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Home My WebLink AboutBuilding Permit #141 - 21 BONNY LANE 8/28/2003 1 , TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING , �• a ,mss ��.' a:.y rr `R ' BUILDING PERMIT NUMBER: � �Cj I DATE ISSUED: SIGNATURE: Building Conunissioner/lEg3ector of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: towe-. (o D, 3 - Map Number Parcel Number �1 ark 14J dveK- / IMA- �—� 1.3 Zoning Information: 1.4 Property Dimensions: Zoning Distrid Proposed Use Lot Area Frontage ft 1.6 BUILDING SETBACKS ft Front Yard . Side Yard Rear Yard Required Provide R red Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record �7 / �,/ (� N�Id✓l V Pe La 41,0 Z� l7d YI h1� Lq�12 ��U✓T rl �l'1 0V �G 1�I5 Name(Print) Address for Service 9768 -2143 Signature Telephone 2.2 Owner of Record: Name r4:nt Address for Service: O z M Si nature' Telephone SECTION 3-CONSTRUCTION SERVICES 1 90 3.1 Licensed Construction Supervisor: Not Applicable ❑ {M,Ryk `ry`ai\ka I Pe�P s&-'7 'edcp- Licensed Construction Supe isor:: 6606 z 1 l39 5M/an/M License Number M Address C-7 W(p—q4, Expiration D to Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number M r Address Expiration Date Signature Telephone Q Location �� BnNN�1 AAU--,�- 8-38-0a r No. I I Date MORTiy TOWN OF NORTH ANDOVER 00w A Certificate of Occupancy $ IT �cMus E<� Building/Frame Permit Fee $ �� S s Foundation Permit Fee $ Other Permit Fee $ L TOTAL $ • Check # 0 16656 Building Inspector rm ertiffitrate of tatunre REGISTERED Q of ut�F G ISSUED BY APPLICATION :_ ANCHOR INDUSTRIES INC. Date of Manufacture i NUMBER EVANSVILLE,INDIANA 47711 5/31/94 ' � F140.1 Order Number�i- M��y P MANUFACTURERS OF THE FINISHED RET�`�O TENT PRODUCTS DESCRIBED HEREIN 055459 ; This is to certify that the materials described have been flame-retardant treated (or are inherently noninflammable) and were supplied to: PETERSON PARTY CENTER INC t 139 SWANSON ST I; WINCHESTER MA 01890 Certification is hereby made that: The articles described on this Certificate have been treated with a flame-retardant i. approved chemical and that the application of said chemical was done in conformance i ' with California Fire Marshall Code, equal to or exceeds NFPA 701, CPAI 84, ULC 109 Method of application: 01 Serial#: t, 8157000C (0002) %Itl Description of item certified: CENTU END 40Wx2O VL W W 1610Q SNYDER WITHOUT BLOCKOUT Imp Flame Retardant Process Used Will Not Be Removed By Washing And Is Effective For The Life Of The Fabric SNYDER MANUFACTURING3to Flame Resistant FinishNEW Signed: ate_ A. I TENT ARTMENT—ANCHOR INDUSTRIES INC. .r w .. .r nnr ..r 1 .r .�► .� t w. I IN c s �et ` ` r It ftp Z Of . l�t � stanve . . • f. REGISTERED Q of �(i� C ISSUED BY f APPLICATION y �y ANCHOR INDUSTRIES INC. Date of Manufacture 1 y :o NUMBER r EVANSVILLE, INDIANA 47711 5/31/94 �a F140.1 F� M�Q`'Qp MANUFACTURERS OF THE FINISHED Order Number f RETpa TENT PRODUCTS DESCRIBED HEREIN 055459 j d This is to certify that the materials described have been flame-retardant treated r. (or are inherently noninflammable) and were supplied to: PETERSON PARTY CENTER INC �. 139 SWANSON ST , WINCHESTER MA 01890 , /Iq - �o Certification is hereby made that: u The articles described on this Certificate have been treated with aflame-retardant I °r approved chemical and that the application of said chemical was done in conformance �o with California Fire Marshall Code, equal to or exceeds NFPA 701, CPAI 84, ULC 109 Method of application: r u, %r Serial#: 8157000C (0004) Description of item certified: CENTU MID 40Wx20 VL W W i r.•' 1610Q SNYDER WITHOUT BLOCKOUT >ru� Flame Retardant Process Used Will Not Be Removed B '«< Washing And Is Effective For The Life Of The Fabric II SNYDER MANUFACTURING NEW Signed: 11 , 1 It of Flame Resistant Finish dttw• TENT ARTMENT—ANCHOR INDUSTRIES INC. • „�O� � �i �i �i �i .... ..r �r .r �r O � \r vvO..ro\go*0�ro\ I I I O r PLPd-��rjEDipJJEND onEEDMErmEm Rjujur�oi-EN-21 IMPORTANT DOCUMENT S 5 5 5 5 (fertifirate of if lame 1316"Ve'a5taure 5 5 ISSUED BY REGISTERED �iF G Date of Manufacture 5 APPLICATION Q � i CNOR. 3/06/98 5 5 NUMBER NDUSTRIES INC. 5 y�Z EVANSVILLE, INDIANA 47711 Order Number 5 5 F121.4 S 183326 5 ET MANUFACTURERS OF THE FINISHED 5 TENT PRODUCTS DESCRIBED HEREIN 5 5 This is to certify that the materials described have been flame-retardant treated 5 5 (or are inherently noninflammable) and were supplied to: S 5S PETERSON PARTY CENTER INC S 5 ON ST 139 SWANS5 S 5 SWINCHESTER MA 01890 5 5 5 Certification is hereby made that: 5 S The articles described on this Certificate have been treated with a flame-retardant approved 5 S chemical and that the application of said chemical was done in conformance with California Fire 5 5 Marshal Code, equal to exceeds NFPA 701, CPAI 84, ULC 109. 5 5 The method of the FR chemical application is: 5 �j Serial #: 8001800 (0001) 5 5 Description of item certified: 5 5 FI TOP 20W X 30 VL W W 5 5 � 5 5 Flame Retardant Process Used Will Not Be Removed By 5 5 Washing And Is Effective For The Life Of The Fabric 5 5 Signed: L Name of Applicator of Flame Resistant Finish TENT DEPARTMENT—ANCHOR INDUSTRIES INC. L� D rJflJ�rJff�rJ�EP[ [J�rJ�EPEPr PrJ�[P[J�EPEPr PEJ�[J�EPEIEPE PEP[�E..j 1��rJ�r�rJ�EPr�rJ��rJ�rJ�EPr�E I��rJ�rJ�rJ�r�rJ�rJ�tPc PE P[ [J�[J�[J�rJ�EPctEPCJ�CnEPCPCJ�[ [1�PCJ�[�rJ�EPr�rJ�rJ��PrJ�r PEPEPEPEPE P (001MW,u,flftw�r<<</ of A,,,wac1wJe BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 060219 Birthdate: 04/27/1954 Expires: 04/27/2005 Tr.no: 9542 Restricted: 00 MARK TRAINA 33 HANFORD RDS, [2a/ STONEHAM, MA 02180 Administrator _-� The Commonwealth of Massachusetts Department of Industrial Accidents fat O/l/ce a//ores7igat/oos —__ - 600 Washington Street Boston, Mass. 02111 ~ `7 Workers' Compensation Insur-2nce Affidavit nzmt:� locition. city phone t ❑ I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity 1 am an employet providing workers' compensation for my employees working on this job. comotnyname C c/ Y� J�'•�.� / ��T�� /�ylJ 4 /' �/� addrCIS: i 3 Ste✓ C' ✓r��/ s�` city: �!�-,!'�,?,ti�y�..�r'� Yyt;C,•' � -,., nhonc intnranc; co. / 7; �i!r ' _Ugllcy M J i arra a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: L:�can� name i nom• ..�-��_...-::.:+:��...w.«........�•r-..��`=_�s"s'Ya�3£:,."d..;.�,.�'�s+s�.n.� ir,.r—a'. �--A.r1T-•�s.9�s�__ _-.arr..-�ratr..r� �.G�L�ys}�r"1ar^s�:v-�n.�,'J�'.psi=re:.�u...�'„�,..�ae�t,::.� c9moinv nrme• add ress- cirv: ohon # insuran[c Co, policy it r1II1e 'a f�IdOCa 7 t1[ :.q � �s��aa t:�-�-�� Re3zwx >•� IC�+a��.�—�.��.� Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of it fine up to 51.500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. I understand that a copy of this statement may be forwarded to the Officc of Investigations of the DIA for coverage verification. I do hereby certify under the pains acrd penallies of perjury that the information provided above is true and correct Signature Date r � Print nameo�`�Nf 1>l ✓tiP�/\-�' Phone q %Y�—7o7V' �D official use only do not write in this area to be completed by city or town official city or to-n: permit/license M 7CO)HC21[h tment i (] check if immedute response is required ice ent contact per-ion: phone z; r-iOthcr nd 411 T, V -it JQT r :4 Ort F. 1-7*..- , I_71" Ill 01i "I t t. it :rt Ni, .. ............ • 4N z Jr uri 7,W Jill! 0;4p w4i;�. ."tgt T. fii C/o I ALI l 04, Nrii WAR'," NORTH 0Twn of f r oAndover {,. to No. � 8ja803 o� o� L �HIC � dower, Mass., %S0RATED PPG`-` . H 4` BOARD OF HEALTH Food/Kitchen PERMIT . T D Septic System P*&4 fka N BUILDING INSPECTOR THIS CERTIFIES THAT..... ..........d. ... . Foundation .............................................. .....................................L�'has permission to erect........... � $�.... buildings on ....�..I........ .O..1V.N�.f!':....... N.�......... Rough ♦ �d i o� 1'•aAi S 9" 3 TOM dye�� 403 Chimney tobe occupied as.......... ......... .................................... ............................................................. ...................... ........................ provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. 6142 , O PLUMBING INSPECTOR as VVIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough ., ............ M...A .......... ..............................................:...... Service BUILDING INSPECTOR Final Occupancy Permit Required t0 Occupy Building GAS INSPECTOR 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. =SEE REVERSE SIDE smoke Det.