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HomeMy WebLinkAboutBuilding Permit #942 - 120 SALEM STREET 6/28/2012 BUILDING PERMIT o�No D 6Ati TOWN OF NORTH ANDOVER 3a yE:,,.- ._ tb �� APPLICATION FOR PLAN EXAMINATION ° ; y r �a � Permit fd0. r Date Received ��RAO a��y� RSSACHUS�'t Date Issued: IMPORTANT:Applicant must complete all items on this page yfi•y� s,�.,. dim au SPw'` u. .,y., „x c;y+, t�.t P+S'.� °MGtr ,, �f. rr.,<.e� t� vn s: +. P c+e7 "T+��.;*_1 �r`t �17 ft r rgd�y...� r{ �' i 3 f -,y..g. a .' 'a�' �7�F' .4-dI�' r+<`'"'�; y iLO.CARTI©Ni 'w+.i � #s..x r N �.ariAt•,. ,s.s -M+tin+V .wSs.,..c�r 4vT �r�+�s� � a 5��.r—,a ,,�y� ”'t*r "� �c $ 4P��t "� .. f �ttSa.., Ykk '4 PRO EPEP RTY OWNER ''_ _ a y{ . r? .� ;Punt :. ,, .A x �. MAP N®s_ PA ELe xZONINGDIS=TRICT� s =Historic vDist�ict Y � `� �' � � z ,�- ,�, - ,4„�-� a',a. "a...,.- ,, t,�.res..�'^*��'..L�S r""ia xr ��t 'r z '^ '��vy �n .'� �. �'','►,,. ;, �.=.�..� ,�..�.��.�.'. _ ..,�a� .�;�.��. -�.�: Maciime ShoP.�Villa9e�aY. S �� n �� s� TYPE OF IMPROVEMENT PROPOSED USE ' Residential Non- Residential New Building One family Addition Two or more family Industrial Alteration No. of units: Commercial Repair, replacement Assessory Bldg Others: Demolition Other l :.;; .i ;f r w� + .moo Y ti h Ps h- r : Septi Well ';�, �, 'i �EFloodp�la�n �� Wetllaa_n.ds `'� # = VV�,atershed Disfrict �,� �' _ ,,. �� 4Water/Sewer. ,��.._,.4..F...-.�., . . . DESCRIPTI N OF WORK TO BE PREFORMED: i av w � � ��S e cGC ,. c� � _k Iden 'fication Please T pe or Print Cle ly) OWNER: Name: fA Pc,�I +- lNle �s �ru< ���i Phone: s Address: l-2 QrM t r�GQo�e _ •.,,�.�.;. �--,�-�� �-.�.���•�r-ter �'�,.�, 4.��=, �.� �-- �..� �.��,-�... CONTIRAC�T®R 4Name i N ' S� �L tic = � :.. Phone �l�.2'9 �r��� 'J�2 : . .' ,..,,,,p .� s- - "-, w ,,,+.... ._„^^� -- -`°--$ '. 'ter- �:: y�"z.-n`r�..�,,.'�sZ. c, {t ` ' V 1 r `..F JY`••r l.•�/ `V Isr scar 'F I lS ''}1 'K A"cld�ess� . YZ G lM 5_ :I�GI _ - .'? .,._=-f - , �Su ervisor"sC struction Licens `�� � y4 '� ` R �,P I� e l __�L-- Exp 4Date g` `�- � ri 4 a �{ ^S 3 ?;�'�+,E 'k y�rE � ��r"r�r %t'' �� "^R:;r�° r � �` �`�'� + re Hometlm rovementgLicen e `� . : �. 7�,� dEzp Date: �, � Y. v ARCHITECT/ENGINEER Phone: Re No. Address: 9• FEE SCHEDULE.BULDING PERMIT.$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.00 PER S.F. D Total Project Cost: $ 7 4f0 O FEE: $ v Check No.: Receipt No.: ���� NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund ti Signature;of Agent/Owner � .�4�4 ° _��ti�.• 4* 1sk p'ature of contractor �'�� �t : .4:,a : Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work ❑ Engineering Affidavits for Engineered products NOTE: II off from Fire Department prior to issuance of Bldg Permit A dumpster permits require sign p p g Addition Or Decks ❑ Building Permit Application ❑ Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report ❑ Engineering Affidavits for Engineered products NOTE: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must thenget this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application a I Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2008 Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL Public Sewer Tanning/Massage/Body Art Swimming Pools Well Tobacco Sales Food Packaging/Sales Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on ' Signature COMMENTS HEALTH Reviewed on Signature COMMENTS I Zoning Board of Appeals:Variance, Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water & Sewer Connection/Signature&Date Driveway Permit I DPW Town Engineer: Signature: Located 384 Os ood Street f, '* rp %�7E�.`-c'�''' a �Y'd{4 s. aL ,'d. X �_S2- �n;r o"�`k s a.Lvt - FIRE"DEPARTMENT =Temp Dempster on siteyes ".fnoi�� Xr�- �,� � ` -t , w... # r - L-1 '124 Main St er eta '- s�..�+�rY* 1*tom aar..,� " .`t]�� FireDepartmentsignatureldate 1P,6t � ' k.-oc.a..,-r.>..�—�.�.. *:'�f`.!^.�:-- ..., - �.ra'�:� ac+a:.w.3r.�iiii ,..�:'�.�,ii�c. ,..a..s.::�..:i.s.;:�.ruga;.�.....�'4s.+.:.N€.5�....,,s.-_.:,•.ia.n,-a-;:r:�k,7hs. -J Dimension Number of Stories: Totals square feet of floor area based on Exterior xtenor dimensions. � Total land area, sq. ft.: ELECTRICAL: Movement of Meter location, mast or service drop requires approval of Electrical Inspector Yes No DANGER ZONE LITERATURE: Yes No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA— (For department use) I ❑ Notified for pickup - Date Doe.Building Permit Revised 2008 Location No. zj Date o - TOWN OF NORTH ANDOVER • Certificate of Occupancy $ Building/Frame Permit Fee t d Foundation Permit Fee $ �'J Other Permit Fee $ TOTAL $ Check#� 25468 wilding Inspector NORTH -own of t ndover . - 0% No. h ver, Mass ° �ycocHIC"IWICK Q°R.►TE o ►�P�,�.c5 S U . BOARD OF HEALTH PERM D Food/Kitchen Septic System THIS CERTIFIES THAT ...................... ... . �.. . ...... ..........................k..... ........... ....................... BUILDING INSPECTOR ASOL Foundation has permission to erect . ............. ........ buildin son .... ,,. ....... ..... .....� ......... Rough to be occupied as .... �.�... .......C.R. .� .. .....saw.....0 4A0!S.......j... ....:...... Chimney provided that the person accepting this permit shall in ery respect conform to the terms of the application Final on file in this office, and to the provisions of the Codes and By-Laws relaWAX tion, rat" and° Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTI Rough Service ............................. Final BU ECTOR GAS INSPECTOR Oeeupaney Permit Required to Oeeupy Building Rough Display in a Conspicuous Place on the Premises — Do .Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. SEE REVERSE SIDE L NameNameA Company Name L i,sja 1, SIDING GUY, INC. 17Street Address(do not use a Post Office box address) Contractor/Salesperson/Owner Name �LS 5 p((1AA .Joe Wink 978-621-0729 City/Town State Zip Code Business Address(must include a street address) 0 "j0(if.JL pq 181 Concord Road Daytime Phone Evening Phone City/Town State Zip Code Chelmsford, MA 01824 Mailing Address(It different from above) Fax 978-256-0606 Federal Employer ID or S.S.Number 043502484 Home Improvement Contractor Reg.Number Expiration date Law requires that most home y improvement contractors have 294'377 a valid registration number ' r o The Contractor agrees to do the following work for the Homeowner: 7 (Describe in detail the work to completed,specifying the type,brand,and grade of materials to be used,use additional sheets if necessary.) S P Required Permits-The following building permits are required Proposed Start and Completion Schedule-The following schedule will and will be secured by the contractor as the homeowner's agent: be adhered to unless circumstances beyond the contractor's control arise (Owners who secure their own permits will be excluded from the Guaranty Fund provisions off0ycDte when contractor will begin contracted work. MGL chapter 142A.) ` !aX (r-Date when contracted work will be substantially completed. Total Contract Price and-Payment Schedule The Contractor agrees to perform the work,furnish the material and labor specified above for the total sum of: Z Yoe/ (*) Payments will be made according to the following schedule: $ AT START $ Y�l by HALFWAY $ upon completion of the contract. (Law forbids demanding full payment until contract is completed to both party's satisfaction) The following material/equipment must be special $ V to be paid for ordered before the contracted work begins in order to meet the completion schedule.(**) $_ to be paid for NOTES:(*)Including all finance charges(**)Law requires that any deposit or down-payment required by the contractor before work begins may not exceed the greater of(a)one-third of the total contract price or(b)the actual cost of any special equipment or custom made material which must be special ordered in advance to meet the completion schedule. Express Warranty-Is an express warranty being provided by the contractor? ❑No❑Yes(all terms of the warranty must be attached to the contract) Subcontractors-The contractor agrees to be solely responsible for completion of the work described regardless of the actions of any third party/subcontractor utilized by the contractor. The contractor further agrees to be solely responsible for all payments to all subcontractors for materials and labor under this agreement Siding Guy work guaranteed as long as we're in business Contract Acceptance-Upon signing,this document becomes a binding contract under law. Unless otherwise noted within this document,the contract shall not imply that any lien or other security interest has been placed on the residence. Review the following cautions and notices carefully before signing this contract. • Don't be pressured into signing the contract.Take time to read and fully understand it. Ask questions if something is unclear. • Make sure the contractor has a valid Home Improvement Contractor Registration. The law requires most home improvement contractors and subcontractors to be registered with the Director of Home Improvement Contractor Registration. You may inquire about contractor registration by writing to the Director at 10 Park Plaza,Room 5170,Boston,MA 02116 or by calling 617-973-8787 or 888-283-3757. • Does the contractor have insurance? Ask the Contractor for his insurance company information so that you can confirm coverage,or ask to see a copy of a"proof of insurance"document. • Know your rights and responsibilities. Read the Important Information on the reverse side of this form and get a copy of the Consumer Guide to the Home Improvement Contractor Law. I You may cancel this agreement if it has been signed at a place other than the contractor's normal place of business,provided you notify the i contractor in writing at his/her main office or branch office by ordinary mail posted,by telegram sent or by delivery,not later than midnight of the ` third business day following the signing of this agreement. See the attached notice of cancellation form for an explanation of this right. DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES!!! 4 Two identigal copies of the contract must be completed and signed. One copy should go to the homeowner. The other co y should be kept by the contractor. I �, - ZG - /Z - omeowne s Signa re Date Con actor's Signature Date i t. --- — J M &64.0) Ba°�uuea L sine✓ss Reg Office of Consumer Affairs& CTOR HOME IMPROVEMENT CONTRA Type' Registration 1T1,290 -Corporation ° Expiration 31512014 - SI G GUY INC: JOE WINK 181 CONCORD RD Undersecretar CHELMSFORD;MA 01824:;„ '' tts- mcpartn►cnt of public Safc" i•9ass.tciiuscI �\� ., ��ul ttions and Standards Board of Buildin.,Re' -'u,. or License Construction Sup 92 1020 j License: CS , Restricted to: 00 r `� JOE WINK 32 CONCORD RD 3. BILLERICA,-MA 01821 ,v Expiration: 812812012 TrK..102092 x^ A' WD- CERTIFICATE OF LIA131LITY INSURANCE DATE(MM/oOrYYYY) PRoour 5/22/2 012 JAN SLJLLIVAN INSVEix1NCE AGENCY I]IVLYCANDF pTe IS ISSNFERS UED l AS A Ml1PON� THEN OR INFORMATION TH 8135 Sin Street HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR Tau aury, MA 01876 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. (97 BSI-9600 INSUREI'!@ Siding Ginn I>RC INSURERS AFFORDING COVERAGE NAIL# INSURER A: —0 a e Insuran a CoiapaaY 16] COncOrd goad INSURER B: AIG InS11rance Company Chelmsford, MA 01824 'INSURER C: Pl gra.m TnSurance Company INSURER 0. COVE IES INSURER E: THE CIES OF INSURANCE LISTED BELOW HAVE BEFy ISSUED TQ THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY !UREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH. TO WHICH MAY TAIN,THE INSURANCE AFFORDED 8Y THE PORGIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH DOL AGGREGATELIMITSSHOWNMAY�yVEE1EENREDUCEDBYPAIpC!AIMS. THIS CERTIFICATE MAY 8E ISSUED OR MBR D LTR Nd TYPE RAN E J �ENt RAL LIABILITY POLICY NUMBER p 1C EUOoCIVE POLICY EXPIRATION DATE MP.VDDlYY LI COMMERCIALGENERALLIABILITY MITS EACH ac CURtiENC[ $ L000,000 CLAI►dSMAOE OX OCCUR PREMISEmU S Eel m1mW xenee $ JPO 000 A CLS-1198503I / WED EXP{Anyonspa'son) $ 5 Q00 3/ 03/� f�z 0 3/22/13 PERSONAL 1,14JURY — -- $ 1 0 0,000 -1 POLICY LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000 OQO UTPOLICY ITT I LOC PRDDt1CTS-COMPIOPACG $ 2,Q00 040 AUTOMOBILE LIABILITY ANYAUTO I COMg1NED SINGLE LIMIT `ALLOWNEDAUTOS I {Eaeccident) g 1,000,0D0 X SCHEDULEDAUTOS C 'BODILY INJURY HwEag AUTOs PGC1 Q 00 g 6 64 632 tPer person) NOWOWNEDALrrOS 0 9/21/11 09/21/12 POrDaxToertgRY $ 3ARAGELIABILITY RROPERTY DAMAGE S I4t),O0� rr (ParaccIcent) _fANYfW7D II AUTO ONLY-EAgCC PENT 13 -XCESSPJMBRELLA LIABILITY OTHER THAN EAACC S J OCCUR CCAIMSAUTOQNLV; AGG $ _ NADE EACH OCCURRENCE AGGREGATE GGREGATE $ RETENTION g 5 1 ERSCOMPENSATIOAIAkO $ t )YFRS LIABILITY $ � :ROf.PLtRF�IyEgTpORq PMrjW CLIJOED9>��tnryg IWC 89J-OB-38 x RYLIII R esdibeundar 0Q/1Q/22 0 4/10/13 E.L.EACHACCIOENT $ 100,000 4L PROVISIONS below I Z E.L.DISEASE-EA EMPLOYE $ :L00'000 E.L,DISEASE-POLICY LIMIT S 500000 I I � DESCF NOF OPERATIONSlLOCAITONSJVEHICLESIEXCLU$IONSADOEDBYENDORSEMEIYT/SPECVILPROVISIDNS Jo: h Wink is cornered by the workers co mpensatiort policy. CERATE HOLDER The Si CANCELLATION g7 CC cord Ro IOULD SraNY DF THE ASOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPI L`heltIISfOrd DATETIIEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MATO RATIQy 0 9 29 TTeN NOTICE T4 THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO DO Sp SHALL I IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE REPRESENTIVES. INSURER ITS AGENTS OR + TA AU7HORtZE ENTATIVE of 1(20011 08) �d 4ACORD CORPORATION 1988 8b8�6988166 The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual): /acr 6 U Address: �,$( Crvc,,yd I"z City/State/Zip: C�eL6,l;1�4 km4- 61 S i Y Phone#: 77F-62/-0724' Are you an employer?Check the appropriate box: Type of project(required): 1.[Kh am a employer with 4. ❑ I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2. [_] I am a sole proprietor or partner- listed on the attached sheet. ['Remodeling ship and have no employees These sub-contractors have 8. ❑Demolition working for me in any capacity. workers' comp.insurance. 9. ❑Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its required.] officers have exercised their 10.❑Electrical repairs or additions 3.❑ 1 am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs insurance required.]f employees. [No workers' comp.insurance required.] 13.❑ Other *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. I 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 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: Cj Policy#or Self-ins.Lic.#: Ld`C g q,5 Q g - 3 Expiration Date: 946 -/72 Job Site Address: 17. City/State/Zip:_ /V, q p�.d�,vG�Z �r 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 r the ,pains a/n�d penalties of perjury that the information provided above is true and correct. Si nature: q W /x'_/G Date: 6 r2 Q �� 2- Phone#: l 7 9- l� A- 6 7i7 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#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such 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 compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of 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 permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn 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 call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel. #617-727-4900 ext 406 or 1-877-MASSAFE Revised 5-26-05 Fax# 617-727-7749 www.mass.gov/dia TOWN OF NORTH ANDOVER NORTH BUILDING DEPARTMENT of �t�ED ,6g1'o 1600 Osgood Street, Suite 2-36, North Andover Ma 01845 0 4t - NOTICE OF VIOLATION ORATED rPP` '�� _ 9SSgcHUS�� Date: Address: Building Zoning BylawrE3 Stop Work Order ❑ Certificate of Inspections Electrical Plumbing Gas Violation observed: irl - UA) 0iA ILg Failure o y ur p rt t comply with this notice within 10 days may subject you to penalties prescribed by Massachusetts Law 780CM / No d_.owef"s Zoning By law. Please contact the Building Department for further information at 978-688-9545 Inspector Home Owner Contractor