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Home My WebLink AboutMiscellaneous - 94 MILLPOND 4/30/2018NORrH ANDOVER BRANCH NORTH ANDOVER, Massachusetts 018459998 2445930845-0099 09/23/2010 (800)275-8777 03:52:10 PM — Sales Receipt Product Sale Unit Final Description Qty Price Price BOSTON MA 02111 $5.00 Zone -1 Priority Mail 1 lb. 1.10 oz, Expected Delivery: Fri 09/24/10 Delivery Confirmation $0.70 Label #: 03091830000053063838 Customer Postage -$7.00 Subtotal: $0.00 Issue PVI: ; - $0.00 oc� Total: Jam/ $0.00 Paid by: Orde, )s at USPS Com/shop or cal' Stamp24. Go to USk w icknship to pr ir:t shipping labels with postage. For other information call 1 -800 -ASK -USPS. Get your mail when and where you want it with a secure Post Office Box. Sign up for a box online at usps.com/poboxes. Bill#:10001.00487221. Clerk:ll All sales final on stamps and postage Refunds for guaranteed services only Thank you for your business HELP US SERVE YOU BETTER Go to: https://Postalexperience.com/Pos TELL US ABOUT YOUR RECENT POSTAL EXPERIENCE YOUR OPINION COUNTS Customer Copy TM U.S. Postal Service Delivery ConfirmqtionMReceipt z to Postage and Delivery Confirmation fees must be paid before mailing. .0 Article Sent To: (to be completed,bymaile� ' 1 Cr W...................... .D :fFiasse Pmr Geary) zm .... ....... ...................... . (� IoLn o�. _ POSTAL CUSTOMER: 0 C3 \.` Keep this receipt. For Inquiries: C3 rk Access Internet web site at C3 O a%Here acP� www.usps.com0 Co Q or call 1-800-222-1811 D r' � CH K ONE (POSTAL USE ONLY) M or 0 77 /p�Priority Mail-Service C3 fin^ H ��ar, ��/ ❑First -Class MaiPparcel _— ❑Package Services parcel PS Form 152, May 2002 (See Reverse) SS3a00V Aa3A1130 A11V3N :10 13313H1 OlWdOZI 138V1 HOV11V'Z 3131MOO'L *3Sn Ol MOH •96eUan00 UO suollellwil pue suolldo algellene Buivaaouoo uollewiolul jol jalsewlsod leool moi loeluoo •96Mn00 sapiAad legl aopuas leloads jaglo jo 'pjM pamsul japlsuoo 'p81ls9p sl 069JOA03 /Illuwapul ll •papinoid sl 96eJan03 amuinsul ON •a6elsod pue'sluawasiopue jo s6uiInw 'lagel aalnias leloods 'ssaJppe tianpap Pug wnlaj jol g6noua 96jel aq lsnw aosl aql qulod lsoNolgl sp le HoI41 „b/E ueyl aaow sl legl wall ue yo xoq a sl laoued V ■ (IIeNI lirig-1 pue'I!L N elpaW 'JOMIN paluud puno8 'lsod laoJed) slaoied S031AJOS 96eMoed Pug 'slaoied� p1m sselo-lsll j ; aovuag FIN Auoud gjIM algel!ene Aluo sl ■ IOinbul uodn Nanpap.peldwage io/pue IUanllap to owll pue alep sapinoid ■ GOIJUGS Siyl AJ2AII2n C.ICA September 23, 2010 bldg. 20, Suite 2-36 North Andover, MA 01845 Phone: 978-688-9545 Fax: 978-688-9542 Attorney Kevin M. Sullivan, Murphy & Riley P.C. 141 Tremont Street Boston, MA 02111 Please see the attached information that you requested. Xeroxed copy of the file for 94 Millpond, North Andover, MA 01845. Please mail a check in the amount of $18.40 made out to the Town of North Andover, and mail it to the address on our letter -head. Thank you. Mary Ippolito, Building Assistant cc G. Brown, Building Inspector enclosure Date .... Z,29 / .......... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that..(2"a,---" ........................................................................................... has permission to perform,4�� ... wiring in the building of .......................................................... at ..................... .. .... North Andov(ei Mass. Fee/ . ........ Lic. No. . .............. . ... .... ... ELECTRICAL 7i ic SP CTO Check # 8573 v am: � A 5; lj Z: W CO3 s .7 C3 ❑ 13 Ej Z 0 13 1113 El ❑ o ID In 13 13 Z: W CO3 s .7 C3 ❑ ❑ Ej 2efrartment W _tire Service BOARD OF FIRE PREVIHNTION REGULATIONS OI iicia] Ilse Only P ermit No �3 xpancy and Fee lecked 1/071 il.:ave blink � Iw♦AL WORK APPLI`;;Al' ION FOR PERTO PERF ORM ELE.., ii r%r R 12,00 All we •k to be performed in accordance with the Massachusetts Electrical Code (MEC), J (PLEASE PRLVT 11r M OR TYPE ALL INDate:_ 1/F/('aFORMATION) To the Inspector '!f Iii es: City or To'>wri of: Horth Andover By this application thy: undersigned gives notice of his or her intention to perform the electrical �jork d. -,scribed below. Location (StreaA & Ywakber) jE Millp,and _ -• ;fay Weiner / Great North T(lepholte No. Owner or Ten.�.ut _. _ - Owner's Address Name _ -- — �:AI►l: 1'b1ropriate Box) Is this permit i a conjunction with a building permit? Yes ❑Noity Auti!.orization (Cherk Purpose of Building rondo - 12J tindgrd Ej No of Meters 1 Existing Servi,::e: 2, Amps -0 /230 Volts Overhead[ rd [] No, of Meters New Service Amps / _ Volts Overhead [7Und g Number of Feeders , end Ampacitye . Location and IVaturc of Proposed Electrical Work: Rewiring of Condo dueto wa::er _ �a g r --•- --- – — - Completion of the ollowin table may ire wai• ed b • the Ins ec•tor o 'Wires. o. 01' - -- ota No. of Cei .-Susp- (Paddle) Fans Transfo :mere ISA rN ecessed Lu ininaires - _ KVA ' No. of Hot Tubs Generators umitta.ire Outlets A ove -Tn- �� o. o. Einerg-eine—yLig nt�F�g F- Siwimming Pool roil. grnd. Battery Units uministires h u No. of Oil Burners FIRE A I,A.RI\'1S No. of Zones ecep t:tcle ()uttlets _ - o. o f :tecti:�n and Switc,ius Pio. of Gas Burners Initiatin= Devices Tt}tal No. of ).lertin; Devices Rang, s No. of Air Cond. Tpns feat ump •, um,,er ons ... Deteelhon/Ale -tin Devices Wast:::Dispusers Totals: ur�ctpaLocal [ .I ❑OtherDish��+ashes s '.apace/Area Heating KW Con nechonecurit) Svst; ms: o.oDryers Heating Appliances KW No. itf �e� ices or E,uivalent — -- o. o o.'— Data '-Wiring: c►. o stet Kyt Bstlll:asts IVn. )f Dei tcesor,Egnivalent Heaters Signs a econimun cations.Wiring ' �e Bathtubs P1o. of Motors Total HP N,�. �f De' aces or Equivalent No. Hydroutassal, - '- '—'- OTHER: _ - - -- Attach additional detail �f desired, or �s red. sired by the Inspector of ►4'ire,c. $6,800.00 When rtired by municipal policy.) Estimated Ve.hae o?'E,lectrical Work: ( e q'' Work to Star-:: 113 /09 _ Inspections to be requested in accordance with MEC Rule 10, t►r�d upon completion. p INSURANC, E; CC. VO GE: Unless waived by the owner, no pe tecirintooedone' coverage i �f its : i bstantial equivalent. The cAcal work may issue unless the licensee :�rovidus proof of .iability inst:urance including "completed P in force, and has exhibited roof of s t< to the: ps ,:rmit isuing office. undersigned csrtifi1:s that such coverage isCHECK OI` E : 1T iIJRANCE ❑ BOND ❑ OTHER [I(Specify:) 1 certify, un iter th.: pains and penalties of perjury, that the information o this �ipplieation is t►u�! and complete. LIC. NO.: 14302 FIRM NAME: kndover Electric Ser_rices, Inc LIC. NO.: Signature /� -- 978-475 4995 Licensee: _Robe (b. Branca..—t! B•ui . Tel. No.: (If applicable enter 'exempt" in the license ',umber line.) A,l':. Tel. No.: 19 Dille St, Andover, MA 01810 Address: —. __ *Per M.G.I. �. 14'', s. 57-61, security wo:I requires Department of Public Safer` "S" Lice e: Lin. urance cge OWNER'S INSIIRANCE naAIVEowi h► hereby waive his requirement I amaware that the Licensee does not rve he (che:.lhe b:� a int, [] owner [D owner's allent. required by law...s}� my signature b r,DEj,►,'vilT FEE: $ Owner/Agwal Telephone No.__ - L •— Signature __ - 3/ LIU t f Date ....... TOWN OF NORTH ANDOVER 0 VP 0 0 PERMIT FOR WIRING 4L IWWAW . C04US This certifies that .......... ... ................................................... has permission to perform .... wiring in the building of ......... \xj.;—=1.'.Ve1z .................................................. at ................................ ......... North Andover, Mass. 4/ Fee .......''a ..... Lic. No....�19 724� ....... LECTRICALINSPECTOR E! Check # 898& Commonwealth of Massachusetts UVDepartment of Fire Services BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. eUw Occupancy and Fee Checked [Rev. 1/07] (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT WINK OR TYPE ALL INFORMATION) Date: City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice ce of his orher intention to perform the electrical work described below. Location (Street & Number) ./ 4p Owner or Tenant Owner's Address 9 - Telephone No. Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Boz) Purpose of Building Utility Authorization No. Existing Service -20Amps 10-70 / y®Volts Overhead ❑ Undgrd No. of Meters New Service Amps / Volts Overhead ❑ Und rd g ❑ No. of Meters Number of Feeders and.Ampacity Location and Nature of Proposed Electrical Work: Completion of the followin table may be waived by the Ins ector of Wires. ' No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No• of Total . Transformers KVA No. of Luminaire Outlets Generators KVA SEE No. of Luminaires Above ❑ In -o. d. 0 of Emergency.Lighting rnd. Batte Units --, No. of Receptacle Outlets No. of OR Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No..of Detection and Initiatin Devices No. of Ranges No. of Air Cond. Tonsl No. of Alerting Devices No. of Waste Disposers Heat Pump Number ons KW Totals: No. of elf. -Contained Detection/Alertin Devices t No. of Dishwashers Space/Area Heating KW Local ❑ Municipal El Other Connection No. of Dryers Heating Appliances KW Security Systems:* No. of Water' No..of No. No. of Devices or Equivalent Data Wiring, Heatersof Si s Ballasts No. Hydromassage Bathtubs . No. of Motors Total gp No. of Devices or Equivalent Telecommunications Wiring: OTHER: No. of Devices or E uivalent Attach additional detail if desired, or as required by the Inspector of Wires. Estimated Value of Electrical Work: . (When required by municipal policy.) Work to Start Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such cove page ism force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify, under the pai.2s and enalties of perju , that the information on this application is true and complete. FIRM NAME d r� C� LIC. NO.: Licensee: Signa turef ex LIC. NO.: 2 (If applicable, enter "mpt " in the license nu her line.) Address: GC. I/ o � 03-o "71' Bus. Tel. No. qr -ill / _//L � *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Alt. L lc. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) ❑ owner ❑ owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE: $ 31)- The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Nrashington Street Boston, MA 02111 t' i www.muss.gov/dia . Workers' Compensation Insurance Affidavit: Builders!Contractors/Eiectricians/Plumbers Name (Business/Organization/individual): Address: _ 1'� Q L) city/state/zip.--LS�,Czep 63677. 7 Phone #:. C/,Z S � U7` — l/- Are you an employer? Cheek the appropriate box: 1. F -1I a employer with 4, ❑ 1 am a general contractor and I Type of projecteq ' r at (red): pioyees (full and/or part-time).* have hired the sub -contractors 6. ❑ New construction 2. I am a:sole proprietor or partner- listed on the attached sheet. 7 ❑ Remodeling ship and have no employees These suit -contractors have 8. ❑ Demolition working for mein any capacity. [No workers' comp. insurance workers' comp. insurance. 5. ❑ We are a corporation and its g ❑Building addition required.] officers have exercised their 10. ❑ Electrical repairs or additions 3. ❑ I am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myseI£ [No•workers' comp. c. 1.52, § 1(4),and we have no 12.❑ Roof repairs insurance required.] t employees. [No workers' 13.7 Other comp. insurance required_] -•v ••rr••.. — un. u1=&s cox s t mus[ also tilt out the section below showing their workem' compensation policy information. t homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheat showing the name of the sub -contractors and their workers' comp_ poiicy information. Iam an employer that is providing: workers ' comp tion insurance for my employees: Below is the policy and job site . Insurance Company Name: Policy # or Self -ins. Lie. #: Expiration Date: l Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). ' Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine ,r of upto$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. ! do hereby certj& under the pains andpenWfias of perjury that the information provided above is true and correct Signature: ''i2� Date.- Phone ate.Phone #: % t/77 ==Oth6r only. Do not write in this area, to be completed by city or town. officiaL n: Permii/License # ority (circle one):Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector son: Phone #: 3 .� Information and Instructions Massachusetts General Laws. chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. 'However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dweiiing house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence..oir compliance with the insurance 'coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of pubiic work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants,� Please fill out the workers' compensation, affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) Lwith no employees other than the , members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage.. Also be sure to sign and date the affidavit. The affidavit should he returned to the city or town that the application for the permit or license is being requested, notthe Department of Industrial Accidents. Should you have any .questions regarding the law or if you are required to obtain a workers' compensation policy, please call the Department at the number. listed below. Self-insured companies should enter their self-insurance license number on the appropriate dine. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/license applications in any given year, need only submit one affidavit indicating current policy information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or town}" A. copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.) said person is NOT.required to complete this affidavit " The Office of Investigations would lice to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel. # 617-727-4900 ext 406 or I-8.77-MASSAFE Fax # 617-727-774 Revised 5-26-05 www.mass.gov/dia ti s.? Date ..... .......... . ...... .... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...... ,!`?.......� has permission to perform wiring in the building of .........../tib/ h...�......................................... ....... ......... at ............ ......................... -North Andover, Mass. Fee. V -5...P.' .. Lic. No.3.I4a ........� ELECTRI..�......... CAL INSPE/� Check 11 14 979 8983 lclx Commonwealth of Massachusetts WjDepartment of Fire Services BOARD OF FIRE PREVENTION REGULATIONS W, use oniy Permit No. _ M� Occupancy and Fee Checked ev. 9/o5j eave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MECO 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: '� -,=) q _d 1 City or Town of: Ljo Fir" A NZ, o c r-, To the Inspector of Wires: By this application the undersigned gives notice o or her intention to perforin the electrical work descr%ed below. Location (Street & Number) 9L( Owner or Tenants l �,-, SLR Telephone No. Owner's Address ---- Is this permit in conjunction with a building -permit? Yes .IM No ❑ (Check Appropriate Boz) Purpose of Building�� t pFt,, c�� Utility Authorization No. Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Overhead ❑ Undgrd ❑ Overhead ❑ Undgrd ❑ No. of Meters No. of Meters No. of Recessed Luminaires w,.::con v rrte ot:owm ratite may be waived by the hu or oWires. f No. of Ce&-Susp. (Paddle) Fans o. of Total— Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of LuminairesSwimming Pool Above El- ❑ o. o mergency Lipting rid. d. Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No.oftion a Initiatin Devices No. of Ranges No. of Air Cond. Tons No• of Alerting Devices No. of Waste Disposers Heat Pump I AqM!Le!Lj Tonsgoi. of Self-contained Totals:-------- .._..._ .. .......... ....... ... DetectioniAlertin Devices No. of Dishwashers Space/Area HeatingMunicipal KW Local ❑ Connection ❑ Other No. of Dryers Heating Appliances KW Secarity ystems: No. of WaterNo. Heaters KW o. S' Ballasts No. of Devices or Equivalent Data Wiring. No. of Devices or—Equivalent No. Hydromassage Bathtubs No. of Motors Total HP ecommumcations Mm Na of Devices or E uivalent OTHER: L-0-00-TRic v RC7 �t izt _ L Amort 3 Y,57 -c r/ Estimated Value of Electrical Work: /,rte n ..... .. ......0:�,,..,. ueratt y aestrea, or as required by the Inspector of Wires. (When required by municipal policy.) Work to Start: b' - � L(_og Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ® BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties ofper that the information on this application is true and complete. FIRM NAME: 15OS c5c e r o 2S -T t. LIC. NO.: 119 9 C - Licensee: -1> , PF--�'-o r r rt+ Signature LIC. NO.: (If applicable, enter "exempt " in the license number line) Bas. Tel. NO.: Li Address: 9157va� 6 /7>��r�-,,Q *Security System Contractor License required for this work, if applicable, enter the license number here: No.: OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the (check one) OLJowner owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE. $ 3& � 7� �D�� INSPECTIONAL SERVICES DEPARTMENT ViEMG/PLUMBING/GAS INSPECTION LOG INSPECTION REQUEST: ❑ PLUMBM OCAS DATEOF! TYPE OF INSPECTION: On ❑ OTHER OPASS 0 FAM 0 REQUESTED RECD ON VIA.- 0![TONE 11 MAIL 0 OFF VISIT CORRECTION NOTEIINSPECTON JOB ADDRESS: C/ KT.NTN INSPECTION ASSIGNMM DATE OFFICE NOTE INSPECTION REQUEST: ❑ PLUMBING EICAS ❑ TYPE OFINSPECTION: 11ROUGH &W-A—L�OaIWER REQUEFIEDR8C'DO"—.l YlAi 11PHONE 11MAB. 0OFF vIsIT --74- JOB ADDRESS: 6 '? ",-f I)Artl PERW#-Z7Ca' INSPECTION AS3MMENTDATE: _jE- - Z- -0,9 OFFICE NOfE:C? INSPECTION REQUEST: d �11PLUMBING EICa E] TYPE OF INSPECTION. DROWH CIRGL -0 OTHER REQUESTED RECD ON VIA: IA., PW?ffl ❑ MAIL 0 OFF VISIT JOB ADDRESS: % 41 PERMITO -3 INSPECTION ASSIGNMENT DATE: 2 - MICE NCYTE- INSPECTION REQUEST: 0 WIRING 0 PLUMBING OGAS ❑ TYPE OF INSPECTION: 11ROUIGH (]FINAL [IOTHER - REQUESTEDI RECD ON _vm, 0 PHONE 0 MAIL El OFF visff JOB ADDRESS: PERMIT# INSPECTION ASSIGNMENT DATE OFFICE NOTE:. INSPECTED ------------- DATE !0!F"ggel�: PASS 0 FAIL ❑ CORRECTION Nommspecrom z BY:. / z - "?- - e ;/ - DATE OF W2f9ejj&.-_� "? o . [I CORRECTION NarEANSPECTOR I �? I Fr k .q,- rt INSPECTED BY: DATE OF INSPECTION: ❑ PASS 0 FAIL ❑ CORRECTION Nam4NsPEcTojt cc Communication Result Report ( May. 8, 2012 3:32PM) 2) Date/Time: May, 8, 2012 3:31PM File Page No. Mode Destination Pg (S) Result Not Sent ---------------------------------------------------------------------------------------------------- 5260 Memory TX 816174233750 P. 2 OK ---------------------------------------------------------------------------------------------------- Reason for error E. 1) Hang uD or I i n e fa i, E. 2) Busy E.3) No answer E.4) No facsimile connection E. S) Exceeded max . E —mai 1 s i z e L�J oiRaal+.tw Os[y C ,eYWARD OF FIRE PREV17NTION REGOIATIONS lro7] <euat APPLI AIATIONpFORmPE:RM -ro _, ORM FLEX IJV I I AL0WORK Date:_ (PL.SASE PRUT)A INK OR 7YPR ALL 1NFORMA77OA9 - City ur Tb xm of: Borth -1,T- r To the f—Peclar : Location No. Date /O .? o /0 NORT1y TOWN OF NORTH ANDOVER f �,r a • y Certificate of Occupancy $ Building/Frame /Frame Permit Fee $ a,KMU 9 Foundation Permit Fee $ othe, Permit Fee $ v TOTAL $ 119.4-10 Check # O �� 23519 wilding Inspector JOHNSON Mark B. Johnson (MA, NH, Dc) BORENSTEIN, LLC Donald F. Borenstein (MA, ME, NH) ATTORNEYS AT LAW Kristine M. Sheehy (MA) Mary Ippolito, Building Department Town of North Andover 1600 Osgood Stsreet Bldg. 20, Suite 2-36 North Andover, MA 01845 Re: Jay Weiner v. Millpond Homeowners Association, Inc., et als 94 Millpond, North Andover MA Dear Ms. Ippolito: Enclosed please find a check in the amount of $19.40 for documents produced with regard to the above -referenced matter. Thank you for your cooperation in this matter. Very truly yours, JOHNSON & BORENSTEIN, LLC Denise A. Brogna DAB/mbf Enclosure Denise A. Brogna (MA, CA) 12 Chestnut Street Kathryn M. Morin (MA, NH, ME) Andover, MA 01810-3706 Lorri Gill Covitz (MA) Tel: 978-475-4488 Leslie C. Carey (MA, RI) Fax: 978-475-6703 Karin M. Theo (MA) www.jbllclaw.com denise@jbllclaw.com Paralegals Michele C. Jonikas Karen L. Bussell Danielle R. Corey Melanie J. O'Connell October 4,2010 Mary Ippolito, Building Department Town of North Andover 1600 Osgood Stsreet Bldg. 20, Suite 2-36 North Andover, MA 01845 Re: Jay Weiner v. Millpond Homeowners Association, Inc., et als 94 Millpond, North Andover MA Dear Ms. Ippolito: Enclosed please find a check in the amount of $19.40 for documents produced with regard to the above -referenced matter. Thank you for your cooperation in this matter. Very truly yours, JOHNSON & BORENSTEIN, LLC Denise A. Brogna DAB/mbf Enclosure JOHNSON Mark B. Johnson (MA, tvx, DC) BORENSTEIN, LLC Donald F. Borenstein (MA, ME, NH) ATTORNEYS AT LAW Kristine M. Sheehy (MA) Denise A. Brogna (MA, CA) 12 Chestnut Street Kathryn M. Morin (MA, NH, ME) Andover, MA 01810-3706 Lorri Gill Covitz (MA) Tel: 978-475-4488 Leslie C. Carey (MA, RI) Fax: 978-475-6703 Karin M. Theo (MA) www.jbilclaw.com denise@jbllclaw.com Paralegals Michele C. Jonikas Karen L. Bussell Danielle R. Corey September 16, 2010 Keeper of Records North Andover Building Department 1600 Osgood Street North Andover, MA 01845 Re: Jay Weiner v. Millpond Homeowners Association, Inc., et al C.A. No. 10-1538A Dear Sir/Madam: This office received a copy of the Notice of Deposition and Deposition Subpoena for 9/29/2010 at 10:30 served upon you by attorney Kevin Sullivan with regard to the above -referenced matter. Please forward a copy of the documents you produce pursuant to that subpoena to this office as well. Thank you for your anticipated cooperation. Very truly yours, JOHNSON & BORENSTEIN, LLC 4A Of YIu-j �n Denise A. Brogna DAB/mbf Cc: Jay Weiner V y J DEPOSITION SUBPOENA: DUCES TECUM WITH OFFICERS RETURN OF SERVICE ESSEX, SS, JAY WEINER, PLAINTIFF VS. COMMONWEALTH OF MASSACHUSETTS TRIAL COURT SUPERIOR COURT DEPT. CIVIL ACTION NO. 10-1538A MILLPOND HOMEOWNERS ASSOCIATION, INC., TRUSTEES MILLPOND HOMEOWNERS ASSOCIATION, INC., WILLIAM ANDERSON as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., PHILLIP CAHILL as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., WILLIAM HAUSER as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., RICHARD NAWROCKI as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., KATHY BURKE as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., PAM CRAWFORD as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., BETH MAZIN as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., ANTOON BOUDREAU CONSTRUCTION, INC., MICHAEL ANTOON AND KENNE'T'H BOUDREAU DEFENDANTS TO: Keeper of Records North Andover Building Department 1600 Osgood Street North. Andover, MA 01845 TRUE COPY ATTEST YOU ARE HEREBY COMMANDED in the name of the Commonwealth of Massachusetts in accordance with the provisions of Rule 45 of the Massachusetts Rules of Civil Procedure to appear and testify on behalf of the Defendants before a Notary Public of the Commonwealth, at the office of Attorneys ]Kevin M. Sullivan, Murphy & Riley, P.C., 141 Tremont Street, Boston, MA 02111 At 10:30 a.m. on September 29, 2010, and to testify as to your knowledge, at the taking of deposition in the above --entitled action. - 2 Ck'-Pe son YOU ARE HEREBY COMMANDED in the name of the Commonwealth of Massachusetts in accordance with the provisions of Rule 45 of the Massachusetts Rules of Civil Procedure to appear and testify on behalf of the Defendants before a Notary Public of the Commonwealth, at the office of Attorneys ]Kevin M. Sullivan, Murphy & Riley, P.C., 141 Tremont Street, Boston, MA 02111 At 10:30 a.m. on September 29, 2010, and to testify as to your knowledge, at the taking of deposition in the above --entitled action. - 2 *And you are further required to bring with you the documents listed in Schedule A attached hereto. Hereof fail not as you will answer your default under the pains and penalties in the law in that behalf made and provided. Kevin M Sullivan, BBOff 567914 Attorney for Defendants MURPHY & RILEY, P.C. 141 Tremont Street Boston, MA 02111 617-423-3700 Dated: September 13, 2010 ette M. Griffin, No P is y Commission Expires: 2/I5I2013 �SsNwlillli1/ S,yam 4-1. GR i 3 SCHEDULE A A complete copy of the building file for 94 Millpond, North Andover, MA, including but not limited to all documents concerning inspections, applications, permits, plans, specifications, photographs, correspondence, memoranda, notes, notices, citations, and any other documents relating to the property, construction of the property, or alteration of the property. Please note that copies of the requested records may be provided in lieu of an appearance at the deposition noticed herein. If you have any questions or cannot comply with this subpoena, please contact Attorney Kevin M. Sullivan, 617423-3700. ESSEX, SS. JAY WEINER, PLAINTIFF VS. COMMONWEALTH OF MASSACHUSETTS TRIAL COURT SUPERIOR COURT DEPT. CIVIL ACTION NO. 10-1538A MILLPOND HOMEOWNERS ASSOCIATION, INC., TRUSTEES MILLPOND HOMEOWNERS ASSOCIATION, INC., WILLIAM ANDERSON as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., PHILLIP CAHILL as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., WILLIAM HAUSER as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., RICHARD NAWROCKI as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., KATHY BURKE as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., PAM CRAWFORD as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., BETH MAZIN as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., ANTOON BOUDREAU CONSTRUCTION, INC., MICHAEL ANTOON AND KENNETH BOUDREAU DEFENDANTS NOTICE OF TAKING DEPOSITION TO: Denise A. Brogna, Esq. Johnson & Borenstein 12 Chestnut Street Andover, MA 01810 Please take notice that at 10:30 a.m. on Wednesday, September 29, 2010, at the offices Kevin M. Sullivan, MURPHY & RILEY, P.C., 141 Tremont Street, Boston, Massachusetts 02111, the Defendants in this action, by their attorneys will take the deposition upon oral examination of the Keeper of Records, North Andover Building Department, 1600 Osgood Street, North Andover, MA 01845, pursuant to the applicable provisions of the Massachusetts Rules of Civil Procedure, before a Notary Public in and for the Commonwealth of Massachusetts, or before some other officer authorized by law to administer oaths. The oral examination will continue from day to day until completed. The deponent is further required to bring to the deposition the documents listed in the attached Schedule A. You are invited to attend and cross examine. CERTIFICATE OF SERVICE I hereby certify that on this day a true copy of the within document was served upon the attorney oAetem rd or ch party by mail. DATED: er 1392 010 DEFENDANTS, By their Attorney, Kevin Ni. u ivan BBO# 567914 MURPHY & RILEY, P.C. 141 Tremont Street Boston, MA 02111 (617) 423-3700 KSullivan(- MurphyRiley.com rol SCHEDULE A A complete copy of the building file for 94 Millpond, North Andover, MA, including but not limited to all documents concerning inspections, applications, permits, plans, specifications, photographs, correspondence, memoranda, notes, notices, citations, and any other documents relating to the property, construction of the property, or alteration of the property. Please note that copies of the requested records may be provided in lieu of an. appearance . at the deposition noticed herein. If you have any questions or cannot comply with this subpoena, please contact Attorney Kevin M. Sullivan, 617423-3700. 7 SCHEDULE A A complete copy of the building file for 94 Millpond, North Andover, MA, including but not limited to all documents concerning inspections, applications, permits, plans, specifications, photographs, correspondence, memoranda, notes, notices, citations, and any other documents relating to the property, construction of the property, or alteration of the property. Please note that copies of the requested records may be provided in lieu of an appearance at the deposition noticed herein. If you have any questions or cannot comply with this subpoena, please contact Attorney Kevin M. Sullivan, 617423-3700. ESSEX, SS. JAY WEINER, PLAINTIFF VS. COMMONWEALTH OF MASSACHUSETTS TRIAL COURT SUPERIOR COURT DEPT. CIVIL ACTION NO. 10-1538A MILLPOND HOMEOWNERS ASSOCIATION, INC., TRUSTEES MILLPOND HOMEOWNERS ASSOCIATION, INC., WILLIAM ANDERSON as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., PHILLIP CAHILL as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., WILLIAM HAUSER as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., RICHARD NAWROCKI as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., KATHY BURKE as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., PAM CRAWFORD as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., BETH MAZIN as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., ANTOON BOUDREAU CONSTRUCTION, INC., MICHAEL ANTOON AND KENNETH BOUDREAU DEFENDANTS NOTICE OF TAKING DEPOSITION TO: Denise A. Brogna, Esq. Johnson & Borenstein 12 Chestnut Street Andover, MA 01810 Please take notice that at 10:30 a.m. on Wednesday, September 29, 2010, at the offices Kevin M. Sullivan, MURPHY & RILEY, P.C., 141 Tremont Street, Boston, Massachusetts 02111, the Defendants in this action, by their attorneys will take the deposition upon oral examination of the Keeper of Records, North Andover Building Department, 1600 Osgood Street, North Andover, MA 01845, pursuant to the applicable provisions of the Massachusetts Rules of Civil Procedure, before a Notary Public in and for the Commonwealth of Massachusetts, or before some other officer authorized by law to administer oaths. The oral examination will continue from day to day until completed. COMMONWEALTH OF MASSACHUSETTS ESSEX, SS. TRIAL COURT SUPERIOR COURT DEPT. CIVIL ACTION NO. 10-1538A JAY WEINER, PLAINTIFF VS. MILLPOND HOMEOWNERS ASSOCIATION, INC., TRUSTEES MILLPOND HOMEOWNERS ASSOCIATION, INC., WILLIAM ANDERSON as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., PHILLIP CAHILL as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., WILLIAM HAUSER as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., RICHARD NAWROCKI as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., KATHY BURKE as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., PAM CRAWFORD as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., BETH MAZIN as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., ANTOON BOUDREAU CONSTRUCTION, INC., MICHAEL ANTOON AND KENNETH BOUDREAU DEFENDANTS NOTICE OF TAKING DEPOSITION TO: Denise A. Brogna, Esq. Johnson & Borenstein 12 Chestnut Street Andover, MA 01810 Please take notice that at 10:30 a.m. on Wednesday, September 29, 2010, at the offices Kevin M. Sullivan, MURPHY & RILEY, P.C., 141 Tremont Street, Boston, Massachusetts 02111, the Defendants in this action, by their attorneys will take the deposition upon oral examination of the Keeper of Records, North Andover Building Department, 1600 Osgood Street, North Andover, MA 01845, pursuant to the applicable provisions of the Massachusetts Rules of Civil Procedure, before a Notary Public in and for the Commonwealth of Massachusetts, or before some other officer authorized by law to administer oaths. The oral examination will continue from day to day until completed. �6 The deponent is further required to bring to the deposition the documents listed in the attached Schedule A. You are invited to attend and cross examine. CERTIFICATE OF SERVICE I hereby certify that on this day a true copy of the within document was served upon the attorney of rejorj4or Bach party by mail. DATED: 5eptem'ber 13, 2010 DEFENDANTS, By their Attorney, Kevin M. u ivan BBO# 567914 MURPHY & RILEY, P.C. 141 Tremont Street Boston, MA 02111 (617) 423-3700 KSullivan6 MurphyRi1Tg.com The deponent is further required to bring to the deposition the documents listed in the attached Schedule A. You are invited to attend and cross examine. CERTIFICATE OF SERVICE I hereby certifiy that on this day a true copy of the within document was served upon the attorney of re ord or ch party by mail. DATED: eptem er 13, 2010 DEFENDANTS, By their Attorney, Kevin M.u livan BBO# 567914 MURPHY & RILEY, P.C. 141 Tremont Street Boston, MA 02111 (617) 423-3700 KSullivanOMurphyRiley.com DEPOSITION SUBPOENA: DUCES TECUM ESSEX, SS, JAY WEINER, PLAINTIFF VS. COMMONWEALTH OF MASSACHUSETTS TRIAL COURT SUPERIOR COURT DEPT. CIVIL ACTION NO. 10-1538A MILLPOND HOMEOWNERS ASSOCIATION, INC., TRUSTEES MILLPOND HOMEOWNERS ASSOCIATION, INC., WILLIAM ANDERSON as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., PHILLIP CAHILL as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., WILLIAM HAUSER as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., RICHARD NAWROCKI as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., KATHY BURKE as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., PAM CRAWFORD as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., BETH MAZIN as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., ANTOON BOUDREAU CONSTRUCTION, INC., MICHAEL ANTOON AND KENNETH BOUDREAU DEFENDANTS TO: Keeper of Records North Andover Building Department 1600 Osgood Street North. Andover, MA 01845 NlmAr DE" A TRITE COPY ATTEST Process server &Disinterested Person YOU ARE HEREBY COMMANDED in the name of the Commonwealth of Massachusetts in accordance with the provisions of Rule 45 of the Massachusetts Rules of Civil Procedure to appear and testify ori behalf of the Defendants before a Notary Public of the Commonwealth, at the office of Attorneys Kevin M. Sullivan, Murphy & Riley, P.C., 141 Tremont Street, Boston, MA 02111 At 10:30 a.m. on September 29, 2010, and to testify as to your knowledge, at the taking of deposition in the above -entitled action. - 13 *And you are further required to bring with you the documents listed in Schedule A attached hereto. Hereof fail not as you will answer your default under the pains and penalties in the law in that behalf made and provided. Kevin M. Sullivan, BBOff 567914 Attorney for Defendants MURPHY & RILEY, P.C. 141 Tremont Street Boston, MA 02111 617-423-3700 Dated: September 13, 2010 (C' ette M. Griffin, No P is y Commission Expires: 2/15/2013 203 SCHEDULE A A complete copy of the building file for 94 Millpond, North Andover, MA, including but not limited to all documents concerning inspections, applications, permits, plans, specifications, photographs, correspondence, memoranda, notes, notices, citations, and any other documents relating to the property, construction of the property, or alteration of the property. Please note that copies of the requested records may be provided in lieu of an appearance at the deposition noticed herein. If you have any questions or cannot comply with this subpoena, please contact Attorney Kevin M. Sullivan, 617423-3700. .Q COMMONWEALTH OF MASSACHUSETTS ESSEX, SS. TRIAL COURT SUPERIOR COURT DEPT. CIVIL ACTION NO. 10-1538A JAY WEINER, PLAINTIFF VS. MILLPOND HOMEOWNERS ASSOCIATION, INC., TRUSTEES MILLPOND HOMEOWNERS ASSOCIATION, INC., WILLIAM ANDERSON as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., PHILLIP CAHILL as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., WILLIAM HAUSER as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., RICHARD NAWROCKI as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., KATHY BURKE as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., PAM CRAWFORD as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., BETH MAZIN as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., ANTOON BOUDREAU CONSTRUCTION, INC., MICHAEL ANTOON AND KENNETH BOUDREAU DEFENDANTS NOTICE OF TAKING DEPOSITION TO: Denise A. Brogna, Esq. Johnson & Borenstein 12 Chestnut Street Andover, MA 01810 Please take notice that at 10:30 a.m. on Wednesday, September 29, 2010, at the offices Kevin M. Sullivan, MURPHY & RILEY, P.C., 141 Tremont Street, Boston, Massachusetts 02111, the Defendants in this action, by their attorneys will take the deposition upon oral examination of the Keeper of Records, North Andover Building Department, 1600 Osgood Street, North Andover, MA 01845, pursuant to the applicable provisions of the Massachusetts Rules of Civil Procedure, before a Notary Public in and for the Commonwealth of Massachusetts, or before some other officer authorized by law to administer oaths. The oral examination will continue from day to day until completed. %& The deponent is further required to bring to the deposition the documents listed in the attached Schedule A. You are invited to attend and cross examine. CERTIFICATE OF SERVICE I hereby certify that on this day a true copy of the within document was served upon the attorney of re ord or ch party by mail. DATED: eptem er 13, 2010 DEFENDANTS, By their Attorney, Kevin M.u livan BBO# 567914 MURPHY & RILEY, P.C. 141 Tremont Street Boston, MA 02111 (617) 423-3700 KSullivanOfflurphyRilaxom 17 Universal Forest Products 155 Bay Road, PO Box 945 / Belchertown, MA. 01007 Phone: 413-323-7247 Fax: 413-323-5780 / Rep: Mike Ellerbrook Antoon-Boudreau Construction Inc 94 Mill Pond Rd. North Andover, MA EWP Calc Packet Sent For Seals: 7/6/09 Expect Sealed Calcs to Customer before Noon on 7/7/09 SHOP DRAWING APPROVAL THESE DRAWINGS ARE THE SOLE SOURCE FOR ORDERING OF EWP PRODUCTS AND VOIDS ALL PREVIOUS ARCHITECTURAL OR OTHER EWP DRAWINGS. REVIEW AND APPROVAL OF THESE DRAWINGS MUST BE RECEIVED BEFORE ANY EWP PRODUCTS WILL BE ORDERED. VERIFY ALL CONDITIONS TO INSURE AGAINST CHANGES THAT WILL RESULT IN EXTRA CHARGES TO YOU. PLEASE INITIAL EACH ATTACHED EWP CALC SHEET. 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O r 1 Z - r r In2Q NNo0o0oX 0 m Om nym� y =— r mm 20 = in r <s`O Oc ?' 2Hy� 2Hg t+t+Nt+N M.3 D WWiiiii 130 m O H.0-1, Fn Xy11 ��mmmmmz a mm my r� z� `-' a m -- Ny II 11 1 1 1 1 1 1 NNOOOOOW Z 3 �m 1 adss_ m �1 �y Moo S° m o �m51in O 2 -- _ O HOW m wmm N m� C)wCD Z m�ara _— 0 -- x I'M _ D SDo Bm t'J r o9 vN 3N 2f, — oroolJoo t+ �0 cn t-11 Z 3 m 3m G) m n y%J —_ wowwoww 0000000 ^ 8 �� O I — ,, h no � mnmN oa Za h H > �� tea' 0�. 10 O —_ — HOS p 01.7 9 0 z w °�I° — D — m — oitn mror (A v zmozA vo m �� d �k N1 0 D Yi w m CCD 0) � N H T omo�� CL oW.wcm * __ do O d0 — m co OW00 O o v- -- mzsnrH p rd K�qn Hrv�.7 m m Hvr v yG�1 zy 0 v — — RL'. [0 H nz nm n r . — Kz e L.bib ZO HW G G H o� m 1-1 7o Z7 GGn w V y y V -- 0 Ln NwN W In F+',Otl M q •' to Ow£ JAaF P 11 11 II O I t�1 V '!' Wn w %< �\ W W 000 HHH N W N y m v ro 0 0 0 am 0o WWW aaW rq ro ro ,mw tom 4, Ul ��e j Date.! �� •1tiv TOWN OF NORTH ANDOVER c PERMIT FOR PLUMBING SSACMU'S� Thiscertifies that ... [ �. �....... 0� _ .................. . has permission to perform ... PA1.4f.1 ......... plumbing in the buildings of : c { S. L/ ..' �.� (.�!�":..� :... , . at .NorthAndover, Mass. �Gl�u ��,� Fee. ........ Lic. No .. ....... ....:..:_......�....-.� ....... . PLUMBING INSPECTOR Check !t 8201 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location Owners Is Type of Occul New 0 Renovation Date Perin # o Amount `C l'$ Replacement Plans Submitted Yes ❑ No ❑ Do kl 1 1.14 - 40 MIME IN a OOOOOOOOOtuO ; ON � ..: uNu 0 ENIMEM 000000EMI IN000 . ,. WEINUUMMOM =10u000 WIME0�0000i0i0 .., .. MWIEMMMEMIM 0iOE00000000�0WEI . ,. O�OOO�OOOOOOi0i0i00MMIME i00iMIN .. Or000i0000®�� 00000 •. OOOOOOOOOOOOOOOOOOOOOOO000 •. OOOOOOOOOOOOOOOOOOOOOOOOME (Print or type) / ,Q/ r L Check one: Certificate Installing Company Name / c (v, (/ / °� C ® Corp. Address Partner. Business Telephone D _ Firm/Co. Name of Licensed Plumber: ' Insurance Coverage: Indicate thetype o insurance coverage by checking the appropriate box: Liability insurance policy 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 IOwner ❑ Agent F1 I hereby certify that all of the details and information I have submrtte4or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and install a 'eTs rfOrmed under Permit Issued f r is application will be in compliance with all pertinent provisions of the Massachus lumbing C Ch of the General Laws. Byigna ur i se.,Kriumoer Title Type of Pl mbing License �� — City/Town icense um er Master �/ journeyman ❑ APPROVED (OFFICE USE ONLY 3"� The Commorzwealth of Massachusetts Department of Industrial Accidents t1,. J 1k office ofInvestigations tilt}! GQD Nrashircpton Street J.a"� Boston, MA 02111 c � www_mas.�gov/din . Workers' Compensation Insurance Affidavit. Builders/C Applicant nformation oatsetors/Eiecirici$os/pinmbers I Pie ase Print Legibly Name (Business/Organization/Individual):_ %2� P• City/,Rate/zip: 1U Phone #.. Are an employer? Check the appropriate box: i • LI I am a employer with �_ 4. ❑ I am a general contractor and I employes (full and/or part-time).' 2. ❑ I am .a.sole proprietor or have bared the sub -contractors listed partner- ship and have no employees on the attached sheet 3 These sub -contractors have working for mein any capacity, [Tho workers' comp, insurance workers' comp. insurance. 5. ❑ We are a corporation and its required.] . 3.❑ I am a homeowner doing Offiicers have exercised their all work myself, [No•workirs' comp. right of exemption per MOL c, L52, § 1(4),'and we have no insurance required.] t employees. [No workers' COMM insurance uired ] Type of Prefect (requimd): 6. ❑ New construction . 7. ❑ Remodeling g- ❑ Demolition 9. ❑ Building addition 10.❑ .Electrical repairs or additions I I .❑ Plumbing Maim, or additions I2.❑ Roof repairs I3.❑.Other `f+nY appiiearrt filet checks bo>r}! I must also fall out the section below showing their workers' bompahsatiori poiuy mformahoa I i Homeowners who submit phis Rt idavh indicating they am doing a11 work and then hire outside contractors 1Cotft R t m that Check this box mustattaehed an add;tiaas: shear show' roust submtt a new affidavit indiaatisg such. wing. the norm of the sub.cormaetonf and their work=' cor ;P. PON ire j am an a io er that -- � s . i iurmehoa. !' {�rasddusg:aot�iers Co/npensadan /nd'uraneefornry.enipfo infonnafion. yees Blow is thepolicy andyab site . Insurance Com Pay Name: � / V,191/f Policy # or Self= -ins. Lie. #: Expiration Date: Job Site Address: Attach a copy of the workers' compensationCity/swarzip• policy declaration page (showing the policy number and expiration dstte). . Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal( fine up to $I,500.00 and/or one-year imprisonment; as well as civil penalties in the form of a STOP WORK ORD penalties d a fine Of up to 5250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penalties of perjury that the information provided above is due and rowed Si tore: Date: Phone #: Official ase only. 13o not wrdte in this area m he compfet�d or town o ' fficW City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2 lluilding Departumeut 3. City/Tovvn Clerk 4. Electrical Inspector S. Plumbing Inspector 6.Otbez Contact Person; Phone #: 3S Information and Instructions Massachusetts General Laws chapter 152 requires all emp 3oyers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract ofhire:, - express or implied, oral or written." !' An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the'foregoing engaged in a joint enterprise, and includi"g the legal representatives of a deceased employer, or the receiver ortrustee -of an individual, partnership, association or other legal entity, employing employees. 'However the owner•of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs.. persons to do maintenance, construction or repair work an such dwelling horse or on the grounds or building appurtenant thereto shall, not because of sucb employment be deemed to be an employer." MGL chapter 152, 525C(6) also states that "every state or local iiednsing agency shall withhold the issuance or renewal of a license or permit to operate a business or *a construct buildings in the commonwealth for any applicant who has not produced acceptable evidence.oir compliance with the insurance coverage required." Additionally, MOL chapter 152, §25C(7) states `Neither t3he commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the cdr>rtraeting authority," Applicants Please fill I out the workers' compensation• affidavit compiem-tely, by checking the boxes that apply to your situation and, if necessary, supply sub -contractors) name(s), address(es): Fund phone number(s) along with their certificates) of insurance. Limited Liability Companies (LLC) or LimitedLiability Partnerships (LLP) with no employees other than the members or partners, are not rcquired1to carry workers' cci--rnpensation insurance. Ifan LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage.. Also be sure to sign and date tate at'ftdavit. The affidavit should be retrained to the city or town that the application for the peirnit or license is being requested, not tine Department of Industrial Accidents. Should you have any questions regarding the law or if you are regnired to obtain a workers' oompensation policy, please -cap the Department at the nurnber, listed below. Self-;nQLred cnanparies s_hoLvld e.nter+heh self-insurance license number on the'appropriate, line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition, an applicant that must submit multiple permit/iiomm applications in any given year, need only submit one affidavit indicating current policy ',information (if necessary) and under "Job Site Address" the applicant should write "all locations in (city or gown)." A copy of'the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for fi&m permits or licenses. A new affidavit must be filled out each year. Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.) said person is NOT required to complete this affidavit The Office of Investisptions would hike to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Musac usetts Depattment of bndmtrial Accidents Office of Umestigatiotra 600 Washington Street Boston, MA 112111 TeL # 617-727-4900 ext 406 or 1-8.77-M-A.SSAFE Revised 5-26-05 Fax # 617-727-7744 www.mam.gov/dia V d Date. !,� �3 � ."?...... . "ORT/y 3� TOWN OF NORTH ANDOVER • PERMIT FOR LS INSTALLATION t .?.� This certifies that ..... �� . i . .... ................... . has permission for gas installation . RI-Y.I'.F x..-..% in the buildings of ... ir. ......................... at ...01./... ,/1., .f , , , ?o. , , , , , North Andover, Mass. 2 -o� Fee. .. Lic. No.l ,5i.ri .... ... . ��. ,,.syr ....... JAS INSPECTORS ' Check # fi T- 6896 MASSACHUSETTS UNIFORM APPLICAT ON FOR PERMIT TO DO GAS FITTING vvd (Type or print) Date a NORTH ANDOVER, MASSACHUSETTS Building Locations 1z /J'a // Permit # v ` Amount $ Owner's Name VV . iliCi ,v Pj� New ❑ Renovation Replacement Plans Submitted N v (Pritt or type) "i �J �, ' j L L C Check one: Certificate Installing Company b' /jt 11 Corp.. . Address = S (- 6 11 /d ��i�yL 1/ i �� '' / `�� f7 ; D3819 ❑ Partner. 921 usmess a ep one Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes No If you have checked Les, please ' to the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity 0 Bond Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner Agent 0 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 installatio quyformed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachuse s Code an� 142 e General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) " Signhture of Licensed Plumber s Fitter Lic E9 -raster Journeyman Or Gas Fitter �G w w w a p U d -D x x z H z c N z W w d W x x d° c x > w F z H w a W W W F W E" x1 cC Cw7 z w> w E z F. d W z C7 Q p > o W °o F, w U o x �a x o x w a 3 a a w x > SUB-BASEM ENT BASEM ENT 1ST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR 5TH. FLOOR 6TH. FLOOR 7TH. FLOOR __..,.......__...... B.TH. FLOOR JA (Pritt or type) "i �J �, ' j L L C Check one: Certificate Installing Company b' /jt 11 Corp.. . Address = S (- 6 11 /d ��i�yL 1/ i �� '' / `�� f7 ; D3819 ❑ Partner. 921 usmess a ep one Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes No If you have checked Les, please ' to the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity 0 Bond Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner Agent 0 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 installatio quyformed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachuse s Code an� 142 e General Laws. By: Title City/Town APPROVED (OFFICE USE ONLY) " Signhture of Licensed Plumber s Fitter Lic E9 -raster Journeyman Or Gas Fitter le k, 1. of LV2=achusette IJ pa of Industrial ACCL enir of InAffsV afions V. 601 1r;Tlashirigtan Street Boslori • , MA 02111 Workers' Cam eur.atioa fusiuranee.ALMti�ys�gav/dig . cant Fnfbr�atian c�$vi$to'I�ers/Coatracfors/Eieciriciga s/P[mmbers Name (susiacss/Drp) ni�ott/lndividteal t eeibf - Please Print - Ad&ess: ..City/State%Zsg; ff nV,;� e A�� 0� � Plione Y a empiayert Cheek.the aPPr0Pri2te•bDk. ' I: al ata a. employer with �tployees (full andJorpart-bine).* 4. I Tri � am a general contractor and I Protect (required): 2•� I am.asole..!�dnrs ptaPn have: hied the sub- 6. 'Naw constluc i' . . pminer- . ship and havano employees iiste:d on. the attached sheet i 1. ' Titre �]: Remodeiigg sub -contractor have working for me is �' SPY• [No workers pomp. . P tasuaattce .. warkccs' com i S' [� imoiitian p. asurance. 9, El Btu'ldi 5. ]] We: aro a_ Corporation.and addition re. ed ] 3•❑ I gin s homeowner dairtg its C Efic s have axercised their 10,[1 �eetrical all work myseI£ [MC). 1`fo warks' cep, nrsunu right of e7cein on' or additions c i Ph P�iV1t3L I I.�] Plumbing rep 2, § I (4),'.and-we have ce.re ire t q° ] no .employe .& [Tufo worker' 12 I] Roof repairs *Any Vpiicsntfhat gip. insurancorequire&] I3.j].pthm• ai►scks bei#1 meest tiiso Fitt oitttbe sr_cEian below ntsowing theirovorkee�' co 1 fiomeouraM; who.sdbmit this Rlff& vh find' toPencetion oi' _ �Caatrscfnts f m eb t®ang thoy sue Going all wns it ,end Mheai lite otaside rontraetars mfom�ation, eek t&ra box ►nustattaW2*d ser add.�iaasi sh ectsfwwi g eeerrtgoftheivb-cantreetoes ita =-WafndavitMaioeiigsuch.' I�yqy . a±r E"'Y�D.N� 1S�OT.7OVLQjI►a :IPQ!'�.G.�v�� .�.iF.' er WOt*=. Ccs r•..T'.'J.i�nnnwou. irtfnt2 = iristrr�ce,ar suJ'. eInves &"1��,.s — J�r� insm'anee Company Name: iJ •xe Fad rare jac ,: Poiiry # or Serf -ins Lie. #. " Job Site Addrms•. Expusfton Rafe: Attach a copy of the workers' .� Chylstat�m utperusafion.Policydec_a tion showing Failure to secure coven; a as Pam ( , the policy number and e !; required unifier Section 25A of MCiL c. 152 can lead to the itis Dail; xpit$tion dsf?e). fine up io 1;1,5DU DO and/or one-year imprisonment; as wen p on of criminal Of up to 9250.00 a :is civti penalfim in the form of a p sties of a Invest; against the violator. Be advised that a e of this STDp WORT{ ORU£R and a fine gations of the DIA for ittsUrance cov °�' moment miry be forwarded to the tJfiace of etage verin"caticsn, t da herehj, certify under the pains and pence/>t�. of peryrr Y jhar the infarmaVaaP vcrn ' �istraiwr: . ded above is Vue and 00"rd Official use nnfy. do not uprate is this area, xv he con ply by . or tt►wn o ?"W City or Town: - IssuingAndo Permit/Licanse # b rrt3' (Circle one}: 1. Hoard of BeatEh 2 Sueitfittg Department 3. City/Town ICierit 4. Electrical Ins ector 5 fi Other P S. Man;biv�- itas pecEor Contact Person: Phone#; 3y IHIUFM2itIUH M JIM MSIrUCTIOEIS Massachusetts Cranaral Laws.chaptar 152 requires all empp I c)y= to provide wdilced, comptemsation for their employees. Pursuantto this statute, an mpioyer is defined as "_..,evcxy persotn in the service of another under arty contract of hh- q, express or implied, oral or wriftm" An employer is: defined as "m individual partnership, i&=dzticn, carporafion or other Imo entity, or zny two at more of the'famping engaged in &joint antcrp se, and. inqlud*-kg-t'hc; legal rqx=t=rIm6v= of a deceased amplayer, brIhc - rctxiver ortnztre•of m individual, partnership, associmiartn or. other legal entity, employing cvrploy=. 'Yiowvw the own6r. of a dwelling house having nat.morz than th= apaLrtments and who resides therein, or the occupant of 6s. dwelling house of another whoemplays persons to do me-Intmumce, construction or repair work on -'such dwelliqhotise Ir or on the grounds or buil&g appurtmr= thereto shall ncs.-r- be:cause of such =3ployment be: d--med to be an employar." MOL chapter 152, PC(6) also states that -every state mar- Weal 666nsing agency shall withhold the immancz or renewal of a license or permit to operate a business or *o conoract buildmp in the commonwealth for any applicant who has not produced mmeptable evidence -or compramee with th.e..'insurance coverage requOrmi", - Additionally, MGL chapter I 5Z §25C(7) "Neither tzbi.c'cmmnanimalth- nor any of its-oolifiagl . subdivisions shall miter into any ==u:t for the PMfOMMnM of public Waric until-accept:able. evidence of cmxplian= with the ksn m=. q=zm=Its of this chapter have b=o prwmfta tD.thc; cc:xxtracting aulhority.- ..kpPrIcauts Please, fill out the workers' .camp==6 on. affidavit completely, etely, by oh=king the boxes that apply to. your situation and, if necessary, nipplys6b-contractors) name(jj),raddrnss(eg):wnd phon.tnumber(s) along with their cwtificate(s)-of insurance. Limittd-Liability Companies (6LC)ar Limited Liability. Partnerships (LLP) -with no--c:rnployces othetflurn the members -orpmthers, am not riquired,to cwry -workeiWom-Tripmisation irusuim = Van LLC or -LLP does have crnpioyees, a policy is mqijired. Be advised that this RflicIaLvit may be submitted to the* Departracrit of Industrial, -date the affidavit. 7"heaffidavitsbWd. Aczid=gz fnr confirmatian of insurm= covenantAlso F. e sum to sip and be returned to the city or town that the Epprication for fim permit or H=nw is being requested, nottht Dcqwr nal of Industrial Accidants.- Should you have any quesdons rt;ar%finZ.the law or if you are required W obtain A wOi=,.. Oorqpansatiwi policy, picast-call the Dqmatrnant zt. the -nuwmber. listed bolaw. Self insured ooynpanitsshould mritmfhe:ir solf-i m-muncc license nmnt= an tht'spProprIam llh= City or Town Cffic.iniz Please be sure that t6 a5devit is complete and printed legibly. Tho D-cparkineat has provided a space at 4te bothm of the affidavit foryou.to fill out in, the event the.Offi= of Investigations has-tc, contact you regarding Iffic applicant Please be. sure to fill hi the pm-mit/license nurnbcr which weill be used as a reference number. In addition, an applicant that must m6mit multiple Pmw&lliczm applications in any giv= yc3r, need only submit arm affidavit indicatingm=9 policyin.fbrmsfion (if necessary) and under "Job Site Address" t6 apphoant should write "all iocaiions in city - or town). -4' A cvPy 6i` 6e affidavit that . has b=n.offieWly. starnpcd or marked by the city or town may be provided to the applicantas proof that a Valid affidavit is an file for fitarm - permits or licenses. Anew affidavifmust` bcffDcdout each year. Wh=e a home owner or citizen ii obtaining a licenses or permit not related to any business or =nmercial vrnture (i.e. EL dog license or permit tp bum leaves etc.) said PM36n is NOT.required to -complete this zfm-dzviL The Office; of Investizoans; would Igm to th:ank you in ad%ranzt ffir.your cooperation and should you have any questions, pl=v-- do not• hesitate to give us a =11. The Department's address, telcphane.ana fax number.. The CommonwmalthofMamachuse= Depart neat of Imd=qtrW Ac6dcmts 4fiice of ruvestignfions 600 Washington St=t Boston, MA €12111 TeL -9 617-727-4900 6= 406 or 1-977-MASSAFE Bruised 5-26.-05 Fax 4 61 7-727-7749 WwwMass grov/dia LAWRENCE H. OGDEN, P.E. 198 EAST MAIN STREET GEORGETOWN, MA 01833 978-352-8318 fax 978 352-2858 cell: 978-502-5921 July 31, 2009 Mr. Michael Antoon Antoon Boudreau Construction 14 Bearse Ave. Methuen, Ma. 01844 RE:. Condo Unit 94. Mi11-Pond Road, North Andover, MA. 01845 Dear Mr. Antoon As you requested I visited the site7/14/09 to review the installation of LVL members and pre engineered joist utilized in the repair of the structure. These are shown on plans prepared by Antoon Boudreau Construction dated .6/9/09. I requested that rim joist blocking be installed at the bearing ends of the joist. I revisited the site 7/29/09 to verify that this work was complete. Based on my site visit I can certify that to the best of my knowledge the installation of the LVLs and pre engineered joist utilized in theXave structure appears to be acceptable.®�$p13% 161NA�" must be In RED Should you have any questions please do not hesate to call. Yours truly, (:� Lawre ce H. Ogden P.E. 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BV88I1 uoTjeajsT6a8 NOMAD 1N3W3AObdWI13WOH r/�at'ny✓rnT•�rw-A ��varn'c°��aiu.°J to Ae A Yk W'e'e„+.-�=v�'Mi"4 •.:.a't+z°`.M+'dr" _. _max+.-`.. �� . _ Kt�..-r'-'.^ �� >..s�•., ..wtryt`"VrA,..tY,+'lsz. y 2 Date. :�.s.":�� l.. .- "ORTM TOWN OF NORTH ANDOVER pf o ,s,ti ya'"E n 0 p PERMIT FOR GAS INSTALLATION s O 1!7 M This certifies that c . . has permission for gas installation ...r .. .... . in the buildings of ...(........................... .. at ...�..... , North Andover, .Ma Fee -3.2 Lic. No.. 3.T : (. S ..��-X11...... GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File r�. IASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) 1�Mass./Date 19 Permit # Building Location 9 Z%/ 194 Owner's Name /oP. 74 Type of Occupancy New Q Renovation ❑ Replacement ❑ Plans Submitted: Yes ❑ No [fir Installing Co��m--pp�ann�yName� Address Business Telephone Name of Licensed Plumber or Gas Fitter - ---- - -- Check one: Corporation ❑ Partnership ❑ Firm/Co. Certificate # INSURANCE COVERAGE: I have a ur'rent liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142 Yes No ❑,: If you have checked Yes, please indicate the type coverage by checking the appropriate box. A liability, insurance policy. p Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware.that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and;that my:signature on this permit application waives this requirement. Check one: Owner ❑ Agent ❑ Signature o"t Owner -or Owner's Agent I hereby car and that all of the Mass FBy -- Title _ City/Town APPRI y 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 dumbing work and installation performed under the permit issued for this application will be in compliance with all pertinent provisions chusetts State Gas Code and Chapter 142 of the General Laws. Type of License: C) Plumber K Gasfitter Signature of Licensed Plumber or Gas Fitter A Master License Number 3 Sys' U Journeyman 07 MMMMMMMMMMMMMMMMMMMMMMMM MMMMMMMMMMMMMMMMMMMMMMMMMM ■ 111111[3111.1111119�immmmlmmm M M MMMMMMMMMMMM MMMMMMMMMMMM Installing Co��m--pp�ann�yName� Address Business Telephone Name of Licensed Plumber or Gas Fitter - ---- - -- Check one: Corporation ❑ Partnership ❑ Firm/Co. Certificate # INSURANCE COVERAGE: I have a ur'rent liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142 Yes No ❑,: If you have checked Yes, please indicate the type coverage by checking the appropriate box. A liability, insurance policy. p Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware.that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and;that my:signature on this permit application waives this requirement. Check one: Owner ❑ Agent ❑ Signature o"t Owner -or Owner's Agent I hereby car and that all of the Mass FBy -- Title _ City/Town APPRI y 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 dumbing work and installation performed under the permit issued for this application will be in compliance with all pertinent provisions chusetts State Gas Code and Chapter 142 of the General Laws. Type of License: C) Plumber K Gasfitter Signature of Licensed Plumber or Gas Fitter A Master License Number 3 Sys' U Journeyman 07 i � � i D l 1 I i. " , m m m � z m D F c m m m � N •. `s r m I � � o D z D m � z inN m 3 Z w _ •O. m p 0 0 m c s m m m � z m D F c m m m � N •. `s r m I D z D m � z inN m m m m � z m D F c m m m � N •. `s r m I MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) NO , ANDOVER , MA Mass. Date 4 �« 19 _ Permit �- A /6 _. Building Lc=Icn [ILLI POND Owner's Name 109e�j NO . ANDOVER , MA Type of Occupancy RES �r New ® Renovation ❑ Replacement 0 . Plans Submitted: Yes❑ No ❑ I 1 I I I I �7 I I I V1 • x n N Ww ¢ N G rc O O U O N F- n \ Q Uj < © N F cc O O = 0 C a F N V fit J OLU W I < W > e W = 1 I 0 O w a O t��I1f1 r O Ci W 7 O C- J U C Y O a. F' 0 SUB—BSMT, I I I I I I I I I I BASEMENT I I J 1ST FLOOR I I I I I I 2ND FLOOR I I I I I I I I I I (/} ORD FLOOR V �I I 4TH FLOOR I I I I I I I I I I I I I STH FLOOR Ii 6TH FLOOR i f 1 7TH FLOOR STH FLOOR I I I I I I I I Installing Company Name CALLAHAN AIR CONDITIONING Check one: Certificate 11r Address 91 BELMONT STREET 13 Corporation N0. ANDOVER, MA . 01 845 ❑ Partnership Business Telephone 508-689-9233 ❑ Firm/Co. Name of L)censed Plumber or Gas Fater JOSEPH KEVIN CALLAHAN INSURANCE COVERAGE: I have a current IlablMy Insurance policy or its substantial equtvale�-,t which meets the requirements of MGL Ch. 142- Yes 42Yes Q No ❑ If you have checked Les, please Indicate the type coverage by checking the appropriate box A liability Insurance policy 0 Other type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws. and that my signature on this permit application waives this requirement. Check one: Owner❑ Agent ❑ Signature of Owner or Owners Agent I hereby certify that all of the delaiis and information I have submitted (or entered i, 0"e appficallon are true and accurate to the best of my knowledge and that all plumbing work and InstaflaUcns performed under the per it I sued for this appllcaU will b In Gflencewi � all pert.lnent provisions of the Massachusetts State Gas Cada and C:,)apter 142 of Lha neral La- y Ti"olul' f Ucense: �� A umber gnatur o c nse umbe or Gas iter Title sritter ter L'c:.nse Number M- 3 4 4 0 iCity/Tcwn neyman nrrrx�vr. f5 i�Ti 1� c � d -.flrr-1;Lxa•.�°"4+""'v M..- ._.,. _., �a.,.��.,;L1 y,=-'_""`"aL.Ea:o;c::�.r�ie.;►:.�:.�,�:,.^-r•'•�--w r .. 2 i o s Date VZ,31� 1.: ...... NpR7M TOWN OF NORTH ANDOVER '� PERMIT FOR GAS INSTALLATION' t A �9SSACeNUS - $ This certifies that . L 1.11114e -V.— 411E ......... _ has permission for gas installation S .............. in the buildings of ... R AG. ... ...... ........ . . at ............ , North Andover, Maig. 1 U7 GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File' F y � ;� swcN September 23, 2010 Town of North Andover 1600 Osgood Street Bldg. 20, Suite 2-36 North Andover, MA 01845 Phone: 978-688-9545 Fax: 978-688-9542 Attorney Kevin M. Sullivan, Murphy & Riley P.C. 141 Tremont Street Boston, MA 02111 Please see the attached information that you requested. Xeroxed copy of the file for 94 Millpond, North Andover, MA 01845. Please mail a check in the amount of $18.40 made out to the Town of North Andover, and mail it to the address on our letter -head. Thank you. Mary Ippolito, Building Assistant cc G. Brown, Building Inspector enclosure ATTEST: A True Copy �..d Town Clerk, 4r No.: Date TOWN OF NORTH ANDOVER BUILDING DEPARTMENT 1q 1'y CHUS y cul inn Ins' ector I of the file for 94 Millpona, .iVvrui tuiay..-.a, Please mail a check in the amount of $18.40 made out to the Town of North Andover, and mail it to the address on our letter -head. Thank you. Mary Ippolito, Building Assistant cc G. Brown, Building Inspector enclosure ATTEST; A True Copy Town Clerk b Town of North Andover 1600 Osgood Street BuildingDepartMent Bldg 20, Suite 2-36 North Andover, MA 01845 Phone: 97&688-9545 Fay 97&688-9542 MEMO TO: Denise Brogna Cc: Gerry Brown, Building Inspector "FROM: Mary Ippolito, Building Department DATE: September 29, 2010 SUBJECT: YOUR. REQUEST FOR COPIES Enclosed please find a copy of the file for 94 Millpond, North Andover, MA 01845. We charge $0.20 per page; please submit a check in the amount of $19.40 made out to the Town of North Andover to the address above. R Thank you. Jw 4 ESSEX, ss. JAY WEINER., Plaintiff V. COMMONWEALTH OF MASSACHUSETTS TRIAL COURT SUPERIOR COURT DEPT. C.A. No 10-1538A MILLPOND HOMEOWNERS ASSOCIATION, INC., TRUSTEES MILLPOND HOMEOWNERS ASSOCIATION, INC., WILLIAM ANDERSON as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., PHILLIP CAHILL as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., WILLIAM HAUSER as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., RICHARD NAWROCKI as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., KATHY BURKE as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., PAM CRAWFORD as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., BETH MAZIN as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., ANTOON BOUDREAU CONSTRUCTION, INC., MICHAEL ANTOON AND KENNETH BOUDREAU, Defendants SUBPOENA DUCES TECUM To: Keeper of the Records North Andover Building Department 1600 Osgood Street North Andover, MA 01845 GREETINGS: YOU ARE HEREBY COMMANDED in the name of the Commonwealth of Massachusetts in accordance with the provisions of Rule 45 of the Massachusetts Rules of Civil Procedure to appear and testify on your own behalf before Johnson & Borenstein, LLC, 12 Chestnut Street, Andover, MA 01810, on the 26th day of October, 2010 at 10:00 a.m. and to testify at the taking of testimony in the above entitled action. AND YOU ARE TO BRING WITH YOU THE DOCUMENTS LISTED ON EXHIBIT A ATTACHED. Hereof fail not as yoqBR✓,6?,1%P that behalf made al'g� lv�: vJJ 24. 20., p ♦_ 10 U P' ',',iii '• �awOfM'*��'•� your default under the pains and penalties in the law in Notary Public: - 5 w— My Commission Expires: 0 - EXHIBIT "A" A complete copy of the building file for 94 Millpond Road, North Andover, MA, including but not limited to all documents concerning inspections, applications, permits, plans, specifications, photographs, correspondence, memoranda, notes, notices, citations, and any other documents relating to the property, construction of the property, or alteration of the property. Please note that copies of the requested records may be provided in lieu of an appearance at the deposition noticed herein. If you have any questions or cannot comply with this subpoena, please contact Denise A. Brogna at Johnson & Borenstein, LLC. CERTIFICATE OF SERVICE I, Denise A. Brogna, hereby certify that I have this _,:�day of September, 2010, forwarded a photo -copy of the foregoing Subpoena Duces Tecum and Notice of Deposition , by first class mail, postage prepaid, to: Christian Colwell, Esq. 45 Osgood Street Methuen, MA 01844 Kevin M. Sullivan, Esq. Murphy & Riley, P.C. 141 Tremont Street Boston, MA 02111 � c Denise A. Brogna TO: FROM: DATE: 0 Town of North Andover 1600 Osgood Street Building DgwMent Bldg. 20, Suite 2-36 North Andes, MA 01845 Phone: 97&688-9545 Fax 97868&9542 MEMO Denise Brogna Cc: Gerry Brown, Building Inspector Mary Ippolito, Building Department SUBJECT: September 29, 2010 YOUR REQUEST FOR COPIES Enclosed please find a copy of the file for 94 Millpond, North Andover, MA 01845. We charge $0.20 per page; please submit a check in the amount of $19.40 made out to the Town of North Andover to the address above. d Thank you. AT=1 A '!► 10 Town Clerk Town Clerk Location No. Date Go NORTIy TOWN OF NORTH ANDOVER O0 •Certificate of Occupancy $ Building/Frame Permit Fee $ Mus Foundation Permit Fee $ ©� Permit Fee $ '7. 91 TOTAL $ Check # %-Al)ll 23502 'Building Inspector • RONALD BERTHEIM DBA NORTHERN PROCESS SERVERS 252B PLEASANT ST. METHUEN, MA 01844-7115 TO THE PAY 7dZ// �i ORDER OF IM Bank America's Most Convenient Bank® FOR 11100414L11' I:211370S4S1: 4141 9/rte ZI !/`, 53.7054/2113 142 DATE 8 2443684081'' 7 Faalurai -L-A -R S NOT VALID AFTER 90 DAYS INC., WILLIAM AN1llLKNUN as 1 KUJ 1 r -r, 1v111.1-rUIN" HOMEOWNERS ASSOCIATION, INC., PHILLIP CAHILL as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., WILLIAM HAUSER as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., RICHARD NAWROCKI as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., KATHY BURKE as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., PAM CRAWFORD as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., BETH MAZIN as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., ANTOON BOUDREAU CONSTRUCTION, INC., MICHAEL ANTOON AND KENNETH BOUDREAU, Defendants SUBPOENA DUCES TECUM To: Keeper of the Records North Andover Building Department 1600 Osgood Street North Andover, MA 01845 GREETINGS: YOU ARE HEREBY COMMANDED in the name of the Commonwealth of Massachusetts in accordance with the provisions of Rule 45 of the Massachusetts Rules of Civil Procedure to appear and testify on your own behalf before Johnson & Borenstein, LLC, 12 Chestnut Street, Andover, MA 01810, on the 26"' day of October, 2010 at 10:00 a.m. and to testify at the taking of testimony in the above entitled action. AND YOU ARE TO BRING WITH YOU THE DOCUMENTS LISTED ON EXHIBIT A ATTACHED. Hereof fail not as yo��✓�1''apy that behalf made al'gjq r� your default under the pains and penalties in the law in Notary Public: My Commission Expires: SS— a 1-1 ^ -;2 3 Location No. Date ?/ /ro TOWN OF NORTH ANDOVER F' 9 i y • Certificate of Occupancy $ CMUS s'•CU Eta Building/Frame Permit Fee. $ , Foundation Permit Fee $ ? Other Permit Fee $ UU t o (�s u J( Cifp,5,. i.WTOTAL $ Check # d LP Buirding Insp dor C) R •++ Tow O O W n 2� u°.• d o n c �• f 01 0 o .W m C — D a = O CL � c r CD o CD Z �; 3 ° O -nm p R m 3 v 0C ` ri C� Z �i3� CD =' Co fCDD C CID= w C c o EA 69 69 fA 69 CID 7 Z v - a � m C O Ln r 03 .0 03 i■ O r r O Ln r Ln O r. O O O O ru r Ln r. i' R + t. I ! m I 0 i f I � G lil K r 0 z d 'x 0 M 0 CnC v O M ,.:.. �i z 00 o< 0 Dr Rq0 o . m0 �< m m z O M ni COD .:t * O N # O 0 0 r U) Security features. Details on back O 0 CD DO 0= m CL O 0 o 0 o � CCm G N �D C7 O D C ORO c D co 1 C/) C, z cn t- 00. x w 0 C7 --i m cn .x. y � D GO * O 0 at 1 U7 2 * * v rn. cn D * T z D * z o v m * O * O N # O 0 0 r U) Security features. Details on back O ESSEX, ss. JAY WEINER., Plaintiff V. 4 COMMONWEALTH OF MASSACHUSETTS TRIAL COURT SUPERIOR COURT DEPT. C.A. No 10-1538A MILLPOND HOMEOWNERS ASSOCIATION, INC., TRUSTEES MILLPOND HOMEOWNERS ASSOCIATION, INC., WILLIAM ANDERSON NC.as TPHILLIP CAHILL MILLPOND HOMEOWNERS ASSOCIATION, as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., WILLIAM HAUSER as TRUSTEE MILLPOND KI HOMEOWNERS O EOWNERS ASSOCIATION, INC., RICHARD NA R RUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., KATHY BURKE as TRUSTEE MILLPONDSTEO MIOLPOND HOMEOWNWNERS ERS INC., PAM CRAWFORD as TRU ASSOCIATION, INC., BETH MAZIN as TRUSTEE MILLPOND HOMEOWNERS ASSOCIATION, INC., ANTOON BOUDREAU CONSTRUCTION, INC., MICHAEL ANTOON AND KENNETH BOUDREAU, Defendants SUBPOENA DUCES TECUM To: Keeper of the Records North Andover Building Department 1600 Osgood Street North Andover, MA 01845 GREETINGS: YOU ARE HEREBY COMMANDED in the name of the Commonwealth of Massachusetts in accordance with the provisions of Rule 45 of the Massachusetts Rules of Civil Procedure to appear and testify on your own behalf before Johnson & Borenstein, LLC, 12 Chestnut Street, Andover, MA 01810, on the 26`h day of October, 2010 at 10:00 a.m. and to testify at the taking of testimony in the above entitled action. AND YOU ARE TO BRING WITH YOU THE DOCUMENTS LISTED ON EXHIBIT A ATTACHED. Hereof fai that behalf r your default under the pains and penalties in the law in Notary Public:�� `' L 5 3 My Commission Expires: S