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Home My WebLink AboutMiscellaneous - 84 ACADEMY ROAD 4/30/2018I 0) 3. C) m C) C) North Andover Board of Assessors Public Access Click Sea[ To Retum Search for Parcels Search for Sales Summary Residence Detached Structure Condo Commercial Page I of I ' � � li I � I I � I � � I I I � 110 Sroperty Record Card ---- ---- ---- - Location: 84 ACADEMY ROAD Owner Name: WORDEN, JAMES D WORDEN, ANITA RAJAN Owner Address: 84 ACADEMY ROAD City: NORTH ANDOVER State: MA Zip: 01845 Neighborhood: 7 - 7 Land Area: 4.01 acres Use Code: 101-SNGL-FAM-RES Total Finished Area: 5029 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 742,100 686,100 Building Value: 484,000 437,600 Land Value: 258,100 248,500 Market Land Value: 258,10,0 Chapter Land Value: http://csc-ma.us/PROPAPP/display.do?linkld=2256019&town=NandoverPubAcc 3/19/2013 co co 4 C4�1 �x w 0 0 co -0 Q); UY a co! 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F.- L) �oc -0 co C: rL,-, L) LLJ 0 co 0 0 , I (L) a) C: :3 10), 0 -,,Cf .�= L 1: L U- LL,(-) CL w U) 0 CD cn ca 0 - Cl) 0 LO m C? 0 C) CD 9 co Cl) 0 9 C! co 0) 2 CD 04 LocationZ�� A -2 - No. Date ----7 Check # 10al- 2'/ Y"i 0 TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $a&Y Foundation Permit Fee $ !f - Other Permit Fee $ TOTAL Building Inspector TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: Date R eceived Date Issued: '-IMPORTANT: Applicant must complete all items on this page LOCATIO P t PROPERTY OWNER - Print 100- Year Old Structure MAP NO: PARCELM�0 ZONING DISTRICT: Historic District f Machine Shop Villa no 11 - - e ves e no .TYPE OF IMPROVEMENT- PROPOSED USE Residential Non- Residential 0 New Building 11 One family 11 Addition El Two or more family 11 Industrial 11 Alteration No. of units: 11 Commercial 0 Repair, replacement El Assessory Bldg 11 Others: 0 Demolition El Oth-er El Septic 1 0 Well 0,Floodplain 0 Wetlands ii Watershed. -District 11 Water/Sewer DESCRIPTION OF WORK TO BE PERFUIRIVIEU: ()CT -7-ut, L PzOd& Lb L) 5 (L -,ro Identification Please Type or Print Clearly) OWNER: Name: Phone: Aririmcc- CONTRACTOR �Name: "�h"`one:- Address: Supervisor's Construction License: Exp. Date:. Home Ihmprovement License: ARCH ITECT/ENG I NEER Phone: Address: Reg. No. FEE SCHEDULE: BULDING PERMIT.'$12.00 PER $1000.00 OF THE TOTAL ESTIMATED COSTBASED ON $125.00 PER S.F. "'20 Total Project Cost: $ (�-Z) FEE: $ Check No.: 0 Receipt No.: NOTE: Persons contrac�ng with unregistered contractors do not have acc ss t the guaran ul� a Plans Submitted LJ: Plans Waived CertifieJ Plot Plan Sta pe Plans L1 Plans Submitted:[] Plans Waived C -ertified Plot Plan El Stamped Plans F1 -TYPE-OFSEWERAGEDISPOSA-L Reviewed on Public Sewer Tanning/Massage/BodXAxt Swimming Pools Well E] Tobacco Sales El Foo d Packqging/Sales El Private,,(septic tank, etc- Per'maAdnt:D11nnpster on site THE -FOLLOWING SECTIONS FOR -OFFICE USE ONLY' INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE,APPR.OVED �PLANNING'& DEVELOPMENT - COMMENTS I -_� Uicitc4e_� CL -CONSERVATION Reviewed on - W 0" ) COMMENTS KEALTH Reviewed on Signature C6MMENTS `5 r -,D klr�j C::, n. K_X_� 7' "'.ve F-Yc_ s4t__�, 4� Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Co mments Water & Sewer Connection/Signature & Date Driveway Permit DPW Toiv2 Engineer: Signature: Located 384 Osgood Street -ARE DEPARTM,F_-.NT: �� Temp Dumoter on site, Located -at J �4 Ma in Strdet:-. ye§. . no 'Fire Dbpi&ff64t.gjgh tujeejd.ait6,i a t COMMENTS -Dim-ension- - Number of Stories: Total square feet of floor area, based on Exterior dimensions. Jotal'land area, sq..ft.-. E L EC TRI CA L: Move m e n t of. M ete r loca fib n-, rriast -or s e.rv�i c e d ro p re q u i res a p p rova I of Electrical Inspector Yes No DANGER.ZONE LITERATURE: Yes No MGL -.Chapter 166 SectIon 21 A =,.F and G rnin.$10041000 fine NOTES and DATA — (For department use) Doc.Building Pennit Revised 2010 F— Building Department The fol�'iwi.ng'ig a -list. ofthere4uited.forms to befilled out forthe appropriate permit tobe obtained. Roofir�g, Siding, Interior Rehabilitation Permits 13,1-jilding Permit Application Workers COmp Affidavit Photo Copy Of H. I.C. And/Or- C.S. L'-� Licenses Copy of Contract Floor Plan Or Proposed Interior Work Engineering Affidavits for Engineered products NOTE: All dumpster. permits require sign off from Fire -Department prior to issuance of Bldg Permit Addition Or Decks o Building Permit Application u Certified Surveyed Plot Plan u Workers Comp Affidavit a Photo Copy of H.I.C. And C.S.L. Licenses L3 Copy Of Contract o Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) u Mass check Energy Compliance Report (If Applicable) Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off, from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) • Building Permit Application • Certified Proposed Plot Plan ci Photo of H.I.C. And C.S.L. Licenses Workers Comp Affidavit Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (if Applicable) Copy of Contract zi Mass check Energy Compliance Report Li Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all casci if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the api)�?al period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be subm-tted with the building application Doc: Doc.Buifflng Permit Revised 2012 pp-!: Pi d�l rA n 0 t,4c. 0 zi —j C.00 >% M :(Dr 0 > U) 0 0 m E'o 0 w c 0 T o o a 0 CA tm CM r 0 r_ a 0 CL a) co LU -0 o o r, 2 .2 u) c 0 0 uj E ui L) 0-0 rL U) G)'5 = CA ch -0 04- a am E (a o " C 0 0 F- = � CL 0 L) > uj CL Cl) CO Cl) 1�- 0 LLI 0- x Ul 0 C0 ui LLI —j CL 91 iki, 0 E -0 0 z 0 ca CL cc 0 0 CL 0 0- 0 Cc cts —j --o r.L 0 4) z 0 CL it 4K 0 cc 0 0 0 0 C4 CD 0 2 'OE CD . a Cf- z LLI LU 0 LLI Ln L) LL z z LLI 0 Ln z LU Ix LU ai a) ui ca cu Y -0 tto to. to bD 0 0- :3 0 m ,E =1 = E o 0 (1) 0 0 iE 0 0 (u =3 E U V) LL U cr co Ln tA uj CL Cl) CO Cl) 1�- 0 LLI 0- x Ul 0 C0 ui LLI —j CL 91 iki, 0 E -0 0 z 0 ca CL cc 0 0 CL 0 0- 0 Cc cts —j --o r.L 0 4) z 0 CL it 4K 0 cc 0 0 E C4 CD 0 2 'OE CD . a uj CL Cl) CO Cl) 1�- 0 LLI 0- x Ul 0 C0 ui LLI —j CL 91 iki, 0 E -0 0 z 0 ca CL cc 0 0 CL 0 0- 0 Cc cts —j --o r.L 0 4) z 0 CL Tize Commonvealth ofMassachusetts Departmintoflndgstrlql,4eclda-ts Office ofruvesfigaflow 60 . 0 Washington Street Boston., MA 02111 um-Mass-govIdla Warke-rql Com-oengatlonfmuraAce Affidavit: Buffder,5/Contractors/Blectriclaiasi�I orP Address. Cj,YJ,S,,,e ,fzv: /L/,, Phono ih- Are you an e)rnployer? Cfieckthe appropriatebox- Ty� B of project ( yeqmlred): 1. 1 am a employer with _ 4.El I am a general contractor and 1 6. []Now cOnstraction employees (fim and/or part-time),* 2.0 1 am a s oJG propriator or p artner- have like d the sub- c ontractors listed on the attached sheet. 7. deling El Remo ship and:lavano.emplcYOO� These sub-contractorg have workers' comp. insurance, 8. El Demolition 9. ElBuilding addition WoAdng forma immy capacity. PTO workers, comp. �nsurauca 5. We ate a corp ora�on and it's 10.r] Electrical repairs or additions required.] 3. 1 am a homeowner A1119 all, work officers have exercised their right of exemption p or MOL 11.[] Plumbing repairs or additions myself [No Workers, bomp. c. 152, §1(4), andwahav-ano 1211 Roofrepairs; JusuranGareqa1red-1 T employe6s. [No workeX31 13.E] otji,,:r comp. insurance reqmired.] KAm7applicautthat &erksboxfif must also ftU.6u.tthosec.gonbel6wshovingthe!r Workers' compensadonpolicYlotbrolatl0n. f-ilomeownerawlio sabmit ibis affidavit indlGatingfftey ko doing allworg and then Re outside contractors mast submit anew affidavit iadicatifig such. Teontractors that rhedkthls box must dtaGhed @a laIddiffonal shectslowingthe name of the subrcontractors andthek workers' comp. policy information. I am an einy . fOyei'thidlgvrOvldlngWOylfOrsleomuelisationinsurancefo,-MymTloyees. MOW WheJ0110Y afi(fjOb Site InsuXance Company Polloy # or Sellf, ins, VG. ff. Expiration Data: Tob Site Address, rcity/Statelzip; Attach a copy of Me workers" cOmPeu�a-ffon-policy declaration page (showing the PolicYnumber and expixation. date). qofa Failure to secura coveraga.as xeTwe(lundor Section 25A ofMGL o. 152 can lead to the, imposition oforlmhalpanaltle. fmo -up to $1,500.00 andlior bne,-Yoar MPrisonment, as wellas ciOpenalties in the form of a STOP.WORK ORDER and a fine of -up to $250.00 a day against t�o v.ioldor. Be, advised that a copy of thL9 statemontmay be forwarded to ffie Office of- lnvast�gations of the DIA for ffisurance coverage Verification. B1qVj jut f vided above is true and correct, Molierebye F per ytilatifte-In ormafionpro /41 Date: offyclal use opbi. vo not 1prite ht Mis area, to be completerf bY c4V or town official CW or Town: Permit/License 0 issuing AuthorRY (ekele wie)* 1. Board of Health 2.130dingDepartment 3.0tyff-mm Clerk 4. ElectricalInspector 5. Plumbing Inspector 6. Wher 'DY, — . Mt Information and -Instructi ons Massachusetts General Laws chapter 152 req�ires all employers to provide workers, compensation for their employees. Pursuar�t to this statute, an era . ,ployeels dcfmcd as --evelYperson. hi the service of o d y coiitr t o express or implied, oral ar -mjtten.,, an thDrlm Cran ac fbiro,. An wVloydig defined as "an individuaL partnership, association, corporation or other legal ent!V, oranytwooxmola of the f6rejo'�j engaged in ajoint anterprise, and;nr,1udft19thG legal of a:daccasedqmplpypr�,0r't1'L0 Xedelvir G Or-tnigtc 'Ofanindividual ' partnership, as�ociatlon or other legal entftM employing eniployees. &ev6_rth6 ONmOr Of a dwelling househaving nOtMOM than three apartnents andwho resides therein ortheocoupantoftho dwolffighouso of another who employs persons to do m tanance or on the grounds or'building a ,constracdouozxopa*r'.'workorLsu6hdweBhghouso Pp-artenanttlierefoshallnotbocausoofsu(;henaplo�mentbadeemedtobeanenaplayer.,I UGL chapter 152, §25C(6) also states that "every state or JoW 11 In - GeRsIng agency shall withhold the Issilance or renewal of a license or p ermit to op erate a business or to construct buildings in the commonwealth for any applicant who has not produced -acceptable evidence of compliance with tU iusurance coverage required." Additionally, MGL chajpter 152, §25C(7)statos, 'Weither the commonweaffil nor any of its p olifical subdivilsions Shan enter into any c ontract for the p ffformance of public work until ' acceptable evidence Of cOMPEPM with theinsuranco requirements ofthis chapter have b eon presented ta the contracting authority.11 Applicanig Pleas G fill out the, woxi-ers, c * OMPOMUOU af ff davit completely, by checking ffio boxes that apply to your situation and, if ILGcOssat3l; supply sub-coritractor(s) name(s), aft-OSS(CS) and phone number(s) along witli their certificate(s) of IRSUrance. Limited Liability Companies (LLC) or Limited Liability Parluorsbips (LU) vdth no employees other thm the members Orl?�rtuers, aronotroquiredto caWworkers, compensation hiswaum. If auLLIC orLLP doeshave omployeps,apolicylsiaquired. Be advised thatthi� affidavitmay be submitted to the Department of Industrial Accidents fbT con&matlonof insurance coverage. Also be sure to sign and date the afada-vit. �Ia affidavit should be returned to the city or tova that1he application fortfiGporolit or license is behigreqaeste notteD ' . q, . B.Partmentof Industrial Accidents. Sllouldyouhavo any questions regarding ffio law or if you are requiredto obtain a*orkersl Copipe,usation,polfey, please, call the Department at tho number listed below. Self-insured companies Aculd entortheir self-insurance license number on tho S`pp Ike. City or Town Officials Please be sure thatthe affidavitis complete andprintodlegibly. ThoDopartment has provided a space attho bottom ofthe affidavitfoxyouto 0 o-atinth,, eventthe Offfoe of hivestigations has to contact you regarding the applicant. Please bc-surO to f R in the pennifflicenso number Whichwill be used as a reference number, Inaddition.,anapplicant applications in any given ' . year, nood only submit OnGaffidavitindica-ffiag cutr6nt PORGY Wo=fttlon (if necessaxy) and under "Yob Site Address- the applicant sRouldwrito ,all lo* cations or toV74"A &py dthe affidavit thathas baeiu offlGially sta�mped or marked by the city or town maybe providpa to the applicant as proof that a valid affidavit.19* OR:fflGf0X bi-M0130nialts or licenses. Anew affidavitmistbaffleLdbuteach year, Where a home 0 -Mer or citizen is obtaining a licc)use 040nnit not related to any buslaoss or commercial venture (i.e. a dog license oriermit to burn leaves etc.) said person is NOT required to complete this affidavit. The Office 01nVesggations, would like to thank you in advance fox your cooperation and shQi:ddyQ-a have anyguestion Please do no-thesitate to give us a cal s, Tlae, DepattmeuPs address, telophono, and fax number: T1,Q . -Woafth of DePartmeDt of Xaduatdal Accldentg 6bQ WaftgtM . B09Q4, MA 02111 617-7-27--4900 Qxt 406 Qr- 1-8 -7� ,7 Revisad5-26-05 Fox # 617-727-7749 North Andover MIMAP June 9, 2014 0-58.0--0027 #2 095, . 1, #1 O'D "3 095.10-0Q00 - 0,58.10-002111 095.0 07- Ir290 #290 0,5800-0025 20 0112 993.070009 8- 0 095.0-0006 '��.0:0006 A5 1. 111 In #316 #311 9320 ------- i 456 095.0-01071 IM :#325 096.0-0075 11 058.4-'o OP6.0-0073 V -451- #3�45 8 1059A)i6flim, 096.M02 096 0-8071 096.0-0002 R2 Q9611. -0067 #3§7 096 0-;0066 T11 11% bricDIStrA t 096.0�'0981 #391 096.0-0093 0' 096.0-008 Q9-0 096.0-0082 A- 9 Rf .3u,\ #401 059.,0�002 69401 OU34Z 096.0-0048 09 .0 078 #411 '17" #56 cad U 6' -2 C ,10 #8 0 �096: \XR\ Rail Line -, Wetlands Zoning Int mtates 93 Exempt Lands ! ! Busi.— s 1 Distrll� 1 13 B . 2 Ditnc S" 0 =msi! s 3 District 0 Busi— s 4 District Horizontal Datum: MA Statelplane Coordinate System, Datum NAD83, Meters Data Sources: The data for this map was produced by Merrimack Valley Planning Commission lMVPC) using data provided by the Town of Roads 0 Ge,era Business District C. Ea-mana 0 Pl—n.i C—m—W Ds,, rl C.rrid. Development Dist 0 t- E3 MVPC Boundary 0 Corido Develop ant Dist 0 C3 Municipal Boundary 13 Corrido Development Dist North Andover. Additional data provided by the Executive Office of Environmental AffaindMassGIS. The information depicted on this map is for planning purposes only. It may not be adequate for legal boundary definition or regulatory interpretation. THE TOWN OF NORTH ANDOVER Zoning 0 eray Industri it 1 District v Adult Ente ainment Zustri 12 District 494 MAKES NO WARRANTIES, EXPRESSED OR IMPLIED, CONCERNING THE ACCURACY, COMPLETENESS, RELIABILITY, OR SUITABILITY OF THESE DATA. THE TOWN OF NORTH ANDOVER DOES NOT Down I ndustri 13 District wn Overlay District t 0 Industri I S District Historic District S A SLIME ANY LIABILITY ASSOCIATED WITH THE USE OR MISUSE CF THIS INFORMATION 23 Water P Residei ce I District notection 11 Radice, ce 2 District SAC 0 Parcels 92 R—idei ce 3 District V Hydrographic Features de� ce 4 Di hict 1 264 ft de, ce 5 District St.... de ce 6 District —'v,—ge tesidenti.1 District A3massachusetts Department of COnservation and Recreatio� i NOV 2 9 2006 TYPE OR PRJNT�ONLY Office of Water Resources well,'Completion Report TOWN OF NORT .1 � 1 P ER 1. WELL LOCATION HANDIt 0 Required) North ako L woct Address at Well Location: j�4 �. q erty Owner/Clie nt: Subdivision Name- Wn Mailing Address- I Ca j -r7 City/Towr e_4 , (1;) wo 'je City/Town: Assessors Map�. Assessors.Lot #: NOTE:.Assessors Map and Lot # man atory.:if no sti Board -of Health permit obtained: Yes Me'" -Not Required 0 Permi eet ai4dress -available 2. WORK PERFOR Jsued' MED. 3. WELL TYPE 4. DRILLING METHOD 6. CASIN Overbur en Bedrock From (ft) A TO Type P), - Thickness Di e I _7 I ro] P. 14- i. WELL LOG RDEN . I . I SIM Water Loss or Dro n Extra rom LITHOLOGY Bearing Addition b -ii Fast or El 11 El 0 (ft) Code Color Comment Zone of Fluid St Slow Drill Rate -SCREEN L Y / N Y N F S From (tt) TO (ft) Type Slot Size Diameter 0 Y / N Y N S 0 El El (60 iLL Y N Y N S 1:1 El 0 �Q C6 0 CIL I Y N Y N F Ej Q El U- LG Y N Y K, ri�A/ 8. ANNULAR SEAL/FILTER PACK/ABANDONMENT MTL. S D C) (0) 9� Y N Y N J(aF _S "' (tt) TO (ft) Material Description Purpose. Y I N Y N F I S 0 El Y / N Y N F S El 1:1 El Y I N V hi r c El El El Ej WELL LOG BEDROCK, 1:1 El El Ej Water Drop in Extra Extra Vis . ibie LosE 9. SITE SKETCH LITHOLOGY Bearing Fast or ; or # of Drill Large Ru8t Addition Fractures )m (ft) TO (ft) ode Comment Zone Stem Chij s Slow 0�; a P brill Rat, Staining Of Fluid per bot 0 A b N:F S Y/ N Y/ N 0 4G 0 DT C) N Y N S Y N Y/ N Y/ N Y N� S Y N Y/ N Y / N Y N S Y/ N Y/ N �0 Y/ N Y N S Y N Y/ N Y/ N Y/ N, S Y N Y/ N Y j N Y/ N F S YJ N Y/ N Y/ N Y/ N F I S Y/ N Y/ N Y/ N N F S - -Y /N Y/ Y/ N IN F S Y YJ N —A IONS MANDATORY FOR PRO[ N WELLS) Yield Time Pumped Pumping Level 11 - STATIC WATER LEVEL (ALL WELLS) ate ethod (GPM) (hrs & mi I Time to Recover - flecovery Depth Below I IN (Ft. B 1; GS) (hrs & min) (Ft. BGS) 411 Date Measured Ground Su!��e (ft) A,_: 1 PERMANENT PUMP (IF AVAILj )p Description ip Intake Depth (fi -OMMENTS NELL DRII I FP,Q N6TE. -Well 13. ADDITIONAL WELL INFORMATION Hors'epower DevelgpedrY)/ N Fracture Enhancement Y Nominal Pump Capaci d N . Surface Seal Type (913m) Disinfecte all -vu, armior auancioned under mY supervision, according to -applicable and fegulations,*and this reportAs complete and c'O'h'ect to the best of my.knowledge. Q-041sing Driller Signature: A;;Z) Registration do- :�-4altGdrnplete: —Rig Pemnit#: L Reports mustbe kedh -1 7 T fi � y the reg4tered -well dfiller within 30 ikvs of well com,71p w Z151 pr cl a. A ?; ",ITTM. �n w LL. C) H Nu 41.1 g MP i w F_ :z CC) r -j w < ui C� o CLO: W C) CD W w w CN 'u'llall ml-,�fig 0 0 co 0 w LL W C�j 0 w < w (n cn O:z w C,� < CL w C) F-- Lo C) 0 gay �A (If cl 0 alf < LLI LLI _j CL -3 00 w LLI U_ :z F__ w >_ w < cn > hl!g AN: LU 01 00 UJ _j C/) _j 0 w (L 0 z 2A, CL F q 123" w HhN AlO J� 9 CADEMY i 9- 5:6 WN In 1A Piz ACORDT. CERTIFICATE OF LIABILITY INSURANCE _3ATE IMM/DDtYYYY) F 07111/2014 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(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER COSTELLO INSURANCE AGENCY 2 South Kimball St. PO Box 5248 Bradford, MA 01835 CONTACT NAME: Emily Costello PHONE (A/C, No, Ext), 978.374.6352 N.078, 521,5127 h -MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURERA: Merchants Insurance Group INSURED Quinlan & Rand Contractors 34 Trinity Court No Andover, MA 0194S INSURER 8: AIM Insurance Co. 33758 INSURER C: INSURER D: EACH OCCURRENCE $ 1,000,000 _DAMAGETC`_ffENTED_ INSURER E: INSURER F: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE ADDr[S� INSR I WVD POLICY NUMBER PD–LI-CY _EFF (MM/DDIYYYY) POLICY EXP (MM/DDIYYYY) LIMITS GENERAL LIABILITY BOPI064274 03/12/2014 03/12/2015 EACH OCCURRENCE $ 1,000,000 _DAMAGETC`_ffENTED_ X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE T OCCUR — PREMISES (Ea occurrence) $ 500,000 MED EXP (Any one person) $ 15,000 A PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN1 AGGREGATE LIMIT APPLIES PER: —1 PRODUCTS - COMP/OP AGG $ 2,000,000 P LOC 7 POLICY FX jERCoi F $ AUTOMOBILE LIABILITY GUMIJINED �i[NIJLL LIMI I (Ea accident) BODILY INJURY (Per person) $ ANY AUTO ALL OWNED SCHEDULED AUTOS AUTOS BODILY INJURY (Per accident) $ NON -OWNED HIRED AUTOS AUTOS PROPER I Y DAMAG-F (Per arcident) $ $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS -MADE AGGREGATE $ DED I I RETENTION$ $ B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE[:Y] OFFICER/MEMBER EXCLUDED? NIA VWC10060152792013A 03108/2014 03/08/2015 X I TWCRS PA,,% CTH- ER E.L. EACH ACCIDENT $ 100,000 E.L. DISEASE - E 0100 (Mandatory in NH) If yes, describe under E.L. DISEASE - POLICY LIMIT s 500,000 DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS f VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space is required) Partners Quinlan & Rand have elected to be excluded from Worker's Compensation coverage. ��n I IrM01A I F_ r1WL_LJMr% UANtotl_ILA I IUN 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 Town of North Andover Nor,th Andover, MA William Costello Q 1988-20`10 ACORD C07ARATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD I T' Offlice, b '?A air$, �VE� Y TAA P� OME I is 1 10,9 a n tr �io _ W01 x ir ation C, P4rtfiership QUINLAN& RA,.ND BUILh9Rj,,,,,, TImbTHY QUINLAN 34 TRINITY CT �:N A K�A P1845 �U..Oci,qrsecrctary 1, �1'-Chse . 0" registration valid fOr Aefore the e-pir Use only . I x , ation date... It found return to: 'Office Of Consumer Affai rs and ]Business Regulatiou 10 Park PlaZa - Suite'�l 70 Boston, MA 021j�� No alid "Put Sig4ature, Massachusetts - Department of Public Safety Board of.Building Regulations and Standards Construction Supen-i-sor License: CS -055288 T, IS TIEMOTHY R QU1TiLAN I ST. ONGE TERRACE' Haverhill MA 01930 w Expi ratior Commis�sioner 03/05/2011 Quinlan & Rand Builders 34 Trinity Court North Andover NU 01845 978-457-0528 / 978-457-2698 CSL# CS -055288 / HIC 111089 CONTRACT Customer: James Warden 84 Academy Rd. North Andover MA 01845 Quinlan & Rand Builders proposes to do the following work at the above address in accordance with the supplied construction drawings - Lay out the excavation and provide vertical and horizontal control - Form footings, install rebar, place concrete, strip footing boards - Install wall rebar, form walls, place concrete, strip forms - Form ceiling of tunnel, install rebar, place concrete, strip forms - Apply tuf-n-dry rubberized foundation waterproofing - Excavation, backfill, and trucking by others Total estimated cost of work Payment schedule: Performance payments 50% after walls 50% after waterproofing I agree to the following terms -----�Custome�' $22,000.00 Builder Date ....... 'A0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING SA US This certifies that ....... ............ ....... 7 .................. has permission to perform ......... ................................. wiring in the building of ........ ................................................. at ...... ;FZ/ 'jp'� D ............ . North Andover., Mass. ... CA; Fee ... Lic. No. ........... P44"0.;.I(A . ........... ELECrRICAL INSPE�4bR Check # &I 'z I A Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 67 2 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/05] (1,a,,bI,nk) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PPJNT IN INK OR TYPE ALL INFORMA TION) Date: City or Town of: 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) k L/ A C- 4 J welrot4v Telephone No. 9,7011-7,71-4.5�ly Owner or Tenant Owner's Address Is this permit in conjunction with a building permit? Yes 1:1 No El� (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Volts OverheadF] UndgrdF-1 No. of Meters New Service Amps Volts Overhead UndgrdEJ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion of the followinQ table mav be waived bv the InsDector of Wires. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans N Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above In- grnd. grnd. F] 'No. of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS INo. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiating Devices No. of Ranges TotaF— No. of Air Cond. Tons — No. of Alerting Devices No. of Waste Disposers Heat Pump Totals; iumber Fons ly... I KW I 'y No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local Ej Mun'c'PP' D Other Connection No. of Dryers "eating Appliances KW Security Systems:* No. of Devices or Equivalent No. of Water KW Heaters 0.0 No. of Signs Ballasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE [I BOND F1 OTHERE] (Specify:) lcerti,fy, underthepains andpenalties ofperjury, thatthe information on this application is true and complete. FIRM NAME: LIC. NO.: A/9 -457 - Licensee: b -S Signature,,��/ LIC. NO.: r-"1&d0y,6 (Ifapplicable, enter lexempt " in1the hrense number line.) Bus. Tel. No.: 7&- NO -Wla C2&( Address: , 01&,,Al S/ 5&ce,� 1.4 eg-104Z) Alt. Tel. No.:2&-,9n-0111Y-T *Security System Contractor License required for this work; if applicable, enter the license number here: 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 Elowner's agent. Owner/Agent Signature Telephone No. PERMIT FEE. $ *Vllde� 0 WLocation 0 No. -7 T-0 Date Check # SVd TOWN OF NORTH ANDOVER Certificate of Occupancy $ 960 )( �;[ = Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ I �&� 9232 Bui ding Inspector TOWN OF NORTHANDOVER I—Few 1ENATION APPLICATION FOR PLAN EXA% Permit NO:— Date Received: 6'-122�0 6� Date lssued:z'_-_�— 6� IMPORTANT: Applicant must complete all items on this 1-06ATION rrint zr PROPERTY OIA-NER 141ORI-1-1v Print ZONING DISTRICT: C MAP NO.:-1-L—PARCEL: TYPE AND USE OF BUI[LDING HISTORIC DISTRICT PROPOSED USE Residential I' O�"M 0 fam i K-��E TYPE OF IMPROVEMENT PROPOSED USE Residential 14i One farn i ly 4e%,v. Building Two or mo i ily Two or m rn ore family E- Addition No. of units: Alteration N -k- Repair, replacement Assessory Bldg F: Demolition Other Moving (relocation) Foundation only DESCRIPTION OF WOR�T:O ZEP�RIEFO�RMED� me -W ISI?f,;,7 fN-,') CISY',01 0/-i� W _�06qr� 46�b Atw--44 V Identification Please Type or Print CIearI3 010VNER: Name: Address: CONTFLXCTOR Name: 4 t. YES 0 Non- Residential Industrial L Commercial �j Others: ic AKFj) -t- A-1 L � �()T r2� Address: 4G- — --- V , L? 1-z-11oe SuperNisor's Construction License* Exp. Date:__ Horne Improvement License: Exp. Date:—� �06) ARC HITECT.-EMENEER j5n4Nt4FL �IKAI- Namc: Phone: --)-71 (06) �57�W-IiWfll Atr- Address: --Reg. No. --------- FEE SCHEDULE: BULDIAG PERMIT.- S10.00 PER S1000-00 OF THE TOT IL ESTIMATED COST BASED ON S12-5-00 PER S.F. Total Pmject Cost:$--- 111400-FEE1 q2-6, (J W 1).70, Check No.: Receipt No.: M cl�> lla�.-c I ol'4 -7 �' Wpff 14,31b takingie DL"-- q- 3 TYPE OF SENVARGE DISPOSAL ran n i ng.A1 assage; Body Art S"irnmint, Pools aliv Seher Well Tobacco Sales Food Packa2ing'Sales Permanent DUmpster on Site Pflute (septic tank, etc. Electric Meter location to project NOTE: Persons contracthig with unregistered contractors do not have decess to the guit fund r Signature of Agent,O"rier Signature of Contra or 2, - Plans Submitted /plans Waived Certified Plot Plan Stamped Plans T"E FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT F1 E]Water Shed Special Permit EJ Site Plan Special Permit 11 Other COMMENTS I . I CONSERVATION COMMENTS HEALTH COMINMENTS DATE REJECTED ,DATE APPROVED DATE REJECTED DATEAPPROVED Zoning Board of Appeals: Variance, Petition No: Zonino Decision! receipt SUbmitted yes Planning Board Decision: — ------ --Cornnients Cooscr%aticn ',Vatcr & S,�" (x connection �i,,nattjre & date ferrip DUmpsteren site )es_jio)� Fire Department si.-natury date_ Building Pcrmit Appro,,cd and [SSLlcd by-: 611'lft- 11;i-c 2 (1'4 v Building Setback Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided DIMENSION Number of Stories: Total land area, sq. ft.: NOTES and DAT. % — (For department use) Total square reet of noor area, based on Exterior dimensions._ I P�,!.c3,1t I r,(;NAL.SLK', ICLIS 0ITAP I'AL'4 i- UPI C. -t". 1A h, -1 1, Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits Building Permit Application Workers Comp Affidavit Photo Copy Of H.I.C. And/Or C.S.L. Licenses Copy of Contract Floor Plan Or Proposed Interior Work Addition Or Decks :3 Building Permit Application • Surveyed Plot Plan • Workers Comp Affidavit j . Photo Copy of H.I.C. And C.S.L. Licenses 1:3 Copy Of Contract 0 Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydrau Calculations (If Applicable) 3 Mass check Energy Compliance Report (.If Applicable) New Construction (Single and Two Family) • Building Permit Application • Certified Proposed Plot Plan Photo of H.I.C. And C.S.L. Licenses Workers Comp Affidavit umed) to Include Sprinkler Plan And Two Sets of Building Plans (One To Be Ret Hydraulic Calculations (if Applicable) Copy of Contract Mass check Energy Compliance Report In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One Cop3r and proof of recording must be submitted with the building application :)414:: ION %1. SFR%'I( ES DFP�Rl IIE\ I':1111FOW105 Pa, -t: 40' 1 EMANUEL ENGINEERING, INC. ENGINEERING CONSULTANTS June 1, 2006 Ms. Steven Martin 16 Congress Street Salisbury, MAO 1952 Re: Foundation Repairs & Modifications 84 Academy Road North Andover, MA Dear Mr. Martin: W 118 PORTSMOUTH AVENUE A202 STRATHAM, NEW HAMPSHIRE 03885 (603) 772-4400 FAX (603) 772-4487 www.emanuelengineering.com At your request, a site visit was made on May 25, 2006 to the above address to view the foundation work under way. The purpose of the foundation modifications include the following: 1. Increase the head room height in the basement. 2. Install a drainage system to remove excess water in the basement. 3 3. Install new posts supporting the super structure. Our scope of work is to render an opinion on the work performed. No structural calculations have been performed. Discussion & Observations Briefly, the repairs and modifications include the following. The basement earthen floor was lowered approximately 13 inches. Underpinning of the stone masonry wall was performed using a reiterative process of cast -in-place reinforced concrete. The interior face of the stone masonry was re -pointed. Larger new footings were constructed for each new post in the same location as the old posts. CIVIL - STRUCTURAL * SITE AND LAND PLANNING * CONSTRUCTION MANAGEMENT Conclusions All visible work appears in a good workmanship and sound condition. The underpinning process you described to me is appropriate for this kind of work. The footings constructed were an improvement since the original posts had no footing or a small stone under the post. This completes my report. If you have any questions or require further assistance, please advise. Very truly yours, Fred Emanuel, P.E. Attachment: Photos (14 pages) File: kls/P:/2006 Jobs/06-085 Steven Martinr/Lefter dated 6-1-06,doc "o. 3M4 xA- 'i P 17R 210-10 pow 4 f it 05 25 2006 11�16 H WIN T Steven Martin Job#06-085 P-5 Steven Martin Job#06-085 P-6 IV All 06 74 01) 25 2()(-)(') 1 1 )l lb ki Orr O�- )�-) )006 11 21 'ry - -�S� " - I'* I�i" " 01) 25 Steven Martin Job#06-085 WE 77 M—I N\ V R 4k _�:F-7� IL - ih 7 LA 25 2006 1 )s 7-i /UU6 r X" iiid I IA- rr 05 2-j 2006 11 - 56 ir4l er V: ) � ) Steven Martin Job#06-085 P-13 Steven Martin Job#06-085 P-14 11,41 0 1-4, >INy- 0 Cj w �o 0 42 0 4 TrI, v CD LIJ 6 am z 0 co u cz r, �2. cz 6 U) -hd 0 co 1-4, >INy- 0 Cj w �o 0 42 0 4 TrI, v CD LIJ 6 am z U) 0 C/) P-4 to U) z 0 C/) U) v .P� 121 CD 0 E CD CD CO2 co Ma E Q cc CL CO) COD C.3 cc CL CO2 Co CM cc co IngL- CL cL cm< CD CD CL CO3 C5 cc C40 COP LU LU U) ce LLI LU LLI U) trs low: ci ts 0 Wa C, ts E %At- ca Ma CD =Cm CID to COI ca CM CD ;,, 0 CO2 z CD CL I -E 42 0 'm CO) AS LA- I-- ui CA CL= 'o W U) CM o lia 4D CA 0 -L Z cz C — U) 0 C/) P-4 to U) z 0 C/) U) v .P� 121 CD 0 E CD CD CO2 co Ma E Q cc CL CO) COD C.3 cc CL CO2 Co CM cc co IngL- CL cL cm< CD CD CL CO3 C5 cc C40 COP LU LU U) ce LLI LU LLI U) Date. ...... 40 N 6 TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION CH This certifies that . . . 5 ........... has permission for gas installation . in the buildings of . AA -C., A �t .� ............................. at A.C. k9. A�.trn ....... North Andover, Mass. Fee o2.-?. . 7. Lic. No. ..... or�- GASINSPECTOR Check# 43 7 5445 "I MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASF-ITTING (Print or Type) h3 0 P-3 H LQ 0 C)V(-- 9- . Mass. Date -2— Permit #-5- 4- Building Location A 0 r 0 \K owners NameIAKES & ArJ 17A WOP-DE K)09:M At,) C Type of Occupancy PX - M:1' New Ej Renovation 0 Replacement E] Plans Submitted: YesO No E] Installing Company Name BAY STATE GAS COMPANY Address 55 MARSTON STREET LAWRENCE, MA 01840 Business Telephone q 7 IB- 6 87-110 5 Name of Licensed Plumber or Gas Fitter Francis X. Corkery Check one: Certif icate Corporation 1862 0 Partnership 0 Firm/Co. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes K No El If you have checked yes, please Indicate the type coverage by checking the appropriate box. A liability insurance policy P< Other type of indemnity El Bond 0 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: Signature of Owner or- Owne(s Agent OwnerO Agent El I hereby certify that all of the details and information I have submitted (or entered) in abo pplication are true and accurAte to the best of my o' in aDo pplipation knowledge and that all plumbing work and installations performed under the permit is u f r this application will W, n, J pliance with all Ge 's s pom pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the G ne S. BY Tne ofmUibceernse: lu Title WGasfitter o Licensed Plumber or Gas Master License Number -374-5 CityfTown Journeyman APPF40VEL) KA-FICE USE ONLY) i wool on OEM] MENNINNEIREMENNEMN 0 Now 0 OMEN won mom MENOMONEE 0 IN no mom son son MEAL" 0 on 0 K."au a 9. M so 01 Installing Company Name BAY STATE GAS COMPANY Address 55 MARSTON STREET LAWRENCE, MA 01840 Business Telephone q 7 IB- 6 87-110 5 Name of Licensed Plumber or Gas Fitter Francis X. Corkery Check one: Certif icate Corporation 1862 0 Partnership 0 Firm/Co. INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yes K No El If you have checked yes, please Indicate the type coverage by checking the appropriate box. A liability insurance policy P< Other type of indemnity El Bond 0 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: Signature of Owner or- Owne(s Agent OwnerO Agent El I hereby certify that all of the details and information I have submitted (or entered) in abo pplication are true and accurAte to the best of my o' in aDo pplipation knowledge and that all plumbing work and installations performed under the permit is u f r this application will W, n, J pliance with all Ge 's s pom pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the G ne S. BY Tne ofmUibceernse: lu Title WGasfitter o Licensed Plumber or Gas Master License Number -374-5 CityfTown Journeyman APPF40VEL) KA-FICE USE ONLY) i Date ....... '31ZAx TOWN OF NORTH ANDOVER PERMIT FOR WIRING SA HU This certifies that ...... �M� ...... ............................. has permission to perform ............. wiring in the building of ....... ...... ...................... at ...... ............. �; ................. X, North Andover, Mass Fee ........... Lic. No.-e.�413. . ...... Check # —IY6 X-/ - ELECMICAL INSP6�MR 5 A4 Cl) (D (D 0 00 (D CN W, C () �D CU E =34 0 .0 C> CO CN 0 0 , ) r- 04 OC) (0 Co 04 -C 4) Ure Only ermit No. a�z Wepartment of Fire Services VBOARD OF FIRE PREVENTION REGULATIONYS, Occupancy and Fee Checked Rev. 11/991 (1 .... bl,,k) APPLICATION FOR PERMIT TO 'ORM ELECTRICAL WORK All work to be performed in accordance with t e Mas achu its Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINTIN INK OR TYPE ALL INFORMATION) Date: .3 City or Town of.- To the Inspecior of Wires: By this application the undersigned giveq notice of his or her intMion to perform the electrical work described below. Location (Street & Number) A94 Owner or Tenant 19ma 1,4 wo,-4,1 Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes E] No [�r (Check Appropriate Box) Purpose of Building Existing Service Amps I Volts New Service Amps Volts Number of Feeders and Ampacity Utility Authorization No. Overhead [:] Undgrd [:] No. of Meters Overhead D UndgrdF� No. of Meters Location and Nature of Proposed Electrical Work: Completion o f the following table maybe waived by the Inspector of Wires. No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans �;;�;formers lkv�: No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above o In- 1-1 No. of Emergency Lighting grnd. grnd. Battery Units No. of Receptacle Outlets No. of Oil Burners FIREALARMS JNo.ofZones 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 Heat Pump I Number * * ............ ...... I Tons .......... ... ..... .... .... ...... J..K.W ........... No. of Self -Contained Totals: I I Detection/Alerting Devices E] Municip I No. of Dishwashers Space/Area Heating KW 'Local ConnectP El Other No. of Dryers Heating Appliances Security Systems: KW Nn- nf np.virev nr Rnuivnlent 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 Eauivalent IOTHER: -J�,v FIVIV y A C, & y - -rlv vw4f S /Jew /I Attach additional detail if*desired, or as required by the Inspector of Wires. 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 Cover is in force, and has exhibited proof of same to the permit issuing office. �Ke CHECK ONE: INSURX BOND [:] OTHER [] (Specify:) (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: -3///,o I/ Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under the pains and penalties ofperjury, that lite information on this application is true and complete. FIRM NAME: /V,7 11qJ1,eS LIC. NO.:.,# /SA� Licensee: aZ,-,eZE. 11,-Aec SignatureAf--�/�� LIC. (If applicable, enter "exempt " in thIlicense number line.) Bus. Tel. No.: ,;2 / I JkAe,1 -9 Address: Alt. Tel. No.: de//.7(?/ 14 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)E] owner 0 owner's agent. Owner/Agent Signature Telephone No. FEE. $ ATTACHMENT 2 SIMPLIFIED PROCESS INTERCONNECTION Installation Information Certificate of Completion Li Check if owner -installed Interconnecting Customer: _R.V�.Raan �Utili _Accoun�t.Contact Person: James Worden Mailing Address: 84 Academy Rd. Apt Rear Location of Facility (if different from above): City: North Andover State: MA — Zip Code: 0 1845 Telephone (Daytime): 781932-9009 (Evening): 979 685-9781 Facsimile Number: 781932-9219 E -Mail Address: worden@solectria.com Electrician: Name: Michael Hughes Mailing Address: 264 Main St City: Stoneham State: MA — Zip Code: 02180 Telephone (Daytime): 781279-0443 (Evening): 781279-0443 Facsimile Number: License number: 19 / ff/5� E -Mail Address: Date Approval of Install Facility granted by the Company: Application ID number: Inspection: The system has been installed and inspected in compliance with the local Building/Electrical Code of North Andover, Essex (City/County) Signed (Local Electrical Wiring Inspector, or attach signed electrical inspectioyn).g5��—� �d40� Name (printed): �j 6�m es De (c) (a, Date: __�Ifflld /z/ As a condition of interconnection you are required to send/fax a copy of this form along with a copy of the signed electrical permit to (insert Company's name below): Name: Tim RouRhan, John Bzura Company: Masschusetts Electric Mail 1: 55 Bearfoot Rd. Mail 2: City,StateZIP: Northboro,MA01532 Fax No.: -5 zi – 76) /0 __ ej Terms and Conditions for Simplified Interconnections 1. Construction of the Facility. The Interconnecting Customer may proceed to construct the Facility once the Approval to Install the Facility has been signed by the Company. 2. Interconnection and operation. The Interconnecting Customer may operate Facility and interconnect with the Company's system once the following has occurred: 2. 1. Municipal Inspection: Upon completing construction, the Interconnecting Customer will cause the Facility to be inspected or otherwise certified by the local electrical wiring inspector with jurisdiction. 2.2. Certificate of Completion: The Interconnecting Customer returns the Certificate of Completion appearing as Attachment 2 to the Agreement to the Company at address noted. 2.3. Company has completed or waived the right to inspection. 3. Company Right of Inspection. Within ten (10) business days after receipt of the Certificate of Completion, the Company may, upon reasonable notice and at a mutually convenient time, conduct an inspection of the Facility to ensure that all equipment has been appropriately installed and that all electrical connections have been made in accordance with the Tariff. The Company has the right to disconnect the Facility in the event of improper installation or failure to return Certificate of Completion. If the Company does not inspect in 10 days or by mutual agreement of the Parties, the Witness Test is deemed waived. 4. Safe Operations and Maintenance. The Interconnecting Customer shall be fully responsible to operate, maintain, and repair the Facility. 5. Access. The Company shall have access to the disconnect switch (if required) of the Facility at all times. 6. Disconnection. The Company may temporarily disconnect the Facility to facilitate planned or emergency Company work. 7. Metering and Billing. All Facilities approved under this Agreement qualify for net metering, as approved by the Department from time to time, and the following is necessary to implement the net metering provisions: 7.1. Interconnecting Customer Provides Meter Socket. The Interconnecting Customer shall furnish and install, if not already in place, the necessary meter socket and wiring in accordance with accepted electrical standards. 7.2. Company Installs Meter. The Company shall furnish and install a meter capable of net metering within ten (10) business days after receipt of the Certificate of Completion if inspection is waived, or within 10 business days after the inspection is completed, if such meter is not already in place. 8. Indemnification. Interconnecting Customer and Company shall each indemnify, defend and hold the other, its directors, officers, employees and agents (including, but not limited to, Affiliates and contractors and their employees), harmless from and against all liabilities, damages, losses, penalties, claims, demands, suits and proceedings of any nature whatsoever for personal injury (including death) or property damages to unaffiliated third parties that arise out of, or are in any manner connected with, the performance of this Agreement by that party, except to the extent that such injury or damages to unaffiliated third parties may be attributable to the negligence or willful misconduct of the party seeking indemnification. 9. Limitation of Liability. Each party's liability to the other party for any loss, cost, claim, injury, liability, or expense, including reasonable attorney's fees, relating to or arising from any act or omission in its performance of this Agreement, shall be limited to the amount of direct damage actually incurred. In no event shall either party be liable to the other party for any indirect, incidental, special, consequential, or punitive damages of any kind whatsoever. 10. Termination. This Agreement maybe terminated under the following conditions: 10.1. By Mutual Agreement. The Parties agree in writing to terminate the Agreement. 10.2. By Interconnecting Customer. The Interconnecting Customer may terminate this Agreement by providing written notice to Company. 10.3. By the Company. The Company may terminate this Agreement (1) if the Facility fails to operate for any consecutive 12 month period, or (2) in the event that the Facility impairs the operation of the electric distribution system or service to other customers or materially impairs the local circuit and the Interconnecting Customer does not cure the impairment. 11. AssignmentlTransfer of Ownership of the Facility: This Agreement shall survive the transfer of ownership of the Facility to a new owner when the new owner agrees in writing to comply with the terms of this Agreement and so notifies the Company. 12. Interconnection Tariff: These Terms and Conditions are pursuant to the Company's Tariff for the Interconnection of Interconnecting Customer -Owned Generating Facilities, as approved by the Department of Telecommunications and Energy and as the same may be amended from time to time ("Interconnection Tariff"). All defined terms set forth in these Terms and Conditions are as defined in the Interconnection Tariff (see Company's website for complete tariff). Simplified Interconnection Application and Service Agreement for Facilities with Inverter Capacity of 10kW and under Contact Information Legal Name and address of Interconnecting Customer applicant (or, if an Individual, Individual's Name) Company Name: Contact Person: R.V.Rajan (Utilily Account) Mailing Address: 84 AcadeMy Rd. Apt Rear City: — North Andover State: MA Zip Code: 01845 Telephone (Daytime): 978 794-2303 (Evening): 978 794-2303 Facsimile Number: E -Mail Address:. rajrajanOOI@comcast.net Alternative Contact Information (if different from Applicant) Name:— James Worden Mailing Address: 84 Academy Rd. City: North Andover — State: MA ZipCode: 01845 Telephone (Daytime): 781932-9009 _ (Evening): 978 685-9781 Facsimile Number: 781932-9219 E -Mail Address: wordenp_solectria.com Ownership (include % ownership by any electric utility): 100% customer owned Confidentiality Statement: "I agree to allow information regarding the processing of my application (without my name and address) to be reviewed by the Massachusetts DG Collaborative that is exploring ways to further expedite future interconnections." Yes—x— No Facilijy Information Location (if different from above): Electric Service Company: Mass Electric Account Number (if available): 04413 00110 08 Inverter Manufacturer SMA America Inc. Model SWR 250OU SBD Nameplate Rating: 2.5 (kW) _ (kVA) 240 (AC Volts) Single X or Three Phase System Design Capacity: 0.9_ (kW) _ (kVA) Prime Mover: Photovoltaic X Reciprocating Engine 0 Fuel Cell E] Turbine El Other Energy Source: Solar 0 Wind F] Hydro, E] Diesel [] Natural Gas [] Fuel Oil El Other UL1741 Listed? Yes X No Need an air quality permit from DEP? Yes No Not Sure If "yes", have you applied for it?-Yes_No Estimated Install Date: - Apr 10, '04 Est. In -Service Date: April 16, 2004 Customer SiiznatuTe (attach manufacturer's cutsheet showing UL 1741 listing & sign herej I hereby certify that, to the best of my knowledge, all of the information provided in this application is true and I agree to the Terms and Conditions on the following page: Interconnecting Customer Signature: Title: .�-Pptuval"m 1 .. ..... ..... . ........ * ....... ..... ** ....... ............... * .......... Date: Mar 18, 2004 Installation of the Facility is approved contingent upon the terms and conditions of this Agreement, and agreement to any system modifications, if required (Are system modifications required? Yes_ No__): Company Signature: Title: Date: Application ID number: Company waives inspection/witness test? Yes—No Exhibit C: Simplified Process Interconnection Application Instructions General Information If you wish to submit an application to interconnect your generating Facility using the Simplified Process (I OkW or less, inverter -based, UL 174 1 -listed) please fill out the attached application form down to the space for your signature. Once complete, please sign and attach any documentation provided by the generator manufacturer describing the UL1741 listing for the generator. The process is as follows: 1. Application process: a. Interconnecting Customer submits a Simplified Application filled out properly and completely. b. The electric utility Company acknowledges to the Interconnecting Customer receipt of the application within three business days of receipt. c. Company evaluates the application for completeness and notifies the Interconnecting Customer within 10 days of receipt that the application is or is not complete and, if not, advises what is missing. 2. Company verifies Facility equipment can be interconnected safely and reliably. Company signs application approval line and sends to Customer. In certain rare circumstances, the Company may require the Interconnecting Customer to pay for minor System Modifications, if so, an estimate will be sent back with the approved application requiring the Interconnecting Customer's consent to pay for the modifications. 3. After installation, customer returns Certificate of Completion. Prior to parallel operation Company may inspect Facility for compliance with standards which may include a witness test, and schedules appropriate metering replacement, if necessary. Company notifies Interconnecting Customer in writing that interconnection of the Facility is authorized. If the witness test is not satisfactory, the Company has the right to disconnect the Facility. The Interconnecting Customer has no right to operate in parallel until a witness test has been performed or previously waived on the Application Form. The Company is obligated to complete this witness test within 10 days of the receipt of the Certificate of Completion, If the Company does not inspect in 10 days or by mutual agreement of the Parties, the Witness Test is deemed waived. Contact Information: You must provide the contact information for the legal applicant (i.e. the Interconnecting Customer). If another party is responsible for interfacing with the Company (utility), you should provide his/her/its contact information as well. Ownership Information: Please enter the legal names of the owner or owners of the Facility. Include the percentage ownership (if any) by any Company or public utility holding company, or by any entity owned by either. Confidentiality Statement: In an ongoing effort to improve the interconnection process for Interconnecting Customers, the information you provide and the results of the application process will be aggregated with the information of other applicants and periodically reviewed by a DG Collaborative of industry participants that has been organized by the Massachusetts Department of Telecommunications and Energy (DTE). The aggregation process mixes the data together so that specific details for one Interconnecting Customer are not revealed. In addition to this process, you may choose to allow the information specific to your application to be shared with the Collaborative by answering "Yes" to the Confidentiality Statement question on the first page. Please note that even in this case your identification information (contact data) and specific Facility location will not be shared. Facility Information UL 1741 Listed? This standard ("Inverters, Converters, and Controllers for Use in Independent Power Systems") addresses the electrical interconnection design of various forms of generating equipment. Many manufacturers choose to submit their equipment to a Nationally Recognized Testing Laboratory (NRTL) that verifies compliance with UL1741. This "listing" is then marked on the equipment and supporting documentation. DEP Air Quali!y Permit Needed? A Facility may be considered a point source of emissions of concern by the Massachusetts Department of Environmental Protection (DEP). Therefore, when submitting this application, please indicate whether the proposed Facility will require an Air Quality Permit. You must answer these questions, however, your specific answers will not affect whether your application is deemed complete. Please contact the DEP to determine whether the generating technology planned for your Facility qualifies for a DEP waiver or requires a pernift. ATTACHMENT 2 SIMPLIFIED PROCESS INTERCONNECTION Certificate of Completion Installation Information 0 Check if owner -installed Interconnecting Customer: Worden Contact Person: James D Worden Mailing Address: 84 Academy Rd Location of Facility (if different from above): City: North Andover State: MA - Zip Code: 01845 Telephone (Daytime): 781932-9009 (Evening): 978 685-9781 Facsimile Number: 781932-9219 E -Mail Address: . worden(a)solectria.com Electrician: Name: Michael Hughes Mailing Address: City: Stoneham State: MA - Zip Code: 02180 Telephone (Daytime): 781279-0443 (Evening): 781279-0443 Facsimile Number: E -Mail Address: License number: Date Approval of Install Facility granted by the Company: Application ID number: Inspection: The system has been installed and inspected in compliance with the local Building/Electrical Code of North Andover, Essex (City/County) Signed (Local Electrical Wiring Inspector, or attach signed electrical inspection)>.r�7 Name (printed): C;4,Vhe5 C) Date: Ah/ As a condition of interconnection you are required to send/fax a copy of this form along with a copy of the signed electrical permit to (insert Company's name below): Name: Tim Rouahan. John Bzura Company: Masschusetts Electric Mail 1:_ 55 Bearfoot Rd. Mail 2: City, State ZIP: Northboro, MA 01532 Fax No.: 7,01v Terms and Conditions for Simplified Interconnections 1. Construction of the Facility. The Interconnecting Customer may proceed to construct the Facility once the Approval to Install the Facility has been signed by the Company. 2. Interconnection and operation. The Interconnecting Customer may operate Facility and interconnect with the Company's system once the following has occurred: 2.1. Municipal Inspection: Upon completing construction, the Interconnecting Customer will cause the Facility to be inspected or otherwise certified by the local electrical wiring inspector with jurisdiction. 2.2. Certificate of Completion: The Interconnecting Customer returns the Certificate of Completion appearing as Attachment 2 to the Agreement to the Company at address noted. 2.3. Company has completed or waived the right to Inspection. 3. Company Right of Inspection. Within ten (10) business days after receipt of the Certificate of Completion, the Company may, upon reasonable notice and at a mutually convenient time, conduct an inspection of the Facility to ensure that all equipment has been appropriately installed and that all electrical connections have been made in accordance with the Tariff. The Company has the right to disconnect the Facility in the event of improper installation or failure to return Certificate of Completion. If the Company does not inspect in 10 days or by mutual agreement of the Parties, the Witness Test is deemed waived. 4. Safe Operations and Maintenance. The Interconnecting Customer shall be fully responsible to operate, maintain, and repair the Facility. 5. Access. The Company shall have access to the disconnect switch (if required) of the Facility at all times. 6. Disconnection. The Company may temporarily disconnect the Facility to facilitate planned or emergency Company work. 7. Metering and Billing. All Facilities approved under this Agreement qualify for net metering, as approved by the Department from time to time, and the following is necessary to implement the net metering provisions: 7.1. Interconnecting Customer Provides Meter Socket. The Interconnecting Customer shall furnish and install, if not already in place, the necessary meter socket and wiring in accordance with accepted electrical standards. 7.2. Company Installs Meter. The Company shall furnish and install a meter capable of net metering within ten (10) business days after receipt of the Certificate of Completion if inspection is waived, or within 10 business days after the inspection is completed, if such meter is not already in place. Indemnification. Interconnecting Customer and Company shall each indemnify, defend and hold the other, its directors, officers, employees and agents (including, but not limited to, Affiliates and contractors and their employees), harmless from and against all liabilities, damages, losses, penalties, claims, demands, suits and proceedings of any nature whatsoever for personal injury (including death) or property damages to unaffiliated third parties that arise out of, or are in any manner connected with, the performance of this Agreement by that party, except to the extent that such injury or damages to unaffiliated third parties may be attributable to the negligence or willful misconduct of the party seeking indemnification. 9. Limitation of Liability. Each party's liability to the other party for any loss, cost, claim, injury, liability, or expense, including reasonable attorney's fees, relating to or arising from any act or omission in its performance of this Agreement, shall be limited to the amount of direct damage actually incurred. In no event shall either party be liable to the other party for any indirect, incidental, special, consequential, or punitive damages of any kind whatsoever. 10. Termination. This Agreement maybe terminated under the following conditions: 10.1. By Mutual Agreement. The Parties agree in writing to terminate the Agreement. 10.2. By Interconnecting Customer. The Interconnecting Customer may terminate this Agreement by providing written notice to Company. 10.3. By the Company. The Company may terminate this Agreement (1) if the Facility fails to operate for any consecutive 12 month period, or (2) in the event that the Facility impairs the operation of the electric distribution system or service to other customers or materially impairs the local circuit and the Interconnecting Customer does not cure the impairment. 11. Assign ment/Transfer of Ownership of the Facility: This Agreement shall survive the transfer of ownership of the Facility to a new owner when the new owner agrees in writing to comply with the terms of this Agreement and so notifies the Company. 12. Interconnection Tariff: These Terms and Conditions are pursuant to the Company's Tariff for the Interconnection of Interconnecting Customer -Owned Generating Facilities, as approved by the Department of Telecommunications and Energy and as the same may be amended from time to time ("Interconnection Tariff"). All defined terms set forth in these Terms and Conditions are as defined in the Interconnection Tariff (see Company's website for complete tariff). Simplified Interconnection Application and Service Agreement for Facilities with Inverter Capacity of 10kW and under Contact Information Legal Name and address of Interconnecting Customer applicant (or, if an Individual, Individual's Name) Company Name: Contact Person: James D. Worden Mailing Address: 84 Academy Rd. City: — North Andover State: MA Zip Code: 01845 Telephone (Daytime): 781932-9009 (Evening): 978 685-9781 Facsimile Number: 781932-9219 E -Mail Address: wordenOsolectria.com Alternative Contact Information (if different from Applicant) Name: Mailing Address: Citv: Telephone (Daytime): Facsimile Number: State: (Evening): — E -Mail Address: Zip Code: Ownership (include % ownership by any electric utility): 100% customer owned Confidentiality Statement: "I agree to allow information regarding the processing of my application (without my name and address) to be reviewed by the Massachusetts DG Collaborative that is exploring ways to further expedite future interconnections." Yes—x— No Facility Information Location (if different from above): Electric Service Company: Mass Electric Account Number (if available): 04413 00130 09 Inverter Manufacturen— SMA America Inc. Model SWR 180OU SBD Nameplate Rating: 1.8 (kW) _ (kVA) 120 (AC Volts) Single X or Three Phase System Design Capacity: _2.0 (nom.)_ (kW) _ (kVA) Prime Mover: Photovoltaic X Reciprocating Engine 0 Fuel Cell F] Turbine F-1 Other Energy Source: Solar 0 Wind E] Hydro F] Diesel Ej Natural Gas 0 Fuel Oil F� Other UL 1741 Listed? Yes X No Need an air quality permit from DEP? Yes No Not Sure If "yes", have you applied for it?-Yes—No Estimated Install Date: —April 10, '04 Est. In -Service Date: April 16, 2004 Customer Signature (attach manufacturer's cutsheet showiniz UL 1741 listing & sign here) I hereby certify that, to the best of my knowledge, all of the information provided in this application is true and I agree to the Terms and Conditions on the following page: Interconnecting Customer Signature: Title: Date: —Mar 18, 2004 (FqrCompaffy'ugeoWy) .. ............. Installation of the Facility is approved contingent upon the terms and conditions of this Agreement, and agreement to any system modifications, if required (Are system modifications required? Yes_ No--): Company Signature: — Title: Date: Application ID number: Company waives inspection/witness test? Yes—No Exhibit C: Simplified Process Interconnection Application Instructions General Information If you wish to submit an application to interconnect your generating Facility using the Simplified Process (10kW or less, inverter -based, UL 1741 -listed) please fill out the attached application form down to the space for your signature. Once complete, please sign and attach any documentation provided by the generator manufacturer describing the UL 1741 listing for the generator. The process is as follows: 1. Application process: a. Interconnecting Customer submits a Simplified Application filled out properly and completely. b. The electric utility Company acknowledges to the Interconnecting Customer receipt of the application within three business days of receipt. c. Company evaluates the application for completeness and notifies the Interconnecting Customer within 10 days of receipt that the application is or is not complete and, if not, advises what is missing. 2. Company verifies Facility equipment can be interconnected safely and reliably. Company signs application approval line and sends to Customer. In certain rare circumstances, the Company may require the Interconnecting Customer to pay for minor System Modifications, if so, an estimate will be sent back with the approved application requiring the Interconnecting Customer's consent to pay for the modifications. 3. After installation, customer returns Certificate of Completion. Prior to parallel operation Company may inspect Facility for compliance with standards which may include a witness test, and schedules appropriate metering replacement, if necessary. Company notifies Interconnecting Customer in writing that interconnection of the Facility is authorized. If the witness test is not satisfactory, the Company has the right to disconnect the Facility. The Interconnecting Customer has no right to operate in parallel until a witness test has been performed or previously waived on the Application Form. The Company is obligated to complete this witness test within 10 days of the receipt of the Certificate of Completion. If the Company does not inspect in 10 days or by mutual agreement of the Parties, the Witness Test is deemed waived. Contact Information: You must provide the contact information for the legal applicant (i.e. the Interconnecting Customer). If another party is responsible for interfacing with the Company (utility), you should provide his/her/its contact information as well. Ownership Information: Please enter the legal names of the owner or owners of the Facility. Include the percentage ownership (if any) by any Company or public utility holding company, or by any entity owned by either. Confidentiality Statement: In an ongoing effort to improve the interconnection process for Interconnecting Customers, the information you provide and the results of the application process will be aggregated with the information of other applicants and periodically reviewed by a DG Collaborative of industry participants that has been organized by the Massachusetts Department of Telecommunications and Energy (DTE). The aggregation process mixes the data together so that specific details for one Interconnecting Customer are not revealed. In addition to this process, you may choose to allow the information specific to your application to be shared with the Collaborative by answering "Yes" to the Confidentiality Statement question on the first page. Please note that even in this case your identification information (contact data) and specific Facility location will not be shared. Facility Information UL 1741 Listed? This standard ("Inverters, Converters, and Controllers for Use in Independent Power Systems") addresses the electrical interconnection design of various forms of generating equipment. Many manufacturers choose to submit their equipment to a Nationally Recognized Testing Laboratory (NRTL) that verifies compliance with UL 174 1. This "listing" is then marked on the equipment and supporting documentation. DEP Air Qualijy Permit Needed? A Facility may be considered a point source of emissions of concern by the Massachusetts Department of Environmental Protection (DEP). Therefore, when submitting this application, please indicate whether the proposed Facility will require an Air Quality Permit. You must answer these questions, however, your specific answers will not affect whether your application is deemed complete. Please contact the DEP to determine whether the generating technology planned for your Facility qualifies for a DEP waiver or requires a permit. 0 0 w 0 w N ul IL :E m A w Z > 3: 0 0 13 0 z Z U. m < 0 J X m I.- o ac 0 0 0 0 u I - z W w U) z 0 w w 0 , I w 'n 0 4 N IL z m 0 :E 01 CA tv 0 U. z 0 0 z u 0 z (n w IN z -Z < 2 (A U) z i -W w w w C5 z u z z ;� o o �: E- N J 0 0 13 Ir w z u I x U) x Ld m 0 0 -i LL LL 0 w N U) 0 cc 0 W 0 LL 0 m z 2 z w w z W w w m 0 w z 0 0 0 X m w LL n w w w r u u u z z z w z I x u LL 0 w z 2 F- D m V) w a 0 u LL 0 z w 2 w 0 Z 0 0 1, Z 0 w u J < Z D M 13: z LL i 0 F- u (n w a. 0 0 m Amlo-mr- z z . 0 0 F- 0 w w N 13 w w a U) L W L I-. U) 0 z > 0 IL 0 0 0 u 0 u 0 u JWL-(pd6dmw,< 0 F- U m m m 0 Z F: U) W P: m W 0 W L w M w x tL 0 0 m 0 0 z z z z z w 0 N a u u D 0 c F- z 0 N c (1) (A L z z 0 0 0 u u w w w L w 0 0 f cl J L 0 C3 w w w 0 0 i w -ic 4 (n M 0. 1 w x tL 0 0 m 0 0 z z z z z w N 0 F- 0 W w LL IL z 0 li ul z M.k 00 ww u x zu 0 a. x 0)- . Z�z �. . J 0 0 a. J U �-- ILL z 0 0 S I U) IL Z U) omw u LL. z w0a. IU)W 7a z 0 #A ;-n z xw wx w 0 L 0<2 x m W W IL z 0 ti W WZ U) U) w 0 ro< I- J lz � z 0 2' 0 - z ?S z 0 z 0 z 0 T 0 -.0 0 --TT— 1 11 -TMI u 0 z :* X: z 9 -.�A 0 0 0 51 Z U z 0 a - -t z z o-";iRil000 lz z => u u Zzy :E 0 in Go m � O.t2,ouv z 0 z 0 PiR 0 u u 0 . z 0 > TFM u � z 0 2' 0 - z ?S z 0 z 0 z 0 T 0 -.0 0 z u 0 z :* X: z 0 z o 0 0 0 z z > !� I 0;� ? I z ;7 0 z u8u 0 w 0 0 �jm z 0 D 0 -Z 0 0 0 0 z 0 z 0 z 0 z 0 0 z 0 0 z 0 0 0 z z - z 0 0 z 0 o-";iRil000 o z => u u Zzy v in m � O.t2,ouv Lj�� 0 00 Ln PiR < 0 0 u u . > 0 z u8u 0 w 0 0 �jm z 0 D 0 -Z 0 0 0 0 Kathy C. Stevens 83 Academy Rd. North Andover, MA 0 1845 978-683-5522 November 12, 2005 Gerald Brown Inspector of Buildings Community Development 400 Osgood Street North Andover, MA 0 1845 RE: 114AcademyRoad: Determination of number of units Town of North Andover Street Listings for 2005-1995 Dear Mr. Brown: Thank you for your time last week. I appreciate your willingness to listen to my concerns. In determining the number of units at 114 Academy Road, I hope you would be willing to consider the attached street listings for the period 2005-1995, when the property was owned by Forrest and Linda Blanchard. During that period they are the only individuals listed at 114 Academy Rd. However, as I mentioned, I believe that Forrest Blanchard's mother lived with them for several years prior to her death a year or two ago. Sincerely, " C) - st'. 2005 STREET LISTING BORN FCT v NO. APT. NAME # 230 MU—RAH� MALCOLM A I TOWN OF NORTH ANDOVER, MA V NO. APT. NAME BORN PCT ABBOTTST * 250 SOLOMON LISA A 2 DEMERS MA RION L 1925 6 1958 6 1962 6 2 DEMERS MAURA A 1953 6 338 2 DEMERS MICHAEL A 1970 6 # 20 LARSON DEREK C LARSON KATHERINE D 1977 a # # 20 20 SAWYER CHRISTOPHER M 1970 8 1976 a 353 25 CARLSON JASON L CARLSON MARCIA E 1974 6 WASSERMAN MARGARET R 25 32 MAVER JILLiAN A mAVER JOHN JAMES JR 1969 6 1972 6 1967 1964 6 32 37 UNIEJEWSKI DIANE 1982 6 1953 6 364 37 UNIEJEWSKI VIRGINIA DICARLO-DUNAGAN JULIE A 1969 6 ZURAWSKI VIOLA S 44 44 DUNAGAN SHELLEY E 1904 6 1950 6 49 JAWORSKI RUDOLF A 1942 6 49 JAWORSKI SUSAN K COGLtAN0 CURTIS ALEXANDER 1983 8 1965 4 1956 4 56 56 COGLIANO DIANE S 1958 6 1954 6 429 56 COGLIANO MATTHEW 1952 6 56 COGLIANO PAULA 1946 6 61 SARCLA JOSEPH A SARCIA MICHELE JOSEPHINE 1947 6 1950 4 1970 4 61 # 76 CRAVEN DAVID E CRAVEN JACQUELINE K 1951 6 1963 6 58 # 76 # 76 CRAVEN KATHLEEN A 1951 6 1975 6 MCGAULEY DEBORAH ANN . 76 STEIN JOAN C STEIN STEVEN A 1975 6 1943 4 1944 4 . 76 # so FORD LISA M HAMEL ASHLEY E 1963 a 1987 a 84 90 # 90 MCCULLOUGH STEPHEN A 1962 6 1949 6 WORDEN JAMES D BLANCHARD FORREST SUMNER go 96 GILLIS ANNE M GILLIS MICHAEL A 1947 6 6 1945 4 4 96 GILLIS TIMOTHY J M 1964 1946 6 135 101 DAINOWSKI DONNA 1919 6 PiCKUL DAVID PICKUL KIMBERLY 101 DAINOWSKI LUCY M 1952 7 1927 4 1 OAR 4 112 LEBLANC DEBRA L 1961 7 ACUSHNETs . r 112 LEBLANC JOHN J 1957 7 1957 3 1973 3 122 MYERS ELLEN B MYERS ROBERT B 1952 7 # is 122 127 PENNEY DAVID J 1960 6 1963 6 VIVEIROS JANIS E VASAPO"' — 1— v 127 PENNEY HELAINE M 1961 6 139 139 QUINN KAREN M QUINN MICHAEL J 1959 6 7 MIELE GLORIA M 142 WESCOTT ANDREW M 1963 19" 7 1955 3 142 WESCOTT BETH M ET M KRUPKOWSKI MARGAR 1962 6 # 18 151 151 KRUPKOWSKI MARK D 1960 6 1957 7 CONROY DAVID M CONROY DAVID M JR # 152 JOHNSON DAVID B JOHNSON MICHELLE A 1965 7 1971 3 1970 3 152 161 ROY DONALD W 1952 6 1955 6 27 161 ROYDONNAJ ROY LYNDSAY DAWN 1983 6 LY HUNG SAU ROUND BRUCE D 161 162 COMERFORD BRENDA J COMERFORD THOMAS J 1970 7 1985 7 1964 3 1954 3 # 162 171 NOLETTE KAREN S 1964 6 1968 6 35 # 38 * 171 NOLETTE THOMAS J 1795 7 1960 3 3 174 HELLA CYNTHIA HELLA R ICHARD A 1795 7 * 39 174 185 SCHELLHORN JOHN B 11946 6 1963 6 MANOSJAMES HAROLD W 185 SEAVEY STEPHANIE ANNE 1950 7 186 VELARDI KENNETH C VELARDI SALLY A 1954 7 6 197 ROBERT SON MICHELLE J 1966 6 197 ROBERTSON SCOTT A 1965 7 19, 198 SANTORO JOHN J SANTORO KATHLEEN ALYSA 1967 7 1969 7 210 MORIN DUANE D 1972 7 2`10 MORIN KERRY ANN 1947 7 # 220 BURKE JAMES C 1979 7 # 220 BURKEJAMIM BURKE JENNIFER M 19T7 7 # 220 # 220 BURKE JILLIAN F 1982 7 1951 7 # 2211 BURKE KAREN M 1914 6 225 FROST ALICE A 1964 7 226 REICH JUDITH E REICH MARK ROBERT 1963 7 226 # 230 DELIDOW LYNN M 1959 7 # = INACTIVE VOTER 2005 STREET LISTING BORN FCT v NO. APT. NAME # 230 MU—RAH� MALCOLM A 1954 7 7 * 240 MILARDO CARRIE A 1964 1960 7 * 250 SOLOMON DAVID R 1961 7 * 250 SOLOMON LISA A 1947 6 * 275 NIEMI SANDRA C 1962 6 * 275 * 338 NIEMI WAYNE J IPPOLfTO THOMAS D 1936 7 338 LEARY-IPPOLITO MARY E '1943 7 6 * 339 O'NEILL KATHLEEN PAGONES 1955 5 * 339 O'NEILL PAUL J WONDRASCH SHARON D 1952 1958 6 * 345 * 353 CONNOLLY JAMES M 6 1961 6 353 CONNOLLY ROSE M WASSERMAN KEVIN R i9es 7 366 356 WASSERMAN MARGARET R 1963 7 6 361 APPLETON JULIE 1967 1964 6 361 APPLETON RICHARD 1946 7 364 DUFRESNE ELIZABETH A 1922 7 364 ZURAWSKI VIOLA S 1946 7 416 HANNAN KENNETH S 1947 7 416 M7 HANNAN LINDA GATTO NANCY V 1954 4 417 GATTO PETER V 1965 4 1956 4 417 GATTO VINCENT J '1928 4 429 HERMANS SHIRLEY M ACADEW RD 32 MACLAREN ALA 0 UGLAS 1953 _ 4 4 MACLAREN ROWAN HIGGINBOTTOM 1954 32 56 MUSSER KATHLEEN E 1950 4 1970 4 56 ADAM DANA C 071 4 58 ADAM TRACI L FREEMAN HARRISON CROWELL JR 1940 4 83 83 MCGAULEY DEBORAH ANN 1952 4 83 STEVENS KATHY C 1943 4 1944 4 54 RAJAN mARAGADHA V 1968 4 84 WORDEN ANITA RAJAN 1967 4 84 WORDEN JAMES D BLANCHARD FORREST SUMNER 1943 4 114 114 BLANCHARD LINDA MAE 1945 4 4 135 PICKUL CAITLIN E 1984 1966 4 135 PICKUL CHRISTOPHER 1956 4 135 135 PiCKUL DAVID PICKUL KIMBERLY 1958 4 140 STEVENS ROBERT D 1927 4 1 OAR 4 * 1 VU THUYET 0 ACUSHNETs . r * 16 DONOVAN DAVID JOSEPH 1957 3 1973 3 # 16 DEFREMAS DANA M 1965 3 # is DEFREITAS JOSEPH H 3 # 18 VIVEIROS JANIS E VASAPO"' — 1— v 1955 3 4140 # 21 ir, ADAMSAVE ------ * '10 MIELE GLORIA M 1927 3 1955 3 * is DALY SUSAN J PERKINS ROBERT P JR 1955 3 * 16 # is CONROY BARBARA L 1956 3 1978 3 # 18 CONROY DANIEL SCOTT iw 3 is CONROY DAVID M CONROY DAVID M JR 1982 3 # 18 23 OBRIEN LISA M 1971 3 1970 3 * 23 OBRIEN STEPHEN W 1961 3 27 LE DUONG K 3 * 27 LY HUNG SAU ROUND BRUCE D 1958 3 * 30 * 30 ROUND KIMBERLEE L 1964 3 1954 3 * 35 * STROM DANIEL J STROM YUYING M 1959 3 35 # 38 * BURKE SEAN 1968 3 COLFORD CHRISTOPHER DIDHAM 1957 3 38 * 38 COLFORD DAWN DIDHAM 1960 3 3 * 39 MAHAN JAMES E 1953 1964 3 * 39 MAHAN SHELLI M 1923 3 * 52 MANOSJAMES HAROLD W 1929 3 * 59 RITTER I * = VOTER TOWN OF NORTH ANDOVER, MA 2004 v NO. APT. NAME BORN PCr V NO. APT. ABBOTTST STREET LISTING NAME BORN PCr ABBOTT ST Con't 2 DEMERS MARION L 1925 6 MURPHY MALCOLM A 2 DEMERS MAURA A 1958 6 MILARDO CARRIE A 2 DEMERS MICHAEL A 1953 6 SOLOMON DAVID R 20 SAWYER CHRISTOPHER M 1970 6 SOLOMON LISA A 20 SAWYER LAURIE A 1967 6 NIEMI JASON T 25 CARLSON JASON L 1976 6 NIEMI SANDRA C 25 CARLSON MARCIA E 1974 6 NIEMI WAYNE J 32 MAVER JILLIAN A 1969 6 IPPOLITO THOMAS D 32 MAVER JOHN JAMES JR 1972 6 LEARY-IPPOUTO MARY E 37 UNIEJEWSKI DIANE 1982 6 O'NEILL KATHLEEN PAGONES 37 UNIEJEWSKI VIRGINIA 1953 6 O'NEILL PAUL J 44 DICARLO-DUNAGAN JULIE A 1969 6 WONDRASCH SHARON D - 44 DUNAGAN SHELLEY E 1964 6 CONNOLLY JAMES M 49 JAWORSKI RUDOLF A 1950 6 CONNOLLY ROSE M 49 JAWORSKI SUSAN K 1942 6 WASSERMAN KEVIN R 56 COGLIANO CURTIS ALEXANDER 1983 6 WASSERMAN MARGARET R 56 COGUANO DIANE S 1958 6 APPLETON JULIE 56 COGLIANO MATTHEW 1984 6 APPLETON RICHARD 56 COGLIANO PAUL A 1952 6 DUFRESNE ELIZABETH A 61 SARCIA JOSEPH A 1946 6 HANNAN KENNETH S 61 SARCIA MICHELE JOSEPHINE 1947 6 HANNAN LINDA 76 CRAVEN DAVID E 1951 6 HANNAN LISA K 76 CRAVEN JACQUELINE 6 GATTO NANCY V 76 CRAVEN KATHLEEN A 1951 6 GATTO PETER V so FORD USA M 1963 6 GATTO VINCENT J 90 MCCULLOUGH STEPHEN A 1962 6 HERMANSJOSEPHT 96 GILLIS ANNE M 1949 6 HERMANS SHIRLEY M 16 96 GILLIS MICHAEL A GILLIS TIMOTHY J 1947 6 1984 6 101 DAINOWSKI LUCY M 1919 6 110 TORREYJOANA � - 1932 7 112 LEBLANC DEBRA L 1962 7 112 LEBLANC JOHN J 1961 7 121 TROUVILLE MARK R 1956 6 121 TROUVILLE MARY ELLEN 1954 6 122 MYERS ELLEN B 1957 7 122 MYERS ROBERT 8 1952 7 127 PENNEY DAVID J 1960 6 127 PENNEY HELAINE M 1963 6 132 FEHR CAROL S 1944 7 132 FEHR WILLARD R 1943 7 139 QUINN KAREN M 1961 6 139 QUINN MICHAEL J 1959 6 142 WESCOTTANDREWM 1963 7 142 WESCOTTBETHM 1964 7 151 KRUPKOWSKI MARGARET M 1962 6 151 KRUPKOWSKI MARK D 1960 6 152 JOHNSON DAVID B 1967 7 161 ROY DONALD W 1952 6 161 ROY DONNA J 1955 6 161 ROY LYNDSAY DAWN 1983 6 162 COMERFORD BRENDA J 1970 7 162 COMERFORD THOMAS J 1966 7 171 NOLETTE KAREN S 1964 6 171 NOLETTE THOMAS J 1968 6 174 HELLA CYNTHIA 1795 7 174 HELLA RICHARD A 1795 7 185 SCHELLHORN JOHN 8 1946 6 185 SEAVEY STEPHANIE ANNE 1963 6 186 VELARDI KENNETH C 1950 7 186 VELARDII SALLY A 1954 7 197 ROBERTSON MICHELLE J 1966 6 197 ROBERTSON SCOTT A 1966 6 198 SANTORO JOHN J 1965 7 198 SA14TORO KATHLEEN ALYSA 1967 7 200 FORGERONJOSEPHT 1963 7 210 MORIN DUANE DANIEL 1959 7 210 MORINKERRYANN 1972 7 220 BURKE JAMES C 1947 7 220 BURKEJAMIM 1979 7 220 BURKE JENNIFER M 1977 7 220 BURKE JILUAN F 1982 7 220 225 BURKE KAREN M FROST ALICE A 1951 7 1914 6 226 REICH JUDITH E 1964 7 226 230 REICH MARK ROBERT DELIDOW LYNN M 1963 7 1959 7 INACTTVE VOTER STREET LISTING NAME BORN PCr ABBOTT ST Con't 230 MURPHY MALCOLM A 1954 7 240 MILARDO CARRIE A 1964 7 250 SOLOMON DAVID R 1960 7 250 SOLOMON LISA A 1961 7 275 NIEMI JASON T 1980 a 275 NIEMI SANDRA C 1947 6 275 NIEMI WAYNE J 1952 6 338 IPPOLITO THOMAS D 1936 7 338 LEARY-IPPOUTO MARY E 1943 7 339 O'NEILL KATHLEEN PAGONES 1955 6 339 O'NEILL PAUL J 1962 6 345 WONDRASCH SHARON D - 1956 6 353 CONNOLLY JAMES M 1962 6 353 CONNOLLY ROSE M 1961 6 356 WASSERMAN KEVIN R 1966 7 356 WASSERMAN MARGARET R 1963 7 361 APPLETON JULIE 1967 6 361 APPLETON RICHARD 1964 6 364 DUFRESNE ELIZABETH A 1946 7 416 HANNAN KENNETH S 1946 7 416 HANNAN LINDA 1947 7 416 HANNAN LISA K 1971 7 417 GATTO NANCY V 1954 4 417 GATTO PETER V 1985 4 417 GATTO VINCENT J 1956 4 429 HERMANSJOSEPHT 1926 4 429 HERMANS SHIRLEY M 1928 4 ACADEMY RD 32 GOWDYGERALDINEF 1961 4 32 GOWDYTREVORA 1956 4 56 MUSSER KATHLEEN E 1950 4 56 WALKER DAVID M 1979 4 56R ADAM DANA C 1970 4 56R ADAM TRACI L 1971 4 83 FREEMAN HARRISON CROWELL JR 1940 4 83 MCGAULEY DEBORAH ANN 1952 4 83 STEVENS KATHY C 1943 4 84 RAJAN MARAGADHAM V 1944 4 84 RAJAN R V 1937 4 84 WORDEN ANITA RAJAN 1968 4 84 WORDEN JAMES D 1967 4 114 BLANCHARD FORREST SUMNER 1943 4 114 BLANCHARD LINDA MAE 1945 4 135 PICKUL CAITUN E 1984 4 135 PICKUL CHRISTOPHER 1986 4 135 PICKUL DAVID 1956 4 135 PICKUL KIMBERLY 1958 4 140 STEVENS EDMUND B 1963 4 * 140 STEVENS ROBERT D 1927 4 * 140 1 VU THUYET 0 1946 4 ACUSHNETST * 16 DONOVAN DAVID JOSEPH 1957 3 * Is DEFREITAS DANA M 1973 3 * 18 DEFREITAS JOSEPH H 1965 3 # 18 VIVEIROS JANIS E 1951 3 21 BROMBERG ALEXANDER 1984 3 21 VASAPOLU ARLENE K 1955 3 ADAMS AVE 10 MIELE GLORIA M 1927 3 16 DALY SUSAN J 1955 3 16 PERKINS ROBERT P JR 1955 3 18 CONROY BARBARA L 1956 3 18 CONROY DANIEL SCOTT 1978 3 18 CONROY DAVID M 1954 3 18 CONROY DAVID M JR 1982 3 23 GOODROW JENNIFER A 1969 3 23 GOODROW MATTHEW 1954 3 27 LE DUONG K 1961 3 27 LE HUNG S 1961 3 30 ROUND BRUCE D 1958 3 30 ROUND KIMBERLEE L 1964 3 35 STROM DANIEL J 1954 3 35 STROM YUYING M 1959 3 38 BURKE SEAN 1968 3 *=VOTER TOWN OF NORTH ANDOVER, MA ,V No. AFT. T NAME BORN PCT 2 DEMERS MARION L 1925 6 2 DEMERS MAURA A 1958 6 2 DEMERS MICHAEL A 1953 6 20 SAWYER CHRISTOPHER M 1970 6 �20 SAWYER LAURIE A 1967 6 32 MAVER JILLIAN A 1969 6 Z MAVERJOHNJAMESJR 1972 6 37 UNIEJEWSKI DIANE 1982 6 37, UNIEJEWSKI VIRGINIA 1953 6 �4 DICARLO-DUNAGAN JULIE A 1969 6 �g HERN KEVIN A 1967 6 '49 JAWORSKI RUDOLF A 1950 6 J. JAWORSKI SUSAN K 1942 6 564 COGLIANO CURTIS ALEXANDER 1983 6 O'NEILL PAUL J COGLIANO DIANE S 1958 6 6;, COGLIANO MATTHEW 1984 6 CONNOLLY JAMES M COGLIANO PAUL A 1952 6 CONNOLLY ROSE M SARCLA JOSEPH A 1946 6 WASSERMAN MARGARET R SARCIA MICHELE JOSEPHINE 1947 6 APPLETON JULIE CRAVEN DAVID E 1951 6 APPLETON RICHARD CRAVEN JACQUELINE 1983 6 DUFRESNE ELIZABETH A CRAVEN KATHLEEN A 1951 6 AVERKA FAYE L FORD LISA M 1963 6 AVERKAJOSEPHJ MCCULLOUGH STEPHEN A 1962 6 HANNAN KENNETH S JR GILLIS ANNE M 1949 6 GILLIS MICHAEL A 1947 6 416 GILLIS TIMOTHY J 1984 6 416 DAINOWSKI LUCY M 1919 6 417 TORREY JOAN A 1932 7 417 LEBLANC DEBRA L 1962 7 417 LEBLANC JOHN J 1961 7 429 ATROUVILLE MARK R 1956 6 429 'iROU'VILLE MARY ELLEN 1954 6 TROUVILLE STEFANIE A 1984 6 4MYERS ELLEN B 1957 7 IMYERS ROBERT B 1.952 7 �PENNEY DAVID J 1960 6 IPENINEY HELAINE M 1963 6 fFEHR CAROL 1944 7 ;.4EHR MEGAN C 1974 7 MR WILLARD biNN KAREN M 1943 7 -CQUINN MICHAEL J 1961 1959 6 6 I'MCOTTANDREWM 1963 7 OTT BETH M 1964 7 t�RUPKOWSKI MARGARET M 1962 6 i ft,PKOWSKI MARK D 1960 6 GERALD WILLIAM 1960 7 INSON DAVID B 1967 7 PPNALD W 1952 6 DONNA 1 1955 6 R- OY LYNDSAY DAWN 1983 6 RD BRENDA J 1970 7 FORDTHOMASi 1956 7 KAREN S 1964 6 THomASj 1968 6 tA MATTHEW D 1795 1976 7 7 RDA 1795 7 RNJOHNB 1946 6 PHANIEANNE 1963 6 NETH C 1950 7 A -- 1954 7 MICHELLE J 1966 6 ,PCOTTA 1966 6 ",N J 1965 7 LEEN ALYSA 1967 7 EPH T 1963 7 U NE 1965 7 E,PANIEL 1969 7 1 IN C-1 1972 7 1947 1979 7 7 1973 7 1982 7 1951 7 1914 6 VOTER 2003 STREET LISTING V NO. AFT. NAME BORN PCT ABBOTT ST Con't GOWDY GERALDINE F 1961 226 REICH JUDITH E 1964 7 226 REICH MARK ROBERT 1963 7 230 DELIDOW LYNN M 1959 7 230 MURPHY MALCOLM A 1954 7 240 MILARDO CARRIE A 1964 7 250 SOLOMON DAVID R 1960 7 250 SOLOMON LISA A 1961 7 275 NIEMI JASON T 1980 6 275 NIEMI SANDRA C 1947 6 275 NIEMI WAYNE J 1952 6 338 IPPOLITO THOMAS D 1936 7 338 LEARY-IPPOLITO MARY E 1943 7 339 O'NEILL KATHLEEN PAGONES 1955 6 339 O'NEILL PAUL J 1962 6 345 WONDRASCH SHARON D 1958 6 353 CONNOLLY JAMES M 1962 6 353 CONNOLLY ROSE M 1961 6 356 WASSERMAN MARGARET R 1963 7 361 APPLETON JULIE 1967 6 361 APPLETON RICHARD 1964 6 * 364 DUFRESNE ELIZABETH A 1946 7 * 383 AVERKA FAYE L 1913 6 * 383 AVERKAJOSEPHJ 1953 6 * 416 HANNAN KENNETH S JR 1973 7 * 416 HANNAN KENNETH S 1946 7 416 HANNAN LINDA 1947 7 416 HANNAN LISA K 1971 7 417 GATTO NANCY V 1954 4 417 GATTO PETER V 1985 4 417 GATTO VINCENT J 1956 4 429 HERMANSJOSEPHT 1926 4 429 HERMANS SHIRLEY M 1928 4 ACADEMY RD 32 GOWDY GERALDINE F 1961 4 32 GOWDYTREVORA 1956 4 56 MUSSER KATHLEEN E 1950 4 56 WALKER DAVID M 1979 4 56R ADAM DANA C 1970 4 56R ADAM TRACI L 1971 4 83 FREEMAN HARRISON CROWELL JR 1940 4 83 MCGAULEY DEBORAH ANN 1952 4 83 STEVENS CAROLINE R 1919 4 83 STEVENS KATHY C 1943 4 84 RAJAN MARAGADHAM V 19" 4 84 RAJAN R V 1937 4 84 WORDEN ANITA RAJAN 1968 4 84 WORDEN JAMES D 1967 4 114 BLANCHARD FORREST SUMNER 1943 4 114 BLANCHARD LINDA MAE 1945 4 135 PICKUL CAFTLIN E 1984 4 135 PICKUL DAVID 1956 4 135 PICKUL KIMBERLY 1958 4 140 STEVENS EDMUND B 1963 4 140 STEVENS NANCY L 1936 4 140 STEVENS ROBERT D 1927 4 140 1 VU THUYET 0 1946 4 ACUSHNETST 16 DONOVAN DAVID JOSEPH 1957 3 18 DEFREITAS DANA M 1973 3 18 DEFREITAS JOSEPH H 1965 3 # 18 VIVEIROS JANIS E 1951 3 21 BROMBERG ALEXANDER 19B4 3 21 VASAPOLLI ARLENE K 1955 3 ADAMS AVE 10 MIELE GLORIA M 1927 3 16 DALY SUSAN J 1955 3 16 PERKINS ROBERT P JR 1955 3 18 CONROY BARBARA L 1956 3 18 CONROY DANIEL SCOTT 1978 3 18 CONROY DAVID M JR 1982 3 18 CONROY DAVID M 1954 3 23 GOODROW JENNIFER A 1969 3 23 GOODROWMATTHIEW 1964 3 # 27 DODGE FREDERICK J 1933 3 * = VOTER TOWN OF NORTH ANDOVER, MA . V NO. AFr. NAME BORN PC`r ABBOTTST . 8 HANNAN KENNETH S JR 1973 6 . 8 HANNAN KE141NETH S 1946 6 . 8 HANNAN LINDA 1947 6 . 8 HANNAN LISA K 1971 6 . 20 SAWYER CHRISTOPHER M 1970 6 . 20 SAWYER LAURIE A 1967 6 . 25 CAMPOLINI ERNEST T 1945 6 . 25 CAMPOLINI LINDA J 1954 6 25 CAMPOLINI RANDY 1981 6 . 32 MAVER JILUAN A 1969 6 32 MAVER JOHN JAMES JR 1972 6 37 UNIEJEWSKI DIANE 1982 6 37 UNIEJEWSKI JOSEPH 1954 6 * 37 UNIEJEWSKI VIRGINIA 1953 6 * 44 HERN KEVIN A 1967 6 * 44 PATTAVINA-HERN ANN MARIE 1962 6 * 49 JAWORSKI RUDOLF A 1950 6 * 49 JAWORSKI SUSAN K 1942 6 * 56 COGUANO CURTIS ALEXANDER 1983 6 * 56 COGLIANO DIANE S 1958 6 56 COGLIANO MATTHEW 1984 6 * 56 COGLIANO PAUL A 1952 6 * 61 SARCIA JOSEPH A 1946 6 * 61 SARCIA MICHELE JOSEPHINE 1947 6 * 76 CRAVEN DAVID E 1951 6 76 CRAVEN JACQUELINE 1983 6 * 76 CRAVEN KATHLEEN A 1951 6 * 90 FORD LISA M 1963 6 * 90 MCCULLOUGH STEPHEN A 1962 6 96 GILLIS ANNE M 1949 6 96 GILLIS MICHAEL A 1947 6 96 GILLIS RYAN MICHAEL 1977 6 96 GILLIS TIMOTHY J 1984 6 101 DAINOWSKI LUCY M 1919 6 110 TORREY JOAN A 1932 7 112 LEBLANC DEBRA L 1962 7 112 LEBLANC JOHN J 1961 7 121 TROUVILLE MARK R 1956 6 121 TROUVILLE MARY ELLEN 1954 6 122 MYERS ELLEN B 1957 7 122 MYERS ROBERT B 1952 7 127 PENNEY DAVID J 1960 6 127 PENNEY HELAINE M 1963 6 132 FEHR CAROL 1944 7 132 FEHR WILLARD 1943 7 139 QUINN KAREN M 1961 6 139 QUINN MICHAEL J 1959 6 142 WESCOTT ANDREW M 1963 7 142 WESCOTT BETH M 1964 7 * 151 KRUPKOWSKI MARGARET M 1962 6 * 151 KRUPKOWSKI MARK D 1960 6 # 152 FITZGERALD WILLIAM 1960 7 * 152 JOHNSON DAVID B 1967 7 * 161 ROY DONALD W 1952 6 * 161 ROY DONNA J 1955 6 * 161 ROY LYNDSAY DAWN 1983 6 162 COMERFORD BRENDA J 1970 7 162 COMERFORD THOMAS J 1966 7 171 NOLETTE KAREN S 1964 6 171 NOLETTE THOMAS J 1968 6 174 HELLA CYNTHIA 1795 7 174 HELLA MATTHEW D 1976 7 174 HELLA RICHARD A 1795 7 185 SCHELLHORN JOHN B 1946 6 185 �EAVEY STEPHANIE ANNE 1963 6 186 VELARDI KENNETH C 1950 7 186 VELARDI SALLY A 1954 7 197 ROBERTSON MICHELLE J 1966 6 197 ROBERTSON SCOTT A 1966 6 198 SANTORO JOHN J 1965 7 198 SANTORO KATHLEEN ALYSA 1967 7 # = INACTIVE VOTER 2002 ST"ET LISTING V NO. APT. NAME BORN PCT ABBOTT ST Con't * 200 TYLER DAVID A - 1958 7 * 200 TYLER JACQUELINE 1965 7 * 210 O'REILLY LORI A 1962 7 * 210 O'REILLY MICHAEL J 1957 7 * 220 BURKE JAMES C 1947 7 220 BURKEJAMIM 1979 7 * 220 BURKE JENNIFER M 1973 7 * 220 BURKE JILLAN F 1982 7 * 220 BURKE KAREN M 1951 7 * 225 FROST ALICE A 1914 6 * 226 REICH JUDITH E 1964 7 * 226 REICH MARK ROBERT 1963 7 * 230 DELIDOW LYNN M 1959 7 * 230 MURPHY MALCOLM A 1954 7 * 240 BORERI CARRIE ANNE 1964 , 7 * 250 SOLOMON DAVID R 1960 7 * 250 SOLOMON USA A 1961 7 * 275 NIEMI JASON T 1980 6 * 275 NIEMI SANDRA C 1947 6 * 275 NIEMI WAYNE J 1952 6 * 338 IPPOLfTO THOMAS D 1936 7 * 338 LEARY-IPPOLITO MARY E 1943 7 * 339 O'NEILL KATHLEEN PAGONES 1955 6 * 339 O'NEILL PAUL J 1962 6 * 345 WONDRASCH SHARON D 1958 6 * 353 CONNOLLY JAMES M 1962 6 353 CONNOLLY ROSE M 1961 6 353 HUGHES DIANE STRUGLINSKI 1964 6 353 HUGHES TIMOTHY C 1959 6 356 WASSERMAN MARGARET R 1963 7 361 APPLETON JULIE 1967 6 361 APPLETON RICHARD 1964 6 361 LURVEY DEBORAH J 1963 6 361 LURVEY ROBERT E 1960 6 364 DUFRESNE ELIZABETH A 1946 7 383 AVERKA FAYE L 1913 6 383 AVERKAJOSEPHJ 1953 6 417 GATTO NANCY V 1954 4 417 GATTO VINCENT J 1956 4 429 HERMANSJOSEPHT 1926 4 429 HERMANS SHIRLEY M 1928 4 ACADEMY RD . 32 GOWDY GERALDINE F 1961 4 . 32 GOWDY TREVOR A 1956 4 . 56 MUSSER KATHLEEN E 1950 4 . 56 WALKER DAVID M 1979 4 . 56R ADAM DANA C 1970 4 . 56R ADAM TRACI L 1971 4 . 83 FREEMAN HARRISON CROWELL JR 1940 4 . 83 MCGAULEY DEBORAH ANN 1952 4 . 83 STEVENS CAROLINE R 1919 4 . 83 STEVENS KATHY C 1943 4 . 84 WORDEN ANITA RAJAN 1968 4 . 84 WORDEN JAMES D 1967 4 . 84R MURPHY STACEY A 1966 4 . 114 BLANCHARD FORREST SUMNER 1943 4 . 114 BLANCHARD LINDA MAE 1945 4 . 135 PICKUL CAITLIN E 1984 4 . 135 PICKUL DAVID 1956 4 . 135 PiCKUL KIMBERLY 1958 4 . 140 STEVENS NANCY L 1936 4 . 140 STEVENS ROBERT D 1927 4 . 140 1 VU THUYET Q 1946 4 ACUSHNET ST 16 DONOVAN DAVID JOSEPH 1957 3 18 DEFREITAS DANA M 1973 3 18 DEFREITAS JOSEPH H 1965 3 18 VIVEIROS JANIS E 1951 3 21 BROMBERG ALEXANDER 1984 3 2`1 VASAPOLLI ARLENE K 1955 3 * = VOTER ni p F!", 7 11 11 if �7 TOWN OF NORTH ANDOVER, MA V NO. AFT. NAME BORN PCT ABBOTTST 8 HANNANIXENNETH S 1946 5 8 HANNAN KENNETH S JR 1973 5 8 HANNAN I-WbA 1947 5 20 SAWYER CHRISTOPHER M 1970 5 20 SAWYER LAURIE ANN 1967 5 25 CAMPOLINI ERNEST T 1945 5 25 CAMPOLINI LINDA J 1954 5 25 CAMPOLINIRANDY 1981 5 32 MAVER JILLIAN A 1969 5 32 MAVER JOHN JAMES JR 1972 5 37 UNIEJEWSKI DIANE 1982 5 37 UNIEJEWSKI JOSEPH 1954 5 37 UNIEJEWSKI VIRGINIA 1953 5 44 HERN KEVIN ANTHONY 1967 5 44 PATTAVINA-HERN ANN MARIE 1962 5 49 JAWORSKI RUDOLF A 1950 5 49 JAWORSKI SUSAN K 1942 5 56 COGLIANO CURTIS 1983 5 56 COGLIANO DIANE S 1958 5 56 COGLIANO PAUL A 1952 5 61 SARCIA JOSEPH A 1946 5 61 SARCIA MICHELE JOSEPHINE 1947 5 76 CRAVEN DAVID E 1951 5 76 CRAVEN JACQUELINE 1983 5 76 CRAVEN KATHLEEN A 1951 5 90 FORD LISA M 1963 5 90 MCCULLOUGH STEPHEN A 1962 5 96 GILLS ANNE M 19-49 5 96 GILLIS MICHAEL A 1947 5 96 GILLIS RYAN MICHAEL 1977 5 101 DAINOWSKI LUCY M 1919 5 101 DAINOWSKI STANLEY J 1920 5 110 TORREY JOAN A 1932 5 110 TORREY JOHN F 1931 5 112 LEBLANC DEBRA L 1962 5 112 LEBLANC JOHN J 1961 5 122 MYERS ELLEN B 1957 5 122 MYERS ROBERT B 1952 5 127 PENNEY DAVID J 1960 5 127 PENNEY HELAINE M 1963 5 132 FEHR CAROL 1944 5 132 FEHR JONATHAN D 1972 5 132 FEHR WILLARD 1943 5 139 QUINN KAREN M 1961 5 139 QUINN MICHAEL J 1959 5 142 WESCOTT ANDREW M 1963 5 142 WESCOTT BETH M 1964 5 151 KRUPKOWSKI MARGARET M 1962 5 151 KRUPKOWSKI MARK D 1960 5 # 152 FITZGERALD AUDREY K 1963 5 # 152 FITZGERALD WILLIAM 1960 5 * 152 JOHNSON DAVID B 1967 5 . 161 ROY DONALD W 1952 5 * 161 ROYDONNAJ 1955 5 161 ROY LYNDSAY D iga3 5 162 COMERFORD BRENDA J 1970 5 162 COMERFORD THOMAS J 1966 5 174 HELLA CYNTHIA 5 174 HELLA MATTHEW D 1976 5 174 HELLA RICHARD A 5 185 SCHEULKORN JOHN 8 1946 5 185 SEAVEY STEPHANIE ANNE 1963 5 186 VELARDI KENNETH C 1950 5 186 VELARDI SALLY A 1954 5 197 PORTEN JOEL S 1964 5 197 PORTEN PAULA L 1965 5 198 MARTIN ANNE F 1947 S 198 MARTIN DONALD G 1948 5 200 TYLER DAVID A 1958 6 200 TYLER JACQUELINE 1965 5 200 1 muRCKO DAVID isal 5 # = INAMVE VOTER 2001 STREET LISTING V NO. APT. NAME BORN PCT ABBOTT ST Con't 210 O'REILLY LORI A 1962 5 210 UREILLY MICHAEL J 1957 5 # 213 BEAULIEU JULIE E 1956 5 # 213 EARNSHAW FREDERICK W 1944 5 220 BURKE JAMES C 1947 5 220 BURKEJAMIM 1979 5 220 BURKE JENNIFER M 1973 5 220 BURKE JILLIAN F 1982 5 220 BURKE KAREN M 1951 5 225 FROST ALICE A 1914 5 226 REICH JUDITH E 1964 5 226 REICH MARK ROBERT 1963 5 230 DELIDOW LYNN M 1959 5 230 MURPHY MALCOLM A 1954 5 240 BORERI CARRIE ANNE 1964 5 250 WOLF HEIDI A 1974 5 250 WOLF PHILIP B 1941 5 250 WOLF TERESA E 1946 5 275 NIEMI JASON 1980 5 275 NIEMI SANDRA C 1947 5 275 NIEMI WAYNE J 1952 5 338 IPPOLITO THOMAS D 1936 5 338 LEARY4PPOUTO MARY E 1943 5 339 ORIOL JEAN H 1939 5 339 ORIOL NANCY E 1946 5 339 ORIOLVALERIE 1977 5 345 WONDRASCH SHARON D 1958 5 353 HUGHES DIANE STRUGLINSKI 1964 5 353 HUGHES TIMOTHY C 1959 5 356 1 BURKARDT MICHAEL P 1983 5 356 1 BURKARDT PAMELA H 1953 5 3661 SURKARDT THOMAS M im 5 361 LURVEY DEBORAH J 1963 5 361 LURVEY ROBERT 1960 5 364 DUFRESNE ELIZABETH A 1946 5 383 AVERKA FAYE L 1913 5 383 AVERKAJOSEPHJ 1953 5 417 GA7TO NANCY V 1954 5 417 GATTO VINCENT J 1956 5 429 HERMANS JOSEPH T 1926 5 429 HERMANS SHIRLEY M 1928 5 ACADEMY RD 32 GOWDY GERALDINE F 1961 4 32 GOWDY TREVOR A 1956 4 56 MUSSER KATHLEEN E 1950 4 56 WALKER DAVID M 1979 4 56 R ADAM DANA C 1970 4 56R ADAM TRACI L 1971 4 83 FREEMAN HARRISON CROWELL JR 1940 4 113 MCGAULEY DEBORAH ANN 1952 4 83 STEVENS CAROLINE R 1919 4 83 STEVENS KATHY C 1943 4 84 WORDEN ANITA RAJAN 1968 4 84 WORDEN JAMES D 1967 4 84R MURPHY STACEY A 1966 4 114 BLANCHARD FORREST SUMNER 1943 4 114 BLANCHARD LINDA MAE 1945 4 135 PICKUL DAVID 1956 4 135 PICKUL KIMBERLY 1958 4 140 STEVENS NANCY L 1936 4 140 STEVENS ROBERT D 1927 4 140 VU THUYET Q 1946 4 ACUSHNETST 16 DONOVAN DAVID JOSEPH 1957 3 18 DEFREITAS DANA 1'973 3 18 DEFREITAS JOSEPH lgss 3 18 MEYER GRACE A 1952 3 18 VIVEIROS JANIS 1951 3 is MCINTOSH MEREDITH M 1968 3 21 VASAPOLLI ARLENE K 1955 3 VOTER El V I TOWN OF NORTH ANDOVER, MA V. . NO. APT. NAME PRECINCT 2000 STREET LISTING ABBOTTST MATOLA LINDA J 5 8 HANNAN KENNETH S 5 8 HANNAN KENNETH S JR 5 8 HANNAN LINDA 5 8 HANNAN LISA 5 20 SAWYER LAURIE ANN 5 20 SAWYER CHRISTOPHER M 5 25 CAMPOLINI ERNEST T 5 25 CAMPOLINIRANDY 5 25 CAMPOLINI LINDA J 5 32 MAVER JILLIAN A 5 37 UNIEJEWSKI DIANE 5 37 UNIEJEWSKI JOSEPH 5 37 UNIEJEWSKI VIRGINIA 5 44 PATTAVINA-HERN ANN MARIE 5 44 VOLPONE CHARLES J JR 5 44 VOLPONE RITA G 5 49 JAWORSKI SUSAN K 5 49 JAWORSKI RUDOLF A 5 56 COGLIANO PAUL A 5 56 COGUANO DIANE S 5 61 SARCIA JOSEPH A 5 61 SARCIA MICHELE JOSEPHINE 5 76 CRAVEN DAVID E 5 76 CRAVEN KATHLEEN A 5 90 FORD LISA M 5 90 MCCULLOUGH STEPHEN A 5 96 GILLIS ANNE M 5 96 GILLIS RYAN MICHAEL 5 96 GILLIS MICHAEL A 5 101 DAINOWSKI LUCY M 5 101 DAINOWSKI STANLEY J 5 101 DAINOWSKI STANLEY 5 110 TORREY JOAN A 5 110 TORREY JOHN F 5 112 LEBLANC DEBRA L 5 112 LEBLANC JOHN J 5 122 MYERS ELLEN B 5 122 MYERS ROBERT B 5 127 MIKA GARY D 5 127 PENNEY HELAINE M 5 127 PENNEY DAVID J 5 132 FEHR CAROL 5 132 FEHR MEGAN 5 132 FEHR WILLARD 5 132 FEHR JONATHAN D 5 139 QUINN KAREN M 5 139 QUINN MICHAEL J 5 142 WESCOTT ANDREW M 5 142 WESCOTT BETH M 5 151 KRUPKOWSKI MARK D 5 151 KRUPKOWSKI MARGARET M 5 0 152 FITZGERALD AUDREY K 5 # 152 FITZGERALD WILLIAM 5 152 JOHNSON DAVID 5 161 ROY DONNA J 5 161 ROY DONALD W 5 162 COMEFORD BRENDA J 5 162 COMEFORD THOMAS JAMES JR 5 162 COMERFORD THOMAS J 5 171 LING DAVID J 5 171 LING SAMATHA J 5 174 HELLA CYNTHIA 5 174 HELLA MATTHEW D 5 174 HELLA RICHARD A 5 185 SCHELLHORN JOHN B 5 185 SEAVEY STEPHANIE ANNE 5 186 VELARDI SALLY A 5 186 VELARDI KENNETH C 5 197 PORTEN JOEL S 5 197 PORTEN PAULA L 5 198 MARTIN ANNE F 5 198 MARTIN DONALD G 5 198 MART;N ERIN M 5 198 MART N KELLY T 5 200 TYLERJACQUEUNE 5 200 TYLER DAVID A 5 V. NO. APT. NAME PRECINCT ABBOTT ST Con't 200 1 MATOLA LINDA J 5 200 1 MATOLA WILLIAM G 5 200 1 MURCKO DAVID 5 200 1 MURCKO DANIELLA A 5 210 O'REILLY LORI A 5 210 O'REILLY MICHAEL J 5 213 BEAULIEU JULIE E 5 213 EARNSHAW FREDERICK W 5 220 BURKE JAMES C 5 220 BURKEJAMIM 5 220 BURKE JENNIFER M 5 220 BURKE KAREN M 5 220 BURKE JILLIAN F 5 225 FROST ALICE - 5 226 REICH JUDITH E 5 230 DELIDOW LYNN M 5 230 MURPHY MALCOLM A 5 240 BORERI CARRIE ANNE 5 240 BORERI KEVIN 5 250 WOLF HEIDI 5 250 WOLF TERESA E 5 250 WOLF PHILIP B 5 275 NIEMI JASON 5 275 NIEMI SANDRA C 5 275 NIEMI WAYNE J 5 338 IPPOLITO THOMAS D 5 338 LEARYAPPOLITO MARY E 5 339 ORIOL VALERIE 5 339 ORIOL JEAN H 5 339 ORIOL NANCY E 5 345 WONDRASCH SHARON D 5 353 HUGHES DIANE STRUGLINSKI 5 353 HUGHES TIMOTHY C 5 '356 1 BURKARDT THOMAS M 5 356 1 BURKARDT PAMELA H 5 361 LURVEY ROBERT 5 361 LURVEY DEBORAH J 5 364 DUFRESNE ELIZABETH A 5 383 AVERKA FAYE L 5 383 AVERKAJOSEPHJ 5 417 GATTOVINCENTJ 5 417 GATTO NANCY V 5 429 HERMANS JOSEPH T 5 429 HERMANS SHIRLEY M 5 ACADEMY RD 32 GOWDY GERALDINE F 4 32 GOWDY TREVOR A 4 56 MUSSER KATHLEEN E 4 56 WALKER DAVID M 4 56 R ADAM DANA C 4 56R ADAM TRACI L 4 83 FREEMAN HARRISON CROWELL JR 4 83 MCGAULEY DEBORAH ANN 4 83 STEVENS KATHY C 4 83 STEVENS CAROLINE R 4 # 84 BISSONNETTE DANIEL R 4 # 84 CRANSTON WILLIAM S 4 * 84 VENES SHARON K 4 * 84 VENES ROBERT 0 4 84 WORDEN JAMES P 4 84 WORDEN ANITA RAJAN 4 94R MURPHY STACEY A 4 114 BLANCHARD FORREST SUMNER 4 114 BLANCHARD LINDA MAE 4 135 PICKUL DAVID 4 135 PICKUL KIMBERLY 4 140 STEVENS NANCY L 4 140 STEVENS ROBERT D 4 140 VU THUYET 0 4 ACUSHNETST 18 JACKSON GAIL P 3 18 MEYER GRACE A 3 19 MCINTOSH MEREDITH M 3 21 VASAPOLLI ARLENE K 3 # INACTIVE VOTER VOTER 1999 STREET LISTING V. NO. APT. NAME TOWN OF NORTH ANDOVER ABBOTT ST Con't 220 BURKEJAMESC MA 220 V. NO. APT. NAME BORN PCT 220 BURKE KAREN M 1951 5 220 BURKEJAMIM ASIBOTTST 225 FROST ALICE 1914 5 .8 HANNAN KENNETH S 1946 5 # 226 8 HANNAN KENNETH S JR 8 1973 5 VOGEL STUART 8 HANNAN LISA 1971 5 1946 5 8 HANNAN LINDA 1947 5 230 20 SALES CHRISTOPHER M 1970 5 BORERI KEVIN 20 SAWYER LAURIE ANN 1967 5 1964 5 25 CAMPOLINI ERNEST T 1945 5 250 25 CAMPOLINI RANDY 1981 5 WOLF PHILIP 8 25 CAMPOLINI LINDA J 1954 5 .1980 5 32 MAVER JILLIAN A 1969 5 275 37 UNIEJEWSKI JOSEPH 1954 5 IPPOLITO THOMAS D 37 UNIEJEWSKI VIRGINIA 1953 5 1943 5 44 VOLPONE CHARLES J JR 1937 5 339 44 VOLPONE RITA G 1937 5 ORIOL VALERIE 49 JAWORSKI SUSAN K 1942 5 1961 5 49 JAWORSKI RUDOLF A 1950 5 353 56 COGLIANO PAUL A 1952 5 7�- 56 COGLIANO DIANE 8 1958 5 3% 1 61 SARCIA JOSEPH A 1946 5 LURVEY ROBERT 61 SARCIA MICHELE JOSEPHINE 1947 5 LURVEY DEBORAH J 76 CRAVEN DAVID E 1951 5 1946 5 76 CRAVEN KATHLEEN A 1951 5 363 90 FORD LISA M 1963 5 GATTO NANCY V 90 MCCULLOUGH STEPHEN A 1962 5 1956 5 90 MCCULLOUGH STEVE A 1962 5 429 96 GILLIS ANNE M 1949 5 96 GILLIS MICHAEL A 1947 5 32 96 GILLIS RYAN MICHAEL 1977 5 MUSSER KATHLEEN E 101 DAINOWSKI LUCY M 1919 5 1979 4 101 DAINOWSKI STANLEY 1920 5 56R 110 TORREYJOANA 1932 5 FREEMAN HARRISON CROWELL 1940 4 110 TORREY JOHN F 1931 5 * 83 112 LEBLANC DEBRA L 1962 5 STEVENS CAROLINE R 112 LEBLANC JOHN J 1961 5 1965 4 122 MYERS ELLEN B 122 MYERS ROBERT B 1957 5 84 127 MIKA GARY D 1952 1953 5 5 VENES SHARON K 127 PENNEY HELAINE M 132 1963 5 1937 4 FEHR CAROL 1944 5 84 132 FEHR JONATHAN 1972 5 MURPHY STACEY A 132 FEHR WILLARD 1943 5 114 132 FEHR MEGAN 1974 5 HOPKINS DARREN T 139 QUINN KAREN M 1961 5 1947 4 139 QUINN MICHAEL J Z 1959 5 140 142 WESCOTT ANDREW M 142 1963 5 STEVENS NANCY L WESCOTT BETH M 1964 5 1946 4 151 KRUPKOWSKIMARGARETM 151 KRUPKOWSKI MARK D 1962 5 140 1 # 152 FITZGERALD AUDREY K 152 1960 1963 5 5 FITZGERALD WILLIAM 152 1960 5 18 JOHNSON DAVID 161 ROY DONALD W 1795 5 MCINTOSH MEREDITH M 161 ROY DONNA 1 1952 1955 5 5 1957 3 162 HANRAHAN ARTHUR L -X-162 1941 5 HANRAHAN REGINA G 171 1943 5 DUFFY ARTHUR X 171 1967 5 DUFFY KATHLEEN C 174 1968 5 HELLA CYNTHIA -,96- � 174 HELLA RICHARD A 1795 5 SCHELLHORN JOHN B 4 1795 1946 5 5 4. SEAVEY STEPHANIE ANNE 1963 5 VELARDI KENNETH C 1950 5 VELARDI SALLY A 197 PORTENJOELS 1954 5 �'PORTEN PAULA L 1964 5 M ARTIN ANNE F 1965 5 "MARTIN DONALD G 1947 1948 5 MARTIN ERIN M 1978 5 5 MARTIN KELLY T MATOLA 1978 5 LINDA J -200 1 MATOLA WILLIAM G 1957 5 MURCKO DAVID 1962 1981 5 5 MURCKO DANIELLA A "?P�,'O'REILLY LORI 1977 5 A O'REILLY MICHAEL J ULIEU JULIE E 1962 1957 5 5 NSHAW FREDERICK W 1956 5 1944 5 #=INACTIVE VOTER 1999 STREET LISTING V. NO. APT. NAME BORN PCT ABBOTT ST Con't 220 BURKEJAMESC 1947 5 220 BURKE JENNIFER M 1973 5 220 BURKE KAREN M 1951 5 220 BURKEJAMIM 1979 5 225 FROST ALICE 1914 5 # 226 VOGELAMY 1973 5 # 226 VOGEL KIMBERLY GENE 1976 5 226 VOGEL STUART 8 1945 5 226 VOGEL DIANE M 1946 5 230 MUNJAL MANOJ 1961 5 230 MUNJAL PREETI N 1963 5 240 BORERI KEVIN 1963 5 240 BORERI CARRIE ANNE 1964 5 250 WOLF HEIDI 1974 5 250 WOLF TERESA E 1946 5 250 WOLF PHILIP 8 1941 5 275 NIEMI JASON .1980 5 275 NIEMI WAYNE J 1952 5 275 NIEMI SANDRA C 1947 5 338 IPPOLITO THOMAS D 1936 5 338 LEARY-IPPOL[TO MARY E 1943 5 339 ORIOL JEAN H 1939 5 339 ORIOL NANCY E 1946 5 339 ORIOL VALERIE 1977 5 345 WONDRASCH CRAIG 1961 5 345 WONDRASCH SHARON D 1958 5 353 HUGHES DIANE STRUGLINSKI 19& 5 353 HUGHES TIMOTHY C 1959 5 356 1 BURKARDT PAMELA H 1953 5 3% 1 BURKARDT THOMAS M 1958 5 361 LURVEY ROBERT 1960 5 361 LURVEY DEBORAH J 1963 5 364 DUFRESNE ELIZABETH A 1946 5 383 AvERKA FAYE L 1913 5 363 AVERKAJOSEPHJ 1953 5 417 GATTO NANCY V 1954 5 417 GATTO VINCENT J 1956 5 429 HERMANS JOSEPH T 1926 5 429 HERMANS SHIRLEY M 1928 5 ACADEMY RD 32 G DY GERALDINE F 1961 4 32 GOWDY TREVOR A 1956 4 56 MUSSER KATHLEEN E 1950 4 56 WALKER DAVID M 1979 4 56 R ADAM DANA C 1970 4 56R ADAM TRACI L 1971 4 * 83 FREEMAN HARRISON CROWELL 1940 4 * 83 MCGAULEY DEBORAH ANN 1952 4 * 83 STEVENS KATHY C 1943 4 83 STEVENS CAROLINE R 1919 4 # 84 13ISSONNETTE DANIEL R 1965 4 84 CRANSTON WILLIAM S 1963 4 84 RAJAN ANITA V 1968 4 # 84 VENES SHARON K 1942 4 # 84 VENES ROBERT 0 1937 4 64 WORDEN ANITA RAJAN 1968 4 84 WORDEN JAMES P 1967 4 84R MURPHY STACEY A 1966 4 114 BLANCHARD FORREST SUMNER I M 4 114 13LANCHARD LINDA MAE 1945 4 135 HOPKINS DARREN T 1976 4 135 HOPKINS GREGORY T 1947 4 135 HOPKINS LESLIE M 1947 4 140 STEVENS ROBERT D 1927 4 140 STEVENS NANCY L 1936 4 140 VU THUYET 0 1946 4 140 VU LONG H 1978 4 140 1 STEVENS EDMUND B 1963 4 ACUSHNETST 18 JACKSON GAIL P 1951 3 18 MEYER GRACE A 1952 3 19 MCINTOSH MEREDITH M -1968 3 # 21 BROMBERG STEWART L 1957 3 21 VASAPOLLI ARLENE K 1955 3 El L. -I TOWN OF NORTH ANDOVER MA 01845 V. NO. APT. NAME YOB ACADEMY RD 32 G&DY, GERALDINE F-1961 1959 32 GOWDY, TREVOR A im 56 WALKER, DAVID M 1979 66 MUSSER, KATHLEEN E 19W 56 R ADAM, DANA C 1970 R 56R ADAM,TRACIL 1965 83 BURGESS, YVONNE 1946 83 STEVENS. KATHY C 1943 83 STEVENS, CAROLINE R 1919 83 MOGAULEY, DEBORAH ANN 1952 83 FREEMAN. HARRISON CROWELL jr 1940 84 BISSONNETTE, DANIEL R 1965 84 VENES, SHARON K 1942 84 VENES, ROBERT 0 1937 84 CRANSTON, WILLIAM S 1963 84 EVANS, JUS11N 1978 114 BLANCHARD, FORREST SUMNER 1943 114 BLANCHARD, LINDA MAE 1945 135 HOPKINS, DARREN T 1976 135 HOPKINS, GREGORY T 1947 135 HOPKINS, LESUE M 1947 135 HOPKINS, KRISTAN S 1973 140 STEVENS, NANCY L 1936 140 STEVENS, ROBERT D 1927 140 1 STEVENS, EDMUND B 1963 ALCOTr WAY 1 MCANDREW, MICHAEL JOSEPH 1959 I MCANDREW, KATHLEEN P 1949 2 YEH, CHANGKUO 1958 3 FURBER, STEPHEN P 1964 3 FURBER, CANDACE M 1966 4 GRIFFIN, LAUREN M 1965 5 CLINTON, PAULA M 1795 5 CLINTON, JOHN MICHAEL 1978 5 MONTGOMERY, JAMES R 1950 5 CUNTON� RAYMOND M JR l9u 6 CLINTON, RAYMOND MARTIN 111 1975 6 GENDEL, CAROL S 1946 7 BROWN, THERESA L 1963 7 OCONNOR, SUSAN B 1968 7 OCONNOR, JOHN M 1965 7 KENNEDY, DEANNA L 1967 8 MARIE, KELLY K 1966 8 MARIE, ROBERT F JR 1964 9 PARKS, KENNETH DAVID 1964 9 PARKS, LAURA S 1966 10 GRASSO, GAYLE F 19% 12 LEBOSS, ANDREA T 1948 13 GRIFFITHS, BRIAN 1775 13 GRIFFITHS, PAULA M 1955 14 MCALARY, FREDERICK B 1947 16 BEOHNER, PAUL L lD45 17 LEWIN, JOSHUA ADAM 19T7 17 LEWIN, ELAINE ELLEN 1w is VANDEVENTER, CORNELIS J 1IM9 18 VANDEVENTER MARY E 1950 19 CHABOT, PAUL L 1941 20 FRANK, HOWARD S 1953 20 FRANK, EILEEN M 1967 21 MARTELL, JOSEPHINE A 1951 22 TAYLOR, GAVAN A im 23 BOWEN, EILEEN R 1957 23 REDINGTON, JOHN J 1955 24 01MMINO, MIKEL A 1971 24 RIDDLE, THOMAS 19W 27 YANG, HOSEONG 1979 28 KHESIN, MARK J 19M 28 KHESIN, ALLA IN9 29 BENNETT, JOAN L 1931 29 BENNETT, JOSEPH J 1958 31 FORSYTHE, MAUREEN T 1945 32 BRANDANO, MICHELLE S iqm 32 BRANDANO,ROYJ 1962 33 LAYCOB, MAPJLYN 1955 34 HALIVILLE. ANTOINE A 1966 34 HALIVILLE, MARIE M 1943 34 HALIVILLE.. FRANOOIS P 1932 35 LEUNG, CHEPJ SIUKWAN ims 35 TREBACH, SHERYL A 1971 35 TRERACH, MARILYN G 1944 36 HASHEM, MADELINE MAY i9m 37 SCHUBARTH, NANCY L 1951 37 KITE, LANDON JR 1937 37 SCHURARTH, CROMWELL H JR 1953 38 ANDERSONI-KARLSON, HEIDI 1956 38 BRENNAN, USA M 1961 38 BRENNAN, SEAN P 1961 39 STODDARD, KENNETH IRVING ism ANDOVER ST- - 169 HAMMOND, DOROTHY B 1924 178 FRANZ ROBERT G 192a A =VOTEIR 54 PRECINCT: 04 V. NO. APT. N All" --- ANDOVER ST Conl 178 CHASE, MARY C 1949 179 PAPPACENO, SIDER J 1953 179 SIDER, MICHAEL 1 1962 193 CEPUKAS, ALISON P 1918 196 BAILEY, THOMAS R 1946 196 BAILEY, MATTHEW THOMAS 1979 196 BAILEY, DENA J 1947 201 BIONDI, JOSEPH P 1965 207 HEGARTY, CAITLIN E 1977 207 HEGARTY, CORNELIUS F 1978 207 HEGARTY, SUSAN A 1948 207 HEGARTY. CORNELIUS F JR 1946 210 SARACUSA. MICHELLE 1961 212 MCGRATH, JAMES J 1944 212 MOGRATH, MARY C 1943 230 ROBERTSON, HELEN S 1931 240 GILES, ANN M 1948 240 GILES, RICHARD L M2 240 GILES, JOSHUA LINCOLN 19T7 250 WALSH, EILEEN M 1929 250 WALSH, JOHN F 1923 262 DICKMAN, DONNA M 1959 262 PRANGE,DONALD 1954 262 PRANGE, PETER 0991 264 KENDRICK, LINDA M 1%9 264 KENDRICK, JOHN J 1963 276 HOLMAN, CHARLES A 1959 276 HOLMAN, JOAN 1959 281 MASOOLA, MARY L 1934 289 HYDER, DAVID MICHAEL im 289 HYDER, BRENDA JOYCE 1956 290 COHEN, LARA A 1969 290 HAREUCK, BENJAMIN JOSEF i9w 297 BRACK, JOYCE A 1962 297 BRACK, TIMOTHY E 1960 297 SABET, WALLY M 1959 300 MAHONEY, THOMAS 1964 309 STROBEL, JOHN E 1942 309 STROBEL, SHIRLEY A 1942 312 DRISCOLL, THOMAS J 1930 322 ADAM, ALFRED D 1943 322 ADAM, DONNA M 1938 322 ADAM, SARAH A 1977 330 WILSON, CHARLES P 1944 330 WILSON, MICHELE A 1946 350 KIRK, PETER R 1963 350 PAPPAS-KIM L 1961 360 GEORGE, ELEANOR M i9m 360 GEORGE, THEODORA 1920 398 SULLIVAN, JAMES C 1972 398 SULLIVAN, ELLEN H 1942 404 GILLIS, LISA J 1965 424 MESERVEY, RICHARD MICHAEL 1795 424 MESERVEY, SUSAN JOY 179S 426 SENA, FREDERICK J 1963 ANDREWCIR I MORKESKI, MICHAEL 1952 1 MORKESKI, MELINDA 1980 1 MORKESKI. MARY ELLEN 1957 2 UFLER, J. ROBERT 1937 3 SATRIALE, LYNN 1956 3 PAGE, GAIL A 1951 4 FITZWATER, JEAN E 1926 5 DOYLE, RAYMOND 1922 5 DOYLE, SHAUN 1955 5 DOYLE, EILEEN 1927 6 CHASE. GEORGE M 1942 6 LETCH, BOBBIE ivis 6 FREEMAN, DOROTHY E 1925 7 BELISLE, ROBERT R 1950 7 BELISLE, JAMES R 1975 7 BELISLE, LINDA JEAN 1952 FORD, CHRISTOPHER 1895 LEDOUX, JOHN 1964 8 FORD, DONNA A 1965 8 FORDMARK 1965 9 ENGLISH, USA m 1962 9 FLANAGAN, DAVID P 1964 9 FLANAGAN,CATHYJ 1969 9 ENGLISH, SHAWN M 1956 10 CHEN, HUCY-RU 1963 10 YOUNG, ALBERT C 1959 12 GERRAUGHTY. JULIE E 1963 13 EPSTEIN. GARY J 1958 14 WALKER; PAULA N 1965 14 WALKER. KEITH W 1958 14 TREMBLAY, THOMAS M 1960 15 FERRANn, WILLIAM D 1950 15 FERRANTI, LAURIE A 1964 16 BROWN, MICHAEL 1870 18 BROWN, BONNIE 1870 16 KESSUEN. ROBIN M 1962 TOWN OF NORTH ANDOVER 1997 STREET LISTING P V STNO APT NAME YOB "o I P V STNO APT NAME YOB 05 ABB017 ST �'� 1963 05 05 8 HANNAN. KENNETH S 1w 250 05 8 HANNAN, KENNETH S JR 1973 WOLF, TERESA E 05 8 HANNAN, LINDA 1947 1947 05 275 HANNAN. LISA 1971 05 05 285 CAMPOLINI. ERNEST T 1945 338 05 25 CAMPOLINI. LINDA J 1954 ORIOL, JEAN H 05 37 UNIEJEWSKI. JOSEPH 1954 1946 05 37 UNIEJEWSKI. VIRGINIA 1953 05 * 05 49 JAWORSKI, RUDOLF A 1950 345 05 49 JAWORSKI, SUSAN K 1942 HUGHES, DIANE STRUGLINSKI 05 * 61 SARCIA, JOSEPH A 1946 1959 05 * 61 SARCIA, MICHELE JOSEPHINE 1947 05 * 05 * 76 CRAVEN, DAVID E 1951 361 05 * 76 CRAVEN. KATHLEEN A 1951 LURVEY. ROBERT 05 90 FORD, LISA M 1963 I w 05 96 GILLIS, ANNE M 1949 05 * 05 96 GILLIS, MICHAEL A 1947 383 05 96 GILLIS. RYAN MICHAEL 1977 CITTADINI. JH)IT'H"E 05 101 DAINOWSKI, LUCY M 1919 1956 05 1 01 DAINOWSKI, STANLEY 1920 05 * 05 110 TORREY, JOAN A 1932 429 05 110 TORREY. JOHN F 1931 HERMANS. SHIRLEY M 05 112 LEBLANC. DEBRA L 1962 05 112 LEBLANC, JOHN J 1961 0! 22 1122 MYERS, ELLEN B 1957 05 MYERS, ROBERT 8 1952 05 127 MIKA, GARY 0 1953 05. 127 MIKA, MARGARET A 195" 05 127 PENNEY, HELAINE M 1963 05 132 PEHR,CAROL 1944 06 132 FEHR,JONATHAN 1972 05 132 FEHR.MEGAN 1974 05 132 FEHR. WILLARD 1943 05 39 1,39 OU�NN. KAREN M 961 05 OU NN, MICHAEL J 11959 05 142 WESCOTT, ANDREW M 1963 05 142 WESCOTT. BETH M 19r>4 05 151 KRUPKOWSKI, MARGARET M 1962 gm 05 151 KRUPKOWSKI, MARK D 1960 IN 05 1 52 FITZGERALD, AUDREY K .1963 05 152 FITZGERALD, WILLIAM 1960 05 161 ROY. DONALD W 1952 05 161 ROY. DONNA J 1955 om 05 162 HANRAHAN. ARTHUR L 1941 it 05 162 HANRAHAN, REGINA G 1943 05 62 HANRAHAN, WILLIAM T 1967 05 171 DUFFY, ARTHUR X 1967 05 171 DUFFY, KATHLEEN C 1967 05 05 1 74 174 HELLA. CYNTHIA HELLA, MATTHEW D 1795 1976 05 174 HELLA, MICHAEL A 1972 05 174 HELLA, RICHARD A 1795 05 186 VELARDI, KENNETH C 1950 05 05 186 197 VELARDI, SALLY A PORTEN, JOEL S 1954 1964 05 197 PORTEN, PAULA L 1965 05 198 MARTIN, ANNE F 1947 05 198 MARTIN, CATHERINE A 1975 05 05 198 98 MARTIN, DONALD G MARTIN, ERIN M 1948 1978 05 198 MARTIN, KELLY T 1978 05 * 200 1 MATOLA, LINDA J 1957 05 * 200 1 MATOLA, WILLIAM G 1962 05 200 1 MUFICKO, DANIELLA 1977 05 210 O'REILLY, LORI A 1962 05 * 210 O'REILLY, MICHAEL J 1957 05 * 213 BEAULIEU. JULIE E 1956 05 * 213 EARNSHAW. FREDERICK W 1944 05 * 220 BURKE, JAMES C 1947 os 220 BURKE, JAMI M 1979 05 220 BURKE, JENNIFER M 1973 05 220 BURKE, KAREN M 1951 05 225 FROST, ALICE 1914 05 226 VOGEL, AMY 1973 05 226 VOGEL. DIANE M 1946 05 226 VOGEL. KIMBERLY GENE 1976 05 226 VOGEL. STUART 8 1945 05 230 MUNJAL MANOJ 1961 05 230 MUNJAL. PREETI N 1963 05 240 BORERI, CARRIE ANNE 1964 INDICATES VOTER "o I P V STNO APT NAME YOB 05 240 BORERI, KEVIN 1963 05 250 WOLF, HEIDI 1974 05 250 WOLF, PHILIP B 1941 05 250 WOLF, TERESA E 1946 05 275 NIEMI, SANDRA C 1947 05 275 NIEMI, WAYNE J 1952 05 338 IPPOLITO, MARY E 1943 05 338 IPPOLITO, THOMAS D 1936 05 339 ORIOL, JEAN H 1939 05 339 ORIOL, NANCY E 1946 05 * 339 ORIOL VALERIE 1977 05 * 345 WONDRASCH, CRAIG 1961 05 * 345 WONDRASCH, SHARON D 1958 05 * 353 HUGHES, DIANE STRUGLINSKI 1964 05 ' 353 HUGHES, TIMOTHY C 1959 05 ' 356 1 BURKARDT. PAMELA H 1953 05 * 356 1 BURKARDT. THOMAS M 1958 05 * 361 LURVEY. DEBORAH J lD63 05 * 361 LURVEY. ROBERT I D60 05 * 364 DUFRESNE. ELIZABF I w 05 ' 364 DUFRESNE. SHAV�':. 1971 05 * 383 AVERK4, FAYE L 1913 055 * 383 AVERKA, JOS-:P!" 1953 05 ' 417 CITTADINI. JH)IT'H"E 1956 05 * 417 CITTADINI. PETER 1 1956 05 * 417 GATTO, NANCY V 1954 05 * 417 GATTO. VINCENT J 1956 05 ' 429 HERMANS, JOSEPHT 192E 05 ' 429 HERMANS. SHIRLEY M 1928 ACADEMY RD 04 32 GOWDY, GERALDINE F 1961 04 32 GOWDY, TREVOR A 1956 04 56 MUSSER, KATHLEEN E 195C 04 56 WALKER. DAVIE) M 1979 04 56 R ADAM. DANA C 1970 04 83 MCGAULEY, DEBORAH ANN 1952 04 83 STEVENS. CAROLINE R 1919 04 83 STEVENS. KATHY C 1943 04 84 BISSONNETTE, DANIEL R 1965 E4 84 CRANSTON. WILLIAM S 1963 04 84 EVANS, JUSTIN 1978 04 84 VENES, ROBERT 0 1937 04 84 VENES, SHARON K 194�1 04 * 114 BLANCHARD, FORREST SUMNE 1943 04 ' 114 BLANCHARD, LINDA MAE 1w 04 ' 135 HOPKINS, DARREN T 1976 04 * 135 HOPKINS. GREGORY T 1947 04 135 HOPKINS, KRISTAN S 1973 04 ' 135 HOPKINS, LESLIE M 1947 04 * 140 STEVENS, AMELIA F 1962 04 * 140 STEVENS, NANCY L 1936 04 * 140 STEVENS, ROBERT 0 1927 04 * 140 1 STEVENS. EDMUND 8 196-. ACUSHNETST 03 ' 16 VASAPOLLI, ARLENE K 1955 03 * 18 JACKSON, GAIL P 19E 1 03 ' 21 BROMBERG, STEWART L 1957 03 21 NISHIO, HIROYUKI 1954 03 21 NISHIC, SHITOSUE 1960 ADAMS AVE 03 * 10 MIELE, GLORIA M 1927 03 16 DALY, SUSAN 1955 03 - 16 PERKINS, ROBERT P JR 1955 03 - 18 CONROY, DANIEL SCOTT 1978 03 is GALLO,PETER 1973 03 * 23 DUFRESNE, ROBERT H SR 1941 03 * 23 DUFRESNE, WILLIAM T 1795 03 ' 27 DODGE. FREDERICK J 1933 03 - 27 DODGE. MARIE A 1930 03 * 30 ROUND, BRUCE D 1958 03 * 30 ROUND. KIMBERLEE L 1964 03 * 35 STROM. DANIEL J 1954 03 * 35 STROM, YUYING M 1959 03 * 38 PROVENICAL CHERYL ANN 1960 -,A0 4 (6 6 ED Town of North Andover Massachusetts STEVENS MEMORIAL LIBRARY 345 MAIN STREET NORTH ANDOVER, MA 01845 A S 0 F A N U A R y 1 9 a 6 Celebrating 350 Tears A)y 6 9 4 9 6 6 -Reaistrars Toard of J1 , p W., 3oyce LA Tradshaw, 7own Clerk ("Mnd� Xeo Cafond 7 iden 'T"y 17.445 TOWN OF NORTH ANDOVER 1996 STREET LISTING PCT STNO AP T NAME yoB OCCUPATION ABBOTT ST - - IS41 HOMEMAKER 05 8 HANNAN, KENNETH J 1973 STUDENT 05' 8 HANNAN, KENNETH S 19" SELF-EMPLOYED as* 8 HANNAN, LINDA 1947 SELF EMPLOYED 05* 8 HANNAN, LISA 1971 STUDENT 05* 2S CAMPOUNI, ERNEST T 1545 TRUCK DRIVER as, 25 CAMPOLINI, LINDA J 1964 SECRETARY 05* 37 UNIEJEWSKI, JOSEPH 1964 MANAGER 05* 37 UNIEJEWSKI, VIRGINIA 1953 HOMEMAKER as* 49 JAWORSKI, RUDOLF A 1950 ATTORNEY as* 49 JAWORSKI, SUSAN K I S42 FIN 05* 61 SARCIA, JOSEPH A 1946 SUPERVISOR as* 61 SARCIA, MICHELE JOSEPHINE 194T INS MGR as* 76 CRAVEN, DAVID E DUFRESNE, ELIZABETH A 05* 76 CRAVEN, KATHLEEN A DUFRESNE, SHAWN R 05 so FORD, USA M 1963 ACCOUNTANT 05* se GILLIS, ANNE M IS49 R.N. 05* es GILLIS, MICHAEL A 1947 INSURANCE 05 96 GILLIS, RYAN M 19T7 05* 101 DAINOWSKI, LUCY M 1919 RETIRED 05 101 DAJNOWSKI, STANLEY 1920 RETIRED as* 110 TORREY, JOAN A 1932 AT HOME 05* 110 TORREY, JOHN F 1931 ELEC.ENG. 05* 112 LEBLANC, DEBRA L 1962 ENGINEER 05* 112 LEBLANC, JOHN J 1961 ENGINEER 05*122 MYERS, ELLEN 6 1957 RESPIRATOR TH 05*122 MYERS, ROBERT B 1952 PHYSICIAN 05* 1Z7 MIKA, GARY D 1963 PERSONNEL MGR 05*127 MIKA, MARGARET A 1961 ATHOME 05' 177 PENNEY, HELAINE M 1963 05* 132 FEHRCAROL IS" SECRIETARY 05 132 FEMR.JONATMAN 1972 FOOD SERVICE 05* 132 FEHRMEGAN 1974 UNION COLLEGE 05*132 FEHR, WILLARD 1943 BUSINESS MAN 05* 139 QUINN, KAREN M 1961 BOOKKEEPER 05* 139 QUINN, MICHAEL J 1969 PROPERTY MANA 05* 142 WESCOTT. ANDREW M 1963 MARKETING MAN 05* `142 WESCOTT, 13ETH M IS" CHEM.ENG. as* 161 KRUPKOWSKI,.MARGARET M 1962 HOMEMAKER 05* 151 KRUPKOWSKI, MARK D 1960 SELF EMPLOYED 05* 152 FITZGERALD, AUDREY K IM ENGINEER 05* 152 FITZGERALD, WILLIAM 1960 MANAGER as* 161 ROY, DONALD W 1962 SOCIAL WORKER 05* i6l ROY, DONNA J 1955 TEACHER 05*162 HANRAHAN, ARTHUR L 1941 SALESMAN 05*'162 HANRAHAN, REGINA G 1943 HOUSEWIFEfBOO 05*162 HANRAHAN, WILLIAM T 1967 SOCIAL WORKER OS* 171 CONNELLY, HEIDI A 1960 HOMEMAKER as* 171 CONNELLY, MIC14AEL C 1960 PHYSICIAN 05* 174 HELLA, CYNTHIA RN - 05 174 HELLA, MATTHEW 0 1976 G5* 174 HELLA, MICHAEL A 1972 05*174 HELLA, RICHARD A MECHANICAL EN 05* 186 VELARDI, KENNETH C 1960 SECURITY COOR 05* 186 VELARDI, SALLY A 19" HOME 05* 198 MARTIN, ANNE F 1947 BOOKKEEPER 05 198 MARTIN, CATHERINE A 1975 COLLEGE 05*198 MARTIN, DONALD G 1948 CERT. DENTAL 05 198 MARTIN, ERIN M 1978 STUDENT as 198 MARTIN, KELLY T 19718 STUDENT 05* 200 1 MATOLA, LINDA J 1957 TEACHER AIDE 05* 200 1 MATOLA, WILLIAM 0 1962 ENGINEER 05 200 1 MURCKO, DANIELLA 19T7 05 210 VREILLY, LORI A MGR 05 210 O-REILLY, MICHAEL J 1957 MGR 05* 213 BEAULIEU, JULIE E 1966 SALES MANAGER 05* 213 EARNSHAW, FREDERICK W 1944 ACCOUNTANT 05* 220 BURKE, JAMES C 1947 MGR FINANCE 05* 220 BURKE, JENNIFER M 1973 05* 220 BURKE, KAREN M 1961 HOME 05* 226 FROST, ALICE 1914 RETIRED 054226 VOGEL, AMY 1973 STUDENT 06* 226 VOGEL, DIANE M 1946 HOUSEWIFE 05* =6 VOGEL, KIMBERLY GENE 1976 05* 226 VOGEL, STUART B IMS SALES REP. 05* 230 MUNJAL, MANOJ 1961 ENGINEER 05 230 MUNJAL, PREETI N 1963 ENGINEER 05* 240 RUANE, DAVID P `1938 SALES * INDICATES VOTER PAGE 1 PCT STNO APIT NAME Y08 OCCUPATION 05* 240 RUANE, JUDITH A IS41 HOMEMAKER 05* 250 WOLF, HEIDI 1974 COLLEGE 05* 250 WOLF, PHILIP 9 1941 VICE-PRES. CO 05,250 WOLF, TERESA E 1946 HOMEMAKER 05* Z75 DEPIPPO, JOHN E 1967 ACCOUNTANT 05* 275 DEPIPPO, MARIA A 1957 ATHOME 05* 338 IPPOLITO, MARY E 1943 SECRETARY 05* 338 IPPOLITO, THOMAS D 1936 RETIRED 05 339 ORIOL, JEAN H 1939 SELF EMPLOYED 05* 339 ORIOL, NANCY E 1S46 SELF EMPLOYED 05* 339 ORIOL, VALERIE 1977 STUDENT 05* 356 1 BURKARDT, PAMELA H 1953 SALES/ADMINIS 05* 356 1 BURKARDT, THOMAS M 1958 DIRECTOR 05* 364 DUFRESNE, ELIZABETH A 1946 ACCOUNTING TE 05* 364 DUFRESNE, SHAWN R 1971 CARPENTER 05* 383 AVERKA, FAYE L 1913 AT HOME 05* 383 AVERKA, JOSEPH J ISS3 PHOTOGRAPHER 06* 417 CITTADINI, JUDITH E 19SS HOMEMAKER 06* 417 CITTADINI, PETER 1 1956 SALES 05* 417 GATTO, NANCY V 1964 05* 4`17 GATTO, VINCENT J 1956 05* 429 HERMANS, JOSEPH T 1926 RETIRED 05* 429 HERMANS, SHIRLEY M 1928 AT HOME ACADEMY RD 04* 32 GOWDY, GERALDINE F 1961 04* 32 GOWDY, TREVOR A 1956 04* 56 MUSSER, KATHLEEN E 1950 CLERGY 04* 56 R ADAM, DANA C 1970 LANDSCAPER 04* 83 STEVENS, CAROLINE R 1919 ATHOME 04* 83 STEVENS, KATHY C iso TEACHER 04' 84 BISSONNETTE, DANIEL R 1966 STUDENT 04* 84 CRANSTON, WILLIAM S 1963 SOFTWARE ENGI C4 84 EVANS, JUSTIN 1978 04* 84 VENES, ROBERT 0 1937 MANAGER 04* 84 VENES, SHARON K 1942 RECEPTIONIST 04* 114 BLANCHARD, FORREST SUMN 1943 04* 114 BLANCHARD, LINDA MAE 1S46 04 135 HOPKINS, DARREN T 1976 CORNELL UNIV 04* 135 HOPKINS, GREGORY T 1947 MANAGER 04 135 HOPKINS, KRISTAN S 1973 CORNELL UNIVE 04* 135 HOPKINS, LESLIE M 1S47 HOMEMAKER 04* 140 STEVENS, AMELIA F l9s2 SOCIAL WORKER 04* 14.0 STEVENS, NANCY L 1936 04* 140 STEVENS, ROBERT D 1927 RETIRED 04* 140 1 STEVENS, EDMUND B 1963 DISHWASHER ACUSHNETST 03* 18 JACKSON, GAIL P 1951 03 21 NISHIO, HIROYUKI 1954 MADICO ENGINE 03 21 NISHIO, SHITOSUE 1960 ADAMS AVE a 10 MIELE, GLORIA M 1927 RETIRED 033: is PERKINS, ROBERT P JR 1956 03 is ZAJDI, FATIMA F Is" 03 is ZAJDI, FEROZ S 1947 03 is GALLO,PETER 1973 03* 23 DUFRESNE, ROBERT S 1941 MASS. ELECTRI 03- 23 DUFRESNE, WILLIAM T 03* 27 DODGE, FREDERICK J 1933 RETIRED 03' Z7 DODGE, MARIE A 1930 AT HOME 03' 30 ROUND, BRUCE D 1968 MERCHANT 03* 30 ROUND, KIMBERLEE L is" OFFICE MANAGE 03- 3s STROM, DANIEL J `1964 03- 35 STROM, YUYING M 1959 03* 38 PROVENCAL, CHERYL ANN 1960 03- 38 PROVENCAL, PAUL N 1963 03* 39 MAHAN, FREDERICK J iSI8 REnREO 03- 51 LAWLOR CHAD R 1977 03- 51 LONG,DEBRA 1966 0 51 LONG, MICHAEL 1962 NJLF.D. 033: 52 MANOS, JAMES 1923 RETIRED 03* 59 RITTER, CHRIS R 19S9 MACHINIST 03* 59 RITTER, HAROLD W 1929 EXTERMINATOR 03* 59 RITTER, JOANNE E '1932 PATIENT ACCTS lw(NctAeL.L-,,previ'oos OLL)L5�,p<(4 il AMPTON N WIRA. 1-1 A LEY E i NA E E AN B AMES R I A M ERESA L ELLY J BERT JR 4YA 'A T k B kM R A iTOPHER I CORNELIS j I MARY E !N A 'N A ;HUR S iNE M R ULIE AWRENCE G S L PH L ARFNE RI HARD ISHE ALICE M INE M EN L M P iN R PAGE 121 SALES/MARKETING ;TG BANKER ETAIL STORE NCR RETIRED R ETIRED MILITARY ACCT REP DISTRICT KGR ACCT EXECUTIVE �914 HOUSEWIFE ,908 RETIRED .944 RN .975 �948 INVESTMENT BAVK�R 950 CUSTO ER SERVICL 961 COLLEGE PROFESSOR 94� SAFET AD Y MINISTRATOR 946 947 964 R.N 963 BUSINESS MGR 963 DESIGNER 939 TEACHER 939 ENGINEER 939 ENGINEER 931 RETIRED 958 DESIGNER 962 CONSTRUCTION 974 937 HOUSEWIFE 932 PHYSICIAN 955 SYSTEMS PROGRAMMER ;28 ?07 ?61 ?6j )4 SALES 058 CUST SVC MGR NO. ANDOVER PRECINCT 4 NO. APT.# NAME ........................ "MUPIN; ......................... BORN OCCUPATION m ....... GOO Di G GERALDINE :D TREVOR ............ F 961 EVANS ELIZABETH A T 956 GEN NG I WCCM/WCCY KITTREDGE NANCY A 1956 A:T N SSER KATHLEEN E 1956 SISTORIAN 5 LE 6 TOCKDALE SID 1930 CLERGY 6 R ADAM DANA 1954 CANE LINDSEY C 1970 LANDSCAPER STEVENS CAROLINE R 1953 FLIGHT ATTEND STEVENS CORNELIA R 19 9 AT HOME 3 EVENS; KATHY C I 9 3 FLIGHT ATTENDANT 14 B SSONNETTE DANIEL R 19 3 TEACHER CRANSTON WILLIAM 6 1965 STUDENT 14 4 VENES ROBERT 4 VENEs SHARON 0 K 1963 1937 SOFTGWARE ENGINEER MARA ER BLANCHARD FORREST M 1942 RECEPTIONIST 4 BLANCHARD LINDA 1943 4 WIN HELL 114 M ELIZABETH 1945 WI HELL PA L 1951 CHEMIST 5 HOP INS DAR W EN T 1951 SHEET METAL NECH. HOPKINS GREGOR 1976 55 HO KINS KRISTAN Y T 1947 HOPKINS LESLIE 6 M 1973 CMANAGER ORNELL UNIVERSITY 1450 STEVENS NANCY LEE 1947 HOMEMAKER STEVENS ROBERT 1936 [40 40 STEVENS SAMUEL D 1927 RETIRED 140 1 STEVENS EDMUND H 1961 B IT,rnT-P WAV 1963 DISHWASHER il AMPTON N WIRA. 1-1 A LEY E i NA E E AN B AMES R I A M ERESA L ELLY J BERT JR 4YA 'A T k B kM R A iTOPHER I CORNELIS j I MARY E !N A 'N A ;HUR S iNE M R ULIE AWRENCE G S L PH L ARFNE RI HARD ISHE ALICE M INE M EN L M P iN R PAGE 121 SALES/MARKETING ;TG BANKER ETAIL STORE NCR RETIRED R ETIRED MILITARY ACCT REP DISTRICT KGR ACCT EXECUTIVE �914 HOUSEWIFE ,908 RETIRED .944 RN .975 �948 INVESTMENT BAVK�R 950 CUSTO ER SERVICL 961 COLLEGE PROFESSOR 94� SAFET AD Y MINISTRATOR 946 947 964 R.N 963 BUSINESS MGR 963 DESIGNER 939 TEACHER 939 ENGINEER 939 ENGINEER 931 RETIRED 958 DESIGNER 962 CONSTRUCTION 974 937 HOUSEWIFE 932 PHYSICIAN 955 SYSTEMS PROGRAMMER ;28 ?07 ?61 ?6j )4 SALES 058 CUST SVC MGR 01/08/260B 09:08 FAX 978 685 5800 CARLSON-SMAG TOWN OF NORTH ANDOVER MASSACHUSETTS NORTH ANDOVER OLD CENTER HISTORIC DISTRICT COMMISSION 10 Qu I I VV I January 6, 20D6 VIA FACSIMILE 978 69.89542 Building Inspection Town of North Andover North Andover, MA 0 1845 TO WHOM IT MIGHT CONCERM Please be advised that repairing the ametural,damage for the propetiy at 114 Academ y ROad-, does not need approval of the Historical Commission. Section 6B I exempts ordinary maintenance, replacement and repair ftom the b�ylaws. It therefore does not need approval from the Olde Center Historical District Commission. Any questions please call me at 978 685 5000. Sincerely, George 11. Schruender, Jr. Chairman North Andovcr Historical District Commission H. CROWELL FREEMAN, JR. ATTORNEY AT LAW 76 CANAL STREET, 4th FLOOR BOSTON, MASSACHUSETTS 02114 (617) 367-3137 FAX (617) 367-6491 November 6, 2005 EMAIL HFreemanlaw@aol.com Gerald Brown Inspector of Buildings Community Development 400 Osgood Street North Andover, MA 01845 RE: 114 Academy Road: Request for Determination of Number of Units Dear Mr. Brown: I am writing you on behalf of my wife Kathy Stevens, who is the owner of 83 Academy Road, North Andover. It has come to her attention that William Barrett has submitted an Application and Plans to allow a five unit condo conversion of 114 Academy Road. The initial application was denied on August 18, 2005 by Michael McGuire, then acting building inspector. A review of the initial application filed by Mr. Barrett indicates that this application characterized current B-3 existing use of this property as a two to three family building. The denial of this application by Michael McGuire, acting bluilding inspector, indicates that this property is a 3 Family. There is an asterisk before the word three family and this denotation is not explained in the face of the document. My wife questions this characterization. She asks that you determine how many units are in the house now and when each unit was issued a permit for construction. We offer the following four documents for your examination in this determination process. The first of these documents (attached) is the realtor's, Valerie Duffield of Caldwell Banker, listing of this property which identifies it as a single family. The second document is a home inspection done by John Ward of Homestead Report dated June 28, 2005. This report, which is attached, characterizes the building as a 2 family, Colonial (see page two). The third document is the North Andover Assessor's Office Property Record Card, printed on 11/4/05(attached). This document characterizes the property which identifies the use code as 104 -TWO -FAM -RES. Finally we have attached a copy of the Title Five report dated April 2, 2005, which states that the property has five bedrooms and three persons living on the premises. My wife, whose family have resided at 83 Academy Rd. for many years, believes that this second unit at 114 Academy Road may have been a in-law apartment. We would appreciate your reviewing these materials and any other information which you may deem appropriate and advise us of your determination at home at 978-683-5522 or crowtuck@aol.com. Thank you for your cooperation in this matter. 114 Academy Rd. North Andover, MA Index Of Information 1. Real Estate Listing by Valerie Duffield, Coldwell Banker 2. Active Building Permit Application and Permit 4281 3. Building Permit Application for five (5) unit condo conversion, proposed parking and five car garage plan, Zoning by-law denial 4. Homestead Report (see page 2 Building Type) 5. Assessor's Report (Listed as two (2) Family) 6. Title V Report (see page 6) # of Bedrooms Valerie Duffield Coldwell Banker 978-4824110 114 Academy Road North Andover, MA 01846-4022 Single Family MLS #: 70186588 Status: Sold List Price: Sale Price: $1,=,000 $1,184,OW List Date: Sale Date: 10/4/2005 516/2005 Days on Market: 91 Off Market Date: 6/22/2005 County: Area: Essex County Property Features Room: 17 Style: Antique Bedrooms: 5 Type: Detached Full Bath: 5 Acres: 1.57 Half Bath: 2 Lot Size: 68389 sq. ft. Master Bath: Yes Gross Living Area: 4947 sq. ft. Living Room: Foundation Size: 40xlS;16x23;35x Fireplaces: 7 (Fieldstone) Year Built: 1820 Garage: 2 Attached, Storage Color: white Parking: 6 Off -Street L "r,%, A WL - PIN a 17 Photos 0 Room Descriptions Features Room Level Size Features Appliances: Range, Dishwasher, Reffigerator Living Room: 1 14x14 Fireplace, Hard Wood Basement: Yes Partial, Interior Access, Bulkhead, Sump Floor Pump, Concrete Floor Dining Room: 1 21x14 Hard Wood Floor Construction: Frame Family Room: I 17x14 Wall to WaR Carpet Cooling: None Kitchen: I 16xii Hard Wood Floor, Electric: Circuit Breakers, 200 Amps Say/Bow Windows, Exterior: Clapboard Dining Area, Pantry Exterior Features: Porch, Inground Pool, Barn/Stable, Master Bedroom: 2 17x14 Fireplace, Hard Wood Screens, Fenced Yard Floor Heating: Central Heak Hot Water Baseboard, Oil Bedroom 2: 2 14x14 Hard Wood Floor Hot Water: Oil, Tank Bedroom 3: 2 12x12 Hard Wood Floor Interior Features: Security System, Cable Available, Walk - Bedroom 4: 2 1Sx13 Hard Wood Floor up Attic Bedroom 5: 3 1Sx19 Fireplace, Hard Wood Lead Paint: Unknown Floor Road Type: Public, Paved, Publicly Maint. Bath 1: 1 Full Bath, Hot Tub/Spa Roof: Asphalt/Fiberglass Shingles Bath 2: 1 Half Bath Sewer and Water: City/Town Water, Private Sewerage Bath 3: 2 Full Bath Waterfront: No Laundry: 1 Den: 2 17x12 Hard Wood Floor Other: 1 17x14 Fireplace, Walk-in Closek Hard Wood Floor Game Room: 3 19x17 Cathedral Ceils, Hard Wood Floor OUW: 3 23x13 Hard Wood Floor Other: 1 15x10 Fireplace, Hard Wood Floor Bathroom: 3 Full Bath Remarks Tax Information Pin #: M1:00096 B:00035 L:00000 ciailk-Stevens House in historical North Andover distrkt Assessment: $684,400 on 1.57 acres with mature plantings & gorgeous vistas. Taxes: $7885 Tax Year: 2005 5+ bedrooms, 7 FPs, 5 full & 2 half baths, updated furnace, electric, & plumbing, 2 staircases, fabulous 3rd Book: 4062 Page: 6 http://h3d.mlspin.com/search/Print—Reports.asp 11/5/2005 .). -03MLS ." A"El� — — — floor, garage, shed & pool. Cert: Zoning Code: R3 Map: Block: Lot: Listing Inforipation Drections: Old Center to Academy Original Price: $1,184,000 Showing: Sub -Agent: Call Ust Office, Call Ust Agent, Acoompanied Sub -Agent Comp.: 2.S Showings, Appointment Reqd, Sign Showing: Buyer -Agent: call Ust Officer Call List Agent;r Accompanied Buyer Agent Comp.: 2-S Showings, Appointment Req'd, Sign Showing: Facilitator — Facilitator Comp.: Special Showing Instructions: Start May 12th Ust Agent sets up a accompanies all showings Exclusions: Call listing agent Usting Agreement Type: Exclusive Right to Sell Disclosures: Entry Onfy: No Firm Remarks: Showings start May 12th. List Agent sets up & accompanies Usting office: Prudential Howe & Doherty [B (978) 475-5100 Ext. 2236 Usting Agent: Amy Sebell [B (978) BOB -1852 Team Member: Sale Office: Ullian Montalto Signature []3 (978) 47S-1400 Sale Agent: C. Richard Barrett [B (8") 681.0 The Infonnation in this listing was gathered from third party sources Including the seller and public records. MLS Property Information Network and Its subscribers disclaim arry and all representations or warranties as to the accuracy of this Information. Coftent 02ODS MLS Property Information Network, Inc. htup://h3d.ndspin.com/search/Print—Reports.asp 11/5/2005 gnaturc 27 9 - 3 .2 Registered Home mprovcmcnt Contractor Not Applicable o Company Name Registration Number Address z Signature Telenhn�- Expiration Date TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT !ELA_%8EMvATF OR DEMOLISH -AO ORTWO ILY DWEL LING FAM "1011 SIM1641111 filir BUILDING PERMIT DATE Is C SIGNATURE Building Commissioner/I r of Buildings Date SECTION I-SITT INFORMATIO 1.1 t Property Address: 1.2 Assessm Map arcel Numbw. AcaclervNv Qd 9 (P - Map Number —Parcel Number 1.3 Zunirig 1.4 PrOPertY Dimenstons: P, Z,Mi,g DjaZid Prolmsed Usc 1.6 BUMDING SETBACKS (ft) Lot Am (sn FrORtA Front Yard- Si(k, Yard Rear Yard Required Provide 7- R6qair6o Provided Rcquired Ptrovid�ed I.Mder SW*PAGLC-40.154) ZoIr 1.5. Flood Zan 134o"I Syst= Public 0 Privw 0 OuWde Flood Zone 0 Munkipid 0 sy'. 0 00 Site Dispoe 0, SECTION -2 ��'PROPERTY OWNEItSHIMAUTHORIUD A41;E UlStj"Ct: Yz-.3 0 2.1 Owner of Record A—) IM A-CL&�� i�rre�ff HC)Mt5 —IC)qq -rl -t- AX A: -.) r rip', V Cy Name ( P1 nt Address tor Service 1 -� /ok �/ . Pr, Signatu"'. . . . . . . 2.2 Owne; r of Record: Namq,�rint Address for Service: Sidfiatdre Telephone SECTION 3 - CONSTRUCTION SERVICES 90 3.1 Licensed Construction Supervisor: C 0 7-4- Not Applicable 0 Licensed Construction Supervisor: 0 , (OLD, AeNd&je,- License Number Address Q: E iration Date gnaturc 27 9 - 3 .2 Registered Home mprovcmcnt Contractor Not Applicable o Company Name Registration Number Address z Signature Telenhn�- Expiration Date Ir V�. SECTION 4 - WORKERS COMPENSATION (KG -1- C 152 § 25c(6) workers Compensation Insurance affidavit must be completed and submitted,with this application. Failure to provide this affidavit will tesult in the denial of the issuance of the buil4Ldi permit. Signed affidavit Attached Yes ....... 19" . No ....... 0 ACTIONS Description o Proposed Work (cht"ek appliceble on - 0 New Construction 0 Existing Building W s) '13" Altcrations(s) 0 Accessory Bldg. n Demolition 0 Other 0 Specify Brief Description of Proposed Work; IS ()()r nt �-,d-s 0' n'cl S.1 I 1 10 �k ek- k- k 01 e_.a , '-)n itern Estimated Cost (Dollu) to be Completed by pennit applicant OMCIAL USE ONLY 1. Building (a) Bulldm g Pernit Fee Multiolier NU 2 3RD 2 Electrical (b) Estimated Total Cost,of Constructi on 3 Plurphing Building Permit fee (a) x (b) ....... 4 MeChMliW (HVAC)1 THICKNESS 5- X 6 Total (1+2+1�--44-5) I F 00& Check Number T- SftnON 7a OWNER'AIITHORUATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERAUT as Owner/Authorized Agent of subject property Hereby. authorize to art oil My behalf, in all matters relative to work authorized by this building permit applicatiodn. Signature of Owner Date vwe,,rY^PJ -ru r%U/%JV1D1A1rr1=i(%D1F71V" AVIRMT "VVY AIDATIWIN as 0 er/Authorized Agent of subject property Hereby declare that the, statements and information on the foregoing application arc true and accurate, to the best of my knowledge and belief e. Print Q) -7 105 Si ture of Owner/Agent Date 140. OF STORIES SIZE BASEMENT OR SLAB tJ1'A-5-e(n (',A -t7 777, T -1 - 1-1-tk/ SIZE OF FLOOR TRABERS NU 2 3RD SPAN DMENSIONS OF SILLS DUVIENSIONS OF POSTS DINENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL I OF CHDANEY IS BUILDING ON SOLD) OR FELLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 44 0 o P4 u x 0-4 %W qw,. ui ca 0 CO .0 co:, U com.. IL w cc 0 CE :.,a- 'o US 10 0 CL cm mi c 0 A ct AM CLL) QW: CD Acoo 4D CLO" 0 C,O uj :L S CL LU CD U ca CLS Cc U) z 0 �D 0 u C/) U) 7 -- ow C40 a 2 Zv P� 4-A TZ3 G3 C3 E 4D G3 CL cm Ea CD E cc cc G3 0 CD, a— I-- = CL. CL. Cc 0 0. co co Z C3 a) CL C.3 W cc cc CL C42 w LLI U) C9 LU LLI C9 w w U) TOWN OF NORTH ANDOVER BUILDING DEPARTMENT kPPLICATION To CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING se BUILDING PERMFr NUMBER: DATE ISSUED: SIGNATURE: Building Commissioner/Inspector of Buildings Date %RCTION I- SITE WFORMATION 1.1 Property Address: 1.2 Assessors Map and ParcGI Number: 15-6— Map Number Parcel Number 1.3 Zoning Information: 1-4 Property Dimensions: 3 Zoning District Proposed Use Lot Area (sf) Frontage (ft) 1.6 BURDING SETBACKS (ft) Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 30 -yo -P o' —+T: Z-6 K - e z- 3 c, J-- ,Q / C) 1.7 Water Supply M.4aL.C.40. 54) 1.5. Flood Zone Information: zooe Outside Rood Zone K 1.9 Sewerage Disposal System: Municipal 0 T(3 C- on Site Disposal System Public X private 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT --Thi,,7t7,5r1c Distj,jc-�: Yes 2.1 Owner of Record i5orp.7t Name (P int) '5 Telephone 2.2 Owner of Record: Name Print ' &Y ,, Address for Senice : Address for Service: SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable 0 dllllll,l—�;�,,,� Ac -,- Licensed Construction Supervisor� A- License Number Addre S /yzzx Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Company Name Add,ess, Not Applicable 0 Registration Number Expiration Date ou M X z 0 SECTION 4 - WORKERS COTIM"It'NSA TFON (INI, G. L —25—c(-6) -I 2 -V'Orker, —Compensation �iTA- ---L— in the denial of the issuance 01, tile buildi Sublylitlicd with this applicatiot. Failureto provide this affidavit will r, lu"U'rig permit INO ....... i�j SECTIONS Dkscr' "Or Of Pro evk lao,kahk' 0' P i�elxCoiistructio Existing BwAdijw, F1 Repair(s), 0 Aliciationq-) 'Addition 0 soi�� 7 molition Other 0 Specify 131-icf De"Scriptiol I of' Proposed wc)T--- �50 c-V'7v SECTION 6 - EST ATED CONSTRLJCTION COSTS Estimated Cos t �(-Dol lar) to be OFFICIAL SLi ON COM Ly leted b�, rmit a licant Building (a) Building, Permit Fee Maltipher t E-stinia(ed Total Cost Of 3 PILwuiib Ing Coristructiorl Build ig, Permit fee (a) x (b) ]4 Mechariicaj (HvAc) an' P -t-On 5 Fire Protection 6 T I + Total (1+24-3+4+5 S SECTION 7, OWNER 11,51ORIZATION T, Check Number ECTION 7a OWNER AU - ORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUI1,D1NG PER 'IT as O-v�7,,cr/AtiffioriZed Agent of subject property Flereby authorize---- to act on IMY behalf, in all matters ielativelte, work authori7ed bv this b-uilding nnitapplication- Signature of O��qlel -!iE . CTION 7 . b OWNER/AUTHORIZED AGENT DECLARATION Eat, property ---tas OWDer/Authorized Agent of subject I-leteby declare that the statements wid information on the foregoing applicaLion are true and accurate, Wid belief' to the best of my knowledp Print Nanic Si91-1atUF(-Of0�,%m-r/A 0 1,101:11:171 -03'' Oil 317 NO. - S17L BASE STAB a— SlZi '1' 0 F F 1, 0 R ITM B I RS SPANT 3` DP,vll--NSfO\-'S OF STL1,S Mlvi,P�SJONS OF POSITS S T IT, ( I —IR T HEI G I A' UUNJ). THICKNESS —S 17 E OF FOOTi1,TG x 2,4/� !]:,R1A.[, OF CI [[[vlt,�! ANIT), JS 13 M.:)ING ON SOLIT) I I f,,C]T, ri To fj�-iVj. GAS, 1,TNTV7 i 1,ii PECTION PLA:' A w VC R— RAW MA. hytri 1181-Ir—kJAP-0 1 lof.:3S46 L3 or_ plan No. m par Cl ty/TOwn of We,. A WM�c—c�- Q. Tax Assessors Map. '5AV1"6,S _R + 4 �JOSEF% S'T'. C- CE E -r -l -Z -r 4- hereby certify that the above Nortga9t inspection Plan was prepared for us# [a connection witk a nfv Mortgage and is not Amdtil or r#�rtventd to be. a property lint or land survey. It cannot be used for establishing fenctt badge f walls or building mm Me r sponsibility Is eitmdtd herein to the land ovaor or occupant. The location of the original building(s) as shown 'rffiv Vas ;" C01911ance with the local applicable zoning bylaws in effect when constructed, with respect to horizontal sensional requiresenti, to lot lines or is extept fro* violation inforcovent action under Mass G.L. Title Vil, Chap. 40A, Sec. unless otlitrvise shown herein. Subjtct building(s) ties in a flood zone designated Zones_ X and shown an RK map Comounity-Pantl I 2-5012:2jajC). Datodt - C' -Z - 5 3� job No. 0 T- 4,YD 4 JCO, lKURnRATEO, LAMI USE i DEVELOPMENT CONSULTANTS 4 AUTUMN LAKE, KETMEN, MA 01844 508-683 Zoning Bylaw Denial Town of North Andover Building DeParUnsnt 400 Osgood St. Norat Andover, L pwria 97&4%&sw Fax 979 6" 1116-49 ,e '% ��, 0 A.1 On . . ....... RL �� :: . n and PISMMS your Applica6an is piesse be mWised UM ~ review of you, Appl g Bw masons, DENIED for #w ft�ng ZonLn I BYMw m"On'_' no /Ic - J we 0 Specia pumim pmnning Bosird Item Notes variance Acme otlw #= ronteas Special Permit Pwwn Variance FMfte Exception Lot Special Lot area lnwfteflt Corn Permit mon Ddvwmv Special 2 Lot AMR Preexisting ,LIS S Continuing Retirement SPIM POMIR ,=� Lot Complies I Ind"Wwant Sderly H*Ain Large Estate Condo I Permit ASMS111 �PWM�M EarM Ramy�wWS '0 - j� I , )ScWI _permjtZSA — - Use ilar not Insufficiart Information 9t Permit B U" R-6 Derwity Special Permit I AMAW 2 Not Allowed 3 USS Pree)d!�� 4 SWial Permit Reqlwp�� 5 insufficlent .1nibmudion C Setback setbim*s comply 2 Front InsufficlOnt 3 Left Side Insufficient PAll 4 Right Side Insuffident 6 Rear lnwffident G 6 Preexisting setback(s) - �S� 7 n t'on Insufficiftt information wl� —7 D vwawshsd I "na Not in Watershed 2 In Wateralmd 3 Lot Prior to 10/24M ot r I W 'L 4 d rood non Zone to be Determined D 6� s rnl7 rmatio Insufficient Information p E HWbxk District 1 w w In Mrbid review required 2 Not in dWdct :ng 3 0 . stion InroAcmd Information Rernedy for the awye Is ctwcked twiOw- -- we 0 Specia pumim pmnning Bosird varlarice 1�,( Site Plan Rewlaw SPGM—WPsrmd variance Acme otlw #= ronteas Special Permit Pwwn Variance FMfte Exception Lot Special Lot Area Variance Z;_� Corn Permit mon Ddvwmv Special 1 h,,t Variance Congregate Howing Special Permit Continuing Retirement SPIM POMIR ,=� :0131M Mchd penonji, ;1:11 It IL@!?Wy_d . ;Wit Non C_�ing Use ZBA I Ind"Wwant Sderly H*Ain Large Estate Condo I Permit ASMS111 �PWM�M EarM Ramy�wWS '0 - j� I , )ScWI _permjtZSA — - Use ilar not I Planned Drisicipment District SPOOMI Pi7rW 9t Permit Plan - Residential Pe ' nnit —a. —Lj Special Permit pnmwjsun i mxKx� R-6 Derwity Special Permit wateraiw §E!E�w Permit TheabMMMWWW - " ' spiershan d woh is bmW -the pign mid kdwrafian at&MIGIL NodefiWOMISIAMMW or adwe WM be buied an View a a by tM q*hmt nor shall vich I 141910MONne by the "Who" ' t* for DEMAL Any ineGMICiM MW@x" a do all I n, or adw u6sawt MWMN 10 be Wd" at ft dMaNibn Of #0 ft q4*0 00 be OVA& ke 00 - Sd NKOPOFd@d how sub" DopwbTwt Me Mechad dmumad Mod PRO RrAaw NoTdW SIM be mftdW'-- by , , Thebliding , p , j,vM miain dpkM;qdd0GMw0dion jW ftsbmse, you ff&* Sea now Wilding PORMapplimookmaodbignilispolpliftivomaL 03- 0 to ZL MuildOg Departrfwvt OftM SQnature ApplicStiOn Recowed Application ied Homestead Reyortsm 208 PIKE STREET TEWKSBURY, MA 01876 (978) 351-6263 (978) 858-0076 —fax John Ward, Inspector MA - License #115 "Let us check your Homestead" June 28, 2005 Bill Barrett 1049 Turnpike Street North Andover, MA 0 1845 Dear Mr. Barrett, 51e e 1�_ I— Thank you for choosing ffomestead Report for you inspection needs. Attached is your report for the property located at 114 Academy Road, North Andover, MA We are dedicated to making the inspection process an informative and learning experience. Good luck in the remainder of your home buying experience. If you have any questions or concerns regarding your property's inspection, please feel free to contact me at any time. Sincerely, John Ward Homestead Report P. S. We build our business on satisfied customers and rijWralk Thank you, John Ward, Homestead Report. Report Index INSPECTION CONDITIONS EXTERIOR - FOUNDATION - BASEMENT ROOF SYSTEM PLUMBING HEATING - AIR CONDITIONING ELECTRICAL SYSTEM INTERIOR GARAGE -CARPORT KITCHEN - APPLIANCES - LAUNDRY BATHROOMS POOLJHOT TUB & EQUIPMENT GROUNDS 2 5 7 8 10 12 13 15 16 17 19 20 ! 14 Academy Rd INSPECTION CONDITIONS CLIENT & SITE INFORMATION: FILE #: 114 Academy Rd. DATE OF INSPECTION: 06/27/05. 11ME OF INSPECTION: gam. CLIENT NAME: Bill Barrett. MAILING ADDRESS: 1049 Tumpike St. CITYISTATErZIP: N. Andover, MA 01845. PHONE#: 978-682-4529. FAX #: email bill-barrett@comcast.net. INSPECTION LOCATION: 114 Academy Rd. CITYISTATEOP: North Andover, MA. CLIMATIC CONDITIONS: WEATHER: Partly Cloudy. SOIL CONDITIONS: Dry. APPROXIMATE OUTSIDE TIEMPERATURE: 78. BUILDING CHARACTERISTICS: MAIN ENTRY FACES: Southwest. ESTIMATED AGE OF HOUSE: 1820. BUILDING TYPE: 2 family, Colonial. STORIES: SPACE BELOW GRADE: 114 Academy Rd Basement, Crawl space. UTILITY SERVICES: WATER SOURCE: Public. SEWAGE DISPOSAL: Private. UTILITIES STATUS: All utilities on. OTHER INFORMATION: AREA: Town. HOUSE OCCUPIED? Yes. CLIENT PRESENT: Yes. PEOPLE PRESENT: Listing agent, Selling agent. PAYMENT INFORMATION: TOTAL FEE: $400. PAID BY: Check. REPORT LIMITATIONS This report is intended only as a general guide to help the client make his own evaluation of the overall condition of the home, and is not intended to reflect the value of the premises, nor make any representation as to the advisability of purchase. The report expresses the personal opinions of the inspector, based upon his visual impressions of the conditions that existed at the time of the inspection only. The inspection and report are not intended to be technically exhaustive, or to imply that every component was inspected, or that every possible defect was discovered. No disassembly of equipment, opening of walls, moving of furniture, appliances or stored items, or excavation was performed. All components and conditions which by the nature of their location are concealed, camouflaged or difficult to inspect are excluded from the report. Systems and conditions which are not within the scope of the building inspection include, but are not limited to: formaldehyde, lead paint, asbestos, toxic or flammable materials, and other environmental hazards; pest infestation, playground equipment, efficiency measurement of insulation or heating and cooling equipment, internal or underground drainage or plumbing, any systems which are shut down or otherwise secured; water wells (water quality and quantity) zoning ordinances; intercoms; security systems; heat sensors; cosmetics or building code conformity. Any general comments about these systems and conditions are informational only and do not represent an inspection. The inspection report should not be construed as a compliance inspection of any governmental or non governmental codes or regulations. The report is not intended to be a warranty or guarantee of the present or future adequacy or performance of the structure, its systems, or their component parts. This report does not constitute any express or implied warranty of merchantability or fitness for use regarding the condition of the property and it should not be relied upon as such. Any opinions expressed regarding adequacy, capacity, or expected life of components are general estimates based on information about similar components and occasional wide variations are to be expected between such estimates and actual experience. We certify that our inspectors have no interest, present or contemplated, in this property or its improvement and no involvement with tradespeople or benefits derived from any sales or improvements. To the best of our knowledge and belief, all statements and information in this report are true and correct. 3 I 1 11*4 Academy Rd Should any disagreement or dispute arise as a result of this inspection or report, it shall be decided by arbitration and shall be submitted for binding, non -appealable arbitration to the American Arbitration Association in accordance with its Construction Industry Arbitration Rules then obtaining, unless the parties mutually agree otherwise. In the event of a claim, the Client will allow the Inspection Company to inspect the claim prior to any repairs or waive the right to make the claim. Client agrees not to disturb or repair or have repaired anything which may constitute evidence relating to the complaint, except in the case of an emergency. Client Signature: Date: -Inspector is authorized to disclose iripsection report information to; I/we do not wish to disclose inspection to any other parties. 4 A I i 14 Academy Rd EXTERIOR - FOUNDATION - BASEMENT Areas hidden from view by finished walls or stored items can not be judged and are not a part of this inspection. Minor cracks are typical in many foundations and most do not represent a structural problem. If major cracks are present along with bowing, we routinely recommend further evaluation be made by a qualified structural engineer. All exterior grades should allow for surface and roof water to flow away from the foundation. All concrete floor slabs experience some degree of cracking due to shrinkage in the drying process. In most instances floor coverings prevent recognition of cracks or settlement in all but the most severe cases. Where carpeting and other floor coverings are installed, the materials and condition of the flooring underneath cannot be determined. WALLS: MATERIAL: Wood siding._ CONDITION: Cracks noted are typical. Some past repairs noted. The front comer is inside the the the foundation stone. Ground contact noted. This condition has a high potential for insect and water damage. TRIM: MATERIAL: Wood. COND1111ON: Ground contact noted at the side and the barn area. Frass like material noted at the front comer board. Recent repairs noted to the trim on the side at the ground contact. Metal patches noted on some sections of the facia and rake boards. CHIMNEY: MATERIAL: Brick. CONDITION: Unlined flue. The front chimney on the driveway side has a large crack noted on the 3rd floor. Loose and deteriorated mortar also noted. Water stains noted on the ceiling. The rear chimney has a large lean towards the street. BASEMENTICRAWL SPACE: ACCESSIBILITY: Basement is unfinished, Limited viewing due to heavy storage. Limited viewing due to insulation. Evidence of prior rodent activity was noted. You may wish to have treatment carried out by a licensed extenninator. CRAWL SPACE: Broken/sagging framing. Water damage,rot and insect damage noted. Earth -to -Wood contact is found. The viewing was limited, due to clearance, debris and asbestos like material. Many ant hills noted in the damp dirt floor. The field stone foundation in the rear appears to have a water stain. Ponding of water may be present. Major structural repairs are needed in the crawl space. BASEMENT WALLS - TYPE: Stone, Brick. . CONDITION: Typical deterioration for the age. Water seepagetstains noted in many areas. Next to the crawl space is a bucket of water from the seepage at the old cast waste pipe. 5 114.Academy Rd BEAMS: Many of the beams have been re supportedi boxed in. One of the main beams next to the chimney has deterioration and old insect damage. Many sections of the sill plate have been replaced. Issues noted on the interior beams on the I st and 2nd floors. The beam next to the 1 st fire place has a recent steel plate added. The 2nd floor right bedroom has many recent small bolts added, these appear to have been installed improperly. FLOOR JOISTS: Many of the joists have been sistered together. One of the joists to the right of the center of the house has old damage. The sister joist in the center, with the column was installed improperly. Improper header of the side dormars. COLUMNSISUPPORTS: Many temporary type columns noted. Many of the columns were the recent work to the beams and joists have improper footing. BASEMENT FLOOR AND DRAINAGE: Symptoms of prior water entry exist, Typical settlement cracks noted. The following problems were noted at the sump: Recommend extending the discharge line. The rear and side sump holes have standing water. Recommend installing a secondary pump and a battery back up power supply. The rear sump hole has no pump. OTHER OBSERVATIONS: Signs of rodent traps and chemicals. Recently installed wood trim and paint noted at the sill plate on the inside of the bulk head. n- vut noarG ot assessors rUO11C Access TOWO Of -NOrth- Andover Board of A-sslt�ssora I,age i ot:z Property Record Ca Parcel ID: 210/096.0-0035-0000.0 Community: North Andov4 ev %-."cjk on SKefcli Enlarge Sale Mice, 245,00 0,; Sale Date: 06/09/1994 Arm.s Length Sale Code: L-NO-REPOCESSN Grantor: FDIC/WINCHELL Cdrt D'6c,- Book:0406 Page: 0006 http://csc-ma.usNandoverPubAcc/jsp/Homejsp?Page=3&LinkId=465742 7/29/2005 c lz u c ca u on 7E! 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U- 00 a - (n COMMONAVEA-L*TH OF MA-SSACHUSETTS EXECUTI-\,T OFFICE OF ENrv-IRO.NME.NTTAL.-'�-PF-A-IRS DEPARTMENT OF ENVIRONMENTAL PROTECTION TITLE 5 OFFICIAL INSPECTION FORIM - NOT FOR VOLUNTARY ASSESS,�,,JE.N'TS SUBSURFACE SEWAGE DISPOSAL SYSTEM FOR.M PART A CERTIFICATION Prupt:ri� Address� c - '- - � & /-f a r- ;Tf O�, ner's Name: 0" ner's Address: 1.1 4-A --LL., Z-1 " - Date of Inspection: �4- — Mme of �nspeclor: (please print) Lz Comp3n ' v Nanne: Address: 0 ;> C/ 'r eleptione Number: -R 0-c ,i(7,,R! I , f - CERTIFICATION STATEMENT that 1 have personally �n5pec�ed the sewage disposal system at this address and that the infor-mation rtpo:-.-r- is rrue. accu . rate and complete as of the lime of the inspection. The inspection was perfor-med bas,-,-, �:)n an", experience in the proper function and maintenance of on site sewage disposal s\ -stems I an, a DEP ed S.Yslem inspector pursuant 10 Section 15.340 of Title 5 (31 0 CMR 15.000) The S\sier-. Passes — Conditionally Passes — Needs Further Evaluation b� the Loca, -APpro� Falls �n�,Pecfor's Sic.1nature: Date: S�*s�em :nspectorshall submit a copy of this inspection r�epon lotheApproYtno Aumori[� --)'zP�-A-ihjn 30 days Ofcompleling this inspection. If Lhe system is a shaied system or has a des!qn !Ic)�, o" ��Teater the inspector ud the system owner shall submit the repon to the appropriate reg!or.3'; tD,,:R!na! should be stnt to t he system 0,Aner and copies sent to the buyer, if app! icable. 2.r�.d C C oim-m en i s 1.1 T H OU G h TH I S R -E POR T ViA Y BE D.E EIV,- ED REL B' L OR GUARANTIES ARE EXPRESSIT OR IMPLjE1;. i s r I eporl 01`11)e describes condi!ions Lit the ti— of inspection and under ii -le conditions of use j� -FD's �[Wec(!011 Goes no( address ho�s the system �,sill perform in the fulurc under !f�e s�-.nj, ;ons of use, plo� 1 0 1 Pa2e 2 of I I OFFICIAL INSPECTION FORM — NOT FORVOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTIONFORm PART A CERTIF1CATION (continued) Properi) Address: /14'/- 0 Ni n e r: ... Fo ,,, ','E 5 7- D,aie of Inspection: Inspection SummarY: Check A,B,C,D or E J ALWAYS complete all Of Section D A. SYsiern Passes: L-Xl have not found any information which indicates that any of the failure criteria described in "110 CVR � )03 or X. -, 10 CMR Ill 304 exist Any failare criteria not evaluated are indicated belo\�. Comments: B. S.\Slem Conclitionalk Passes.. One or more system components as described in the "Conditional Pass" section need to be replactj o� repa,_red The system, upon completion of the replacement or repaLr, as approved by the Board of Health. %�111 pass es. no or not determined (Y,K,ND) in the for the followina statemen(s. If "not cleierm!n�,_;' T.-)�� septic tank is metal a-nd over 20 years old* or the sep(ic.tank- (whether metal or not) I S, ' s 'r urso!J,'�d� exhibits substantial infiftration or exl7diration or tank failure is imminent. System Will pass inspel-tion In", �amlk is replaced with a complying septic LarLk as approved b� the Board of Health Septic tan� -ill pass inspection if it is structurally sound, n'oi leakinL) and if a Cenificale OF Coll):) j, :n�Et:ng that the tank is less than 20 years old is avallabl'e- N D ex p i a in i Obiervation of sewage backup or break, out or high static water leyel in the distribution bo\ due to Droke:� cz)s�n.:cied P!pe(s) or due to a broken, senled or uneven disrTibution box. System will pass inspec:jon of Board of Health) broken pipe(s) are replaced obst-iruction is removed distribution box is leveled or replaced N D e �,.D I a: n S\ siem r�:quirecl pumping mort than 4 times a Year due to brok-en or obstructed pipcks, -1 ins�ectlon if (with approval of the Board of Health): broken pipe(s) are replaced obsmuction is removed f x P a 2 t _'� c " -� .; OFFICIAL INSPECTIONFORM - NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSA-L SYSTEM INSPECTION FORM PART A CERTIFICATION (continued) Propert.N Address: 0 A" �9. , 0,6 n e r: "� C, _'-'1x"_- D3te of Inspection: C - FurtheF Evaluation is Required by the Board of Health: Conditions exist which requLre further evaluation by Lhe Board of Health in order to cetertillne :1 . Wtl S\ �;C'n tO Prolect public health, safety or the envirorLment. I S-C -nn \s ill pass unless Board or Health determines in accordance A ith 310 CNIR 1 �303(1 )(b) th2t the s�stem is not functioning in a manner which -ill protect public health, safe[.\ and lht: en\ironnient: Cesspool Or priv) is \� ithin 50 feet of a surface water cesspool Or P"I\ N is within 50 feet of a borderLng vegetated wetland or a salt marsin SNslem %yill fail unless the Board of Health (and Public Water Supplier, if anN ) del rmin S h. the s\stf'n) is functioning in a manner that protects the public health, safety and envi"ronment: TF,.e system has a septic Lank, and soil absorption system (SAS) and the SAS is within !00 Cee!. oj-_, S-_lriace �Naier supply or rributary to a surface water supply The system has a septic tank and SAS and the SAS is within a Zone I of a pull, . lic T .�'.e sXs[cm h3s a septic tank and SAS and the SAS is within 50 feet of a pr;N 3!e a :Ine S\rSte-m has a septic �3nk and SAS and the SAS i� less that) 100 feet 0 07 \�3!e.r SUP 01 e 11 Method used to determine distance S�em passes I the wt -11 waier anal sis. perfonned at a DEP ceniFied labor3ic,\ and �oi�,tiie organic compounds indicates that the \� ell is free from POIlUtIOn !rol'r' 1�1121 Presence Of ammonia nirrogen and nitrate naTogen is equal to or less than -� ppn,,, pro� ioed o,,3i no ,a -lure criierij are triggered A copy of the analysis must be ariached to this form 3 Oiher: PaE,- , or I I OFFICIA-L INSPECTION FOR -M — NOT FOR VOLUNTARY ASSESSMENTS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION, FOR -m PART A CERTIFICATION (continued) Proper -TN A.ddress: /, / 'Y- /9i- C " 6' L5 / 1/1, )VO, e r: c)Y O"n Daie of Inspection: D SNstem Failure Criteria applicable to all systems: You must indicate "yes" or --no" to each ofthe following for all Lrispections: Y e S o / Backup of sewage into facility or system component due to overloaded or clogEed SAS Ql� ct�sDc)ol 0' Discharge or pondLng of effluent to the surface of the ground or surface waiers due to an over�o , a cIc,_,aed SAS or cesspool Static liquid level in the distribution box above ouilet inven due to an overloaded or cio-ged SAS Or cesspool Liquid depth �n cesspool is less than 6" below inyeri or available volume is less than ','� day llo\� Required pw-npino more than 4 times Ln the last year NOT due to clogged or obsTucted pi'pe(s) Nurnoe� ot times pumped An\ portion of the SAS, cesspool or privy is below high ground Water elevation kn� portion of cesspool or privy is within 100 feet of a sur -face water suppl�, or rributar-N to a suir:'ace ��ater suppl�, An\ norii,on of a cesspool or privy is within a Zone I of a public well. por-tion of a cesspool or privy is within 50 feet of a private water supply well. An\ portion of a cesspool or priv-y is less than 100 feet but greater than 50 f`eet from a pr!v3te �� ater supply well with no acceptable water qualiry analysis. [Th is system passes if the N% ell' wa ter a na IN sis. performed at 2 DEP certified laboratory, for coliform bacteria and volatilt- organic compoun . ds ind icates that the NA ell is free from pollution from that facility and the presence of 'a in mon i�i nitrogen and nitrate nitrogen is equal to or less than 5 ppm, provided that no other failure critvrlj ire triggered. A copy of the analysis must be attached to this form.1 �s",,o) The sN stem fails. I have determined that one or more of [lie above failure criter,3 e described in 110 C N1 R 15 �0,. there fore the sysiem f3i is The systern o,,� he llo.v j Heahn to determine what will be necessary to correct the failure E. Large SN stems: -robe considered a large system the system must serve 2 facility with a design noNN of I o.on (,pd to pd 'N c j must indicate either '-yes" or "no" to each of the followino: !'oiioN� ina criteria apply to large systems Ln addition to the criteria above) S n C !t`le S\ siern is "'Ithin 400 feet of a surface drinking water suppiv the s\stt!m is within 200 feet of a tribuLary to a surfact drinking water suppl\ �t S\siem is located in a nitrogen sensitive area (Interim Wellhel-d Protection Ar��,.j 1�� D Zone �l of a public %kater supply well riLve ans-ered "yes" to any question in Section E the system is considered a signiFicant .rJt_1i, Or Llr�3%,�',�- �,;zm D above the large system has failed. The owner or operator of any laree sysiem corsid�,e_f 2 r�! threa! under Section E or failed under Section D shall upgrade the system in accordanc�� %� !t., —ne s� siern owner shou id contact the appropriate regional oMce oi the D�parime ni OFFICIAL INNSPECTIONFOR-M — NOT FOR VOLUNTARY ASSESS \1 EN'FS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOP—NI PART B CHECKLIST ProperiN Address: 41C 0 Da�e of Inspection: llowir.2 have been done. You must indicate "Yes" or "no" as to each of the followin,-_,. es o PurnPin2 information was provided by the owner. occupant. or Board of Health ere an\ of the system components pumped out Lin the previous two weeks Has the s)stem received normal Aows in the previous rwo week period H3\e larRe volumes of wat.er been incToduced to the system recently or as pan of Lhis inspection ZWere as built plans of the sysiern obiained and exami�ned'l (if they were not available nott: as N Was the facihiv or dwelling inspected for signs ofsewage back up Was the site inspecied for signs of break out Were all s\stem components, excludia-ig the SAS, located on site Were the septic tank manholes uncovered, opened, and the interior ofthe t3n1k lnspecl,�d !'or ��,t 17�e D2: - , �s or iees, material ofconsn-uction, dimensions, depth of liquid, depth of'sludge and depm 0. S�,= \VaS 11`e f3C111[\ o��ner (and occupants il"different from owner) provided \N th o! suosurl . ace se��1.2e disposal $\Stems I '!,e size and location of the Soil Absorption System (SAS) on the site has been Jeterm,P�c Da,,�: C". ZZ— Existing information. For example, a plan at the Board of Health. Determined in the field (if an\ of the failure criteria rela�ed to Pari C is at isse 3��rrr 1 0,� pp -able) 10 CNIR 15 302(.3)(b)l 5 P�Qe ,, 01- 1 1 OFFICIAL INSPECTION FORM — NOT FOR VOLUNT.,6�.RY.-"LssEss"iEN-rs SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFOR-MIATION', Propert.� Addres�: //74 1"-Clya'5 /5z "V O'n v I C- k' ONsner- f:--oAh'r--:57 6L/:�-Cl/-/94',�' Ume of Inspection:__ FLOW CONDITIONS R E S I D ENTI A L T Number of bedrooms (acival)� 5, DE S�C\ Flo�� based on 3 10 C.M��l 5.203 (for example! I 10 gpd x # of bedrooni of curTent residents. 3 Does esidence have a garbage grurider (yes or t2-rizr,, on a separate sewage system (Yes OraQD [if yes separate inspect systern inspected ves r no): ion requiredl 00 — �:-,s.jnril use iyes o r(no). a!zr rneter rz�jdiniis, Javaii3ble (last 2 years usaQe (2pd) /I E7 P �; m P a)o , Las; z 21� of occupancy: cl 1�tq CONINIERCIAL/11'N'DUSTIRIAL \-Dt ol establishment D '- :o%k t . oased on 3 10 CMR 15.203): izpd cesip flo,,k tse3ts.,persons.!sqh,eic.): Grease present (yes or no): %�asie holding tank- present (yes or no) %�aste discharged to the Title 5 system (yes or no) m-ie� %3dirss, if available� 01 occupanc�iuse OT H E R (describe): GENERAL INFORMATION PLH)PIFIC Records pumped as pan of the inspection (,Yes or(ff): -�rne pumped _gallons -- How was quantic\ pumped determinedr' !or ---,mpine OF S)'STEM t3nj�. distribution box, soil absorption system i -I 2je cesspool 0�� ctlsspool Sf'.—'Ied S.� stem �yes or no) (if Yes, anzch previous inspection records, if anN) --Vlem3live iechnolo�jv Anach a copvofth.- current operation and em, o %� n e r) !anl Artach 3 COPY Of Lhe DEP approval ,:):. �! -,� T i d es C r i b (�) of �31! romnnnents. date installed (if - kno�,n) and source of infom)aiinn Odors de�ected �� hen arriving at the site (yes o r(f DO 6 OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARYASSESSNIENTS SUBSUR-FACE SEWAGE DISPOSAL SYSTEM INSPECTIONFOlt\1 PART C SYSTEM INFORMATION (continued) Pro pc rt y Add ress: 0,, neri D,-ite of Inspection: BUILDING SEWER (locate on site plan) Dtp!h Delo- grade of consrruction — cast iron 40 PVC _other (explain): rll:s�ar�ce firorr private water supply well or Suc6on line: r��s ton condition ofJOIFILS, venting, evidence of lTa�agpe, etc SEPTIC TANK: �—/( locate on site plan) Dt:)t`� 6eio%� a-Taclt. o!,consrrucLion _zc-oncrete —metal —fiberglass --polyethylene o J —7— (ne ri, exp I a in) , :! K n - , :S metal list age Is age confirmed by a Certificate of Compliance (yes or no) (arlach, a copy of P� E 12, S:u 0 2 c f7om top of siuOpe to bortom of outlet tee or baMe. S-= !-Jcv-ness: S' t 10 rn top of scum to top of outlet tee or baffle: D; S�2 7�, - fTOM bOnom of scum to bcnom of outlet tee or birne j:m-nsions determined /,Op, o,3,,:f ents (on PUMpin2 recommenclai ions, inlet and outlet tee or bat-ne condit ion. scructura inte,-F it.\, ;e, is -�-.t 'o outlet invert. evidence of leaka2e. etc ) C R E.A S E T R. -k P: —(locate on site plan) gade Mate':al of consmuction� —concrete —metal —fiberglass _other CXp!3!n) -,.,.M. e.n. s i o n � ri, c Kn,. ss rTOm top 01 scum to top of outlet tee or baMe: �rom bonom of scum to boriorn oCoutlet tee or bani —e D3'le of iast pumping '=,�r-!s on pumping recommendations, inlet and outlet tee of baMe condition, sn-uciL:,n1 judet inven. evidence of ltakaee. eic.): P32e 8 ()!, ! I OFFICIAL INSPECTION FOR -M —NOT FOP, VOLUNINTARYASSESSMEX'FS SUBSURYACE SEWAGE DISPOSAL SYSTEM INSPECTION FOR N1 PART C SYSTEM INFOR-MATION'tcowinuedi Properi) Address: �Wl- 1�1-'14a�5411 ' t14,' b 41 7-717711 O,A n v r: Date of Inspection. —C TIGHT or HOLDING TA.NK/!��/9— (tank must be pumped a! time of inspection)(locate on s!tt plant Depth belo�N giade: Material of consrTuction: _concrete _meLal _Fiberglass ___polyethylene other(explam�, Y, 1-7) t 111 —10 n S C 2allons Destpri FIoA Lallons/dav Alarrn present �yes or no) Alanp. level. Alarm in working order (yes or no): Date of last pumping- — Comments (condition of alarm and 1716�t switches, etc DISTRIBUTION BOX: /-""(if present must be opened)(locate on site plan) D;� iiQ ui�' le�el above outlet inveri� C) Cof"'Iments (note if box is level and disuibution to Outlets equal, any evidence of solids carr�over, an� e\ 1�enc- 0� !eaka2e into or out of bo\, etc /Z' 0 L 5e, I'L \1 P C H A \1 8 C. R �Z�-(!ocaie on site plan) P, -,m -r -s !n %�c)�'King order (\-es or no) A:.Ir-m,s in. vorkinia order (yes or no) comnlenis (nole condition of pump chamber, condition of pumps and appurienances. etc Page 9 of OFFICIAL INSPECTION FORM — NOT FOR VOLUNTARY ASS ESSN1 E,.,,'TS SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FORNI PART C SYSTEM INFORMATION (continued) PropertN.Address: Kt*' O�Nner:J(r�KRE'�T Date of f_nspection. SOIL ABSORPTION SYSTEM (SAS): _ (locate 00 site plan, excav2tion not required) F 'S.AS not located explain why�. T.N pe 1 e 3 c r- I r, L P"S. number: !taching chambers, number: leaching, PaHeries, number: ieachina trenches, number, lengik.._. leachina fields. number, dimensionsi o\ erflo�� cesspool, number� innovative,altemative system Type/name of techriolo0y: Commems (note condition of soil, signs of hydraulic faiiure, 0 level of ponding, damp soil, condition 01 7 etc 0 S �G,KS 0 L) i,�E CESSPOOL�/a ,Z�j (cesspool must be pumped as part of inspect 10n)(10C31e On Site Dlan) conf-12uration top of liquid to inlet invert: D�7n,. solids layer D.Mtn�iorlls 0! cesspooi w- construction. iF�Ji.-ziiion o! aroundwater inflo", (yes or n o): C -Imrnenis (note condition of soil, signs of hydraulic failure, level of pondl.na, condition of ve2etal 10r. e(- I PRIV't 4A, (locate on site plan) irucl ton. Dt7nn oF sohds t_ �7-,me nis (note cond it ion of sol 1, s igns o f hydrau I ic fai lure, le ve I of pondi ng, cond it ton o e�je� Or � �t 9 page 10 of I � OFFICIAL INSPECTION FORM - NOT FOR VOLUNTARY ASSESSME,-"I", SUBSURFACE SEWAGE DISPOSAL SYSTEM INSPECTION FOR%1 PART C SYSTEM INFORMATION , (continued) Propert.� Address: '7C 19 C/9 /11 t�z 147 Y /2/ �3 0,Aner: c,5T Date of Inspection: -Z- — SKLETCH OF SEWAGE DISPOSAL SYSTEM Pro� ide a sketch of the seA age disposal system includLng ties to at least two per -mane ni reference lancinz!r�, S :)ench,marks Locate all wel Is within 100 feet. Locate where public ,vaier supply enters the bu ildm2 X v ,.9 -;- E /-' , 13ATESON AM a" ANDOVW MA MO Box FLA t, SUBJ'U'.RF/," S E 1,VA 6 E D1,S)PO—`�AL 5YSTE,1�7 LOCATION: 'r-ll�z A�f4PS-Al)o' IVORTH A 1) A T E ' A VJ, 30, 7'�q r� (--, 1) - 7> C77 PV �: NO Ni a breakthrouqh in pn'ce and quality Solectria introduces the PVI 1800/PVI 2500 inverters: a new standard of exceptional quality at an extraordinary price. IW jiE3 f-: 11 13 0 0 CI: 13 13 0 0 0 13 13 E3 El 13 Solectria introduces the PVI 1800/PVI 2500 inverters: a new standard of exceptional quality at an extraordinary price. IW PV1 18001PV12500 RELIABLEI INDUSTRIAL QUALITY! RELIABILITY The PVl 1800/PV1 2500 provides industry leading reliability. One look at the automated production and PCB assembly inside the inverter shows its industrial quality. Rigorously designed and tested for the harshest conditions, the PVl 1800/PVI 2500 proves to be consistently reliable. EASY TO INSTALL SAFETY The PV1 1800/PVI 2500 can be installed easily and quickly, The PVl 1 SOO/PVI 2500 has been tested to the UL1 741 both indoors and outdoors. With a weight of 35 lb- (16 kg) standard and meets all the requirements. An important (compared to an average 70 lb..(32 kg) for a typical inverter) selling point of this inverter is the galvanic isolation, which the PVl 1800/PVI 2500 is very easy to handle. The inverters increases both reliability and safety. also include 'pre -wired' AC and DC cables for quick wiring at 0 the jobsite without opening the inverter! HIGH THERMAL PERFORMANCE 13 All aluminium construction and high efficiency design provi- EASY TO OPERATE: PLUG AND PLAY des full rated power in ambient temperatures up to 140oF With the PVl 1800/PVI 2500, Solectria once again confirms (60oC). No derating will occur! its innovative reputation. With LCD display and auto detect 0 RS 232-485 as standard equipment, there is true 'Plug and 11 play' capability This gives the PVl 1800/PVI 2500 a PC (3 a interface with excellent monitoring and data acquisition 13 M capability. 0 13 E3 13 M 0 13 E3 13 [3 0 13 E3 E3 0 [3 13 13 0 13 E3 0 13 0 0 0 0 11 (3 a 13 13 M 13 TECHNICAL SPECIFICATIONS PV118001PV12500: input Continuous power 18## 1980 W 2750 W Recommended Max. PV array power, STC rating 2200 Wp 3100 Wp MPPT voltage range 125V DC - 350V DC 125V DC - 350V DC Maximum voltage (OCV-cold) 400V DC 400V DC Maximum DC current 11 ADC 15 ADC Continuous powe� 1800 W 2500 W Nominal voltage 240/208V AC 240/208V AC Voltage range 240/208V AC -12%/+10% 240/208V AC -12%/+10% Nominal current 7.5A/8.7A 10AA/1 2A Frequency 60 Hz; +/- 1 % 60 Hz; +/- I % Power factor Unity Unity Distortion factor (THD) <4% <4% Operational overall efficiency > 93 % >93 % Gener,A information DC and AC cDnnections pre -w=ire pre -wired Housing material Aluminium Aluminium Convection cooling Yes Yes / Fan Weight 34.2 Lbs / 15.5 kg 36,4 Lbs / 16.5 kg Ambient temperature - 137 to + 1 40'F -I 3'F to + 140'F Relative humidity 95% 95% Enclosure NEMA 4 / IF 65 NEMA 4 / IP 65 jDilme'nsions Length 18.5 inches (470 mm) 23.6 inches (600 mm) Width 13.1 inches (333 mm) 13.1 inches (333 mm) Height 5.63 inches (143 mm) 5.63 inches (143 mm) [Com, runication Indicators LCD display & LEDs for status indication and error messages External communication RS 232 or 485 (standard equipment) (automatic recognition of RS 232 or 485) Data logger PVIDAQ PC / Modem / Cell based logging Designed to meet UL listed to UL1 741 UL Listed to UL1741 IEEE1547/IEEE929 IEEE1547/IEEE929 FCC part IS A&B FCC part 15 A&B ANSI C62.41 C 1 & C3 ANSI C62.41 C1 & C3 warranty Standard 5 years Standard 5 years PV1 18001PV12500 DATA LOGGING FOR EASY SERVICE -7AND REPORTING! PV1 18001PV12500 THE AD VA NTA GES: C3 Full rated power at 140'F (60'C) ambient temperature 0 Premium efficiency 11 Weatherproof housing to NEMA 4/IP 65 • IRS 232/485, Plug & Play standard • Integrated LCD Display standard • Galvanic isolAon with HF transformer • Easy to insta1 — only 35 lb. (16 kg) E3 Standard 5 year warranty PV1 18001PV12500 DATA LOGGING FOR EASY SERVICE 13 Simple logging with PC, without any additional device 13 External data logger available (PVIDAQ) 13 Track system power output over any time period 13 Verify system performance 13 Track data via internet E3 13 El 0 13 0 El 13 11 0 0 DATA ACQUISITION AND CONTROL PVIDAQ - INTELLIGENT TECHNOLOGY FOR INTELLIGENT ENERGY USE PVIDAQ has been developed for owners and operators of photovoltaic systems, which use PV11800/PV12500 inverters. PVIDAQ connects your PV inverter to the internet without a PC. PVIDAQ is based on a high-tech mini web -server, is equipped with digi- tal and analog interfaces and, thanks to its integrated GSM modem, relays all of the recorded data via e-mail in a matter of seconds and at a low cost. The inverter data is processed in a central database. You can access to the data records at any time using protected internet access. PVIDAQ performs'remote and local monitoring of your PV system, and issues a warning signal when an error occurs. You choose'the type of alarm signal you'would like (FAX, e-mail, text message (SMS)). An additional acoustic or visual alarm can be installed on site. PVIDAQ also allows the inverter to be monito7ed with a PC. PVl 1 PVl 2 PVl 3 PVl XX Internetportal Direct connection 0 �IA Data transfer Alarm (SMS, Fax, email) 1131111 11 PVIDAQ PERFORMANCE AT A GLANCE Decentralised recording of energy data for your PV inverter system Remote reading of kWh Cost-eff icient and automatic data transfer via e-mail 7 Access to data records from anywhere in the world via the internet Easy to operate, even by untrained personnel Alarm signals by fax, e-mail text message (SMS) I Extra: Local acoustic or visual alarms Connection of revenue -grade energy sensors, environmental sensors and others Communicates via the GSIVI network I � I SOMMIA '11- T-tsd—Awr IdIS11111110 Energy Perfo�nce Ratio 08.2004 20—M OWN" y Generation 24.07.2004 SOLECTRIA 0 errmww�" L2 [=Energy SOLECTRIA PV12500 Our PVIDAQ monitoring System enables you to monitor your solar energy system around the clock. The data is recorded locally by the PVIDAQ MONITORING SYSTEM and relayed to our server via the GSM network. Using your password, you can retrieve your unit's data at any time using any internet access anywhere in the world. if desired, we can also alert you and the installer responsible for your system of any signi- SO-L,ECMA ficant deviation in your system performance (i.e. no output). How you benefit: The data has already been processed and ready for your viewing and use. How you benefit: No additional telephone lines need to be added. With PVIDAQ, your photovoltaic system is displayed and Available in the future will be a service to track and compare monitored via the GSM mobile network and the internet your PV systems performance to local solar irraclation data platform and report to you deviation from expected modeled perfor- Measures up to four analog inputs (e.g. solar irriclation, mance. temperature) L. Reads pulses from up to four external kWh meters Reports kWh generated Shows inverter and PV system performance Quick alarms Data can be used for production tracking and/or REC (Renewable Energy Credits) with automatic reporting Calculation of environmental contribution s4 k wer os= ilse,ms. Y pow e Solectria designs, manufactures and delivers clean, efficient, and sustainable energy and transportation solutions. We also offer engineering services for distributed power generation, vehicle systems, and industrial automation. - With an extensive history of delivering industry leading products and advances for harsh environments such as automotive, truck, bus, military and off road, Solectria's performance and reliability are strategic values. With an ISO 9001:2000 certified process and a customer focused team, we are committed to your success. f � i j ,I! I- ze -- -------- > ,I! I- ze IJ 1-4 �4 to LL FROM : SOLECTRIARENEWRBLES PHONE NO. : 978 683 9702 Apr. 08 2006 05:17AM PI *$SOLECTRIA R E N E W A B L E S Fax Message To: -Tv PE M ug my Company-, Fax: (17yj Phone: (4z?J �ff - 75-4� From: lu &K -D— (Iva) -IN J -P, Company: SOLECTRIA RENEWABLES, LLC Date: 4-- / -710 Pages: 2- #(;--SoLU --s-Y5-7&0 , A -C � t)7C 04-, CC: I . . 0 For Review -- D Please Comment 0 Please Reply STATEMENT OF CONFIDENTIALITY The information contained in this fax is intended for the exclusive use of The addressee and may contain confidential or privileged inforrnation. If you are not the intended recipient, you are hereby notified that any form of dissemination of this communication is strictly prohibited. If this fax was sent to you in error, please notify us immediately by phone. pf-7K7 WIT E"M pu--�-t4 Solectria Renewables designs and manufactures premium efficiency, high reliability power electronics and systems for renewable power generation. We also offer engineering services for renewable power systems and distributed power generation. 360 Merrimack Street, Bldg. 9, Lawrence, Massachuseft 01843 USA Ph 978.683.9700 - Fax 978.683.9702 - www.solron.com *40 US Date ..... ; � -. 7—'V— 04 ...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ......... M ...... ....... ................................................ has permission to perform ....... ......... ....................... wiring in the building A4�.L4104�Aw .................................................... at ..... �79..AKIID.FOV ......... .............. . North Andover, Mass. Fee. Lic. No?� . ..... ....................... Check 'y 3?- E. ELEcriucAL INspEcrOR 6 5 41 L.09-n-renonweap.h. or massachus eas Department of Fire Services Permit No. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked ki [Rev. 11/991 (leaveblank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMA TION) Date: City or Town of: V To the Inspector of Wires.' g- id gi By this application the undersi n - ves noticie of his or her intention to perform the electrical work described below. Location (Street & Number) 8q Owner or Tenant a�-s a4rW&I Telephone No. Owner's Address 6~e Is this permit in conjunction with a building permit? Yes F-1 No � (Check Appropriate Box) Purpose of Building &±/-r� Utility Authorization No. f Existing Service -A��o Amps /.P,:, Volts Overhead Undgrd No. of Meters New Servic - Amps Volts Overhead Undgrd No. of Meters Number of Feeders and Ampacity I r Location and Nature of Proposed Electrical Work- Jt�� cm/ z� j/ /1// v eev .2*Xo4� P�q Completion of the following table may be waived by the Inspector of Wires.,V 4V No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Above 0 In- Swimming Pool grnd. grnd. El No. of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS INo. 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 Heat Pu p in Totals: I Number I ........... - ........ ..... I Ton� .......... I .......... J..K.W ........... No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local [:] Municipal El Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water KW Heaters No. of No. of Signs Ballasts Data Wiring: I No. of Devices or Equivalent No. Hyoromassage Bathtubs No. of Motors Total UP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of Wires. 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 covera force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ' BONDE] OTHER [:] (Specify:) (Expiration Date) Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: I certify, under the Inspections to be requested in accordance with MEC Rule 10, and upon completion. andpenalties ofperjuiy, that the information on this application is true and complete. FIRM NAME: 14,oAes LIC. NO.: "AMvs-& Licensee: Signature �/� LIC. NO.:,�F7,Wav Y,( , (Ifapplicab?e, enter "exempt" ilthe license number line) Bus. Tel. No.: 7(fl - 714 -"1-2 Address: 1$�W,11 ��/ Alt. Tel. No.: 7kl-ax 79 -40 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) El owner E] owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE. $ WEA vv c- Pvc pi - 0 I I FROM : SOLECTRIARENEWABLES PHONE NO. : 978 683 9702 Mar. 25 2006 02:01AM P2 Cr Simplified Interconnection Application and Service Agreement for Facilities with Inverter Capacity of I0kW and under Contact Information Legal Mame and address of Interconnecting Customer applicant (or, if an individual, Individual's Name) Company Name: Contact Person: James D. Worden Mailing Address: 84Academy Rd City: North Andover State: MA Zip Code: Q1845 Telephone (Daytime): 781932-9009 (Evening) 978685- . 9791 Facsimile Number: 781 932-9219 E -Mail Address: worden@sole-ctdo.com Alternative Contact information (if different from Applicant) Name: Mailing Address: City: State: Zip Code: Telephone (Daytime): (Evening): Facsimile Number: E -Mail Address: Ownership (include % ownership by any electric utility): I Mj customer owned Confidentiality Statement: "I agree to allow information rcgardit g the processing of my application (without my name and address) to be reviewed by the Massachusetts DO Collaborative that is exploring ways to further expedite future interconnections." Yes__X No Facility Inform to ion . Location (if different from above): Electric Service Company: Mass Electric Account Number (if Inverter Manufacturer: eruea tic. Nameplate Rating: 2�S (kW) (kVA)2 i System Design Capacity: ____2.0 (nom.)_ (kW) FVJ 2smo _ (AC Volts) Singled or Three _ Phase (kVA) Prime Mover: Photovoltaic X Reciprocating Engine El Fuel Cell ❑ Turbine ❑ Other Energy Source: Solar [3 Wind ❑ Hydro ❑ Diesel ❑ Natural Gas [] Fuel Oil ❑ Other UL1741 Listed? Yeses_ No Need an air quality permit from DEP? Yes No _Not Sure _ If "yes", have you applied for it? Yes No _ Estimated Install Date: Mar 15.'0-4 Est. In -Service Date: March 22, 2004 Customer Signature (attach manufacturer's cutsheet showing UL1741 listing `& sign here) I hereby certify that, to the best of my knowledge, all of the information provided in this application is true and I agree to the Terms and Conditions on the following page: Interconnecting Customer Signature: Title: 60"W Ayd- Date: Feb 20.2004 Installation of the Facility is approved contingent upon the terms and conditions of this Agreement, and agreement to any system modifications, if required (Are system modifications required? Yes_ Nom: Company Signature:' _ Title: FRikCifft- t_KfC, Date: 6 'O Application ID number. h—Z. Company waives inspection/witness test? Yes Nox FROM SOLECTRIARENEWABLES PHONE NO. : 978 683 9702 Mar. 25 2006 02:02AM P3 Z.� Simplified Interconnection Application and Service Agreement for Facilities with Inverter Capacity of IOkW and under Contact Information Legal No= and address of Interconnecting Customer applicant (or, if an Individual, Individual's Name) Convany-Name: Contact Person: R V Raian (Utili}y Account) Mailing Address: 84 Academy Rd. Apt Rear City: North Andover State: MA Zip Code: 01845 _ Telephone (Daytime): 978 794-2303 (Evening): 978 794-2303 Facsimile Number: E -Mail Address: raira, jan00IAcommuLnet Alternative Contact Information (if different from Applicant) Name: James Worden Mailing Address; 84 Academy Rd. City: North Andover State;,,)`-tA Zip Code: 01845 Telephone (Daytime): 781932-9009 (Evening): 978 685-9781 Facsimile Number: 781952--2219 E -Mail Address. worden(c0solectria.egm Ownership (include % ownership by any electric utility): 100% customer owned Confidentiality Statement: "I agree to allow information regarding the processing of my application (without my name and address) to be reviewed by the Massachusetts DG Collaborative that is exploring ways to fitter expedite future interconnections." Yes_____X No Facilitv ln&mzm = �r �%/ Location (if different from above): C �"' 6- Electric Service Company: Mass Electric 7,0 Account Number (if available): 04413 00110 08 2 11 /0 Inverter Manufacturer: SMA America Inc. Model SWR 1800U SBD 7 Nameplate Rating: 11 (kW) (kVA) 120 (AC Volts) Single __& or Three_ System Design Capacity:0.9 (kW) (kVA) , t,J'7 �M Prime Mover. Photovoltaic X Reciprocating Engine D Fuel Call E] Turbine E] Other " _ 1 Energy Source: Solar ❑ Wind ❑ Hydro ❑ Diesel ❑ Natural Gas ❑ Fuel Oil ❑ Other _ ULt 741 Listed? Yes X No Need an air quality permit from DEP? Yes No , Not Sure If "yes", have you applied for it? Yes j4o _ Estimated Install Date: Mar 15. 104 Est. In -Service Date: March 22, 2004 Customer Signature (attach manufacturer's cutsheet showing ULA 1 listing & sign here) 1 hereby certify that, to the best of my knowledge, all of the information provided in this application is true and I agree to the Terms and Conditions on the following page: Interconnecting Customer Signature: tri" Title: Date: Feb 20.2004_ Installation of the Facility is approved contingent upon the terms and conditions of this Agreement, and agreement to any system modifications, if required (Are system modifications required? Yes_ Nom: I Company Signature: b•It am Title -.PRINCIPAL L --W. Date: 2 Of Application ID number: Company waives inspection witness test? Yes_No-X FROM : SOLECTRIARENEWABLES PHONE NO. : 978 683 9702 Apr. 08 2006 05:18AM P2 James Worden From: Bzura, John J. (US-NBRO-Eng.) [JOHN.BZURA@us.ngrid.com] Sent: Friday, March 31, 2006 11:06 AM To; James Worden Subject: RE: North Andover Electrical Inspector James, We do not require external disconnects for UL -1141 inverter -based systems rated at 10 kW or less. Without further information on this site and the systems, I can't say much more. John -----Original Message ----- From: James Worden [mailto:jamesmsolren.com] Sent: Friday, March 31, 2006 11:07 AM To: Bzura, John J. (US-NBRO-Eng.) Subject: FW: North Andover Electrical Inspector John, Any thoughts on this? Both AC disconnects are inside the basement within 10' of the utility entry point and kWh meters (as you may remember in photos). Also, we have a sign posted right beside the kWh meters stating that the site has a Grid -Interactive Photovoltaic System and disconnects are located just inside this utility entry point. As long as this is still OK with you, I'm sure the inspector will be OK with it as well. We have the other array nearly ready to go. Thank you very much, James -----Original Message ----- From: James Worden [mailto:jamesesolzen.com] sent: Friday, March 24, 2006 1:01 PM To: John Bzura Subject: North Andover Electrical Inspector John, The North Andover Electrical Inspector is new and wants to talk to you about our new solar system and about the allowance of grid connected PV systems in general. He also wants to talk to you about outside AC disconnects. He is under the impression that you would require these even for our residential system instead of a sign posted at the utility enterance and the visible -blade AC disconnects located within 101 of the utility enterance inside as they are now. He may call you or in case you need to reach him, here is his info: Peter Murphy North Andover Electrical Inspector 978 688-9545 fax: 978 685-9542 1 FROM : SOLECTRIARENEWABLES PHONE NO. : 978 683 9702 Mar. 25 2006 02:00AM P1 SMECTRIA A- lq<-10 ro y RENEWABLES iQ, �rgov Fax Message To: P -/ c// From: Lvohh Company: F- C AC ZVsP, Company: SOLECTRIA RENEWABLES, LLC Fax: gs*Z Date: 3 Phone: <� 7 C kx—q-'g-f5 Pages: 3 Re: S= t1!t� ,.>-y,;r7-,Avj ❑ For Review O Please Comment ❑ Please Reply STATEMENT OF CONFIDENTIALITY The information contained in this fax is intended for the exclusive use of the addressee and may contain confidential or privileged information. If you are not the intended recipient, you are hereby notified that any form of dissemination of this communication is strictly prohibited. if this fax was sent to you In error, please notify us immediately by phone. A PAk 4 z75'zo t A -c -C H Uri -5- 14A 4 0 �-a `do- 7-M �r,57 Ur TYL t T l�c�- -tDl\l 41VD StAt ycL A6Z: W - t -rZl� P� `� �P �9�4�d,�Yfr' l 414R-7'/ft-r-/T ,�iQ&k) -rf/J ?��M i'!� �� .rte 2,S 9-W SIS - ,*-y 4Z 67:4 K To/ -'w 6 z Vt ,,,- 1V Gv 0 / 4,T %JV 4 6/V TF4 wrm 'tcS Cv 1wrek7w, . Solectria Renewables designs and manufactures premium efficiency, high reliability power electronics and systems for renewable power generation. We also offer engineering services for renewable power systems and distributed power generation. 360 Merrimack Street, Bldg. 9, Lawrence, Massachusetts 01843 USA Ph 978.683.9700 • Fax 978.683.9702 • www.soiren.com S % �Ct.4GjA1 Dom/ e co r�rnlS,o ✓ �lir7'.9 y � Gv�ii�i 9aEs lea /�t/Ltil d� /��/�r ►��r�t-� 8�/B ,�rr ��?- � � � kw /�vvc. /�-•— ,�r 1�I.g/�v lao �� 1��.arh� 8Y 740 Ar Ais Re?l cel O/Gf I/w Pv"l`tcr iVe / (J/'� Pte/ relp4W /�w 1,vZvi /Cit .9 V8, 41e ;-.re �o,T.j rev e%--e7ov„slo— Mie A1 -r.41 w1i,W L'Grrrr of/y g,ytif k4e //Lk/ 1,v" .* ,nor /��/� ��. /�2�'�/ Gd/! A 1ys4;V1 '4�✓C�cg1 /�✓r CG.v6�iiA, A G� P b` Tti.�C�/GN Aws 41- % tet✓ `/ s/�rY'.v-y. � Game Bf�'>/P"� ,r'�/J- C�"��"'o%rr //a l'G�•�u�1/-/� s/S�,�f1 Q� /Av v4'e4 � /�- bI sCO�.�Gvls) ��"J /}rC /�/ ja/�S� � �� -- f 74 ,gas% �o�,f. �,>s� c►�.�f�H�-w� Ft, 75-X /, a s- - /D, 4! -41 -me Af7,P mese- ,411� v� //a WA, p�14- 366W wAh' 7A /,J '% 6,v 9, 75-,4 dl/ C" I--/- A0" r rsc asp /c' bs,.,.,.r 1 %/ �..S�ew Q-0. X 50% li /SW 170'074 d ()4A z 141r,4 a Aw 7- C� 3 q Y k J1 3S4 P z c. p3 -&A k rwK,. .r Q Exhibit C: Simplified Process Interconnection Application Instructions General Information If you wish to submit an application to interconnect your generating Facility using the Simplified Process (10kW or less, inverter -based, UL1741-listed) please fill out the attached application form down to the space for your signature. Once complete, please sign and attach any documentation provided by the generator manufacturer describing the UL1741 listing for the generator. The process is as follows: 1. Application process: a. Interconnecting Customer submits a Simplified Application filled out properly and completely. b. The electric utility Company acknowledges to the Interconnecting Customer receipt of the application within three business days of receipt. c. Company evaluates the application for completeness and notifies the Interconnecting Customer within 10 days of receipt that the application is or is not complete and, if not, advises what is missing. 2. Company verifies Facility equipment can be interconnected safely and reliably. Company signs application approval line and sends to Customer. In certain rare circumstances, the Company may require the Interconnecting Customer to pay for minor System Modifications, if so, an estimate will be sent back with the approved application requiring the Interconnecting Customer's consent to pay for the modifications. 3. After installation, customer returns Certificate of Completion. Prior to parallel operation Company may inspect Facility for compliance with standards which may include a witness test, and schedules appropriate metering replacement, if necessary. Company notifies Interconnecting Customer in writing that interconnection of the Facility is authorized. If the witness test is not satisfactory, the Company has the right to disconnect the Facility. The Interconnecting Customer has no right to operate in parallel until a witness test has been performed or previously waived on the Application Form. The Company is obligated to complete this witness test within 10 days of the receipt of the Certificate of Completion. If the Company does not inspect in 10 days or by mutual agreement of the Parties, the Witness Test is deemed waived. Contact Information: You must provide the contact information for the legal applicant (i.e. the Interconnecting Customer). If another party is responsible for interfacing with the Company (utility), you should provide his/her/its contact information as well. Ownership Information: Please enter the legal names of the owner or owners of the Facility. Include the percentage ownership (if any) by any Company or public utility holding company, or by any entity owned by either. Confidentiality Statement: In an ongoing effort to improve the interconnection process for Interconnecting Customers, the information you provide and the results of the application process will be aggregated with the information of other applicants and periodically reviewed by a DG Collaborative of industry participants that has been organized by the Massachusetts Department of Telecommunications and Energy (DTE). The aggregation process mixes the data together so that specific details for one Interconnecting Customer are not revealed. In addition to this process, you may choose to allow the information specific to your application to be shared with the Collaborative by answering "Yes" to the Confidentiality Statement question on the first page. Please note that even in this case your identification information (contact data) and specific Facility location will not be shared. Facility Information UL1741 Listed? This standard ("Inverters, Converters, and Controllers for Use in Independent Power Systems") addresses the electrical interconnection design of various forms of generating equipment. Many manufacturers choose to submit their equipment to a Nationally Recognized Testing Laboratory (NRTL) that verifies compliance with UL1741. This "listing" is then marked on the equipment and supporting documentation. DEP Air Quality Permit Needed? A Facility may be considered a point source of emissions of concern by the Massachusetts Department of Environmental Protection (DEP). Therefore, when submitting this application, please indicate whether the proposed Facility will require an Air Quality Permit. You must answer these questions, however, your specific answers will not affect whether your application is deemed complete. Please contact the DEP to determine whether the generating technology planned for your Facility qualifies for a DEP waiver or requires a permit. Simplified Interconnection Application and Service Agreement for Facilities with Inverter Capacity of 10kW and under Contact Information Legal Name and address of Interconnecting Customer applicant (or, if an Individual, Individual's Name) Company Name: Contact Person: R.V.Rajan Utility Account) Mailing Address: 84 Academy Rd. Apt Rear City: North Andover State: MA Zip Code: 01845 Telephone (Daytime): 978 685-9781 (Evening): 978 685-9781 Facsimile Number: E -Mail Address: anitarajanworden(a),comcast.net Alternative Contact Information (if different from Applicant) Name: James Worden Mailing Address: 84 Academy Rd. (Apt. Rear) City: North Andover State: MA Zip Code: 01845 Telephone (Daytime): 978 771-6574 (Evening): 978 771-6574 Facsimile Number: 978 683-9702 E -Mail Address: james0solren.com Ownership (include % ownership by any electric utility): 100% customer owned Confidentiality Statement: "I agree to allow information regarding the processing of my application (without my name and address) to be reviewed by the Massachusetts DG Collaborative that is exploring ways to further expedite future interconnections." Yes—x— No Facility Information Location (if different from above): Electric Service Company: Ngrid / Mass Electric Account Number (if available): 04413 00110 08 Inverter Manufacturer: Solectria Renewables. Model PVI2500-240VAC Nameplate Rating: 2.5 (kW) (kVA) 240 (AC Volts) Single X or Three Phase System Design Capacity: _2.5 (kW) (kVA) Prime Mover: Photovoltaic X Reciprocating Engine ❑ Fuel Cell ❑ Turbine ❑ Other Energy Source: Solar ❑ Wind ❑ Hydro ❑ Diesel ❑ Natural Gas ❑ Fuel Oil ❑ Other UL1741 Listed? Yes X No Need an air quality permit from DEP? Yes No _ Not Sure If "yes", have you applied for it?-Yes—No _ Estimated Install Date: Apr 1, `06 Est. In -Service Date: April 10, 2006 Customer Signature (attach manufacturer's cut sheet showing UL 1741 listing & sign here I hereby certify that, to the best of my knowledge, all of the information provided in this application is true and I agree to the Terms and Conditions on the following page: Interconnecting Customer Signature,,?� � Title: Date: Feb 9, 2006 Installation of the Facility is approved contingent upon the terms and conditions of this Agreement, and agreement to any system modifications, if required (Are system modifications required? Yes_ Nom: Company Signature: Title: Date: Application ID number: Company waives inspection/witness test? Yes No Terms and Conditions for Simplified Interconnections 1. Construction of the Facility. The Interconnecting Customer may proceed to construct the Facility once the Approval to Install the Facility has been signed by the Company. 2. Interconnection and operation. The Interconnecting Customer may operate Facility and interconnect with the Company's system once the following has occurred: 2.1. Municipal Inspection: Upon completing construction, the Interconnecting Customer will cause the Facility to be inspected or otherwise certified by the local electrical wiring inspector with jurisdiction. 2.2. Certificate of Completion: The Interconnecting Customer returns the Certificate of Completion appearing as Attachment 2 to the Agreement to the Company at address noted. 2.3. Company has completed or waived the right to inspection. 3. Company Right of Inspection. Within ten (10) business days after receipt of the Certificate of Completion, the Company may, upon reasonable notice and at a mutually convenient time, conduct an inspection of the Facility to ensure that all equipment has been appropriately installed and that all electrical connections have been made in accordance with the Tariff. The Company has the right to disconnect the Facility in the event of improper installation or failure to return Certificate of Completion. If the Company does not inspect in 10 days or by mutual agreement of the Parties, the Witness Test is deemed waived. 4. Safe Operations and Maintenance. The Interconnecting Customer shall be fully responsible to operate, maintain, and repair the Facility. 5. Access. The Company shall have access to the disconnect switch (if required) of the Facility at all times. 6. Disconnection. The Company may temporarily disconnect the Facility to facilitate planned or emergency Company work. 7. Metering and Billing. All Facilities approved under this Agreement qualify for net metering, as approved by the Department from time to time, and the following is necessary to implement the net metering provisions: 7.1. Interconnecting Customer Provides Meter Socket. The Interconnecting Customer shall furnish and install, if not already in place, the necessary meter socket and wiring in accordance with accepted electrical standards. 7.2. Company Installs Meter. The Company shall furnish and install a meter capable of net metering within ten (10) business days after receipt of the Certificate of Completion if inspection is waived, or within 10 business days after the inspection is completed, if such meter is not already in place. Indemnification. Interconnecting Customer and Company shall each indemnify, defend and hold the other, its directors, officers, employees and agents (including, but not limited to, Affiliates and contractors and their employees), harmless from and against all liabilities, damages, losses, penalties, claims, demands, suits and proceedings of any nature whatsoever for personal injury (including death) or property damages to unaffiliated third parties that arise out of, or are in any manner connected with, the performance of this Agreement by that parry, except to the extent that such injury or damages to unaffiliated third parties may be attributable to the negligence or willful misconduct of the parry seeking indemnification. 9. Limitation of Liability. Each party's liability to the other party for any loss, cost, claim, injury, liability, or expense, including reasonable attorney's fees, relating to or arising from any act or omission in its performance of this Agreement, shall be limited to the amount of direct damage actually incurred. In no event shall either party be liable to the other party for any indirect, incidental, special, consequential, or punitive damages of any kind whatsoever. 10. Termination. This Agreement may be terminated under the following conditions: 10.1. By Mutual Agreement. The Parties agree in writing to terminate the Agreement. 10.2. By Interconnecting Customer. The Interconnecting Customer may terminate this Agreement by providing written notice to Company. 10.3. By the Company. The Company may terminate this Agreement (1) if the Facility fails to operate for any consecutive 12 month period, or (2) in the event that the Facility impairs the operation of the electric distribution system or service to other customers or materially impairs the local circuit and the Interconnecting Customer does not cure the impairment. 11. Assignment/Transfer of Ownership of the Facility: This Agreement shall survive the transfer of ownership of the Facility to a new owner when the new owner agrees in writing to comply with the terms of this Agreement and so notifies the Company. 12. Interconnection Tariff: These Terms and Conditions are pursuant to the Company's Tariff for the Interconnection of Interconnecting Customer -Owned Generating Facilities, as approved by the Department of Telecommunications and Energy and as the same may be amended from time to time ("Interconnection Tariff'). All defined terms set forth in these Terms and Conditions are as defined in the Interconnection Tariff (see Company's website for complete tariff). ATTACHMENT 2 SIMPLIFIED PROCESS INTERCONNECTION Certificate of Completion Installation Information ❑ Check if owner -installed Interconnecting Customer: _ R.V.Rajan (Utility Account) Contact Person: James Worden Mailing Address: 84 Academy Rd. Apt Rear Location of Facility (if different from above): City: North Andover State: MA Zip Code: 01845 Telephone (Daytime): 978 771-6574 (Evening): 978 771-6574 Facsimile Number: 978 683-9702 E -Mail Address: jamesna,solren.com Electrician: Name: Michael Hughes M. Hughes Electrical Mailing Address: 264 Main St City: Stoneham State: MA Zip Code: 02180 Telephone (Daytime): 781710-9912 (cell) (Evening): 781279-0443 Facsimile Number: E -Mail Address: wirenut277@comcast.net License number: Master Lic.# A18156 Journeyman's Lic.# E26046 Date Approval of Install Facility granted by the Company: Application ID number: Inspection: The system has been installed and inspected in compliance with the local Building/Electrical Code of North Andover Essex (City/County) Signed (Local Electrical Wiring Inspector, or attach signed electrical inspection): lzz;� A�_O* Name (printed): � �- in U A /ig/- ' � Date: q - % -06 As a condition of interconnection you are required to send/fax a copy of this form along with a copy of the signed electrical permit to (insert Company's name below): Name: Tim Rouehan, John Bzura Company: Masschusetts Electric Mail 1: 55 Bearfoot Rd. Mail 2: City, State ZIP: Northboro. MA 01532 Fax No.: