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HomeMy WebLinkAboutMiscellaneous - Exception (590)\� i� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTIK� (Print or Type) t NORTH ANDOVER ,Mass. Date l uilding Location % Permit iI ,Zo g �- ez� Owners Name New irl Renovation D Replacement Plans Submitted r tr"F ML Ur t ypej Check one: Certificate Installing Company Name � j�Corp. Address ,���� /"--` Partner. Firm/Co. Business Telephone:������() Name of Licensed Plumber or Gas Fitter ��Cq/ &OliaPL Insurance Coverage.: Indicate he type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Q Bond Insurance Waiver: I, th undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. Signature of owner/agent of property . Owner u Agent ID 1 hereby certify that all of the details and information 1 have submitted (or entered) in above application are true and accurate to the best of my knowledge and slut all plumbing work and installations perfornIc1 under, permit isseed fo: this application will brin compliance with aD pertinent provisions of the Massachusetts State Cas Code and chapter 142 of tho Cenetal Laws, — By TYPE LICENSE: Plumber Title asfitter Signatur of Licensed ,City/Town: Master Plumber or Gasfitter APPROVED (oFFiCE USE ONLY) Journeyman License N ber • r • • • aaaaaaaaaaaaaaaaaaaaaa MEMO EEEEEEEEEEEMEMErEME0 0 noEE .. ■on Eno MEEEMMEEMEEEEaEEno • • • - EEMaEno on ENE -. ... EEEEEEEMEMEEMEEMEEaMEEnEE =Z15:1410 EEEMOMMMMOErEEMEMEMEMEEME■ FLOORSTR • • • - .. aaaaaaaaaaaaraaaanaaaaaso ■EEMEEEEMMEMEEtEEMEEMEENONE ■EMEMEMnMMEEEEMEEEEEEEon • • - Emmaus aaaaaaaaaaaaaaaaaaa■ tr"F ML Ur t ypej Check one: Certificate Installing Company Name � j�Corp. Address ,���� /"--` Partner. Firm/Co. Business Telephone:������() Name of Licensed Plumber or Gas Fitter ��Cq/ &OliaPL Insurance Coverage.: Indicate he type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Q Bond Insurance Waiver: I, th undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. Signature of owner/agent of property . Owner u Agent ID 1 hereby certify that all of the details and information 1 have submitted (or entered) in above application are true and accurate to the best of my knowledge and slut all plumbing work and installations perfornIc1 under, permit isseed fo: this application will brin compliance with aD pertinent provisions of the Massachusetts State Cas Code and chapter 142 of tho Cenetal Laws, — By TYPE LICENSE: Plumber Title asfitter Signatur of Licensed ,City/Town: Master Plumber or Gasfitter APPROVED (oFFiCE USE ONLY) Journeyman License N ber 2208 Date . ,,ORTH TOWNOFNORTH ANDOVER p -0� PERMIT FOR GAS INSTALLATION~ SSACH This certifies that .....? ft :..... has permission for gas installation in the buildings of ..l u:r3"g-HvAd A40 6L-' ` 2I= .. ..... ..., at ./7-7. North Andover, Mass:L�� � a Feer./5,"'' . Lic. No..�S4 .. .... ....... . w 5kA L L dr --0- 3 03 S GAS INSPECTOR 4" WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File IFI Safety Insurance P.O. Box 55098 Boston MA 02205 617-951-0600 September 23, 2016 Building Commissioner or Inspector of Buildings Fire Department or Arson Squad Board of Health or Board of Selectman City Hall NORTH ANDOVER, MA 01845 Insured: NICOLE GARABEDIAN and STEPHEN GARABEDIAN Property Address: 180 CHICKERING RD UNIT 110, NORTH ANDOVER MA Policy Number: HMA0281652 Claim Number: BOS00071817 Date of Loss: 9/21/2016 Notice of Loss Under M.G.L. c. 139,E 3B This communication shall serve as written notice pursuant to M.G.L. c. 139, § 3B that [Safety Insurance Company] ("Safety") has received a claim involving loss, damage or destruction to a building or other structure at the above -referenced address which may either: (1) meet or exceed $1,000; or (2) cause the condition or the building or other structure to render M.G.L. c. 143, § 6 applicable. In accordance with M.G.L. c. 139, § 3B, if the city or town intends to initiate proceedings designed to perfect a lien under Section 3B, M.G.L. c. 143, § 9 or M.G.L. c. 111, § 127B, please notify Safety of the same by certified mail. Kindly forward such notice to my attention, at the address indicated above, and include with such notice a reference to the above-described insured, property address, policy number and claim number. If you have any questions regarding this notice, please feel free to contact me directly at 617-951-0600, extension 5015. Sincerely, Pete Najarian Claim Examiner January 19, 2016 THEN O9tFOd0(fDIED0�9�afiAGROU Po U FORM OF NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B Building Commissioner, or Inspector of Buildings c/o City or Town Hall 1600 Osgood Street North Andover, MA 01845 Board of Health or Board of Selectmen c/o City or Town Hall 1600 Osgood Street North Andover, MA 01845 Fire Department or Arson Squad c/o City or Town Hall 1600 Osgood Street North Andover, MA 01845 RE: Our File No.: P1605448 Insured: KITTREDGE CROSSING CONDOMINIUM Address: 180 CHICKERING ROAD, NORTH ANDOVER, MA Policy No.: R1373344A Loss Date: 08/29/2015 Loss Type: Building or Other Structure Damage Acclaim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Ch. 143, Sec. 6 to be applicable. If any notice under Mass. Gen. Laws, Ch. 139, Sec. 3B is appropriate, please direct it to my attention and include a reference to the captioned insured, location, policy number, loss date and claim or file number. If no reply is received from your office within ten days, we will assume you have no liens of any type against this property, and the claim will be paid in our customary manner. Sincerely, Dawn L. Parmeggiani Property Claims Examiner 1-800-688-1825 x1119 NORFOLK & DEDHAM MUTUAL FIRE INSURANCE CO.222 Ames Street, P.O. Box 9109, Dedham, MA 02027-9109 DORCHESTER MUTUAL INSURANCE CO. Telephone: (800) 688-1825 FITCHBURG MUTUAL INSURANCE CO. o Fax: (781) 329-1818 Safety Insurance PO Box 55098 Boston, MA 02205 Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Board of Health or Inspector of Buildings Board of Selectman City Hall City Hall NORTH ANDOVER, MA 01845 NORTH ANDOVER, MA 01845 RE: Insured: RAYMOND P BOUCHER and FRANCINE BOUCHER Property Address: 180 CHICKERING RD UNIT #208, NORTH ANDOVER, MA Policy Number: HMA 0305712 Claim Number: BOS00065898 Date of Loss: 8/29/2015 Company: Safety Insurance Company Claim has been made involving loss, damage or destruction of the above -captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass. Gen. Laws, Chapter 139, Section 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim number. Lisa Monette Claim Examiner Safety Insurance Company Homeowners Claims Unit P. O. Box 55098 Boston, MA 02205-5098 Phone: (857) 233-8618 Fax: (617) 535-5833 Email: lisamonette@safetyinsurance.com November 13, 2015 THEN OPFFO0.0(f�DED0-0AflflGROU Pe U September 24, 2015 FORM OF NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B Building Commissioner, or Inspector of Buildings c/o City or Town Hall 1600 Osgood Street North Andover, MA 01845 Board of Health or Board of Selectmen c/o City or Town Hall 1600 Osgood Street North Andover, MA 01845 Fire Department or Arson Squad c/o City or Town Hall 1600 Osgood Street North Andover, MA 01845 RE: Our File No.: P1500919 Insured: KITTREDGE CROSSING CONDOMINIUM Address: 180 CHICKERING ROAD, NORTH ANDOVER, MA Policy No.: R1373344A Loss Date: 07/17/2015 Loss Type: Building or Other Structure Damage A claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Ch. 143, Sec. 6 to be applicable. If any notice under Mass. Gen. Laws, Ch. 139, Sec. 3B is appropriate, please direct it to my attention and include a reference to the captioned insured, location, policy number, loss date and claim or file number., If no reply is received from your office within ten days, we will assume you have no liens of any type against this property, and the claim will be paid in our customary manner. Sincerely, Michelle M. Roust Senior Property Claims Examiner 1-800-688-1825 x1171 NORFOLK & DEDHAM MUTUAL FIRE INSURANCE CO.222 Ames Street, P.O. Box 9109, Dedham, MA 02027-9109 DORCHESTER MUTUAL INSURANCE CO. Telephone: (800) 688-1825 FITCHBURG MUTUAL INSURANCE CO. o Fax: (781) 329-1818 THEWORIFO0.0(lf,.�DEDHAfiAGROUN J September 25, 2015 FORM OF NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASS. GEN. LAWS, CH. 139, SEC. 313 Building Commissioner, or Inspector of Buildings c/o City or Town Hall 1600 Osgood Street North Andover, MA 01845 Board of Health or Board of Selectmen c/o City or Town Hall 1600 Osgood Street North Andover, MA 01845 Fire Department or Arson Squad c/o City or Town Hall 1600 Osgood Street North Andover, MA 01845 RE: Our File No.: P1500972 Insured: KITTREDGE CROSSING CONDOMINIUM Address: 180 CHICKERING ROAD, NORTH ANDOVER, MA Policy No.: R1373344A Loss Date: 07/22/2015 Loss Type: Building or Other Structure Damage A claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Ch. 143, Sec. 6 to be applicable. If any notice under Mass. Gen. Laws, Ch. 139, Sec. 3B is appropriate, please direct it to my attention and include a reference to the captioned insured, location, policy number, loss date and claim or file number. If no reply is received from your office within ten days, we will assume you have no liens of any type against this property, and the claim will be paid in our customary manner. Sincerely, Michelle M. Roust Senior Property Claims Examiner 1-800-688-1825 x1171 NORFOLK & DEDHAM MUTUAL FIRE INSURANCE CO.222 Ames Street, P.O. Box 9109, Dedham, MA 02027-9109 DORCHESTER MUTUAL INSURANCE CO.We Telephone: (800) 688-1825 FITCHBURG MUTUAL INSURANCE CO. Fax: (781) 329-1818 4128 TRAVELERS JW The Travelers Indemnity Company P.O. Box 1450 Middleboro, MA 02344-1450 07/06/2015 Town of North Andover Building Inspector 120 Main Street North Andover MA 01845 Insured: Kenia-K Franco Claim Number: HXV1062 Policy Number: OF0828-983373193-636 -1 Date of Loss: 06/14/2015 Loss Location: 180 Chickering Road, Apt North' Andover MA To: Board of Selectmen Building Commissioner Inspector of Buildings Board of Health A claim has been made involving loss, damage or destruction of the above captioned property which may either exceed $1,000 or cause Massachusetts General Laws Chapter 143, Section 6 to be applicable. If any notice under Massachusetts General Laws Chapter 139, Section 313 is appropriate, please direct it to my attention and include a reference to our insured, the policy number, the claim/file number, the date of loss, and the location. If you `have any questions, please feel free to contact me at (508)946-6317 or email me at NVILANDR@travelers.com. Sincerely, Nicholas Vilandre Claim Professional (508)946-6317 Ext. 9466317 Fax: (877)786-5584 --Email--NVILAN DR@travelers.com - On this date, I caused copies of this notice to be sent to the persons named above at the addresses indicated above by first class mail. Signature Date P0062 F3162C1515188004128 00001 N LC CL z co M It' tk Nk\ �7 \j asc 0 o s O C 'r O V U ea ev coo c ' E cr CF :. ts m� .z.� .tea y E S .0 Cs :cam . o c m C N � y C b y Q1 • - m a .0 C C C File y O O y Of /� CD P, N m '11. 0 cm mom �ZC3 1 cm oc �o c Q m :2m0 .o = 42 m w 03 N ~ sO) CD y m rO-. VS C ev = m :5O y C:LAJ O W .y O !EC 2 R m�y� C CL�Z1= i1 6 0 v CD 0 E W O V Z CD CL CD CO) � C CD cm ca ®� .ca 0 E m m CD 0 CD L H � y.r C7 - ; CD 100 civ o a CM M Ca C3 J 'p Z CD*. ya C •� cC — V d Lli 0 U) LU VJ w W CCw VJ ZONa,114 � u M ^1 n,7 �� u yRj g o O G W o PLO L. z v oo ... cn w w w c� W U)cn �1 �7 \j asc 0 o s O C 'r O V U ea ev coo c ' E cr CF :. ts m� .z.� .tea y E S .0 Cs :cam . o c m C N � y C b y Q1 • - m a .0 C C C File y O O y Of /� CD P, N m '11. 0 cm mom �ZC3 1 cm oc �o c Q m :2m0 .o = 42 m w 03 N ~ sO) CD y m rO-. VS C ev = m :5O y C:LAJ O W .y O !EC 2 R m�y� C CL�Z1= i1 6 0 v CD 0 E W O V Z CD CL CD CO) � C CD cm ca ®� .ca 0 E m m CD 0 CD L H � y.r C7 - ; CD 100 civ o a CM M Ca C3 J 'p Z CD*. ya C •� cC — V d Lli 0 U) LU VJ w W CCw VJ Terra Properties, LLC 231 Sutton Street North Andover, MA 01845 January 16, 2004 D. Robert Nicetta Building Commissioner Town of North Andover 27 Charles Street N. Andover, MA 01845 RE: Kittredge Crossing Building 1(C) Dear Mr. Nicetta Pursuant to my meeting with Fire Chief William Dolan, we have agreed to install an electric heating element with an independent thermostat, in each of the mechanical rooms. This heating unit will come on as a backup should the HVAC unit fail. Also, at the request of the Fire Chief, we will be installing automatic door closures on each mechanical room door. In addition, we will implementing these same measures in both Buildings 2(A) and 3(B). If you have any questions, please do not hesitate to contact me at 978-327-6540 ext. 15. ,LLC CIT'stinA Minicucci Project Manager m x m C/) 0 m M' �o s � Caw d to CL n PteCOD? �..! CD CLc "C I CD CD Er o cD W CC y. CL ® CO) C CO) cp " n7 z f7 '10 o w G c (n o b o n' Z d O ►-� °2 CD0 1 w W ^ ` r ryas L ` ai O CD c co s$ g s -4 C C, y p CO p r _apaO CO o C2 m M CA C2 o. C -)m ® CA Z = Zrm Ic to O� =r CLdC y 91 �d G a NN y � b m m : O y O O ~°O r. n O Zs.� CCD =r I Go p� p O CL Er r� Cp m y :!8 C 7 VJ C O m _ O=r, CL p y c' � /�� c � V/ d �® C CD FW 0 0, aa�. O O CD 0 cn CD � °� • s ice+- CA w y 04 �'CD SCD c.a :ce :q y � c p v; cn cn pd o cp " n7 f7 '10 o w G c (n o b o n' Z d O ►-� °2 1 w W ^ ` r ryas L ` ai O \' ►l i Ll 0 2000 EDITION AIA DOCUMENT Certificate of Substantial Completion (Instructions on reverse side) PROJECT: KIT-rMEDCF <fRvs5iw(, PROJECT NUMBER: — NA -- (Name and address) ,200 6V1,cK45vv6 90 CONTRACT FOR: — AIA — 6704-2000 OWNER ❑ ARCHITECT ❑ AJozr)4 /4NJOve.e /14 CONTRACT DATE: — NA— CONTRACTOR ❑ TO OWNER: TERRA PQUPE2TIES CTO CONTRACTOR: OPEC 1-I EE CoNsrrtUc77oN 0)„e FIELD ❑ (Name and address) ° (Name and address) P PO Bo h' Io3l, 312/J. N%AlN Sit I CoRPoIeA� Pp_ OTHER El ANLb✓ee I`N 01910 13 L M vnJ f N I -I CU 3 2 Z 0 PROJECT OR PORTION OF THE PROJECT DESIGNATED FOR PARTIAL OCCUPANCY OR USE SHALL INCLUDE: QUI LDIIJG 0 1 (C) a THE IpJavtGw w 1iUILD1,.16-. The Work performed under this Contract has been reviewed and found, to the Architect's best knowledge, information and belief, to be substantially complete. Substantial Completion is the stage in the progressof the Work when the Work or designated portion is sufficiently complete in accordance with ,the Contract Documents so that the Owner can occupy or utilize the Work for its intended use. The date of Substantial Completion of the Project or portion designated above is the date of issuance established by. this Certificate, which is also the date of commencement of applicable warranties required by the Contract Documents, except as stated below: ,/ORBIaCH ARCHITECT BRoB� T 3 V DATE OF ISSUANCE A list of items to e completed or corrected is attached hereto. The failure to include any items on such list does not alter the responsibility of the Contractor to complete all Work in accordance with the Contract Documents. Unless otherwise agreed to in writing, the date of commencement of warranties for items on the attached list will be the date of issuance of the final Certificate of Payment or the date of final payment. Cost estimate of Work that is incomplete or defective: The Contractor will complete or correct the Work on the list of items attached hereto within days from the above date of Substantial Completion. HACK C. WILLIA,1es C99T,KACTOR BY DATE The Owner accepts the Work or designated portion as sul possession at (time) on complete and will assume full (date). AA\ No. 9085 BOSTON, MASS. \STH OF MA�'SP� A1109111a,00 P01, vesl1�ee T �G �0-,d, 0 /� L�3 OWNER BY DA ©2000 AIA@ The responsibilities of the Owner and Contractor for security, maintenance, heat, utilities, damage to AIA DOCUMENT G704-2000 the Work and insurance shall be as follows: CERTIFICATE OF (Note: Owner's and Contractor's legal and insurance counsel should determine and review insurance requirements and coverage.) SUBSTANTIAL COMPLETION ©1000 The American Institute of Architects. Reproduction of the material herein or substantial quotation of its provisions without written permission of the AIA violates the copyright lavis of the United States and will subject the violator to legal prosecution. WARNING: Unlicensed photocopying violates U.S. copyright laws and will subject the violator to legal prosecution. The American Institute of Architects 1735 New York Avenue, N.W. Washington, D.C. 20006-5292 IIIA D O O. .O 0 ©2000 AIA® AIA DOCUMENT G704-2000 INSTRUCTIONS The American Institute of Architects 1735 New York Avenue, N.W. Washington, D.C. 20006-5292 Instructions GENERAL INFORMATION PURPOSE. This .document was developed to establish the date of Substantial Completion for the purpose of commencement of applicable warranties and to allow the Owner to occupy or utilize the Work or des- ignated portion. :Y - RELATED DOCUMENTS. This document was prepared for use under the terms of AIA general conditions, including AIA Document A2oi, General Conditions of the Contract for Construction; and the general conditions contained in AIA Document A107, Abbreviated Owner -Contractor Agreement Form'for Construction Projects of Limited Scope -Stipulated Sum. USE OF CURRENT DOCUMENTS. Prior to using any AIA document, the user should consult the AIA, an AIA component chapter or a current AIA Documents Price List to determine the current edition of each document. REPRODUCTIONS. AIA Document G704 is a copyrighted work and may not be reproduced or excerpted '. from in substantial part without the express written permission of the AIA. The G704 document, is intended to be used as a consumable—that is, the original document purchased by the user is intended to be consumed in the course of being used. There is no implied permission to reproduce this document, nor does membership in The American Institute of Architects confer any further rights to reproduce G7o4. A limited license is hereby granted to retail purchasers to reproduce a maximum of TEN copies of a com- pleted or executed G704, but only for use in connection with.a particular project. 4 COMPLETING THE G704 FORM • After the words "Project or Portion of the Project Designated For Partial Occupancy Or Use Shall Include:", insert a detailed description of the Project or portion(s) of the Project that have been.accept- ed as being substantially complete. < w • Determine Work to be completed. Provide a list of items that are to be completed or corrected and attach. a • Determine dates for completion of the Work. • Establish an amount to be withheld to complete the Work. i - EXECUTION OF THE DOCUMENT The G704 document should be executed in not less than triplicate by the Owner, Architect and { f Contractor, each of whom retains an original. , WARNING: Unlicensed photocopying violates U.S. copyright laws and will subject the violator to legal prosecution. x E -d �1019 689 6L6 2uissoj0 a2p8jgjT A dS0:E0 b0 91 Uer 0. a E 0 U \ ' O U N j @ Q Y V Y J ka! id.ko a �C�iri -d 0 m N - C O C 0. E 0 U L N c�a •C c 'O C O a) l4 Y co fl3 3 c - C O N CL QI N O OC Q 2 l3 co I O N V w c O 3 cNaE `o `m oc m r 3 •O E o O L m N � O 3 o V a a QI N S Cc)CA. 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N N N N N N N N N N N N NNNN N N N N N N N N N N N N N0 11-d 1,019 669 6G6 2u T SSOJ3 o2poijI T A dG0 =60 ir0 9T uer c 0 ti �o m cc CL m 9 21'd 1,019 689 BL6 2uissoJ0 a2p8j4jT N dg0:E0 1,0 91 uer co 9 m f4 N C U Et 'd b019 E89 8LG 2uissou0 a2p8ujgiA d80:E0 t0 91 uer Y C C 0-t2 8 C) v. v z i .0 > vv a ��w J - Q v :v .y - .z 3 m m Q J d C C •fC O O O C L V L p _.._: '1 a O _ O w OL m — O O D1 C U f0 N E> •O a m 0 _ O U y .+ _ m Z, C U -0 m O o E> O O O '� E m w^N, (0 t7 ^N, y y O O UCo N O a) V C O N :;: •= E co U U O C C m c9 y N C O N N C ca U �N > O to f0 CO y O L N ::. 7 '.�-� O C (d — O y NO y (9 > >' `- 0 3 q 3 O f/1 .O-. 3$ c c o� c N L• N N E 2 O Y :� Q C c c O E E C 'O Z c 0 0 V L L Y N C 3 C C .� C G p 7 y >> «� O L+ Q C O O C m m O L O G O C i C .. C > O C Y N U C L L N E CC C CO Y 7— fCL 4 lU O) (0 IO 'OO _ fC 3� w N_ L voi vOi ai uoi L c E X p a .U• a o a> a o .: ,: Y m m •O m C v -0 o -}'p` b L E p Y L N 3 is �'S .N. o o..:.. o. C O U O U O U o U m O E L O O p 'O 0 N w ca O C U O •p a C W> C O p N cc, O 'O W L (0 L p 0 C C O f6 t p O E' y N _ o Y N f0 _ co C O E Y G7 an d (A d L .. .O.• �f0 �9 .% L m f9 N V1 N tOo fLA N 3 :. O O p C L yN CO N N N 7 .� N 61 h m y (A p -�- x j Pm O C m _m 0 0 0 •C � O :- O o 0� •C mo E 0 0 0 t6 0 0 0 0 f1S cm p N L L t U y= L O. Cis=': .: 'O ' L •C to A U U U m OL L L U Q _0 U N m N m }~ O O C U U f0 m L L L t L L ...►.`C L OL U U UOOO . .f0 L 0 " "UU NN Y E N E N N N N E E •a � Y Y r•,';: y N@ �[ .1C rn N N' N E E E E - N M. O.. N O N O N O N O N O N O N O N O N O N O N O N O N O N O N O N— O 0 r 0 0 00 — 0 0 0 0 0 0 0 0 0 0 0 0 0 O. O O O N N N N N N N N N N N N N N N N N: N N N N N N N N N N N N N N N N N N CSC — '- Et 'd b019 E89 8LG 2uissou0 a2p8ujgiA d80:E0 t0 91 uer Building C Walk-Thru List 12.31.03 nI_u.. b..... rin e.i..H.. Complete BN Item? 101 1/6/04 kitchen no water to fridge 101 1/6/04 kitchen trash compactor missing 101 1/6/04 mba finish install around whirpool tub 102 1/6/04 2ndba cracks in tile along grout line 102 1/6/04 kitchen trash compactor missing 102 1/6/04 living missing HVAC grill 102 1/6/04 mbr remove shipping button from bottom of door 102 1/6/04 meth holes in wall 102 1/6/04 meth missing weatherstipping 103 1/6/04 balcony loose door handle 103 1/6/04 balcony missing sprinkler head trim 103 1/6/04 balcony threshold not installed 103 1/6/04 balcony dent in patio door threshhold 103 1/6/04 balcony puddle of water next to balcony could be a problem 103 1/6/04 balcony doors not painted 103 1/6/04 den finish carpet install 103 1/6/04 entry missing switchplate by entry 103 1/6/04 general smoke detectors bagged 103 1/6/04 kitchen finish install appliances 103 1/6/04 kitchen molding above cabinets needs putty and paint 103 1/6/04 laundry doors not installed 103 1/6/04 laundry dryer vent trim ring missing 103 1/6/04 living battery needed for thermostat 103 1/6/04 mbr threshold missing 103 1/6/04 mbr closet doors not installed 103 1/6/04 mbr closet shelves not installed 103 1/6/04 mech weatherstripping not installed 103 1/6/04 mech hole in mech room wall 104 1/6/04 2ndba frx vanity bottom trim 104 1/6/04 2ndbed patch hole by cable outlet 104 1/6/04 2ndbed install closet shelves 104 1/6/04 2ndbed install closet doors 104 1/6/04 2ndbed install doornob on bedroom door 104 1/6/04 dining patch gouge in wall 104 1/6/04 entry fix deadbolt 104 1/6/04 entry repair by outlet next to door 104 1/6/04 general remove smoke det. Covers 104 1/6/04 kitchen install bottom panel of dishwasher 104 1/6/04 kitchen missing gasket for disposal 104 1/6/04 kitchen no water to dishwasher 104 1/6/04 kitchen strange sound from dishwasher 104 1/6/04 kitchen fix wall above outlet in backsplash 104 1/6/04 kitchen install weight on sprayer hose 104 1/6/04 kitchen door trim to laundry room cracked by door nob 104 1/6/04 laundry missing cover for drain 104 1/6/04 laundry dryer vent trim ring 104 1/6/04 living nick in ceiling 104 1/6/04 mba caulk right side of vanity 104 1/6/04 mbr missing baseboard in closet 104 1/6/04 mbr missing shelving in closet 104 1/6/04 mbr missing switchplate in closet 104 1/6/04 mech install weather stripping. 104 1/6/04 mech patch holes in drywall 104 1/6/04 mech install threshold 105 1/6/04 2ndba sink drains slowly 105 1/6/04 2ndba one of the vanity lights not working 105 1/6/04 2ndbr closet doors missing 105 1/6/04 2ndbr closet shelves missing 105 1/6/04 balcony loose door handle 105 1/6/04 dining paint touch ups 105 1/6/04 kitchen refrigerator rocks 105 1/6/04 laundry doorknob missing 105 1/6/04 laundry missing floor drain 105 1/6/04 laundry couple leaks from water shutoff 105 1/6/04 living closet doorhandle missing 105 1/6/04 living closet shelf, rod missing 105 1/6/04 mba Isink drains slowly 105 1/6/04 mba I bathroom fan excessively loud 105 1/6/04 mbr doorknob missing 105 1/6/04 mbr sprinkler cover in closet missing 105 1/6/04 mbr closet shelves missing 105 1/6/04 mbr doorknob missing in closet 105 1/6/04 mech holes in closet 106 1/6/04 2ndbr outlet cover not installed 106 1/6/04 2ndbr this room is a DEN and should not have a door 106 1%6/04 2ndbr right window not staying up 106 1/6/04 2ndbr sprinkler head cover missing 106 1/6/04 balcony loose door handle 106 1/6/04 balcon sprinkler head trim missing 106 1/6/04 general no hot water 106 1/6/04 general no battery in thermostat 106 1/6/04 general paint touch ups needed 106 1/6/04 kitchen some cabinets missing bumpers 106 1/6/04 kitchen sink missing 106 1/6/04 kitchen disposal missing 106 1/6/04 kitchen paint touch ups 106 1/6/04 laundry trim ring on dryer vent 106 1/6/04 living smoke detector hanging from ceiling and is bagged 106 1%6/04 living closet shelves missing 106 1/6/04 mba whirlpool door not closed 106 1/6/04 mbr ding in wall in closet 106 1/,6/04 mech weatherstripping on door missing 106 1/6/04 mech holes in wall in closet 107 1/6/04 2ndba none of the lights work 107 1/6/04 2ndbr outlet by door to bathroom has piece of a plug in the ground 107 1/6/04 2ndbr closet doors not installed 107 1/6/04 2ndbr closet shelves missing 107 1/6/04 balcony doorknob loose 107 1/6/04 balcony door needs painting 107 1/6/04 balcony clean up from sprinkler leak 107 1/6/04 balcony carpet coming up in living room by door to balcony 107 1/6/04 dining needs painting 107 1/6/04 entry switchplate to be installed 107 1/6/04 entry peephole missing 107 1/6/04 kitchen trash compactor not installed 107 1%6/04 kitchen install bottom panel of dishwaser 107 1/6/04 kitchen patch hole in cabinet above microwave 107 1/6/04 laundry drain cover to be secured 107 1/6/04 laundry needs painting 107 1/6/04 living closet shelves missing 107 1/6/04 mbr missing cable outlet 107 1/6/04 mbr seam in baseboard 107 1/6/04 mbr closet to be painted 107 1/6/04 mbr sprinkler heads falling down in room and closet 107 1/6/04 mbr closet shelves missing 107 1/6/04 mech install weather stripping 107 1/6/04 mech patch holes in drywall 108 1/6/04 2ndbr closet door hardware missing 108 1/6/04 2ndbr closet shelves missing 108 1/6/04 2ndbr fa bump in wall next to cable outlet 108 1/6/04 entry paint touch up around entry door 108 1/6/04 general baseboards need paint 108 1/6/04 general paint touch ups 108 1/6/04 kitchen dimmer doesn't work (on/off no dim) 108 1/6/04 kitchen poor caulking job on the counter/backsplash install 108 1/6/04 laundry needs painting 108 1/6/04 living closet door handle missing 108 1/6/04 living ding in ceiling b/w heat vent and sprinkler 108 1/6/04 mech patch holes in drywall 108 1/6/04 mech install weather stripping/ door sweep 109 1/6/04 balcony doors not painted 109 1/6/04 bed baseboard not painted 109 1/6/04 bed align closet doors 109 1/6/04 bed closet door nobs missing 109 1/6/04 general flooring-thresholds, baseboard molding not finished 109 1/6/04 general baseboard needs paint 109 1/6/04 kitchen needs painting 109 1/6/04 kitchen backsplash to be caulked or remounted 109 1/6/04 living closet door not installed 109 1/6/04 living patio door nob loose 109 1/6/04 mba light not centered on vanity 109 1/6/04 mba needs painting 109 1/6/04 mech room patch holes in walls 109 1/6/04 mech room install weather stripping 109 1/6/04 mech room door rubs on floor 110 1/6/04 2ndba vanity light not working 110 1/6/04 balcony door handle is loose 110 1/6/04 entry deadbolt doesn't work 110 1/6/04 entry peephole missing 110 1/6/04 general both baths, entire kitchen and most baseboard need painting 110 1/6/04 eneral some cracks in crown molding 110 1/6/04 general Floor seperating 110 1/6/04 laundry door hardware not installed 110 1/6/04 laundry vent needs trim ring 110 1/6/04 mba lights not centered over medicine cabinet 110 1/6/04 mba sink drains slowly 110 1/6/04 mbr dent in bottom left window by lock 111 1/6/04 2ndba outlet sticks out by vanity 111 1V6/04 2ndbr window won't stay engaged 111 1/6/04 2ndbr door rubs on carpet 111 1/6/04 2ndbr crooked cable outlet 111 1/6/04 2ndbr closet doors not installed 111 1/6/04 2ndbr closet shelves not installed 111 1/6/04 2ndbr closet door knobs missing 111 1/6/04 entry missing door sweep 111 1/6/04 general needs lots of touch up or really an overall second coat 111 1/6/04 kitchen scratches in breakfast bar top nearest door 111 1/6/04 kitchen refrig needs to be secured 111 116/04 kitchen missing drawer to L of dishwasher 111 1/6/04 kitchen missing stopper for disposal drain 111 1/6/04 kitchen big hole in back of lazy susan 111 1/6/04 kitchen left most top cabinet door to be re -aligned (shows big gap when viewed from side) 111 1/6/04 kitchen no water to dishwasher 111 1/6/04 kitchen stove rocks 111 1/6/04 kitchen needs painting 111 1/6/04 laundry missing left laundry handle 111 1%6/04 laundry doors don't stay closed 111 1/6/04 laundry laundry doors damaged at bottom 111 1/6/04 living thermostat needs batteries/no power 111 1/6/04 living closet doors not installed 111 116/04 mba slow sink drain 111 1/6/04 mba needs painting 111 1/6/04 mbr closet door knobs missing 111 1/6/04 mbr closet shelves not installed 111 1/6/04 mbr door rubs on carpet 111 1/6/04 mech touch up around pipes 112 12/31/03 2ndba missing threshold 112 1/6/04 2ndba missing threshold 112 12/31/03 2ndbr carpet install not finished, no threshold 112 12/31/03 2ndbr closet doors not installed 112 12/31/03 2ndbr closet shelving not installed 112 1/6/04 2ndbr closet knobs not installed 112 1/6/04 2ndbr crooked cable outlet 112 1/6/04 2ndbr missing threshold 112 1/6/04 entry missing door sweep 112 1/6/04 entry missing threshold 112 12/31/03 kitchen install appliances 112 1/6/04 kitchen hardwood floor not finished to edge under appliances 112 1/6/04 kitchen appliance install not fininshed 112 1/6/04 kitchen wrong refrigerator in unit- should be stainless steel 112 1/6/04 kitchen hole to be patched above backsplash above outlet 112 12/31/03 laundry doors don't stay shut 112 12/31/03 laundry drain missing cover plate 112 12/31/03 laundry door hardware missing 112 1/6/04 laundry doors don't stay closed 112 1/6/04 laundry right bottom door damaged 112 1/6/04 laundry left door handle missing 112 12/31/03 living mantle is pulling away from wall 112 1/6/04 living hardwood floor not finished to edge in closet 112 1/6/04 living closet doors not installed 112 1/6/04 living wood floor separating by transition to carpet in living room 112 12/31/03 mba needs second coat of paint 112 1/6/04 mba tub is damaged 112 1/6/04 mbr door rubs on carpet 112 1/6/04 mbr missing threshold 112 1/6/04 mech weatherstripping mech room door 112 1/6/04 overall needs lots of touch up or really an overall second coat 112 1/6/04 overall closet door knobs missing Please Reply to: P.O. Box 1526 • Littleton, MA 01460 • (978) 486-9877 • Fax (978) 952-2408 CONCORD LUMBER CORPORATION LITTLETON LUMBER THE ARCHITECTURE DEPARTMENT ROBERT J. VORBACH - ARCHITECT P.O. BOX 1526 - 55 WHITE STREET LITTLETON, MA 01460 TELEPHONE: 978-486-9877 FAX: 978-952-2408 DATE: 12-18-03 BUILDING DEPARTMENT - INSPECTIONAL SERVICES NORTH ANDOVER, MASSACHUSETTS RE: KITTREDGE CROSSING BUILDING 1 FINAL LETTER PER COMPLETION Dear Sirs, The Architecture Department at Littleton Lumber, Robert J. Vorbach, Architect has supervised the design of and the construction drawings for the above mentioned project, as well as provided on site administration during construction. This office certifies to the best of our knowledge that the building is in compliance with all local, state, and national code mandates as they apply to the project type, and scope. ARoll Sincerely, �c$`��. vo 21 No. 908 BOSTON. MASS. J Robert J. Vorbac q-sP'- The Architecture De Littleton Lumber - Littleton, Massachusetts Concord Lumber Littleton Lumber Littleton Millwork Kitchen Works 126 Lowell Road, Concord, MA 55 White Street, Littleton, MA 2 Omega Way, Littleton, MA 69 Great Road, Acton, MA Final Report of Special Inspections Project: Kittredge Crossing, Building I Location: North Andover, MA Owner: Terra Properties, LLC General Contractor: Opechee Construction Corporation 11 Corporate Drive Belmont, NH 03220 Architect of Record O echee Construction Corporation, Belmont, NH Structural Engineer of Record: .ISNAssociates, Inc., Portsmouth, NH To the best of my information, knowledge and belief, the special inspections required for this project, itemized in the Statement of Special Inspections submitted for permit, have been performed and discovered discrepancies have been reported. Comments: (Attach 8 1\2," X 11" continuation sheets if required to complete the description of corrections.) Interim reports submitted prior to this final report form a basis for, and are to be considered an integral part of this final report. Respectfully Submitted, JSN Associates, Inc. Registration Seal Special Inspector Hossein Salehkhou, P.E. (Type or Print) One Autumn Street Portsmouth, NH 03801 %A OFHOSSEIN �^ SA EHKHOU o STRUCTURAL gna re No. 38367 / O �CtSTEP�� CONAL Date DEC 10"2003 BY.-------------------- CONSTRUCTION AFFADAVIT INTERMEDIATE CONSTRUCTION DATE: Adm PROJECT: Kittredge Crossing 200 Chickering Road North Andover, MA LVR Corporation PROFESSIONAL. ENGINEERS CONSTRUCTION SERVICES 88 FOUNDRY STREET WAKEFIELD. MA 01880 TEL: (781) 245-9888 FAX: (781) 246-0330 In accordance with Section 116.0 Construction Control of 780 CMR Massachusetts State Building Code, 6th Edition, 1, Lawrence V. Roy, being a Massachusetts registered professional engineer (No. 34505 & 38913) certify that I or my authorized representative have inspected the installation of electrical and fire alarm systems at the above -referenced project on the date(s) shown below. The work completed to date is as described below and in compliance with applicable plans and specifications, which have been designed in accordance Massachusetts State Building, Code 780 CMR, 6th Edition, National Electrical Code, and Massachusetts Electrical Code. Please contact me with any questions or comments. Thank you, Inspection Date: %O9 15"'1V& Buildings Inspected: `../ 2 3 4 S Work Observed & Comments: E rjyl_sll 15?'C__CTV91C0ft_. >' �Y� S. Engineer - MA Reg. No. Lawrence V. Roy, 34505 LVR Corp 88 Foundry Street, Wakefield, MA 01880 (781)245-9888 fire protection • mechanical • electrical • 103 Francestown Road Greenfield, NH 03047 Telephone (603) 547-2251 Fax (603) 547-2253 E-mail miccd@localnet.com December 1, 2003 Project: Kittredge Crossing 200 Chickering Road Building 1 North Andover, MA As per Section 116.0 of the Massachusetts State Building Code, i hereby ceitify that I, or my authorized representative, have conducted .inspections of the Plumbing & Gas systems at the above referenced project on a regular basis. The work completed is installed in compliance with the applicable plans, specifications & the Massachusetts State Plumbing & Fuel Gas Code. If you have any questions or comments, please do not hesitate to call. i cerely, Joel Gordon, P.E. OF JOEL � GORDON \ MECHANICAL No. 31392 ,off '� • 4' S�ONAL Pluming �Aezgn Seruce . . . . ....................... . CONTROL CONSTRUCTION - SECTION 116.0 M.S.B.C. CERTIFICATE OF ENGINEERING/ARCHITECTURE BUILDING INSPECTOR TOWN OF NORTH ANDOVER 27 CHARLES STREET NORTH ANDOVER MA 01845 GENTLEMEN: I, MARK VINCELLO, HEREBY CERTIFY THAT THE HVAC SYSTEMS AT THE KITTREDGE CROSSING APARTMENT BUILDING NO. 1 ON ROUTE 125 IN NORTH ANDOVER MASSACHUSETTS TO THE BEST OF OUR KNOWLEDGE CONFORM IN ALL RESPECTS TO THE MASSACHUSETTS STATE AND LOCAL BUILDING CODE AND APPLICABLE FEDERAL REGULATIONS. AUTHORIZED SIGNATURE: DATE: REGISTRATION: NOTE: ENGINEER "WET STAMP" MUST BE AFFIXED TO THIS FORM. OF L MAR. VINCELL® � No. 35748 FSSlONAL ���' Town of North Andover`CRTH Building Department �Ri_� �g�A+ 27 Charles Street North Andover, Massachusetts 01845 _ (978) 688-9545 Fax (978) 688-9542 O [D[HI[M,YVKp 7 APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS -- Gw P -b I�17 00 1- 3 1 l C� LOT NUMBERSUBDIVISION \ aC �o DATE REQUEST FILED DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED ALL WORD AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. - WATER METER ATE 7Z D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. 1.2 SIGNATURE-/ DPW AUT 1V Town of North Andover AOR Building Department a4�� 'g�� 0 27 Charles Street 0 1 ; North Andover, Massachusetts 01845 _ (978) 688-9545 Fax (978) 688-9542 y�" LOLNI[ YJ{ W%M CHU��� APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS b �. 1 L k P� j 1,� �-r T� U f T- 3 U LOT NUMBER SUBDIVISION �ie,c� �J CA0az"( DATE RE QUEST FLET _ �V, t J DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. — WATER METER DATE / D� D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED R TO THE INSPECTION REQUEST DATE. SIGNATURE / DPW T ORIZATION Town of North Andover AOR Building Department 0 27 Charles Street North Andover, Massachusetts 01845 _ (978) 688-9545 Fax (978) 688-9542 � 04ATED A�a`y°�jGi is"Sq HUS APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS KI 0 Gr .b IST) U I fi �6 Oct C LOT DATE REQUEST FILED DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN -OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. - WATER METER DATE �% U D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR. TO THE INSPECTION REQUEST DATE. SIGNA / DPW AU RIZATION Town of North Andover Building Departments 27 Charles Street North Andover, Massachusetts 01845 -W (978) 688-9545 Fax (978) 688-9542 cwu APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS NO U\Lk GZj 0 C -r _P_b pT) U I _r �� 3o LOT NUMBER SUBDIVISION i DATE REQUEST FILED DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D_P.W. —WATER METER DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE/ DPW AUTHO ION p6K Town of Forth Andover � ORT I Building Department, `�� �, 0 27 Charles Street 0 North Andover, Massachusetts 01845 41 (978) 688-9545 Fax (978) 688-9542 cocHinvwx. APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS d U\C ,GQ 1 0 Gr 1-1b 6l) U.0 I T 301 LOT NUMBER SUBDIVISION DATE REQUEST FILED I.LQ C DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W..—WATER METER - DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIO O THE INSPECTION REQUEST DATE. SIGNATURE / DPW AUTHO TION l6K Town of North Andover OORTH Building Departments ?`E `, a �� ^g 0 27 Charles Street North Andover, Massachusetts 01845 _ (978) 688-9545 Fax (978) 688-9542 [o[H [n[wx■ AMU����� APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS tg() C-k\Ue7,-1►U& 'Plk-T) U0 A r 30% C- LOT LOT NUMBER SUBDIVISION4-yy �sso� DATE REQUEST FILED oA DATE READY FOR INSPECTION \ V1 TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. — WATER METER DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SI NA / DPW AUTH TION Town of North Andover F-r Building Department 27 Charles Street 0 ; North Andover, Massachusetts 01845 _ (978) 688-9545 Fax (978) 688-9542 (o(HK Nd WKp 7\ APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS U\Ck-eZj 0 C,- P -b {el7 Li g 36 5 C- LOT DATE REQUEST FILED 1 \ VL9 W DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED ALL WORD AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. — WATER METER�� DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SI NA / DPW AUTH ATION a6K Town of North Andover Building Department �4, _� ���a 0 27 Charles Street North Andover, Massachusetts 01845 _ (978) 688-9545 Fax (978) 688-9542 COiN [NCiVKM TED l.P�a°qGi APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION A, - ADDRESS I fib 304 C— LOT LOT DATE REQUEST FILED DATE READY FOR INSPECTION T 6 TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIl2ED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. — WATER METER D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRI TO THE INSPECTION REQUEST DATE. SIGNATURE / DPW AUTHO �JOJN� i bK Town of North Andover by Building Department .� g5T` �4� 27 Charles Street ; North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 C��� APPLICATION FOR CERTIFICATE OF OCCUPANCY/ INSPECTION ADDRESSi b C1�L kCT'`� �r .P -b {-Ti U I6 305 LOT NUMBER SUBDIVISION 'C \l i , tJ— ' DATE REQUEST FILED A l (, 1 q DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUMED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. —WATER METER DATE z� / D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. 9X SIGNATURE / DPW AUT ATION MIN Town of North Andover � Building Department�s`� 'g�6 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 O t rtis 1� .Y'k CHUS CO[MI[N2 iVXN APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS _ 1�� CN\C;k n`i AeD U i T— LOT NUMBER SUBDIVISION 1. �"ss I (. DATE REQUEST FILED �\Lp k DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. - WATER METER ATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED P O THE INSPECTION REQUEST DATE. SIGNATURE / DPW AUTHORICATION Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 0ORT �� [ocwitwtwxw APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS HO CA 1 U k e LOT NUMBER DATE REQUEST FILED DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P. W.. — WATER METE �Q DATE D.P_W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE / DPW AUTH TION 55� n� Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 SORT 0 ti MIN APPLICATION FOR CERTIFICATE OF OCCUPANCY I INSPECTION ADDRESS ISO U C k GQ %r P -b Ie17 U1 fi LOT NUMBER DATE REQUEST FILED \ _ \ U0 DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED 3Sir-q ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. -WATER METER InSfA,11--ed- DATE 12./ 3/ d D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTIO REQUEST DATE. IGNATURE / DPW AU O ATION Town of North Andover tAORTH Building Department, 0 27 Charles Street 0 North Andover, Massachusetts 01845 _ (978) 688-9545 Fax (978) 688-9542 O cocwiHtwecp �' D . p'4ATSD APa _sa� APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS 1 b GIS L k n`.i iJ G .P -b A;D U f r al I C LOT DATE REQUEST FILED DATE READY FOR INSPECTION d_q rA TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. —WATER METER 1O.S+a-11-ed- DATE IZ 0 D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE IN PECTIO REQUEST DATE. SIGNATURE / DPW AUTH TION i�� Town of North Andover OORTH .� Building Department �S'gib Hca 27 Charles Street 0� North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 p cm HI[w41VKw 7 ->®�ApARss» APS - APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS n`-1 0 Cr .p -b fVn l7 { fimC- LOT DATE REQUEST FILED DATE READY FOR INSPECTION .SUBDIVISION. oiA , TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIIZED ALL WORD AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS T k4E FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P. W. — WATER METER DATE i D_P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO INSPECTION REQUEST DATE. SIGNATURE / DPW AUT ATION Town of North Andover OORTH Building Department �� 'i;` 27 Charles Street North Andover, Massachusetts 01845 4 _ (978) 688-9545 Fax (978) 688-9542 w CDLNI[N; WKM \ r TS 0 3A APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS Rb AD U0 1 T- LOT NUMBER SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ME ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. —WATER METER 1 V)S+a j I -P cL DATE 1 D_P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE / DPW AUTHO ION M� Town of North Andover Building Department T4w 'g�$ 0 27 Charles Street 0 North Andover, Massachusetts 01845 _ (978) 688-9545 Fax (978) 688-9542 rocwiHiwKw � 's MUS CHUS APPLICATION FOR CERTIFICATE OF OCCUPANCY I INSPECTION ADDRESS i �. 1Lk Q -I 1,) �r .p -b AT) I .fi aoff C- LOT NUMBER SUBDIVISION DATE REQUEST FILED �Q t OA DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. — WATER METER jjj �DATE (Z' �b D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR THE INSPECTION REQUEST DATE. SIGNATURE / DPW AUTHO TION Town of North Andover FORTH Building Department,? 0 27 Charles Street ; North Andover, Massachusetts 01845 _ (978) 688-9545 Fax (978) 688-9542 COC HI[NDnKN 7' �QDRATlD CRUS APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS -- �, L Q-1 0 Cr .P -b 4,T,) U I r LOT NUMBER SUBDIVISION \ �C, DATE REQUEST FILED 1 �Lc � 0 �-I DATE READY FOR INSPECTION I I21\ TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W..—WATER METER jn&+at1-fd DATE 17— 13 /03 D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE / DPW AUTHO TION Town of North Andover Building Department, ; ` 27 Charles Street North Andover, Massachusetts 01845 _ (978) 688-9545 Fax (978) 688-9542O'VATED 0' cocH[Hewx■ APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS 1 Q CAA \C�,e'7-1 0 Cr p -b A;D f LOT NUMBER SUBDIVISION 1 I��Q. C 5S1 DATE REQUEST FILED � 0 G DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WELL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. —WATER METER In c, I—a 11- DATE 12-/ --3, / O 3 D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE / DPW AUTHO A ION Town of North Andover ;AO Building Department `; �� �s� 0 27 Charles Street North Andover, Massachusetts 01845 _ (978) 688-9545 Fax (978) 688-9542 o c c.niivrecw � '� ' Teo APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS _ Q LA U %r P—b 1VT) l i _fi o�p C- LOT LOT NUMBER SUBDMSION l Y- DATE REQUEST FILED I� P dLi DATE READY FOR INSPECTION 1 11-t TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORD AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P. W. — WATER METER I VIS%a 11-P c - DATEz -2 D D-P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRS TO THE INSPECTION REQUEST DATE. SIGNATURE / DPW ALJ 11Z ATION Town of North Andover� tAORTH Building Departments 0g'4`� � 27 Charles Street ; North Andover, Massachusetts 01845 41 _ (978) 688-9545 Fax (978) 688-9542 COCHI[ '; ivKN APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS i bi H\ L k j'� I L .P -b An 0 I fi d C;2 LOT NUMBER SUBDIVISION k� f j 5 DATE REQUEST FILED ) I' DATE READY FOR INSPECTION I \ Z:v I O TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIltED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE _ OFFICIAL USE ONLY ROUTING D.P.W. — WATER METER 05+6t i e o DATE 1 Z' 3 / o D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE/ DPW AUTHATION Iff, Town of North Andover I AORT14 � Building Department ; ` 'g `bn o 27 Charles Street North Andover, Massachusetts Ol 845 (978) 688-9545 Fax (978) 688-9542 O = IANi 7\ C HU HU CDLNIf piWXM APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS 19 () Q-1 .0 (r P—b AeT) 00 1 fi 4e 03 C LOT NUMBER SUBDIVISION_LA�(kII V J�l DATE REQUEST FILED DATE READY FOR INSPECTION I I til I U `'I TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. —WATER METER i/1S DATE /U D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNA DPW AUTHO TION I/ 1 Town of North Andover :40R'rh Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 _ COr ryl[MT'NNK \ 4ATeD D.Pa~.��'S ACHUS APPLICATION FOR CERTIFICATE OF OCCUPANCY] INSPECTION ADDRESS , Q CJl\Ck,eZI U & .P -b Pk -T:) L1 f rt` . LOT NUMBER SUBDIVISION t p , 55 1 hZ DATE REQUEST FILED ` Lo DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. — WATER METER DATE /a -l-3 /0 3 D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SI NATURE / DPW AUTHO TION Town of North Andover � :AORTH Building Department �g',,� *a 0 27 Charles Street �0 ; North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 " +t CO{NILXC iY!f N Areo APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS (r —0 AT) UA j -r LOT NUMBER SUBDIVISION A1141 DATE REQUEST FILED , ' LP �()q DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORD AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P. W. — WATER METER DATE D� D.P_W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PAIQR Tq, HIE INSPECTION REQUEST DATE. SIGNATURE / DPW A,KTANRIZATION Town of North Andover ORTH Building Department 27 Charles Street 1 �' North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 w CDCHI[Yt{WXM \ r Q01fAT110 uses APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESSi b N 1 L k �j'`.i (P—b IST) l i Q I fia 1 i LOT DATE REQUEST FILED DATE READY FOR INSPECTION I 1T 1 D TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. —WATER METER II -4 DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED 7TO THE INSPECTION REQUEST DATE. SIGNATURE / DPW AUTH ATION Town of North Andover �� :AORTH Building Department �'`� 4a�4'�. 27 Charles Street 1 �` North Andover, Massachusetts d 1845 (978) 688-9545 Fax (978) 688-954240 CP!HI[H7'NKM APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS b �. 1Gk � (r .P -b IST) u E fi 1 I LOT NUMBER SUBDMSION DATE REQUEST FILED DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P. W. — WATER METER I n, 4 -a,11 -ed DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE / DPW =THO TION Town of North Andover'q!T�h Building Departments` 27 Charles Street' North Andover, Massachusetts 01845 _ (978) 688-9545 Fax (978) 688-9542 CDL HI[ Zw1iM 1 '� ��S CWU S � APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS GN \ L �' P M.� (r P—b k 1 i 1' 1 a 1 16) C LOT DATE REQUEST FILED I I KP DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED ALL WORK AND SIGN—OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE—INSPECTION FEE OF TWENTY—FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. —WATER METER W4a-(I7-d DATE /:2)C/L D_P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE / DPW AUTAOkIZATION Town of North Andover I Building Department 27 Charles Street 0 North Andover, Massachusetts 01845 W 978 688-9545 Fax 978 688-9542 [OLNI[Ni YVYN APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS t:-R\U GQ Q C -r P-0 jVD LOT DATE REQUEST FILED WO +� DATE READY FOR INSPECTION i �0 TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIlZED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE _ OFFICIAL USE ONLY ROUTING D.P.W..— WATER METER ! r -)S jZ;c/ 1-P d DATE _ /--,- )(do D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED P TO THE INSPECT ON REQUEST DATE. SIGNA / DPW AUT ATION Town of North Andover :����� Building Department, � ?`� 27 Charles Street ; North Andover, Massachusetts 01845 _ 978 688-9545 Fax 978 688-9542 4t [DGN tt�WXM AT** . C, APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS 190 U\Gk.G(-r .P -b JVT) U I fi� / ox C LOT NUMBER SUBDIVISION &A. ' OAOSS t Y� DATE REQUEST FILED oL1 DATE READY FOR INSPECTION I I ZM O TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIlZED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. — WATER METERded DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO T INSPECTION REQUEST DATE. SIGNATURE / DPW A ORIZATION Town of North Andover . OORTH � Building Department,�� ; `. a Ria 0 27 Charles Street a North Andover, Massachusetts 01845 41 _ 978 688-9545 Fax 978 688-9542 coc�iHowec■ APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS /07 L LOT DATE REQUEST FILED DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED ALL WORD AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. — WATER METER hn-`a l) to d DATE 12-/ D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. GNATURE / DPW AUTH ATION Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 4, 0 r1h4 DLNILX; WKN APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS i b t 1Ck.eZ-1 1 c .P—b ATS L1 ! .T- -,I-e l i0 C LOT DATE REQUEST FILED h I l( 1 b DATE READY FOR INSPECTION I K A�Aco xo'5'�� TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. - WATER METER I nS+a 11 -ed DATE Z 11 qfL(—)3 D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SI ATURE / DPW AUTHO ATION Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS 1 � b L 1L �n�-�_ ►J G P -b ATS U k) i -r LOT DATE REQUEST FILED DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORD AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P. W. - WATER METER in DATE D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SI NATURE / DPW AU ATION z6K Town of North Andover Building Department 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 �1 =A �• COL NIt L%'/%M 7\ APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS , Cil\�%k �P�.j 1.) �c P -b lin 1 r 101+ C LOT DATE REQUEST FILED DATE READY FOR INSPECTION t TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUMED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. -WATER METER InS- 11 f d_ DATE l -2-1 lo -:5 D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNA / DPW A T RIZATION Town of North Andover� .,A0R�� Building Department r0 0 27 Charles Street North Andover, Massachusetts 0.1 845 (978) 688-9545 Fax (978) 688-9542 CCIGMI[NLWKM \ SA HUS APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS 190 &k 1 L k C LOT DATE REQUEST FILED DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORD AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. —WATER METER (5- (t- DATE �ZI LI/(j 3 D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE / DPW AUT ATION i� Town of North Andover ; OR � Building Department,�?`� 27 Charles Street North Andover, Massachusetts 01845 -W (978) 688-9545 Fax (978) 688-9542 q COC HICK;'MKN rQ `y APPLICATION FOR CERTIFICATE OF OCCUPANCY I INSPECTION ADDRESS C,4A1UGQ 0 (-r P_b AT�) U fi b 10 :2— 'L LOT NUMBER SUBDIVISION DATE REQUEST FILED vA DATE READY FOR INSPECTION I I :), . TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED ALL WORK AND SIGN -OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. -WATER METER jl1S-tZjed DATE / D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE / DPW ORIZATION { Town of North Andover RTH age Building Department, 27 Charles Street North Andover, Massachusetts 01845 _ (978) 688-9545 Fax (978) 688-9542 COL NIL N;WKM \ HU APPLICATION FOR CERTIFICATE OF OCCUPANCY / INSPECTION ADDRESS b U\LUeZj 0 (,- 10 ( C LOT NUMBER' SUB DIVISION,,�i{��C DATE REQUEST FILED L DATE READY FOR INSPECTION TEN (10) DAYS NOTICE PRIOR TO CLOSING DATE IS REOUIRED ALL WORK AND SIGN-OFF'S MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY-FIVE ($25.) DOLLARS WILL BE CHARGED IF THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES. SIGNATURE OFFICIAL USE ONLY ROUTING D.P.W. - WATER METER ATE D_P_W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIOR TO THE INSPECTION REQUEST DATE. SIGNATURE /DPW ORIZATION wv engineering associoTes po PC Box -76c1 keene new hamp5hire 05451 605 352 7007 January 14, 2004 Mr. D. Robert Nicetta Building Commissioner Town of North Andover 27 Charles Street North Andover, MA 01845 Re: Kittredge Crossing Apartment Buildings WVA Project No. 03009 Dear Robert: As discussed on site on December 16`x', the water heaters and air handling units are installed in the same mechanical closet in the 'T' units: There are no code restrictions which prohibit this equipment from being installed in the same space. In order to .replace the water heaters, the air handling units will need to be temporarily removed. There is no code restrictions which prohibits removal of one piece of'equipment to replace another. Very truly yours, WV Engineering Associates, PA Mark D. Vincello, PE cc: Mr. John Salizzoni Accurate Air Mr. Mark Williams Opechee Construction Corporation e [�. CJ VINCELL® ZAA No. 35748 µOft T), ' O D Y Y y ; 7SSA`H�6E' CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 265 (11-13-02) Bate• TanuarX 30, 2004 THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAYBE OCCUPIED AS Unit #101 -- TWO BEDROOM UNIT ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGUALTIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTON STREET, NORTH ANDOVER MA 01845 Building Inspector of NQftTH 9N � � A f � W yySSNCHUSE `y CERTIFICATE OF USE & OCCUPANCY Building Permit Number 265 (11-13-02)Date: January 30, 2004 THIS CERTIFIES THAT TBE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAY BE OCCUPIED AS Unit #102 -- TWO BEDROOM UNIT µIN ACCORDANCE WITR THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 4,lT° ET, NO NDO�ER, MA 0184.5 Building Inspector Of NORTH A igen .e q0 AS e �ZShCHUS' CERTIFICATE OF USE & OCCUPANCY Building Permit Number 265 (11-13-02) Date: January 30, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich Building MAY BE OCCUPIED AS uNTT # 103 -- ONE gFDR00M UNTT IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC �3 N STRE ORTtI ANDOVER, MA 01845 Building Inspector Of ,NOR7p ,N # i r # �'TSACHOS�S CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 265 (11-13-02) Date' January 30, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAYBE OCCUPIED AS UNIT # 104 -- TWO BEDROOM UNIT ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGUALTIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLE =.. 2231 SUTTON STREET, NORTH ANDOVER, MA 01845 Building Inspector P� HORTH RH ySSaCHUS CERTIFICATE OF USE & OCCUPANCY Building Permit Number 265 (11-13-02) Date: January 30, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Buildi h MAYBE OCCUPIED AS UNIT #105 --TWO BEDROOM UNIT IN ACCORDANCE WITH THE PROVISIONS -OF -THE MASSACHUSETTS -STAT -10 GCODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUFD TO: TERRA PROPERTIES, LLC 231UT . EET, N ANDbVER A 01845 `J Building. Inspector Of ,NORTy 4ti O •�a �9SSACHUSE� 5 CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 265 (11-13-02) Date: January 30, 2004 THIS CERTIFEES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAYBE OCCUPIED AS UNIT #106 -- ONE BEDROOM UNIT ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGUALTIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTO STREET, ORTH'ANDOVER, MA 01845 Building. Inspector CERTIFICATE OF USE & OCCUPANCY ME JIM -1779 Building Permit Number 265 (11-13-02) Date: January 30, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAY BE OCCUPIED AS UNIT #107 -- TWO BEDROOM UNIT *IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTON STREET, NORTH ANDOVER, MA 01845 Building Inspector Of pORTN 4N ' O 0 04 ��aSACHUS M1� CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 265 (11-13-02) Date: January 30, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road - "Ipswich" Building MAY BE OCCUPIED AS UNIT # 108 -- TWO BEDROOM UNIT ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGUALTIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTON STREET ORTH•ANDOVER, MASO1845 Building Inspector NO oTH oF�,i a'4 obi Y Y YSSNtNUSEt CERTIFICATE OF USE & OCCUPANCY Building Permit Number 265 ( 11-13-02) Date: January 30, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "I.pswich" Buildin MAY BE OCCUPIED AS UNIT # 109 -- ONE BEDROOM UNIT IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTON STREET,.NORTH ANDOVER, MA 01845 B ' ding Inspector R.. 1N � A 9 �4S'TNCNUSE{ . CERTIFICATE OF USE & OCCUPANCY Building Permit Number 265 (11-13-02) Date: January 30, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAYBE OCCUPIED AS UNIT #110 -- TWO BEDROOM UNIT ACCORDANCE WITH T. PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGUALTIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTON STREET, NORTH ANDOVER, MA 01845. µORTN bf< �"qN0 y"SACNUS CERTIFICATE OF USE & OCCUPANCY Building Permit Number 265 (11-13-02) Date: January 30, 2004 C.1 RX Q AR I 1 THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAYBE OCCUPIED AS UNIT #111 -- TWO BEDROOM UNIT IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTON STREET, NORT DOVER, M01845 `J Building Inspector y�S=gcRus tia CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER BuildingPermit Number 265 (11-13-02) Januar 30 2004 Date: y , THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAYBE OCCUPIED AS iIl1iTT # 1 1 y __ Two RFnRnnM UNIT ACCORDANCE VYITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGUALTIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTON STREET, ORTH ANDOVER, MA 01845 Building Inspector a. �SSRC104ti5ES CERTIFICATE OF USE & OCCUPANCY gJ W '1' AlTN OF 1 6111.8 ANDOWER O AJP. Building Permit Number 265 (11-13-02) Date: January 30, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED MAY BE OCCUPIED AS UNIT #201 -- TWO BEDROOM UNIT IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTON STREET, NORTH ANDOVER, MA 01845 Building Inspector O`,I+ORTM .qNo }_ .� fes, `� • t .y a ��sstcwu��`54y CERTIFICATE OF USE. & OCCUPANCY TOWN OF NORTH ANDOVER THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- " Ipswich" Building MAY BE OCCUPIED AS UNIT #202 -- TWO BEDROOM UNIT ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTTIER REGUALTIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIESTi. LLC 231 SUTTON STREET, NORTH ANDOVER, MA 01845 t • Buitding Inspector of µOR'flf 9k �ZZACHUSE� CERTIFICATE OF USE & OCCUPANCY Building Permit Number 265 (11-13-02) Date: January 30, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAY BE OCCUPIED AS UNIT. #203 -- ONE BEDROOM UNIT ' IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTON STRE T, NORTH DOVER 01845 B 'ding Inspector f NpNT!(, ti . A C % Y n��a y '4f •O+ o �"4y SSACH�S�� CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 265 (11-13-02) Date: January 30, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAY BE OCCUPIED AS UNIT #204 -- TWO BEDROOM UNIT ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGUALTIONS AS MAY APPLY. CERTIFICATE ISSUED TO TERRA PROPERTIES, LLC 231 SUTTON STREET, NORTH ANDOVER, MA 01845 Building Inspector Of pORTH q MO a ° F O � � � a # � N 3 9" 4'rSxcHus�t'f' CERTIFICATE OF USE & OCCUPANCY Building Permit Number 265 (11-13-02) Date: January 30, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAY BE OCCUPIED.AS UNIT #205 -- TWO BEDROOM UNIT 'IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRASPROPERTIES, LLC 231 SUTTON STREET, NORT NDOVER, MA 01845 .. `J Building Inspector °t HOflTH qry . k s o i r 9SSACHUS£Z . CERTIFICATE OF USE & OCCUPANCY Building Permit Number 265 (11-13-02) Date January 30, 2004 THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAY BE OCCUPIED ASUNIT . #206 -- ONE BEDROOM UNIT ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGUA]LTIONS AS NIAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTON STREET, NORTH ANDOVER, MA 01845 Building Inspector Cr •4ORT" Ay O • }2 a OL r r �SSACHU`+E{ ' CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit NumbCT 265(11-13-02) Date' January 30 2004 01 RIN pis 11.31 THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAYBE OCCUPIED AS Unit #208 -- TWO BEDROOM UNIT ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGUALTIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTON STREET NORT11 ANDOVER, MA 01845 Building Inspector f NORTH A i Y ♦ Y r4. sSACH�SE CERTIFICATE OF USE & OCCUPANCY Building Permit Number 265 (11-13-02) Date: January 30, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAY BE OCCUPIED AS UNIT #207 -- ONE BEDROOM UNIT IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLE'. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTON STREET, NOR NDOI NA 01845 Building Inspector Of HON TN �N s 41-lu s Y SACHUS j CERTIFICATE OF USE & OCCUPANCY Building Permit Number 265 (11-13-02) Date: 3n„ary .3 l , 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAY BE OCCUPIED AS UNIT #209 -- ONE BEDROOM UNIT ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGUALTIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTON..STREET, NOJaH ANDOVER, MA 01845 `J Building Inspector E Koerh i 4Ss�IRMU5gt CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER E Building Permit Number 265 (11-13-02) Date; January 30, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAY HE OCCUPIED AS UNIT #210 -- ONE BEDROOM UNIT 'IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO TERRA PROPERTIES, LLC 231 SUTTON STREET, NORT DOVER, MAA01845 Building Inspector KoxrN �pa�r�ea .a ykOQ`. 4 9 * ; a Ory >ta+.a Nit( S�wCNUl¢ CERTIFICATE OF USE & OCCUPANCY Building Permit Number 265 (11-13-02) Date January 30, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAY BE OCCUPIED AS. T #21�1� -- TWO BEDROOM UNIT ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGUALTIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, L 2 TREET, `h N A 01845 Building Inspector o. CERTIFICATE OF USE & OCCUPANCY Building Permit Number 265 (11-13-02) Date: January 30, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Buildin MAY BE OCCUPIED AS UNIT #212 -- TWO BEDROOM UNIT IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTON STREET, NORTH ANDOVER, MA 01845 'ding Inspector Of HORT1/ 1H . O �ySSHCHO°+ES CERTIFICATE OF USE & OCCUPANCY Building Permit Number 265(11-13-02) Date: January 30 2004 THIS CERTIFIES THAT THE BUILDING (LOCATED ON 180 Chickering Road -- "Ipswich" Building MAYBE OCCUPIED AS UNIT #301 -- TWO BEDROOM UNIT ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGUALTIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTON STREET, TH ANDOVE MA 01845 ` J� Building Inspector 1 fAO qT" • 1 �SSRCNU�kt CERTIFICATE OF USE & OCCUPANCY Building Permit Number 265 (11-13-02) Date: January 30, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAY BE OCCUPIED AS UNIT #302 -- TWO BEDROOM UNIT `IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTON STREET, NORTX ANDOVER, MA 01845 ding Inspector Of s s S k SSACiiUe W��49 Sej CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 265-(11-13-02) Date: January 30, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAY BE OCCUPIED AS UNIT #303 -- ONE BEDROOM UNIT ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGUALTIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTON STREET, NO ANDOVER A_01845 Building Inspector OM „ O pra AN yY,?SvR�rcv °��t.(vJ SHCHI��E CERTIFICATE OF USE & OCCUPANCY Building Permit NuMber 265 (11-13-02) Date: January 30, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building. MAY BE OCCUPIED AS UNIT #304 -- TWO BEDROOM UNIT JW ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTON STREET, NORTH 4NDOVER, MA 01845 Building Inspector 4 µOR7l, h � A R k �SSgCNU`aES CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 265 (11-13=02) Date: January 30, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAY BE OCCUPIED AS UNIT #305 - TWO BEDROOM UNIT ACCORDANCE WrM THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGUALTIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTON STREET, NORTH ANAOVER, MA 01845 'J. Building Inspector tl Of `NOR704 A� O i d! . �4SSRGN�`5Ett9 .. GER T`I,FICA1'E OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 265 (11-13-02) Date: January 13, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAY BE OCCUPIED AS UNIT #306 -- ONEBBEDROOM UNIT IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTON STREET, NORTH ANDOVER, MA 01845 g Spector OF tLORTH Ay 41 • r. �•%,fSACiiUS�'K 5 CERTIFICATE OF USE & OCCUPANCY Building Permit Number 265 (11-13-02) Date: January 30, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAY BE OCCUPIED AS UNIT #307 -- TWO BEDROOM UNIT IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTON STREET, NORTH 1\ANDOVER, MA 01845 Binding Inspector Of NORTH q e 00 t Y 1SSACNUS CERTIFICATE, OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 265 (11-13-02) Date: January 30 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAY BE OCCUPIED AS UNIT #308 -- TWO BEDROOM. UNIT ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGUALTIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC . 231SUTTONSTREET., NO TH ANDOVER, MA `J Building Inspector i- O y. Y �, 11 Air SSACHpSEt CERTIFICATE OF USE & OCCUPANCY Building Permit Dumber 265 (11-13-02) Date. Tan,,ar34 10, 20Q4 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAY BE OCCUPIED AS UNIT #309 -- ONE BEDROOMMIUNIT IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO: T�P,r ra Properties, LLC ��l Sutto�Stre�ef ' North 18 Building Inspector Of +NONTM AN �O Y r t � f '� ' ��eq d�. Wit. +�� • � ?SSACHU9 i4h CERTIFICATE OF USE & OCCUPANCY NORTHTOWN OF ANDOVER Building Permit mb' a !. anuary1 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- V -Ipswich" B ii 1 chi ng MAY BE OCCUPIED AS UNIT #310- -- ONE BEDROOM UNIT ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGUALTIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTIES, LLC 231 SUTTON STREET, NOR ANDOVER, MA 01845 Building Inspector Y Of OORTH 7 n '4 �� ofw'�e .•, o o m J. A °^tire° N° qy �CSACHUSES e CERTIFICATE OF USE & OCCUPANCY TOS OF NORTH ANDOVER Building Perrmt Number 265 (11-13-02) Date: January 30, 2004 THIS CERTIFIES THAT THE BUILDING LOCATED ON 180 Chickering Road -- "Ipswich" Building MAYBE OCCUPIED AS UNIT #311 -- TWO BEDROOM UNIT W ACCORDANCE wym THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO: TERRA PROPERTI LLC• J. ON �.ST , 0 R •. Building Inspector = e HO 3 ° h A A 4 9S'r1CHU`+et . 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TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION This certifies that :... ............................... has permission for gas installation .i!T 1�rKir#�y .. ..',! in the buildings of ........................: �' ....................: .................:.....................................:............ at l .1 !ra?a1. //��....��JA ..................: North ndAver, Mass. Fee..(,,q)��.. Lic. No. r' ©3 ... ........i�_................................................ CaAS NSPECTOR Check # .% �' ,s 1 0 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK _ CITY North Andover ; MA DATE8/11/2014 PERMIT # I , 1 1 1 JOBSITE ADDRESS 180,190,200,210,200, Chickering rd OWNER'S NAME I KittredgeCrossing Condo Trust GOWNER'; ADDRESS' Same _ _ i TEIJ, FAX TYPE OR PRINT I OCCUPANCYTYPE COMMERCIALI EDUCATIONAL RESIDENTIAL � 1 CLEARLY' 1 NEW: RENOVATION: E] REPLACEMENT: ® PLANS SUBMITTED: YES NO APPLIANCES 1 1. FLOORS=- BSM 1 1! 2 3 4 5 6 7. 8 9 ;10 11 12 13•1- 14 BOILER i1 BOOSTER CONVERSION BURNER: COOK STOVE DIRECT VENT HEATER DRYER FIREPLACES FRYOLAT.OR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT' OVEN POOL HEATER., 1L�� ROOM I SPACE HEATER ROOF TOP UNIT + i ;- TEST UNIT HEATER � � 7- UNVENTED ROOM HEATERS ! a" WATER HEATER,[___ OTHER Bonding of CSST in all bld i INSURANCE COVERAGE I have a current liabili insurance policy or its substantial equivalent which meets the requirements' of MGL. Ch. 142, YES [j NO Ej I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING. THE APPROPRIATE.BOX BELOW LIABILITY INSURANCE POLICY OTHER TYPE INDEMNITY ®i BOND OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage'requir'ed by Chapter 142 of the ' Massachusetts General Laws; and that my signature on this permit application waives this requirement. I i CHECK ONE ONLY: OWNER E] AGENT.' SIGNATURE OF OWNER OR AGENT ; 7 l I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge 1 and that all plumbing work and installations performed under the permit issued for this application;will be in comp' ' all Pern nt provision the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER-GASFITTER NAME' Lyle CarterJr LICENSE # 19036 SIG MTU Y MP ® MGF ® JPJ.GF Ej LPGI ® CORPORATION ,PARTNERSHIPQ# LLC# COMPANY NAME: LGC ; , ADDRESS 63 Valley Rd I CITY ; Dracut ' STATE MA' ZIP 101826 TEL ,978-957-4643 I FAX CELL 978-804-5432 EMAIL carteriyle@ymail:com s ! I EI 'O z t o U a W J i t . F I _ ZO z o E w � w F a u LUz V1 N W a Wi r1; > a O W w U) L7 zo a CIO F a a d+ - ca W 2 W F— U. t 3 � •�r`€ � t�"' n.r. �F, r_ iat'; ; f J .:. , � r. :� - • t . ; c:..t -, „ .r , , t - E T _. 1 t. 1 T. r: r, �., t 44j'?: �o ,. .. . , �.y �' � [ ,Y,, .. J w ! ' ,9 t.. .. it'" . - ,,6'r rM14� ,� l ' l P Y r`• QM 'V V W The Commonwealth of Massachusetts Department of IndustrialAccidents Office of Investigations 1 Congress Street, Suite 100 Boston, MA 02114-2017 www mass gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization4ndividual): Lyle Carter Jr Address: 63 Valley Rd Dracut MA 01826 Phone #: 978-804-5432 Are you an employer? Check the appropriate box: i. ❑ I am a employer with 4. E] I am a general contractor and I employees (full and/or part-time).* have hired the sub -contractors 2.0 I am a sole proprietor or partner- listed on the attached sheet. ship and have no employees These sub -contractors have working for mein any capacity.. employees and have workers' [No workers' comp. insurance comp. insurance.: required.] 5. ❑ We are a corporation and its 3. ❑ I am a homeowner doing all work officers have exercised their myself. [No workers' comp. right of exemption per MGL insurance required.] t c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11. Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other 'Any applicant that checks box #1 must also fill out the section below showing their workers' 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 sheet showing the name of the sub -contractors and state whether or not those entities have employees. If the subcontractors have employees, they must provide their workers' comp. policy number. I am an employer that is providing workers' compensation insurance for my employees Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lic. #: Expiration Date: 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 of up to $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. I do hereby certify under the pains andpenaldees off 'erjury that the informationprovided above is true and correct 8/11/2014 Phone #: U t 8-OU40F3Z Official use only. Do not write in this area, to be completed by city or town official. City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING rrWORK CITY North Andover _ MA DATE 8/1112014PERMIT # JOBSITE ADDRESS .180 190,200,210,200, Chickering rd OWNER'S NAME KittredgeCrossing Condo Trust G. OWNER ADDRESS Same TELF FAX TYPE OR OCCUPANCY TYPE COMMERCIAL[] EDUCATIONAL [ RESIDENTIAL PRINT' CLEARLY NEW: RENOVATION: Ej REPLACEMENT: Ej PLANS SUBMITTED: YES[] NOrE] APPLIANCES 1 FLOORS- BSM. , 1 2 3 4 5 6 7, 8 9 10 11 12 ` 13- 14 BOILER _. L-4 -,� -.. 'a _ BOOSTER �g CONVERSION BURNER. COOK STOVE DIRECT VENT HEATER DRYER FIREPLACErz FRYOLATOR FURNACE GENERATOR- GRILLEL INFRARED HEATERsal- LABORATORY COCKS .�1.. �.. - MAKEUP AIR UNIT 7--J, L�_ r OVEN, POOCHEATER— ROOM ISPACE HEATER ROOF TOP UNIT��w. L -J m� TEST UNIT HEATER������C� UNVENTEDROOM HEATER ��[____�®-__. WATER HEATER!�� OTH ER Bondinq of CSST in all bld INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142. ,YES NO [ I IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING. THE APPROPRIATE.BOX BELOW LIABILITY INSURANCE POLICY 9d OTHER TYPE INDEMNITY BOND OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. CHECK ONE ONLY: OWNER E] AGENT El SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information .I have'submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in comPjy0'ZF. all Perti nt provision the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. 190]3 PLUMBER GASFITTER NAMELyle Carter,Jr LICENSE # 19036 SIG A. - NAME[ [D MGF 0 JP ] JGF [j LPG[ ® CORPORATION ®# PARTNERSHIPE]#I j LLC [:]# COMPANY NAME: LGC 'ADDRESS 63 Valle Rd CITY 1 Dracut STATE®ZIP 01826 yTEL 978-57-4643' , - -_9.� FAX l - CELL 978 804-5432 EMAIL carterlyle@ymail.com r F •O z z 0 F U W a a w - a 0 E z O 1A ❑ W O , _ a � F O w O ko a z U w 3 w z a � a w iY O W w w a zz a ►� .J F a ar � N lJ I 2 W °z U t W ' a d L7 x x 0 a {; P. 1 Communication Result Report ( Aug:26. 2014 8:43AM ) 1) Town of North Andover 2) Community Development Date/Time; Aug:26. 2014 0:41AM File Page No. Mode Destination Pg (S) Result Not Sent ---------------------------------------------------------------------------------------------------- 2914 Memory TX 819786864664 P. 2 OK ---------------------------------------------------------------------------------------------------- Reasonfor MASSACHUSETTS UNIEot1N1 APPLICATION FOR A PERMR TO PERFORM GAS PITTINIG� WORK error M9 DATE�f�14:_]PERkIrr a `P E. 1) Hang up or line fail E.2) Busy E.3) 9EW:rj RENO1lATIOICE] REPLACEMENT -.0 WRNS SUBUTIED YESD N00 No answerE.4) FLOORS-- esee. l 2 7 A 5 6 7. B 9 1 lD 1 11 R 1 13 14 No facsimile connection E.5) 00WERSIONSURNER . Exceeded max. E — mail size E.6) Destination does not support IP — Fax !L, MASSACHUSETTS UNIEot1N1 APPLICATION FOR A PERMR TO PERFORM GAS PITTINIG� WORK - M9 DATE�f�14:_]PERkIrr a `P J0851TEkODRESS160190_71MJ,21aIU3, lickmilBM-.--IOYJIIERSNNAE �YIhe09aCtBtsl,Wn�CondoTnt�t .. 1 G; OIVNERADDRESS Sam .._�._ TYPS OR PRINT' OCCUPANCY TYPE . COMMERGN[j EDUCATIONALG] RESIDENTIALC� CLEARLY 9EW:rj RENO1lATIOICE] REPLACEMENT -.0 WRNS SUBUTIED YESD N00 APPLIANCES I. FLOORS-- esee. l 2 7 A 5 6 7. B 9 1 lD 1 11 R 1 13 14 BOM AL BOOSTER 00WERSIONSURNER . OODR STOVE ._ ._ _. .. •-_. - .. ..._. ._... _ DIRECT VENT HEATER ...__.. _.. _... _. .. •:. _... _...�. -_. .. ... __ URVER FlREP.LACE - — FRYOLATOR _. ... .... _. - FURNXE GENERATOR GPoLIE ERARED HEATER F.- — LABORATORYCOG6- tOKEUPAIRUNIT- OVEtd - 2OLHEATER ROOMISPACEHEATER ROOFTOPLVDT 41_ _ TEST -- - UNIT FIFATER UNVENTED ROUM HEATER VIATFRHFATER' OTHER Doom NCSSTin aIlNd=IF__.. . .. �' ...- ._.. - .... _ .. .. _ ._.__—_,..--�..... Ri AIRA Dfg COVFFAGE ]M1aveacidliRR eD bdln hLsummspolicp ari6 sebstalfid equimlenirih¢M1 dnt¢uNce requnemelEofm.4Si.142 „ YES UINO n I IFVDU CHEWDYFS. PLEASE[EDICATETHETYPEOFCW..wjwERYCH®rinTRE APPROPOOLTE-BDABETO LIABILITY IRSURANCE POUCY I✓j. OMERTYPEINDMMTV O BOND OVILWSDSURANCEIVAIVER:l6maw O.Ithelicmced=nol.hayeFh6idH12nO WhrdW4lquredby ChapWl42e41he IAaseathua>n GenalLwv andlhm my signature NI UdsPam' L"fim Wa;—tM, reVft-nt. FLECK ONE ONLY, OWNER A(;ENT[j SIGNATUREOF OWNER URAGEAT l herea'/taa!ymalall dRdeblJsenQ NRmmVJon Wy7ioOlan aye?mewed eauroubavhmldmyW�'�aade d oMff epemfte:rtedf]MdY AB dthat Ba Wu onlerme Mad: ap¢ka5¢�1YR 4a Mcan �M�1`�e pmi• aq atb wffl Llmta rE wFj cadtl wm vlarIad Maseadro lb Stefe PLrtnbha0ode antl QigolerlA2aFilen Gondel LecS. PLUtABER-dASATTER NAMEF.I.Cab,Jr 19638 SIGNATU _ ��UCENSE MP NGF JP[] JGFEl LPGI❑ CORPORATION[:]# ��PARNdERSHIP©s[�__..- RCC# COMPANY NAME:LGC__ ADORES563. Valley Rd - T CITY Dlatul ..._�� - STATE®ZP OIITW TAX�� 8788D4G132EMAIL tada1111deeQAnaTartn _ ::� _ Safety Insurance Form of Notice of Casualty Loss to Building, Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Board of Health or Inspector of Buildings Board of Selectman City Hall City Hall NORTH ANDOVER, MA 001845- NORTH ANDOVER, MA 001845- AE ' Insured: ` DANIEL BONOrand ANNA BONO, Property Address: 190 CHICKERING RD #102D, NORTH ANDOVER, MA ' Policy Number: HMA 0116354 Claim Number: BOS00044648 Date of Loss: 8/1/2014 Company: Safety Insurance Company Claim has been made involving loss, damage or destruction of the above -captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass. Gen. Laws, Chapter 139, Section 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim number. Coleman Foley Claim Examiner 8/5/2014 Safety Insurance Company Homeowners Claims Unit P. O. Box 55098 Boston, MA 02205-5098 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: 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 throughoutthe 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 he issued to the person, frm 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 of ongoing construction activity, and maybe.deemed_bytho Tnsp.ector_of_W.ires abandoned_and.irwalidaf_he_. . 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 purpose 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. d extending"through August 15, 2012. /KRule 8—Permit/Date Closed: yNote: Reapply for new per ❑ Permit Extension Act—Permit/Date Closed: Date .. l D:....`- .... TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,1 his certifies that ....... ��.&. T�' ..... . has permission to perform ..... �yZ. bA�?� wiring in the building of .. 6 -- A19.!5�-14W .............. . at.:,.IF0 �/,�G,16/�.!rti� ....�,�nG, North Andover, Mass. p0 Fee Lic. Nov.15 � .4 .. .... �. . ELCTRICAL INSPECTOR Check #0 7z/ 11131 Contrnonwealtie of Ma34acluo"HJ 2,partmant o/ Jiro sawic69 -ARD OF FIRE PREVENTION REGULATIONS PermitNo. 6 � / 3/ Occupancy and Fee Checked Rev. 11071 (leave blank) B FOR PERMIT TO PERFORM�ELECTRICA o WORK APPLICATIONi All work to be performed in accordance with die Massachusetts Date' (PLEASE PRINT IN INK OR TYPE A 1 INF 9A ION) . City or Town of: _ Lle,{n To the In4(NE of Wires: By this application the undersigned gtves notice of his or her inten onto perform th 1 ctrical work 1- 1 ¢escrib� be ow. &Number) �����m ' Location (Street 104 Telephone No. Owner or Tenant Owner's Address Yes No ❑ (Check Appropriate Box) Is this permit in conjunction with a building permit? Utility Authorization No. purpose of Building Und rd ❑ No. of Meters Amps volts Overhead ❑ g Existing Service — Und rd No. of Meters Volts Overhead E]g New Service Amps Number of Feeders and AmpacityUS Location and Nature of proposed Electrical Work: 'Tn 64 /� No. of Recessed Luminaires No. of Luminaire Outlets 1o. of Luminaires Vo. of Receptacle Outlets Vo. of switches No. of Ranges No, of Waste Disposers No. of Dishwashers NorNo. of Dryers o. of ater _ KW Heaters . Bathtubs No. of Ceil: Susp. (Paddle) Fans -------------- No. of Hot Tubs ---- Above Swimming Pool rod. 111- ❑ No. of oil Burners No. of Gas Burners Total No. of Air Cond. Tons eat umpu_ mer Tons K Totals: Space/Area Heating KW Heating Appliances KW o. of No. of Ballasts o. of Motors Total HP in (able m 6e u o. of Transformc . o meJG;enerat10:rS Battery Un o. KVA ALARMS INo. of Zones No. of Alerting Devices Municipal❑ Other Local ❑ r,nnect►on No. of OTHER: Attach additional detail if desired, or as required 6y the Inspector of n'+re (When required by municipal policy.) Estimated Value of Electrical Work:ance with Work to Start: �. Inspections to be requestedein no ermiifor the co performance of electrical wok may issue unlet INSURANCE COVERAGE: Un waived by the own P equivalent. The the Licensee provides proof of liabilitoverage 0 y ' suran �iCecta µas ex}itbited proof of s pleted » ce to the per tit issui g o� undersigned certifies that such cav 13eOtI�D OTHER ❑ (Specify:) (, I �� Z �� CHECK ONE: INSURANCE t/ t theeffirination on ris apphcatrb' u true arrtl on eI certify, under the airsalydpe►r f' of erlury,LIC. NO.. /e r FIRM NAME: v e4 LIC. NO.: Signature Licensee: � e h p Bus. Tel. No. (ifapplicable. "mem t,, in the license mm�ber li / Alt. Tel. No. - (if Address: t / 2 Public Safi �ty. *Per M.G.L. c.147,s,57- 61, security w reawiare aP eCens a dos not have the liability insurance coverage normally OWNER'S INSURANCE WAIVER: i am owner ❑ owner's age required by law. By my signature below, I hereby waive this requirement. I am the (checkrPE ) ❑ required gent RMITFEE: $ Telephone No. Signature 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00 § Rule 8: In accordance with theprovisions 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 r on the prescribed form. After a permit application has been accepted by an Inspector of Wires appointed pursuant to M. GI c. 166, § 32, an electrical permit shall be issued to the person, 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 shallbe limited as to the time of ongoing construction. activity, and maybe deemed_bytheJnspectoLof_Wires abandoned_and_in.Yalid.ifbe_. 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 purpose by establishing an automatic four-year extension to certain-permits aad 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 m effect or existence during the qualifying period beginning on August 15, 2008.and extending'through August 15, 2012. ule 8 — Permit/Date Closed:.__ � �� Note: Reapply for new permk�- ❑ PermitExtensionAct —Permit/Date Closed: A - Date...... � ... .. ............ TOWN OF NORTH ANDOVER MOWPERMIT FOR WIRING This certifies that ....... -le ...... ....... has permission to perform ... %.. ...... /r., 7 .. .................. wiring in the building of ..........4. q �/', ... ......................................... at ... ............ p ..... . North Andover, Mass. Lic. No. JAC ........ .... ... ......... ....... )7ee , _ ­­* * * * i qfti.C��MR AL PECTO Check # 53 6,4 10541 :µ rN eommonwea& o f 111amact uieii 2epadmed o f -76Pe S.rufLcej BOARD OF FIRE PREVENTION REGULATIONS Official lUse �Only Permit No. 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 IN INK OR TYPE ALL INFORMATION) Date: \i IZI NN City or 'Town of. n �,� \, - IN n 4 ay t -•r To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) Parcel Ib: Owner or Tenant 0" Z) , N�� �� v Telephone No.617 335 % d 6 'L Owner's Address q. Is this permit in conjunction with a building permit? Yes ❑ No K] (Check Appropriate Box) Purpose of Building -CO-45 Existing Service Amps / Volts New Service Amps / Volts Number of Feeders and Ampacity Utility Authorization No. Overhead ❑ U ndgrd ❑ No. of Meters Overhead ❑ €i.ndgrd ❑ No. of Meters Location and Nature of Proposed Electrical Work: rye\qct. �W Completion ofthe following table may be vvaived by the Inspector of R.ires. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs Generators KVA No. of Luminaires Swimming Pool Above 0In- ❑ rind. grnd. o. of Emergency Lighting Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners of Detection and No. Initiating Devices No. of Ranges No. of Air Cond. Total Tons No. of Alerting Devices No. of Waste Disposers Heat Pump Number . _.... Tons .---..- ............................. KW No. of Self -Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local Municipal Connection [I Other No. of Dryers Heating Appliances KW Security Systems:* No. of Devices or E uivalent j No. of Water KW No. of No. of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent OTHER: Attach additional detail if desired, or as required by the Inspector of lr'ires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and comm -fete. FIRM NAME: yr v�rr�b't � Se,� u ►cel r+ c LIC. NO.: Licensee: I t71� yam„ �ti� P,i.�,n Signature LIC. NO.:�/ (Ifapplicable, enter "exempt" in the license number line.) e� Bus, Tel. No.•t1ok 9i9%\ Address: -\ \n'1 t\\ \ n!s '& r, q. A 1- kv.. \" %1= r Alt. Tel. No.:1—i;�\ SVS A *Per M.G.L. c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. _ OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally by lave. By my signature below, I l.ereb-, waive this t _ Tir�'n'.--n-.. F , ; ti,o h=,t- n. ri ❑ owner ❑ o4ner's agent. Owner/Agent - - .. Signature YAe�p `.,3)No. PEK11IT J E April 15, 2014 TH ERlORIFO0.0((D�DEDHAHAGROUP@ FORM OF NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B Building Commissioner, or Inspector of Buildings c/o City or Town Hall 1600 Osgood Street North Andover, MA 01845 Board of Health or Board of Selectmen c/o City or Town Hall 1600 Osgood Street North Andover, MA 01845 Fire Department or Arson Squad c/o City or Town Hall 1600 Osgood Street North Andover, MA 01845 RE: Our File No.: P1473012 Insured: KITTREDGE CROSSING CONDOMINIUM C/O AFFINITY REALTY & PROP MGT Address: 180 CHICKERING ROAD, NORTH ANDOVER, MA Policy No.: R1373344A Loss Date: 03/26/2014 Loss Type: Building or Other Structure Damage A claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Ch. 143, Sec. 6 to be applicable. If any notice under Mass. Gen. Laws, Ch. 139, Sec. 3B is appropriate, please direct it to my attention and include a reference to the captioned insured, location, policy number, loss date and claim or file number. If no reply is received from your office within ten days, we will assume you have no liens of any type against this property, and the claim will be paid in our customary manner. Sincerely, Michelle M. Roust Senior Property Claims Examiner 1-800-688-1825 x1171 NORFOLK & DEDHAM MUTUAL FIRE INSURANCE CO.222 Ames Street, P.O. Box 9109, Dedham, MA 02027-9109 DORCHESTER MUTUAL INSURANCE CO. Telephone: (800) 688-1825 FITCHBURG MUTUAL INSURANCE CO. � ® Fax: (781) 329-1818 10068 Date .710143 ... TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that .... .... 9 ........ has permission to perform plumbing in the buildings of at ... ............ !�'? C . ,North Andover, Mass. /W.Fee .�?�0 �-..: Lic. No./3f?�/ ... .................. ... PLUMBING INSPECTOR Check # 163 a - -�- --K -' [N#5��unmuu/TSuw/rorvv"xrruC°" ="�.-""".-'..~.. .~-~.,__________.� � DA] PERM11 ury -'-~' Nmw� JOB�TE8DDRESS U� | O�NERADORESS \�� FAX N~ / �-' TYPE OR OCCUPANCYTYPE COMMERCIAL EDUCATIONAL RES|DENT|AL'.� PRINT } �� pLANSSUGM|TTED� YES�- C1 EARLY VVA (ONUO1 -EIE � � R8XO� Y�PL[�[|0�CK[[O|[TYPFOFC0V[R8�[DYCHEC�NGH4PPROPJBDE U v0UCC � /|�0UTY|N�URANCEPOL|CY�� 0THEnTYPE0F|NDEMN�YBOND � UUUNER� '5|NSQR&NCEA\VEk|x �momorodm\|hc|icenspe hxinsurance coxoogomquimd`byChapi:r142n|Un! ' h \ �xoxc useUs |icJdnn����|hi�mquimmun|� �pnom|| �s. xnd|hutmysignummon|hispnnni��py^ . CHECKONE ONLY: O�N[R'- 86E0T�__ � ' SI ��6��*i|vma|u�v�xnovhn�annmmnnmmn�/navc»u""".�"". �.`~.~.^"._rdi'"ci --_. , mw i //», .muxm/onnmmompmmmnrm�maunmm,uoeomnnou"oVc /*c�w"nusmmkvm� � oonwm/vc"'"~""""=~..~` i --��-.-'�u n�Np|onmi/mcnocn.mc*o,x,�*r"r�*,ounmn - - SIGNATURE ' LICENSE 11 � PLUMBER'SNANE | �p\- ')pLJ RAT--�- C0RPO|ON�r�1 # P�RTNER3H|PF-�0 LLC| | �� -------- ` COMPANY NAME_ ADDRESS E [ 101608 TEL ------- STATE �p-798-9956 11-y 'horcnster | ` ---'--------------� FXXI 50,8713-95H)' CELL E-MAIL31 --'----- f '--- ------� ~�-1 \ "� � _- ` The common.wetiltli SIJ m1dssuctm,9elvw dJi fAazL���t taiatl�ifr�trA>flccdt�pat� ® ice ®f Inivest%tntioll 7 iC'on goes Street, Suite _700 Boston, MA 02114-20-77 '*. i 61' mmass. g"ovItlia Workers' CoAfl pensatiotA.IiiASur- ce A.Mdavile.Btiilders/CoAAllll actCoA ss/.Elec ricians/P�A.AAAibbe s Pleas -'P, Out -Legibll pD1➢1�aAAtL �°A'Af®fl'AAA�At7:11®{iA _.- ---. _ _ Name (Business/Organization/Individual): 24 NIRS INC Address: 134 Gold St itv/ tatL/%ip:Worcester MA 01608 Phone #:508-798-9955 Are you aa employer? Check tine`app ro.jDrikwbox: .. ! . M I am a eiliployer with 50 4. []s1.am a general contractor and 1, employees (full and/or port-t:itne).* 2. i and a sole proprietor or partner- ship and have no employees working for mein any capacity. [No workers' comp. insurance required.] 3. 1 am a homeowner doing all work myself. JNo workers' comp. insurance required.]' have hired the sub -contractors listed on the attached.sheet. 'These sub -contractors have employees and.have workers` C01111). insurance.': 5. We are a corporation and its officers have exercised their right of exemption. per MCT c. 152, §1(4), and -we have no employees. 1_No workers' comp. insurance required.] Tvpe,of`p)a-oject=("eduia•ecl): 6. [j'New construction 7. E] Remodeling S. []'Dcnx)lition 9. E'13uilding addition 10.0 Electriud repairs or ,ldditions 11.[] Plumbing -repairs or additions 12..0 Roof repairs l 3.0.01 her_______ Any applicant that checks box ttI must also 1111 out the seefion below slowing their workers compensation policy information. I lonaeownef;s who.submit this affidavit indicating tlicy are doing all wort: and then hire outside contractors must sul)mit .a new ,affidavit indicating such. zContractoa;s that check this box must attached an additional shed showing the name ol'the sub-contractois and stale whether or not those ontities have employees. 1f the sub -contractors have employees, tlacy.Must provide their work.crs' con"p. policy cumber. I am adl-emj)lOver that jv.pd'ovldddlA, workers' coml)ensatlon insurance fordnj? e)ddtll0)Ce.1:" BC'101Uid1':P%l;Z' fl(l�l'-C)' (d17(�JO/T 1'1tL' RIR f ordiR(RtdORl. insurance Company Nanle: Liberty Mutual Insurance Company Policy 11 or Sell -ins. Lic. 4: Job Sile Address WC531S387893012 ALL JOSS Expiration Date: 10/12/2013 city/state/zip: ALL Attach a copy of the workers' coAnp➢ensatiop policy declaration page (showing the policy number and'expiration date). Failure to secure: coverage'as required under Section 25A of MGL c. 15'2, can lead to tale imposition of criminal penalties of :t Mile up to `1,500.00 and/or one -yeti' imprisonment, as well as civil penalties in the form of a S'T'OP WORK—ORD ,R and.a Title OFUI) to $250.00a day against the violator. Be advised that a copy of this stat:ement may be forwarded to the Office of Investigations of the DIA l'or insurance coverage verification. I do herebv Certf�a untl'r the pains and pen(altiewof leer%desy'tld(di`t/de'iddfordilr`dtiodl prot,ided above is-ltrme and correct. 19f ficial use and y. Do not ovrite in thio (irea,� to he completed bti city (Jr town official. City Or Town: Permit/license # Issuing Authority (circle one): 1. Board of Health 2. Building ..Dep)artmennt 3. City/Town Cleric 4. (electrical Inspector 5. Plumbing lnnsp Letor 6. O lien Contact Person: Ilio ne : r fi nd"I oftii A MaSSaChUs'etts General Laws chapter 152 rc,quires all,elilployersitoll)rovlde.worl<ers' compensation fo► then employees: Pursuant to this Statute, an-emr)/nt�ee is clef ned asij .:.every,,per"soil ill t'lieservice of another under any contract,of�l lie- express or implied, oral or written.' ti 'Pfl.r—;:AT. j`2 dC 'p. f,F r•i � •� MA •,., .'.�yF w p_ ` An ei�aPlote�.ls delinCd'as� an indrvrdt.1,0' artnershlp,�51's4u,i�tlon, corpolati`on or�otlielticgiil Intity"ol`ai�yttw:o o�4ilidie us� r -I` cd;,n -1--joint enter )l isc and II1CIlIC1111 the Ic al 1 c �rescntativcs of a dccc aged' cm to c l 'oi the afilic forcgoiaig enga1 . �.g,t �g _ •e1 _ . : P y ' :r .:� reCeiVCr or trustee of in individual, pal•tnership, association or other legal entity},,employino employees. Flowever the owner of a•clwellill(_1•house having not.moreAllan three apartments and.who �csi`dcsl't.lieiein;'oi,tll'e;occupant>oftlie' dwelling house Of allothCr who employs persons to do maintenance, Construction or repair work on sucli dwelling hoose or on the grounds -01'.brlildin(',apl)tll•tCll�lllt tllCl•CtO shall ilot because Of SIICI] Cllll)lOylllejlt be dcenietl '�an{ciiipl'oyeI " MGL chaptergt52„ti25C(6)..also,sltites that;,eyerylstaie-or loclil licensing agency,Khallw>thhold'the;issuanccFor' aenewal ofh/i'license o�} pei,mit)fo Oki -ate a=business or to construct,,buil din, g' in the'com nonweaItlitfolt 411y; v;g applicant wii� aha hotrproduced.. cepelble evidence of,comphaiice with the rnsurince coveraeger><equired.” . AdcGtiona.l.Iy,,MGI ,claapicr_`1.52�.5?5C(�).'st rtes'`"Neither onvv,ealth_ll.ol anyjo(tlts l�olltlG� 1 subdlvlslrnl� shall ._ enter into any conta�iCt foirthe pertOrMancc of public},work unti1taccepti�ble evidence o{„colllmce;wi;th.the ln_stuance requirements ofathlschdpterhave',beeli presented'to tlie;contlacting atiliority." f , Applicants Please fall oert..-,the woikcrs< Compensation affdav;it'conlplctcly,+by chcelciiig the boxes that applyTto.your situa'tloh and,. if necessary, supply sub-contracior(s) mune(s)=address(es)falid'l)lrone,ntullber(s) along with theiicelti.ficate(s) of insurance. LinlltedaLiablllty,Coriipantes (LLC) or I Ignited Llabiflty'Partnerships (LLP) wrtli lloleni'iiloyete's other fhan e. th members or palinels,.alernotlequued to carry wori e s. conlpensation,,instn•ance. If an LLC or 1.11 does have employees, a.policy; is requirecl. Be advised that. this ifficlavit'may, bel submit:ted to the Department of Industrial l A4^�4+1 i -4.4, d - Accident:s for conllrn atlonlofinlsuz rncc c &orage. AlsonUesS�>�>t�e to s>� nland'c�lateYt�he afiul�avil�^ The afG�davlt should x 0 4 1'fti f i be rctiuncd;io,the city'oi�towalah3atithe app'ilcatiori ob the pctlllit.ol licellse is'being,req uested1,notithEjD�ha1{nlent61 Industrial A`cciztcllls : S11041 d<youo°have an y;,duestionsi,regaldnit the I•aw:01„It yo urarC;requueci;tOxObtalll a;workels,,' corn )cnsationA)olrc �;. lease,cali�.the,Dc artnlent gat th&nunlbei fisted°below •Self ui�sured7coln �`anles�shoul'dienterl'tli'eir• ..I F , I y P f? t I sell-ldlSllrancO,llLLnse;lltllll'bel 011.tlle appropllateli,ne YM.t.. ti .'s r s _LL-.+ _, ^•J:.•....at.,.;. ......-,..ti City or Town Officials ` Please be sure thatithe affidavit is complete and printed legibly. The Depal`tnlcnt,has orcividd&'a space.at thefliottom of the attidavitl lot vo,il`to fill'out�in;the;event: the Office of Investigations has'to c oiitaci.you4r=eg�rdingrthe.appl;ieant. Please be sure to fllliinthe permit/license number which will be used as a reference number. i l addition,.an applicant th,rl;.nnist stlla111.1 nl"ultiulc pu mp/llrens�c c}j pllc tlions.ill any bi1ven;year,..i eed only. submit one affidavltTlii"dicatrng cuuent . policy„ irlfOlmirtion,(iifanecessaly) andjunder "Job Site Address'° the applicant should write "all locationsul, Y, (city or �.�. .�ll'''•'�''-. ir.;.�:�Siltr4Fd:,.,, � .r:"r�4�'4�'�,�e .,.f��ii :�.,yi@.4.iti FT�..� x town)�,-A,c6py ol�tl1e�11Iid1 It1hat lia&b6L officially{stanlpecl �ol mai-k&dtbvftloe-city 0 �towll� My be provided to tate If P' . 7 z.t t r f ahpllc mt.as.prooitli�it•.a valad alli'davrt3ls on file fol future pe'rmrts or Ilccnses., new af(rdavll must be filled out,cM i vrr -it:. rtt tot .`.str r:4vl t -1r <TJ.1 di" dr i�T,?pSt -".tim m -.-r rJi}I "wE{)s +et4ir•.t., T "1 year. "Whel'effl}hOI11e�v����CI,:O1 Gltl%el},IsiobtaEninga}IICeilSCTO�yp� I��ITT Of,1Cl�tC }t0 cany- bus«I� e�s�oi-corn erclal velltlll•C (i.e. a clog license or'permi't to burn leaves etc.) said person Is'N'0'1 requtlecl to.conljpfete_thls aifddVit. . - , wF. ��. '�"`? �:. ""^ � .-,. Y S..'A. .e... C;",,;•'a"_ x ,"i:�„.'�, .. � ria ; - : '^'*+� � �• izr � �s.4,.. �^, L...+C'�t" ' . "!"'^ - .... The Officeu"ol �filvcstl,gationsewould l_Il.c.to thaull. you ui aCyancerifol yqul �oop�elatror and hquld you;I ave�� ny questlor�s, 111(dSC CIO 110trbGSltaiC tO IVC'LISia Call:..,'`w Th'c Deliairlmetit's address telephone a141x)nuiriiier:* I Revlsedn7-201.0,• T'llf . Conlnl.onwealfh o (Massachusetts DE ciftinei-it oi' Indus .tial Accide is Office fief-Invesfightion 4 ,T' , ,,, . I C, g ess,Street, Suite 1,00 Boston MA 6� f 14-2017 31' t t. � �•t.s Tf-'r l s`3 `tF=(4F,r�'}T�fffir, rel'# 61:7-727`-4900`ext 40b.or 1='877= -,"SS -A -1 .ri �.at;# 617-727 7749 ` __vww.ina`ss..gov/di��;-- OUT. * �- o n mi 69804807 DDB '07702013 07.09-196{T CLASS jhEST `;HGT SEX. 6 A4 -07 {{ f PORTER.; MICHAEL Ctr , DELARGY RD o LOT#8' j: HARDWICK.MA ux s-aSr „:tom ,' "•� # i 01.037-,01'.17 otoais5i x l COMMONWEALTH OF MASSACHUSETTS;, SIJ:EET META'L WORKERS' AS •A IMA.STER--U.NRESTRI,CTED . VA ISSUES THE ABOVE LICENSE TO: hiICHA.E°C. C PORTER LOT °8 RE.LARGY. cR,p H'A R D;W..' I C K M -A, 0 10 3,7 0 0'0 ,0 1.1242: 07/2'8/14 234.650 I I r . `a.: R .r'4F`,""n°"'°�""`..�,.�,.. �..,,...nm�; �-«.,G�y+ J97 .rte "`. � ..- . �. -� ,n,K ": �}G•�:y.�y � I COMMONWEALTH OF MASSAGH; SETTS ; �� e e • .• a :o a o �PLIUMBE:RS GASP ITTERS LICENSED A'S MA.ST,ER PLUMBER" i ISSUES THE ABOVE LICENSE TO: y t � M.ICHA:E'L •C P0RTL, P'0 BOX 25.1 N.ARD+WICK, MA. 0103..7 0.251 13671. 015/01/1 $1676`327.7 , Im s w•smtiseua —� ��sys.-_a..b^ w.,r s . _.. n. ,, i* I q -COMMONWEALTH!:OF MASSACN,USBT'TS o • e •-s ® • •e • PLUMBERS. AND GASIF'ITTERS REGI;STE;RED AS A PLL11M'B�I�NO 'CORP �q ISSUES THE'ABOVE LICENSE TO II "c $ mCHAEL C; 'PORTE'R `""��'�• HR'S IN;C 24 .>. LOT 8 DELARGY RD H A R D.W. I'C K RA 0 10-3 7 Q40,10`0:" t; 3516 05tol/14. 316:175 I e7.• e 2 0 9234 Date.?. ......... 3?�. <��•�^;:,'+ TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACMus�d This certifies that ...... has permission to perform!`�fr plumbing in the buildings of at .. dl.© -SCS �1 t�4 ...� t. ► ?I?! , No h A dover;Mass. Fee.-T;!�. Lic. No....gG? / PLUMBING INSPECTOR Check # 103-3 P. TYPE OR PRINT - CLEARLY ETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK CITY77 --A _MA _DATE f \2 --]-PERMIT #- -- — - - -- -- - JOBSITEADDRESS ^_ � �___.._-..__..�._�_.._��. _�Nc 4C�rc�r.ty 1_- h Cl �t3 O� OWNER'S NAME OWNER ADDRESS _ a r TEL I f%k? 3 3 j 9S o FAX ? -- - OCCUPANCY TYPE COMMERCIAL'L-1 EDUCATIONAL D NEW: i i RENOVATION: REPLACEMENT: L RESIDENTIAL PLANS SUBMITTED: YES ' ­j _I NOK DRINKING FOUNTAIN FOOD DISPOSER FLOOR / AREA DRAIN INTERCEPTOR (INTEF KITCHEN SINK LAVATORY SHOWER STALL SERVICE / MOP SINK TOILET URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES WATER PIPING OTHER INSURANCE COVERAGE: I have a current liabilityinsurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. YES Xk NO IF YOU CHECKED YES, PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY wXw OTHER TYPE OF INDEMNITY BOND I OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws, and that my signature on this permit application waives this requirement. SIGNATURE OF OWNER OR AGENT CHECK ONE ONLY: OWNER AGENT ^_ 1 leieuy cerury mac an «use aecaris arm inrortn,auon 1 nave suomitted or entered regarding this application are true and accurate to the best of m kknowledge and that all plumbing work and installations perfomned under the permit issued for this application will be in compliance wi II Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME- -,-%A4Lrtck-rc1oxjap�ee� _i LICENSE# �%-�p�Z� = SIGNATURE MP .x JP ;r CORPORATION kPARTNERSHIP # LLC COMPANY NAME; ADDRESS CITY; ��r C a` r� STATE i @�T ;ZIP Z TEL - FAX CELL; :EMAIL W E� H Mirk Z � m❑ J � � W W w O Z CLLU w a W NAr Qi Fri a � o w a U \ ND CL CL LU L H H W a a a x Wo Safety Insurance Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Inspector of Buildings City Hall N ANDOVER, MA 01845 'RE: Insured:" " Property Address: Policy Number: Claim Number: Date of Loss: Company: Board of Health or Board of Selectman City Hall N ANDOVER, MA 01845 -ROBERT HARRINGTON and CATHERINE-HARRINGTON 180 CHICKERING RD 102C, N ANDOVER, MA HMA 0228322 BOS00038270 6/15/2013 Safety Insurance Company Claim has been made involving loss, damage or destruction of the above -captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass. Gen. Laws, Chapter 139, Section 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim number. Bobby Negron Claim Examiner 7/22/2013 Safety Insurance Company Homeowners Claims Unit P. O. Box 55098 Boston, MA 02205-5098 Phone: (617) 951-0600 EXT 3357 Fax: (617) 960-5743 Email: BobbyNegron@SafetyInsurance.com August 22, 2012 Building Inspector's Office 120 Main St North Andover MA 01845 Insured: Kittredge Crossing C_ ondominium Property Address: 180 Chickering Rd Underwriting Company: Tower Group Companies of New York Policy Number: CPC702419201 Date of Loss: 8/13/2012 Claim Number: T00001724601 ZI Claim has been made involving loss, damage or destruction of the above -captioned property, which .may exceed $5000. If any notice under Massachusetts General Laws, Chanter 175, Section 97A is appropriate, please direct it to the attention of this writer and include a reference to the above -captioned insured, location, policy number, date of loss and claim number. On this date, I caused copies of this notice to be sent to the persons named above at the address indicated above by first class mail. Signature: DAVID STEFANIK, Property Claim Specialist Er,,�t_.1j�ft i.}.(rvd9+'i.�.:st.n k•.,...,�,t:...'l. "r.,s".. .-.".'ifi _ .. .".�. Tower Group Companies Claims Department P.O. Box 5155, Buffalo, NY, 142405155 Phone: (781) 884-4383 Fax: (888) 892-1640 www.twrgrp.com AMM C3c ,$M CLAIMS DEPT. August 14, 2012 Commerce Insurance$M The Commerce Insurance Ccmpany$M Citation Insurance Ccmpany$M Members of The Commerce Group, Inc." 11 Gore Road, Webster, Massachusetts 01570 (508) 949-1500 www.Commerceinsurance.com BUILDING COMMISSIONER or INSPECTOR OF BUILDINGS TOWN/CITY HALL N ANDOVER MA 01845 Board of Health or Board of Selectmen Town/City Hall RE: Our Insured: DAVID C BARKER JR Property Address: 180 CHICKERING RD UNIT 36C Policy#: BCDCNS Date of Loss: 08/13/2012 File#: CCVK91-XARA61 Claim has been made involving loss, damage, or destruction of the above captioned property which may exceed $1,000, or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If any notice under Massachusetts General Laws, Chapter 139, Section 3B is appropriate, please direct it to my attention. Please reference the above captioned insured, location, policy number, date of loss, and file number on any correspondence. ESTHER OWEILL Telephone: (508)949-1500 Ext: 15388 Sr Claim Representative, Property Toll Free: 1-800-221-1605, Ext: 15388 On this date, I cause copies of this notice to be sent to the persons indicated above, at the address above, by first class mail. August 14, 2012 s .., CoI1 mCrc CIumpanies .... COME GROW WITH US CIC 254 (Rev. 4/95) MAIL M80 Date: 1 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACMUS� r This certifies that ....OA`.� has permission to perform ... ll � .(� ... ........ . 9. plumbing in the buildings of . �. CG ( ...... _ .. ..... , at 4 0 .C4!41:: Gj. /2a� .. /. Q .... , NorthtA dover, Mass. Fee,30 "... Linc. No.. ..................... . . PLUMBING INSPECTOR Check #p) V---�` MASSACHUSETTS UWORM APPLICATION FOR PERMIT TO D O PLUMBIlNG (Type or print) NORTH ANDOVER,MA.SSACHUSETIS ( Date `tel � .e 0 i n Owners Name I ! Permit # Building I ovation % toust Type of Occupancy, 00de New Renovation Replacement 4 IiJAJLUk2.E`` Plans Submitted Yes !.._d No II Check one: Certificate (Print -or type) Installing Company Name COQ• -- Address 8060 � Partner. = Uf , f 11 Firm/Co. Name ofLicensed Plumber: Is')Ada �__ _ I— Insurance Coverage: Indicate the type of insurancee coverage by checking appropriate box: Liability insurance policy Other type of indemnity. ;Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one o£the above three insurance _ Signature KIOwnerAgent gn . I hereby certify that all of the details and information I have submitted (or entere ) in above application are.true and'accurate to the best of myowledge and that all plumbing work and in 'ons perfo ed Permit is for this application will be in all nneinentnrovisions of theMassac�tatePl} tiling e, r 142 ofthe General Laws. ;D (OFFICE USE ONLY ype of Plumbing License ense um er iCMaster 14 Journeyman tJ • s •J 1 • f ' .��.----..� is t t' .■...-.---, Plans Submitted Yes !.._d No II Check one: Certificate (Print -or type) Installing Company Name COQ• -- Address 8060 � Partner. = Uf , f 11 Firm/Co. Name ofLicensed Plumber: Is')Ada �__ _ I— Insurance Coverage: Indicate the type of insurancee coverage by checking appropriate box: Liability insurance policy Other type of indemnity. ;Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one o£the above three insurance _ Signature KIOwnerAgent gn . I hereby certify that all of the details and information I have submitted (or entere ) in above application are.true and'accurate to the best of myowledge and that all plumbing work and in 'ons perfo ed Permit is for this application will be in all nneinentnrovisions of theMassac�tatePl} tiling e, r 142 ofthe General Laws. ;D (OFFICE USE ONLY ype of Plumbing License ense um er iCMaster 14 Journeyman tJ The Comrnonz•veaith of lllassachusetts Department of £ndustrialAccidents f office of-t"livestzgaiions 60.0 W ZShinb'tori ,fit -eet Bostoyz, 1 0_7_111 )VW-Mas&gov/din Workers' Compensation Insurance Affidavit: BuBders/ContractorsXlectzicians/Plumbers �Iicant -Information. x xcasc 1 �1J<LT J Name (Business/Or,o nization/Individual): Address: ' A U sn �A City/State/Zip: 1,/ V2__ Phone #: Are you an employer? Check ill . --1. propriate b0%: 1- 0 I ant a employer with 4. ❑ I am a,:, eral contractor and I employees (hill and/orpart time).* have hired the sub -contractors ?, I am a sole proprietor or partner- listed on •the aitiched sheet I ' p and have no employees These sub --contractors have working for mein any capacity. r/( [No workers' comp. ms ran Ce workers' c�0mp, insurance. �. ❑ We are a corporation and its 3 . ❑required.] am a homeowner doing officers have exercised their .I all work myself [No workers' comp, right of exemption per MGL c. 152, § I (4.), and we have insurance required.] t no employees. [No •workers' comp. iasuraum , re d Type of project (required): 6. 11 Ne,* construction 7. El Remodeling 8. [1Demolifion 9. ElBuilding addition 10.0Electrical repairs or additions I1.❑ Plumbing repairs or additions 12.n Roofrepairs 4 ] ' 13 -El Other `n�' ='?ic_ :t *h_E i�U� bov� �•;ss ,?sC Ertl ect the sece,__ belov., ah_ �_=ftcirwexieas' com�r��r • .�... ' Harneowners who submifttiis affidavit indicatin th , _,e .� g e1 cing all w,,:ii and then him loutside eonuzcton zid,-t a- nit a new aindavit u3dicafing such. +Contrectoxs that ch�k fh;; for M1= arched an addiuoaal sheet showia.• the uame'of the sub -contactors and theirworkem' comp. poRrinformation lam an ernplge-r that is providing workers' conzpensar,wn insurance for inforrnadam my employees Beloit is the policy and job site. Insurance Company Name: Policy # or Self --ins. Lic. #: a-piration Date: Job Site Address: City/State/Zip: Attach a copy -of the workers' compensation policy decIarai-tanpage (sha�vv;;rtg the pokey number•and expiration date). Failure to secure coverage as required under Section 25A ofMGL G. 152 can lead to the imposition of criminal penalties of a nue 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 a Of up to 5250;00 a day against the violator. Be advised that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for insurance coverage verification. Ido herebycertify and the pains ndpc?ia es o er' rpt thirt the information. provided above is true and c; -- correct �- r. , i sem. Official zcse only. Do not write in this area, to be completed by city or town official City or Town: P`ermit/License # - Issuing Authority (circle one): X. Board of Health 2. EuiIainR Department 3. Czfy/Z'ownClerk 6. Other 4. Electrical Inspector S. Plumbing Inspector Contact Person: Phone'#: Date. /7� . �'< •:''tia TOWN OF NORTH AMOVER PERMIT FOR PLUMBING This certifies that ............,..................... . has .permission to perform .. .. -. ........ plumbing in thebuildingsof ............ at .l fJ �? . . j?-�- ...... l ..!.oil ,North Andover, Mass. Fee���! ." .. Lic. No ?'% .I// .............. . PLl7M�81NG INSPECTOR Check # ew'>C�P/ ePa7 41 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building Location ( ( G C I ,,A iQ d -y Owner A/ i New Renovation 0 Replacement "YrH TR Fc Date Permit # Amount Plans Submitted Yes [:] No (Print or type) /, I Installing CompanyName- Check one: Certificate 7 S �ASQ,>+.i �/trJr�.�iJ� � ��i�,'�"jr J ,a Corp Address i t/ S/9%d Partner. Business Telephone jg/–yGf-ja A16 % r--� Fum/Co. Name of Licensed Plumber: Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity Com{ Bond Insurance Waiver: L 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 installatiperformed der P 't Issued for this application will be in compliance with all pertinent provisions of the Massachus S Plumbing C and pter 142 of the General Laws. By; ,� um Title T 'PA&bing License City/Town 1 �7 P � fJ rcense rum �r MasterElJourneyman APPROVED (OFFICE USE ONLY 0' The Commonwealth of Massachusetts Department of industrial Accidents Office of investigations 600 Washington Street Boston, MA 02111 www.mass govldia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Name (Business/Organization/Individual): 17 Sg�- A Address- City/State/Zip:­ S pl I p.,P7 MA 61 Phone #: Are you an employer? Check the appropriate box: 1. ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/or part-time).* 2. ( I am a sole proprietor or have hired the sub -contractors listed partner- on the attached sheet $ ship and have no employees These sub -contractors have working for me in any capacity. [No workers' comp. insurance workers' comp. insurance. S. ❑ We. are a corporation and its required.] 3. ❑ I am a homeowner doing all work officers have exercised their right of exemption per MGL myself. [No workers' comp. c. 152, §1(4), and we have no insurance required.] t employees_ [No workers' comp. insurance required.] '.AflV anniinnnr rl,ar ..k�..L.. L__. Lr __ Type of project (required): 6. ❑ New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.0 Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other -uv iitt Vial lliG JCC."aQ^ De 04,11 snowing :net: work compensation poiinformation, Homeowners who submit this amdavit indie sting 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 sheet showing the name of the sub -contractors and their workers' comp. policy information. - I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy # or Self -ins. Lic. #: Expiration Date: 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 of up to $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. I do hereby certify uni r the pains an allies of perjury that the information provided above is true and correct 77717, � G 9�5-/ Official use only. Do not write in this area, to be completed by city or town official, City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 6. Other Contact Person: >--09 4. Electrical Inspector 5. PIumbing Inspector Phone #: 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. "Howeverthe 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 dwelling 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 of coinpliance 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 public 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-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with 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 be returned to the city or town that the application for the permit or license is being requested, not the 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 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 permittlicense 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 like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a calla The Department's address, telephone and fax number. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, IIIA 02111 Tel. # 617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax # 617-727-7749 vrwvv.mass.gov/dia Date. NORTH TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING 6Z This certifies that ..... ... .,......... ... ?.: has permission to perform'....:.... .................... plumbing in the build-ings of , ,�. ` ?-f, -�� ............... . at ,.. . (<orth Andover, Mass. ?-3c3 � Of, � r Fee . Lic.. No -'..� ............. PLUM IN I P T R LU B .G NS EC O Check # 79013 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Building New ' Date �® Permit # v Amount ? -) -�S-7 Renovation Li Replacement ' LZI Plans Submitted yes ❑ No ri TV7MTT*a vin ki ualt Vl LypC) Installing Company Nam p�,�'�if/m� �,�� Check one: Certificate �1??�i //✓0 " X1.5 ED Corp. Address �D Partner. Business I elephone � 1 Firm/Co. Name of Licensed Plumber. Ale", Insurance Coverage: Indicate the type of insurance coverage by checldng the appropriate box: Liability insurance policy M Other type of indemnity ❑ finBond F1 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 Massachusetts S lumbing C d Cha of the General Laws. By:iu1 i9nare o T7icencr. Title Type'of Plumbing License v City/Town 1 21 i�c ns� m e APPROVED (omcE USE ONLY Master ❑ Journeyman Date .... .. TOWN OF NORTH ANDOVER PERMIT FOR WIRING ,.This certifies that ...... * d.,�7 ...... ......................... I - has permission to perform ............. S�. ... ........... ............................... wiring in the building of .... ......................... at A Id.( ...... h And er, A ........ /ass. Fee ....L/` ........... Lic. No.....2 ...... .................. ................. LECTRICAL INSPECTOR X 5i�Tila�i� Check # 4593 �N The Commonwealth of LYla$$achu$ett$ FOR OFF ` ,4 . _.{ _ = Permit No. i Department of Public Safety Occupancy & 1(ee Checked z' BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 (leave blank) APPLICATION FOR PERMIT TO PERFORM .ELECTRICAL WORK All work will be performed, in accordance with the Massachusetts General Code. 5227 CMR 12-.00, (D (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date - —19 -015r City or Town of ��� To the Inspector of Wires: The undersigned applies for a permit to perfor the el Jtrical work describe below: O 4 Location (Street and Number) f'�e y Owner or Tenant Owner's Address i Is this permit in conjunction with a building permit? Purpose of Building Existing Service Amps / Volts New Service Amps Volts Dumber of Feeders and Ampacity ation and Nature of Proposed E Yes ❑ No ❑ (Check Appropriate Boxl Utility Authorization No. Overhead ❑ Underground ❑ . No. of Mete s` Overhead ❑ Underground ❑ No. of Meters. No. of Lighting Outlets No. of Hot Tubs No. of Transformers Tot I KVA No. of Lighting Fixtures Swimming Pool Above grnd. ❑ In-grnd. ❑ Generators KVA No. of Receptacle Outlets No. of Oil Burners No. of Emer Li htin Batter 41*1*11 g Lighting y to. 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 Detection/Sounding Devices No. of Ranges No. of Air Cond. Total Tons No. of Disposals P No. of Total Total [feat Pumps Tons Kw No. of Dishwashers Space/Area Heating KW No. of Dryers Heating Devices KW No. of [Vater Heaters KW No. of Signs No. of.Ballasts Local ❑ Muncipal Connection ❑Other No. of Hydro Massage Tubs No. of Motors Total HP Low Voltage Wiring OTHER: 1NSUI ANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws 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 this office. YES ❑ NO ❑ If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ❑ BOND 0. OTHER ❑ (Please Specify) (ErpG ion Date) Estimated Value of Electrical Work $ Work to Start Ins c io ate Requested: Rough Final Signed under th penalties of perjury: FIRM NAME LIC. NO. Licensee Signature LIC NO. / ._ Address Bus. Tel. No. City/Town Zip D19'7Q Alt. Tel. No. OWNER'S IN! . CE WAIVER: Iam aware that the Licensee DOES NOT HAVE the insurance coverage or its substantiaU'. * equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this require a t. Owner ❑ Agent ❑ (Please check one) i Telephone No. PERMIT FEE $ 1 40 (SivnatnrP of Owner nr Avpntt COMMONWEALTIJ QF MASSACHUSETTS OF ELECTRICIANS REGISTERED SYSTEM --..CONTRACTOR IOqkjo ssug ANDREW S R)ORS tj. PO .BOX 103 LYNNFIELD:' 0-10,35 ;es 358 C 07/31%04 349852 COMMONWEALTH OF I OF ELECTRICIANS REGISTERED SYSTENJECHNICINJ AN dl ISSUES. THIS�tl" NSE TO ANDREW -,S R K 'ONS N PO BOX 1035 i LYNNFIELD t9 4 0 — 3 0 3 1168 D 07/31/04 349853 DEPARTMENT OF PUBLIC SAFETY Llcense:,,p�C SYS CERT. CLEARANCE Number`6S CC 001055 lug Rlrthdatse J$49 ANDREW ARONSQ PO BOX 1036 '�* LYNNFIALD, MA 01 Tr. no: 210 0dwh Commissioner z Date ...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that. . ... .. ... 11 ...... .................... .................................... has permission to perform .... .. .. . .... ..... ......................................... wiring in the building of ........... !/. .,.�C�.. .�� `L-� ..../t ................... at• ...... . .............. ................ North Andover, Mass. Fee2��.1.. ........... Lic. No...'-'. . .... .......................................................... ELECTRICAL INSPECTOR A Check 4 5097 Commonwealth of Massachusetts Official Use Department of Fire BOARD OF FIRE PR APPLICATION FOR PERMIT All work to be performed in accordance with the 1 (PLEASE PRINT IN INK OR TYPE ALL INFORMATI N) City or Town of: North Andover By this. application the undersigned gives notice of his o'` her tE Location (Street & Number) 180 Chickering Rd Unit�O Owner or Tenant Francine Owner's Address 180 Chickering Rd Unit North Is this permit in conjunction with a building permit? Purpose of Building residential Permit no. Services �C' e Occupancy and Fee Checked 00 I16N REGULATIONS [Rev. 11/99] (leaveblank) PERFORM ELECTRICAL WORK husetts Electrical Code (MEC),527 CMR 12.00 to Date: 3.23.2004 To the Inect re of Wire a electrtcalwor�C describedsbelow. Telephone No. 1-978-975-1153 MA 01845 Yes ❑ No [X] (Check Appropriate Box) Utility Authorization No. Existing Service Amps / Overhead ❑ Undgrd ❑ New Service Amps / Overhead ❑ Undgrd ❑ Number of Feeders and Ampacity No of Meters No of Meters Location and Nature of Proposed Electrical Work: change box in ceiling to fan rated box and hang fan No. of Recessed Fixtures No. of Ceil.-Susp. (Paddle) Fans No. of Total I Transformers KVA No. of Lighting Outlets No. of Hot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above In -No grnd. ❑ rnd ❑ of Emergency Lighting Batter Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiatin2 Devices No. of Ranges No of Air Cond. No of Alerting Devices, . No. of Waste Disposers Heat Pump Number Tons KW No. of Self -Contained Totals: Detection/Alerting Devices No. of Dishwashers Space/Area HeatingKWoca Municipal Other ❑ Connection ❑ No. of Dryers Heating Applicances KW Security Systems: No. of Devices or Equivalent No. of Water Kit No. of No. of Data Wiring: Heaters Si ns Ballasts No. of Devices of Equivalent No. of Hydromassage Bathtubs No of Motors Telecommunications Wiring: Total HP No. of Devices of Equivalent OTHER: itt h addi 'onal detail i e iredd or s re fired b die Ins pe r n Cres. INSURANCE COVERAGE: Unless waived by the owner, no permit for die performance otf e�ectficai %VA ma tssuepun�°edtWie 4 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: K] INSURANCE ❑ BOND[—] OTHER (Specify:) (Expiration Date) 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 I certify, under the pains and penalties of perjury, that the information on this application is true and complete. FIRM NAME Power Wiring & Emergency Response, Inc. LIC. NO.: A17354 Licensee: Stephen Decker Signature7 LIC. NO.: + (If applicable enter "exempt" in the license number line) Bus. Tel. No.: 1-800-418-3221 Address: 44 Stedman St, Unit 2, Lowell, MA 01851 Alt. Tel. 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 (chec on) ownero❑�ner's agent. f� Owner/Agent PERMIT FEE $ 25.00 CDIUMIAa Gas - of Massachusetts A NiSource Company 995 Belmont Street Brockton, MA 02301 January 23, 2013 Mr. Antho ay Paimikaria 180 Chickering Road, apt. 1030 North Andover, MA 01845 Dear Mr. Palmiganw. Dui;iiia; a recent visit, our serviee techrilcian detected a safety prohle-in with your gag conversion burner at 186 Chickering Rd., Apt, 1033 — North Andover, MA 01845 - fisiing broke on flex. Aceordingiy, we have issued a Warning `71aag because of this situation. Under the circumstances, we strongly urge you to correct the code violation. In addition, the Massuehusetts code Partahli g tv tho iristfifialloll of gas appllanees and gas piping, established under Chapter 737, Acts of 1960, rewires that the condition be reineditd. If you have any questions, please call our service Department at 1MO-677-5052 and ask to speak with the Service Supervisor. Please disregard this notice if the condition has been corrected, Sincerely, Columbia Gas of Massachusetts r.. .