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HomeMy WebLinkAboutMiscellaneous - 75 BOSTON STREET 4/30/2018Date. f HORT" 1 oo` L't TOWN OF NORTH ANDOVER RMIT FOR PLUMBING This certifies that .Ir/�C.!j .`. �' f �..!� .............. has permission to perform .... t ........................ plumbing in the buildings of ............... at..,7. S' .. 7 P. t A. .............. . North Andover, Mass. Fee. 3?'. . . . Lic. No.. 3. L t .. �� ................../' ....... PLUMBING INS P -CAR Check # 79 Y V 6662 Y E � MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING /(Print or Type) /� "Ae)-jdv�,l- , Mass. Date Permit # Building Location -75B A s l -n j K�a Owner's Name hzi /7% GL Z -7 A0 •"-cD5 —' 12 -7'2 Type of Occupancy Residential New ❑ Renovation ❑ Replacement Plans Submitted: Yes ❑ No ❑ FIXTURES Installing Company Name Heritage Htg. &Pig. Co. Inc. Check one: Address 35 Pleasant Street CX Corporation Stoneham; Ma 02180 ❑ Partnership Business Telephone 781 -438-7776 f-1 Firm/Co. Name of Licensed Plumber Gordon Switzer Certificate 714 INSURANCE COVERAGE: I have a current I144ility Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes ® No ❑ If you have checked ,es, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy (H 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 ❑ 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 compliance with all . pertinent provisions of the Massachusetts State PlumbingCode and Chaple 142 of the General Laws. By rgn ure of LicenSed-Pliffilber Title Type of License: Master [X Journeyman ❑ City/Town 8 3 2 2 APPROVE 0 O License Number %" Watts 9D bfp on water line to water boiler Y cn O z r O W W n X Z 41 J a N Cr dF rt Z N Z _ W Z N ,., d ¢ coN X Cr t, N X a (Itr a a -Ir-ii V Z W z FO F=- w N d w' N o O a j N rr ~ J O C O LL l x x w r a o> r d a 2 r a 3 o=° x X WN x a z yr a ►" o X z a a 0 J, O 0 N__ a¢ z z .t w► a w a LL o 0 X U a 1i N X f- N LL C7 7 J a C_' M (O (d b rd SUB—BSMT. BASEMENT IST FLOOR 2ND FLOOR bRD.FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR Installing Company Name Heritage Htg. &Pig. Co. Inc. Check one: Address 35 Pleasant Street CX Corporation Stoneham; Ma 02180 ❑ Partnership Business Telephone 781 -438-7776 f-1 Firm/Co. Name of Licensed Plumber Gordon Switzer Certificate 714 INSURANCE COVERAGE: I have a current I144ility Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes ® No ❑ If you have checked ,es, please Indicate the type coverage by checking the appropriate box. A liability Insurance policy (H 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 ❑ 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 compliance with all . pertinent provisions of the Massachusetts State PlumbingCode and Chaple 142 of the General Laws. By rgn ure of LicenSed-Pliffilber Title Type of License: Master [X Journeyman ❑ City/Town 8 3 2 2 APPROVE 0 O License Number %" Watts 9D bfp on water line to water boiler � oil m. LL SII o m a o r z .tl O W h - d ZJ o. `m � T J J Z CL O W O A j O W ~ U F- LL U. oc O O z a U. o O_ •J O W m d U J � w-• a LU LL d. N W U W Y N N z O U W a N z J d z LL � oil m. LL SII o m a o r z .tl O W h - d ZJ s Date..L Z....Dtl..... TOWN OF NORTH ANDOVER VOW • PERMIT FOR GAS INSTALLATION This certifies that . �4 ./ ... �d i.' ............. has permission for gas installation ... to t k- _ .... . in thebuildings of qk:%y (I V- !F' S "�............. . at ..... 6a +uv-\ ..1 ?t........ �. , North Andover, `Muss. V Fee..'.? .... Lic. No ��03 ... .................... . . GAS INSPECTOR Check 6541 1 — ., \ ri/S�JJr'+VriUJG r J J ver�� •�, •. . (Print or. Type) Mass. Date AA Permit 'Y Building Lotion T Owner's Name :§2h (-%e&k4P—nye lei-e� /AA Type.oroc=eancj hplans-$ubmitte✓: Yes❑ NoNew n Renovation 77 Replacement ❑ G Installing Company Name Address /r©u — �t�,�te�. Business Telephone 4 7 3 a� 3 Name of Licensed Piumber or Gas Fitter Check one: Certificate p Corporation p. Partnership 0 Firm/Co. INSURANCE COVERAGE: I have a current liability insuranc Icy. or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes" No g g appropriate box if you have checked Yes, please Indicate the type coverage by. checking the app p A liability insurance policy D Other type of indemnity ❑ Bond . D OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the ins=nc- coverage required by Chapter 14 ass. General Laws, and that my signature on this permit application waives this requirement. Cbec one: Owner Agent D Sig a of OwrAr or Owners Agent I hereby certify that all of the details and infomution 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 pertna issued tar this application will be in compliance wish all pertinent provisions of the Massachusetts State.Gas Code and Chapter 142 of the GeneralgyTI'lturneyman of Ucartse`.Plumber Sgnatureea 4umoer ar Gas atter Title Gasfitter aster license Number, j4lTown iPPf1CVEi7 l0 MUS, ONLYT N G Y 2 G m m N H 0: U 0 � rs r . ►. C . W W J W v 0 G u ¢ y ¢ d �. O .,G � F- � ;< C! WW G • W J 2' < W W .D ¢ 0 W~ W W h Q J ill F� W r7 O 1• 2 J h h h W w m •O W Q M _ s O 0 �� .� C d .<r CQl C y s aQ. sus—aslmT. R BASEMENT I I 1 ST FLOOR I 2ND FLOOR 1 3RD FLOOR ATM FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR Installing Company Name Address /r©u — �t�,�te�. Business Telephone 4 7 3 a� 3 Name of Licensed Piumber or Gas Fitter Check one: Certificate p Corporation p. Partnership 0 Firm/Co. INSURANCE COVERAGE: I have a current liability insuranc Icy. or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes" No g g appropriate box if you have checked Yes, please Indicate the type coverage by. checking the app p A liability insurance policy D Other type of indemnity ❑ Bond . D OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the ins=nc- coverage required by Chapter 14 ass. General Laws, and that my signature on this permit application waives this requirement. Cbec one: Owner Agent D Sig a of OwrAr or Owners Agent I hereby certify that all of the details and infomution 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 pertna issued tar this application will be in compliance wish all pertinent provisions of the Massachusetts State.Gas Code and Chapter 142 of the GeneralgyTI'lturneyman of Ucartse`.Plumber Sgnatureea 4umoer ar Gas atter Title Gasfitter aster license Number, j4lTown iPPf1CVEi7 l0 MUS, ONLYT a - Q f. f. A 96 • H. 0 a W a • a o O Z 6 p W LL W 4 O a o CL 4I N ' - W 1 O� a .. - .... -• Date... ......................... TOWN OF NORTH ANDOVER PERMIT FOR WIRING ' This certifies that ............................................................................................. n has permission to performer' wiring in the building of ..., .y U at..../...�?...........,_,........................� .. ,North Andover, Mass. Fee �5.�....... Lic. No��:I"................... ELECTRICAL INSPE - R Check # • �,.. _. Commonwealth of Massachusetts a Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS 1 Official Use Only Permit No. Occupancy and Fee Checked [Rev. 1/071 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code ( EC), 27 CMR 12.00 (PLEASE PRINT W INK OR TYPE ALL INFORMATION) Date: y 0 City or Town of. NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of s or her intention to perform the electrical work described below. Location (Street & Number) 0 S-ju r1 Owner or Tenant Telephone No. % �, Owner's Address %� /��� , _ _ Is this permit in conjunction with a b ' dingpermit? Yes No S lF1 (Check Appropriate Box) f P B ` urpose ouuujug 1 , Utility Authorization No. Existing Service Amrd ps / Volts Overhead ❑ Und g ❑ No, of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No, of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: No. of Recessed Luminaires of Luminaire Outlets No. of Luminaires No. of Receptacle Outlets No. of Switches No. of Ranges No. of Waste Disposers No. of Dishwashers No. of Dryers Heaters KW No. Hydromassage Bathtubs � GI M Completion o the ollowin table No. of Ceil.-Susp. (Paddle) Fans No• Tra; No. of Hot Tubs Gen Swimming Poolnd.e ❑ vrrnd ❑ R.H of Oil Burners No. of Gas Burners of Air Cond. 1 om' Tons Space/Area Heating KW Heating Appliances KW No. of No. of Signs Ballasts . be waived by the Inspector of Wires. Total rmers KVA ors KVA FIRE ALARMS INo. of Zones o. of Alerting Devices o. of Self -Contained tion/Alerting Devices Municipal ❑ rnnnnrlinn ❑ Other o. of Devices or Wiring: o. of Devices or No. of Motors Total HP (Telecommunications No. of Devices or Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of lectrica}Work: SQ Q .Cir .(When required by municipal policy.) Work to Start: ( 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 cove ge is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Lt ---j ❑ OTHER ❑ (Specify:) I certify, under the pains and penaltt ices of perjury, that the information on this application is true and complete. FIRM NAME: _ tj 2 e c\ C ' e. c4 r ' C L LC LIC. NO.: ;20 Licensee: Signature LIC. NO.: (If applicable, enter " empt " i the license number line) Address:n C r) t t P o (� S �/ Bus. Tel. No.: r/7Y il` 0 y *Per M.G.L c. 147, s. 57-61, security work requires Department Alt. Tel. No.: 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 Signature Telephone No. PERMIT FEE.- be EE. t - 0 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street gio Boston, MA 02111 www nmss gov/dia . Workers' Compensation Insitrance Affidavit: Builders/Contractors/Eiectricians/Plumbers Applicant Information Please Print Le�ebly Name (Business/Organization/Individual):_ Je C 12 C t C Ll Address: ------------------- City/State/Zip: �(, O t k� Phone #:--22-7 YQ CI <227-7 Are you an employer? Check the appropriate box: I . ❑ 1 am a employer with 4. ❑ I am a general contractor and I �/MPIOYem (full and/or part-time).* have hiired the sub -contractors I am a.soie proprietor or partner- listed on the attached sheet. � ship and have no employees These sui:s-contractors have working for mein any capacity, [No workers' comp. insurance workers' comp. insurance. 5. ❑ We are a corporation and its required..] 3. ❑ I am a homeowner doing all work officers have exercised their right of exemption per MGL myself. [No -workers' comp. c. 152, § I(4),'and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12. ❑ Roof repairs 13- ❑ .Other -•vrr••�••� -1-1 u194;cy cox If i must also tttl 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 mustattaehed an additional sheet showing the name of the sub -contactors and their workers' comp. policy infomtetion. I am an employer that.rs providing workers' compensation insurance for my employees: Below is. the information. policy and job site Insurance Company Name: Policy # or Self --ins. Lie. #: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the .workers' compensation policy declaration page (showing the policy number and expiration daie� 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. Ido hereby cert& unde the pains and penalties of perjury that the information provided above is and correct Official use only. Do not write in this area, to be completed by city or town officiaL City or Town: Permit/License #t Issuing Authority (circle one): I. 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 ipgal 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 busiaess 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 I52, §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 cant' 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 ofthe 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 fixture 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 lnvestiWions 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. 9 617-727-4900 ext 406 or 1-877-MASSAFE Fax 4 617-727-7744 Revised 5 -26 -QS www.mass.gov/dia Date. L 7/< i. . NORTH TOWN OF NORTH AN VER �a ,r .... '♦ OL PERMIT%FOR P MBING This certifies that ................ has permission to perform ... t-?.%! ................... . plumbing in the buildings of .-i,. ,,�,�. t✓ I �? .............. at .... ... .. ` .......... .... . North Andover, Mass. Fee. .S.A .... Lic. No.2. yG.3. J . ....... PLUMBEC ING INSPTOR Check # ? � 7715 'MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO ISO PLUMBING fPrint or Type) t - Permit Ma--slIs. Date �/ a 5 �� 0&, # Building Location % S & DSTp h cS i Owner's Name �Oyl�Gt vH f�(� P Ma r +14 A-ki d o t e r Type of Occupancy Air New ❑ Renovation ❑ Replacement ❑ Plans Submitted: Yes ❑ No ❑ FIXTURES Installing Company Name`'A,4�> Check one:. Certificate Add ❑ Corporation z ' cs e., e" s ,,..: br ❑ Partnership Business Telephone 9:k s3 ❑ hrm/Co. Name of licensed Plumberr INSURANCE COVERAGE: I have a current liability insulae icy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes ❑ No or If you have checked Vis. 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 f the . General Laws. and that my signature on this permit application waives this requirement. Owner _—Agent ❑ tor= r spent -- 1hereby certify that all of the details and information I have submitted for 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 compliance with all pertinent provisions of the Massachusetts State Plumbing a and er 142 of the General taws. ��yd3�. Signature of trcensed Plumber Title _z H r car °D a z o x z < W Y Z N J < N 0: V F<- N OZ H Q¢ b a ¢ ¢ Z V < C O= < V A. U. O z < 3 x V = 1L O al O C< ¢ !- < M W Z¢ y O Q J= ¢ O o. ¢ 4. W= L S; 3 0 (� Z S 1- Y d¢ < Z Y Z, W IL A6 Y x W <' r- < O S p O < H < O Z <J O O J N < C ¢ W cc J- < O O V < S- h - >c m to o a j; s m ,�. v a< 3¢ m o SUB—BSMT. BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name`'A,4�> Check one:. Certificate Add ❑ Corporation z ' cs e., e" s ,,..: br ❑ Partnership Business Telephone 9:k s3 ❑ hrm/Co. Name of licensed Plumberr INSURANCE COVERAGE: I have a current liability insulae icy or Its substantial equivalent which meets the requirements of MGL Ch. 142. Yes ❑ No or If you have checked Vis. 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 f the . General Laws. and that my signature on this permit application waives this requirement. Owner _—Agent ❑ tor= r spent -- 1hereby certify that all of the details and information I have submitted for 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 compliance with all pertinent provisions of the Massachusetts State Plumbing a and er 142 of the General taws. ��yd3�. Signature of trcensed Plumber Title D �I 1 1 r� -- _In • O ' 2 N i O A O � O _ r. O o S � O s ° N O . N � .� Z A fA O p C C i • � r S Sc O Z O -- _In • O ' 2 N O O N . N Z -- _In • O ' 2 N -I"" -.�2 -e- Date ... ....... ". S.. ..... . ex This certifies that ........ - - -.a-, has permission for gas installation in the buildings of ........................... ......... at -,�,IV- North -Andover, Mass. Fee .... Lic. No........... GAS E Check # 6378 TOWN OF • NORTH ANDOVER 1 40F." PERMIT FOR GAS INSTALLATION ex This certifies that ........ - - -.a-, has permission for gas installation in the buildings of ........................... ......... at -,�,IV- North -Andover, Mass. Fee .... Lic. No........... GAS E Check # 6378 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) Mass. Date 2 Permit # - Buildingrr r'1 rL,fo-cation / 13 Am Si. Owner's Name .�� n Yt (I r- a M 1C No A` lover Type of Occupancy -s New ❑ Renovation ❑ Replacement ❑ Plans Submitted: Yes❑ No ❑ Installing Company Name A—,01 .h ^ U Check one: Certificate Address .2 eC) vt r%O-C r Ce iL1 ❑ Corporation L� CJz V C► T C C O ❑ . Partnership Business Telephone 9 7 8 3 (Q © 9;� S 3 p Firm/Co. Name of Licensed Plumber or. Gas Fitter ,-I L,. — 9 1<6 b t C�J-0— INSURANCE COVERAGE: I have a current liability insuranc policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes El No Cr 4f you have checked 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 4he,. General Laws, and that my signature on this permit application waives this requirement. Check one: Owners Agent ❑ Signatwb of Owner or ner's Agent I hereby certify that all of the details and information 1 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 compliance with all pertinent provisions of the Massachusetts State.Gas Code and Chapter 142 of the General L-aws. By Tof Vicense..7--- Plumber Signatu Licensed Plum atter Title Gasen i Mastter r License NumberD` row I f5u revmari . run ", M-EMENNEENEENEEMEN E�Evmw Installing Company Name A—,01 .h ^ U Check one: Certificate Address .2 eC) vt r%O-C r Ce iL1 ❑ Corporation L� CJz V C► T C C O ❑ . Partnership Business Telephone 9 7 8 3 (Q © 9;� S 3 p Firm/Co. Name of Licensed Plumber or. Gas Fitter ,-I L,. — 9 1<6 b t C�J-0— INSURANCE COVERAGE: I have a current liability insuranc policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes El No Cr 4f you have checked 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 4he,. General Laws, and that my signature on this permit application waives this requirement. Check one: Owners Agent ❑ Signatwb of Owner or ner's Agent I hereby certify that all of the details and information 1 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 compliance with all pertinent provisions of the Massachusetts State.Gas Code and Chapter 142 of the General L-aws. By Tof Vicense..7--- Plumber Signatu Licensed Plum atter Title Gasen i Mastter r License NumberD` row I f5u revmari . zj 0 P 0 W 0. N _Z N N W O 6 IL Z O H V W a N 2 J a V O z_• H r LL N' Q W J O z � t 0 o 0 W N C r W r V � LL ¢ • 0 O = 4 O O LL LL 3 = W Q m V J 0. W W LL N W v W Y N Z O H V W a N 2 J a V P P IK i I I i Cs o I W r Z Q W ¢ r � t r O W d O Z J • P P IK i Cf1.515 Date.'F�..;;�.:..0.6 .. TOWN OF NORTH ANDOVER ��ao �a as OL p PERMIT FOR WIRING This certifies that ..! �-�-cam * :-..�1�.....121...................................... has permission to perform .. . wiring in the building ofne It 11 at.....��.................................... 6t ... .. .............. , North Andover, Mass. od' Fe'e�d ................ Lic. No�/..� .. v...—-�.... .......... ELECTRICALINSPECTO� Check # /���_ � ...�,� •.,,et4,.,! 4Jrb� 1rY1t1Y { (A r ? Prrivtit 1tt� ICr Nr 6o ,< ,'d! ••^^�.••..,,,, SOARDOF FIRE PREVENTION RFGU1-AT1()1NnaOccopAncyinjr-em Cjjor,tCd APPLICATION FOR PE,40AITTO PERFORM .art lniQf rUt atult I0 19c perlArn,r.l in 317rnrt1a1lrc -11 .ae 41.�ts;trt,u•tC'is (l;rint9t (mn,tc f;t;' rJ'J,c"rrSf'�'klrvTt,vINK ORTYPP,rJt. J, 1 1r.sa.lcniR J]cla /J� �r City Ar'1'otvtl (J:{ ►v�,�/ P--- By tins apphr.:tlturt t!►a urlttrrsc�ii,:�] . iJ t+li+,r; f!�f ,: r I�Itet Ir,r�tf tsf 1or�f hf/„r 'kr(Ar P), !l'rr �s P .lr"IC3l m'01k dcarnbm below. �.arartun (5trtiet .0 IV l,nthcr•).,.... ... CL 4tvnpr or T mlftt Owner'sikirais _.__.. _�__ �. �'clCp41�11tR1p. il Is this )+crIllit hl Ccr►tjurlcltir,I, trill :► huiltlln� 1>�r,:,':� ' 1'cS (��j ( "-""'"""""'^^�-^`^ Pill I„,sc of wat,rrtrl,t C yr f J I�10 4- � �: r1pprowia to 130,1) Lt,lity rllathuri711i , ... u t;vtr• t`lie, ju .............._.,--*>,•',�.�'�•-n,�,,,,,.,,,,,,,,.,.,., rVu•I,lAtctcrs Lt -4! zt,!.l.�.t. ...,.,.... /Irr,r,s _.-._._f.,.,..._._� ulla U,crl,rati �� I.Ifrt1 rJ m^^~^-••... iVult►Iter trf f'caJers `71rt1 Arlt4,ac;ly � � lyQ o!',1later�. 1.ocaliuu will) Nature of 1�i . tltrwct-sac+lt lFittt,rce ,tin, t,! s^t•II.•�' � � .'” usr, (1 1tJ\llcj 1';1n.4 i�' nlrccltri.e�l„�r�rr,,r�rgf S, . r►f 1^Iklttinli Qntl�t� _.__,_. _._.._._. .� ?ra fa lata `!T`tl1Af " 4of llul 'f'ut,s_rr? .. of 1,.1 I,til► i.' _� A k ltlrtl'c Si•110►e ^ . �_._. � >w(...__. J^r�J. VA Q. t,e ar.11t@f0t1Rc ..o.of Re(`cfltacle OUJIVJ.i u, rYtteIr r n Pr t_. _1No. 0 Air . AIStYitrlteQ __._...._.r�,T," J'1J, A>;.,/1�Rf11 a�'ra. 02(11►att....... . oP 11111C*3Tombtu, of %�l�Pllr1 a ota'two i�?""eiT of DisIm..ASltereetSpacp/;1rr1 11t'11j11TI1•of DIyrrx ._.-_.___...__ ... .arRllllf.lp1 ct^�,"IIo ruQRlj0Ij t,l Cutter•^�iT1iQr ._ _..� _ — i�1b _ ur,1y YStSttIA: lie -loci tr 1<11' _ - r�n, fit _..._..... 't� �.._ ..,_,�� " O) dry a. of ^^m" - cs or ,E WYA1011 t'VA. 1artRrottt•�c�a_._..... .-.•...,______--_-_ _......�';i^n4....__._..__ ._.,..._„'�fattatts �� n1'" 11'irin �---.,..,. rlt' Unfttti,bs - tio,: �.���lrrs at ,airplpllt �a ornl ar.s Tor dipPlRtdltllli t'AIIA 0� �#Fr2;..,, _ _..._ ... �_.._�.._. �� "�t oR t' lag, "'"' 1,V.Si,'?t.�rtif.,' � � �-._._._.._._._...___._ __ ...-���ne6 ,lrfdr i•,�'......_,.- _..-----.._,._..,.M.......,.,....T '•.-.....•�„ A". 1C.Q1 1l�1�,'I«: Ultle-is watvcd by,hc at,r,.et, no IC nl A,"rnri r%l14Pr, Q�, nr nr r•c rr;rgl%pi N,q lrlspa�trar of iV/rrr the IireRsct pra�teJ,rs�imorar{tab iup sur.�tttr. incl,rti,,i 'cnn completed o ,%"� Aran, fc,r t(+ perfarm.^+ntc ejrciQcrricnl \a'prt; rtr�y resort u111031 uflitf^rsigrie r,QrilffrS Ihat attcrl cnvic eve Is Itti fr�rrc, a ,rJ J .,s c tluhitcd rr,cr'rtr�n' cov�rARC ar ha autt$I�ntit►I Pquiv>�1cnl, 'Tire CFIEi;K O�tE. !�'j4Ri1PIF(, P cl santt: 1a ;l,F permi�iestttug orrice ��,�,� Sq C:) c)tIrJ�R ,�'I,t•;.ir r ►._,..�. u.��. ��. .�aJ ' tical 1Vslk r . ^^.•.•..^�,-• Notk It, Sr1,l ��_ - Ov+ ,t•n (rq,I,tc,i by ninwr paJ pni,,"� 1 t�\Pwiison Dmc) - t.._L.._ figQeN,-J I„.1tr. �,f J t't'rri%, tr;hl, r rift• frlin i , ,,�,; c \, r;lt MFC u� f,ulc ! Iry Y ;., . ;, �1, 111d 111lnrl Lut ll lesion. r 11ft.r nl,Irlfr•01.'u+, n 1,1tt•'�'eo fttrt'rr „t/n C)II�Vrsc _ t t `�J _'; r. . ' t.lr tN d . ` IN I.I2'r+ if1" 11. I;4 r,•T1y�r..1 VrR. I ., �!,... �// t`,as. T+cf.;No �, tt^,?Irtf t t� (J 1 :, Jr,f :It't( tJ,C' I is �' ,c '",+"^^•+,E�,.,, t C A O iNn •' Q\rur r/r\. il\' n' <+r, q ,,..ri,; i n; rr T t. ,+s +,al lfn,n rba ,.at;lir) ,,,xurartrC ctrl " ..'" Y 6t�i,.f4wc ha•luv f t,. ti ... �c„t i 1 t, tl�c^ (t i,rck cra117' slmt11I S'Irnll;tltlrf` rt,IC) ..........__,.,_...,..._M....-,,.,_......_.._..� .,. _-.., ncr �Qtttt:rsa•enl. Location /\� -4 MORT" TOWN OF NORTH ANDOVER Certificate Occupancy of $ gCMUS � swcMust Building/Frame /Frame Permit Fee $ 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL Check # •� 55 70 a --,-.Building Inspecto TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING �. BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: Building Commissioner/12REtor of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 6s rr� `r /cr7 ,6 3 Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Y3� 8aa z 12 CJ 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 S Wly M.G.L.C.40.t54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public , Private ❑ Zone Outside Flood Zone ❑ Municipal 5l On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Name (Print) Address for Service: V7 Signature Telephone 2.2 Owner of Record: A Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed `Construction Supervisor: / Not Applicable ❑ L, -.c S -Y-- p4f^S/J�1l �/Ar M CC,7 je-AC f ' ` Licensed Construction Supervisor: 06 /17s r WLicense Number C � •r,S ;L r f�G� • iia v t^��n � �l/� . Address �y r Y/ z V � `t ( ! 4— ,/)(� — �GG Z (— C �-! J r Expiration Date Signature v Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ S�lv�.,,� Cil f{aC•l!'�� I Q D �' �S Company Name P Q fC �, n / Q ` J �G� /�� ` Registration Number Address �'(G` YL67 OL 41 Expiration Date Si nature Telephone 00 M LTJ O, �JJ A I� O Z M 90 O on ic r v M r Z^ V/ 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 buildiMpermit. Signed affidavit Attached Yes ....... V No ....... ❑ SECTION 5 Description of Proposed Work checkA applicable) New Construction ❑ Existing Building ❑ I Repair(s) ❑ Alterations(s) ❑ Addition 4-� Accessory Bldg. ❑ I Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: enc%t ;,� sf�- /h�lzScr'�-�� Arc67 I SECTION 6 - ESTIMATED CONSTRUCTION COSTS 1 Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICUL USE ONLY 1. Building �GG (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x (b) 10 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 24 co 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/AUTHORIZED AGENT DECLARATION 1, t' t U i���rtS JV I (-k f n "'c4j!u tri, �, has 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 Ir ::c '_4-c 6"'l Print Nam Siature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS iST 2 ND 3 SPAN DE\4ENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS DIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUII,DING CONNECTED TO NATURAL GAS LINE R IWA 3 S� � �0 j2 FORM U - LOT RELEASE FORM 10 / 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. ***************�***************AP//PLICANT FILLS OUT THIS SECTION*********************** APPLICANT CirA2 Q PHONE LOCATION: Assessor's Map Number % 6 /� PARCEL SUBDIVISION LOT (S) STREET O S `� ST. NUMBER 'ZSR ************************************OFFICIAL USE ONLY*********************************** RECO ' MENDATION CONSERVATION ADMI COMMENTS TOWN PLANNER COMM FOOD INSPECTOR -HEALTH TOWN AGENTS: ,TOR DATE APPROVED / 0 0,:k DATE REJECTED 4 DATE APPROVED DATE REJECTED 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 mw" -a ('11, O L,n -i s � T DAT A60RD r M 1 `� t `� tl (FANIIDDIYY) rM ' :. R t 1w► 0 7101/2002 z , K r r ,x ,, x.. ....,,j. r.. „s- .tf3, Y DDUCERSerial # A14911 THIS CERTIFICATE ISISSUEDAS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE AON RISK SERVICES, INC. OF FLORIDA HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR 1001 BRICKELL BAY DRIVE, SUITE #1100 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. MIAMI, FL 33131 4937 COMPANIES AFFORDING COVERAGE 800.743-8130 - coMAv AMERICAN MOTORISTS INSURANCE COMPANY — - WIRED-- PAM —� -- ADP TOTALSOURCE, INC. Eco, B 10200 SUNSET DRIVE MIAMI, FL 33173 COMPANY *ALTERNATE EMPLOYER: C COMPANY SYLVAIN CONTRACTING LLC D �1JRAGES' k Y i 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAYBE 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. TPOUCYEFFECTIVE POUCY EXPIRATION LIMITS TYPE OF INSURANCE POLICY NUMBER DATE (MWDDIYY) DATE I1111=01" I GENERAL LIABILITY GENERAL AGGREGATE�— COrvIAERCIAL GENERAL LIABILITY PGt'iDLICTS • COI AGCIs C' AJNS MADE OCCUR PERSONAL & .AD', IN -J -Py .'— $ -----------`� ERS 3 COrJRACTOR'S PROs EACirCCURP.ENCE $ I FIRE DAMAGE ;Ary one fire) $ MEL EXP (A'ri me person) $ AUTOMOBILE L--� LIABILITY I I ANY AUTO G)MBINED Sirrid. E''-Gv1!T Is AtA OWNED AUTOS �-- _. --- -------4— ---.--.._. _..----- �- — I BOCILY INJURY I $ SCHEDULED AUTOS (Perperscr!) I I HIRED AUTOS I(Perecclaanry DILY INJURY $ NON-OWNEDAUTOS I r1,1101ERTYDAMAGE J �$ — GARAGE LIABILITY At., fo or LY. EA AC0M,1 — OTHEP THAN AUTO ONLY JANY AUTO EACHACCOENT $ i AGGREGATE $ EXESS LIABILITY C EACH OCCURRENCE �' IAGGREGATE $ 11 UMBRELLA FORM —_- ($ V'HERTHANUMBRELLAFORM 'WORKER'SCOMPENSATION AND 5BG115434-00 06/30/2002 06/30/2003 !X TORS LA 7, SER -� EMPLOYERS' LABILITY EL EACH .ACCIDENT Is 1,000,000 .HEppcvw.EIOR) TINCL I ELD!SEASE-POLK:YLIMIT $ 11000,000 PAR i FERJEHECUiIVE ' FFICEFSeRE EY.CL I EL DIS'EASE•F_A EMPLOYEE $ 1,000,000 OTHER I ' I — I I I iCRIPTION OF 0 ERATIONWLOCATIONSfVEHICLESISP CIAL ITEMS .L EMPLOYEES WORKING FOR THE ABOVE NAMED CLIENT COMPANY, PAID UNDER ADP TOTALSOURCE, INC.'S PAYROLL, WILL BE COVERED x'DER THE ABOVE STATED POLICY. *THE ABOVE NAMED CLIENT IS AN ALTERNATE EMPLOYER UNDER THIS POLICY. =R:TIFICAT�I,F(OLAI*I� t '.• r 'k3A1�G�ff;A'T14f1' w ' y :' ,y ,,' -.. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE SYLVAIN CONTRACTING LLC EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL o PLAISTOW ROAD 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, PLAISTOW, NH 03865 BUT FAILURE TO MAIL SUCH NOTICE $HALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHqMED REPRESENT ATIV_ oD ' i ` z a A�gra>►�t�o3ATraN t$s , �r 2 2 �- , .5-r/ Z a 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: (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 The Commonwealth of Massachusetts = Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Name Please Print Name: Location: City Phone # I am a homeowner performing all work myself. 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 City // atf 60 Phone #: Insurance Co. /i^ c%'r[t�A /' ii rtJ�-J - L^j` Policv # Company name: Address City Phone #: Insurance Co. Policv # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of,a fine up to $1,500.00 and/or one years' imprisonment_as_yell_as_civil.penaltiesinsheiorm..fa ST_OP.W. _ORK ORDER-and_a.fine..ofl$]DOM)-a-day.againstme. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and nalties of perjury that the information provided above is true and correct. Signature _ _ Date , A& /- �-- Print name r! -c IS � ca/i e ^ I Phone # Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensing Building Dept DCheck if immediate response is required E] Licensing Board D Selectman's Office Contact person: Phone #. D Health Department D Other CONSUMER INFORMATJON FORM - "SUNROONTS" Massacluselts Slale Building Code (780 CMR; Appendix J, Section ,11.1,2.3,1) s The .tvtassach"setls State Building Code (730 C1 ) includes provisions to ensure that houses and house additions meet energy efficiency standards. This supplemental CONSUMER MFORNIATION 1701W is to be filed as part 'o,f tiie building permit application when a builder/contractor or homeowner, constnicting/installing a house addition with very large percentage of glass to opaque wall, seeks to utilize a special energy conservation exemption option for "sunroom" additions to an existing house (780 CMR, Appendix J, Section J1.1.2J.1). This FORM is not intended to prevent 'a homeowner from selecting a "sunroom' of any size, configuration, orientation, form of eonstniction or percent glazing, bill rather is only intendcil to assist homeowners in becoming aware of some of the important energy conservation and year- round comfort considerations involved in selecting and utilizing a "sunkoom" addition. The connection of ''sunroom" sinictures to 'residential buildings May create comfort and energy consumption issues due to uncontrolled solar gain or uncontrolled radiation cooling of the main house. In the selection and constniction/installntiort of "sunroorns", included below is a non-required, open-ended list of product and design considerations dist tr homeowner may wish to consider before actually constnicting/installing a ''sunroom". It is recommended that consumers carefully review these options with their designer, builder, or contractor, in order to minimize potential energy consumption endror house discomfort issues. In addition, the qualifications and reputation of the company or individuals to be hired are important considerations. PRODUCT ANi) DESIGN CONST ERATIONS1ZE LATE.D TO "SbWR00MS" • Solar Orientation anti NaWral Shading • Type of Glazing • Insulating value • Solar hent gain • 1'rnme materials • Glazing to frame sealing and gasketing materials/ seal durability rine!/or wenther tightness of the sunroom • Adequate ventiln(lon - Operable windows and fans Applied Shading Sy3tems Insulation level in floors, wally, and ceilings r pogyil)IL` Snnroom Isolation from the mita house via a wall and/or door or slider • Beating and Cooling Nfethods: Efficiency, Zoning and Controls Homeowner Ack.nowledgtnent The 1'1,lassachusetts State Building Code, Section 11.1.2.3.1, requires that the actual property owner (not the owner's agent or representative) acknowledge receipt of this CONSUMER fNFOR IMATION FORKd prior to issunnce of a Building Pef-mil for a project that includes "sunroom" additions to an existing residential building. In accordance with this requirement, the undersigned hereby acknowledges tliat she/he has read the infonnation in this rloeurnent concerning sunroom comfort and energy conservation. ll�lo Z Signanire )f Actual lwilding Ow r Date Sf G Q r U d _ -7 130J to n /�Gt Print Name Address of Permitted Project Owner Address (i('different than project location) Owner's telephone number TIO miam NatureScape Visibly Better- THERMADECKTm FLOOR PANEL SPAN CHART 48" x 35/8" E.P.S. & 65/8" E.P.S. with (2)15/32 O.S.B. LAMINATES 48" x35/," E.P.S. with (2) 15/32 O.S.B. LAMINATES CLEAR SPAN LENGTH U240 10 15 20 25 30 35 40 45 50 (S) 60 65 70 75 80 85 90 95 100 PSF PSF PSF PSF PSF PSF PSF PSF PSFPSF PSF PSF PSF PSF PSF PSF PSF PSF PSF PSF 3.625" 1# Foam 2 ea. 15/32 OSB 12'6" 12' 11'6" 11' 10'6" 10' 9'6" 9' 8' 6" 9' 8" 9' 6" 9' 4" 9' 8' 8" 8' 6" 8'4" 7'68" 12' 6' 48" x 35/8" E.P.S. with (2) 15/32 O.S.B. LAMINATES CLEAR SPAN LENGTH A -U3 o 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 100 PSF PSF PSF PSF PSF PSF PSF PSF PSF PSF PSF PSF PSF PSF PSF PSF PS PS PSF 3.625" 2# Foam 2 ea. 15/32 OSB 13'6" 12'6" 12' 11'8" 11'4" 11' 10'6" 10' 9' 10" 9' 8" 9' 6" 9' 4" 9' 8' 8" 8' 6" 8'4" 7'68" 12' 6' 48" x 65/8" E.P.S. with (2) 15/32 O.S.B. LAMINATES CLEAR SPAN LENGTH — - U360 10 15 20 25 30 35 40 45 50 55 60 65 70 75 80 85 90 95 100 PSF PSF PSF PSF PSF PSF PSF PSF PSF PSF PSF PSF PSF PSF PSF PSF PSF PSF PSF 6.625" 2# Foam 2 ea. 15/32 OSB 22'8" 21'8" 21' 6" 21' 2" 20' 19.91. 19' 18' 2" 17'2" 16' 10" 16' 6' 6' 2" 15' 6" 15' 1" 14' 8" 14' 2" 13' 10" 12' 10'6' Step 1 Take known A or V? for your area. Step 2 Take PSF design required for job. Step 3 Select appropriate column to determine maximum span for particular foam density. Example: Known 0360 Known 40 PSF load Using a 3 5/8" panel with 15/32 OSB both sides and 2 Ib foam shows a maximum span of 10'6". ENGINEERING APPLICABLE ON LY TO PGT PRODUCTS 50 Revised 1/29/01 .M NatureScape Visibly Better.^ THERMADECKTA° FLOOR PANEL SYSTEM 1%16(t2x4or Wood Joiner Minimum 1 x 4 Fascia Board / Ile - Therm Panel Minimum 2 x�r Foundation Runner Minimum 4 x 4 Post 7 Minimum 1 x 4 Fascia Board 1 • , 3/4 3/4= . F ' 31/2" 3 5/8" Polystyrene 2x4or2x6 \ Lumber 1/2" Oriented Strand Board 2 pieces (O.S.B.) ENGINEERING APPLICABLE NOTE: Ledger board, joiner, fascia and support structure not included. ON LY TO PGT PRODUCTS 48 Revised 1/29/01 I .. t," '.. ..'' ` ..L.I. '. ..'• ' iii I ,� �,�r `.,� � 2 x# Lumber �'' • % `, 1%16(t2x4or Wood Joiner Minimum 1 x 4 Fascia Board / Ile - Therm Panel Minimum 2 x�r Foundation Runner Minimum 4 x 4 Post 7 Minimum 1 x 4 Fascia Board 1 • , 3/4 3/4= . F ' 31/2" 3 5/8" Polystyrene 2x4or2x6 \ Lumber 1/2" Oriented Strand Board 2 pieces (O.S.B.) ENGINEERING APPLICABLE NOTE: Ledger board, joiner, fascia and support structure not included. ON LY TO PGT PRODUCTS 48 Revised 1/29/01 M NatureScape Visibly Better- PANEL-LOCKTm ROOF PANEL SPAN CHART LOAD SPAN CHART 48" x 3" 3105-H14 COMPOSITE PANEL CLEAR SPAN LENGTH NATURESCAPE PATIO ROOM, typical screen room (check local codes) - _ U80110 10 20 25 MPH 40 60 65 70 80 90 100 DEFLECTION P.S.F. P.S.F. P.S.F. 31 P.S.F.P.S.F. P.S.F. P.S.F. P.S.F. P.S.F. P.S.F. P.S.F. 3" 1 Ib Foam 16' 14' 13' 6" 13' 12' 8' 7-6" 0.024 Aluminum 3" 2 lb Foam 16' 4" 15' 14' 10" 13'9" 12' 9" 10'8" 9' 4" 3" 2 Ib Foam 17' 16-6" 16' 15' 14' 12' 4" 12' 4" 1 Ib Foam 19'2" 16' 10" 16-2" 167" 14' 5" 12-5" 12'2" 10,111, 9110" 8'8" T 6" 0.024 Aluminum 4" 2 Ib Foam 20' 5" 19,101, 19-2" 18' 16' 10" 14-8" 14'5"_ 13'6"_ 12'4" 11-2" 9' 8" 0.030 Aluminum 1 6" 2 Ib Foam 29' 28' 27'6" 26' 24'7" 19'7" 19' 18' 16'6" 15' 13' 0.030 Aluminum A -U120 DEFLECTION 3" 1 Ib Foam 15' 13-4" 113-11" 12-2" 11' 1" 8-11" 8-1" 0.024 Aluminum 3" 2 Ib Foam 0.024 Aluminum 15' 7" 14'4" 13'10" 12' 10" 12-3" 9' 4" 8-9" 3" 2 Ib Foam 0.030 Aluminum 16' 7" 16' 15' 14' 12' 10.1.. 9.10.. 4" 1 Ib Foam 0.024 Aluminum 18 16' 1" 15' 8" 14-7" 13' 10' 6" 10' 8'5" 6' 4" 4' 2" 2' 1" 4" 2 Ib Foam 0.030 Aluminum 19' 11" 19'2" 18' 16' 10" 14'5" 10' 1" 9' 10" 9' 6'8" 4' 6" 2'2" 6 2 Ib Foam " 6" 2 Aluminum 28' 6" 27'6" 26' 4" 24' 6" 21' 15' 14' 1" 12' 9' 6' 3' NOTES: 1. All readings taken under load. 5. Foam also referred to as EPS. 2. Uniform load PSF (pounds per square foot) 6. Panel connection incidental to span. 3. All lengths were a result of direct testing 7. For greater spans, contact PGT. with infinite analysis calculations. 4. Data to be used for NatureScape panels only. Step 1 Take known A or U? for your area. If unknown, take worst case and most accepted of U180. Step 2 Take PSF design required for job. Step 3 Select appropriate column to determine maximum span for particular combination of skin thickness and foam thickness and density. Revised 1/29/01 Example Known LA 20 Known 40 psf load Using a 3" panel with .030 aluminum skin and 2 Ib foam shows a maximum span of 12'. 51 3" Panel 4" Panel 6" Panel 3" Panel 4" Panel 6" Panel ENGINEERING APPLICABLE ONLYTO PGT PRODUCTS SHOIS1AM 1 31VO fel 31011:3-IVJS I :31V0 :A8 a3unsV3Y1 :A8 (010 181JO1N30 QIAVQ --AB JWVU(j i ( ) 'lid 4 4 u 0 z l� z fY TO O z 0 tl A w .c a2 o w v a V) w G w o.0 w v U � w w a o w G w a w W ao' co w x 2 �. cdC w W W A w cA z cn x o cn ui Om J a �co aD c A C H 5 C U9. C/) E--' v U 'd•fl z o C/)" C C ?j lC • t CD C o O C3C r xN yam"' :E¢ 00 CL ro - N fly c �E_ D CD m o0 �. C.3.. • cbi me u E co m m m G. �: ` O N N •" co;ca C� N :x C moo • Em`s �i'• m o 5 m m = N m mom m cc a c omwo = N W cc t •+ fl t •H .w.. O C O � W .E aL O`r c •N O m c.D cm Q' Q Q� O: V� = A m:9 J m � CO) O C F— $ CL.- CIO J a i--1 A w U9. C/) E--' z o C/)" z o z� r w0 a T IO CDO CD O 0 I y GD M L .0 C 0 co Q CL H O O V .51 CA C O L) m C cc CO)CL is L O V CO CL CO2 C CO Q, c CDm 0 U) LLI U) crW W Irw U) N° 1 %S0 Date ....... z - . 20 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .�.. f',w....�:....................................... has permission to perform wiring in the building of .................................................... at .... r, .................................... .................... , North Andover, Mass. Fee.J ............... Lic. No�/1/1.23. ICAL� .. { ............ G ELECTRINSPECTOR 0$/04!9911�!� WHITE: Applicant CAWY: Building bw. PA1I'INK: Treasurer V t l 1 r Office Use Only w / 7 Q Department of Public Safety �,1 Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 1200 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed In accordance with the Massachusetts Electrical Code. S27 CMR 12:00 (PLEASE PRINT IN INK OR FPE ALL INFORMATION) Date t-1- 2-1,.:"— 7c7 City or Town of an4 44i�o1er4 To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work desdr a below. M7 1 Location (Street & Number) Owner or Owner's Address PARCEL Is this permit in conjunction with a building permit: Yes � No ❑ (Check Apprgpr£atex`a Nd.'G�KL Purpose of Building ��(t,( IL1s'` I�i. c1f✓UJ/�°a Utility Authorization N6C'h,� r- 2�4 Existing Service Amps / ty Volts Overhead Undgrd ❑ No. of Meters i New Service Amps �0/ 110 Volts Overhead Undgrd ❑ No. of Meters_ Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work e 15 No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total RVA No. of Lighting Fixtures Swimming Pool In- grnde ❑ grnd. ❑ Generators KVA No. of Receptacle Outlets 129 -No. of Oil Burners No. of Emergency LightingBattery Units No. of Switch Outlets is No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Sounding Devices No. of Self Contained Detection/Sounding Devices Local EJ Municipal ❑Other Connection No. of Ranges % No. of Air Cond. Total tons No. of Disposals ` No. of Heat s Total Total Tons KW No. of DishwashersSpace/Area Heating KW No. of Dryers Heating Devices KW No. of Water Heaters KW No, of No. o Signs Ballasts Low Voltage Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES)g NO ❑ I have submitted valid proof of same to this office. YES► NO If you have chedked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE BOND ❑ OTHER ❑ (Pleape Specify) � Estimated Value of Electrical Work $ S� ®� xpiration Date Work to Start Inspection Date Requested: Signed under the penalties of perjury: Rough Final FIRM NAME l] n _ LIC. NO. Licensee Qr3�2.� 14zjLA— Signatute LIC. N0. Ao 3-:30 /�������\ B Tel. No._kt �II Z'3 a 1 Address ��� 44(5 r — rA:! �e—�� Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub- stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEE $ BVI Signature of Owner or Agent R w IL Wn U w J w 4% F- 0 O J 0 w H w J CL 2 O U w i— ¢ Com• d Location 075 00M� A) Ste" No. 3 6-) V Date NORT1y TOWN OF NORTH ANDOVER p Certificate of Occupancy $ a ; ; Building/Frame Permit Fee $ 'YJ` Foundation Permit Fee $ / Ss�CHU Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ r` Building Inspector 08/04/99 11:34 195.40 RD Div. Public Works IM c '`6 0 XO z V \ J F a w _ F J � � U F � I z U W Z z_ z - ? C C w � U � C L N c G C O Q V L c O z 'f C L.� C ' z 0 � F x J � - U t � t c '`6 0 XO z V \ J F a w _ F J � U F U W Z z_ z - ? C � � L � G C V L c c '`6 R XO z V \ J F a w _ F J � F U W Z z_ z - ? C '`6 R XO V \ J F a w _ F J � � ,. .. �� , .� fi'� Va .�,M} .,y � ` e�i8j. �.:.: �a.,,,,,,,,anf(f �,�-.. J ,� D J Mon 0 O FEM4 d o c ` h � c o. R� CD c t o ' o 0 E a 1310 Z�:0 O. m OR N E c 3�= E d � L a! A mm C m ... Qf 1 m cc L = C H A O E m L � aav � m mN c .c CO O v H o o = Gm ` Z O.� w.+ c C O c m N O c C = m m .- c N 0 y m COD 4- t *a A c r.+ •N d.= = Z ui �E E -o 4 y o C.3 0om C g CO306 m � c 'o x v � o O $ az m > 0 0 0 V of i .T 2 O H y .E C O co Q. CO) O O d c O :L] C ts co O. H C CD CM C O C m m L: a C a C. a E a x A w aa ch O w p a C U C ii w p C 8 W p C acn z O C w W c 7 o cn Nd p cn D J Mon 0 O FEM4 d o c ` h � c o. R� CD c t o ' o 0 E a 1310 Z�:0 O. m OR N E c 3�= E d � L a! A mm C m ... Qf 1 m cc L = C H A O E m L � aav � m mN c .c CO O v H o o = Gm ` Z O.� w.+ c C O c m N O c C = m m .- c N 0 y m COD 4- t *a A c r.+ •N d.= = Z ui �E E -o 4 y o C.3 0om C g CO306 m � c 'o x v � o O $ az m > 0 0 0 V of i .T 2 O H y .E C O co Q. CO) O O d c O :L] C ts co O. H C CD CM C O C m m L: C C. E 0 U) U) Ir w crw w U) 145 65 uwg no. haggertyScale : 1/2 " = 1 ' Design :. 06/07/99 ;I dimensions & size designations This is an original design and must Date 06/21/99 ven are subject to verification on not be released or copied unless .b site and adjustment to fit job applicable fee has been paid or job -- onditionsr order placed. Designer �. ~- | §_§ ! . �. / ^2 \ \ } �f \ \ ..::.:. �§ $ [ ;! o¥ 30 �p § m ƒ\� \. ,| ■ � « „� : . . . } }i � § COT,(§Zpt ƒz� ■. ƒ.� ul w 0 o it w: . > ©' ~- | ..::.:. #: : 2 Steve & Karen Garufo 75 Boston Street N. Andover, NLA, 01845 Building & Remodeling Kitchen Remove cabinets, appliances, and flooring Gut walls down to studs Install sunlight garden window Install 36" x 80" French door Do rough wiring and plumbing up to code Insulate outside wall; install 1/z" blueboard and plaster Install new oak flooring; sand and refinish three coats Install new kitchen cabinets and counter tops Install new appliances (supplied by owner) 7/2/99 Home: (978) 557-8175 Steve: (781) 933-8090 Karen: (978) 318-0600 Bathroom Remove sink and counter top; and one section of drywall Redo plumbing and electrical up to code Install '/2" blueboard and plaster; Install new vanity with sink faucet; install new toilet Install 8" white ceramic tile floor (supplied by Home Team, Inc.) Bathroom fixtures not to exceed $1,000. Bedrooms Cut opening between two bedrooms Size to be determined by owner; finish in plaster or pine Floors Remove carpet and tack strips Sand and refinish three coats of polyurathene Total labor and material $30,000.00 Deposit $15,000. Rough Insp. $7,500. Finish Insp. $5,000. Balance $2,500. Neil Haggerty President Home Team, Inc. M 9i 'Town of North Andover F HORTFj 1 OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES 27 Charles Street North Andover, Massachusetts 01845 WILLIAM J. SCOTT SS 4CHU�r Director (978)688-9531 Fax(978)688-9542 In accordance with the provisions of MCL 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 c 11, S 150 A. The debris will be disposed of in: Sk C t�k�re (Location of Facility) V / — Signature of Permit Applicant -7 -/g�q Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector 'J- I 9 BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-95.10 PLANNING 688-9535 - Date,F - �< - . 5. c. 4103 ,AORTpt TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING -X� CHU This certifies that 1#4 ................ has permission to perform .... k t.-: r ............ plumbing in the buildings of ................. at .... /-3 o. Y. North Andover, Mass. Fee. Lic. No...,? 3 Z .7 . ...... ........ LUMBING INSPECTOR 08/04/99 11:50 33-00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 4 33 - MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) / Mass. Date 1 g_jE Permit # 6 03 ' g �� Owner's Name bat .1 Building Location 0 New ❑ Type of Occupancy. Residential -Denpyation ❑ Replacement Pians Submitted: Yes ❑ No 11 .40 Z FIXTURES I ® 0101■■■■■ ■ ■ 0101■■■■■ �■.... 0101 ■■■■■�■■ ■ 0101■■■ ®■■■■■■■■■0.0■S■■■■■e■00010■ ...MM ■�■..■.. ... ■000■■■■■aM■■■■■■MM©■■MiMi ••0101■■■■ ■■■■■■■■■■■■®■■ • • 0101■■■■■ ■e■■■■■ mom ■0001■■ ■ ■■EaEMM■ 0101■ ■ ■ .. MEN ENEEN ■■■� ..■■■0-SEEMSOMMEN ■MS MME ■MEN Installing Company Name Heritage Htg , &Plg . Co . Inc. Address 35 Pleasant Street Stoneham, Ma 02180 Business Telephone Name of Licensed Plumbe _7 81 - 4 3 a --U fi — Gordon Switzer Check one: Certificate LX Corporation 714 (-1 Partnership I 1 Firm/Co. — INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalen" vwhich mccts the requirements of MGL Ch. 142. Yes 91 No ❑ If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability Insurance policy L-3 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 compliance with all pertinent provisions of the Massachuse!ts State Plumbin Cods and Chapt r lA2 0 the General Laws. By-- — — Signature of Licensed Plumber Title _- -- --- Type of Liconse. Master IX Journeyman [J City/Town _ $ 3 2 2 APPROVED OFFICE USE ONLY) License Number J Z O w N w U a LL O crO LL 3 O J W m N Z O F- U W 0.. z. N' V) wl c ai OI a 0. w w LL m w m M J CL Ol