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HomeMy WebLinkAboutMiscellaneous - 85 LANCASTER ROAD 4/30/2018A Data.. TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION Thiscertifies that(.-).--/ ......................... has permission for gas installation . ... ............. 1�2 in the buildings of ... .. ). . . ................. atCrt.............. N h Andover, Mass. Fee.... .... Lic. No.. GAS INSPEjpijl� Check 6369 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) n gg Town Date Permit # Building Location ?,�- Owner's Name Type of Occupancy_ J. Installing 'I A.4.4 --- Business T New Renovation'o Replacement p Plans Submitted: Yesp No p 0.3 0 Name of Uce6sed .Plumber or Gas Fitter I Check one: 9--i oration ❑ Partnership ❑ Firm/Co. Certificate INSURANCE CO GE: have a erre icy Insurance Ej u a policy or Its substantial equivalent which rnee4.s the requirements of MGL Ch. 142. H you have checked yes, please fr a the type coverage by checking the appropriate box A liability Insurance policy a Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General taws. and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in ication are true and accurate to the best of my knoMAedge and that all plumbing work and installations performed under the permit ' for is application will be in mplianoe with all Pertinent provisions of the Massachusetts State Gas Code and/Ch'a'pter 142 of By. T cense: Signature of Licensed u or Gas fitter Title er ? kyr o �YRoWn yLicense Number ��J O IC _ ONL WANT 0.3 0 Name of Uce6sed .Plumber or Gas Fitter I Check one: 9--i oration ❑ Partnership ❑ Firm/Co. Certificate INSURANCE CO GE: have a erre icy Insurance Ej u a policy or Its substantial equivalent which rnee4.s the requirements of MGL Ch. 142. H you have checked yes, please fr a the type coverage by checking the appropriate box A liability Insurance policy a Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General taws. and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner❑ Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in ication are true and accurate to the best of my knoMAedge and that all plumbing work and installations performed under the permit ' for is application will be in mplianoe with all Pertinent provisions of the Massachusetts State Gas Code and/Ch'a'pter 142 of By. T cense: Signature of Licensed u or Gas fitter Title er ? kyr o �YRoWn yLicense Number ��J O IC _ ONL 5971 Date f-&- <j— ............................. TOWN OF NORTH ANDOVER PERMIT FOR WIRING Thiscertifies that ... .......................................................................................... ..... has -permission to perform A.— ........ .................................................. wiring in the building of ... ...... . ................................ at ...`'....o;qorth Andover, Mass. .. ............. .... AFee �K .......... Lic. No? .. ... . .. .... . ... . . ... ELECTRICAL INSPECTOR ~Check # 3 9 ;-z X J Official Use Only Commonwealth of Massachusetts ffi h stgJPermit No. Department of Fire Services Occupancy and F/la:) ked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 11/99] ea APPLICATION FOR PERMIT TO PERFORM ELECTRICWWORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date:-/-, LjC u,Sj j . City or Town of: Nm t} AM dove A. To the Inspector of Wiles: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) g 5 L&t,l CA-axo dt_. P__C3,�Q cj . Owner or Tenanta'i ,p, .1-.1 M u 9_ f1 ki —/ Telephone No. Owner's Address_25 1614CASI'po- 9oA-c% N0>1XR ANDOPK—MA Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building �e g la Q� C Utility Authorization No. Existing Service 9W Amps a o / rIL o Volts Overhead ❑ Undgrd ® No. of Meters ) New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: R CLOD V I_ �'� rG w� A -D L. g it r 1 In) O'C' sr-, "owl Add .�.->•�,� 1.� WE ;J 1Ai&L 1� t,.� r' �T-S CoinDletion of the followinP table may he waived by the In.vnPrtnr n(Wirac 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 Swimming Pool Above rnd. ❑ In- rnd. F71 No. o Emergency Lighting Battery Units No. of Receptacle Outlets 4 No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. ot Detection and Devices No. of Ranges TotaInitiatin No. of Air Cond. Tons l No. of Alerting Devices No. of Waste Disposers Heat Pump Totals: Number Tons I KW I No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal ❑ Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water Heaters KW No. of 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: ?_eTe_ 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 coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of El Work: (When required by municipal policy.) Work to Start:AeApa4insandpenalties J Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, undeof perjury, that the information on this application is true and complete. FIRM NAMED U lJ U-),¢ I I &A { (p c'[' LIC. NO.: Ct M (2, Licensee: Y/+tkL(2m!►' ;1 R -O j Signatur LIC. NO.: W50 "TIz.. (If applicable, enter "exempt " in the licenselnumber line.) Bus. Tel. No. O (— 30644 Address:",:S [,Lt wt-rq 0 b P% v e,►+o {.I t, S 1,1 i 0 0 L4 5 Alt. Tel. N(*: — 00 7 OWNER'S INSURANCE WAIVER:'l am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent PERMIT FEE. S ?" -4; v Signature Telephone No. TOWN OF ANDOVER ELECTRICAL PERMIT FEES (Effective.March 12, 2003) MINIMUM PERMIT FEES: RESIDENTIAL $25.00 COMMERCIAL $100.00 NO SE CABLE ON OUTSIDE OF BUILDING Air Conditioners: $40.00 each Alarm Systems Security: (for fire systems see smoke/heat detectors) Residential: $40.00 Commercial: up to 10 Devices $60.00 additional devices over 10- $1.00 each Carnival Equipment: $50.00 each Ceiling Fans: $1.00 each Commercial New Construction or Alterations: $100.00 per 1,000 Sq. Ft. of Construction Space Commercial Service Change/ Repair: Must have Utility Authorization Number $100 (first 100 amperes or fraction, one meter) a) each additional 100 amperes capacity or fraction. $30.00 b) each additional meter $25.00 Commercial Temporary Service: $100.00 Must have Utility Authorization Number Commercial Repair and/or Maintenance Permit: (Blanket Permit) up to 2 Electricians $150.00 per pair of Electricians over 2 $50.00 Data/Telecommunication: Residential: $1.00 per port Commercial: $30.00 up to 10 devices over 10 - $1.00 each Dishwashers & Disposals: $5.00 Each Dryers: $15.00 Each Emergency Lighting (Rattary I lnitc) $ 1.00 each unit Feeders or Sub -feeders: each 100 amp capacity of fraction thereof Residential: $5.00 each Commercial: $15.00 each Gas/Oil Burners: Residential: $20.00 each Commercial $20.00 each Generators Residential & Commercial: a) including photovoltaic & generating Equip Per KVA $1.00 b) un -interruptible power systems, per KVA $1.00 c) batteries over 100 amp. hours, per cell $1.00 Heat Devices: $1.00 each Heat Pumps: $40.00 each Hydro -Massage Bathtubs/ Hot Tubs: $20.00 each Lighting Fixtures $1.00 each Lighting Outlets: $1.00 each Major Appliances: (not listed) $20 each Motors: (per hp or fractional part thereof) $2.00 Oil /Gas Burners: Residential $20.00 each Commercial $20.00 each Office Furnishings: per circuit $10 (Relocatable Partitions/Cubicles) Outlets & Fixture: $1.00 each Ovens Built in/Counter Top Units: $10.00 each Panel Change/Circuit Breaker: Residential: $20.00 Commercial: $25.00 Phone Jacks: See data/telecommunications Ranges $15.00 each Receptacle Outlets: $1.00 each Recessed Fixtures: $1.00 each Re -inspection Fee: $25.00 Repair to Service Residential: $20.00 Residential New Construction (Dwelling): $220.00 (with service up to 200 amps) Must have Utility Authorization Number for services over 200 amps see below a) for each 100 amps capacity or fraction add $20.00 l "I each additional ,,e♦ e $D 11 0) .%00 c) each additional panel/sub panel $25.00 Residential Additions/Alterations: $220.00 maximum Residential Service Change or Underground Service: $40.00 Must have Utility Authorization Number a) one meter, up to 100 amp capacity $40.00 b) each additional 100 amp capacity or fraction $20.00 c) each additional meter ..$10.00 Sewer Ejection Pump: $25.00 Signs: $25.00 each ballast Smoke & Heat Detectors & Initiating Devices: Residential: $1.00 each Commercial: $60.00 up to 10 devices over 10 - $1.00 each Space Heaters: area heating $1.00 each Sub -Panel: $25.00 Swimming Pools: Residential: Above Ground: $25.00 Inground: $50.00 Commercial Pool: $100.00 Switches: $1.00 each Temporary Service: Must have Utility Authorization Number Residential $25.00 Commercial $100.00 Transformers: a) capacitors, Per KVA $1.00 b) ducts, conduit & conductors (Associated w/ Padmount Transformers) $25 c) each manhole $10.00 d) each handhold $5.00 e) per KVA $1.00 f) primary feeders, $25.00 each (over 600 volts, non-utility owned) g) vaults and equip. $25.00 each Washers: $15.00 each Waste Disposals: $5.00 each Water Heaters: $30.00 each *For Multi -Family & Large Commercial Project see Wiring Inspector for pricing: Paul Kennedy (978) 623-8306 (Office Hours 8 am to 10 am) *Inspection Schedule: 1 ROUGH 1 FINAL i I TRENCH (if applicable) ADDITIONAL INSPECTIONS *$25.00 (if applicable) (revised 09/04) 80 V,9'171 619 /Irl �9 . 5-. o s Pt -ti 101 Commonwealth of Massachusetts War Department of Fire Services , ` BOARD OF FIRE PREVENTION REGULATIONS Official Use Permit No. _0-1 Occupancy and Fee ecked ,ev.11/99] bnv Innlr) APPLICATION FOR PERMIT TO PERFORM ELECTRICWORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT WINK OR TYPE ALL INFORMATION) Dater Lj6,4.S 1 City or\Town of: b[ak-711 AgAUX&A-., To the Arp, &or of By this applicatioir the undersigned gives notice 'o`f his onher intention to perform the electrical work described tiafdvv% ry Location (Street & Number) g 5 L►4N �'fTi2 yl Ro A Owner or Tenant Bim„'i A -iJ (y) U.12.. 'P 1A —/ Telephone No. Owner's Address ►UliZT:�L/!� Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building �e. g'.1 QW-) CP, Utility Authorization No. Existing Service _9(2Q Amps I,-) Q / Jy ()Volts Overhead ❑ Undgrd No. of Meters New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: 9'p—Lo O fl- Px, s t -t v.0 (� a d "o vvi , A- A a_ _R, . , . i--eA, ,ate _,, 1 r t ►,-q to Completion of the followine, table may be waived by the InsDector of Wirer_ 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 FixturesSwimming Pool Above ❑ In- ❑ rnd, rnd. o. o Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. o Detection an Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices g No. of Waste Disposers Heat Pump Totals: Number I. Tons I KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers Space/Area Hefting KW Local ❑ Municipal [J Other Connection No. of Dryers Heating Appliances KW Security Systems: No. of Devices or Equivalent No. of Water Heaters KW No. of 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: r 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 coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) (Expiration Date) Estimated Value of El ctrical Work: (When required by municipal policy.) Work to Start: �' a 0 Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certify, under t e pait:s and penalties ofperjury, that the information on this application is true and complete. FIRM NAME:I U M n,,4 t T LIC. NO.: 9 Q Cl IM Licensee: /�ayyi,Sl (t o Signatur LIC. NO.: �Ji� SI2 (If applicable, enter "exempt "inthe licens number line.) Bus. Tel. No. .6 1-3t7(�(, Address:_ �Li r.lTp w� l� Ry Ido l I t S 1Q � 14 - 0 -i 0 q �j Alt. Tel. N�: 7 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverag6 normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent v Signature Telephone No. PERMIT FEE: $ ° Location eS Z-A'VWSLP No. Date r NORT�y TOWN OF NORTH ANDOVER OL s Certificate of Occupancy $ .12 CHU''<� swcNusa Building/Frame /Frame Permit Fee $ 9 Foundation Permit Fee $ O Other Permit Fee $ TOTAL $ Check # f / *--s Building Inspector v TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING This Sectim for U>Pfieiat Use �� _. BUILDING PERMIT NUMBER:DATE ISSUED: _1 X SIGNATURE: (L Building COMMISSioner/I for of Buildings Date SECTION 1- SITE INFORMATION I Z 1.1 Property Address: -�,-,� 1.2 Assessors Map and Parcel Number: Map Number Parcel Number O 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Re red Provided v 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: Public ❑ Private ❑ Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record a [?tom LA��►�ft�/ UL !� d�r�/ Name (Print) Address for Service : `Ivy N 1 Signature Telephone 2.2 Owner of Record: Name Print Address for Service: O Z M Si nature Telephone SECTION 3 - CONSTRUCl'ION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: a2 f, L," , ruVs j �l y ) R 1 14 1 �7 ��-�r��`�' d /7 [rC� /V l ! Not Applicable 11 j O License Number Address Signatur j Tel phone!, l r 2 Expiration D to 3.2Registered Home Improvement Contractor Not Applicable 0 v r r ^z^ 1i Company Nam &V /����`� J g/1�) � �J / ���p� % U Registration Number Expirat on Date OY� S� Addre . ianatur Tele hone SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of t e building permit. Signed affidavit Attached Yes ...... No ....... ❑ SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. J Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: Work: //'t- W94CL 41tn?,VJ Lott_,, r SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estirna,ed Cost (Dollar) to beOFFI Completed by permit applicant Ie1i, tlS%,fi?NLY 1. Building / (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) 4 Mechanical (HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property ev Hereby authoriz A&r/04-,ts to act on beh n all ative o wautl ed by this building pennit application. a Signal of Oxyner V Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, 4� - 'i /� as Owner/Authorized Agent of subject property Herebv declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and beiil t Print Dt�— n CJ Si<imature f Ou /A ent Date NO. OF STORIES SIZE BASENENT OR SLAB SV E OF FLOOR TIMBERS 1 2` 3 RD SP, -\-N DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS 111:IGIIT OF FOUNDATION THICKNESS SI/_E OI- FOOTING X iVIATERIAL OF CHINM,Y IS I3U1LDFNG ON SOLID OR FILLED LAND I' i3iJILDING CONNECTED TO NATURAL GAS LINE 01aV14VV0 Lnu D:/D raa UU1/UUL ACO -RD„ CERTIFICATE OF LIABILITY INSURANCEDATE 06/30/2005) PRODUCER (603) 669-0704 FAX (603)669-6831 ,Infanti1ne Insurance, Inc. P.O. Box 5125 Manchester, NH 03108 Joyce Dunlap THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC # INSURED Blackdog Builders, Inc. 7 Red Roof Lane Unit 1 Salem, NH 03079 INSURERA: Peerless Insurance. 24198 INSURERS: Acadia Insurance Co. 31325 INSURERC: INSURER D: INSURER E: rnvr_oer_cc 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. II T R qR TYPE OF INSURANCE t- POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS GENERALLIABILfTY CBP9869957 07/01/2005 07/01/2006 EACH OCCURRENCE $ 1,000,00 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED $ 100,000 CLAIMS MADE FX] OCCUR MED EXP (Any one person) $ 5,000 A' PERSONAL & ADV INJURY S 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEML AGGREGATE LIMIT APPLIES PER* PRODUCTS - COMP/OP AGG $ 2,000,000 POLICY PRO- JECT LOC - AUTOMOBILE LIABILITY BA9860458 07/01/2005 07/01/2006 COMBINED SINGLE LIMIT $ X ANY AUTO (Ea accident) 1,000,00 BODILY INJURY ALL OWNED AUTOS SCHEDULED AUTOS (Per person) $ A BODILY INJURY X HIRED AUTOS X NON -OWNED AUTOS - (Per accident) $ PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESWUMBRELLA LIABILITY EACH OCCURRENCE $ AGGREGATE $ OCCUR FICLAIMS MADE S DEDUCTIBLE $ RETENTION $ $ WORKERS COMPENSATION AND WCA006920414 07/01/2005 07/01/2006 X I WC STATUS I 0111 - EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ 100,000 B ANY PROPRIEfORIPARTNERIEXECUTIVE OFFICERIMEMBEREXCLUDED? E.L. DISEASE - EA EMPLOYEE $ 100,00 If yes. describe under E.L. DISEASE -POLICY LIMIT $ 500 00 SPECIAL PROVISIONS below OTHER DESCRIPTION OF OPERATIONS I LpCATIONS I VEHICLE� I EXCLUSIONS ADDED BY ENDORSEMENT [SPECIAL PROVISIONS ut Various work throughothe policy term. ServiceMagic Inc. Att: Insurance Dept 14203 Denver West Parkway Building 64, Suite 200 Golden, CO 80401 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY DF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. HOR5WIFVIP RESENTATIVE � 11 C'1 '! ACORD 25 (2001108) I -AA: k5bb)G5U-9bL1 ©ACORD CORPORATION 1988 ,per ✓�-��,��r� ��a . �\ Board of Building.Regulations and Standards lug E*R&W HOME IMPROVEMENT CONTRACTOR Rog l5tratibn s'. 1.06877 712812006 rjype Private Corporation f f� BLACKDOG BUIttiN DAVID BRYAN 7 RED ROOF LN: Salem, NH 03079 Administrator License or registration valid for individul use only before the expiration date. If found return to: Board of Buiil'ding..Regulations and Standards One Mlliburton Place Rm 1301 Boston; Mai 02108 i Not vali: i uts*ature __...._ _ :j 00 - 35,000 611 enclosed space. - _ ✓fie �anvnioriureaCC� _o�ac`iuQeli4'' (MGL C.112 S.60L) BOARD OF BUILDINNGREGULATIONS + r 1A -Masonryonly s� License CONSTRUCTION`SUPERVISOR 1G-1 & 2 Family Homes Failure to possess a current edition of the l; Number,:,CS 083443: i I, Massachusetts State Building Code license. F tx'r Birthdate 04/25/1958 is cause for revocation of this ; ' Ex(sires 04l25/2006 Tr. no: 83443 i Restricted w WILLIAWS RICHARDSON 23 SYLVAN, DR ,per ✓�-��,��r� ��a . �\ Board of Building.Regulations and Standards lug E*R&W HOME IMPROVEMENT CONTRACTOR Rog l5tratibn s'. 1.06877 712812006 rjype Private Corporation f f� BLACKDOG BUIttiN DAVID BRYAN 7 RED ROOF LN: Salem, NH 03079 Administrator License or registration valid for individul use only before the expiration date. If found return to: Board of Buiil'ding..Regulations and Standards One Mlliburton Place Rm 1301 Boston; Mai 02108 i Not vali: i uts*ature BUSINESS CONDITIONS TO THIS CONSTRUCTION CONTRACT This Contract, dated is by and between: Brian and Nancy Murphy 85 Lancaster Road North Andover, MA 01845 Blackdog project code MURPH-5575-B (Hereafter referred. to as OWNER), and Blackdog Builders, Inc. 7 Redroof Lane, Unit #1 Salem, NH 03079 (603) 898-0868 (Hereafter referred to as CONTRACTOR). Work will be performed at: 85 Lancaster Road, North Andover, MA 01845 (Hereafter referred to as PROPERTY) 7. "r-IVCKAL This CONTRACT is for the following work and materials to be performed by the CONTRACTOR on the PROPERTY address shown above. The project is generally described as follows: Master Walk in Closet and Bedroom Re -work (Hereafter referred to as WORK) The CONTRACT consists of this document, any plans, the specifications, the Blackdog client package and the Construction Contract. (Hereafter collectively referred to as the "CONTRACT") 2. PRICE The total price for the WORK agreed upon is $18,611.70. Payment terms are set out below in Paragraph 6. This proposal may be withdrawn by us if not accepted within thirty (30) days. 3. STARTING AND COMPLETION PROVISIONS The WORK will begin in July, 2005 and will be completed in August, 2005, absent unusual or unforeseen circumstances, on providing this CONTRACT and any related CONTRACT documents are accepted when presented. Projects requiring two contracts (one for construction work and one for bath or kitchen product) will not be slotted into the schedule until both agreements have been executed. The aforementioned dates reflect our present workload. Projects are assigned a slot in our work schedule as they are accepted, on a first come first served basis. These dates may move based on the completion time of the project that immediately preceded yours. 4. PERMITS AND APPLICABLE CODES; COMPLIANCE WITH LOCAL LAW a. All work to be done under this CONTRACT will be in accordance with local, state and county building code. The CONTRACTOR shall obtain all necessary permits and pay all required permit and plan fees from the CONTRACT sum, unless otherwise agreed. The CONTRACT price does not include any fees, which may be incurred to obtain a variance, if required. The CONTRACT price does not include any unbid items required by any local building official to bring the project into compliance with any relevant local, state and county building code. 05/23/2005 Contract Proposal — Page 4 of 18 Ib c. Notwithstanding any manufacturer's warranty of any component, appliance, or system, no action may be brought against the CONTRACTOR on this CONTRACT for the performance of this work, except as provided above. 14. SEVERABILITY If any portion of this agreement is found invalid or unenforceable by any court, the remaining provisions shall remain in force between the parties. 15. ENTIRE AGREEMENT This CONTRACT consists of the documents defined herein, and constitutes the entire agreement of the parties. It can be modified only by a written document. OWNER acknowledges that he has read and received a legible copy of this agreement signed by CONTRACTOR, before any work was done, and that he has read and received a legible copy of every other document that OWNER has signed during the negotiation of this Contract.. SUBMITTE Jo,' n N`Ucholson Blackdog Builders, Inc. ACCEPTED: DATE: v DATE: Brian Murphy -� DATE: Nancy hilkiphy 05/23/2005 Contract Proposal — Page 12 of 18 `D V, cr N m co N C co V T T DD v o Z a'Oca) N CD C/) CD CD CD cn v o4k rA (D O CLCl)0 _ CL co w v CL CD CD O Q co Cl) U)77 0 _0 CD x c. C o CD 4p Fr- Z O F=4 W r . c p i••i o �ca to C� C3 .J CL c mm {• V. HQ G; `� w o ts � o N „ ° E c Q 01"f :moo, -ft fti •oc E zip C A p m • y C c lC p 40 73 w O O av C cc ♦: y w� c v► o c mom m • � M p Of 0 w �z O a c Q w c c _ • :ago ~p ti CoLU o LU o a .22 c� z ` H c Z � a �.poc C z y of s W �E�3 f•- r $ a.=.. a0 zo H z O U 2 m T � c CM CD._ h On CD m m CD W � H Z CL }. 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PAGE 1 MAP KJO. 3. 2 RECORD OF OWNERSHIP IDATE BOOK -'PAGE ZONE SUB DIV. LOT NO.I LOCATION �� / 7GRS�e O PURPOSE OF BUILDING C �D ald �„i� 2 Somme .•�. !J OWNER'S NAME b V_I AN/Lf7L�V�\ J Q ky iJ NO. OF STORIES SIZE OWNER'S ADDRESS �c� 1` BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME -'f� Te C }iQ 1 J r� SPAN DIMENSIONS OF SILLS DISTANCE TO NEAREST BUILDING DISTANCE FROM STREET (1 i POSTS DISTANCE FROM LOT LINES - SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION F i 1 I IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER V4-,.-5 BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER C.S IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS SEE BOTH SIDES PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1 - 12 Y ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED 'Deo c+ �' Q q W SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE z PERMIT GRANTED �� o 19 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST 415�', 0 o (3 EST. BLDG. COST PER SQ. FT. V EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY 4691 BUILDING INSPECTOR OWNER TEL. k CONTR. TEL. 11 �,o CONTR. LIC. X ® 5-4 I H.I.C. # Oma I OCCUPANCY SINGLE FAMILY STOkIES MULTI. FAMILY OFFICES APARTMENTS CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 3 1 2 CONCRETE BIL K. PINE BRICK OR STONE HARDW'D PIERS PLASTER _ _ DRY VJALL UNFIN. 3 BASEMENT AREA FULL FIN. B'M'TAREA '/. 1/2 1/1 FIN. ATTIC AREA N_O BM'T FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS 9 FLOORS CLAPBOARDS B l _ DROP SIDING CONCRETE _ WOOD SHINGLES EARTH ASPHALT SIDING HARDV✓'D _ ASBESTOS SIDING _ COMMCN _ VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRI N MAS N Y I ATTIC STIRS. 8 FLOOR STONE ON MASONRY I WIRING STONE ON FRAME SUPERIOR I I POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GAB__ lE J—J HI��JI TOILET 3RM. 12 FIXA GAMBREL I MANSARD 1 LT BUILDING RECORD 12 THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. ROLL ROOFING 11 MODERN FIXTURES TILE FLOOR TILE DADO 6 FRAMING i 1 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM STEEL BMS. 8 COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING _ 7 NO. OF ROOMS RADIANT H'T'G UNIT HEATERS GAS OIL ELECTRIC NO HEATING B'M'T 2nd _ 1•t 13rd I ) CO) d C � O CD 'v O !7 Z y CLO �* O C. y aCc �� a O �v CD O Cr %ocd CD C OCD a O CO) W � v CA O 'O Z CD a O � CD O c CD cn cn n O cn 9 O cnH VJ O z cn O Cl O m x N Q EL. O�m N y -i =31 m n CD m c N$co a$ 3 s = V =r= H b -p ='ate► Er M a� m y o CO2 g Wim: --1 _ o m o go _ O o p N n jo CD a � m Sao o ?; CD cp CA bn �o o C O CD a CDN O .22 a= Q C N Val CCD Po N CD N \ N 0 m� ;co co oC.,. CD CDGoo = 3 a . o CD CD � N . CD m a 1�1 CD m m co s _C ti otv d o o V R o - 0 r x n�� C& G b -p M O hPl it H 0 O C i From: Mugfq To: Ain Tamm e1�f86 a12816:4� 7roo.-r 28'8" 6"ath Led 91 11 _ Storage 24'11" 4 �^ Work a Bedroorrig-- F 111 611 o a 13'4" Q Playroom ` � Murphy - 85 Lancaster Rd 36'10" Dimensions w C) �^ L,gcation Date t NORTh TOWN OF NORTH ANDOVER r.W—jft P Certificate of Occupancy Building/Frame Permit Fee $ Z?320 d "• CHU Foundation Permit Fee $ sACNUSE -Other Permit Fee $ --------- Sewer Connection Fee $ h5 lv-le3 Water Connection Fee , $(,A&10'f7 E TOTAL$ 1 C) C) Af.J Building Inspector 11/29/93 08;44 1,837.40 PAIu �`T 6 750 Div. Public Works Location No. Date r I` TOWN OF NORTH ANDOVER Certificate of Occ _ arm $ Buildirig—[F" ni-e'-permit'F66�'J Foundation Permit Fee $ Other Permit Fee $ 5 Sewer Con,Mtion F8e (9� Water Connection Fee $ TOTAL C1 � SsZ b r fUo'. &G S7 Building Inspector C -Z Diu?Public Works P Location No. N Date NORTh i TOWN OF NORTH ANDOVER o p Certificate of Occupancy, $ Build /Frame PerFee, s��N�s c� Fonda° n Permit Fee Other Permitcgeee$ Sewer ConnectiIft9e $ Water Connection Fee $ TOTAL $ Building Inspector Div. Public Works _,_. -i•"(/ �� "%t.l�`�'�-a�adil*.�-.... s.�`@„Y'...T^^'IG'ia..i+--•u�`y�•`•fvr`!�T'"rs-+� Location No. Date 12—Z —'�--� Y NORTH TOWN OF NORTH ANDOVER Oft�a° ,a�4• F n Certificate of Occupancy $ Building/Frame Per it Fee $ Foundation Perr fft',pe $ /�/J,Qy s�cHusE Other Permit Fee $ Sewer Cor ction Fee $ �! Water Cgnr�dn Fee $ I, TOTAL �� $ N ilding Inspector - 6685 Div. Public Works �6Acation r No. Dated` r--� f ,.ORTp TOWN OF NORTH ANDOVER # Certificate of Occupancy $ " Building/Frame fieri it Fee $ 'SS�cMUS t� Foundation Permit Fee.-- 's Other Permit $ '_ ``,,F..ee Sewer Conng�Fee a Water Con6'60o7n Feed, '$ __--------- w TOTAL�� r Building Inspector Div. Public Works f-Y'Rine NO. �� APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. �� PAGE 1 MAP d40. LOT NO. 2 RECORD OF OWNERSHIP DATE BOOK ;PAGE ZONE SUB DIV. LOT NO. c r s LOCATIO PURPOS F BUIL NG OWNER'S NAME Alz `r NO. OF STORIESSIZEQ OWNER'S ADDRESS Zloo BASEMENT OR SLAB OL ARCHITECT'S NAME BUILDER'S NAME SIZE OF FLOOR TIMBERS IST A'4/�7 2ND a 1n/'� 3RD X TJQ f%CrT O� �F oC !J SPAN /'5 DISTANCE TO NEAREST DfJILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES - SIDES �5 REAR " GIRDERS AREA OF LOT n a_ _ 711-- FRONTAGE HEIGHT OF FOUNDATION THICKNESS d/ O IS BUILDING NEW 40� SIZE OF FOOTING / X / IS BUILDING ADDITION v MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS SEE BOTH SIDES a fF / ±2 v PAGE 1 FILL OUT SECTIONS 1 - 3 WE. PAGE 2 FILL OUT SECTIONS 1 - 12 mg U ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR FEE ,/ • U appy / iQ 'o C"7 PERMIT GRANTED / z 19 OWNER TEL. CONTR. TEL.�— CONTR. LIC. NOV 1 1993 7S 0 3 PROPERTY INFORMATION LAND COST EST. BLDG. COST ::7--;7;20 v EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BOARD OF HEALTH PLANNING BOARD BOARD OF SELECTMEN Wwawl mw InirNGTOR Y BUILDING RECORD 1 OCCUPANCY 12 THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA - ES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. m -. i - Q.nasNd' - ' ti t Y I SINGLE FAMILY STORIES MULTI. FAMILY OFFICES APARTMENTS I I CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE PINE HARDW D 3 tI3 CONCRETE BL K. BRICK OR STONE PIERS PLASTER DRY VJALL _ _ _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ '/. 1/1 '/. FIN. ATTIC AREA NO B M FIRE PLACES HEAD ROOM 7 MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B _ 1 2 �_ 3 _ DROP SIDING WOOD SHINGLES CONCRETE EARTH ASPHALT SIDING ASBESTOS SIDING VERT. SIDING HARDVJ'D COM/.ICN ASPH. TILE STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY BRICK ON FRAME ATTIC STRS. & FLOOR CONC. OR CINDER BLK., WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR I--jPOOR ADEQUATE NONE 10 PLUMBING 5 ROOF GABLE I GAMBRELMANSARD FLAT I HIP BATH (3 FIX.) TOILET RM. 12 FIX.) SHED WATER CLOSET ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. & COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS _ L/ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ lit 13rd II ELECTRIC NO HEATING FORM U - LOT RELEASE FORN INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicant fills out this section***************** APPLICANT: „ s Phone LOCATION: Assessor's Map Number - Parcel l Subdivis ion �- c�•-� Lot (s) lY Street'�,--- St. Number —S — ************************Official Use Only************************ RECOtHUMATIONs OF TOWN AGENTS: Date Approved 1 Z! Conservation Administrator Date Refected • Comments Town Planner •...� W .L ' ii Comments Date Approved k C{ Date Rejected Date Approved Health Agent Date Rejected Comments Public Works - sewer/water connections d' �'A I L- 3 - driveway permit Fire Department`/ -• �(.i°JC l��vt /ci3 u Received by Building Inspector Date � 1 C�41 CERTIFIED FOUNDA TION PLAN LOCATED /N KkP- A+- " VYN SCALE /_ 4C DATE L Scott L. Gi/es R. L.S. 50 Deer Meadow Woad North Andover, Mass. -- N2A- 41 _2�6, �cA��R RaA►D a Irn i Z5 ! VERT/FY THAT OFFSETS SHOWN ARE FOR THE USE „c THE OFFSETS OF THE SU/L DING /NSPEC TOR ONLY SHOWN COMPLY AND SUCH USE /S FOR THE WITH THEZON/NG DETERMINATION OF ZON/NG BY 4AWS OF CONFORMITY OR NON- CONFORM/TY t'4 WHEN CONSTRUCTED.WHEN BUILT ' f f 4 ` `IM 2 g 1993 .,'r r 41 _2�6, �cA��R RaA►D a Irn i Z5 ! VERT/FY THAT OFFSETS SHOWN ARE FOR THE USE „c THE OFFSETS OF THE SU/L DING /NSPEC TOR ONLY SHOWN COMPLY AND SUCH USE /S FOR THE WITH THEZON/NG DETERMINATION OF ZON/NG BY 4AWS OF CONFORMITY OR NON- CONFORM/TY t'4 WHEN CONSTRUCTED.WHEN BUILT ' I � A 9?ON rA cd ►] go lam D �U Ast� C7 h 1 � �A 4-W4CO w CL o 0 O H H y: a s cn _ m � �Cc ti O U3cc O Ey � U c.C.3 H co >cnCDW C o a w Z Z r �• Q c� A� co c mit D C.3 vs o L .rJCD U a c CO r a co �ymC o w C, o. ~ `� = Nc m ca C o c W� H .� r=,,, — Z LAD. � .E o -o Cm.2 C C u. om�~ N.. COO v. m.— o� 1 Go= CD R LU CL y y co L CL ^o i ♦r C 0 co C.) _R CL CO2 0 O v .M CO) C 0 R ev CO) C CD co U co C 0 CD C2- cma c 0 Z co -3- C c CD z Z z J CL J Q z R w Q Cr w w C) 07- A zL Z2\, �� w o�. CO v)a o 9 a, � U W C7 t v w 20 Q .V w° V)ao' r.. to fd U w ^ 1� U no' ciJ ti to Qj y� o co cn V) lam D �U Ast� C7 h 1 � �A 4-W4CO w CL o 0 O H H y: a s cn _ m � �Cc ti O U3cc O Ey � U c.C.3 H co >cnCDW C o a w Z Z r �• Q c� A� co c mit D C.3 vs o L .rJCD U a c CO r a co �ymC o w C, o. ~ `� = Nc m ca C o c W� H .� r=,,, — Z LAD. � .E o -o Cm.2 C C u. om�~ N.. COO v. m.— o� 1 Go= CD R LU CL y y co L CL ^o i ♦r C 0 co C.) _R CL CO2 0 O v .M CO) C 0 R ev CO) C CD co U co C 0 CD C2- cma c 0 Z co -3- C c CD z Z z J CL J Q z R w Q Cr w w C) C.) Z CL V O 06W LL W a � V LL W C.) 0 0) cc G E. w MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFI%TTING (Print or Type) t l NORTH ANDOVER Mass. / Date ��✓ %� ' %� % I uildin Location fQ0 g L9 � C g S �� ci' Permit # � . Owners Name & r' 9 tj 1 New Renovation 15y' Replacement Plans Submitted FIXTURES L (Print or Type) /� Installing Company Name QUr9e.Ss Check one: Certificate Q Corp. Address—(,o Q /ry( rP(n 439, o/ Partner. I yGl J -S 1?GN' a Wt 9 0/9 7/ Firm/Co. Business Telephone: 5OFF & YJ - a//0 Name of Licensed Plumber or Gas Fitter —4, d`.9 {o •- Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy [Other type of indemnity Q Bond Ej Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. J (Print or Type) /� Installing Company Name QUr9e.Ss Check one: Certificate Q Corp. Address—(,o Q /ry( rP(n 439, o/ Partner. I yGl J -S 1?GN' a Wt 9 0/9 7/ Firm/Co. Business Telephone: 5OFF & YJ - a//0 Name of Licensed Plumber or Gas Fitter —4, d`.9 {o •- Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy [Other type of indemnity Q Bond Ej Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. Signature of owner/agent of property Owner 1� Agent F1 I hereby certify that all of the details and information 1 have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and Installations petfotmed under' Permit issued for this application will -be In compliance with all pertinent provisions of the Massachusetts State Gas Code and thaptes 142 of the General LAwa. •. By Title City/Town: APPROVED (OFFICE USE ONLY) TYPE LICENSE: rq-plumber Gasfitter Signature of Licensed Master Plumber or Gasfitter Journeyman License Number ,.,,.''�����.,+w..•r+.:n"r--�� 'fir.+s..^rs-.. `7'' .�.. r„w�a,m,;,,;`T,.,t;:-- .� .. _ .. - . Date. 2424 i f No oTM , TOWN OF NORTH ANDOVER 3? '� PERMIT FOR GAS INSTALLATION Ifs W ........ This certifies that .. VX has permission for Zc stallati n in the buildin of . ................... at.. 44te lf. -, .... , North Andover, Mass. FeeZ,5 .:- . Lic. No. ...............:......... . . GAS INSPECTOR WHITE: Applicant CANAtRY: Building Dept. PINK: Treasurer GOLD: File o .z varor-%jnM Arrus om ium ruff rcntva e I u L/V r &_um is't%A 5�..� (Print or Tvwl NORTH ANDOVER, . Mass. Dais c� BuildingPermit 3.)_0! (] Location g'6—L S C 9 f P f✓' �/ t7wnera , I'�. Name Qd� 9�� � New O Renovation pReplacement ❑ Plans Submitted: Yes ❑ No. ❑ �iXTUAEs -, Check one: Certificate Installing Company Name U r 119lu VLi le; �O Corp. Address 0 %! C17 0/9 O Partnership P'�i 9 O / 8' ❑ Firm/Co. Business Telephone Name of Licensed Plumber /�gN`%f %3y r-jeS' INSURANCE COVERAGE: C -heck one I have a current liability Insurance policy or No substantial equlvalenL Yes O`_ No ❑ If you have checked ygj, please Indicate the type coverage by checking the appropriate box A Ilabllly Insurance policy 0 . Other type of Indemnity 0 Bond O 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: a urs of Ownet or owner's en Owner ❑ Agent ❑ I Mreby certify that all of the delalls and Information 1 have sutxrrttiad for enleredl In above app III are trw and accurate to the Deet of my knowledge and that al plumbing work and installations performed under the p rmfl Issued for this application wit be h compliance with all pedinenl provislons of a Massachusetts State Plumbing Code and Chapter 142 of the General laws. Mf'f1 WED (OFFICE USE ONLY) naLire of Licensed Mmbef License Number // :�' 9 y Type of Plumbing license: Master � Journeyman 0 at » » o s = w < 0 O so J O ile�e t» = at 1w s IL tom [ r t1i°ssYa'�o=sa » •» e o 3 s N L i a _��ou e < °er : urs 0 sut—��MT. •ASOLIONT %� � / f 1ST FLOOR IND FLOOR IND FLOOR 4TH FLOON sTH FLOOR eTH FLOOR. I 14 YTH FL0011 eTH FLOO11 Check one: Certificate Installing Company Name U r 119lu VLi le; �O Corp. Address 0 %! C17 0/9 O Partnership P'�i 9 O / 8' ❑ Firm/Co. Business Telephone Name of Licensed Plumber /�gN`%f %3y r-jeS' INSURANCE COVERAGE: C -heck one I have a current liability Insurance policy or No substantial equlvalenL Yes O`_ No ❑ If you have checked ygj, please Indicate the type coverage by checking the appropriate box A Ilabllly Insurance policy 0 . Other type of Indemnity 0 Bond O 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: a urs of Ownet or owner's en Owner ❑ Agent ❑ I Mreby certify that all of the delalls and Information 1 have sutxrrttiad for enleredl In above app III are trw and accurate to the Deet of my knowledge and that al plumbing work and installations performed under the p rmfl Issued for this application wit be h compliance with all pedinenl provislons of a Massachusetts State Plumbing Code and Chapter 142 of the General laws. Mf'f1 WED (OFFICE USE ONLY) naLire of Licensed Mmbef License Number // :�' 9 y Type of Plumbing license: Master � Journeyman 0 Date. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING NS� This certifies that.. �3._ . ..... • • • t • ?/ has permission to perform ... • IV plumbing in the buildings of : .... / .. .. ........... at .. . �° rA�.>?.,/ ..,� • . ,North ndover, Mass. Fee.. .Lie. No./.C�! ............................. . PLUMBING INSPECTOR 6t197 I4:45 40.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 01 4E (f ommonwratth of _gn5 1Mrtt5 i9epartmi mt af'Vublic —Ailfetq BOARD OF FIRE PREVENTION REGULATIONS 527 C'dR 12:00 Office Use Ono �r / Permit No. ( Occupancy & Fee Checked/ !/� 3/gQ (leave blank) -7V APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 D to /- 6✓�7 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) a (XW or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) �r / a)e�9si� .?;� ,� Owner or Tenant "'� �� m L, Owner's Address con unction with a building permit: Yes _ No r (Check Appropriate Sox) s Is perm( I 1 Purpose of Suildina_ L)C✓��G /,o Utility Authorization No. Existing Service Amos _J Voits Overhead __ Unagrnd New Seniice Amps _I Voits Overhead _ Uncgrna No. of Meters No. of Meters Number of Feeders and Amcacity Location, and Nature of Proposed Electrical Wer < Tatai No. at-ignting Outlets % S' i No. cf Hct ? �s I No. at Transformers KVA No. of LightingFixtures 7 i Swimming Pool Above— In- — ! KVA - grna. cmc. _ Generators No. of Receetacie Outlets No. at Cil =omens No of Sw tc`t Outlets No. or Gas F-urners Total No. of Ranges I Na. at Air Cana. tons Veat Total Total No. of Disposals No.of Pumas Tons KW No. or Dishwashers .- ! SoacerArea Heating No. of Dryers I Heating Devices KW No. at No. of No of Water Heaters KW I Signs Sailasts No. Hyaro Massage was I No. of Motors F P OTHER: No. of Emergency Lighting Sanery Units FIRE .ALARMS No. of Zones No. of Detection and Initiating Devices No. of Sounding Devices No. of Serf Contained DetecnaniSouneing Devices Local -' Municioai Other Connection Low voltage Wiring INSURANCE CCVERAGE: Pursuant to the requirements at %lassacnuset s general Laws - I have a current Liaciiity Insurance Policy inclucing Cam-c:etee Operations Coverage or ;ts substantial eeuivaient. YES _ NO _ have supmirtea valid proof of same to the Offics. YES - NO _ If you nave cttecxea YES. ptease ncicate the type of coverage cy checxing the approoriate cox. INSURANCE = BOND = OTHER = (Pease Scec:!y) (Exoiration Oatei Estimates Value of E!ectncai Work S worx to Start /- 1146 Inscec%on Date Recuestec: Rough GriiGL SAL L F non Signed unser the Penalties at perjury* fI636y LIC. NO. FIRM NAME I)WA�) � • '� � ._.�-- L.censee r��%� Sig at re L1C. NO. ��%g�— Bus. Tet. No. Aooress 17/JO SAGS N ,4ND�v `i v4 G 14 Alt. Tet. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee aces not nave the insurance coverage or is suoscantial eautvalenAt as re- OWNER'S by Massachusetts General Laws. ane :hat my signature an _:s oermit aoPticauon waives this reawrement. Owner 9 (P!ease cnecK one) -eiecnone No. PERMIT FEE S (Signature of Owner or Agent) t�35c5 Date...... P TO 671 NORTH, TOWN OF NORTH ANDOVER PERMIT FOR WIRING: °: ACMUSES This certifies that .... . has permission to perform wiring in the bui ding of ^ `".�--.... ... .., ........:..:....... .• �— / n at ....�....... Q! .::......... . North. dover, Mass. Fee.... .. ° Lic. N ,FA. ..................... o 4 �> ELECTRICAL INSPECTOR i WHITE: Applicant CANARY:.Building Dept. PINK: Treasurer 3