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Miscellaneous - 74 MEADOW LANE 4/30/2018
po A A CJ1 � °n m 6 Dv w o oz o m 0 -. r Date .... � 141 ....................... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION `t ; .... This certifies that v..t1� 1 ........................!:.... ......................................... has permission for gas installation � ..... !- ...f./.t.' ....� .;� ..� inthe buildings ofUU..!.sA ........................................................................ �Jqat ............ �.?......!" ±.................... . North Andover, Mass. FeAPD... �--..... Lic. No.. ........ ."........................................................... ,�j ,, p�( GAS INSPECTOR Check # 1 �' �U ;3r3 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY I N. Andover I MA DATE F/6/2014 ::] PERMIT # JOBSITE ADDRESS 174 Meadow Ln OWNER'S NAME GOWNER ADDRESS I Same ITE IFAXI TYPE OR OCCUPANCY TYPE COMMERCIAL[j EDUCATIONAL ® RESIDENTIALE] PRINT CLEARLY NEW: ❑ RENOVATION: ❑ REPLACEMENT: ❑ PLANS SUBMITTED: YES❑ NO❑ APPLIANCES 7 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 ?EST UNIT HEATER UNVENTED ROOM HEATER WATER HEATER OTHER 11 Re lace 1 Gas Meter x and Piping as Needed INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 YES Q NO ❑ IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY ❑ 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 ® AGENT ❑ SIGNATURE OF OWNER OR AGENT I 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 in4olliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER GASFITTER NAME I Joseph Marino LICENSE # 8736 ! A URE MP Q MGF ❑ JP ❑ JGF ❑ LPGI ❑ CORPORATION ❑# 3285C PARTNER HIP ❑# LLC ❑# COMPANY NAME: RH White Construction Co ADDRESS 141 Central St CITY I Auburn STATE MA ZIP 01501 TEL j_(508)832-3295 FAX 508-926-4347 CELL 508-832-4614 JEMAILI JMarino@RHWhite.com w E� O z z 0 N U W a d z w a z❑ z d O H El W � � W O W O H a U LUz W a w w d W C7 O a a a F J U) iii x w F- LL cn O � v z N 0 UHrA W a z 0-0 0 a 0 x c� z Gn H O z z O H t�J T -1 = ..1 v, tt+ � -o r > ro ro z G� r c z < o C--1 m N m C1 z �* - H m O o X PCI E (D O z c ❑oOil z r z ro n H O z z 0 H J I I jd; cn ®ry. WO. J.. F -r ul; PZ men co m m . .. .. ..... 4i I ti 41 C1J/ LC114 14: CJ4 JU00040 1 z)1 mm wnl I C UuNn I MUU I r-RLIn uz/ GG ® CERTIFICATE OF LIABILITY DATE(MM'MDNMI TY INSURANCE rage 1 of 1 08/29/2013 't'HIS CERTIFICATE Is ISSUED ASA MATTER OF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the Certificate holder in lieu of such endorsement(s). willia p£ Masasehueette, Inc. c/o 26 Century Blvd. P. 0. Box 305191 NRMhville, TN 37230-5191 R. H. White Construction Company, Inc. 41 Central street P. 0. Box 257 Auburn, MA 01501 I WP Nrn. BRA-497- oun aRtu nr r�i[uirv� W V ERAGE NAIL P INSURERA:The Charter Oak rire Ineurancq Company 25615-001 INSURERS:TravalprE; property Casualty COrWany Of Am 25674-003 INSURERC: Ne.tiOnAl Union Piro Tnauranca Company of 7,9445-001 INSURER D; Travelers Ind*Mnity Company 25658-DO1 wwvw"r, �%A L.CKIII-IG AIr_ I IUMISER:20287680 REVISION NUMBER: THIS IS TO CERTIFY THAT 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, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTJL NSR TYpgOpIN8URANCE DD SUB POLICYEFF POLICYEXP POLICY NUMBER LIMITS A GENERALLIAMILITY VTC2000 977RO940-13 9/1/2013 9/1/2014 EACH OCCURRENCE _ 2,000. Q0( X COMMERCIAL GENERALLIABII.ITY ENTED PRE�Ig�B(Eeoewoncrf A _ CLAIMS -MADE 300 paC OCCUR m _ ^ ^- nnFn DED 17 IRETENTIDN& 10.000 D WORKERS COMPENSATION AND EMPLOYERT LIABILITY 1] ANY PROPRIETORIPARTNFRIFXECUTIVENIA OFFICERMIEMSEREXCLUDED? Mendatoary�}ln NH) u�V�tK111I lON W- UPF'RATIONS below :45 OF TE Evidence of Inlnurance VTJCAP 977K955A-13 9/1/2013 9/1/2014 BE87661.40 9/1/2013 9/1/2014 VTRKUB 9205A105-13 19/1,9/1/203.3 19/1/2014 9/1/2014 VTC2XUB A203A71A-13 /2013 more epece PERSONAL&ADV INJURY 000 GF.NERALAGGREGATE S 4.000 000 PRODUCTS-COMPIOPAGG IS 4.nnn nnn 2,000,000 BODILY INJURY(Perpemon) Is BODILY INJURY(Peraceldent) ,; E.L. EACH ACCIDENT !1; 1, 000 000 E.L.DIBEASE-EA EMPLOYEE 5 1,000,000 E.L. DISEASE -POLICY LIMIT $ 11000,000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THERSOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZEDREPRESUNTATNE C00.1:4197604 Tp1:1694012 Cext:20287680 ©1988-2010ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and 1090 are registered marks of ACORD GEN'LAGGREGATE LIMITAPPLIES PER; POLICY PRO LOC 13 AUTOMOBILE LIABILITY X ANYAUTO AALIUTpg WN aUToBULEo X HIREDAUTOS X NON -OWNED AUTOS Co Ded X Cv11 Ded X C LIAR OCCUR HUMBRELLA EXCEs9 LIA6 CLAIMS -MADE � DED 17 IRETENTIDN& 10.000 D WORKERS COMPENSATION AND EMPLOYERT LIABILITY 1] ANY PROPRIETORIPARTNFRIFXECUTIVENIA OFFICERMIEMSEREXCLUDED? Mendatoary�}ln NH) u�V�tK111I lON W- UPF'RATIONS below :45 OF TE Evidence of Inlnurance VTJCAP 977K955A-13 9/1/2013 9/1/2014 BE87661.40 9/1/2013 9/1/2014 VTRKUB 9205A105-13 19/1,9/1/203.3 19/1/2014 9/1/2014 VTC2XUB A203A71A-13 /2013 more epece PERSONAL&ADV INJURY 000 GF.NERALAGGREGATE S 4.000 000 PRODUCTS-COMPIOPAGG IS 4.nnn nnn 2,000,000 BODILY INJURY(Perpemon) Is BODILY INJURY(Peraceldent) ,; E.L. EACH ACCIDENT !1; 1, 000 000 E.L.DIBEASE-EA EMPLOYEE 5 1,000,000 E.L. DISEASE -POLICY LIMIT $ 11000,000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THERSOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZEDREPRESUNTATNE C00.1:4197604 Tp1:1694012 Cext:20287680 ©1988-2010ACORD CORPORATION. All rights reserved. ACORD 25 (2010105) The ACORD name and 1090 are registered marks of ACORD A Location_ I Mo. Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ ut, cM�S Foundation Permit Fee p Other Permit Fee OCT �nnection Fee g _ ter��C/o�nnection Fee No• AndoverTOTAL CohbC cr Building Inspector Div. Public Works -L APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. E /PAGE 1 M P 4140. LOT NO. 2 RECORD OF OWNERSHIP 'DATE BOOK 'PAGE NE SUB DIV. LOT NO. �I I LOCATION PURPOSE OF BUILDING OWNER'S NAME,'4694�cz NO. OF STORIES SIZE OWNER'S ADDRESS7 G BASEMENT OR SLAB ARCHITECT'S NAME - SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING 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 SEE BOTH SIDES • PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 J4 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS S PLANS MUST BE%FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED SIGNATURE OF O.kVNER R AUT ORI;ZED AGENT FEE -;V;) PERMIT GRANTED 1s OWNER TEL. k CONTR. TEL. #7 CONTR. LIC. #!C)! 3 0 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST I s0Q EST. BLDG. COST PER DQ. FT. EST. BLDG. COOT PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN AZ 4, ®UILDI G INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY S-ORIES MULTI. FAMILY OFFICES APARTMENTS CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH d 2 13 PINE HARDw D— PLASTER CONCRETE CONCRETE BL K. BRICK OR STONE --II PIERS DRY WALL _ _ UNFIN. 3 BASEMENT AREA FULL FIN. B M AREA _ 1/1 1/1 1/1 FIN. ATTIC AREA NO B M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN _ 4 WALLS I 9 FLOORS CLAPBOARDS B _ 1 2 �_ 3 _ _ _ DROP SIDING WOOD SHINGLES CONCRETE EARTH ASPHALT SIDING ASBESTOS SIDING VERT. SIDING _ HARDIN' D COMAACN ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY BRICK ON FRAME ATTIC STIRS. 8 FLOOR _ CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIORI� POOR ADEQUATE NONE 10 PLUMBING 5 ROOF GABLE I GAMBRELMANSARD A HIP BATH 13 FIX.) TOILET RM. f2 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 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 ELECTRIC B'M'T 2nd _ le 13rd I NO HEATING THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. O IT LTJ n i ov �q (A 3 0 m c T T T m o =rC1 H i O 21 Cl) m :D o =r r - ,o > T T m o_� C C ado z n T -n 0 37 o v _ Z H n O v 0 T D V m m �G m _—I i !J c� r z J Ir S. J Castricone Roofing & Siding REPAIRS FREE ESTIMATES \ Telephone: (508) 682-4266 MARIO CASTRICONE 61 Water Street, No. Andover, Massachusetts 01845 I/we, the owner(s) of the premises mentioned below, hereby contract with and authorize you as contractor, to furnish all necessary materials, labor and workmanship, to install, construct and place the improvements according to the following specifications, terms and condition on remises below described: Owner's Name..! ...... .......��� .�G.`�JL �.................................................... ......... Job Address ... ,��........ rGL:iLL- ................. ...................City... State .. .:C................... MUM SPECIFICATIONS tX1.0... Ay. . ...........t.. 24 C' r :.G ....... ...... ...... :k.�rte��.................... . ........ .............. .... E ..... .. ............................................................ ........................................... ........./4 �1 ....... ..... ......... �,c t� �._ ........................... ................................................................................................................ Materials and labor to cost ............................ Payable ........................ . ...................... and balance in ................ inenthly installments of $ .................... each, payable on ........................ day of each and every month thereafter until paid irl full ( ............ % charge per year is to be added to above cost of labor and materials and is included in monthly payments.) Contractor will do all of said work in a good workmanlike manner. Upon completion of above work, all undersigned agree to execute and deliver to contractor, their joint note in accord- ance with his (their) above obligation and a completion as requested by the contractor. Upon refusal to do so, contractor may at its option declare the entire contract price or so much as then remains unpaid immediately due and payable. It is agreed that if permitted by law contractor shall be paid by the owner(s), all reasonable costs, attorney fees and expenses, in addition to the amount due and unpaid, that shall be incurred in enforcing the terms and conditions of this contract and/or any lien in connection therewith. It is further agreed.that this contract may be assigned by contractor; and also that the obligations hereof shall bind and apply to their heirs, successors or estates of the parties. The undersigned warrant (s) that he is ( they are) the owner(s) of the above mentioned premises and that legal title thereto stands of record in his ( their) name(s). PROVISO: This contract shall be void and of no effort if credit approved of owner(s) is refused. There are no representations, guaranties or warranties, except such as may be herein incorporated, if any, nor any agreements collateral hereto, nor is this contract dependent upon or subject to any conditions not herein stated. Any sub- sequent agreement in reference hereto shall be binding only if in writing and signed by all parties. Receipt of a copy of this contract is hereby acknowledged, and it is further acknowledged by the undersigned that the foregoing provisions have been read and the contents thereof understood and that no representation or agreement not here- in contained shall be binding upon the parties and that all of the agreements and understandings of said parties are con- tained herein. Owner or Owners are not responsible for Property Damage or Liabilitywhile job is in o eF'�"� t� IN WITNESS WHEREOF, the parties have hereunto signed their names this...... day of .[.e/' -f/.........., 19../.. Accepted: (OWNER HAS 3 DAYS IN WHICH TO CANCEL CONTRACT) ...................... Pe Representative v Signed.. U0 .... ......................................... Owner Signed...................................................................................... Owner Signed...................................................................................