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HomeMy WebLinkAboutMiscellaneous - 81 PRESCOTT STREET 4/30/2018Date.... TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION ke?, r This certifies that . .............j .... - .... ) ............................................................................ has permission for gas installati PuLA-..dz ......... + > I ....... . . .... 10.!.j . .... I ............ inthe huilding f .......................................................................... g at ....... :5 .. ............... ..... . North Andover, Mass. FeePP.......... Lic. No. ... .... ................................................ GASINSPECTOR Check v-52--1 09901 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK "F _ . 4 - �.:.[JOBSITE ITY- fJcoRtN--/a��_� - .e . _ -_ . MA DATE�S�FERMIT# - 0 ADDRESS Pre sc o t T SY OWNER'S NAME ¢ F WI GOWNERADDRESS TEL�__:::::�]FAX TYPE OCCUPANCY TYPE COMMERCIAL EDUCATIONAL RESIDENTIAL PRINT CLEARLY NEW: RENOVATION: D REPLACEMENT: PLANS SUBMITTED: YES N0�'" APPLIANCES 7 FLOORS-► BSM 1 1 ..2T�__ 3_ j 4 1 5 1 6 1 7 1 8 1 9 1 10 1 11 1 12 1 13 1 14 BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER TOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM/ SPACE HEATER ROOF TOP UNIT UNIT HEATER UNVENTED ROOM HEATER WATER HEATER JY INSURANCE COVERAGE have a current liab- ility insurance policy or its substantial equivalent which meets the requirements of MGL. Ch.142 YES WO IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY [ OTHER TYPE INDEMNITY ® BOND F OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. SIGNATURE OF OWNER OR AGENT _ CHECK ONE ONLY: OWNER ® AGENT hereby"certify that all of the details and Information I have submitted or entered regarding this application are true and accura est of my knowledc and that all plumbing work and installations performed under the permit issued for this application will be in compli �wit�Olen't provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.. PLUMBER-GASFITTER NAME -Da�v� moi£ LICENSE SIGNATURE MP EB'MGF®! JP ® JGF �]( LPGI CORPORATION [ 3f.,( PARTNERSHIP ®# LLC [J#= COMPANY NAME: ee ADDRESS CITY 11 STATE' — ZIP 2 f 2 2- TEL G/ FAX L�� CELL S� �d6-14Q4�EMAIL 6f� e 6 on hi A £+►i,zz j9i/lo/50;�i9 .�0 N;l� �Fo�zo dW£ NUDCO In l I M l Z `3r3'I/1lAS ills - ,G S 3H{l`�2l13 �t3N33 } ,G 3.11 J'li V 9. M M d�10 J I��Wh ld tl Stl 43b S+s1313 ; 4 3SN3� I°�l$J�J I M01103 3Hl `S3f15S 1, 35�3%1'("jS1 1 [���t1,js5�33s nld k s m nuwrw FEENBRO.01 SMORAN CERTIFICATE OF LIABILITY INSURANCE FDATE(MhVDDNYYY)-- 1130/2016 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED, the policy(les) must be endorsed. if SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsemen((s). PRODUCER Roggers S Gray Insurance Agency, Inc. 434Rte 134 South Dennis, MA 02660 CONTACT NAME: PHONE FAX AC�No Exit: ac No: (877) 816-2156 ADDRESS: INSURERS AFFORDING COVERAGE HAIC 0 INSURER A:Old Republic General Insurance Corp. 24139 A2CG0750i501 INSURED INSURER e Feeney Brothers Services LLC 103 Clayton St PO BOX 220801 INSURERC• INSURER D: INSURER E: Dorchester, MA 02122 INSURER F: GENERAL AGGREGATE S 2,000;00 COVERAGES CERTIFICATE NUMBER: REVISION NUMBER - THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TOALL THE TERMS, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. 1LTR TYPE OF INSURANCE D S 8R POLICY NUMBER MMILDICY DIYYYY POLICY PIYYXYY LIMITS A X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE a OCCUR A2CG0750i501 0210112015 02/01/2016 EACH OCCURRENCE $ 1,000,00 DAMArj'= TO PREMISES RENT occurrence) S 300,00 MED EXP (Any one person) $ 10,00 PERSONAL BADVINJURY S 1,000,00 GEN'LAGGREGATE LIMIT APPLIES PER: POLICY N JEC LOC OTHER: GENERAL AGGREGATE S 2,000;00 PRODUCTS -COMPIOPAGG $ 2,000,00 $ AUTOMOBILE LIABILITY ANY AUTO ALLO�AAUTOS AUTOS LED NON-O'ANED HIRED AUTOS AUTOS - COMBINED SINGLE LIMIT $ Ea accident BODILY INJURY (Per person) $ BODILYINJURY (Per accident) $ PROPERTY DAMAGE Per accident $ $ UMBRELLA LIAB EXCESSLIAB OCCUR CWP.IS-h1ADE EACH OCCURRENCE $ AGGREGATE $ DED I I RETENTION$ $ A WORKERS ANDEMPLO EnPENSATN RS'LIABIUTY YIN ANY PROPRIETOR(PARTNERIEXECUTNE OFFICERRAEESBEREXCLUDEOT (Mandatory lnNH) Uyes, describe under DESCRIPTION OF OPERATIONS W&N NIA 2CW07501501 02/0112015 02101/2016 X STATUTE ERS E.L. EACH ACCIDENT $ '1,000,00 E.L. DISEASE -FA EMPLOYEC $ 1,000,00 -- E.L. DISEASE - POLICY LIMIT $ 1,000,00 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached It mora space Is required) Town of North Andover 1600 Osgood Street North Andover, MA 01845 P [, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE U N I ©19813-2014 ACORD CORPORATION. All rights reserved. ACORD 26 (2014101.) The ACORD name and logo are registered marks of.ACORD J. ' Cunningham Lindsey U.S., Inc. P.O. Box 703689 Dallas, TX 75370-3689 Telephone (888) 738-8714 Facsimile (214) 488-6766 CLCAT@CL-NA.COM March 20, 2015 TOWN OF NORTH ANDOVER BUILDING COMMISSIONER NORTH ANDOVER TOWN HALL _. 120 Main Street North Andover, MA 01845 Claim Number: A033547173 Policy Number: 08156400005 Company Name: Arbella Mutual Insurance Company Date of Loss: 02/18/2015 Insured: JEFFREY GLEED Cunnin fiham �% l�Lindsey Property Location: 81 PRESCOTT ST, NORTH ANDOVER, MA 01845 To Whom It May Concern: Claim has been made involving loss, damage, or destruction of the above captioned property, which may either exceed $1,000 or cause Massachusetts General Laws, Chapter 143, Section 6, to be applicable. If any notice under Massachusetts General Law, Chapter 139, Section 3B is appropriate, please direct it to the attention of the writer. Kindly include a reference to the captioned insured, location, date of loss and claim number. n. No. Date ..... - 1.946........ NOR7F1 " TOWN OF NORTH ANDOVER PERMIT FOR WIRING 41 This certifies that � 1, P kq I", Fkrd t2 f Ca ........................................................................................... has permission to perform ....... k �....Y` qs?.!Nx—................................. wiring in the building of ...... C�--l.'........................................................ at ............ pk. P...?.CA. �... S1 ...................... . North Andover, Mass. Fee..... C%..... Lic. No. ,�.S.&-.� ef........................................................... q C� ELECTRICAL INSPECTOR C 620/98�a": 25.44 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer / Office Use Only /�j Permit No --JJ_ rW6 Sammy Occupancy 8 Fee CheckedDo-&—t BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts (Please Print in ink or type all information) Town of North Andover The undersigned applies for a permit to perforin the electrical work described below. Location (Street & Number EO P�fC G �X.�/J�U/�T Owner or Tenant L�/'��%� L nom,,, hr (^�� Owners Address Som llf Electrical Code 527 CMR 12:00 Date To the Inspector of Wires: is this permit in conjunction with a building permit Yes} No Cl (Check Appropriate Box) Purpose of Building 5714/ l a ,pyq�,? L F' Utility Authorization No. Existing Service Amps Voits Overhead ❑ Undgmd ❑ No. of Meters New Service Amps Voris Overhead ❑ Undgmd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work w 4--X OTHER: r INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General taws I have a current Liability Insurance Policy includin Completed Operations Coverage or its substantial equivalent® NO = have submitted valid proof of same to the OMZNO = If you hive checked YES please indicate the tyke of co a by checking the appropriate box = BOND = OTHER = (Please Specify) 1 1 4-'1 (Expiration Date) Estimated Value of Electrical Work$ GZMD- y C Work to Start "7 — L Z- --9.? Inspection Date Resquested Rough 7-Z3-9' Final 6V'tt 10 Lt Signed under to Penalties of pedu g�.,� ,,� FIRM NAME /:� d -e -I..— LIC. NO. C� Licensee Y'/ti"G L /fit C/ 8-7tI A Signature01 y� LIC. NO. /! Bus. Tel No. Address �f Alt Tel. No. OWNER'S INSURANCE WAIVER: I am aware the a Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this peftit application waives this requirement. Owner Agent (Please Check one) c Telephone No. PERMIT FEE (Signature of Owner or Agent) Total No. of Light8ng Outlets No. of Hot fuse No. of Transformers KVA Above ❑In C2No. of Lighting Fixtures Swimminq Pool gmd ❑ and ❑ Generators KVA No. of Emergency Lighting No. of Receptacles Outlets No. of Oil Bunters Battery Units No. of Switch Outlets No of Gas Bumers FIRE ALARMS No. of Zone No. of Detection and Total No. of Ranges No of Air Cond Tons Initiating Devices Heat Total Total No. of Diposal No. Pumps Tons KW No. of Sounding Devices No./ of Self Contained No. of Dishwashers Soace/Area Heating KW Oetection/Sounding Devices ❑ Municipal ❑ Other No. of Dryers Heating Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Bailases Winn No. Hydro Massage Tuds No. of Motors Total HP OTHER: r INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General taws I have a current Liability Insurance Policy includin Completed Operations Coverage or its substantial equivalent® NO = have submitted valid proof of same to the OMZNO = If you hive checked YES please indicate the tyke of co a by checking the appropriate box = BOND = OTHER = (Please Specify) 1 1 4-'1 (Expiration Date) Estimated Value of Electrical Work$ GZMD- y C Work to Start "7 — L Z- --9.? Inspection Date Resquested Rough 7-Z3-9' Final 6V'tt 10 Lt Signed under to Penalties of pedu g�.,� ,,� FIRM NAME /:� d -e -I..— LIC. NO. C� Licensee Y'/ti"G L /fit C/ 8-7tI A Signature01 y� LIC. NO. /! Bus. Tel No. Address �f Alt Tel. No. OWNER'S INSURANCE WAIVER: I am aware the a Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this peftit application waives this requirement. Owner Agent (Please Check one) c Telephone No. PERMIT FEE (Signature of Owner or Agent) MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING 1210' (Print or Typel n 19 --Ah ass. Date511 P(ner�m-it # 7 U Building Location Owner's Name -vN' c AY:, ' Type of Occupancy �t S I D E IJ T I L_ New ❑ Renovation ❑ Replacement 2 Plans Submitted: Yes ❑ No ❑ FIXTURES `f3�)U •° TOWN OF NORTH ANDOVER • do PERMIT FOR PLUMBING ,ssAOtl' This certifies that-�........................... . has permission to perform L%.' . 1 plumbing in -the buildings of .._/..! .. • , , , , . �. at . dF .....,.-�`` 4 .. �1. • • • ...... ,North Andover, Mass. Fee . Lic. No. .3 �PLUNG INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer sck one: Certificate rporation tnership , :n/Co. ;e requirements of MGL Ch. 142. riate box. .■. insurance coverage required by ation waives this requirement. eck one: Agent ❑ i are true and accurate to the best of my plication will be in compliance with all Title Ire of Ucensed Plumber City/Town Type of License: Master JourneymaA ❑ APPROVED OFFICE USE ONLY) License Number Y 3 3 5 Z JY H O Z N W W N Y 2 iA J d NN ¢ a U a ~ Z p O 2 W W a O J N W y t- df W S N ¢ H t J ¢ W to N Y a rn W 2 6 3 X V= 0 M ¢ 0W d Q a W Z D a a to z.¢ d ¢ O W W d= W 3 O 2 = Y H < Y W LL IC W < 3 F- << o fA N Q a Z a 0 J 0 J V1 a == ¢¢ w a F- a o O V= a H ]C J m 0 p a J 3 z F as W V p p a i e m O SUB—BSMT. BASEMENT IST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR �- Date.. c `f3�)U •° TOWN OF NORTH ANDOVER • do PERMIT FOR PLUMBING ,ssAOtl' This certifies that-�........................... . has permission to perform L%.' . 1 plumbing in -the buildings of .._/..! .. • , , , , . �. at . dF .....,.-�`` 4 .. �1. • • • ...... ,North Andover, Mass. Fee . Lic. No. .3 �PLUNG INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer sck one: Certificate rporation tnership , :n/Co. ;e requirements of MGL Ch. 142. riate box. .■. insurance coverage required by ation waives this requirement. eck one: Agent ❑ i are true and accurate to the best of my plication will be in compliance with all Title Ire of Ucensed Plumber City/Town Type of License: Master JourneymaA ❑ APPROVED OFFICE USE ONLY) License Number Y 3 3 5 1 In V m .r - A 0 z In 0 s m z � O O v O V r c m z p r O D � m z ic _ v o c -- a z p v 1 In V m .r - A 0 z In 0 s m z � O O v O V r c m z p Location 3 Z No. Date �oRT„ TOWN OF NORTH ANDOVER 09 ; Certificate of Occupancy $ Building/Frame Permit Fee $ } �'� ,•° <�' SswCHuso Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ 1 TOTAL $ y Building Inspector 1 °, 6 5 2Div. 06/23/98 16:13 130.00 PAID Public Works Location No. CL Date „pRTF� TOWN OF NORTH ANDOVER Of •.o .,ti Or " •• 0 Certificate of Occupancy $ i • J + ; , Building/Frame Permit Fee $ cHFoundation Permit Fee $ s�ust Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ a Building Inspector r + t` 06/23/98 16:13 134.4E ��118iv. Public Works D I tj }' m vmi u D r, a� Y � : � A „ - c ? R' F m ? m z N, m _� N D N Z '—: cc A rx. A A ^ m Z N Z z ti a N � m � an '" O N ~ Y A m D m r. v S 7T v D • Q m N 1S O ♦/ m to t� - G Z - � DC Z m I tj Y � : � A „ - c ? R' F m ? m z N, m _� N D N Z A A A ^ m Z N Z = yZy Y N � m � — ~ O N ~ Y A m D m r. v �� r,tz �i m m J C 1S ♦/ ]� to t� - G - � DC Z m Q m N a Z• its �qv 1 — m � A , O m (_' Nm m > Un[ O � r Z p f o r d � d O C M A — Z Z Z vL Z Z Z ci ci -M Ln ^N N m m m Z V z N N S .r D, A rri A (L r � K d � � a v 0 N � T 1 N n Ob I tj c � O Cl) CD 0 Z y CED O -0 CL C7� C C. S. (A � o � 0 o CD v CD o Q c d O CCD O CSD C CDCD N! 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V" A Q 1 �.L T p o t�. FF i � 31 %go -a N w v All ♦ l h P + ski i 7 r lot, �� r a<.�,�..a.. a*+"'�:...•� tt f t -.'. it� ';.� , 11{{77 �,h� 9w � F F r � a� • { �{1� 4 S I t 71 n oa e r V i! V" A Q 1 �.L T p o t�. r V i! V" n 1 �.L T p o t�. FF i � 31 %go H V i! V" O 1 T p o t�. L i � 31 %go -a N w v H 9 7 ' .♦ P'. 1 T p t�. i � 31 %go -a H •— ` __ The Commonwealth of Massachusetts " ( Department of Industrial Accidents -- Office 0/1aresMadons 600 Washington Street Boston, Mass. 02111 Workers' Compensation Insurance Affidavit I name: I location* 911�; VV'". V64000 f L'V citx 3(2kf-Q2-">, W (`'t D 10121 ---__phone# 0 I am a homeowner performing all work myself. )ty tam an employer provlamg worxers- compensation for my employees working on this job. t `t )�.. 0 I am a -sole proprietor, general contractor, or homeowner (circle one) and have hired the contractors listed below who have Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to S1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day 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 a d penalties of perjury that the information provided above is true and correct Signature Date !% Print name A liP�-1� ���— Phone # official use only do not write in this area to be completed by city or town official city or town: permit/license # riBuilding Department oLicensing Board [] check if immediate response is required oSelectmen's Office " C]Health Department contact person: phone #; MOther (revised 3/95 PJA) -- 1 -9Q -,,,j .Ls LLO �5�� � • OZ/ ' 96pa /E6 40 BO/' E66T 9 .( dW •31 D'O , Ob -T 37VOS dW d3AOONV HI HON 4.91 d1S :(110 SdOSS3SSV *-436+ NV7d 13341S 11OOS3dd TB NOIlVO07 9ET / PE49C 'd3d 0330 03379 VHCNdS 9 .(36/-4.93/' -d09D'91dOW LIIL-SL6 (809) VW daACONV H18W ,LS32i,LS a>iIdNEfLL 0E9 'ONI `S31VIOOSSV N83HIHON NVId 101d N01103dSNI 3!DV!DI IOW P KE.SC OTT CERTIFIED TO: ANDOVER BANK S`T K EE --v NOTE: This mortgage inspection was prepared specifically for mortgage purposes and is not to be relied upon as a survey. Northern Associates, Inc. accepts no responsibility for damages resulting from said reliance by anyone other than the said mortgagee and its assigns in j connection with its proposed mortgage financing to said f S mortgagor. 9.0312 0 fCrST GP yp� This mortgage inspection was prepared in accordance 4K0 SVtir� vith the Technical Standards for Mortgage Loan Ispections as adopted by the Massachusetts Association Land Surveyors and Civil Engineers, Inc. I FURTHER STATE THAT IN MY PROFESSIONAL OPINION the principle structure/s and accessory outbuildings, CONFORM with the setback requirements of the local zoning ordinances, and that there are no encroachments of major improvements either way across properly lines except as shown. PANEL # Z500� 25 — 0005 8 ALSO: DATE: (o — 15 —.L-3 iZ 1. Property is not in a Flood Hazard Area. ❑ 2. Property is in a Flood Hazard Area. ❑ 3. Information is insufficient to determine Flood Hazard. Flood Hazard determined from latest Federal Flood Ineironr,n M.tu kA— 0-11 0 Location 6 No. ! Date at "O ;T,yo TOWN OF NORTH ANDOVER o? ! „ Certificate of Occupancy $ z Building/Frame Permit Fee $ • . a ; !4!�,cMus�t Foundation Permit Fee $ r^ ..O•t-herPermit Fee $ . ;;♦""' Sewer Connection Fee $ Water Connection Fee $ TOTAL $ (�PBuilding Inspector a . 9799 Div. 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UgAOQAIV- HXHON 3aai35ut8W OZi` - 30 - -= y.=-- z�� S3013A0 �.. - - t_ IMO - _ ._ a _.:.'-'• __ Com..:- - .._. _. ---_^'_ ____ _- _... _. _. _. _ .._ _. "' ' " "".raw •., _,;�,.--�. . ,.. � ,..-d ' _.. mss.. yd_ 71 `= 3756 Date. 4 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that . 8S.t . .� . j?,,j`G"r e /� .. P?l. f� has permission to perform . 1R.q Y�1� ...(I .r, ? -.. , .... , , , plumbing in the buildings of. , , , , ; , , , , , , , at. .%-/ C:'.s C. �:. 1'y. , . 5 .. , . , , , .... , North Andover, Mass. r •/• Fee .��? f :':.. Lic. No..�a � ............... .... . ....... PLUMBING INSPECTOR 07/15/98 09:52 25.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer CM GIF a� INSPECTIONAL SERVICES DEPARTMENT MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) J t -4-t, t-4-t,i`n^ t�� D v ec- "' Mass. Date _'�j-10 lgNPen10t' Seer�ial#, Building Location) 9yowner's Namee' / Type of Occupancy—12 ~V New ] Renovation !M�' Replacement C' Plans Submitted: Yes [l N d I, - FIXTURES Installing Company Name OLA_ Check one: Certificate Address ; Corporation �1 p _I6,6A Ina s v' [ 7 Partnership Business Telephone?�1,�j c-� Cr�Firm/Co. Name of Licensed Plumber : �1 \ t.�S S P 11 R V 'c�. lr Ptec u p" INSURANCE COVERAGE: I have a current liab'lity insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy ❑ 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 ❑ 1 hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed anda per /for t applic on will be in compliance with all pertinent provisions of the Massachusetts State Plumbing a an apter of the nor aws. Fee $`� Signature o tensed mer Type of License: Master" Journeyman [ j Receipt N License Number z w a N NZ J No Y Z Z U W W Y Z > Q U Q F W Z O ae Z y a W Q ¢ Cr Z Ir N _ U 2 ¢ m X N CC W > Q /� N ,,, O Q Vl Z ¢ S S `0 ¢ W W = O W Q 3 N ¢ 7 Q J w G ¢ F J- 4 Y O ¢ A LL s !- U> ►- O= d Z Z N Y f' Z M O O O N z d W W LL Y W ► O t� Z t 3 f- N 'A Q Q O Q J J <¢ CL ¢ a C a r Y J m N D Q J 3 S f N k V 7 Z 3 l: W O SUB—BSMT. BASEMENT IST FLOOR 2ND FLOOR ]RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name OLA_ Check one: Certificate Address ; Corporation �1 p _I6,6A Ina s v' [ 7 Partnership Business Telephone?�1,�j c-� Cr�Firm/Co. Name of Licensed Plumber : �1 \ t.�S S P 11 R V 'c�. lr Ptec u p" INSURANCE COVERAGE: I have a current liab'lity insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes No If you have checked yes, please indicate the type coverage by checking the appropriate box. A liability insurance policy ❑ 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 ❑ 1 hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed anda per /for t applic on will be in compliance with all pertinent provisions of the Massachusetts State Plumbing a an apter of the nor aws. Fee $`� Signature o tensed mer Type of License: Master" Journeyman [ j Receipt N License Number T Z D r Z V m n 0 a N r T► '71 m � _ M � O b O r z p m�* em I f C ih x o 30 g M ° ° t o c N o o IV z r C j .. Z G1 "r HQRTq TOWN OF NORTH ANDOVER O:t.•o ,• 1.S.Q i • Certificate of Occupancy $ CI1USEt�' Building/Frame Permit Fee $ Foundation Permit Fee $ L Other Permit Fee ,,4.� $ TOTAL $ 9v. Check # 18x93 -Building Ins`Vector Nay 27 05 06:47a Craig L.Green 978-948-5407 p.2 x 'May 25 05 04:39p Jeffrey Gleed 978-683-4620 p.2 TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATIION TO CONSTRUCT REPAIR. RENOVATE, OR DEMOLISH A ONE OR TWO FAMELY DWELL114G BUILDING PERMIT NUMBER_ a- DATE ISSUED: / SIGNATURE: Ell �V Building Commissioner for of BuildinE Date I. l Proyeity address: 1.2 Assessors Map and Parcel .10 /� � r Number: ✓c9oe Parcel W lumber . Y<- 1.3 Zoning tafwmatias: Zonis Dwip Proposad Use 1.4 Propaty Dimensions: La Areas Frontage (fl) 11.6 BUILDING SETBACKS (ft) Front Yard Side Yard Rear Yard it red Provide Required Provided RequiFed Provided 1.7 Waer Soypy %A.G-L.C.aO. 7ql 1.3. Pwblie 7 Yri—c 0 zone Flood Zwc ldbrinsu. 1.9 00"We Flood Zo.e 0 Avaicipw Sewerage Dispos.t sym� C O. sig. Disposal Sysrein = �a:a. s avr. s - rnVr61R t 7 Vw14ZKJrisY/AU LnWJKiLLU AUUM ]- 2.1 Uwner of Record sq - Name (print) Address for Service: It - f Af e rgflatUr Tdcphonc 2.2 Owner of Record: Name Print Address for Service: nature Tek bone ' ON 3 - CONSTRUCTION SERVICES 11 Ueensed Construction Supervisor: Not Applicable D a Licensed Construction Supervisor: /n License Number Address V Signature Telephone 3.2 Registered Hornc lnnpro.crrwnt Contr(accttoor Not Applicable ❑ i >r�, A( V•r Lat-l",kc < to ::ornpany Name / / / "ka G` / Registration Number "dress r)A " Expiration Date SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......❑ No ....... 0 SECTION 5 Description of Proposed Work check su applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) .❑ Addition 0 Accessory Bldg. 0 Demolition ❑ Other 0 Specify Brief Description of Proposed Work: SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant € zR z OSTbt}1�I.�f 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x (b) 4 Mechanical HVAC 5 Fire Protection 6 Total (1+2+3+4+5) L.) Check Number SECTION 7a OWNER AUTHORIZATI N TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf in alma rs relative lo work authorized by this building permit application. Si Hatt e caner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name Signature of Owner/Agent NO. OF STORIES Date SIZE BASEMENT OR. SLAB SIZE OF FLOOR TIMBERS iST2 ND3 RD SPAN DINIENSIONS OF SILLS DIN ENSIONS OF POSTS D[N ENSIONS OF GIRDERS DIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CI-I]NINEY IS 13UILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Stw4 Z6ol FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all -necessary approval / permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. APPLICANT �EEE%LE`t PHONE %�`Coog-�SZ7c�(o ASSESSORS MAP NUMBER LOT NUMBER 660 SUBDIVISION LOT NUMBER STREET :Q,ES COST S STREET NUMBER 81 OFFICIAL USE ONLY ............................................................................ REC ATI SOF TO .A ENTS DATE APPROVED Z� a CONS RVATION ADMNISTkATOR A i. , r DATE REJECTED TOWN PLANNER mmumpal DATE APPROVED DATE REJECTED DATE APPROVED FOOD INSPECTOR - HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR - HEALTH DATE REJECTED COMMENTS PUBLIC WORKS - SEWER / WATER CONNECTIONS DRIVEWAY PERMIT 17WW-11ii.Zi19a11 FIRE DEPARTNIE'NT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE • cz�.E � ��v� M cNT 7---;2 EF S G O 7— 7- 5�'/2/GMT J y ROBERT / J I v KING y J I Na 17871 A�'o �EpJSTE4�° FSSJpNAL r � r 1 0 N� n ST . . $ D 6 w A L 4z' C:Z , M qy I C£RrIFY TO THE ANDOVER 8,4/Vf'r ANO /7-5 T/TLE /IV5[/*PER THAT TMIS PLAN DEPICTS THE RESULTS OF A cuRRENT EXAMINATION OF THE PREMISES DESCRIOEO IN RECORD BooK 2c so PAGE 3/ -y of THE No. REGIS TRY OF DEEDS AND THAT ALL EASEMENTS, ENCROACHMENTS AND BUILDINGS ARE LOCATED ON Ttlf GROUND AS SHOWN HEREON. NOTES: I, THIS PLAN wAs Nor MADW FROM AN /NSTRuMENT MORTGAGE CER TIFI CA TION SURVEY AND /S NOT FOR RECORDING PURPOJES. THE PLAN sHQws THE coNoi rioNs EXISTING As SKE TCH FOR OF THE DATE SHOWN HEREON. CERT/FicAnoN IS G _1 J FOR MOR r AGE PuRPoSES ONLY PROPERTY .e.�- LINES AS SHOWN ARE APPARENT ONLY. c>I Z. THE PREMISES DID CONFORM WITH LOCAL 'V0e AAJD ,VE NIA. ZONING ORDINANCES AT TIME OF CONSTRUCTION. 3. THE PREMISES DO NOT FALL WITHIN A.o.L� aOOD HAZARD ZONES f'E72 FP�►.�► MAXI PREPARED AVY OOOSS /5 -/UI -/83 p'//yC ASSOCIATES /7 WILL /QOM ST. ; .WNDOVER, A•bOSS. Kay 27 05 06:47a Craig L.Green 978-948-5407 P.3 f.GTP IMMmoml _CORD„ CER-CERT9-:*, f � ABILITY-.I.NS.:U . ` i. _ .. a,1 �r2oo5 THIS CERTIFICATE 18 ISSUED AS A MATTER OF INFORMATION PRODUCER (978) 887-8304 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE OR OLDER. THIS CERTIFICATE. EXTENLOW. JAMES UGONE INSURANCE AGENCY ALLTER THE COVERAGE A FORDED BYO THE POLICIES BEAMEND 10 SOUTH MAIN ST., I COMPANIES AFFORDING CQVERAGE SUITE 208 ....... --- -' __--. TOPSFIELD MA 01983 COMPANY FARM FAMILY CASUALTY INSURANCE COMPANY , INSURED COMPANY CRAIG GREEN DBA GREEN'N GROWING COMPANY 524 NEWBURYPORT TURNPIKE C ROWLEY, MA 01969 COMPANY D TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT CERTIFICATE MAY BE ISSUED OR MA*, PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. EXCLUSIONS AND CONDITIONS ---------"_'-- — CO-''--_-. LTR TYPE OF INSURANCE POLICY NUMBER ' POLICY EFFECTRfE POLICY EXPIRATION : LIMITS 7 DATE (MMMONY) DATE (MWDD/YYI " A ! 2005X0655 ! 10/01/04 : 10/01/05 G.ENERALAGG_REGATE • s 1.000.000 GENERALLUIBILITY PRODUCTS - COMPIOP AGG S 2.000:000 X ;COMMERCIAL GE WERAL LIABILITY . . - --. .._ .. _ ; I--_.-_ .__. 1,000,000 S ' I CLAIMS MADE X !OCCUR! _ I PERSONAL 8 ADV INJURY ; 1,000,000 _. OWNER'S 8 CONTRACTOR'S PROT : EACH OCCURRENCE— S FIRE DAMAGE {Any one nre) _ 5 50.000 .. ...` ..._ .. MED EXP (Any one Person) A ! AUTOMOBILE LIABILITY 200104248 01131/05 j 01131/06 COMBINED SINGLE OMIT S ANY AUTO I _ _ __ ........ .. _._... ALL OWNED AUTOS i + BODILY INJURY S 100,000 (Per Person) X . SCHFOIILEO AUTOS- HIREOAUTOS I BODILY INJURY S 300,000 - ---I (Per aWdent) ' NOWOWNEO AUTOS I 1 PROPERTY DAMAGE is 100,000 `. I AUTO ONLY - EA ACCIDENT ; S GARAGE u11BILm - OTHER THAN AUTO ONLY. ' ANY AUTO I . I EACH ACCIDENT _S - • _ .. _..._... ._ _. .-w . — AGGREGATE S i EXCESS LIABILITY r ` I EACH OCCURRENCE S _....I UMBRELLA rORM AGGREGATE S OTHER THAN UMBRELLA FORM A AND 2005W6797 S W STA - � O R LIMNS ER ,. 10!29!04 10!29!05 �.. WORKERS COMPENSATION ' ' -.'.TORY 500,000 EMPLOYERS' LIABILITY£L EACH ACCIDENT S . THE PROPRIETOR! INCL a : EL DISEASE - POLICY LIMIT S 500,000 -"— ----- -- • --- - - i PARTNERSIEXECU71VE _; .OFFICERS ARE: X EXCL : I EL DISEASE - EA EMPLOYEE :S 500,000 OTHER ' I I DESCRIPTION OF OPERATION SILOCATIONSNEHICLESISPECWL ITEMS .CERTIFICATE HOLDER CANCELLATION": SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE FOR EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL INSURANCE 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. VERIFICATION BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY PURPOSES OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. ONLY AUTHORIZED REPRESENTATIVE ACORD 25-5 (1195) @ ACORD CORPORATION 191 CO) m m m CO) m CO) S CO) CD a Z CD O CL � d a� -o o p CD Q ._ CD o C=D CO) d d 0 CO) n� C 0 C CO) d CDO �F CCDO) CA C C10 ?� O d _x O -•fAOQ y O O.O m y N d m Z .O 10 ?fl y m a?CO) m m 0 0 % p O =' �m m x H m O o y. 0 _ o_m �c o SriC , cn a CD HS ►may m 0 V c O. CD CA O d y O N O. nt h � CCD � fti o CD CD CD 0 0 c7 co o m cn cn CD • I� CD n M o� _ ►/^V�Sy] = CD - � 4 CC 0 eo `� d I E -x w m t•' z y IR- �"�, a' o �Y• :0110 w cp 't7 n O z � z E W W V IV E H 0 9 A O P" 0 c Location/ -a J No. 135 Date -N NORT" TOWN OF NORTH ANDOVER f 1 Certificate of Occupancy $ ��s'•"°' E<� Building/Frame Permit Fee $� s�CMus Foundation Permit Fee $ Other Permit Fee $ _ TOTAL $ Check # 13 7 3 Building Inspec`'or Ki TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVAT5 OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: DATE ISSUED: a, ® A SIGNATURE: 000W M" Building Commissioner/1for of Buildings Date SECTION I- SITE INFORMATION 1.1 Property Address: I PkAgsccrr 'ST 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: Zoning Distrid Proposed Use 1.4 Property Dimensions: Lot Areas Frontage (fl) 1.6 BUILDING SETBACKS (ft) Front Yard Side Yard Rear Yard Required Provide ReqLAred. Provided Provided -Reqwred 1.7 Water Supply M.G.L.C.40 54) 1.5. Flood Zone Information: Public 0 Private 0 Zone - -- Outside Flood Zone 0 1.8 Sewerage Disposal System: Municipal 0 On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record CA:1,71— 'St -- Name (Print) Address for Service Signature Telephone ®9 *2.2 Own Kofa§ko—rd: 'N Name Print Address for Service: Signature Tele hone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Not Applicable 0 License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable 0 Company Name Registration Number Address Expiration Date Signature Telephone LV71 0 z M 0 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 .......0 No ....... ❑ SECTION 5 Description of Proposed Work check all applicable New Construction ❑ Existing Building 1K Repair(s) Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition Other ❑ Specify Brief Description of Proposed Work: 11) OVouS1-1 12ErL,6-CE RACK )PP2 C. 44 CSC e617T F61 F). / r ✓/J ��>�G®el�e� 56-7— SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant " {)FFICIAL USE ONLY' x.i4 1. Building 01-/'000 (a) Building Permit Fee Multi Tier 2 Electrical N /¢ (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (e) X (b) 4 Mechanical HVAC �¢ 5 Fire Protection 6 Total 1+2+3+4+5 p Check Number SECTION 7a OWNER AUTHORI ATION TORE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, r 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 OOWNER/AUTHORIZED AGENT DECLARATION I, JE Cr�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 sJ EFF is 45�1 Print Name Z 3�da Signature r t Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 ND3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIlVIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHRVINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE a. M r 0 i -� b0 �00,�^� 1 � 1 1 s FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all -necessary approval / permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. ................11......................................................now ..■ APPLICANT G_FF 9—El ueer3 PHONE S?Ool- ASSESSORS MAP NUMBER SUBDIVISION LOT NUMBER LOT NUMBER STREET P/2ES G077"- 57' STREET NUMBER p OFFICIAL USE ONLY ` RECONVAENDATIONS OF TOWN AGENTS �.. a a a a a 0 a a. a a a Era ..aaaaa■a■aaa..aa.. as a a a a a.aa■ 0 a a a a s a■■■ a a. a s a. a s a. a..■■■■a �n r- (L DATE APPROVED 17 COKSERVATIOR ADMINISTRATOR DATE REJECTED TOWN PLANNER COMMENTS DATE APPROVED DATE REJECTED DATE APPROVED FOOD INSPECTOR - HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR - HEALTH DATE REJECTED COMMENTS PUBLIC WORKS - SEWER / WATER CONNECTIONS DRIVEWAY PERMIT DATE APPROVED FIRE DEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR -a6_ o0 Town of North Andover Building Department 27 Charles Street North Andover, MA. 01845 D. Robert Nicetta�= Building Commissioner (978) 688-9545 `(978) 688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print DATE e 3— O JOB LOCATION I i R-:Sco-ry eT Number Street Address Map / lot "HOMEOWNER-�EFF9-EY 6 Lecb 978 - 6Y -B - :25- O Name Home Phone Work Phone PRESENT MAILING ADDRESS T CE.SC07T tST City Town State Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings of two units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. (State Building Code Section 108.3.5.1) DEFINITION OF HOMEWOWNER: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one or two family dwelling, attached or detached structures ac- cessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other Applicable codes, by-laws, rules and regulations, The undersigned "homeowner" certifies that he/she understands the Town of No. Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL Town of North Andover * NaRiy q O �SLLO 6 O Building Department o 27 Charles Street North Andover Massachusetts 01845 _ y (978) 688-9545 Fax (978) 688-9542 �4So44 It. DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit # the debris resulting from the 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 /at: 6A -(2-77N 6-, 21klOoS72;� Facility location Si a o p lic nt Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. tA b Q L S N bd HLl rn n � tA b Q L S N r" N J. F. SHAW CO., INC. 8 MIDDLESEX AVE., BOX 431 WILMINGTON, MA 01887 (617) 658-2550, FAX (617) 658-2364 N JOB NAME JOB NO. — CALCULATED BY VERIFIED BY— PAGE-OF DATE DATE SCALE I I IF I'L C6 r6l - No 4�- 1 X j.. ...... ... . .. ------- --- �0- ---- ;01 II A . ........ . . ----- ---- ------ -v rl .7 —41 ---- --- IL . ........ .. J. F. SHAW CO., INC. 8 MIDDLESEX AVE., BOX 431 WILMINGTON, MA 01887 (617) 658-2550, FAX (617) 658-2364 JOB NAME JOB NO. CALCULATED BY VERIFIED BY - PAGE OF DATE DATE SCALE tcn�— ,I I I I ; I i 1 i I t I I ' � 1 I I (� ! 1 Az ' I � t I i J. F. SHAW CO., INC. 8 MIDDLESEX AVE., BOX 431 WILMINGTON, MA 01887 (617) 658-2550, FAX (617) 658-2364 JOB NAME JOB NO. -- CALCULATED BY VERIFIED BY_ PAGE OF DATE DATE SCALE I -T17T-- I F+f I I I -- iii �� LST S Tl l A 6 _ s -' 1iaE; —�– — -- G I I _ , _ � I , j r i 1 i i : I m m m U) 0 m _) C d CD c� Z Coo CCD O CL r �' MM CA >c O n v CD CD o CL -r a cia CD CD o CD CD co). CD CZ O_ CO) I c0 9 C z- sd = z ^ O -•viocr y d O m .fl CO) = m0 m CD yci_ao m Z m =10 y --I_ fu O .-I O m N M O COD Cc, _ = O m H CD CC2 O C y CCD c3km N 4t m CLte,...: C2 CRD o nO A M ^�, OR O Cv N _ HCL crC O � .W -7` • CZ16� r CoDO � co = O CD CDC TO 7N O O O '� ., aDor r,l y Z z o ►• mrr CD r�-^�-r t' cn ^ CD G �sC f o C U=® ELM C O �► CD G � CD Cn Cn w �1 7d '�f 7C1 'rf rt7 �7 n 7d 'zf Cn 'rl o ~ Z '' w F w �• cam w w ::T, 0 qs, w GO)CA b r p x !J m M v I *Tai Q O S Date.... (4J .k./P..... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..... C...Af /-S A //I'- 't-, . ........... ....................................... ............................... has permission to perform .... P .P0 1 4- ChApqw-- S-em.,we, .................................... ............................... wiringin the building of ................................................................................... .)q ,North,�ndover, Mass. at ............ ...... Pr.6S.C..0 ............ .............. Fee ... /P,9 . . ... Lic. No . ............. €:.......!............... ..... ........................ ELECTRICALPECTOR A - Check # CA S 11/1' 573`i JIM LUIV/lYlUly rrr.4"17 fir DEPAW31EVl0FPUBIICS4FE7Y Permit No. BOARDOFFIREPREVFIV'170N ONSSl7QNR12:A0 Occupancy &Fees Checked APPLICA71ONFOR PERMIT TO P ORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH T MASS HUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) IDate Town of North Andover The undersigned applies for a permit to Location (Street & Number) 81 Owner or Tenant electrical work described below. Owner's Address 61 L(Z . 7T S r' Is this permit in conjunction with a building permit: Purpose of Building 6- C' O Yes M No To the Inspector of Wires: (Check Appropriate Box) Utility Authorization No. 62,907 Existing Service D O Amp ZO / dVolts Overhead Underground No. of Meters New Service 'Z,D Arnps Zn�Volts Overhead ©Underground M No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA ro grot No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW Connections No. of Water Heaters KW No. of No. of Signs Bailasis II No. Iiydro Massage Tubs No. of Motors Total HP OTHER �[� �'/ J'�1e��G/�F�/J •�,f Jan Itmua =Covetage Plasuatimtt m4manafs zu ftCtnmWLaws IhaveaametLmbkylnsamxFblicymduftCompiet Covet ageorAssubsl�aleguivalat YES NO IhaveshnitiadvdfidpoofofswwlDd eOffim YES u ffyvuhar dvclodYE! ,ple wmdc&thetypeofooveWby muw4my,n BOND OTI�x au. rem** Wodc9DStat Ixd IRMNAurt��iePtrlalhrs�pt�tay ,i'I1_ FRgi IPW� iMME (SCJ L ��ir��5 l ��� Signahae VAPULLAILA Estir i*d Vakr afEbcbxa1 Wade $ Rao I Fuld LmiseNo. 3 f1ZF3 E LicaeNo 342-93 F Btlsr�sTelNa g1S 19119 ���P� Q Z l a't� s� /C.� `" 'Y'I�%/� ,� . % 0 At Tei Na OWNER'S INSURANCEWAVER;Iamm=lhAtheLi wdoesmthaNetheinsuranecom*oriLs GareralLaws and that my signatme en dus pewit application waives this tec}manat (Please check one) Owner Agent ?� (��� S�r� Telephone No. PERMIT FEE $ tgna re of uwnerorX—ge—nr JIM UU[MVIU[v rrr A" n yr tars{.nrii,ziv.0.i l o DEPAR73IDVT OFPUBLICS4FETY BOAROOFFIREPREVEMONREGULA7TONS527a&IZ00 Permit No. Occupancy 8t Fees Checked APPLICA77ONFOR PERMT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover The undersigned applies for a permit to Location (Street & Number) Owner or Tenant Owner's Address the electrical work described below. S-7— To the Inspector of Wires: Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box) I 9 712 Purpose of Building YvJ Utility Authorization No. Existing Service 4e 0 Amp / pVolts Overhead 'Underground New Service �Underground Amps ZO / V/6Volts Overhead �M Number of Feedersand Ainpacity Location and Nature of Proposed Electrical Work No. of Meters No. of Meters No. of Lighting Outlets Y No. of Hot Tubs . No. of Transformers Total KVA No. of Lighting. Fixtures Swimming Pool Above Below Generators " a KVA round eround No. of Receptacle Outlets No l of Oil Bumers - No. of Emergency Lighting Battery Unita No. of Switch Outlets No. of Gas Burners FIRE ALARMS 9No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and Initiating Devices" No. of Sounding Devices -� �. of Disposals No. of 'Heat Total Total Pumps Tons KW No. of Dishwashers Space Area Heating KW . No. of Self Contained Detection/Sounding "Devices Heating Devices KW ers Local Municipal Other Connections a No. of No. of ater Heaters KW Signs Bailasis ro Massage Tuba _ No. of Motors Total HP az .�. NCEb� BOND � O1H 17 kTxfionD&&We*d egt*aalt YES 0 NO . 1a ;. 1fyouhavedtedxdYES,pleas✓indir dretypeoft by EWm*dVa1rofl7er xalWc&$ Final Z,.q 19 01,, 0190 Lia wNa 3 5ZZ73 E I.iaanerlo 73Z F Busi=TdNa 19 _ - . � - - J - AkTciNa 'SINSURANCEWAMT,IamawarethattheLioawdoesinthavetheinsa' meoWoritsaist3 alegirivalaitaste iWbyMassac m9MGenaalLaws ysignahaeendispmnk*pbai'anwanesmm9g,m rtalt. hec one) Owner ® Agent6 Telephone No. PERMIT FEE $ U�ie�/CG-_ ��- o?S'' lei (47 PO Oolr^ Poo C :0ti��1)•' ,brL) C.m Ta Pooc &.soP Aooeleb �'j Naro : bEr'P w ass eo Gertz 0 A4TP -'s �K LoC"%o a ���4. 4O.SS A-dje hoc 9440h.W-V Pet L 07.- � 4. 0:5 PF-mv Q