ofNorth Andover Ut '„ff t3 pY►{3 ) x t„r�F�2'>,;,�i}s} - t ? Building Permit Number��' �7 Date' `lgg5 4E. THIS CERTIFIES THAT LDING LOCATED ON THE BUI �D3 t'L>>t k14yA I�.�V�-` '4� off k ; MAY BE OCCUPIED AS Z RACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE'ANDi 1 , SUCH OTHER REGULATIONS AS MAY APPLY. + r o� ..•r r �� CERTIFICATE ISSUED TO P _41 t •� .r�r O i - a3j. $` gal i ADD S _ rrl ¢ a• • rrti«1t3L ��� F +kl If�. Ft X i s ? o. 'a �.� ui ding Inspector, , g I t Z:51 � {�c"s,�✓,k€ry tz, {y4' c� ¢. � � "'�t(F{"'_; i ;. � rF��: ,y � � � � �''�f`���” r i , dt �f r at r'� � $• b ., 1 i fir�,kr ! . W L Kx��� tix ki# g±r I {g4{j ! ik j moi' � �Bx+ t � "-#» 1�`.� r 1 '. # ••� year 1�+ { 4 e � , i f \ l Date. "OST„ TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACIIUS� This certifies that . . . . . . . . r11- s-rr^G ��}—`�. . . . . . . . . . . . . . �t has permission to perform . . . . . . . . . . . . . . . . . plumbing in ,he buildings of . 17771-4 --k . . . . . . . . . . . . 4 _ .-� . . .�No>�rth Andover, Mass. at . . . . . . . . . . . . . . . . . . . . . . . �.` Fee . . . . .Lic. No.. �ti . r j : . . . . . . . . . . . PLUMBIILG�I 6ECTOR Check # 5159 a.� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) 4, , Mass. Dat ZL�G 2 P it # Building Location Owner's Name;Ti7 xAeLfr' Type of Occupan t S+ 17 E tl A L_ New ❑ Renovation ❑ Replacement R Plan Submitted: Yes❑ No ❑ FIXTURES 2 N < = Y N O z Z W W N O C7 ¢ N 2 N < ¢ _ ~ N Z 0 z 2 ` d O O � W f. LU ¢ u. F- J N H N = N H V W N Y < N a 3 X V z0 O ¢ d W 0 u. ¢ W F� (� W N D . J N ¢ t--cc < Y G ¢ G W ¢3: o F- O = C O H F. = C C N = = W O Q Z < F < < = N H < < O < J J < ¢ ¢ a < o < F- Y J O SUB—BSMT. BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 3 STH FLOOR Installing.Company Name A00>EeT • jPntr t4-rA?_0 Check one: Certificate Address .10 Cf;AC H m a n) PJ ❑ Corporation IY) E%N o ie-/0 fi l A 0 a VLI/ Ell,2-Arm/Co. . Business Telephone -�7�Z-�97 l 2-Arm/Co. Name of Licensed Plumber ( r�-3 Foe T fig ,rolmA req oo INSURANCE COVERAGE: I have a current 1' bility insurance policy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No ❑ ' If you have checked yes, please /indicate the type coverage by checking the appropriate box. A liability insurance policy kd 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: Owner ❑ Agent❑ Signature of Owner or Owner's Agent 1 hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations #ormed under the permit issu for this application will be in compliance with all pertinent provisions of the Massachusetts State Plum ' g e and7 �7 pteof the oral Laws. By re of Licensed Plunumi Title Type of License: Master jam/ Journeyman ❑ City/Town APPPOrVED OFFICE U E ONL License Number �3 3 5 BELOW FOR OFFICE USE ONLY FINAL INSPECTIONS SKETCHES 1 PROGRESS INSPECTIONS FEE NO. APPLICATION FOR PERMIT TO DO PLUMBING NAME &TYPE OF BUILDING LOCATION OF BUILDING PLUMBER PERMIT GRANTED DATE 19 PLUMBING INSPECTOR Date.��./c� I HOR7q <,��° •�tio TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACMUS� n.. i � This certifies that . 1.'� . .". . . . . . . . .?'-I . "�:-``.'" . . has permission to perform . . `� r- . . . . . . . . . . . . . . . . . plumbing int the buildings of . . . . . . :� �'` 1 �% . . . . . . . . . . . at . . . . . . . . . . . . . . . . . . . .< .- . . : . . ... . . . . . . , North Andover, Mass. Feed (" . . . . .Lic. No.. . . . . . . . . �--�-'``al . . . . . . . . . . . . . . PLU I171 SPECTOR Check # / 5835 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS /,,,Jj � / Date _ Building Location� ,Y S 1--0 -1)e Owners Name vl' Permit# Amount 3 e; i Type of Occupancy New Renovation 1-1 Replacement Plans Submitted Yes No FIXTURES x � H z w � U � w x Ua z A w H � z � � o SLFIHMC �ASIHIVIIVI' / / M FLOM . za FLOOR ' 3M HA" 4II Hi" i 5M HA" 6TH mom 7M FLOOR, SIH FLOOR (Print or type) Ul,� r Check one: Certificate Installing Company Name / ✓� �Gj,¢L/ (�/�� ❑ Corp. Address `� - i/G� Partner. / r / usmess Te ep one -fl k Firm/Co. Name of Licensed Plumber: Agz"ZA16����/ Insurance Coverage: Indicate the type of insurance coveragee by checking the appropriate box: Liability insurance policy Other type of indemnity Bond El Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner ❑ Agent 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 installations performed u de I ed for this application will be in compliance with all pertinent provisions of the Massach tate P bi e and apter 142 of the General Laws. By: igna ure o icensea riumoer Title Type of Plumbing License lal;fie City/Town License um er Master ❑ Journeyman APPROVED(OFFICE USE ONLY Office Use Only of Tummnnwral#h of Permit No. -z-V-1 lepart ent of Ilubl-tt Eafettj Occupancy&Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMA 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date �a R or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below Location (Street & Number) ��-� 1-/ Fax x wc,Go & Owner or Tenant k B x CL/oG �� ��✓�f 4- 73 Owner's Address `fid T Is this permit in ccnjunction,with a building permit: Yes `_' No LJ (Check Appropriate Box) r Purpose of Building Utility Authorization No. Existing Service Ar/os _J Volts Overhead Undgrnd No. of Meters New Service 2c2 ) Amps J �loits Overhead r Undgrnd ��No. of Meters 2 Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work too Total No. of Lighting Outlets I No. of Hot abs I No. of Transformers KVA I No. of Lighting Fixtures I Swimming Pcoi ACove.— ln- grnd. _ cmd. Generators KVA No. of Emergency Lighting No. of Recebtacie Outlets I No. of Cil Surners I Battery Units I � No. of Switch Cutlets j No. of Gas Surners FIRE AL-.RMS No. of Zones No. of Air Conc. `otat No. of Detection and No. of Ranges tons Initiating Devices iNo of `'eat Tota! Totai No. of Disposals Pumos Tons ?CIV No. of Sounding Devices No. of Self Contained No. of Dishwashers SoacelArea Heating <W Detectton/Sounding Devices I I — No. of Dryers I Heating _ng Devices KYV Local _ Connec::en Other i No. of No. Low Voltage No. of Water Heaters KW Signs Sa:!as:s Wiring No. Hydro Massage Tubs ! No. of Motors Total HP OTHER: INSURANCE CCVERAGE: Pursuant to the reduirements of Massacauset:s general Laws I have a current Liability Insurance Policy including Comc:etec Ocerancns Coverage or its substantial eauivatent. YES = NO = I have submitted valid proof of same to the Office. YES = NO = it you nave checked YES. -,lease indicate the type of coverage by checking the appropriate box. INSURANCE = BONO = OTHER = (Please Scec:t•:j (Expiration Dates Estimated Value o !ectr al Work s Work to Start G 1a� — Inspection Date =ecuestec: Rough Finai Signed under to Pen ities of perjury FIRM NAME K/ A."C.+e (. G �C Lic. NO. � Licensee Signature G Si 1-!C. NO. / I Bus. Tei. No. AddressT77'� �V n All, Tel. No. OWNER'S INSURANCE WAIVER: I am atidare that the i:censee toes not have the insurance coverage or its substantial eeuivalent as re- quired by Massachusetts General Laws. and that my s:crature on :rs zermt application .valves :his redurement. Owner Agent (Please check ones 6/ i' Teiechone No. PERMIT FEE 5 (Signature of Owner or Agents Date.. . 1.; . .% ......... NORTH oft. •o .OM1 TOWN OF NORTH ANDOVER PERMIT FOR WIRING SSACNuSEt This certifies that . ". ............. = ' ........ ....... ............................. has permission to perform .. �....Ws.e wiring in the building of...: >* ... D CU � at. . ... �; �`�... .... .. .....4.)........,North Andover,Mass.Z FeeATr.......... Lic.No.1-1.6-1A.............................................................. ELECTRICAL INSPECTOR ? WHITE: Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File `MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTIN(`, 1 (Print or Type) NORTH ANDOVER . Mass. Date -F .r 9� lhuilding Location �p3DXLVOD� � Permit # Owners Name —Aga New Renovation D Replacement Plans Submitted ❑ �=� s FIXTUP_S N a dl W 0 cn uC 0 CC O � w = l� W usWil tu O U m F' to • Cr t- d y. x O f cc W Z RI N N W W O Q O W l to t3 W - .-' F• N O � y W N ti: W Z V _W os W W 0'f O H Z j Z W W O T to — W W d 2: 0 O O W < O ; Ou Y W I-- =10 -ZO C W ; a a O SUQ—[3S�.IT. 5ASEMEttT Ay. I ST FLOOR 2ND FLOOR 3RD FLOOR I 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TR FLOOR STRFLOOR - (Print or Type) Check one: Certificate Installing Company Name ANDOVER PLG . & HEATING CO. , Nf . Corp. 2122 Address 573 1 /2 SO. UNION ST. Partner. LAWRENCE , MA. 01843 Firm/Co. Business Telephone: 508 685-8383 Name of Licensed Plumber or Gas Fitter GEORGE 1-AROSE Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Q 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 coverages. Signature of owner/agent of property Owner Agent 1 hereby certify that aU of the dcuils and Information 1 have submitted (or entered)in above application are true and accurate to the belt of my kr+owlcdse and that sU plumbing work and InsuUations petfomied under Permit irseed for this application wiU be In Compliance with all Mtl�ent Provisions or tho)dauachusetts Slate Cas Cuda and Qsaptcz 14:of tho Cenctal Laws- By TYPE LICENSE: Plumber Vr- Title sfitter Signature. of Licensed City/Town: Master Plumber or Gasfitt,er Journeyman APPROVED (OFFtcr- use ONLY) License Number 621 � Date{::�'-'`�`.�./ ../ �� NaaTH TOWN OF NORTH ANDOVER { Cr ph`��iD ,e 1ti0O�A PERMIT FOR GAS INSTALLATION �9SSACHuSES h This certifies that . 5�..?' . . .'.. . . .70". . . -►� -r . . . . . . . f has perm for as installation - - ^ t P g ;; ; �;- in the buildings of . . . . . at �3. `''- ., North Andover, Mass. t . . . . . . . . . . FeeK. . . . . . Lic. No.rte' . . . . . . . . . . . . . . . . . . 08/22/97 14752 20.MS I► CTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer 3055 Date. � �, :�:/ r-...... .. / ,.. r i A i f f "ORT" TOWN OF NORTH ANDOVER a �O♦4��io ,s�hOO PERMIT FOR GAS INSTALLATION S C14 NSTALLATIONSAC14 This certifies that . . . . . . ,�.. . . . . . . . . . . . CT. has permission for gas installation . . .�?R. .) !?. . . . . . . . . . . . .N. . CU in the buildings of . . J. � ./. ... . . . ..«. . . . . . . . . . . . . . . . . at . .?., . .t��, L:: {' . . . . . North Andover, Mass. Fee. ./.5,.: . . Lic. No. 9. : AS INSPECTOR WHITE:Applicant CANARY:Building Dept. PINK:Treasurer _ MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO ASFITTIN* G (Print or Type) NORTH ANDOVER Mass. I Date 14uilding Location_ 40 ;l//gyp Permit # 3 Owners Name ' New Renovation j] Replacement Plans Submitted n FIXTUP=G • � W N x as 03 0 0 to � tu, m ~ z as t- a �- z %� O N ts; 1 tq N N pat y�j O O 0. W I- tA O W .[ .. ,. t- to :" 4 W w 4 j x d = cc us W W a W I.. w I- s Nf y t�t a ,rt > c W < c < < 0` o W a o w t=- tr x o 0 cc > a n. 1- o SUR—BSMT. BASEMENT 1 ST FLOOR 2ND FLOOR 3RD FLOOR I 4TH FLOOR STH FLOOR 6TH FLOOR TTK FLOOR STH FLOOR (Print or .Type) Check one: Certificate Installing Company",Name ANDOVER PLBG. R HTG. CO. , INC® Corp. 2122 Address 5731S0. UNION STREET Partner. LAWRENCE , MA. 01843 Cf Firm/Co. Business Telephone: 978 685-8383 Name�of�rLicensed,"Plumber, or. Gas Fitter GEORGELAROSENON _ I lsUrancP Coverage Indicate the type of insurance coverage by checking'.the appropriate box: Liability insurance policy EED Other type of indemnity = Bond � Insurance Waiver: I , the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner 17 Agent E l hcteby certify that all of the details and information I have submitted (or entered)in above application are true and accurate to the test of my knowledge and that all plumbing worts and installations perfetmed under Permit sus ed fox this application will--0e in nom ace with all r=tlnent Chapter of the Massachusetts Slate Cas Code and upter 142 of the General Laws. —' By ,YPE LICENSE: Title Plumber Gasfitter, Sign ure of Licensed City/Town: Master Plumber or Gasfitter Journeyman 5983 APPROVED (OFFICE USE ONLY) Y.1cense Number