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Miscellaneous - 68 INNIS STREET 4/30/2018
/ 68 INNIS STREET / 210/098.D-0036-0000.0 J i i Date . . .7. TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that . . . . . h�-re? . . . • has permission to perform . .,,�l<.l wiring in the building of . . . -7- rl.�... . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . .. •-7 . . . .. . . . . . . . ,N rth Andover, Mass. Fee . . b-S�Lic. No. . 1:7� 5;� '. . . . . . . . V j . . ELECTRICAL INSPECTOR Check# 5 344 10951 Commonwealth of Massachusetts Official Use Only Permit No. Department of Fire Services Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leaveblank 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 INFORMATIOl9 Date: 71/2//,�,, 1J City or Town of: NORTH ANDOVER To the Inspector of Wires: i 1 \ By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) �,/V/►/� S � i Owner or Tenant T �O C,l C Telephone No. Owner's Address - \ Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building �T_(-,q.�,��C Utility Authorization No. Existing Service �7mci Amps I�p� /,2�(c_Volts Overhead j� Undgrd ❑ No.of Meters _L New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Td fe— ^A- w + S-yz Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets S No.of Hot Tubs Generators KVA Above In- o.o Emergency Lighting No.of Luminaires Swimming Pool rnd. ❑ rnd. ❑ Battery Units No.of Receptacle Outlets 6? No.of Oil Burners FIRE ALARMS No. of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices No.of Ranges No.of Air Cond. C Tonal No.of Alerting Devices No.of Waste Dis osers Heat Pump Number Tons KW No.of Self-Contained p Totals: Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Dr Heating Appliances KW Security Systems:' y No.of Devices or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications No.of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: 7102Z/Q?= Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE PITBOND ❑ OTHER ❑ (Specify:) I certify,under the pains and penalties of perjury,that the information on this application is true and complete. FIRM NAME: . -ra-n, G' 'ec , Rr ` -g•✓ LIC.NO.: (2 Licensee: y.V,o ' �R G.e-,, Signature � �� LIC.NO.: (If applicable,enter "exempt"in the license number line.) Bus.Tel.No.: `31 --53to O617 Address: r/ - g?ra6SSS *Per M.G.Lc. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑ owner's agent. Owner/Agent PERMIT FEE: $ Signature Telephone No. v r ._ • YMS.J.Vl.�1'.J.j,C.(+••sf(��'..•/�••7.'1j1j-I��''f�J.ryCyJ••.AA••��•• ®•�•�ay��.]•��{- +�' • IJ� 'lJ.v.J.�.L7 J-o.�'+J.®J�; � '_ , . •• • oxv . ��ssetX-� _ �'aileQ-•j � �e-zuspectZou xes�ui�'ec�($�O.UQ)�j � hspecta s'co fs: (JCnsp eaOre SIB ature o.pi#als) pate Iq �'asse�•=-j �`ailec�--j � �eans�ectiort,xer�uixe�($�O.OQ)-•j � . �'ns�,ectars'comtizextfs; ([fiastiecfoxs' zgnafure-x<QzEiaXs� .� ' 17//pate �' 3.TJNDAR GROW INSROKOXXON. Passed-j +afIec�- j Xte-ins eetio�xetJuirec�($SD.OD)�j 1 r'nspectors'Comments: (lnspectors', ignatuxe-+ao anitiaTs) Data ,a�7�JP3�CX7fO�1'--;gEXt,�►1XCz�: asset.—[ � �`a�lect•-j � �e fuspectionxequixe�(��OAD)�j � ' ts,�ecf�rs'eoXnmep�fs; . (inspectors'gigaature••io W-Uals) Date ssect�-� � �+.'aztec�--•[ ]. 'Xte�nspecttoxtreguiz'e�($50,OD)�[ � �ecfoxs'coxnx>ztafs; _ . ' S ' �lus�p ector 'f9zgnatuxe xto initials} .iUate ' a Ol.TA GO.ARE TO 13EYMPT OVT.AM MET WRITE I`TM APXA TO M INSPECTED 19 NOT The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): y (� � �C�N r C �. < Address: (A—) 1 City/State/Zip: ( (p p Phone#: — d C 7 Are yo n employer?Check the appropriate box: Type of project(required): 1. I am a employer with L-( — 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ 1 am a sole proprietor or partner- listed on the attached sheet.1 7• ❑Remodeling n 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.❑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.] f employees. [No workers' comp.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. #Contractors 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 employees. Below is the policy and job site information. Insurance Company Name: 74 4q,r-y— --cv Polic #or Self-ins.Lic. #: Y 762 (. )e_a,o s- --n!j 9 Expiration Date: /2 I Job Site Address:_„S{ ✓�; T �/ 4-2 /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. t do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. Signature: � Date 7`(02 Phone#: ci2� Official use only. Do not write in this area,to be completed by city or town official. 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. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, 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 an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house 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." Additionally,MGL chapter 152, §25C(7)states"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 rt 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 r 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 P Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. 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 burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like 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-MASSAFE Revised 5-26-05 Fax#617-727-7749 www.mass.gov/dia Date. .. . . �.v. .. NON7H �Oya4 O ..ao ,a 1ti0 TOWN OF NORTH ANDOVER ~ 9 • - PERMIT FOR GAS INSTALLATION . 9 SACHUSESA P i This certifies that 00 Q . . . ! . . .^.`. . . . . . . . . . . . . . has permission for gas installation Grfi�. . . . .T�Y`.`�t . . . in the buildings of . . . . .�0.0 ' ��. . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . .�?.b. . .:�-:N'�1�. . . �. . � . . . . ., No Aadover s. Fee�U,9� . Lic. No.KD . . . . A . . . . . . . GAS INSPECTOR Check# -3324 8257 a MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITYel— I MA DATES `� PERMIT# JOBSITE ADDRESS OWNER'S NAME GOWNER ADDRESS $ �! n,r� ,S S-I' TE 97_ fid$ _aSa3 FAX11 TYPE OR OCCUPANCY TYPE COMMERCIAL EDUCATIONAL ® RESIDENTIAL PRINT CLEARLY NEW:U RENOVATION:El REPLACEMENT: PLANS SUBMITTED: YES[_I. NO D APPLIANCES Z FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER . FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT TEST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHER _. _ - L _ ! INSURANCE COVERAGE -- 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES In_ NO 1 IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY CN]_ ' OTHER TYPE INDEMNITY © BOND ] OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER DI AGENT I SIGNATURE OF OWNER OR AGENT hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate 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 Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME a**re"4-S Dom► f LICENSE# t�Sls� I SIGNATURE --- i MP EMGF JP �f JGF LPGI ! CORPORATION Q#I, PARTNERS (PZ �_ ( LLC[ f# - COMPANYNAME: 1OA \ �+�+n c`} l— ------- CITY _--_,_ C— -__ �1 I ADDRESS � L!9 c C CITY STATE !M ZIP D I Z-� TEL FAX _ — CELL b�$a$o2` EMAIL _ – ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes.. JN _ THIS APPLICATION SERVES AS THE PERMIT ❑ FEE: $ PERMIT# PLAN REVIEW NOTES r _ A The Commonwealth of Massachusetts Department ofIndustrialAccidents Office of Investigations 600 Washington Street Boston,MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information L Please Print Le ibl Name(Business/Organization/Individual): Address: d- l�t Y4 6 City/State/Zip:_ $>\ A C t cam-- Phone#: 7 Z1612 Are you an employer?Check the appropriate box: Type of project(required): 1.Wani a employer with 4. ❑ I am a general contractor and I ' —� 6. �ew construction employees(full and/or part-time).* have Hired the sub-contractors 2.El am a sole proprietor or partner- listed on the attached sheet.# F1 Remodeling ship and'have no employees These sub-contractors have 8. ❑Demolition workingfor me in an capacity. workers' comp.insurance. Y p t}'• 9. ❑Building addition [No workers'comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their ME]Electrical repairs or additions 3.❑ I am a homeowner doing all work right of exemption per MGL 11.0 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' comp.insurance required.] 13.[i 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 ate doing all work and then hire outside contractors must submit a new affidavit indicating such. #Contractors 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 employees Below is the policy and job site information. �""y 1 Insurance Company Name:. I�P/4�r t Policy#or Self-ins.Lie.#: 4 .�� 93 a 3j Expiration Date: Job Site Address: 6 J �� 1S `ST—` V, An 40VCity/State/Zip: ►N1 Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder 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 maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido hereby cerJ* un r the pains and penalties ofperjury that the information provided ove�,srue and correct. SiMature: Date: Phone#: Official A&only. Do not write in this area,to he completed by city or town official. 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#: i j,. Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, 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 an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house 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" Additionally,MGL chapter 152,§25C(7)states"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-contractors)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 Please be sure that the,affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. 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 like 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 Offlce of Iavestfgations 600 Washington Street Boston,MA,02111 Tel,#617-727-4900 ext 406 or 1-877MMASSAFB Revised 5-26-05 Fax#617-727-7749 wwwanass,govfdia Date. .'? .. .. . . .. . .. . NORTH All Oya��ao ,e,ti0 TOWN OF NORTH ANDOVER ' PERMIT FOR GAS INSTALLATION o. � y . S SACH This certifies that . . '"? u . .} c. . ... . . . . . .. . has permission for gas installation A—.3:: . . . . . . . . . . . . . . . . . . in the buildings of ... . . . .. ..... . . . . . . . . . . . . . . . . . . . . . . . . . . at . ... . . . . . ... . . . . . . . . . . . ., North Andover, Mass. Lic. No../o-P. . . . . �¢. . . . . . . . . . . . . GA I�SOECTOR Check# 6434 i MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) - — NORTH ANDOVER ,Mass. Date 6/05 2008 Permit# �° Building Location 68 INNIS ST Owner's Name JOHN TOCIO Owner Tel# 781 844 7631 Type of Occupancy RESIDENTIAL New 1:1 Renovationz Replacement Plan Submitted: Yet No[:] FIXTURES x U W W W w� O O M x zJ rs H F > z z p F t� Q O W rs p O O O w F ! $30.50 ax > ¢ � ( 44 W Z —j ¢ x > O Q QQ J ui z a ¢ ¢ OO W O w p Gi U � > Q R H s, SUB-BSMT BASEMENT 1ST FLOOR 1 2ND FLOOR 3RD FLOOR 4T"FLOOR 5T"FLOOR a 6T"FLOOR 7T"FLOOR 8T"FLOOR Installing Company Name Eastern Propane & Oil, Inc Check one:' Certificate Address 131 Water Street Corporation Danvers, MA 01923 FlPartnership Business Telephone# 800-322-6628 Firm/Co. Name of Licensed Plumber or Gas Fitter BRIAN KIMBALL INSURANCE COVERAGE: I have a cur liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. Yes ✓ No ❑ If you have c ecked yes,please indicate the type coverage by checking the appropriate box. A 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: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all of the details and information I have submitted(or entered" ntered ve application are true and a rate to the best of my knowledge and that all plumbing work and installations performed under the permit' d for tris application l]b compliance with all ertinent provisions of the Massachusetts State Gas Code and Chapter 142 of t Ge era]Laws. _ �} By Type of License: •dumber Signature of Licensed Plumber or Gas Fitter Title as fitter 1210 • -Master License Number City/Town •-Journeyman APPROVED(OFFICE USE ONLY) Date. . .r. . . ..n . ... .. HORTM p TOWN OF NORTH ANDOVER • - PERMIT FOR GAS INSTALLATION I,SSAC HIUI This certifies that . . . . . . . . . . . . . . . . . . . has permission for gas installation . . . . . . . . . . in the buildings of . . . . . °`'e'`"v. . . . . . . . . . . . . . . . . . . . . . . . . . . at . . . . . . . . . . . . . . . ( ' , North Andover, Mass. Fee`�1 Lic. No.L/���1d . V /�/�;�,�'`'1!. . . . . . . . . . . . GAS INSP' G OR Check# 6109 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) it1 — NORTH ANDOVER Mass. Date 9/06 2007 Permit# �c'9 si Building Location 68 INNIS ST Owner's Name JOHN TOCIO Owner Tel# 781 844 7631 Type of Occupancy RESIDENTIAL New Renovationt Replacement Plan Submitted: Yet No❑ FIXTURES Ma ADDroval R CIOn a a A p o a W #13 300 - 7 U W $36.00 z w a H ° ° z x F Q m F ¢ a' a Q � p Z H V) of w ¢ 'T4 w a4 x > ¢ z LU w z w x w W p > o A F x a s Za W J a rxz >4 v) w z o z o aiw 2 > 0U` 2 w 3 A C<7 a oU a > A a H O w SUB-BSMT BASEMENT 1ST FLOOR 1 2ND FLOOR 3RD FLOOR 4T"FLOOR 5T"FLOOR 6T"FLOOR 7T"FLOOR 8T"FLOOR Installing Company Name Eastern Propane & Oil, Inc Check one: Certificate Address 131 Water Street Corporation Danvers, MA 01923 Partnership Business Telephone# 800-322-6628 Firm/Co. a ��p Name of Licensed Plumber or Gas Fitter -,�i lu INSURANCE COVERAGE: I have a currl liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. Yes ✓ No ❑ If you have c eckedLes,please indicate the type coverage by checking the appropriate box. A liability insurance policyFl. 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 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 under the permit issued for this application will be in mpl' ce with all ertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By Type of License: iLw' _. lumber Signature of Licensed Plumber or Gas Fitter Title ; as fitter J ••Master License Number��� Cityffown •-Journeyman APPROVED(OFFICE USE ONLY) Date. . + 40RTh ' �r��,���,°,;•'�ooL TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING i • r ,SSACHUSf This certifies that . 13c^.I' .'t . . . . has permission to perform . .ke� .i . . . . . . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . at. . . . � ?.�. r. . . . . . . . . . . . . . . . . . .. North Andover, Mass. Fee.3 �. . `.Lic. No.1.2.1 .f. ... . Lc; . . . . . . . . . . . . . . . . . . PLUMBING INSPECTOR Check # C� / 74 B3 '5-o MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING TOWN OF _N69M 4/U�*VEP, 7z��`� » ' BUILDING LOCATION e, 5.7— OWNER'S NAME O C/O RESIDENTIAL[J COMMERCIAL❑ 1- q to NEW 8-q X15 NEW RENOVATION❑ REPLAEMENT El PLANS SUBMITTED: YES El NO❑ &10) 550 FIXTURES 7N Co Co o o 2 —I cn -t O c o D :* W CO O n y 1M a: O = Z W O� UDi Z D D O _ Z Z O n z � 00 � � 0 > D 0 Z f7 D � ZX 25 � � � O � MCf) m D z C G ) m rn o 7 D < cn z z Z BASEMENT 7 FLOOR 0 FLOOR 3` FLOOR r4ff FLOOR VALUE OF PLUMBING WORK $ COMPANY NAME Ca^ ,)Z ys/a/bS LICENSED PLUMBER ADDRESS .20 TELEPHONE# LICENSE# y/� PJ 9 Z MASTER JOURNEYMAN ❑ CHECK ONE: ❑ Corporation Certificate# ❑ Partnership # ❑ Firm/Co.# INSURANCE COVERAGE; I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes ❑ No❑ If you have checked rte, please indicate the pe coverage by checking the appropriate box: A 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: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent I hereby certify that all the details and information I have submitted or entered in the above application are true and accurate 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 with all pertinent provisions of the Massach efts State Plumbing Code and Chapter 142 of the General Laws. Signature of Licensed Plumber FOR OFFICE USE-ONLY: FEE, PERMIT# DATE LICENSE .0 INSURANCE ON FILE D.:WILL;FAX CASH ❑ CHECK 0 CK# LocationyNN� S No. I Date MORT►, TOWN OF NORTH ANDOVER 1 ; . Certificate of Occupancy $ �'�s'•° Eta' Building/Frame Permit Fee $ B s s�cMus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # Aa 1 5 6 J J I/ Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: m �l rl-3 - oma X /l/I G��c.� 3 SIGNATURE: .a4 Building CommissioEELnWlor of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning Diaiict Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide ReqWred Provided Required Provided v 1.7 Water Supply M.GL.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record Name(Print) Address for Service: Signature Telephone Q 2.2 Owner of Record: Name Print Address for Service: O Z M Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ 2 Licensed Construction Supervisor: O /(!--:) O t V e ^ �,-p License Number on Aaarqss Expiration Date � Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name pr A `/V D © V (f/ES Registration Number / r _ r Addrress /J !/� � ` Expiration Date Signature ele hone G) 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 building permit. Signed affidavit Attached Yes.......❑ No.......❑ SECTION 5 Descri tion of Proposed Work check all applicable) New Construction ❑ Existing Building Repair(s) ❑ Alterations(s) Addition ❑ 1%) Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: /Fe/-�-z a/ j �- SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OMCIAL USE ONLY Completed by permit applicant ; 1. Building �—7 6T__ (a) Building Permit Fee .l Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(e) X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number e a 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 to act on My behalf,in all matters relative to work authorized by this building pen-nit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, zc--,-h c S=-4 Z 1, \/ /L 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 am Si ature of Owner/Agent Date N�� 1 NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS 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 FORM U - LOT RELEASE 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 or requirements. *******************************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT ►\ ��� �' L C� U PHONE al-2 y . LOCATION: Assessor's Map Number ✓ PARCEL SUBDIVISION LOT(S) / STREET �N N S C_zA- ST. NUMBER 6 ************************************OFFICIAL USE ONLY*********************************** REC , MENDATIONS OF TOWN AGENTS: 1�- CONSERVATION ADMINIST OR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 jm Proposal Page No. of Pages ALLEN CONSTRUCTION CO. 86 Andover Street NORTH ANDOVER, MASSACHUSETTS 01845 Home Improvement Registration #109740 (978) 682.4962 PROPOSAL SUBMITTED TO PHONE DATE Tom and ILIO-rin Winston 978-685-3511 February 16 , 2002 STREET JOB NAME 68 Innis ST. deck renovation CITY,STATE and ZIP CODE JOB LOCATION North Andover,Ma.01845 SAme ARCHITECT DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: REnovating and adding to existing deck:Obtain the building permit.REmove the existing stairway on side of deck.REmove the ...................................2.,.,..4..".x4.,.p.o.st.s.....-on.......same......s.1..d.e......a.s.......s.t_e p.s.. .D.i.g......4.,..d.e.ep......h.c.l.e.s..i-.t.he.n.......p o u..r......c.o.n.c.r.e.t_e............. piers .REmove the other four posts ,temporarily supporting the deck. Instal ......................................t_h_e...._a.p.p..r.o.p.r.i.a.t.e......post-...a.n.ch.o_r.s...l..b o.1.t.i..n.g......t.o....._t.h.e.......ccn c re.t.e......p.i..e..r..(..6......t.o.t.a..1...).T Nst.a..l.. 6 new posts 611x611in size.Frame a set of stairs off the side of deck clos st ........................t.o.......t.h.e._...p.o.o..1... .S.t.a_i.r.s......wi_l.l.......b.e.......3 2.._.4...,_wi..d.e..f..s.t.ra.i.gh.t.......run.)pr.ob.a.b.i.y....._1..3.._.}..4.......t..o.t.a.i......s ep s .4 2"x12"stringers will be use.Bottom of stairs will rest on the existi g ..........................c.oncre.t.e......p.o.o..l......pa.t..i_o...._Two.......4.. x.4,.,1p.o.s.t.s......,�,o..i..1.i....._b.e......p..i..a.ce.d.......i.n......th.e......c.e.nt.e.r......c.f.......t.h.e............ stringer run.POsts will run to the grade and rest on concrete piers 41 ....................................b.e.1 ow...._g.ra.d..e .S.A.m.e......post......a.n.ch.o.r.s._...w.i..1.1.......b e......u.s e.d....._t.n......s.e.cu..r.e.......p.os.t.......to.......p.i.e.r..:-R e move all existing railings and decking.All existing deck framing will be left .....................D.o.1.t......n.e.w.....c.o..1.on.i.a..l.......s.t.y.i.e.....4.,r.x.4_r,..ra..i.i.......p.o.s.t.s.._...t.o......ou.t.s4 d.e......deck......p.a..r.1,m.et..e..r.. .s.p.a.c.i.n. posts approx.6 ' apart.PLace four posts on the stairway.SCrew and glue down ..............................new......5�., ..,,.x6..r,..deck.ing...._I.N.s.t.a_1..Y.:.....r.i..s.e.r.s......-an......st.a.lrva.y.._.B,u.1..1.d......ra.i..m.i.n.g.s......u.s..i..n.g.......2.ir.x4..r,.. top and bottom rails with colonial balusters spaced 4-421'apart.Stairs wi 1 ......................................have......a.......t.2..Fr.t.op......gra.s.p.a.bi.e......r.al1_.....o.n......each.,...s.i.d.e....._i..n......a..d.d..i_t..i.on......to-.....t.h.e.......s.a.m.e....._r,.a..i..l..i.n. s which exist on deck.Build 'a hinged gate at top of stairway ..........................REmove......a-11.......exc.e.s.s.......d.i..rt... REmo�ze:.....a1..1.......de.br..is._...Aa..l.......l..u.mber.......is.....pres sure-....t.re.a..t.ed.. .. REmove all remodeling debris from the premises . ................................................................................................................................................................................................................................_..............................................................................._..._..............................................................._................................................. ..................................... ......................................................................................................................................................................................................................................................................................................................................................................................... Or proPOSP hereby to furnish material and labor— complete in accordance with above specifications, for the sum of: seven thousand five hundred fifty eight dollars($ 7558 - 00 ). Payment to be made as follows: _I ONe third down $ 519 .004Balance to be paid at completion All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices.Any alteration or deviation from above specifications Authorized involving extra costs will be executed only upon written orders, and will become an extra Signature charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control.Owner to carry fire,tornado and other necessary insurance. Note:This proposal may be Our workers are fully covered by Workman's Compensation Insurance. withdrawn by us if not accepted within days)., Arreptancle of proposal —The above prices, specifications and conditions are satisfactory and are hereby accepted. You are authorized Signature Customer to do the work as specified. Payent will be made as outlined above. - -_. . Date of Acceptance: _9 � � Signature Contractor: 6- ✓fie Ui o7z�no�uuea�i a�..�aeQacc�uae�6 { BOARD OF BUILDING REGULATIONS I License: CONSTRUCTION SUPERVISOR Number: CS 040927 . Birthdate: 05/04/1957 Expires:05/04/2003 Tr.no: 9519 Restricted To: 00 ROBERT W ALLEN _ 86 ANDOVER STS N ANDOVER, MA 01845 Administrator MORTGAGE INSPECTION -- Appleton Land Surveying, Inc. gmmHa.-ERcsi6E w-WAI HtANNWIC su ma mw u+sn s.wvras am Oise =" MORTGAGOR ADDRESS OF PRINCIPAL BUILDING ,Ors/�.zaoaE.e /tis NOTE: THIS mWTWE INSPWW wart { M for rmrtgagt v and b be rasa upon as o surrey. mm accepts no ` res omrbiify for aamoyee r W*q mem sae rekm ,- by myons ww that the said mortgoga ad As angor h eonmetfon wb ib proposed mmtpp &wcirq to sad ` The bkmwron on thb mark" hepsctian b the Vdu" property of A.LS.Lof Waduction or modirwidon of thb malaria bb*klly ` a prolribR4 and may a sub�d to'bga aeDon Wien �,�. .�. .. pier wrRbn convent iron AL.SL le obldm4 CERTF1Cm TO: !or 229 h accadarxe q eTh 1m 7eeMka Staidords to mortgage Lm In- Q O spectlaru a adopttd by tM mano*mfts Amoebtion. of Land Suvtyors ora C1vA Enghisas,Yrs f STATE THAT IN W PROFESSIONAL OPA H R a) F tM OWN *whn/t ad as amy st wh n/s L'oinoc si '1 -17— wRh the&rAn W ntbad rog*mmtt of NK -22G-227 2 - �, =sang&*OW*.and that em an ra enaoochmmts t , ' nmrb Ober way assn pro"Ana —14 te t' _�"�'".• Nota _ ■ Dw4 g b rat beaed wdhin o Food Hazard tom O OwaArg b Watd•w"Flood Haiard Zom-r ❑ Momatbn b kwAkerd to dstm**pod Hazard Flood Hazard&Wm* d from Fl"Food hwrarae �^+aP•�2?GL7 9Ei OiooG C r�`�� Dad Rda enc*: Ek Pg Seas /N�3p * 6� Grt.Na /OoST Dab of kmpw;m //-/-93 ., • iMon Refrmce: PL Na 9.263 bate of Piert J � A S t- r NORTH oTown _ 4 over �O 1 No. al 0 del o �A o r dover, Mass., COCHICKEwICK /gyp ADRATED FC-) S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.... � � .... .�.......0..�.................................................... Foundation has permission to swot..*.t..w............... buildings on ..... .. .... ./l ......... .�............... Rough to be occupied as....1�.,r .Kiv .. .... .�II .... o....E'��.��I A+ rr�..... Chimney provided that the person accepting this permit shall in eve res ect conform to the terms of the application on file in P P P g P every P PP � Final this office, and to the provisions of the Codes and By-Larelating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 0182>731. O �� PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR CRough .................................................................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det. Location No. Date MORTIy TOWN OF NORTH ANDOVER 0 s • � ; ; Certificate of Occupancy $ s °mob+„ ' -L cN�sE<�A Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ �,( TOTAL $ - / D Check # ( S 15760 ` Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING opt BUILDING PERMIT NUMBER. DATE ISSUED: ��/� _ �_ 6 C/ � SIGNATURE: Building Commissioner/IngWor of Buildings Date Z SECTION 1-SITE INFORMATION 1 O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number V 1.3 Zoning Information: I 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record 7 -o r-t + /`�10�i?64 wi 6 Name(Print) Address for Service: &,R_�5-- 3:LIZ Signature Telephone 2.2 Owner of Record: Name Print Address for Service: O Z M Signature Telephone M SECTION 3-CONSTRUCTION SERVICES l� 3.1 Licensed Construction Supervisor: Not Applicable ❑ Ro&,2 /• A zzelt 7-2 /-,,, e--) � ? 0 Licensed construction Supervisor: V _ v���e J License Number Address �c !�"–� �� � f ��� O� / / Expiration Date ic Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ 0 Compa y Name x 'A V T--- -�— /V ee,., /-7fRegistration Number r' Address V �,/l ?D r 2 ?62 ` Expiration Date ^ Signature Tel hone V I SECTION 4-WORKERS COMPENSATION(KG.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 Proposed Work: J3u PL� /a a (w;fDe s�e-,9 o Voz- L '�Cr� C7Gr /4- 7—A i SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be , , OFFICIAL 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 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, ,as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER`/A/UfTHO"R�IZED AGENT DECLARATTIIO-N�� I, �c D � 7� V� - /` /-Z =/' c./ /< <' ,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 qq�� Pri ame i ature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS Ir 2 ND 3 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. / The debris will be disposed of in: sG (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 Ice sLi%eco L)5 C �� � r� ���Le� '� sed Ce b k'ooe� �� C S / L( �2 � f P�rw`�� �b —,L/ Y Ce, 12 I D Ib �'CIL, ei� 5 h e 12 --o coven © e y/y�JSl:1/CUU•l.Vl Watl ` Carbonless EAdams NC 381850 3 PART PROPOSAL A L L v N C'o h <r! u c ' PROPOSAL NO. �(D A✓L./®\/�' FG S 7—., SHEET NU Nd �rN� a V� tD 64 (n 1�� DATE g 7f Monday August 12 ,PROPOSAL SUBMITTED TO: WORK TO BE PERFORMED AT: NAME ADDRESS, �� IriniS Strut Tom and Moira Winston ' ADDRESS 68 Innis Street North Andover,Ma.01845 DATE OF PLANS North Andover,Ma.Q 845 PHONE NO. ARCHITECT 978-685-3511 None We hereby propose to furnish the materials and perform the labor necessary for the completion of i2kisection �bf the new deck. Draw plan,thenlobtain the buildingr Permit.REmov,e- some of h shingles on the ' rnain house roof whereshed roof will tie intd: gable roof' Rafters will be 211x10"16"0C with 5 8"fir° CDX plywood -s,heathing.Suild rak over angs to ma c nouse design.Cover roof -INTith ice s: field towards the tab root, s. Znq es ry U6 ma ! ith 4„ 1 wood.Cover with ;double 411vin ' as close as ossible) .All pine trim will be #0& primed grade. Painting is ,the responsibility of the customer.EXtend the 211vent pipe u through the shed roof, install new boot flashing. move a e bis from e premises . ' All material is guaranteed to be as specified, and the above work to be performed in accordance with the drawings and specifi- cations submitted for above work and completed in a substantial workmanlike manner for the sum of four thoUsand Dollars ($ annn_nn ) with payments to be made as follows. No down payment requi red.Full payment requested at the completion of the . work Respectfully submitted Any alteration or deviation from above specifications involving extra costs will be executed only upon written-order, and will become an extra charge Per over and above the estimate. All agreements contingent upon strikes, ac- cidents,or delays beyond our control. Note—This proposal may be withdrawn by us if not accepted within days. ACCEPTANCE OF PROPOSAL The above prices, specifications and conditions are satisfactory and are hereby accepted.' You are authorized to do the work as specified. Payments will be made,as outlined above. Customer-Tom and Moira Winston Signature Buil r-Robert W.A..1 en J . Date Monday Ate, 12, 2002 Signature JXe Board of Building Regulations and Standards One Ashburton Place - Room 1301 Boston. Massachusetts 02108 Home Improvement Contractor Registration Registration: 109740 Type: DBA Expiration: 9/24/2004 ALLEN CONSTRUCTION CO ROBERT ALLEN -- 86 ANDOVER ST ---- -- -- - - -- - N ANDOVER, MA 01845 Update Address and return card.Mark reason for change. r Address n Renewal r I Employment Lost Card 7X. {nv noauoealll ✓ caeaaa/uael� Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 109740 Board of Building Regulations and Standards Expiration: 9/24/2004 One Ashburton Place Rm 1301 Type: DBA Boston,Ma.02108 4 CONSTRUCTION CO RT ALLEN DOVER ST )OVER,MA 01845 .Administrator Not valid without signature T— � p Jae Ua»c�iuvea� a��=f�crv5cufu5et�s i BOARD OF BUILDING REGULATIONS i = License: CONSTRUCTION SUPERVISOR Number: CS 040927 Birthdate: 05/04/1957 Expires:05/04/2003 Tr.no: 9519 Restricted To: 00 ROBERT W ALLEN 86 ANDOVER ST L•—Administrator N ANDOVER, MA 01845 The Commonwealth of Massachusetts { Department of Industrial Accidents Mice oPlnvestigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit .a . Please forint Mame: oL ,2 W L r Location: 5i& i LD?n ye-a— r� c ci � ��12- Phone d C am a homeowner perforirting all work myself. E—I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. company name: Address' Phone# pollev.# �i�rnparty-l'tart�e: - - - Address G ty: Phone#- Insuranoe'Ca. pally Fa4re to ao'cure coverage as required under Section 25A or Amt 1,52 carr load toft itrtpo t n d MW,*al penamtles;of aline up to$1.500.0© and/or one years'imprisonment as well as dW penalties in tris form of a 5;rop wofbc oil and a fine of($100 00)a day againstptosm.e. t understand that a copy of this statement may be forwarded to the Office of Investigations of the.DIA for coverage verification: /do herby certify under the 9hins and penaAtles of pedury Urat the iMorrb provided abovea bue anacarec�t}, n Signature Date d /d` ^ Print name ve_ , 14 2 Phone# d �2- official use only do not write in this area to be completed by city or town official' Bufldi ' O n9 wept . Doheck if immediate response is requxed Building Dept p Licensing Board p Selectrhan's o€Pice Contact person: Phone# 0 Health De-partment 0 Q€Iter W WORKMAN'S COfi PENSATIOM Town of4Andover 17,8 �.C oa Q LA , ., Ln COCMICHEWICK V RA'rED pP�,`�5 H BOARD OF HEALTH Food/Kitchen PERMIT T Septic System r BUILDING INSPECTOR THIS CERTIFIES THAT.......... ►1�.....!�.........b .................. ................................................................... Foundation has permission to erect..... buildings on .... to.. ..�0 y�5....... .............................. Rough • ............ .. ................. Chimney .......... ...to be occupied as..4.34e.. . O.............................................. 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-taws relating to the Inspection, iteration and Construction of Buildings in the Town of North Andover. -7 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids th!�/63 rmit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ST TS Rough 1 Service APea.......... '00 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 Wali To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. V1 ) p Location a No. Ikon IJJS Date l2 Lei iu NOR7h tiTOWN OF NORTH ANDOVER Ot� � o y� o 3? a OL M A Certificate of Occupancy $ ti + Building/Frame Permit Fee $ ,SSACMUSES� Foundation Permit Fee $ �. Ca Other Permit Fed` Sewer Connection Fee $ • Water Connection Fee $ _ TOTAL $ � �? Building Inspector +� t 6 i v Div. Public Works PER311T NO. S APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP i,10. I LOT NO. 12 RECORD OF OWNERSHIP 'DATE BOOK 'PAGE — ZONE SUB DIV. LOT NO. LOCATIO URPOSE @ f/G�CAe slave' a !r OWNER'S NO. OF STORIES SIZE V I _ BASEMENT OR SLAB _ ARCHITECT'S NAM(En GS�f i / SIZE OF FLOOR TIMBERS IST 2ND 3RD ILDER'S J 1L, 1le Sby-1- SPAN _--_- DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS i DISTANCE FROM LOT LINES-SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LANDIST SEE BOTH BIDES T. COST .2004 6U PAGE I FILL OUT SECTIONS I - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS I - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS P�en3 MUST BE FILED /yAND APPROVED BY BUILDING INSPECTOR \��DFI ED � / � / � BOARD OF HEALTH SIGNA E OF O ER OR AU EO AGENT ,-FEE Z� PLANNING BOARD PERMIT GRANTED BOARD OF SELECTMEN BUILDING INSPECTOR WHITE: Building Dept. CREAM: Assessors CANARY: Treasurer 78/ BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. 64MILY #1 OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION —I $ INTERIOR FINISH - CONCRETE d t 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT 11 AREA FULL FIN. BM'T' AREA _ '/ '/z 3/4 FIN. ATTIC AREA _ NO BMT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B I 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH - ASPHALT SIDING HARDW D ASBESTOS SIDING COMIAC:N VERT. SIDING MPH. TILE STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR IJ POOR ADEQUATE l NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH (3 FIX.) GAMBREL MANSARD TOILET RM. (2 FIX.) _ FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK _ SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING II 11 HEATING WOOD JOIST PIPELESS FURNACE _ FORCED HOT AIR FURN. TIMER BMS. &COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 R NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd 11 NO HEATING r WOOD STOVE INSTALLAHON CHECKLIST F" .gal Permit A building permit is required for the installation of any solid fuel burning appliance. The building permit and installation inspection are limited to the stove installation and not to the stove construction. Stove A. New Lo Wi ILf 5 Used (....i � t� �e B. Type/radiant -Laed We, --Circulating C. Manufacturer T�Jdvsifu` ' —Lab.No. Name/Model No clv�N+r�a�¢ Collar size Dimensions/Height � Length �4 r2 Width Zq`L Chimney L A. New V Existing B. Size(flue area) C. Other appliances attached to flue(Number and flue size) kiaA, D. Prefab(Manufacturer—name and tyge) _— E. Mesanry/Lined 10l-!i � L S6c"�``ytac Pl. � Flue liner Unlined type b manutacturer) F. Height(refer to diagrams) cap OVER, IC' I ---r 2' IMIL Z "1 r V 3zg �o ,MIN. HEARTH Li - CHIMNEY HEIGHT Hearth(non-combustible) L A. Materials Gep.Amt L, T l e B. Sub-floor construction 0ON C,LCA 2 fAC. Minimum dimensions(refer to aiaaram) 4 D KqD Clearances and Wall Protection(see s,eve installation clearances chart) A. Type of wall protection provided AW L / 2e_4o_ & S)D6_5 lLltl B. Clearances(refer to diagrams) -}U Cf4at�Jvs�0Ie �'h/9' S I r FIREPLACE COMIER WALL/CENTER. 13 �tf i • I I. Advantage II - T The World's ` Number One 4 Selling Pellet Stove. 1. No conventional chimney is required, resulting in much lower installation costs. Automatic feed system means stove will burn for extended hours, even days. Takes up less space because it requires as little as 1" clearance to a combustible wall. Damper adjusts to handle variations of pellets, altitude and various installation requirements. Ultra Grate will burn virtually all grades of wood pellets with up to 3% ash content. Built-in window wash system helps prevent ash buildup from obscuring view of flames. Optional thermostat control will adjust heat output automatically. Convection blower provides multiple speeds and quieter operation. Five heat output settings for a wide range of comfort levels. ` Whtf ield° Pellet Stoves Ali t AdvantageII — T SPECIFICATIONS 24'/," 1 12'/,"— .– 12" 31'/"" II'/," 81/2" 51/4" 31'/" 119'." IT/:` MIR �0000000000MIllflMlIll � r u"9" 800011 l I j24'8' _ i FREESTANDING SIDE FREESTANDING BACK INSERT SIDE OVERALL DIMENSIONS CAPACITIES OVERALL DIMENSIONS Width 241/2" BTU Range *7,000-37,000 Width 241/2" Height 311/2" Fuel Capacity 60 lbs. Rear Height 19'/4" Depth 241/2" Burn Time **12-60 hrs. Rear Depth 1211 Overall Depth 241/2" EFFICIENCY&FED.EMISSIONS CLEARANCES INSERT SHROUDS Overall Efficiency 79-81% Back 1" Small 28"x 40" Emissions ***0.9 gm./hr. Side 611 Medium 32"x 44" Status Certified Large 36"x 48" EFFICIENCY&FED.EMISSIONS Same as the freestanding model. AVAILABLE COLORS CAPACITIES Metallic Black Slate Brown BTU Range *7,000-37,000 Fuel Capacity 50 lbs. Burn Time **10-50 hrs. CLEARANCES AVAILABLE OPTIONS Back 1" Advantage Series Log Set Gold Plated Trivet Sbroud Trim Side 6" (Oak or Driftwood) Mantle 18"Fireplace Insert Wall Thermostat The Advantage II-T is approved for mobile home installation. This stove is manufactured and shipped with the Ultra Grate installed, which enables it to burn both"PREMIUM"grade and"STANDARD"t grade wood pellet fuel with up to 3%ash content as defined by the APFI and FFI. *BTUs vary depending on the pellet type. **The burn time will vary with the size and type of fuel being used. Safety tested by:Warnock Hersey, Vancouver, B.C. Approved to: UL1482, UL907, ULCS627, CSAB3662, ULCS628. FIRE ***Advantage III test results. Results based on EPA test methods. Efficiencies vary depending on fuel feed rates. Federal Wi RVQ Emissions Standard-7.5 grams/hr. particulate.Advantage II-T& I11 Door U.S.patent#DES 316,141. l71 11� FUEL FOR THOUGHT Your local authorized Whitfield dealer is: It is important to note that pellet fuel quality varies widely depending on the raw material it is made from. Density,size,moisture and ash --71 — �i � �; . content are all variables that can affect the performance of your / a Whitfield pellet stove.The Advantage II-T is designed to burn both WARM TRADITIONS STOVE SHOPPE 144 Pine Street ! "Premium"and"Standard"t grade pellet fuels that have been -.Danvers,MA 01923 i manufactured to the specifications set by APFI/FFI.Your dealer is an r excellent source of information regarding the various types of pellet _ w (508)777-5562 *. ��— (800)286-5662 fuels approved for your Whitfield. t"Standard"grade pellet fuel approved for use when the Ultra Grate is installed in the unit. .V Above dimensions for general information purposes only.See installation manual for specific diagrams. • �'\^/hI ll eld" Pyro Industries, Inc.maintains an excellent warranty program and trained,fully qualified Whitfield Pellet Stoves pellet stove service and installation technicians throughout its entire dealer sales and service network. Pyro Industries,Inc.,695 Pease Road, Pyro Industries, Inc.reserves the right to change products,specifications and prices without notice. Burlington,WA 98233 O�e ommomzwaa (0��cliriue 610" 0/gawit�- .9c9ee y AL — oaxd a/—qcul pp �u�ana andJlan��zx�a William F. Wc1d ✓��t�oxm�zoa A& gfcce ✓ucu e"'q Governor "' W �la — ne �nxCan ce m m0f Ken1:110 Tsutsumi 14aa6adwleCCa 0.2108 Chairman (617) 727-32(i) Charles J. Dinczio Administrator April 19, 1991 Pyre Industrics, Inc. 11625 Airport Road Everett, WA 98204 Attention: Dr. O. J. Whitfield Subject: Massachusetts Approval Status of Culain of Pyro Industrics Wood Pcllct Shove Systems Dcar Dr. Whitfield: At its Much 26, 1991 monthly meeting, the RIMS voted approval of certain wood pellet burning stoves and heaters for use in Massachusetts - the following inl'ornuttion identifies these products and any voted stipulations and/or raiuirentcnts. p ,r� o Industries, Inc. of, Everett, W.sl_t�tcm Whirl-ield Automatic f=eed, Thermostatically Controlled, Mechanically and Nalurally_Draflcd Wood Pcllct 13111 fling Room Ilcatcrs: - - -- - --- 1) ADVANTAGE II-T (freestanding and Iircplacc insert models): 2) RENAISSANCE; 3) PRODIGY "Tile cited wood pellet burning appliances,as specified in the application materials dated February 6, 1991,are approved for use in Massachusetts subject tri Coll fol nuilice with all other applicable Slate and federal regulations as well as any rcquitenu•ni.s of file Nimm acturer - wlicie mechanicall- vcnfcrl equipment is Spccilic(1 by the (Manufacturer fur through file Sidc w: ll Vvnfing of such appliances,such vr_ntini, systems shall be installed in accordance wills file Manufacturer's installation manual. �t1y„ 4 A i S art of the approval of these wood pellet burning heating appliances,it is required that those products e) P of tile Sta installed in accordance with all applicable sections of the ulnlsl all berin accordance te Building with tire Creq°iuc Code) slccif and that specifically, clearances to combustible construcu - Section 3409.4 of the Code; i.e., Section 3409.4 will, (ncornbust l leor u►ater ls1affordi to tile,nccc,�ssary Inc exposed combustible construction-is protected r protection resistance; (additionally, clearances may be redu,c lle manufacturer's tested clear:►nces "'hen such clearances arc identified on the listing label of suet products. ted 011 'nc�se approvals arc for those wood pellet stovcs/hcatcr1Ca�c�u5c1w Ilrll rcglle u�ctPyro Indo�rlics,Inc.toysubnlit any change in name,design,equipment,installation or rn these products again to the CMSB for consideration of approval truction P ro Industries, Inc. is cautioned shat any recommendaliost for te yBo'roval by (lie lyd o f BuildingtRegulationsland Materials Safety _ Y r Board (CMSB) and any actual approvals ranted by the aspects of product (SBBRS) are based on an approval(l`�clrescess `lrldlisri ltcndedof luse,bll used(onll o tile'applicationly the tmaterials submitted. design, construction, installation pr tile Neither the CMSB nor the SB13RS evalu:,c,ili(crdwal asuct ldi cv�edrhercin s-110110I)c utlll cd ill product opposed to any other product and thcicfc 1 p or promotion of said products. ?i Very truly yours, ' J S , /F�On i� O� B ll: 7i REGULAIIONS AND SInNDnRDS li72 01 Charles J. Din ci Millinistrator CJD/Inlr cc: Mr. Charles R. Brewster, Jr., Car.•cr, MA 02339 \77, aAFETY TESTING In accordance with the specifications and procedures listed in UL 1482 for solid fuel room heaters, the Whitfield Advantage pellet stoves have been independently tested and listed by Warnock Hersey, (an accredited testing laboratory)to UL and CSA standards. UL 1482 states requirements for installation as a freestanding room heater, or hearth insert for masonry or metal (zero clearance)fireplaces.The safety listing label is located inside the hopper lid on Advantage Freestanding stoves or on the outside of the hopper on an Advantage Insert stove. Please read this safety label carefully. It contains important `` information about installation and operation of your Whitfield Pellet Stove.This Owner's Manual is provided to you to supplement, rather than replace or update, the information contained on the safety label. Note that your stove's serial number is located on this label.Your stove's serial number is preceded by a"WH-". This appliance is designed specifically for use only with pelletized fuels.It is tested and listed for residential installation according to current national and local building codes as: r' • A Freestanding Room Heater • A Hearth Insert when installed into a masonry or factory built fireplace • A Built-in Heater • A Mobile Home Heater Note: This stove is not intended for use in commercial installations other than where the stove is being sold without prior approval from Pyro Industries, Inc. The stove will not operate using natural draft, nor without a power source for the blower and fuel feeding systems.The appliance is provided with an exhaust connector for a 3 inch type'IL" double wall vent pipe with stainless steel inner liner(on freestanding & built-in installations), or single wail, stainless steel rigid or flexible pipe (for insert installations). WHITFIELD ADVANTAGE PELLET STOVE SAFETY LABEL WPmxkHenaY LISTED ROOM HEATER.PELLETIZED WOOD FUEL TYPE.ALSO DO NOT REMOVE THIS LABEL CAUTION'HOTSUR- FOR USE IN MOBILE HOMES.AND AS AN INSERT FOR MASONRY MADE IN WH_ FACES WHILE IN OPERA- FIREPLACESANDFACTORYBUILTFIREPLACES.ORASBUILTIN USA- Ti ON.DONOTTOUCH.CON- y MODEL WP2 ADVANTAGE TESTED TO:UL1A82/ULC-4627/ CSA 8366.2M/ULC-5628 REPORT NO:5515(DEC.1991). TACT MAY CAUSE SKIN INS TALL AND USE ONLY IN ACCORDANCE WITH THE MANUFACTURER'S INSTALLATION ""�a r` BURNS.KEEPCHILDREN, INSTRUCDONS.CONTACT LOCAL BUILDING OR FIRE OFFICIALS ABOUT RESTRICTIONS ANON COMBUSTIBLE MATERIAL INSTALLATION INSPECTION IN YOUR AREA.DO NOT CONNECT THIS UNIT TO A CHIMNEY FLUE SERVING ANOTHER FIREPLACE.SEE LOCAL BUILDING CODE AND MANUFALTUREfl'S AND FI,IRNISI..IINGSACONSIDERABIEDIS- INSTIBLEWALLORPRECAUTIONSREETFIRD APPt551NGASBEENTCHIMNEY THRDAND—M- Y� TANCE AWAY. SEE NAMEPLATE AND FOR USLE WALL OR CEILING.THIS PELLET ACCORDANCE W HAS BEEN TESTED WIT LISTED FOR USE IN MANUFACTUREON MES IN ACCORDANCE WITH OREGON ADMINISTRATIVE i tt-W INSTRUCTIONS.TYPE OF FUEL:PEL- RUUS8IA-27-900 THROUGH 8I4-23-909. 1�I-�C M OPEPATE ONLY WITH FIREBRICKS IN RACE.OPERATE ONLY WITH NEW NG DOOR ClOSEO. _ LE 1 u�D WOOD FUELONLY. INSPETTFLUEFflEOUEHRY.CLEAN HEAT E%CMANMUST ED FLUE FREOLENTLYTO PREVENT .� ACCUMULATION LUEFREQUENSOOT LY. HEATER AND FLUEMUSTBEINGOOD S)NIXTIORREGURED r e 1 _ = oENVIRONMENTAL COMPONEHROU0 FO SEA AT ULTRA FGR INSERTEP FU ANIATIONS.ANDOA ECOMPO. r, PROTECTION AGENCY NENTS:SHflOUDFOR INSEflTULTRAGRATE.KEEP FURNISHINGS AND OTHER COM- ..e-a..-- - e.E•.00•+Eo+'Fc�.c..+o�o BUSTIBLE MATERIALS WELL AWAY FROM HEATER. 55 .--s „w... I�J CERTIFIED to comply with ROUTINE MAINTENANCE REMINDER = July 1990 particulate FREQUENCY OF CLEANING AND MAINTENANCE OF YOUR STOVE TI� T1.11 G DEP CHECK THE FOLLOWING PARTS OF YOUR STOVE WEEKLY FOR THE ENDS ON THE ASH CONTENT OF THE PELLETS YOU BURN. :°T--' i•�:�sEL.TT^e emission standards Ecmw�e. FIRST MONTHTO DETERMINE OFCLEANING: .rne +�»o� DATE OF MANUFACTURE A.BURN GRATE w'O:iuc+rs*w oo:.•i wu.0 r• H ciFw.�sow ■■...■■■■■■■..■■■M B.HEAT EXCHANGER TUBES pMADE1NU.SABY:PYROINDUSTRIES,INC. „�,y. C.ASH TRAPS AND ASH PAN GURU GGTON,WA ou+w+e.nss nw w.r.. rz-————u——— - SEE YOUR MANUAL AND/DEALER FOR MORE INFORMATION. R-A Whitfield pellet` arn Warnock Herseystoves Professional are Sery ces, Ltd tested and listed by N 5 Location r I No. 4 Date r NOR7M TOWN OF NORTH ANDOVER o? o- F „ Certificate of Occupancy $ Building/Frame Permit Fee $ cNuFoundation Permit Fee $ � s� s� Other Permit Fee $ ! Sewer Connection Fe $ Water Connection Fee $ a TOTAL $ Building Inspector (' z&� /95 13:15 25.00 PAID .- 9419 Div. Public Works PERJiff NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 M4P iqo. LOT NO. 2 RECORD OF OWNERSHIP *.DATE (BOOK *.PAGE ZONE I SUB DIV. LOT NO. LOCATION PURPOSE OF BUILDING - �r 7 OWNER'S NAME NO. OF STORIES SIZE OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME SPAN DISTANCE TO NEAREST 1#I1-DING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST PAGE 1 FILL OUT SECTIONS i - 3 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS I - 12 SEPTIC PERMIT NO. ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE F D /" � a-7- �-, � mUILDINO INtP[C'TOR 1SIGNATURE OF-OWNER R AUTHORIZE GENT �o F E E !/J OWNER TEL.# PERMIT GRANTED CONTR.TEL.# CONTR.LIC.# 10-3H.I.C.# v 4 BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY rl -OR _ THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY FICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION —I 8 INTERIOR FINISH CONCRETE d 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDWD PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT 11 AREA FULL FIN. B M AREA _ '/ 1/2 % FIN. ATTIC AREA _ N_O B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH _ ASPHALT SIDING HARDTtd'D _ ASBESTOS SIDING _ COMMON VERT. SIDING ASPH. TILE —{I STUCCO ON MASONRY �— STUCCO ON FRAME BRICK N MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR I-1 POOR _ ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH (3 FIX.) GAMBRELMANSARD TOILET RM. 12 FIX.) FLAT I SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING I MODERN FIXTURES TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd ECTRIC _ EL 1st 13rd NO HEATING NORTH own of D No. 619 o �V`br dover, Mass., MOVrE nAM ZZ 199t,r' C.0C C"L�,Ck ox? 7T P V X\ 1 S BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System , THIS CERTIFIES THAT K�- ^ A BUILDING INSPECTOR ....................>���`�1......w1�1za........................................................................................................ Foundation has permission to M../.W........................ buildings on CoS...Z�4ML...... ............................................ Rough to be occupied as �..0.m........ . ao .....L4. Chimney provided that the person accepting this permit shill In every respect conform to the terms of the application on file In Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings In the Town of North Andover. PLUMBING INSPECTOR k f VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough . /' PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR 07 3�8 UNLESS CONS C T5 Rough ....... Service BUILDING I CTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RouFinagh No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. t �� L