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Miscellaneous - 8 Royal Crest
Date ....... ./..fie Z�l............ TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that...........Z.f...►.4.%.��...........G has permission to perform ... ,�.Q,,,,..PUl .0 .. ��a�7 , 4 wiring in the building of......`........ ......................................................... ......................................... at -� ...ky .................................... ... 1.. , North Andover ass. ,Q Fee...s©...... Lic. No..�Q7'..1.............�!?'!!�!/.r.. ............. .............. ELECTRICALINSPECTOR .L Check # 1250t"� P ComrxxarxcveaCih ol Waijachvielli 2epadonent ol5ire Servike:s BOARD OF FIRE PREVENTION REGULATIONS Official Use Uiily Perin i t .No: Occupancy and Fee Checked. [kev. 1/071 cave lilaul.) .APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK !1']I work to be,perfornied in accordance with the Massachusetts Electrical Cotte (MEC), 537 CMR 12:00 (PLEASE PRI'VT I-V hVK OR T37PE ALL I.WORMA'TIO.V) Date: July 7, '2014 City or Town of: , North Andover To the Inspector of Wires: By this application the.undersigned gives notice of his or her intentionto perform the electrical work described below. Location (Street& Number) 50 Royal Crest Drive Building # 8 Apt 3 Owner or Tenant Royal Crest Apartments Telephone No. 978-681-1822 Owner's Address 50 Royal Crest Drive North Andover, MA 01845 Is this permit in conjunction with a building permit? Yes ❑ No 0 (Check Appropriate Box). Purpose of Building Commercial - Apartment Buildings Utility. Authorization No. Existing'Seryice Amps / Volts Overhead ❑-Undgrd ❑ No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and ,Nature .of Proposed Electrical Work: Replace Baseboard Heat Coninletion ofthe f6llowine table rriac he wahed by the Imnector ofTFIres. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No -of Hot Tubs Generators KVA No. of Luminaires Above O n- Swimming Pool rnd. ❑ rnd. 1:1 o. "Emergency Lighting No. Units. No. of Receptacle Outlets No. of.011 Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners o. of Detection an Initiating Devices No. of Ranges g No. of Air Cond. TotalNo. Tons of Alerting Devices g No. of Waste Disposers eat um Totals:_L um er onsJ-KW No. of Self -Contained Detection/Aler fing Devices No. of Dishwashers SpocelArea Heating KW Local ❑ . unicipa ❑ Other Connection No. of Dryers Heating Appliances g pp KW Security ystems: No. of Devices or Equivalent No. of Water KW No..o No. of. Data.Wiring• Ieaters Signs llallasts I No. of Devices or Equivalent No. Hydromassage Bathtubs. No. of Motors. Total HP a ecommunications firing: No. of Devices or E uivalent OTHER: Estimated Value of Electrical Work: .4ttach.additional detail;if*desired, or as requit'led bY the laTector Qf Tftres. (When required by municipal policy.) Work to.Start: 07/07/2014 Tnspections to be requested in accordance with.NTEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for,the performance of electrical work may issue utnless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify-:) I cert fy, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME: The Electricians & Co.. Inc. LIC. NO.: A10737 Licensee: Michael J. Parziale Signature LIC. NO.: E202fi9 (If ahhlicahle, enter "exempt " in the license ntunber line.: j Bus. Tel, No. 781-322-9344 Address: 50 Branch Street Malden, MA 02,148 Alt. Tel. No.: 7R1-322-3100 " Pcr M.G.L. c. 147, s. 57-61, security work rcquires Depmitnient of Public Safcty "S".Liccnsc: Lic. No. 35 GO 001021 OWNER'S INSURANCE WAIVER: lam aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, l hereby waive this requirement. 1 am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERAf1T FEE. $ 125A r t 1�a /Z ll- e''hl f 1 5 e L ti The Commonwealth of Macvsachusetts Department of Industrial.Accidents 4+1" Office of Investigations X ' 600 Washington Street Boston, MA 02111 -- www.muss.guv/diu Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leeibly Name(Busutess/Urganizatioit:lndividual): Address: 50 Branch Street City/State/Zip: Malden, MA 02148 Phone 4: (781) 322-9344 Are you an employer?. Check the appropriate. box: Type,of project'(required ); 1, Q Tam a employer witli 1 4. E] l am a general contractor and 1 h El construction employees (full; andi.orpart-time).* have hired the sub -contractors -New 2. ❑ ham a. sole proprietor or partner-_ listed on the attached sheet. 7. ❑ Remodeling. ship and have no employees These sub -contractors have g, ❑ Demolition. working for me in any .capacity. employees and have workers' 9. ❑ Building addition [No workers' comp: insurance required.] comp. uisurance.a S. We arc a corporation and -its ❑ p 1 Q•❑X Electn of repairs or ad.ditiom , 3.,0 1 a a homeowner doing all work officers have exercised their 11. ❑ .Plttmbing;repairs of -additions hi 7self. � comp. • o workers' right of exemption per MGL 12`.❑ :Kopf repairs insurance regu'ired.] t c. 152. §1(4), and we have no l'•❑•Other employees. [No. workers' conic). insurance reatrired.] "Anyapplicant that checks box #1 must also fill', out the sectiorrbelow showingtheir workers' compensation policy information. Homeowners who submit this.afiidavit indicating they are doing all work and then hire outside contractors must submit anew atiidavit indicatiric such. C ontrack rs that check this box:must attached an aelilitionat sheet shovvine the name of the sub -contractors at/id state wfiether or.not ihosc•enthics Lye employees. If the sub -contractors have employees, they must provide their workers' comp. policy number, um cin emplgl'er that is providing workers' compensation insurance for my employees. ,Below is the poliev and job site information. Insurance Company Name: Hanover Insurance Company Policy #'or Self-ins..Lic. #: WHN 60:55762 Expiration Date: Job Site..Address: 60 Royal Crest Dr. Building 8 Apt. 3 City/state/Zip: North Andover, MA 01845 Attach a copy of the workers' compensation policy declaration page (showing.the policy number and expirationdate). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of 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 againstdie violator. Be advised. that a copy of this statement may be forward;ed,to the Office of Investigations of the DTA for insurance coverage verification.. I do hereby certify under the pains and penalties of perjury that the information provided above is true and correct. S;ianature: Date: July 7, 2014 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 #: ti ��AS�SACT-�C.T�'��'T�'' -,�-.._.rte------�•:� P,, iC MMERCIALw. DI ER'S INCENSE 'Y 4it A3 � 9@ E1W td 1NMBf3t .,�� », ,�. # 08th ALE 6 107 LOCUST ST AANVERS MA_Oi82332G3 A `�,�A �+ r. � r Y `"�`..�",,� � � � s ou nsm•ta,r aw or.t3tdds u Date.) 2 -At! q ......... ......... N OF NORTH ANDOVER IERMIT FOR WIRING .................. ......................... ....................................................... Q .......................... ........ ........................................... at .... ve) I U",V, S+ .................................................................. Fee \2c5' Lic. Nol.5 .. ............................. . .... ......... ....... .... ... --l-1 3 t % .5b Check # 13007 ........... o h Andover, Mass. .......... ............. ELECTRICAL INSPECTOR Commonwealth of Massachusetts Department of Fire Services BOARD OF FIRE PREVENTION REGULATIONS 'M C' y� Oficial Use Only Permit Noo.li1711 Occupancy and Fee Checked Zev. 1/071 (leave blank) .APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK .All work to be performed in accordance with the Massachusetts Electrical Code (NEC), 527 CMR 12.00 (PLEASE PRINT ININK OR TYPE ALL INFORMATION) Date: D e C oiG I q City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) 0—' 1 ,' Z Owner or Tenant ANN,(- Owner's M,COwner's Address i3 U ild Is this permit in conjunction with a building permit? Purpose of Building - Existing Service Amps / Volts New Service Amps / Volts No. Yes ❑ No 9(Check Appropriate Box) Utility Authorization No. Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd ❑ No. of Meters No. of Meters Number.. of Feeders and Ampacity Location and Nature of Proposed EIectrical Work: N 0 -LK ,-tt c- - e(( C on n -e c- 4=t Ort ' 5 i+ -Z 3aSe �pGci r� ekeC_(nic -t, , Un eyol�ctP tr- o s � �S mal (�r6�%->- b�<d1�r5 ��`ul ` Completion ofthe following table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Cell: Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above ❑ In- ❑IVOT-OT rnd. grnd. Emergency Lighting Battery Units No. of Receptacle Outlets 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. Total Tons No. of Alerting Devices No. of Waste Disposers p Heat Pump Totals: Number Tons ......................... KW _ No. of Self -Contained Detection/Alertin Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑Other Connection No.. of Dryers Heating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water KW No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: b 0 Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: 1 , (When required by municipal policy.) )),York to Start: 1 Zi zA t 4 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: INSURA=NCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties ofperjury, that the information on this application is true and complete. FIRMNAME: 'b4tulL( P V. Licensee: I)Jk�j1d (> VjW, (' SignatureUG (a V1 (If applicable enter "exempt" in the license number line.) _ Address: (ct6 D P��C S+ Wc�,�'L, & vA (h A na 4� 1 LTC. NO.: A 1S 1`(A LTC. NO.: 3 1 FJ 0 G Bus. Tel. No.: Alt. Tel. No.: 5 b� *Per M.G.L c. 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': $. ' SignatureturaTelephone No. The Commonwealth of Massachusetts Department of Industrigl Accidents Office of Investigations 600 Washington Street Boston, MA 02111 www.massgov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/E1Please Print Le bl .�,pphcant Information Name (Businessiorganization/Individual): Address: Leto 1P, � -I-- City/Slate/Zip: g (�1�W) Mk ®�'�) Phone#: �^'S� Are you an employer? Check the appropriate bog: �'�' 4. ❑ I am a general contractor and I 1. ❑ I am a employer with employees (full and/or part-time) * have hired the sub -contractors listed on the attached sheet. 2. ❑ I am a sole proprietor ox partner- These sub -contractors have ship and'have no employees working for me in any capacity. workers' comp. insurance. 5. ❑ We are a corporation and its [No workers' comp. insurance officers have exercised their required.] 3. F1 am a homeowner doing all work right of exemption per MGL myself. [No workers' comp. c. 152, §1(4), and we have no employees. [No workers' insurance required.] t 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 *Any applicant that checks box#1 must also fill out the section below showing their workers' compensation policy information. i -Homeowners who submit this affidavit indicating they ale 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. pensation insurance for my employees. Below 1s the policy and job site I am an employer that is providing workers' com information. Insurance Company Name: A < .L j '� Expiration Date: Policy # or Self -ins. Lic. #: W C- ` 00 W5 _1 ] ��— Job Site Address: 5 6 c�o��1 Cr�S - City/State/Zip: 14+ ¢�1J (� OIrC W! G ► 8 U, S 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 DTA for insurance coverage verification. 3 - I do hereby cert fy under the pains and penalties of perjury that the information provided above is true anti correct. 1 _ _ . �el Phone# ` 08'soal— ` - 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 #: C �\ ! r J4 CERTIFICATE OF LIABILITY INSURANCE OF INFORMATION ONLY AND CONFERS NO RIGH CERTIFICATE HOLDER THIS/1 i FICATE IS ISSUED AS A MATTER AUTHORIZED NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND CONTRACT BETWEENTHE ISSUING F INSURER(S)ORDED BY THE POLICIES ��, • KATE DOES N CE DOES NOT CONSTITUTE ,JV. THIS CERTIFICATE OF INSURAN �ftESENTATIVE OR PRODUCER, AND THE CERTIFlCATE HOLDER olic les must be endorsed. if SUBROGATION IS WAIVED, subject to PORTANT: If the certificate holder is an ADDITIONAL INSURED, the p Yf ) lie terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to e certificate holder in lieu of such endorsement(s). CONTACT LESLIE HANK ON FAX NAME: (978) 667-0587 PRODUCERPHONE (978) 667-6150 James O'Connell Insurance Agen E-MAILJIMINS@OCONNELLINS.COM ADDRESS: NAIC # 572 Boston Rd INSURE S AFFORDING COVERAGE Unit 7 INSURER A: Merchants Billerica, MA 01821 „opo R • A- I .M. Insurance INSUREDI NSU RER C DANIEL P VITALE ELECTRIC 190 DALE ST INSURER D Wp,LTHAM, MA 024,51 INSURER E: INSURER F REVISION NUMBER: COVERAGES IOD CERTIFICATE NUMBER: OR CONDITION OF ANY CONTRACT OR OTHEDESCRIBED HEREBOCUMEN IS SUBJECT FH NT WFPTO ALL THE TERMS, CH THIS 1 THIS IS TO C ERTIFY THAT THE POLICIES OF INSURANCE LNSTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PER I INDICATFJ�. NOTWITHSTANDING ANY REQUIREMENT, TER CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY T ou OD BY CY EXP LIMITS EXCLUSIONS AND CONDITIONS OF SUCH aoDLI IES. LIMITS SHOWN MAY HAVE BEEN R1 Po oCCY E F PAID DCY EXP l LTR POLICY NUMBER DI $ 1 OOO OO TYPE OF INSURANCE I R WVD 9/12/14 9/12/15 EACH OCCURRENCE $ 5OO OO BOp9098053 DAMAGE TO RENTED A GENERAL LIABILITY o cur X COMMERCIAL GENERAL LIABILITY MED EXP (Anyone Person) $ 15 OO $ 1000OC CLAIMS -MADE OCCUR PERSONAL&ADV INJURY GENERAL AGGREGATE $ 9.00010C PRODUCTS - COMP/OPAGG $ 2.00 0 0( GEN'LAGGREGATE LIMITAPPLIES PER COMB INEDSINGLELIMIT $ PRO- LOC Ea IN X POLICY BODILY INJURY (Per person) $ AUTOMOBILE LIABILITY BODILY INJURY (Per accident) $ c ANYAUTO PROPERTY DAMAGE $ ALLOWNED SCHEDULED Peraccident AUTOS AUTOS $ NON -OWNED HIRED AUTOS _ AUTOS [� EACH OCCURRENCE $ UMBRELLA LIAB OCCUR AGGREGATE $ EXCESSLIAB CLAIMS -MADE $ 10/11/13 10/11/14 X WC STATU- OTH- DED RETENTION $ 2009 100,( WCC500653801 E.L. EACH ACCIDENT $ B WORKERS COMPENSATION ZOO ( AND EMPLOYERS' LIABILITY Y / N E.L. DISEASE -EA EMPLOYEE $ ANY PROPRIETOR/PARTNER/EXECUTNE -I N / A OFFICE R/MEMBEREXCLUDED? _f E.L. DISEASE -POLICY LIMIT $ 50011 (Mandatory in NH) If ves, describe under-, on nnn�S nelow ORD 101, Additional Renerks Schedule, if more space is required) DESCRIPTION OF OPERATIONS 1 LOCATIONS /VEHICLES (Attach AC E4LECTRICAL WORK 1 TOWN OF NORTH ANDOVER MA 120 MAIN ST NORTH ANDOVERI MA 01845 N SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEF THE EXPIRATION DATE WITH HE POLICyEOF, NOTICPROVISIONS E WILL BE DELIVERED AUTHORIZED REPRESENTATIVE LESLIE HANNON © 1988-2010 A 1 The AC ORD name and logo are registered marks of ACO RD ACORD 25 (2010105) Fax: Phone: a CORPORATION. All rights re: J Date... �aOR7q TOWN OF NORTH ANDOVER 6 PERMIT FOR WIRING This certifies that ....... 7 tK.7.R.07/w has permission to perform . . . .. -s wiring in the building of r -W .. .....4P at ..... Wy .7-h.. North Andover, Mass. a An Fee—S . ......... Lic. No...1.0.7V.,A4, L ...... r. Check # 7172 J _ Cottini.onwealt :of hfassachusetts a — Permit No. 3 Department of Flee Services nt ctvaicy anti 1'cc C:itccked -, BOARD OF FIRE, PREVENTION REGULATIONS[ltev. 'tis] lave plank. APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All w•oA to: be pei-tbi mod in :acwfdancc with the Mussacbusetts Electrical Code (MEC),:5.27 CNIR 12.00 (PLEASL PR1JVT1YTVK OR 7T7 EAL.L I1NrF'ORMATI07V)plate: January 18, 2007 City or Town of North Andover To the inspector of I�Aires: By anis application Ute undersigned giN.res notice of his or her; intention to perforin the electrical work described below. Location (Street & N -am ger)_ 50 Royal Crest Drive Building #8 aN,vne or Tenant Koval. Crest Apartments Telephone No, (978) 686-7311 50 Royal Crest DriveNorth Andover Owner'sAddress, . , MA 01845 Is this permit,in:conjuuction with a.building,permit? Yes ❑ No © (Check Appropriate Boi4) Purpose, of Tau lding Apartment Building Utility Authorization No. Existing Service Amps. / Volts Overhead Undgrd New Senice Amps / volts NumbO of Feeden and Ampiacity Overhoi! ❑ Undeird ❑ No. of metees - -- No-:of Meters Location and.Naktire of Proposed Electrical «'ork: .Emergenc-y call:-.Hanhole conductors cauahl re. Installing new Hanhole and make repairs to wires as necessary cmmnlo inn Oft& fn nt;;PA tahlr mi v ho u.,7ry Z by A, ,Vt ;, wr of W,,i ac No. of Recessed Luminaires No. of Ceil.=Susp_ (Paddle) Fans N.0, of Total Transformers- KVA No. of Luminaire Outlets, No. of Hot Tubs. Generators KVA: Na of Luminaires Swimming Pool Abome � Iii -No. rnd, rnd. o Emergency ig ng I3ttttery Units No. of Receptacle Outlets No, of Oil Burners FIRE ALARMS No. of Zones. No.:of Switches No. of Gas Burners No. o Detection an Initiatio Devices .... ...:. .. No. of Ranges: No, ... Ota. of Air Cond Tons ... tin No. of Alerting Devices No. of Waste Disposers Heatpump m uer Totals:_ .. ITons IKW N;,of Self -Contained miection/Alerdng Devices No. of Dishwashers Space/Area Heating KW Local unictpa mei, Connection . No. of Dryers .Heating Appliances Kid, Security Syystems:* No. of Devices or Equivalent No. of Water , Heaters o. of Na. o - . S►. -ns Ballasts 1�1 tti dVaring: No. of Devices or.E uivalent No. Hydronnassage.Bathtubs _ No.;of Motors: TotalliP 4 ecoiitnXuracations.-Wiring; No. of Devices`or Equivalent OTHER: . Attacfr. ad56tional de-itail if de.sircd, r1r us reguirerl hythe lnspEctor of l� rrss: Estimated Value' of Electrical. Wink:'. (When requiredby municipal..policy= ) Work -to Start 1 /18/06 laaspcctiolls to be requested in accordance with NIEC Rule 10,;aiad wptin completion.. INSURANCE COVERAGE: Ualess:waived.by the owner, no permit 'for the performance of electrical work may issue unless �i the licensee provides proof of liability insurance including "completed operation" coverage or its substantiail equivalent: The undersigned certifies 'that such coveragei.s in force, and has exhibited proof of saatne to t}ee permit issuing office. CHECK ONE: INSUIt-.ANCE ® BOND n OTHER. []I (Specify ) I certify, under the.pa ns andpenallies ofperjury, that (lie information on this• application is true and.complete.: FIRMNAME: LIC. N0' Thp Electricians & .Cow Inc..... 9� �� • A10737. Licensee: Signature Ltc: NOo : E23587 (If oppiicable, enter exentpt" in the license number line) Bus; Tel. No.: 781-322-9344 Address 50 Branch Street M den, .MA 02148 Alt. Tel. No.: 781-322-9346 *Security System ContractorLicense required for this work; if applicable, enter the license number here: OWNER'S.IINSURANCE WAIVER: I ani aware that the L€censee.does not have the liability insurance coverage normally' Sina � e� lain. B n?.y si�natinre heia:a�; I hereby: wTele 1 une yarcnlent.: Iaintlte elneckR�RlidlT FEE: $}55.��xent. q Y P Y q ( )© QFvnei', A c.nt -g p R Location fC�u i Cr,. S4% 4 No. Date Check # '389 r "?-i0 - 0 3 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ /5-0 Foundation Permit Fee Other Permit Fee TOTAL 41 $ L 16143 ,40((' 1� Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH ONE OR TWO FAMtILY DWELLING L�.A a 'zn BUILDING PERMIT NUMBER: DATE ISSUED: tie SIGNATURE: A k za�b- Building Commissioner/Inspector ol'Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Areas Fromm e ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Rered Provided 1.7 Water Supply M.G.L.C.40. 34) 1.5. Flood Zone Information: Public ❑ Private ❑ Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Avar)=.Lc Ccc��a�-� 50 �Dy� �� �csizr�� Ada cr�r OILS Name (Print) Address for Service: Sign atu Telephone G Ina 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construdipn Supervisor: Address Signature Telephone Not Applicable ❑ C. S License Number Expiration Date 3.2 Registered Home Improvement Contractor .S f v 'M y�?t �i it ►?t`I i.�� L it uf� �s I�j1^JG— Not Applicable ❑ t5 iy Z Company Name Registration Number Address Expiration Date Sienature Telephone 00 rn X ic Z O SECTION 4 - WORKERS COMPENSATION (NLG.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 licable New Construction ❑ EYistin ,Building Repair(s) ❑ Alterations(s) )Q Addition ❑ r Accessory Bldg. ' ❑ Mholitick, Of Other ❑ Specify v Brief Description of Proposed Work:&4'° • _z :. "' ") SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be OFFICIAL;USE Completed by permit applicant 1. Building 1 •Z �c J (a) Building Permit Fee Multiplier 2 Electrical I (b) Estimated Total Cost of Construction 3 Plumbing 0 J Building Permit fee (a) X (b) 4 Mechanical (HVAC) C 5 Fire Protection C 6 Total (1+2+3+4+5) c>:; , u+ Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, KEU ( IV TER Ug N � as Owner/Authorized Agent of subject property Hereby authorize SEW MIA C: Q t lL/ to act on IV �beh`al��, all m tters ielative to won aut orized by this building permit application. �l -�, moo! Ph & - ,rte Signature of O%Naier Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 11 , � a 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 w( C Print an / �w U A��IIL Si natlue of ONimer/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DiMENSIONS OF GIRDERS L ILF]GHT OF FOUNDATION THICKNESS SIZE OF FOOTING ) • X MATERIAL. OF CHBvINEY IS BUILDING ON SOLID OR FILLED LAND LA IS BUILDING CONNECTED TO NATURAL GAS LINE No V . fie �anrmwoxu�ea�!% a�,�raoar/u�aelta • � Board of Building Regulations and Standards HOMEIMPROVEMENT CONTRACTOR ,f Registration - X25482 Exration 15104 C � Sean M. Murphy Gen Conn Sean Murphy�� I4 r`f 233 Haverhill St. N Reading, MA 01864 Administrator i . v IZ T1. j BOARD BOARD OF BUILDING REGULATIONS . . License: CONSTRUCTION SUPERVISOR Number, Gnu 065265 B)rEltc�a 09 1968 �� � •' V r1 _ � %2003 Tr. no: 20549 ( Y F� • Rei A SEAN M MURP14,t� _ 233 HAVERHILL ST;Ms N READING, 01864- i .. ,MA Administrator i. Name The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print Name: S tV%K(xei4 Location: ;� r1c7�ft3 G!L'1; 2 City Phone # 1 Y) 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. Companv name: Address City Phone #: Insurance. Co. Policy # Company name: , Address City: Phone#7 Insurance Co. Policv # Failure to secure coverage as required. under Section 25A or MGL 152 can lead to the inPosition of DiMinaf penalties of.a lineup to $1,50():00 and/or one years' inprisonment_as_weU-as_civil_penaltiesiniheiomo-fa-STOP WWW ORDERmd_afine._cf_($1iD0-0D)ariay against.me. 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 penalties of perjury that the infonnation provided above is true and correct Signature Date _ 'Z- / 1 o J o A Print name Y Official use only do not write in this area to be completed by city or town olficiar City or Town Petmit/i icensi D Building Dept ❑Check if immediate response is required [] f.1ceRSilg Beard E] Selectman's Office Contact person: Phone #. i� Health Department D Other 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) -41,1- ,r-� Signature oW ermit Applicant Z/i0 11 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through. the Office of the Building Inspector 8302 dimensions and reprrsentations made are approximate and subject to change without notice. u9men is may vary because of construction details or as deemed necessary by the developer. t COpartment ,, F �' _ Investment and Management Company K F M Contract No: 042391 - 02102003 Community: 042391 SERVICE AGREEMENT BETWEEN OWNER AND CONTRACTOR THIS AGREEMENT is made and entered into by and between Murphy General Contracting the "Contractor") and AIMCO-Royal Crest Estates North Andover, L.P. (the "Owner"), a limited partnership. Owner owns the Property known as Royal Crest Estates No. Andover located at 50 Royal Crest Drive, No. Andover, MA 01845 the "Property"). Owner shall act through its agent, AIMCO (the "Management Company") (the "Agent"). The Owner and Contractor agree as follows: SCOPE OF WORK (See Exhibit Scope of Work) A. The Contractor agrees to perform the work and services required by this Agreement including any drawings, specifications and addenda listed and/or attached hereto (collectively referred to as the "Contract Documents") in accordance with the Contract Documents. Contractor agrees to provide at its sole expense all labor, materials, services, equipment, tools, scaffolds and hoists required to fulfill its obligations and to properly execute and complete the work as described more particularly on the attachment (the "Work") per specification(s) No: NA Exhibits: NA. B. This Agreement represents the entire Agreement between parties and contains all terms and conditions required for the proper execution and completion of the work. The Owner or his Agent may order changes in the Work, consisting of additions, deletions, or other revisions. All changes in the work shall be authorized only by writing, signed by the Owner. In the absence of such signed change order, such work shall be considered to have been performed as part of the original agreement without additional compensation. C. This Agreement will be effective from February 10, 2003 through June 30, 2003. 2. CONTRACT SUM A. Payments to the Service Provider shall be made according to the payment schedule outlined below: Three bedroom Idtchen and bath renovation priced at $15,000 each Units 8-12,114, 27-8 Billable at completion of renovation with 30 day net B. Any payments due under this Agreement will be made no more than once .a month and no later than the twenty-fifth (25`h) day of each month for work completed the previous month. To receive any payment, the Contractor must submit to the Owner an invoice detailing the labor, services, or materials already provided for Work performed for the previous month on or before the first day of the following month. By submission of an invoice for payment, the Contractor warrants that all work performed for Owner by the Contractor to that date is free and clear of liens, claims, security interests or encumbrances from persons or entities providing labor, materials and equipment relating to the invoiced Work. No payment shall be made for equipment or materials which have not yet been installed on the Property. C. Owner may withhold any payment, including the retainage to the Contractor: If there is defective work that has not been remedied; If third parties have filed claims or liens; If the Contractor has failed to pay subcontractors for labor, materials or equipment; If damage has been caused to the Owner or another Contractor; If Contractor fails to submit an invoice as required by the terms of this Agreement; or if Contractor fails to carry out Work in accordance with the Contract Documents. CONTRACTOR OBLIGATIONS A. The Contractor shall supervise and direct the Work using its best skills and efforts and shall perform the Work in strict accordance with the Contract Documents. Contractor warrants that unless otherwise specified, all materials and equipment incorporated in the work will be new and of good quality and free 1 of 6 Initials: Contractor: Agent/Owner: 112t C:\Office97\Word\Service Agreement—Afford rw OPPOR10"ay from faults and defects. To enable the Work to be laid out and prosecuted in an orderly and expeditious manner, Contractor shall, before commencing the Work, submit to Owner a schedule for completing the Work during the hours of 8:30 A.M. and 6:00 P.M., Monday through Friday, unless otherwise agreed to by the Owner. Contractor shall at all times coordinate with Owner with respect to the scheduling, commencement and completion of the Work and perform the Work in a manner that will least disrupt residents of the Property. The Contractor shall require each subcontractor to be bound by this Agreement to the extent of the work performed by such subcontractor. The Contractor agrees to perform the Work with due diligence and without delay. The Contractor will not delay or interfere with any work of the Owner or any subcontractors. Contractor shall coordinate its Work with others performing work at the Property as Owner directs. B. The Contractor shall enforce strict discipline and good order among employees of the Contractor and all other persons carrying out the Work. The Contractor shall not permit employment of unfit persons or persons not skilled in tasks assigned to them. Owner reserves the right to have the Contractor remove an employee from the premises if unfit or unskilled. If requested by Owner, all employees of the Contractor shall wear uniforms with tags or embroidery showing the name of the Contractor and the name of the employee. The Contractor shall employ labor and personnel in accordance with applicable Local, State and Federal laws. C. The Contractor shall pay when due, sales, consumer, use, FICA and unemployment taxes and any other taxes due for the Work or portions thereof provided by the Contractor. D. Prior to commencing the Work, the Contractor shall obtain, at its own expense, all permits and licenses and agrees to pay all royalties that may be necessary for the proper performance of this Work. E. The Contractor shall give notices and comply with all building cedes, local ordinances, laws, rules, regulations and orders of any public authority having jurisdiction over the Property. F. The Contractor will at all times facilitate and permit the inspection of the Work by the Owner, Agent, and public authorities. The Contractor shall not be relieved of its obligations to perform the Work because of tests, inspections, or approvals required or performed by persons other than the Contractor. The Work shall not be accepted until the Owner, Agent and all public authorities have inspected and approved the work and any certificates of occupancy and/or final inspection certificates that are required are issued. G. The Contractor shall at all times be responsible for initiating, maintaining and supervising all safety precautions and programs in connection with the Work. It shall take all reasonable precautions for the safety of, and shall provide all reasonable protection to prevent damage, injury or loss to (1) all employees of Contractor or any other subcontractor perforn ing services on the Property and other persons including, but not limited to, residents or tenants of the Owner and their guests; (2) the Work and all materials and equipment used to complete the Work; and (3) other property at the site or adjacent thereto. The obligation of the Contractor to protect shall include the duty to provide and maintain at its sole expense at the Property, suitable and sufficient guard, lights, barricades and enclosures. All damage or loss to any property caused in whole or in part by the Contractor, its subcontractor or their agents, or anyone directly or indirectly employed by any of them, or by anyone for whose acts of them may be liable, shall be remedied by the Contractor. The Owner reserves the right at all times to halt work that is being performed in an unsafe manner until Contractor rectifies same. H. The Contractor shall at all times keep the premises and surrounding area free from accumulation of waste material or rubbish caused by its performance of the Work. Within twenty-four (24) hours from the completion of any Work, or any portion of Work the Contractor shall remove all waste material, rubbish, tools. Construction equipment, machinery and surplus materials from the Property, and shall leave the Work area broom clean or its equivalent at the end of each workday. If the Contractor fails to clean the premises, Owner may perform the clean up and the cost shall be deducted from any payment requests submitted by the Contractor. Contractor is responsible for removal and proper disposal of all waste from the work. I. Contractor agrees to abide by the Department of Transportation regulations (Part 382 of Title 49 of the Code of Federal Regulations), if applicable. Contractor agrees that any employee operating a motor vehicle at the direction of the Agent or while undertaking the business of this contract is participating in a DOT mandated and approved random drug and alcohol testing program. Failure to maintain such a program in compliance 2 of 6 Initials: Contractor: Agent/Owner: _ 112t C:\Office97\Word\Service Agreement—Afford " - vav4muhrrx with DOT regulations would be grounds for termination of this Agreement pursuant to Section. J. All Contractors must execute the equal employment opportunity addendum. K. Contractor guarantees that all the Work shall be free from defects in workmanship and materials for minimum period of 90 Days from date owner accepts the work and promptly upon Owner's request, Contractor will correct by repair or replacements, without charge, any such defects (and any damage to other property, including without limitation toe work of other subcontractors resulting therefrom or from the correction thereof) which may appear in the Work during that period. Additionally, materials/equipment warranty provided by the manufacturer of said materials/equipment is to' be for a period of 90 Days. If the Contractor fails to commence and to complete the repair or replacement of improper of defective work, as specified, within a reasonable period of time as determined by the Owner, the Owner may proceed to have such work completed by whatever method it may deem expedient and may charge the Contractor for the expense incurred. Notwithstanding any other provision of this Agreement or any or any other contract, agreement or statement or limitation of warranty by Contractor in any agreement between Contractor and Owner, Contractor hereby agrees to extend the term (including the time period and substantive and procedural protections) of any and all warranties, made by Contractor to the Owner, to the Purchaser or Transferee from Owner of the Property, which is the subject of this Agreement, without any additional charge or conditions. L. The Contractor will be responsible to protect living units against the elements at the end of each working day and under no circumstance shall any living unit be left unprotected due to work under the Agreement. In addition no occupied living unit will be without essential services, heat, light, and water at the end of each working day as a result of this work. 4. OWNER OBLIGATIONS A. The Owner shall not be responsible for or assume any liability or responsibility for loss or damage to equipment or materials, tools or other personal property whether owned or leased by the Contractor, subcontractor, their agents, or anyone employed by them in the performance of the Work. B. When work is being performed on Owner's premises where water, power, gas, and toilet facilities are available, the Owner will furnish said utilities and facilities to the Contractor and his workmen. All scheduled uses shall be coordinated and approved by the on-site Community Manager. Where said utilities are not available through the Owners in-place facility, the Contractor shall provide same at his won expense to the extent required to fulfill the contract agreement. CORRECTION OF WORK The Contractor shall promptly correct at his own expense any Work that fails to conform to the requirements of the Contract Documents where such failure to conform appears during the progress of the Work. Contractor warrants and shall also promptly remedy at its own expense any defects due to faulty materials, equipment or workmanship, all within such period or periods of time as may be prescribed by law or by the terms of any applicable guarantee required by the Contract Documents. The provisions of this section apply to work done by subcontractors as well as to work done by direct employees of the Contractor. 6. INSURANCE A. The Contractor shall purchase from and maintain in a company or companies lawfully authorized to do business in the jurisdiction in which the Property is located such primary insurance as will protect the Contractor and the Owner from all claims including, but not limited to, those that may arise out or result from operation of the Contractor under this Agreement and for which the Contractor may be legally liable whether such operations be by the Contractor or a subcontractor or by anyone directly or indirectly employed by any of them or by anyone for whose acts any of them may be liable. *Insurance Coverage to be provided shall include but not be limited to, 1. Comprehensive General Liability. 2. Worker's Compensation and Employers Liability, and 3. Automobile Liability. Coverage written on an occurrence basis in the amounts as follows: 3 of 6 Initials: Contractor: AgenUOwner: C:\Office97\Word\Service Agreement—Afford DVVOANNRT 1. Comprehensive General Liability: 0$500,000 (Oxford) 0$ 1,000,000 (Oxford) ®$1,000,000 per occurrence for contracts from $2,000 to $50,000 (AIMCO) 2. Workers' Compensation and Employers' Liability: ®(Statutory) $100,000 each accident $500,000 disease - policy limit $100,000 disease - each employee 3. Automobile Liability: ®$500,000 combined single limit (AIMCO) E1$ 1,000,000 combined single limit (Oxford) ❑$2,000,000 per occurrence for contracts over $50,000 (AIMCO) 0$5,000,000 per occurrence for security contracts (AIMCO) * Check required amounts. If nothing is checked the maximum insurance requirements apply for each category. B. The Contractor shall, concurrent with the execution of this Agreement, deliver to the Owner a Certificate of Insurance in a form acceptable to the owner evidencing the coverage set forth by this Agreement. The Certificate of Insurance will name the Owner and the Agent as additional insured. In no circumstance shall the Contractor commence any Work without the issuance of policies for all the insurance coverage specified in this section. The Certificate of Insurance and Insurance policies shall contain a provision that coverage under the Insurance policy will not be canceled, allowed to expire or reduced in coverage until after thirty (30) days prior written notice has been given to the Owner. Contractor warrants that they will maintain coverage for two years after completion of Work. 7. PREVENTION OF LIENS The Service Provider acknowledges that no liens shall be attached to the real estate by virtue if any work done hereunder by the Service Provider or by any suppliers, employees, matrialsmen, or other subcontractors employed by him/her and the Service Provider warrants that all such parties hall be advised of same and certifies to the Owner that they are aware thereof and bound thereby. 8. INDEMNIFICATION A. To the fullest extent permitted by law, each party shall indemnify and hold harmless the other party, its owners, shareholders, partners, affiliates, controlling persons, officers, directors, agents and employees from and against any and all claims, damages. Losses. Costs and expenses whenever incurred including, but not limited to, reasonable attorneys' fees, arising out of claims by third parties against a party to this Agreement, of any kind and nature whatsoever, including property damages and bodily injury, resulting from the performance, action or inaction of any party pursuant to this Agreement. B. The indemnification obligation under this Article shall not be limited by any restriction on the amount or type of damages, compensation or benefits payable under workers or workmen's compensation acts, disability benefit acts or other employee benefit acts. C:\Of4 of 6 Initials: Contractor: Agent/Owner: fice97\Word\Service Agreement—Afford ovcoeruNrr C. All provisions of this Agreement that require a party defend or indemnify another party shall survive the termination of the Agreement; 9. OWNER LIABILITY The Contractor, its employees, agents or subcontractors, shall not bring claims or lawsuits under or related to this Agreement against any principals, employees, agents, officers, directors, stockholders, controlling persons, partners or affiliates of the Owner or the Management Company. Any action brought by or on behalf of any employee, agent or subcontractor will be defended and indemnified by the Contractor. The Contractor further agrees that the sole and exclusive remedy of the Contractor for payment and/or performance of this Agreement shall be against the assets of the Owner. 10. OWNER'S RIGHT TO TERMINATE CONTRACT A. Should the Contractor neglect to carry out the Work properly, correct the defective Work or fail to perform any of its obligations under the Contract Documents, the Owner, after three (3) days written notice to the Contractor and its surety,'if any, may without prejudice to any other remedy it may have, direct by written notice that the Contractor stop the Work, make good the deficiencies and may deduct the costs from the payment then or thereafter due to the Contractor or, at the option of the Owner, may terminate this Agreement and take possession of all materials, tools, and appliances and finish the Work by such means as the Owner seed fit. If the unpaid balance of the Contract Sum exceeds the expense of finishing the Work, such excess shall be paid to the Contractor, but if such expense exceeds the unpaid balance the Contractor shall promptly pay the difference to the Owner. B. Notwithstanding anything in this Agreement, the Owner, at its sole discretion, may terminate this Agreement at any time without cause by giving at least thirty (30) day's prior written notice of such termination to the Contractor. Upon any termination of this Agreement, and subject to all the terms and provisions of the Agreement, the contractor shall be entitled to payment at the Contract Sum for all accepted Work finished or installed. However, the Owner may retain from any monies due to the Contractor an amount sufficient to cover Contractor's obligation under any guarantee of materials and workmanship provided in the Contract Documents. Upon the expiration of these obligations, the balance of the amount, if any, shall be paid to the Contractor. The Contractor, upon termination of this Agreement, shall peaceably and quietly surrender to the Owner all premises, facilities, machinery and equipment of or belonging to the Owner or for which Owner has paid Contractor. MISCELLANEOUS A. Nothing contained in this Agreement shall be construed to create the relationship of employer and employee, principal and agent, partnership or joint venture between the partied. It being understood that the only relationship between the parties is that the contractor is an independent contractor of the Owner. Nothing contained in this Agreement shall create any contractual or other relationship between Owner and any subcontractor or supplier. B. The invalidity or unenforceability of any provision shall not affect or limit the validity and enforceability of any other provisions. The waiver by any party of a breach of any provision of the Agreement shall not operate or be construed as a waiver of any subsequent breach by any party. The remedies and rights of the Owner, in the event of any default by the Contractor, are cumulative and in addition to those otherwise available by law. And the expression of any specific right or remedy shall not be construed as preventing the Owner form exercising any other right or remedy it may have. C. Notice required under this Agreement shall be in writing and sent by personal delivery, certified mail, commercial overnight courier (e.g. Federal Express) or certified mail postage prepaid return receipt requested to the parties at the addresses or set forth in this Agreement and to the Regional Office at the address set forte at the end of this Agreement, or to such other addresses as any of the parties may hereafter specify in writing to the other party. Notice shall be deeded effective upon the earlier of actual receipt of five (5) days after mailing via U.S. Mail. 5 of 6 Initials: Contractor: Agent/Owner: 112t C:\Office97\Word\Service Agreement—Afford +, oaoornur+rrx D. The owner .and other indemnified persons have the right to select legal counsel of their own choosing to defend them in any action relating to the subject matter of this Agreement. E. This Agreement shall be construed in accordance with the laws of the State where the work is to be performed. F. The Contractor shall not assign this Agreement. Nothing in this agreement shall preclude or prohibit the Owner from assigning or transferring the whole or any part of the Agreement including the Owner's rights, benefits or obligations hereunder to any corporation, partnership or individual. G. This agreement and all the representations warranted and conditions shall be binding upon and insure to the benefit of the parties and their respective heirs, executors, administrators, assigned and other successors in interest (to the extent permitted by this Agreement). H. Whenever the context so requires, the masculine gender includes the feminine and the neuter as appropriate and vise versa, and the singular includes the plural. Caption headings are for convenience only and are not to be used to construe or interpret the Agreement. IN WITNESS WHEREOF, the parties have executed this Agreement as of the 10th day of February, 2003. OWNER: Royal Crest Estates No. Andover CONTRACTOR: Murphy General Contracting Name of Partnership Print Company Name BY: AIMCO As Agent for Owner BY: Signature Jeff Vimes Print Name Regional VP Title Witness AIMCO Boston ROC Regional Operating Center 55 Dinsmore Ave Street Address Framingham, MA 01701 City, State, Zip C:\Dffice97\Word\Service Agreement—Afford BY: Signature Sean Murphy Print Name Owner Title Witness CONTRACTOR ADDRESS: 233 Haverhill Street Suite No. Reading, MA 01864 TELEPHONE: 617-512-1104 Ext. Fax #: 6 of 6 Initials: Contractor: Agent/Owner: 0 OPOORTUNRY O z 40 N x w A O w v rn w � z z p w O w U G w w PA "z p w C w a a w p a cn G w x p U a a: G w z w x v cn z � cn Q v O a Is co O E co 2 O D y y .c a CD c Q co C..i _Q CO) 0 cv .CL CO) C O V d CIO L Q Cl) 0. COD C co0 co 0 Q O CL 0. cm4 c _-+ C ev cc 0 CO 2 v Q C 0 U) Irw W w O m c ®� O d� C C O O C ;g O p Eot L� V .�CQ t .� :o C,3� u os ® c CD c cc O NM N � C C N O O E CD v m'g c .�: CLC,, :Nm' m �. A f _�YomO cm : _� �Q� aCL O rCa; O Irv: C C® ® Cf O 06 N ® C C g ® t0 3: 3: N � W ,� N ®yOw � �r�.m « C O - 'a a.r C co) CLEC O r m N Z O VO CL 9 ®.0 O N O cm.. CO :210 a Is co O E co 2 O D y y .c a CD c Q co C..i _Q CO) 0 cv .CL CO) C O V d CIO L Q Cl) 0. COD C co0 co 0 Q O CL 0. cm4 c _-+ C ev cc 0 CO 2 v Q C 0 U) Irw W w Date.. : 62 i NORTH 01 .�4, TOWN OF (NORTH ANDOVER A PERMIT IFOR PLUMBING This certifies that ... ... ................................ has permission to perform ............... plumbing -in the buildings off ............... at .. .. /�i. ....... ':. �`'./�n. North Andover, Mass. Fee.. � ... LNo LU sl/� .......... N INSPECTOR Check # 5535 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS �,r `} Date Building Location F jQ"At crust De we -#i1 Z- Owners Name At MGa Permit # t d•&•c f,1L. ^i01W.W j of Amount � `� New Renovation 0 Replacement Iff Plans Submitted Yes ❑ No (Print or type) Installing Company Name <:: ;�r j sall^ll / Address// A nes cr 2 `�) Check one: Certificate Corp.. E] Partner. Firm/Co. Dame of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 0 Other type of indemnityD Bond D Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above t e' sur nce .L I ,` signature Owner El Agent El I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massach�Plumbing �.�� ode andC>pter 142 of the General Laws. . BY igna urivoi McenseQnumoer �-- Type of Plumbing License Title 2 �67-d City/Town cense i um er Master D Journeyman APPROVED (OFFICE USE ONLY S. v Date...! ..........................�... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that .......................................................f¢ S has permission to perform-'^ ��•-��""'� wiring in the building of ..... :`'�..................................dover................... at ..�............:J North tSn, Mass. Fee.. f........... Lic. No' Fv ....... ........... /r �ELECrRICAL INSPECTOR Check # ` 4361 TLIECOMWONWEAL7YIOFMAS94CHUSE17S Office Use only DEPARTAffiW0FPUXJCSAFEfY Permit No BOARDOFFIREPREVEMONREGVIAHONSM7(MI2 QD j Occupancy & Fees Checked =—lam A A.PPLICAHONF'O.R PATO PERFORMEUCT7MICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACMSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover } To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street 1 Owner or Tenant Owner's Address Is this permit in conjunction with a building Purpose of Building permit: Yes L,2SI No " (Check Appropriate Box) . - Utility Authorization No. 3xisting Service =_ Amps _/Volts ` Overhead Underground r-71 No. of Meters few Service Amps / Volts Overhead Underground= No. of Meters lumber of Feeders and Ampacity .ocation and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot TubsNo. of Transformers .Total � No. of Lighting Futures Swimming Pool Above Below °'—Rround ound No. of Receptacle Outlets No. of oil Bumers j Nc:of Switch Outlets Ranges No. of Gas Burners No. Air Cond. Total o. of / of / Tons do: of Disposals No. of Heat Total Total Pum e" Tons KW 1o. of Dishwashers Space Area Heating —�. Kw �— 1o. of Dryers Heating Devices KW �- / To. of wate,",Heaters KW No. of ;�. No. of Gone Rsilacie 'o. Hydro Massage Tubs No. of Motors Total HP Generators KVA No. of Emergency Lighting Battery Units / FIRE ALARMS No. of Detection and Initiating Devices No. of Sounding Devices No. of Self Contained Detection/Sounding Devices LocalMunicipal Connections No. of Zones Other Q mm P►>ataat6odle �M lsGeoerdiLaws �eaammtliabtTdylilsi==Fb Cymciltiirlg(b qke Coveta�pamitstamewhwmtt YES NO eea*niW,dvaWptoafafsanxiDdxOliice YES 1711 F3mbawdedwdYFS,plea9eiod�thetypeofanemWby -- - _ URANKE BOI�ID � , t7IE1Qt � (!'7ea9eSpeaty) � �.✓/ ` �/,� �/ Fskn*dVa1txd WcakV kioSrdit , �' }I�eRWs1ed Raul -�--r� SOD 2dunderRPt ofpetjury ✓1NAME _J ,ei,/e- Ll LicensaNct ,. �� LcukeNo � / I3us�TelNo" � - e�—C2� G C- A)LTe1No. `WSINSURANCEWAIVER;IamawarethattheLicensedossnothavetheir>Stua MCQwrdgeoritssubstantiale nwalentasteytmedb (Nb%adm tsC,ffr dlLaws latmysgmuleonthispwntappli lwaivesttristegtuterrot rse check one) Owner F-1 Agent r � . Telephone No. PERMIT FEE Signature ot Owner Or. f Pent