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HomeMy WebLinkAboutMiscellaneous - 89 GRAY STREET 4/30/2018 (3)N O Date ....... �t...`..` .�. TOWN OF NORTH ANDOVER, PERMIT FOR WIRING This certifies that.................................,:J............., has permission to perform ........ v.l..f.....�!r.'`... wiring in the building of ...............1��.......................................... at ........�.. �� .....5 T ............................... . o Andover, Mass r CAC Fee ... s..-"'.. Lic. No.(24�.. ...................... FF .... , . ..... ' ELBCfRICALINSPECTOR Check It 10503 IV2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule R: In accordance -with the provisions of M.G.L. c. 143, § 3L, the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth, and applications shall be filed on the prescribed form. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. G.L c. 166, § 32, an electrical permit shall be issued to the perVn, firm or corporation stated on the permit application. Such entity shall be responsible for the notification of completion of the work as required in M.G.L. c. 143, § 3L. - Permits shall -be limited as to the time ofongoing construction activity, and may be-deemedby the -Inspector -of -Wires abandoned_and-invalidafle or she has determined that the authorized work has not commenced or has not progressed during the preceding 12 -month period. Upon written application, an extension of time for completion of work shall be permitted for reasonable cause. A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012. The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this puipose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property. With limited exceptions, the Act automatically extends, for four years beyond its otherwise applicable expiration date, any permit or approval that was "in effect or existence" during the qualifying period beginning on August 15, 2008 and extending"through August 15, 2012. 8 — Permit/Date Closed: 0 Permit Extension Act — Permit/Date Closed: ! �%� *** Note: Reapply for new (fln,owntveaRL of )1&j3ac/u<.9etb 2eparlment op" �erviced BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. Occupancy and Fee Checked [Rev. 1107] (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All %vork to be performed in accordance %vith the Massachusetts Electrical Code (\•IEC). 527 CNIR 12.00 (PLEASE PRINT I.V ItVK OR TYPE ALL 1.VF0RIL4T10, ) ' Date: City -or Town of: To the Inspector of Wires: By this application the undersigned giyes.notice of his or her intention to perform the electrical work described below. Location (Street & Number) Owner or Tenant Telephone No. Owner's Address Is this �ermit iri •conjunction with a building permit.' Yes ❑ No (Check Appropriate Box) Purpose of Building Existing Service ' amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Utility. Authorization No. Overhead ❑ Undgrd ; No. of Meters Overhead ❑ ' Un d ❑ ' No. of Meters ComDlerionXfthe following table mai• be tivaived br the lnmerrnr ni ti••irflc No. of Recessed Luminaires No. of Ceil: Susp. (Pad ) Fans No. of . Total Transformers KVA -J J No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires bo ve In- Swimming Pool grnd. ❑ grnd. ❑ t o. of mergency tL aTitin�- Battery Units - -� No. of Receptacle Outletso. of Oil B rners _ )FIRE ALARMS No. of Zones No. of Switches No. f G. s Burners No. of Detection and. - Initiatina Devices No. of Ranges No. o At Cond. - Total Tons No. of Alerting Devices - No. of Waste Disposers He Pum Totals: umber ...". Tons KW No. of Self -Contained Detection/Alerting Devices No. of Dishwashers pace/A`rea Heat • �g KW, . Municipal. Local ❑ Connection ❑ filer No.'of Dryers Heating Appliances KW Security Sgstems:* No. of Devices or Equivalent -� No. of Water KW Heaters No. of Signs o. of B lasts Data Wiring: No. of Devices or Equivalent No. Hydromassage Bathtubs No. of MotorsTota . p 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 NEC Rule 10, and upon cornpletio'n. 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:) Self Insured I certify, under the pains and penalties of perjury, that the ' ormation on this application is true and complete. FIRM NAME: ADT Security Services LIC. NO.: C --ti`6 Licensee: Mark A. Brophy Sign atu e LIC. NO.: C-45 11fopplicable. enter "exempt" in the license hun7ber linea �Bus.Tel..No.- 603-594-S928 Address: 18 Clinton Drive Hollis NH Alt. Tel. No.: *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. 00953 OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ h S :a-VI.LIZiwd 'oN auogdala.L 4 .tnleuDlS luapy/.tauMO 'lua4E S,JanMo ❑ JauMo ❑ (Duo �. Nqo) aqj we I _-luautas!nbal slgl aAlEM X9aaaq I `mopq a.tnleufls , w 4S •MEl �q paalnba! �[[P >Jou 92E10n00 aominsut ,(ltl(gBil aql army lou scop aasuaoi-I aql legl alumu wE I :H3AIVM 3JNVdf1SNI SM3NMO E S 6 0 0 -oN -o!'I :asuao! 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G'.-.�? '0°2, TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING , This certifies that •,r�G:'. "....... ........ • ......... • has permission to perform-... . . ............ A' plumbing in the,buildings of>�. .`...... ... ............ at . .e�'. 9 .. ............. North Andover, Mass. Fee^'Lic. No.. �- —_.. PLUM SPECTOR Check # 5272 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location 7` Permit # ' 2 2:— Amount Owner New U Renovation Replacement Plans Submitted Yes No FIXTURES (Print or type) Installing Company Name Address Check one: 0—ellfiP- Partner. Firm/Co, Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy u Other type of indemnity ❑ Bond t/ Certificate 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 I Signature Owner ❑ Agent 1-1 I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. By igna ure 01 Llcenseaum er T e of P u bi License Title City/Townens um er Master Journeyman 13APPROVED (OFFICE USE ONLY �' 9J3a- Location �- No. n��r X� It) Date NORTH TOWN OF NORTH ANDOVER 9 Certificate of Occupancy $ s�CMus �� Building/Frame Permit Fee $ Coo Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 0 G Check # 1561'U / Building'Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDINGPERMIT NUMBER: DATE ISSUED: SIGNATURE: Building Commissionerfi for of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 -Assessors Map and Parcel Number:�/ �� (/ � 30 Map Number Parcel Number 1.3 Zoning Information: A-/ ? 1.4 Property Dimensions: x - /j -v Zoning District Proposed Use ' Lot Area Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 4 1.7 Water Snpp G.L.C.40. 54) 1.5. Flood Zone Information: Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System Public lPrivate p SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record Name (Print) Address for Service 20 b d Signature Telephone 2.2 Owner of Record: Name Print Address for Service: 9 Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable 0 ��l Licensed Construction Supervisor: License Number x 3 �/,rya/,�2� / � _ tel"( G� i��/G %f"w� / Addres (j 7 �d ✓� d / IL,.() lJ D Expiration Date Signature Telephone 1 3.2 Registered Improvement Contractor Not Applicable 0 Home Company Name 4 � (� � %i✓ f} Registration Number p Address Expiration Date Signature Telephone V M X z O v m SECTION 4 - WORKERS COMPENSATION (1VLG.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......0 No ....... 0 SECTION 5 Descri tion of Proposed Work(check all a Ucable New Construction V Existing Building ❑ Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: i &4Q T/ T 0 MVr 1Vr 1 /VP) � Xo0 ;,h e: l o M/--I-J� t ib ��l///I- L� PiL% (97 L -19A SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed b permit applicant QIIAIS1~r O� ' 1. Building Z� (a) Building Permit Fee Multiplier 2 Electrical / (b) Estimated Total Cost of Construction 3 Plumbing a a Building Permit fee (e) X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 7r Check Number SECTION 7a OWNER AUTHORIZATION IrO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION ,as Owner/Auorized Agen of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name Si ature of Owner/A ent Date NO. OF STORIES SIZE )C BASEMENT OR SLAB SIZE OF FLOOR T VIBERS iST 2 N D -j 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CH &INEY IS BUILDING ON SOLID OR FILLED LAND L _ IS BUILDING CONNECTED TO NATURAL GAS LINE, ON FORM U - LOT RELEASE FORM (g�—c3dl INSTRUCTIONS: This form is used'to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. —AP'P'LICANT FILLS OUT THIS SECTION APPLICANT e' d l3dWZ— PHONE(W L' 2,` X% LOCATION: Assessor's Map Number PARCEL U_ SUBDIVISION LOT (S) STREET ST. NUMBER *****************************************OFFICIAL USE ONLY*********************************** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS 1 S TIC INSPECTO COMMENTS V`7 "Cmi-1 n HEALTH DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED_ PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTO Revised 9\97 jm e�r-F 0 t TE M Robert C. Badley Building & Remodeling_ 499 Waverly Road North Andover, MA 01845 Telephone (978) 682-7087 F TO Mr. & Mrs. Peter 89 Gray Street Finish Work a Specialty Quality Workmanship Free Estimates Builders License #025620 Home Improvement Contractor #100239 7 F Gordon JOB LOCATION North Andover., Mass. same L I L DATE DATE COMPLETED TERMS CONTRACT PROPOSAL BILLING PAGE NO. L -4/1/02 X X X OF 3 PAGES JOB DESCRIPTION: Basement Remodeling All parts of this quotation are based upon submitted drawings, dimensions, and specifications by the owner. The contractor shall maintain an on-site dumpster to dispose of any debris generated as part of this project. All interior and exterior walls shall consist of 2x4 framings at 16" on center. The existing rear kneewall area shall be reframed as required for the removal of piping, etc. A new 2x4 wall shall be framed from the floor level up to the lower end of the kneewall assembly. This new wall shall be approximately 6" forward of the profile of the present kneewall. This will create a shelf effect between the two wall profiles. Following drywall panel installation, the contractor shall cap this shelf assembly with 1x6 pine stock with an eased front edging and scotia apron. The contractor shall complete all items on the "odds and ends" addendum sheet from the owner. The only exception shall be the dehumidifier. A standard fee standing unit can be purchased by the owner for such purposes in the basement area. Interior walls shall follow the submitted schedule as closely as possible. In storage areas (oil tank, furnace, and sump pump), the contractor shall dry, only the side facing finished room areas. All exterior walls shall be studded with 2x4 construction 16" on center with the exception of the abov referenced storage areas. In these areas, the concrete walls shall remain as is. All exterior wall surfaces (new construction and rear kneewall) shall be insulated using R-13 fiberglass insulation followed by the application of a 4 mil polyethelene vapor barrier. All plumbing and heating aspects of the basement remodeling shall be completed as part of other quotes and are not figured into this quotation. All electrical work and pricing for the same basement completion is part of a separate quote as submitted by Scharn Electrical Corp. All existing support steel lally columns shall remain intact. All lally column shall be enclosed with wood framing members and drywalled on all sides with base molding used to finish to process of concealment. Other existing gas pipes, water pipes, drain lines, etc. which interrupt the overall ceiling height and aesthetically interfere with the room dimension. etc. shall be re -located by the plumber whenever possible. The contractor shall apply '/Z" gypsum drywall pensl to all studded walls and the existing wall dividing the basement and garage areas. This wall will re -studded to properly align with others and maintain true plumb and level gemeresosurtehtorree�t2t4estockmentordemerdtoin All bottom wall plates sha p phvent dryrot and damage to stock where it adjoins concrete surfaces. a Robert Ce Baile�V Finish Work a Specialty Quality Workmanship Building & Remodeling Free Estimates 499 Waverly Road North Andover, MA 01845 Telephone (978) 682-7087 TO 0 Mr. & Mrs. Peter Gordon 89 Gray Street North Andover, Mass. L Builders License #025620 Home Improvement Contractor #100239 F 01845 same L JOB LOCATION DATE DATE COMPLETED TERMS CONTRACT PROPOSAL BILLING PAGE N0. 2 4/1/02 1 XXX OF_�R_PAGES JOB DESCRIPTION: Basement Remodeling All drywalled surfaces shall be taped at seams, butt joints, and interior corners using fiberglass mesh tape. Following this, the contractor shall apply three coats of drywall compound, sand the final coati, and apply a latex primer sealer to all surfaces. All ceiling surfaces shall be completed with the use of an Armstrong suspended ceiling system with standard wall angles, main tees, and 24" cross tees. All metal surfaces shall be white. Ceiling tiles shall be 24" x 24" and either be Armstrong #297 or #941 random texture acoustical tile. The contractor shall remove the existing wooden entry door unit from the garage into the basement area. In this door's place, the contractor shalt install a 310" x 6'-8" steel door unit with a 40 minute fire rating. The door unit shall come equipped with full weatherstripping, entry lockset and deadbolt,, and aluminum threshold with an Oak adjustable sill plate. The door shall maintain the six panelled door effect.. All interior door units shall be Masonite solid core 1-3/8" six panelled units with solid jambs and 21/2" colonial casings. All jambs and casings shall be primed and fingerjointed stock. All door swings shall be as per plan. Entry to the oil tank and sump pump locations shall. be via a 2'-4" x 6'-8" unit. Entry to the toy closet shall be via a 3'-0" x 6'-8" unit. Entry from the mud area to the finished basement shall be by way of a 2181 x 6'-8" unit. Entry into the closet under the main stairs shall be accesssible by a 2'-8" x 6'-8" unit.[The present water meter area shall be partitioned and access shall be by a snap on flush panel plywood door supplied and installed by the contractor. Access to the water heater and furnace area shall be via a double door unit (610" x 6'-8" ) with solid jamb and primed 21/2" colonial casing. Doors shall both be actively operational with ball catches to secure to top portions of doors to the top jamb. All interior wood trim shall be primed fingerjointed stock suitable for paintii Existing walls on both sides and the lower end of the platform portion of the stairway shall be removed to create an open effect as illustrated on the submitted elevations. The contractor shall install standard Coffman colonial starting newel posts on both sidesof the starting step and landii newel posts to secure railings and balusters. A11 railing stock shall be M741 and colonial baluster with square tops and bottoms installed every 5" on center along the sides of the stairwell. Atthe upped` end of the stairway where it begins to approach the upper level, the contractor shal install one section of handrail opposite the light switch side of the stairway. There is no provision in this quote for the use of finished oak treads, ri ®beet C. Bailey Finish Work a Specialty Quality Workmanship Building & Remodeling Free Estimates 499 Waverly Road Builders License #025620 North Andover, MA 01845 Home Improvement Telephone (978) 682-7087 Contractor #100239 TO Mr. & Mrs. Peter Gordon 89 Gray Street North Andover, Mass. 01845 same L JOB LOCATION I DATE DATE COMPLETED TERMS CONTRACT PROPOSAL BILLING PAGE NO. 3 411/02 XXX OF 3 PAGES JOB DESCRIPTION: Basement Remodeling or the rebuilding of the main stairway platform. etc. All risers and treads will need to be carpeted by others (not part of this quotation). All newly dywalled areas shall have two finish coats of Benjamin Moore satin finish eggshell enamel applied (color choice by owner). All painted wood work shall have a coat of alkyd primer followed by two coats of Benjamin Moore semigloass oil based trim paint (color selection by owners). The workbench shall consist of 2x4 pressure treated cleats and uprights to accommodate a laminated top of high density particleboard (1'/2"). The contractor shall install pegboard on the 2x3 wall cleats to a height of 48" above the finished counter of the workbench. The lower shelf of the work bench shall be 3/4" MDO laminated board approximately 22" in depth. The water heater/furnace area shall be ventilated by drawing in outside "makeu air through a 4" x4" exterior aluminum vent mounted in the exterior side wall in one of the joist bays. All passage entry sets and hardware shall match that of the main house door units. All base molding shall be 41/4" primed square edged base with a 1" base cap molding applied. All shelving in the toy closet shall be Closet Maid ventilated shelving with a depth of 20" and run the full length of the closet. There will be four shelves in this area with metal supports every 16". A switched 36" flourescent fixture shall illuminate the closet. The question of the "French" drain and possible future access will need to be Hereby Propose to furnish labor and materials complete in accordance with the above specifications for the sum of $ Nineteen Thousand Two Hundred ninety-four and ------------45/100 With payment to be made as follows: $1000 due upon completion of "odds and ends"�, $2500 due upon completion of interior framing; Completion of stairway and re-framing- TC6m; 1Qti0$1500; Comple-tion of 2nswlQtinn $1200; Completion of drywall -$3500; - of door units --$2300; Completion of ceiling -$2000; copmletionof trim -[$2000; Als ed o be fi I ork i e ritple e i ikedue upon comp' manner according to standard practices. Any alteration or deviation from above Authorized specifications involving extra costs will be executed only upon written orders and will Signature become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other Note: This proposal may be withdrawn by Of not necessary insurance, accepted within _ 60 days. Acceptance of Proposal -The above prices, specifications and conditions are satisfactory and are hereby accepted. You are Signature g authorized to do the work as specified. Payment will be made as outlined above. Signature Date Accepted '! SKETCH/AREA TABLE ADDENDUM jAddress 89 GRAY STREET M.1- No. 81301108 NORTH ANDOVER State MA County ESSEX Zip Code01845 dorrower GORDON, PETER& DIANA Lender/Client IPSWICH SAVINGS BANK 24' FAM.RM 14 DR " KIT FOYER FBVQ AU311' SCALE: 1 inch = 12.00 feet i APp(SpF I WARE 210.699-6666 APX-8100 Apex 11 North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11,S150A. The debris will be disposed of in: (Location of Facility) Signature of Pe it Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector am a homeowner The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02911 Workers' Compensation Insurance Afdavit IN, all work myself. IL f I?v E O _m a sole proprietor and have no one working in any capacity f am an employer providing workers' compensation for my employees working on this job. Corn2gay name: Address City: Phona Cg meanv name: Address Clty:.. Rhona* 'L FalIum to secure coverage as "uired under Section 25A or MGL 1.52 can lead to the WVWJtion d crirnin4 penaities. d a fine up to $1.500.00 and/or one years' imprisonment as well as civil penalties in the fomr of a STOP WORK ORand aline of ($10Q00) a day against rne. i understand that a copy of this statement may be forwwded to the Offto cf investigations or the DIA for comae verification. I do herby certify under the pains and penafts of perfwy, drat the Mwnahw provxbd above is true and correct Print lele"ii A11201 —I Official use only do not write in this area to be completed by city or town offlCiai' OCheck if immediate response is requked Building Dept Contact person. Phone # ?M WORKMAN'S COMPENSATION E] Building Dept 0 Licensing Board 0 Selectman's Dtlic6 0 Health Department 0 Other �� ;..� �� N r U) J) C/) 0 m W. y COFJ Cl) d C d 'v O CD O Z CO) CL o �, CD o C. = y aCO -c O 0) - CD c v O CD CI Cr %< a) CD cCDD o CD C CD y� CD C.O CO) c� C I S- CA O 1 Z CD O CD O CCD O �• CO) O Q H rD ao�a y �1 O m O m c% CO) 0 CL C m Z =r O H CL.O_ O1 .di �• y "T1 CD a?d O y O -4 O m y p O_ m .00 n to -« o IIYi" ••► 0z wo 0om WR 1 06 R r �Tj a• � o m 'L `2 1, ,.� C/)m (� c m 0 M n 0 C/) CO) CD to c os m N \ 1\ yQ� O �.CT wdv SIri o m W Z o� .. 0 O � O o CD z C' cn O H 3 G� 0 ;MCA 0. CD SM CR n _ C1: c) CO), o ~' o r ^ a7 a n ro W y °r ro o�c x ts7 r � M w ro 0 OQ x r b ^n 7 °? (� ? � ,, 0 ' on til C 0. r �' b b ^ rt X o x H 0 M )Nmq 0 0 c N2 2. 3 7 3 Date..':, . .......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ....................................................................................... has permission to perform ......... .................... 4 wiring in the building of ....... ............................................................. to q —1 at..ie.(..... .. North Andover, Mass. ............................................. . ............... Fee ............. L. No. L.. ........ ..................... ELECTRICAL INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer C o -A -ro d r i 5 rP�r l �c�� U0S )S rlC t1 CCU l L' c cj /4 F /�]! official Usc olliv • ..:' _c; --� l.�onu;:or:rv,:n(!�i a1� /1',�:JdaC/iuJ,'lt.f .. ` . i fly• IJ, �.,�, pati:.,- r `••!�X\ j C �J t Y ;! I, �..} �� "�artcy and I;= Chccl-ccl BOARD OF FIRE PIRE'VENI lOi� f�i=GUI_ATIOf�lS 1111 wutic to be pCrlurntcd it; accord:ilrcc willi talc (Vi;ls.arli;r:ril ; f_lecirical Cock (1i(,•C), 527 CAIR 12.011) [SE PRINT ININA' 01? Ti'PE,dLL INFORMATION) I 'IIe:.3u - acw0 city ter 'Town of: TO the 111soccto! cif Wil -es: By this applicafiur] tilw uudersic sial hives nonce of iti:: or her ittic:tlion to Pel-lUVII, the cicetrieai work dcscribcd below. Location (S(reet & Number) Olvncr•'s 11:ddrrss ___,�'/% h �. • _�-_--�"` _______.___._.__.._....__ _.__...—_. —__.__—_ _._y^ �.._... .._...-..moi ; ...�__-....._ Is (Ili!;perutit in Conjunction nitll n 1)uiltliog 1;ernlit? Ycs C -� i`{o P (Check Ap1)rol>c'i:iC(" I3nx) If I'carp�>sc t:!' l;uiltlinl; fi/� fO ( '� l)tili(" '.t.iihu:'iratiun i`{u. pp�� Existing Service /Dei Amp..; I;a t p/0 Volts Overhead Untl;,rtl � No. , wl- ic:c 'j- -0 r1::, .• �ly__.�?_`? _ �'uils 0ver11t::I;I UIIdt,t-d El i\'o. ufi`,lctcrs. � — `{;.:it$:cr of Jrti::lir:i•s itntl �tintp:tcit}• ' J.oc:ltiutt :furl N:tiurc ul' 1'ruposctl 1';Iccirical 1'lr,t1.: v- �R u I -- U � 17 Ate; W_ Cumpl._tion oftlt,: fo11,;u•irrr ruble mail be truived by the lit'SPerlor o0r'ir, ;r. No. of l.ec•cssed Fixtures a. `{o. of CCiI.-Sus P:u1d1e Taos h _ 1 ( ) - No. of llut "1'rabs-- - ~�Gcncl•:ltot•s No. of 'I uta! 'k'r:rnsfot•]nrrs1`,1':1. _ No. of Lightiug Uutlr(s __.............-1:1'/1-..-�... t cN �iti1 T uct=hc:le}� 1 l7ifiliiif; ---- ---- 13:1tto t, <, �„ No. of Li( lltitr" Fixtures — Afore _ lir- 5lviatalin;, 1'ao1 � triad. t,turf. 110. ofRecclllacic Outlets No. of Oil 13urnrrs — MRI," ALARMS No. ol'loncs — TIfaof Detections and No. of 51, itches No. of (a s Burners No. of Iur Cot:;!• Toll. ural l'uutlt aJtalctllcr 11:u1�s 1:11' _. __ �,....., __ •. lut:uti - I __. J1a1(iatiilP 1)a;v"iet:$ No. of Aler(itsg I)eviccs No.,of ScII-f t tcilacd- T l5efcctlon/Aler(tntr )cti'tccs �__ No. of 11:1111, C." �• __ :ti`o: oI fisic'iJishos)a s` . Nu. f �)ISh1Y:1S11Ct'S o Sp:tcc!Arc:a llcatin..l 11' Local [, �11n11cipal Other (711711: I 1 .. ,......... _. r.......,...,_. Security Sy;tcnls: iVo. of DcyicCS UI' �'.r�1171_alcut _ _ No. of Drvers llcatiu�� tlppli:u:a's 1011 i\o. oi- Nva tcr iVo. of of Data Niriu(I: > , I� �ti 'ii . hall: sls i l' C'itCi'5 of Devices or Lel uiv'aicut _ 1`cfecottuliunicatio'iis 11'ii:il„ Noltydrontassa;C 13a01tubs' No. ofillolors _.!'oral ill)No. of 1)c -ices orl_ivalcnt V _ _.r... ji V_ --) - t .tttnch cdrlitiunal cirlcii rjr?csi,erl, or usrcr:rircd the lnspcctor of I1'ires. li\SU12a,i`fCl COVERAGE- Unless vvaivecl by the wxlicr, 110 pelniit for tl,-: pc•:furlaaitce of elccirical work play issue u;tless the licensee provides proof of liability irsttrance inciuclin,; "Completed opc-tioc" cover;i(tc or its eubslat)tial edui,ral'cilt, "fire uudeisinilcd certifies (hat Sticll coverAlde is 111 force, and has exhibited proof oC,s , it(, to (lie perllltt issuing office.' CHECK ONE.: 11i?SUR.,\NCL I;ON) ❑ f/ 1'w:R [,� (Snrcify:) (Gxpilalign Cate) Estinlaled Valtie of Electrical Wol-k: _ _ _ ( 11cn requilcd by municip'll policy.) Work to Start: _ Inspcc(ions to he requcs(cd in accordance: ',vi(h N1,EC Rulc 10, and upoi: o. I certifJ." rr)irlcr the pains (11111 pell Ill ttics ufieljuI l', that the infurnlaiivrr art this Will Ffl1_M NAME: IC.NU._ .' .11 LicetsCC: tli.t -nLlers Sii?ii'..� 111C,l'Vt�.:_' t (Ifnpplir:ublc, C'11rCV' "i.Tinrl)c w 1/1v liccJiscnun Iber tillv.) 1SttS: 1'ta. No.: �it7 1 i` t. Address: �tl _�(11.I;r31t) 713"� j ..�.ttt%C}.V�C'.T:, .11'i1.i.._ILI.G�.-s L__, 1�.1t.'E'cl. OWNEWS INSUIZA`vCL WAIVER: 1 an] a%Vart: 11131 rile ;,iccttsc:: itves not Irur•e' file liability insurance covcra-c normally required: bv,law..1:3y my below', I ltereuY,lt,;cive this rccluircutc:tt. I s:n the (check onc) ❑ o%viier ❑ owlicr's anent. Signahuc No 4t; 22 Date. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that .... ............. has permission to perform.....:t.. ....... ......... .plumbing in the buildings of . ............... .at. ..... ................ I North Andover, Mass. Fee....... Lic. No.'� ........... PLUMBING INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Owners Name of b/ Date D� Permit # 21'la3' Amount 146� New ❑ Renovation [31"*� Replacement 0 Plans Submitted Yes [] No ❑ (Print or type) Check one: Certificate Installing Company Name G f�s `T /� ❑ Corp. Address Partner. a l Finn/Co. Business Telephone � El Name ofLicensed Plumber Lrr-eele/�y C Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 3— Other type of indemnity ❑ Bond ❑ 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 Signature Owner Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachus State Plum ing ode and Chapter 142 of the General Laws. By: Signature 0 f LICenSea rIUMDer Type of Plumbing License Title l City/Town 4cense u er Master JourneymanEJ APPROVED (OFFICE USE ONLY • ` 9 I -.-...-..M5.M.-.M.-.-...M (Print or type) Check one: Certificate Installing Company Name G f�s `T /� ❑ Corp. Address Partner. a l Finn/Co. Business Telephone � El Name ofLicensed Plumber Lrr-eele/�y C Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy 3— Other type of indemnity ❑ Bond ❑ 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 Signature Owner Agent ❑ I hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachus State Plum ing ode and Chapter 142 of the General Laws. By: Signature 0 f LICenSea rIUMDer Type of Plumbing License Title l City/Town 4cense u er Master JourneymanEJ APPROVED (OFFICE USE ONLY I I N2 2333 Date.:........... ....... "ORT" 0, TOWN OF NORTH ANDOVER 04 PERMIT FOR WIRING This certifies that' ...... .. . ........ ...... ............. .................. ...... .. ....... has permission to perform .............................................................. wiring in the building of. .................... ........................................... at ... .................. �..v ..... .............................. . North Andover, Mass. — ele", �� . , i I , I Fee. -,2.16 ............ Lic. N&-�=.... . ............ ELECTRICAL INSPECTOR Check # /0 WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 11 TIM COAMONEi 0HO A ' m aiusms Office Use only _ DEAAR72WEVT0FPVBUC&4FVY Pennit No. p�hS3 d BOARDOFFMPREYEMONREGM710NN527CMR12-00 .-tel Occupancy &Fees Checked APPLICATTONFORPE MT TOPERFORMELE=CAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date ' S ' G U Town of North Andover To the Inspector of Wires: The undersigned applies for a perrmit to perform the electrical work described below. P PARCEL Location (Street & Number) Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes Q No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service /d o Amps /20 / 2o2( Volts Overhead Underground No. of Meters New Service Amps / Volts Overhead Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work 1- , the -1 QP m r A Q L., No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above Below Generators KVA ground ground No. of Receptacle Outlets Q (/ No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones I No. of Ranges No. of Air Cond. Total Tons No. of Detection and _ No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers e Space Area Heating KW t No. of Self Contained Detection/Sounding Devices Local Municipal _ Other No. of Dryers Heating Devices KW Cormcetions No. of Water Heaters KW No. of No. of Si Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER- Ihawaammiliab- hrstaameCo�aage Aastm#�ttlere�.manais�C�dlI.avus aitsstlt�alegirivala$ YES NO NOlld'yit>St =Pcbcymdji gCar>p)eCov Ihaw%hn&dvalidproofofsmrtot rCffm YES r', -,"l NO � YyoubmduimdYES,pl=mdc*&e Fcf=uaWlydvdmgthe TpqiriWSCE B ND OR -M a (Pl =Speafy) Esfin� VakrdE acatl Work $ Waktostatt % °O ITL�Rgjmtd Ra# 5 �a bO Final 26 ay Sigrxdulda'e) a`petjtay: - 1` FIRMNAME M i ti N r r a ft. , I P r r t C _ Lic=Na G 3T6 i G Licatsee �h�� �s M t tv �,. e G fL Sig�ae `���L � �- Lioa�eNo Btisu>essTel No. �a� 113A AAA— / S4 bJ0-�- � � 0ZIS / - AltTel.Na t/nS-y8-00 OWI,2SINSURANCEWAIVEP„IatnavawdattheLiowdoesmthavethomard=amWcr&sttbsMrtalegmala>tasr gmodbyMasmdm&Ctn-aLam atrlthatmysigrnttuemttnspand _V7aicesthistegt¢apart (Please check one) Owner ” Agent Signature o wner or Agent Telephone No. PERMIT FEE $ Location e v t-- `l No. I F / Date d�-0,-) TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ E:� y Foundation Permit Fee $ Other Permit Fee $ TOTAL Check # *13772 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING WELDING PERWT NUMBER: t DATE ISSUED - SIGNATURE: W�� Building Commissionerfln�ee(tor �f Buildings Date SECTION I -SITE INFORMATION 1.1 ddress: '4;' 1.2 Assessors Map and Parcel Number: /07-D - gk—OW-0 Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area (sf) Frontage (ft) 1.6 BUIELDING SETBACKS (ft) Front Yard Side Yard Rear Yard Required Recgired Provided Rapired Provided -Provide 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Zone Public 0 Private D Outside Flood Zone 0 Municipal 0 On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record &M Name (Print) Address for Service: Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construct] n Supervisor- Not Applicable 0 Dzf 7A Licensed Construction Super�is_or: License Number dress Expiratiod Date Signature/ Telephone 3.2 R gi tered Home Improvement Contractor Not Applicable 0 /P? 7q 03 Company Name -41, Registration Number Address Signature Telephone NJ SECTION 4 - WORKERS COMPENSATION (XG.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work check altapplicable) New Construction ❑ Existing Building ❑ 1 Repair(s) ❑ Alterations(s) 1Y Addition ❑ Accessory Bldg. ❑ I Demolition ❑ I Other ❑ Specify BriefDqcription of Proposed Woris: �.lU�I�iu6- I SECTION 6 - F.STIMATF.11 rnNCTRlTCTTnN MR.TR I Item Estimated Cost (Dollar) to be Completed by permit applicant OFFICIAL USE ONLY 1. Building (a) Building Permit Fee Multiplier b 2 Electrical /S40 (b) Estimated Total Cost of Construction /3 D m O 3 Plumbing Building Permit fee (a) x tbl 4 Mechanical (HVAC)�- 5 Fire Protection 6 Total 1+2+3+4+5 Check Number bh l lUfN 7a OWAEK Au l'HOK1ZA'f1ON TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, , as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name Signature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS iST2 ND3 RD SPAN DIMENSIONS OF SILLS DrMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE J Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 DEBRIS DISPOSAL FORM NORTH Al E OL O TO `i• 04 •K� �. <OCKI[ W wK M '\ACHu���y In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit # the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, s150a. The debris will be disposed of in /at: V0 Facility location Signatur of Applicant Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. r Xie e.,nwwvva1,1X, a�� l�aaa zrl �.Qelta BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 042540 Birthdate: 11/12/1952 Expires: 11/12/2000 Tr. no: 5096 Restricted To: 00 { DENNIS J KIVLEY 29 LANCASTER RDS HAMPSTEAD, NH 03841 Administrator HOME IMPROVEMENT CONTRACTOR Registration 127295 Type - DBA Expiration 10/05/00 KIVLEY ENTERPRISES DENNIS J. KIVLEY Lj ANCASTER RD. ADMINISTRATOR AMPSTEAD NH 03841 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers' Compensation Insurance Affidavit Please Print Location: 01� /i.A•�C'/J�%r a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity F-1 I am an employer providing workers' compensation for my employees working on this job. Company name: Address City Phone #: Insurance Co. Policy # Company name: Address City Phone #: Insurance Co Policy # Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one years' imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of ($100.00) a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under tpo, Aginland penalties of perjury that the information provided above is true and correct. Print Official use only do not write in this area to be completed by city or town official' []Check if immediate response is required Building Dept Contact person: Phone FORM WORKMAN'S COMPENSATION 6. ❑ Building Dept ❑ Licensing Board ❑ Selectman's Office ❑ Health Department ❑ Other G cM-p 0 --IO �• CO) O Q(A Soso -0 y =�mn m CD C-) v 0c.o z = N o rn' ==r.0�► m LA. T C d Er m a m �' .�► y C O —+ o _ =O A m P14 CD m p = ..r O o ZSto N! C a Con D CSD = '�. c• H ��: �, Z y R CD m o; o ►b CD i'11 r•r' O H o. m c �] n i� G _ • O , W p, CL < ` o ti : o =r m CA) y ; CL C'? ••` o CD Cf) c:r m __ CD = CCD, Z cn =r -� O ac m CD O n o c CCD CO2 _•CD 0 CL = y ` o o CD CCS o 0 .. tm CO)CD C3 w ca O O Jay CD z b= CD o CD _�. a- rZ CD C . O M Cn o Crt Z M?f oil w 'Jd b y c7 w 'jJ n b O 71 w ' d'?7 "b b 0 w (� n '1d 7' 't7 CL 0 Uj � C/) 'r7 o OZ tx 0 c Location No. , 6 v6- Date -7 Nom,. TOWN OF NORTH ANDOVER Certificate of Occupancy -$ Building/Frame Permit Fee $ *Foundation Permit Fee $ l`"&Permit Fee $ �% Sewer Connection Water Connection TOTAL J 06/09/ 13:28 Fee $ Fee $ /Buildin Irfspector )25.00 aa$ Div. Public Works I w w t = 0 w z w 0 C I _ 1 • w w m 2 • 1 w 1 r• 0 = 0 i r 0 � w 0 7 to 1 � i w^ w • 7 M " 0 1 A 1 * Z 1 r r 0 0 i c• 144 :� w i 0 i Q w 1 ■ c s C 0 A � Q o C 0 R o 2 o C 0 C o , 0 a � Z 7 w � 7 ` w ( 1 s z w m " r• r n i w^ w • 7 M " 0 1 A 1 * Z 1 r r 0 0 i c• 144 :� w i 0 i 0 z r • C n O ; i s C 0 A � Q o C 0 R o 2 o C 0 C w > 7 O 0 z , �( C M Y z 7 C Z MO C • • Z c 0 o z w w m " r• r n r r _ $ " c 0 IN �( • Z All M W �� , �I 1p'rF, I ' 0 I. r ' WW z= i 1 O= VZF 1 I n 0tlld ' _ AZO OOJ Dej a ZO - W .11 _ mU o .WOS W BZa ITT I oh , \:-H+ a <Z1- W_ZO j 1 3CtlW1 i on OtR WWW 0 W I TT 2<h �W ., W Z W i Jw, �� �I 1p'rF, i 1 F 1 I O ~ � W ITT I \:-H+ a , 8p + on ( Z 0 I TT sip _ h �� �I i 1 F �� �I I � W ITT I \:-H+ a , 8p on I TT sip _ ZO3 'L'S `ES W a<O O W 0 ►_.r�< pQ�.�i WQ•� W0 pp;zzzy ►pp S ZZ 1=11 r W 0� Q 17 +'a D Town of North Andover OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES 146 Main Street North Andover,. Massachusetts 01845 WILLIAM J. SCOTT Director In accordance with the provisions of MGL c 40 S 54, a condition of Building Permit Number � is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 111, S 150A. NORTF� p�Og4'10 a1ti0T • off+ �� The debris will be disposed of in: /✓L'~GI/�i22 GC' � / )V LL (Location of Facility) ' 4 d Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. k BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 r i• R1,e4t C."Bailey i dmg & Remodeling <99 Waverly Road North Andover, MA 01845 .Telephone (508) 682-7087 TO �Peter Gordon 89 Gray Street "North Andover, Mass. ,y L Finish Work a Specialty Quality Workmanship Free Estimates Builder's License #025620 7 F L JOB LOCATION same 7 11 ATE DATE COMPLETED TERMS CONTRACT PROPOSAL BILLING PAGE NO. 1 1 9 71 1 XXX OF PAGES JOB DESCRIPTION: Exterior clapboarding. Oche:contractor shall remove.existing hardboard siding from the front 3 wall of the main house (upper and lower level) and from the front family room wall area. .1 Exterior window shutters'shall be removed in order to gain access for siding removal. Upon removal of the siding, the coetractor shall apply Typar housewrap over the existing wall sheathing surfaces. After Tyapr installation, the contractor shall install '/Z" x 6" Primed Red Cedar clapboard (smooth side out) using 5d stainless steel siding nails. 8" x 8" Red Cedar light blocks shall be install around the `- two frdnt entry lights. ,fihe'contractor has made provision in this quotation for the installation of of two pieces of side window casing around one of the upper window units. There is rio provision in this quote for painting and/or staining of newly installed clapboard. %Jf the owner wishes to remove the existing front main house gutter in order to gain access tothe 1x10 fascia for replacement, please add $265.00 to the quoted price below. Thescontractor would berrespons'lble for the re-indtallation of all gutter that was previously removed.- emoved..-An.on-site -,n on-sitedumpster shall be provided by the -contractor -for debris disposal. 'A11 window shutter -.s on the front of'the house shall be re -installed after clapboardtny work 1S Completed. Hereby Propose to furnish labor and materials complete in accordance with the above specifications for the sum of thirty-four Hundred forty-two and -----------17/100 ($3442.17) .. With payment to be made as follows: *, d u e upon completion of the family room • f r o n t :wall and removal of ma�fl house siding; remainder upon completion of work as outlined. k :,.All material is guaranteed to be as specified. All work is to be completed in a workmanlike manner according to standard practices. Any alteration or deviation from above Authorized Neeinvolving extra costs will be executed only upon written orders and will Signature become an extra charge over and above the estimate. All agreements contingent upon v strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other Note: This proposal may be drawn b us i /not t 'cessaryinsurance. accepted within 45 days. ,' oceptance of proposal - The above prices, specifications and k•l conditions are satisfactory and are hereby accepted. You are Signature authorized to do the work as specified. Payment will be made g !is;outlined above. ci.,.,n+,inn O y WININ. SOUND • d 17 O CD st Z co Me 06 O CO) O CL y aCc •m 0 o CD CDCL 0 Q rr CD POO O O O C CD y� C2 ci y Sao UC C2 y O Z Oo CSD i C CD M O 0 z m P -0m 7 m 4 S. m m CL m 0 y 0 y mo FA MA cm, �• �- ° ♦ ♦ P s. t ° MA cm, �• �- ° ° ° r Oj cr. n +r r� *., Office Use Onl 7�0 U f Cnammanu oto of �itt�ssar4ug&g . Permit No. �! 111epartmettt of rublic %fetq Occupancy A Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 1 3190 peeve blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date s—' — I? or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work des ribed below. Location (Street & Number) _ �• �' Owner or Tenant Owner's Address Is this permit in conjunction with a building permit: Yes Purpose of Suilding Existing Service - Amps _ I Volts New Service Amps _I Volts No ❑ (Check Appropriate Box) Utility Authorization No, Overhead ❑ Undgrnd ❑ Overhead ❑ Undgrnd ❑ No. of Meters No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work «,1500 YY1PctPr U�.tixc 5� �/^ �•[ _ ori .w � \ i� C c .'i 'S". �i��� No -.,of Lighting Outlets No. of Hat Tubs No. of Transformers TOKVA No. of Lighting Fixtures Swimming Pool Above In- grnd. ❑ grnd. ❑ I Generators KVA —T—No. No. of Emergency Lighting No. of Receptacle Outlets of Oil Burners I Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Initiating Devices No. of Sounding Devices No. of Self Contained No. of Ran Ranges - g No. of Air Cond. Total tons No. of Disposals No. Heat Total Total Pumps Tons KW No. of Dishwashers I Space/Area Heating KW Oetection/Sounding Devices Local ❑ Municipal Connection ❑ Other I No. of Dryers Heating Devices KW No. of No. of Low Voltage No. of Water Heaters KW I Signs Ballasts Wiring No. Hydro Massage "Ibbs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general taws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES NO = I have submitted valid proof of same to the Office. YES = NO Z If you have checked YES, please indicate the type of coverage by Checking the appropriate box. . r C t ^� INSURANCE = BONO � OTHER (Please Specify) �y (Expiration Date) Estimated Value of Electric k $ Work,(p Start Inspection Date Requested: Rough Final Signed under the Perialties of perjury: t FIRM NAME (-�% LIC. NO. licensee Signature LIC. NO. B .24 AIsTel. No. L. Tel. No. — �40y`. AddressTT3 i rrOpc�� OWNER'S INSURANCE WAIVER: I am awe a at the Licensee oes not P. t e insurance coverage or its substantial eq valent as re - i quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Ow Agent (Please check one) ��� Telephone No. - PERMIT FEE 5 �-- _ (Signature of Owner or Agent) x-5565 �� f �9 7 * Date ..... 976 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...... ................................................ has permission to perform ...... ........ ... I..C). ....................... wiring in the building of .... ..................................................... at ....... 7 ..... �tl.?.y ..... 12... ................................ . North Ando -ver, Fee ... ... Lic. No.,1.604.7 ......... 2L ...... /�. NSPE TOR 06/0317" 1:59 1500PAID WHITE: Applicant CANARY: Building ept. PINK: Treasurer � d N2 3 Date..../�............. 31.. r,'..a TOWN OF NORTH ANDOVER .. 's 0L p PERMIT FOR WIRING This certifies that J . �� �' t . ......... has permission to perform . or wiring in the building of ................................................ Sl.............................. /J ��}} F l .... ,.North Ando#er,Mass. Fee .. .�. v'.. �! .. Lic. No -,1.24. 1.Uf? .. ...,1../ 1 .............. -ELECTRICAL INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer 7 COM VON1Ei LTHOFM4 MCHUS EM Office Use onlypp�� DEPARTMENTOFPUBLICSAFEIY Permit No. PT` BOARD 0FMEPREVEW0NRE9ffATI0AN5r MR 120 Occupancy & Fees Checked u . JrATTON FOR PERMIT TO PERFORM ELFt-rMWAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 `� - I / (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat ` (/ Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) Owner or Tenant Owner's Address To the Ins ector of Wires: Is this permit in conjunction with a building permit: J Yes t/ No a (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead a Underground No. of Meters New Service Amps �� Volts Overhead M Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work C'74-77 _ No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total ^^ or T KVA No. of Lighting Fixtures Swimming Pool Above M Below Generators KVA ground ground No. of R=ptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units i No. of Switch Outlets �-C> No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal Other No. of Dryers Heating Devices KW Connections a No. of Water Heaters KW No. of No. of Signs Bailasis No,,Hydro Massage Tubs No. of Motors Total HP 01WR ._�. • :• aMcp box R,SURANICE BOND OUM VA' EViratim D* WbrkIDSW Final sigrWundam of, Btw=TdNV • •, OWNE4t'SMRANMWAM3?,I.ammmethattielmmdbm n vefl�elcsuaroeoaaageori5st>l�latlialegtnvata asiagtmadbyM GalaalIaws mddvtmysigm> cnftptmiappicMmWeivmftmW*wna . (Please check one) Owner M Agent Telephone No. PERMIT FEE $ Location_TDate T ,r No. / (--�r�l- NORT/y TOWN OF NORTH ANDOVER, „ Certificate of Occupancy $ ' Building/Frame Permit Fee $ �SSAC"US Et Foundation Permit Fee $ T Other Permit Fee $ Q ti Sewer Connection Fee $ Water Connection Fee $ TOTAL _ $ ---�� uilding Inspector .+ • Div. Public Works _ 0 ii n 0 0 Z r m � O O T > > -1 r > > n z A z> • n n cl R ca i c T r s -- z A D p r N O i 0- ,C. i Q a A r r r r w J T 0 m A s > '+ 0 c 0 c w m r m i n n•i M '" a c m n J n f a Z ¢ � m Z Z v. Z --4 0 Z O z a 0 a C ~ n _a N A o m < 0 b A m m ; r D c Z T r C J to mz z Z a m rn n Q z m C n -r r > � 0 m _ 0 ii n 0 0 Z m r r I. FI ml m a > a C > C F: " O D z m k IDm C C r O D p 0 0 2 z z • PI o r -n1 O R 0 o a o 0 -j r 0 r F 0 z r F > > z i o m m i7 Q la D A a w I .... III h A L O D m > 00 0 ; m m n F F 0 0 > i > 4 r z z z n z p C Z m nni n L a m i s 0 z m o> 'z 0 Z > Z o ; R ; > A m > A c c 0 ff1t,. m -r Olr z C > 0. m Ic A Z A m a a i w o' O T Z 0 A A m m Q 0 0 ANTL x- t a m m C Q w i r 0 > r m m o m Z r z 0 0 m a Q b z m m 20 b VA _m N 0 � 0 I > ro l m O " Q CD O ... CA 10 CD O z C/) n O z cn r. , mmm,-� C ca=r c =r -i C3 CO2 0 rr Go i a cu O S. CD ,0 V! -i 0 � m CD n CD yCCL� =r"O N •� �, ,. .O► CD H -n O• CZ CL O W � O W CU y N N 0 .+ 10 o fpm: x > > m o to �, c o O 0 y n W =r O m O =r 7R O tco CO O ? CD m y co O CD C CL C H GY D,1 co, CO) CL d a C = v c• a H rCD a CD 1 y ? co _ FW CD CD M CA CD .�' Ct? .O•n p C7 O : CD O 3, =oCD ff: -.CD: ED a . N .-r V CD D1 CD 0 C,_A e G O ` 0 � CD m cn � d° cn - Z .f -D �t1 y w �' fD a CDC w � �' "� w E � a a m W C ' CD O G7 a V z y � CD cn CA o � Y 0 �0 z' CD CD - - - y O• C ca=r c =r -i C3 CO2 0 rr Go i a cu O S. CD ,0 V! -i 0 � m CD n CD yCCL� =r"O N •� �, ,. .O► CD H -n O• CZ CL O W � O W CU y N N 0 .+ 10 o fpm: x > > m o to �, c o O 0 y n W =r O m O =r 7R O tco CO O ? CD m y co O CD C CL C H GY D,1 co, CO) CL d a C = v c• a H rCD a CD 1 y ? co _ FW CD CD M CA CD .�' Ct? .O•n p C7 O : CD O 3, =oCD ff: -.CD: ED a . N .-r V CD D1 CD 0 C,_A e G O ` 0 � CD m cn � d° cn - Z .f -D �t1 y w �' fD a C~ n p w � �' "� w E � a a m W C ' �. p. x G7 a E4 W W z 0 N N omi 0 g, 0 c Date .. ...`.... TOWN OF NORTH ANDOVER A PERMIT FOR PLUMBING This certifies that ... ... • .. has permission to perform .....' f..c... +.'�.................. . plumbing in the buildings of . t ... .................... . at ...:S . .. (. .!a. �..:.............. ,North Andover, Mass. Fee. Lic. No...... .......`- ............... PLUMBING INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK: Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location New r7 Renovation L/_ N, Of Replacement FIXTURES Plans Submitted Yes Date Permit # Amount No El Check one: Certificate Corp; Partner. E]Fin-n/Co. Name ofLicensed Plumber ( Dsl��j Insurance Coverage: Indicate the type of insurance erage by checking the appropriate box: Liability insurance policy U Other type of indemnity ❑ Bond 1071 Insurance W Iver. I. the undersigned; have been made aware that the licensee of this application does not have any one of the above three ins e SignatW Owner Agent I hereby certify that all of the details and information I have submitted (or entered) in above application are true and 'accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Mas�.r� i�gCode gC d Chapter 142 of the General Laws. I Title PROVED (OFFICE USE ONLY Type of Plumbing License License Number Master Tourneyman Locations i No. a l Date a q MOR,M TOWN OF NORTH ANDOVER jza�affiadfta Certificate of Occupancy $ --_ Building/Frame Permit Fee $ c> b•Ar.o 0�,�,, ,ssACHU� Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $� Building Inspector ;, 6 0 08/04/55 11:47 25.00 pan Div. Public Works z - Z ? ' H A T, w 0 42WEEM_y 2 'i G:;-3 ., GD • V I44 mL-7-- lCi baa 7_.-- - = 42WEEM_y 2 • V = r�. X X X iii _ > v. > w > - = Z Z z Y T �t a 2 ^ > Y r S T ZvA, z a > m X £ - N > R > in v CXI to= J rn A x %A 42WEEM_y 2 = m = G _ = > _ > v. > w > - = Z Z z Y T �t a 2 ^ > Y r S T ZvA, z = m = G _ = > _ > v. > w > - = Z Z z Y a 2 ^ > Y S T ZvA, z > m X £ - N > R > in v CXI to= J rn A x %A m m 0 H Ci 1 rj -c ` - m z > m R') > d Q O _0 LA fr 3 _ LA � _ > - mm v m YY H N T F N 2 F > _ m w Ch R d M qu � y „ 41 (�1 T rlz N �C w FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits feom: - Boards and Departments having jurisdiction have been obtained. This does not �e4lie.� the applicant and/or landowner from compliance with any applicable or requirehnts. • ll`'� FILLS OUT THIS SECTION i 00 1J Ca APPLICANT +��( �0r(y✓1 PHONE LOCATION: Assessors Map Number r07 D PARCEL_ SUBDIVISION LOT (S) 00,90�"~-- STREET C9ra. Sfree,f ST. NUMBER OFFICIAL USE ONLY** RECOMMENDATIONS OF TOWN AGENTS: �'t�n �- lZJ' I-� • CONSERVATION ADMINISTRATOR COMMENTS TOWN PLANNER COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED ICt ,C'�, DATE -REJECTED DATE /APPROVED DATE REJECTED - DATE APPROVED DATE REJECTED SEPTIC -I OR -HEALTH DATE APPROVED ,� DATE REJECTED COMMENTS 7— PUBLIC WORKS - SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Town of North Andover F NORTH , OFFICE OF COMMUNITY DEVELOPMENT AND SERVICES i 7Ta� i 27 Charles Street North Andover, Massachusetts 01845 WILLIAIvi J. SCOTT Director (978)688-9531 Fax(978)688-9542 HOMEOWNER LICENSE EXEaAPT10N Please print. % Gy DATETr�% / JOB LOCATION 0�/ ��►'��f -- Number Street Address Section of Town "HOMEOWNER q% rg%��%�a 6/%,,; 73 -7 S 3 Number Home Phone Work Phone PRESENT MAILING ADDRESS 67 Or City Town State Zip Code The current exemption for "homeowners" was extended to include owner -occupied dwellings of six units or less and to allow such homeowners to engage an individual for hire who does not possess a license, provided that the owner acts as supervisor. (State Building Code Section 109.1.1) DEFINITION OF HOMEWOWNER: Person(s) who owns a parcel of land on which he/she resides or intends to reside, on which there is, or is intended to be, a one to six family dwelling, attached or detached structures ac- cessory to such use and and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official, a form acceptable to the Building Official, that he/she shall be responsible for all such work performed under the building permit. (Section 109.1:1) The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other Applicable codes, by-laws, rules and regulations, The undersigned "homeowner" certifies that he/she understands the Town of No. Andover Building Department minimum inspection��cedures and requirements and that he/she will i.�' comply with said procedures and requg"ts./ / > HOMEOWNER'S SIGNA APPROVAL OF BUILDING OFF Note: Three family dwelling 35,000 cubic feet, or larger, will be required to comply with State Building Code Section 127.0 Construction Control. 4 BOARD OF APPE:aLS 688-9541 BUILDING 633-9545 CONSERVATION 685-9530 HEALTIi 68S-9540 PLANNING 683-9535 m x 7) Cf) Cl) m ) NJ 'C C � CO) CM) CD n Z y CL Oy� O CL as y '00 CD o p CD QCL o cr� CDEr CD 0 CD C CD co) CL 0 CO)o CC CD � v CO) O z 0 a o CD 0 CD NO 9 cn cn n O C/) F.", O C c?-Ro m 2 o -• a, o a �, ro o oti Cam 3 m m = o. -N, -%Q O m 0 = ?ar« �pCDN y -► NO 9 cn cn n O C/) F.", O ., on o p ro o 7; oEL cp M x z 0 J6 ob O C NOV-30-95 THU 1:06 o c _- x'07" �' `• 01/ �-s �PP,.�e�r�7U It�l.� ► t •� . S 7 .` t., � i m.tina. 0 r �- X50 . oo • � - �-- �oe:roh 8 slu_�F7 O MORTGAGE INSPECTION PLAN s" -No1« � .. Deed retptded In N• ssv+ Registry of Deeds. Bookte Z9 a'' Page ?(y� And befog shown as lot on a plan by Flo,*" % & eb rl Q5 Datad — t% r— and recorded M QS �tav► 1124i Z Book Page 9 This Inspection plan was not compiled from an instrument survey and is not Intended to be recorded. Under no circumstances ere offsets to be used for establishing property fines or for consuvetion ournosns nf 2nu tiro 1 11 Location of the structures as shown hereon either wereIn compliance with the local zoning by -taws to effect when constructed (with respect to structural setback requirements only), Or were exempt from violation enforcement action under Mass. G.L. fiitle Vil, Chapter 40A. Section 7, �+ .."Wil --slut na wnrnn me t -Km Hazard Zone on F.E.M,A. Community Map No.7i�7 qq , . Flood Hazard Zone has been determined by scale and is not necessarily accurate. Accvtale determination cannot be made unless a vertical control survey is performed, DESIMONE SURVEY SERVICE, INC. 38 Cottee Street Medway, MA 02038 11/30/95 11/30/95 Peter J. Gordon Diana DeCaro 1 lF r r J i 41 IN O D A v 0 r N m r m i 3 m z O m m I WIM 'a a 0 m m r r 0 c -1 N m 0 z N W N m m IM 0 -1 x N 0 m N I/ -Ni A c 0 J 0 z N m* 0 o 0 T a m a N -ani Z TI z p m y m c 0 Z 0 a 0 -� z N m D w g N D n m A i N -� A m o m a n m 0 z; m a A m -Ni m o z N m c 0 A N Z m a 11 x m 0 N z a ; m N ami N N 0 Z m 3 y Z 0 c W p 0 Z Q i i Z r 0 r r r n 1 " z -1 z A 3 z 0 N A i 0 0 0 T o ZO -NI i i � 0 v v p A A -C W n 0 p Z 0 0 m mi 0 A 0 i D 0 m a A A IM 0 r m D z In c r 0 zzzz 0 In 0 z m mmmj O m c r O 0 n O z n O m c r 0 0 In O z fm1 O m r r 2 0 0 z N= 0 A z N N m 0= m m 0-n 0 1 z 0 x m i 0 m pO c 0 i OANN Z 0 o N v N p 3 z N Z N O N r N 9 a z N N m 0 'TI r O A -I m A N Q Z 0 0 N i mT vmi 'a c A 0 N m o C r Z N W m n O A p O m 0 Z 0 D -i C 0 0 * Z z - r m i x m N _ D N IM D °r r 0 N r a 'i A z O N _N N m p O 2 m* 0 o 0 T a m a N -ani Z TI z r r n ZA A 0 A m 10 c N m c O - r m a o z y m c 0 Z 0 a 0 -� z N m a m a> r o m n m A 3 r 0 -I r Z 0 N N g N D n m A i N -� A m o m a n m 0 z; m a A m -Ni m o z N m c 0 A N Z m a 11 x m 0 N z a ; m o f m m 0 M m N N o f m m D 3 m r 0 O 0 Z N 0 Z m 3 y Z 0 c W p 0 Z Q A 9 r 0 m 1 z -1 z N 0. 0 m n m 0 m A 0 i D 0 m a A m In c r 0 zzzz 0 In 0 z m mmmj O m c r O 0 n O z n O m c r 0 0 In O z fm1 O m r r 2 0 0 z N= 0 A D It A D P 0 n z N N m 0= m m 0-n 0 1 z 0 x m i 0 m pO c 0 i OANN Z 0 o N v N p 3 z N Z N O N r N 9 a z N N m 0 'TI r O A -I m A N m D N x PI Z i 0 A N r m Z 0 0 N i mT vmi 'a c A 0 N m o C r Z N W m n O A p O m 0 Z 0 D -i C 0 0 * Z 0 0 i z - r m i - i m N _ D N D r 0 N m * A a 'i A z O N _N N m p r z D z m x i m x � z m N N W 0 AO 7C _ v ID IM >OX NrN m �rzn0 nN • DO NZz CO3 C �k-j D 30U1 0 10 m_o p3m mx -1 7_ D IW0 66o �z_ 103 vOm z m mW0 Nsz r N r20 -ic)r oin0 DSD Z -z -� v 20 vN �D 0z In mm 00 DO 9 V O m a O W O V, O D rA N N T f71 O OOznnnny° A A y y m N VD 200 ` A n A DO Z_ m G1 m M n n f10Z0 N D 3 N DrlZ y 0� a 0 QoTOD OSy P mzp--nn' ND0AU �wy D A NAnn AOO A = y 0 0 0 0 0 0 0 N O y =NS N O O> v A A T mT > T T >Z>D> O Q° 3 N y N� ZyZ L) >>OO� -M > Z Z N O A0> Z� O > a , m T C N?> a' O T A ^ S n �+ D z T O r Gi Z N A O A> DZDD 3 N o T D ��� N 2 y = N 3 O Z 7c o < N = D A Om T OZ m T Z m 0 N r m y N oo j� j N Z 0 { Z n N IT -11 -IT _LLI I I I 1 I I I I I I I I I I I I I I I_ 1LL I _IJP I I = N _ Z� OT—DzDAOmOv O 0 r N C A 0 D S N 2 �, y y rrOy N z A Dy DOD y w N DC y NOD D0 (Q > > m T_ A Z m Z C AA SA M rV C ON n A y y5 > D n IP r m T O m 0 r r n< A S y r= A y— 0 m T 0 A y n � = S 'A A O= Z O p T D W T{ z` D p z O T W 0 T O n T Dn 2 Z m y O`> Z O N N D A zNCZ0 2 A W A DD N y() m Z A D '~ > D m A -� N N y z D mS O A 2 O O 0010.0 A 3 '< n > > T y A m A N r Z T 0 y 7Cnny O Z ti 0 G A -i N -i O Z y A S X` A Z Z O_ x y C -� S �^ D T m 70 O z m O I m W I II G A D m y A T 3 �o O D D � O A A ? N X Z m0 O Z O A Z T A I II I I I II I�I I I ISI IIIIIIII I Illllllw IIII IIIII" >OX NrN m �rzn0 nN • DO NZz CO3 C �k-j D 30U1 0 10 m_o p3m mx -1 7_ D IW0 66o �z_ 103 vOm z m mW0 Nsz r N r20 -ic)r oin0 DSD Z -z -� v 20 vN �D 0z In mm 00 DO 9 Permit A building permit is required for the installation of any solid fuel burning appliance. The building permit and installation inspection are limited to the stove installation and not to the stove construction. - Stove A. New !/" Used B. Type/radiant _ _ Circulating C. Manufacturer Lab. No. (C Name/ Model No. FJ17 /6 'L y Collar size Dimensions/ Height Length Width Chimney A. New Existing B. Size (flue area) 15 X C. Other appliances attached to flue (Number and flue size) ^�M--- D. Prefab (Manufacturer—name and type) , E. Masonry/Lined +/ Flue liner— Unlined iner Unlined (type & manuiad urer) F. Height (refer to diagrams) cap CHIMNEY HEIGHT Hearth anon -combustible) A. Materials B. Sub -floor construction C. Minimum dimensions (refer to diagram) Clearances and Wall Protection (see stove installation clearances chart) A- Tvoe of wall Drotection provided 11 • iC FIREPLACE 7-.M D CORNER 12, MIN. 1 t2u ,MIN. 18 If MIN. ( FUSL/ASH AGG'=n51 HEARTH WALL/CENTER 13 Location No. �___ / 7 Dated ,.ORTh TOWN OF NORTH ANDOVER 41 woL 9 Certificate of Occupancy $ s''••° • E�� Building/Frame Permit Fee $ s�cMus Foundation Permit Fee $ Other Permit Fee $ t TOTAL $ �� r Check # ✓ building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING , BUILDING PERMIT NUMBER: a DATE ISSUED: b / SIGNATURE: Building Conunisgiotrft/IRMLZor of 1§1 1din Date SECTION 1- SITE INFORMATION 1.1 Property Address: �y G S7,) 1.2 Assessors Map and Parcel Number: o z/ v i - 0 3 G Map Number Parcel Number 1.3 �Zyoning Information: �/ vin:;Ue—W,/ �. Zonin District Pr o� se 1.44 Property Dimensions: / /C�j / °2-r /Tl. Lot. Area Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Repired Provided 1.7 Water Supply .G.L.C.40. 54) Public ❑ Private ❑ 1.5. Flood Zone Infomnation: Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: / Municipal 0 On Site Disposal System Q SECT N 2 - PROPERTY OWNERSHMAUTHORIZED AGENT 2.1 Owner of Record /l �z� �� `� U/ v S �✓I�l Name (Print) Addre ss for Service 6� 7 Y-) / 7�; — /,5�/ �-, Signature Telephone 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: a C) / �/ N, lf-� Number Address 7 ��✓7� 3-�o-tea_ xpiration Date rgnatureo Telephone 3.2 Registered Home Improvement Contractor Company Name j�, /j0 Irk 1, �!/ V �/ Not Applicable ❑ r o Y 3 y Registration Number AddressZIL14 /I- 7 Expiration Date S nature Telephone T M a.. z SECTION 4 - WORKERS COMPENSATION (M.G.L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buildi2622rmit. Signed affidavit Attached Yes ....... No ....... ❑ SECTION 5 Descrition of Proposed Work check 9, grapplicable) New Construction ❑ Existing Building Repair(s) ❑ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: t v i�r A �/ n/-) A 11Y r,511PF' � G��/�i�G' L� /171T 7-1f" L. Ilk*, f��rs � �C�of'/�� � SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be �fFFICL QNY Completed by permit applicant 1. Building /0 / I (a) Building Permit Fee l ,- Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing y --v Building Permit fee (a) X (b) 1 a3t �-- 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZAT16N TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTO/RR APPLIES FOR BUILDING PERMIT as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. 2 Signature of Owner Date SECTION 7bbp OWNER/AUTHORIZED AGENT DECLARATION le)# LV 1, //g G as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Na e f Si atu e o Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TRABERS 1STy 2 3 SPAN DIMENSIONS OF SILLS DM ENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax. (978) 688-9542 DEBRIS DISPOSAL FORM ¢ �yQF?Th O� ywy�� •6=.a�OL iL 16 z= �° CO[�N[�y K■ '�\ �9Srp11TEO ePG��� In accordance with the provisions of MGL c 40 s 54, and.a condition of Building permit# the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, s150a. The debris will be disposed of in /at: Facility location Signature of Applicant Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. I am a homeowner performing all worK myseT. I am a sole proprietor and have no one working in any capacity aI am an employer providing workers' compensation for my employees working on this job. Com an name: , Address Ci Phone #: Insurance Co Policv # Ci Phone #: Failure to secure coverage as required under Section 25A or MGL 152 can lead to the Imposition of criminal penalties of a fine up to $1,500 and/or one years` imprisonme.nt_as wen..as_civil penaltiesin-theformof-aSTOP_WORK_ORDER.zod-afine of j.$1.0.0.00)-attay against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains and Print name 1161) 325�7L that the information provided above is true and correct Date �J / /Q/ 79 ?1J�1� Official use only do not write in this area to be completed by city or town official' City or Town Permit/Licensin (] Building Dept oCheck ff immediate response is required .0 Licensing Board ❑ Selectman's Office Contact person: Phone #: 0 Health Department 0 Other + BOARD OF BUILDING REGULATIONS (License: CONSTRUCTION SUPERVISOR + Number:.CS 025620 Birthdate:.03/10/1947 Expires: 03/10/2002 Tr. no: 17749 Restricted To: 00 ROBERT C BAILEY 499 WAVERLY RD N ANDOVER, MA 01845 -eeq� Administrator C0 m m m 0 CA Cl)CD Z CD O a6 r Co O CZ n(0 O O44CDp 06 o- CD O mm C CD d O co CD y .0 CD O CO) d d O y O CA d C13 CD O rF CD CO) CD CO) O O CCD O CD W� I O -• co) O c y "COD y CCL n m n Q y n an T Z •' 'o CCA, -� CL = m CD o CD H c 03 C4 N Ohm: C 2 0 oZCD CA' 0:CC2) C � y � a e C& �m :� �c O ? _a . • !p O O H 7 C'M c c� H O O y H CO) a N cr _ c W C • a N CCD 7 .rt y C43 H CD C CO pt N o: CD o 4 'O O O CD N .%l* C2 C= m m CL C-) cl)' N O CD d o ^ri 0 rA H hj o O '^7 OQ � ?] RL � i '7i Q c � rcn e 10 O CL � o d 0 x y z 0 .3 3 E4 4 3 Date ..... ORTM TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...................................................... `P• has permission to perform ......... ....................................... wiringin the building of ................................................................................... at ........ , . ....... / ....... �11 ...................... North Andover, MaCs. Uv 1�(K7 ......... ........... . Fee.. Lic. N ... ...... L RIC L INS I CTO Check # F .... Umclal use only Q Permit No. <J �f'5 G��2�CL'7�f &4y; %12SS�fL'S�`7'7S Occupancy & Fee Checked BOARD OF FIRE PREVENTION REGULATIONS.527 CMR 12:00 APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 527CMR 12:00 (Please Print in ink or type all information) Date To the Inspector of Wires: ' Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location 0i' 11 Owners Is this permit in conjunction with a building permit Yes V,-- No ❑ (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps Voits Overhead ❑ Undgrnd ❑ No. of Meters New Service Amps Voits Overhead ❑ Undgmd ❑ No. of Meters t Number of Feeders and Ampacity Location and, Nature of Proposed Electrical Work OTHER f ZC�%�C • A dde- TD &(;lb 7? INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO = have submitted valid proof of same to the Office YES = NO= if/4o�� CtyzcJced Y $ease i dica the type of coverage by checking the appropriate box. INSURANCE = BOND = OTHER = . (Please Specify) sye / JIF (Expiration Date) Estimated Value of Electrical W.$rkb �i 000 yv� Work to Start �T�/-�A� .1 _ _ Inspection Date Resquested Rough i1i/N final Signed under t<eoafties of perp! l c FIRM NAME V (j LIC. NO.3L� 0 % Lr enseeS� l 1✓ ChL I &A Signature LIC. NO. ��.d 3, Bus. Tel No. Address �r R[.(.) i�6z& Lbedrl/�0tAyh*SS Alt Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the enses� does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) to Telephone No. PERMIT'FEE $ (Signature of Owner or Agent) Total No. of Lighting Outlets No. of Hot fuse No. of Transformers KVA Above ❑ In ❑ No. of Lighting Fixtures Swimming Pool grnd ❑ grnd ❑ Generators KVA No. of Emergency Lighting No. of Receptacles Outlets ` No. of Oil Burners Battery.Units f No. of Switch Outlets. No of Gas Burners / Z -0A1 r FIRE ALARMS No. of Zone No. of Detection and Total No. of Ran es No of Air Cond Tons Initiating Devices Heat Total Total No. of Di sal No. Pumps Tons KW No. of Sounding Devices No./ of Self Contained No. " Dishwashers Space/Area Heating KW Detection/Sounding Devices ❑ Municipal ❑ Other No. of Dryers Heating -Devices KW Local Connection No. of No. of Low Voltage No. of Water Heaters KW Signs Bailases Wiring No. Hydro Massage Tuds No. of Motors Total HP OTHER f ZC�%�C • A dde- TD &(;lb 7? INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES = NO = have submitted valid proof of same to the Office YES = NO= if/4o�� CtyzcJced Y $ease i dica the type of coverage by checking the appropriate box. INSURANCE = BOND = OTHER = . (Please Specify) sye / JIF (Expiration Date) Estimated Value of Electrical W.$rkb �i 000 yv� Work to Start �T�/-�A� .1 _ _ Inspection Date Resquested Rough i1i/N final Signed under t<eoafties of perp! l c FIRM NAME V (j LIC. NO.3L� 0 % Lr enseeS� l 1✓ ChL I &A Signature LIC. NO. ��.d 3, Bus. Tel No. Address �r R[.(.) i�6z& Lbedrl/�0tAyh*SS Alt Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the enses� does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) to Telephone No. PERMIT'FEE $ (Signature of Owner or Agent) 90 Location I/1 deL,."l a No. V Date %�-S r�..- TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ `re Foundation Permit Fee $ Other Permit Fee TOTAL Check # / 711 7V 18596 $ r% —Building Inspectov TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRINT REPAI RENOVATE, OR DFMOE,ISH A ONE OR TWO FAMILY DWF.1,1.[N(-, Y. BUILDING PERMIT NUMBER: t DATE ISSUED: SIGNATURE: Building Commissioner/las or of Buildipp Date obPD.S.R9 9 0.1 1.1 Property Addreets! 1.2 Assessors Map and Parcel Number/ Z02 M* Number Parcx] Number 1.3 Znnft 10mmatirm: 1.4 PropcFty Dimensions: Zoning -5 District DNowd Uk I.Al Area Q;f) (So' 1.6 BUILDING SETBACKS (ft) Front Yard Side Yard Rear Yard ReLuired pruvi-&- Re a rod Provided Required Provided 0 Wea Sonly M.0L.C.40, 54) 1A Flood Zone Infonumion: LA Sew^eTzge Dinpmal %yxtm= I NMG 0 Privatt 0 Z080 OuwWc Flood Zmc LJ NIVakipal U rtnsite Dkpn4j %ymmM rl 131.1 % -.111AN Z- rKUrMK I T L?Wf'4VKNnW/AUI'HUKJLZFDAGEIN'I' 2-1 Owner of Record 'DiXA- GwA Name (Print) Address For Service: 2.2 Owner ol'Rmord: • Name Yrinr -71C IS A b c 2j Addrogs for 9crvicc: aZ;JLJLV.L1 0 - 4W1Ta1KUw-1JE1L#L1 3.1 iucn---d Construction Supervisor: Not Applicabic 0 j4z, tc Liocnv-4 0-YnOructian Supervisor- Liotnw Number Address Cf / P (0 Signature Telephone 3.2 Rogiskcrr4 Hcmic Improvement Contractor Company Name 1�GF '3 Address Not Avolicable D 134id-t, Registration Num;wr : L f C -- Expiration Date ,a . U1V_IpAG DEPT - SECTTON 4 - WORKERS COMPENSATION (M.G. L C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building it. SiLallcd affidavit Attached Yes — No ....... 0 SECTION 5 Description of Proposed Work dwck tll a licahk New CoJlstrtustiun ❑ 1 Existing Building ❑ 1 Repair(s) Tl I Alterations(s) t I Additinn I i AccessA)ryDIdg. ❑ Demolition nc3ther specify 15� L4 . Brief Description of Proposed Work: SECTION 6 - RSTTMATETI f'tllVf:7R?i Yt Prn1v rd'%C-M r-. U4, ItcJn Estimated Cost (Dollar) to be OPFICiALUS,E ONLY Com lttcd by peraj t applicant 1. (Building I (a) Building Pcrmit Fee multiplier 2 f :lel trical (b) Estimated Total Cost of 117/ d� Construction / 3 P[tJmbing Building permit fee (.) c (h) 4 Mechanical IIVAC 5 fire Protection G Total 1+2+.1+4+5 t —j ear. r•a•r Check Numbcr _ •+'+• I%s R;'J.' %."L"VE r l.r,J UP wIMil I OWNERS AGENT OR CONTRACTOR APPLIES APPLIES F'Ol% BUILDING PERmur (I I...._..-.. _ 1_ _. V�� as Diet/Authorized Agent of subject property Hereby uuthonzc, [DrAVLMA_P.. toact on My Ileltalf, in 1111 IT1141ets relative to work authuri&.,d by this building pcnnit application. Si nature of Owncr Date SECTION 7b ,(OWNER/AIITHORIZED AGENT 'I)CCLARATION tc as 0,a ner/Authnri7ed Agent of subject proporty I lercily tie4la7re Haat. Ille surJteructats anti inlbrrnation on the lbrc:going application are true and accurate, to the best of my knowledge and belief PA4-/la C_ Print Name _ _ -,.., a 6 �- SifiJltltUfe of ORntt'.r/Aeent _ - n. r.. ---- _ -- j NO. OF STORIES _U11iil31v11.:IV] t/r(ilHt3 SIZE OF 11.(x)k T]MHEAS 1ST SPAN SIZE DIMENSIONS OF SILLS DIML•;NSK)N`; OF I�MTS DIMENSIONS OF (HIME.RS I IFI(I [T OF FOIJNDATION THICKNESS S17,Y OF FOOTING X MATFRTAI. 01' Cl1IMNEY IS BUILDING ON SOLID OR FILLED LAND [S.13L11LDING (:0NNIi('T1;) -1.0 NATURAL GAS L[NIi, FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. ****APPLICANT FILLS OUT THIS SECTION APPLICANT PHONE LOCATION: Assessors Map Number 0030 PARCEL SUBDIVISION LOT (S) STREET Ll ✓ ST. NUMBER OFFICIAL USE ONL i.►'1LI L 1 CO 99E-NX1�V A&6ftTRATOR DATE APPROVED DATE REJECTED TOWN PLANNER COMMENTS DATE APPROVED DATE REJECTED FOOD INSPECTOR -HEA TH DATE APPROVED DATE REJECTED J-0 SE TI SPECTOR-H LT DATE APPROVED PUBLIC WORKS - SEWERMATER CONNECTIONS DRIVEWAY PERMIT ireFP+c11lC.D FIRE DEPARTMENT .- 2005 RECEIVED BY BUILDING INSPECTOR DATE Revised 9%97 JM BUILD! IN y DEPT. W MORTGAGE INSPECTION PLAN NORTHERN ASSOCIATES, INC. 342 N.MAIN STREET ANDOVER MA. 01810 TEL:(978) 474-4410 MORTGAGOR: PETER J AND DIANA GORDON LOCATION: 89 GRAY STREET CITY,STKI-E: N ANDOVER MA DATE: 11 /29/98 ,47.29•. FAX:(978) 474--5067 DEED REF. .4392/9 PLAN REF. #712 SCALE: 1=60' JOB #: 98/15935 --EXhTiIJa h' 7JV�.�.� j NEW 6' DOOR FROM PORCH Z (NOf SHOWN IN THIS VIEW) IN I GIS''I mIItlIF- I 1 LJ LJ LJ EXISTING DECK 12'X21' (APPROX) 1.2X8 Pf FRAME @ 16" O.C. 2. 5/ 4" X 6" Pf DECKING 5. LATTICE (TO P.EMAJN) 4, LALLY COLUMN P05f5 fWU CONCITE PAD 5.5fAIP5 (f0 6E REPLACED) 6.51NGLE 2X8 Pf PERIMETER PAND PROPOSED UPGRAWS fO EXISTING DECK I. TO ADD ( 4) 12"0 X 48" DEEP FIGS W/ ANCHORS 2, TO ADD 2X8 Pf TRIPLE [TAM 3. fO ADD 5/ 4" %4 PLY OVERLAY UNDER ROOM 4. fO ADD 6X6 P05f5 W/ KNEE 6RACE5 5, TO ADD ( 2) NEW TREX STAIRS 6. TO ADD J015f HANGERS EXISTING SCREEN 12'X21' (APPROX PROPOSED UPGRl REPLACE EX%Ni WITH NEW 6X6 P WW ALL P05f`, OF DECK WITH AL COIL STOCK. INSTALL 2N, PAN 6LA55 WINDOW`. WITH SCREENS, NEW 6' DOORS 5 - FROM PORCH (NOf SHOWN IN fH15 VIEW) STAIR & RAIL 56" HIGH RAIL II" TOAD 7-5/ 4" RI5E 4" P&U51TR SPACE Project: ette r l i v i n GopeoN P� 5,,2%a GREY STREET BSUNROOMS 89 G 1 Action Blvd., Londonderry NH 03053 NORM ANDOVER, MA 01845 Phone (603) 537 9256 Fax (603) 537 9258 ■ Drawinq: Date: 7/ II/ 05 I Sheet I of I Property Owner Must Complete and Sign This Section If Using A Builder I, P -4Z f a0 C J a %^ , as Owner of the subject property hereby authorize Betterliving Patio Rooms (d.b.a. — Patio Rooms of America) to act on my behalf, in -all matters relative to work authorized by this building permit application. for (address of job) Si 6 Date Owner or Builder (as Agent of Owner) Must Complete and Sign This Section I, 1'(a *Zt-Ck.L `�S hereby declare that the statements (address ofjob) accurate, to the best of my knowledge h belief. Signed under the pains and penalties of perjury. Print Name as Owner/ uthorize on the foregoing application for Signature of Owner/ en Date are true and j,%i w�^,,��:�., ._'-�'�'•`c:.n "";`^._.___ _-_�__ ___--_____�__ ___x.,/i'�'tif ��;-,may �r�� 1�� T!_"�:;r-'�r1`S1a='e *=i? V= r l:n. �'.cf _ •�. Si7 .gt`T_ _'_'T- Y`�'. s3 Mx �,�_ L""[riE.l.�i.�lS�,...,.;; ,t:y r...iL:,;ti�•s-:. , !'1-jrCF, rr.�•, r <-''aa .Gi ..J �.� .T ." _, ti �I� J, _r Muse fid''`' -! ,._ _ _ a ^,` r This _ i1W L' • 7 J ,i � ✓ Cc.'=iC at�.'1 .t2l� AS Vii.:, 1. '�%.�:'J l_i-t..._•,. 1 .t" �. 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',:� C.v'.%T.Yy^,'!^..�u`'it. v�'a'p�'i, .'i ,7.�. .__r%.��''�l �7:,�;y,` i?-����r_:,; ✓i L`. ice; �i �`v �!�\F _rii.+: i; L'ct C: �i a iiQ ic` i'F.Al:.Jt _'`GZ a that __ ..:C2'`-- sum oom" addiZ:toi]S to an ex's- i1�,� ieSia.`-ntiai inc I +'�CcL JL )C.a ar tri -cr; ` T} a ;- �. trv, , ^l.nE+ rii: C n t'161 _ S _ _. ,..r'i _2,.r =Si�P. !i _ E\ �CTC-G:�ic�c 'ha,'Sii�J�� P,2S ;�3� iii'' L. zOi`!" .�li? C:s_:.! i)O'l.�oT''_ _� u�,rt �r�i'�✓ �+^i:5�- a.an?1. �C{G'lG� o�cQO� ��19©��� St NONk4Jover — �— - — L ♦: rrZTi?Va-i1� 1 ,.� •.J.1;.�.� -;,;' �-;e.--`n,L.'_.�+ i SjtC: C: a e? al .LL �al Oy fr„ , - ' a u v 3a Ly ( L E,l n ix. F _ Q `O z i � �y �...d s• �r x � _U O J. O � U O � �V ' 4 nab LY C1 o= F o o i J-'-. ll Z N �`7 aa�n Lu - _ cd 1 ? Lu N Z'CO 'o C ZZ W O v p Z 6+ v ITiS� N i I in 0 C ch Cl) - u ir} ,lO ;rJrU e? al .LL �al Oy fr„ , - ' a u v 3a Ly ( L E,l n ix. F _ Q `O z i � �y �...d s• �r x � _U O J. O � U O � �V ' 4 nab LY C1 o= F o o i J-'-. ll Z N �`7 aa�n Lu - _ cd 1 ? Lu N Z'CO 'o C ZZ W O v p Z 6+ v ITiS� N i I in 0 C ch Cl) I Action Blvd. Unit l Londonderry, NH 03053 phone: 603-537-9256 fax: 603-537-9258 AFFIDAVIT In accordance, with Article 1. Section 114.1.3 of the Massachusetts State Building Code, I certify that all debris resulting from work associated with Permit # will be properly disposed of at Betterliving. Surrooms 1 Action. Blvd. Londonderry, NH 03053 licensed solid waste disposal facility as defined by MGI C11, S150A. Name & Address of Project:�� Street Address�- City/State/Zap W CIO 0%"- Ol k -e&- Name of Permit Applicant'P IM�-- 54-- "O"As (please print name) Signature of Permit Applicant,, (please sign name) Bate: X6-6 /y Betterliving Sunrooms 1 Action Blvd. Unit 1 Londonderry, NH 03053 M1i`,'—a9-2ca �5 92 ; 1 PM BETTERL I V ING FArb*r ,.. 1 50� 27�J 5755P.51 , ►. .1 Y iribUKANCEMnl eaneae a Mq ER o 0 OOS D►!LY AND CONFERS NC1RlCt41TSUPONTHEQCRTIWe In�uranae Agency, Enc. HOLDEE DOES NOT THE3 ALTER THE CpVEMc3E AP�ORD1Ti� I LICIE gND yYI ' 481fy8-0333 INSI�fS�g AFFORDINQ C OVERAGe Petlo Roprtft of Naw FtempshlreINsuR..,�tterfiWna Sun Rooms Df New H1 Action gNd UnftQ INSURER A;-a�donborry, NH Q3063 IN6tJRR<R c; ----- ---�_ IN9uRGR D; CO'1/l11Re['�RR _ INRIIRFbc. ANY I AWAY PERI POLICIES. INaURA'NCE LIBT£q 61,, HAyE BEEN IliUEpTO THE II VT, TERM OR CONDITION OF ANY CONTFaLCT OR OTHEF E INSURANCE AFFORDED BY THE_ 1`01.01;9 DESCRIBED F GATE LIMITS SHOWN MAY HAVE BEEN REDUCED AY PAID 1YPl OP INSURANCE PoucrNut A oe X WsRALUA&L" COMMERCAL4iNERAL LIA9ILm, 35 Saw KZ70S7 _ CLAIMC MAGE FV ,T" OCCUR GEN':AgUREEGIATELIMITAPPLI[B PHR: - POLICY PRO' LOC , A �uroStwluLaElLm 33 UEG UW3916 ANYAUTO ALL OWNED AUT06 �( sGHeOULeoAUYOE NON4INNE] AMp QIRAQELIAE�u1T1' -.. 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