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Building Permit #754 - 33 BEECH STREET 5/17/2007
BUILDING PERMIT TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: n�r Date Issued: (D Date Received 7th., 4L of Residential TYPE OF IMPROVEMENT PROPOSED USE Residential Non- Residential ❑ New Building One family ❑ Addition ❑ Two or more family ❑ Industrial Iteration No. of units: ❑ Commercial ❑ Repair, replacement ❑ Assessory Bldg ❑ Others: ❑ Demolition ❑ Other :Q "Wil r e �0 Flood ❑ Wetiands WaeeshedSepticestic C Water/Sewer a s OWNER: Name: DESCRIPTION OF WORK TO BE PREFORMED: ification Please Type or Print Clearly) s R, d 61,.. ne: 3 — 2—t"7 l ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE: BOLDING PERMIT: $12.00 PER $1000.00 OF THE TOTAL ESTIMATED COST BASED ON $125.00 PER S.F. Total Project Cost: $ U Z� FEE: $ '2- 49 Check No.: /J Receipt No.: a NOTE: Persons contracting with unregistered contractors do not have acc s to t e uaranty f d Signature of Agent/Owne zSignature of contractor Location C- • p a --- No. -t3_ Date NORTH TOWN OF NORTH ANDOVER • OOL D Certificate of Occupancy $ sE<� Mus Building/Frame Permit Fee $ 2 i Foundation Permit Fee $ Other Permit Fee $ — TOTAL $ 4 Check # Y 2029- Building Inspector 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 PLANNING & DEVELOPMENT ❑ COMMENTS DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED CONSERVATION ❑ ❑ COMMENTS HEALTH COMMENTS ■❑ DATE REJECTED DATE APPROVED 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 Located at 384 Osgood Street _FIRE ©EPARTM'ENT _- Temp Dempster an site yes no Located at 124 Main �Streel Fike Department signature/date CO) m m m m omw /♦ YI EP C2 y Cos d C � d O !7 Z CDy 06 o �, � � O d y 300 to -0s CD o p CL � o C7 �c m co CD 0 cc w C CD y� CD O: O y C I C2 CO) O -o Z CD oCD 0 dcCD - F. a O` OZ d o �' r ro a o CrrT^^ p o w d m ro /V/�l / m Vi pt� e z�� H / cn O d � � c z o� O F. a O` OZ d o �' o ro o rr t3i p o w d �'ITI cpn ro oz � � z F. a O` CO) m m m CO) m mm y 10 CD aZ CD O d CL O 0 0 CD CL cr =� CD O CLO CO CD CD .0 CD 0 y d d• O CA n� C. 0 c CD d CD O r� CD CO) CD COD 0 G g,R Om �goC� y w ° a- cc CL �-o C N sa a o � b -JoIr .'co m r m GOD M 0 a. cf) c 0 Z� O y n C =r 4a C. 40 mS. :F: m CLO < s?. m y /C!) C ) O `� m CLCD m IA fA m O � z�N! Cn C O CL y cy rn FW O G g,R Om �goC� y w ° a- cc CL �-o C N sa a o � b -JoIr .'co o r m GOD M 0 a. cf) c 0 Z� O y n =r C. 40 mS. :F: CLO < s?. m y O CLCD m IA fA d y CIO CL Cos O M m CO3 _ W- a c- < m IE ci: yQ m C.� y 7 m O: mom:. CD b �o 0 0 � m N m CD: r 0 C. BL: Mme: cn o w ° a- ° 4� r ro :3o �' b �" x o o GOD M 0 a. cf) ITI \ • d y 0 0 c The COIlpttt+aOM"Wim of MdM'W''rh'Vts► a „ r Ikporti>rtrat of INdIUSIrial Acc+*Ntt Office of INvelfirelions 600 Washington slNret r Mostotr. MA 02111 wWts.wMs&90v/mist Worktrrs' Compensation Insurance Atiidavit: BoilIMMUM df;•ra/Contractotrs/Eketricians/Plt bens D1...._ n_ - . . - Name (tffecim�wdt)muniralkm/tn�fividu;dt; - - cess:_�.��:�,�.�_._.�:�`.._.__�1�1�_.1�..,,�d�,�►.,�., City/State/Zip' ph-�_.. one, H: Are you an employer? Cheek the apprepriue be:: .� l P I am a empioyar with, 4. ❑ 1 an a general contractor. and 1 — ..__ empbyeas (Bell and/or past-fitne).• 2. ❑ 1 am a sola prgwietor or partrfar- have hired the wb-c�on listed on the attached sheet, ship and have: no employees These sub -contractors have wodting for the in atey capacity, workers' camp. insuraetee, (No workem' comp. insurance 5- ❑ We are a corporation and it, required., 3. [] officers have exercised their t am a ho tneowne r doing all work right of "emption per MGL myself [No workers' comp. C. 152. 410). and we have no insurance required. j' employees. (No workem' comp. inseasr m re"ired.l Tylie of Pnsker (nQnit^rft}: - 6. [} New comirwtion 7. tF Remodeling s, ❑ Demolition 9. )n 10.0 Electrical repairs or additiom 11 •❑ Pli mbing repairs or additions 12.[] Roof repairs i 3.❑ other Tnwr %"***14 i4movewom who aebeert 0"N deidwif iw/kMil MeY we dwis ON wn# sed tfwe fries inft►nnwfwn. 'C olNwelers heat abed ft bete nN1M 0"w M Nu tiefwti *M "awrep 1* twee of Me SMMMrMnw sees and fbeir 1t w new nftNpevif indiptiph urs. 1 m1t eNf eatrbyel t N hPRM4111IN9 worklrs'Q� `'" V FACY infi+mobw in f�teaau itaarneoet jor RIPe� Setlow Is elk Mary ,10 aMe Inatmattfee Company Name: !06 5ite Address: w ei Att�mperaetba paley deeflarrifiase ati a copy esrMens' Page (aleowlreg Hee Polly nomber sad e%pireflos etksNsj, Failure to afecure coverage as required under Section 25A of M(3L c. 152 can lend to the imposition of criminal penalties of a firm up m g 1.300) 00 andlor ane -year k"Primitini et. as wen as civil penolties in die, /ixn► of u STOP W<Iiim ORDER esti a fate of up to 5254.OD a Clay tug the: vioiasor. Be advised that a copy of this stusonent may be forwarded to the (lfr of Invaftationt of the Of A for iris rmwe aivemSe verification. I sfo tY►r�}+ /rabss aaedprwo�Airs oIP +a►ot tlMe i�rNsaAlefr /rroy� feadesar � teat oxd c-er� PI►�►nn n• iS1 �) i Q� .r IYAM l uric on&. Do not WV* M I" arwr. to AW ceardived br L* ar gownn - City or Town: _ PermW t.ieefese N ; 0411tag Anderitr (cher ease). ! . tlrtard of ileaft L Quildift Delwartfaeat I Cisyf rowan Clerk 4. fEieetriesl Insptector 1. plo"bift Inspector 6.Ol�r Contest Perseus: Phone "HA NU. :19786833147 Jul. 18 2006 I1:I0AM Pi AC�eQ CERTIFICATE OF LUABiLi ��. TY INSURANCE wT�.TYY, !I.8 . R096RT8 IN Ig Mu S�i=cT INC. T� csRnr tl +a tawED A4f MAtTQR Of INjt—KB tON 1060 08000 STRUT *MY AMo c _ +cNo OW PON NORTH A1NDOM Mh 01885 ' AI's " � fxTr;No on 7 OR 8Y 1Mt F0 BELOW. W" X6VIp MURMY BUILDING 6 w1ups" A"ORp ft 4�..._.. _. R81NOD8LItiG a!xA1e,e ti 169 1B07CL M STVXZT B'R'A W ma �. CE MOM R, MA 01865 - .rteRlt a - n+E POlIC1E8 OF x18URA►aCE LIbTEO BELOtN N>YF Deco me.r..._ _.-- _ ' MAY MATAW NE � on OQNQ1fi0N Of AW- T M 7HWbUMP OW NAME MMW ,, ,t E FOk'111f 1'QIIOY 1'lRKyp,��� iK'�*MST �MbWQE AFF011pEp 0Y THE POLICIES OE80AL p[�MIN'S $L"OT TO All ftowT C M*cm TM18 CCRri NI8t1 OR POUCIA.wv A( �.�lfiATILIMIT1iMDYNrtM11Y/YWAIL�fNgQOLICEDIlYpA1pCWM8. �' '.CONOrT10N� Of SUCK rou6V %um *auCYTsr�ctl� ro y t DWML Lw1LRv 4a **om CUL dws@RAL 1.4�LITY CLANSM DI occlet A� CPPOO60866-01 11/22/05 21/22/06 OtbIL AoellsoAv U%OT wft" nM: AufammAJIVANM AWAM 1 i x.LoweayRoa T� sa�olxao AtlTO:a B I ""`DA1TOa 7AN0277013608 N01'FONM�OAV706 1 OAl1Adt Ltt4JTf 1 I AhvAlmo j E Nefeun LV*Lny t INOtpf[tp00tM�tT)LW /tlt0 b oLovem to MUTv AIM /Ao►AdraH/MAflibat10om bK=530339 G QIFIW^ wm t9 MAMM oN.YCoMm or opt"am Nal 1/23/06 11/23/07 um" ' 000 rComsrGu„M,.� � 00 ROcRA1.°CATe ' 000 000 Rda' Soono foo i t 2, 00o . ane _L. 'L 500,000 ACfrAlllwtr �• >taoltylNAxeT t All1'pp,A V`�ACCA7Ehi �t — o"ON Tow 11A ACC t ��nAphLv: A6t/ s eAe1. arccw�uw,� � AOM MIN t 7/01/06 7/01/07 1 eL e�a�rteclrkgrl I - Soo, 000 Ct. MAN -PCucYLW I t SOO . AAA CERTIRCATE HOL 0008 I ATION j &0" ANY Cp TMK AbM Of3OR"D rOLMOS HANC CRLLM W44*9 TWf WAArm TONIN OF 11NDONER, Mei SART=TT 9TR " wTM gyp. nM IRMJ c OSSUMM wai tis MWO m MAIL 10 hAv- wwrrF-, NoYM"'Coft GA7R rD1.Or.R t�A M M TNQ LOT, MR OAAAII! w w •U I—L Al1DOVSR� Mil olslo MnLDZM D APA 'RDKi1 M0q! NO OlLl0At10f1 011 LMM4RY Op MYV 144)tlptw fl4 1 NR OR M�1lalNMle AUT#A'AVMlr AZAR 'd tow AC011DZ/12001Al1 VACORO CORPORATION ISU NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM fn accordance 4vith the provision of MGL c 40 S 54, a condition of Building Permit at: 3 S �-,, is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by NIGL , 11, S 150 A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section 1 OA. The debris will be disposed of in: L�u ion of Facillty) Fire Department Sign off K/1) Dumpster Permit Signa o Permit Applicant Date 1* 011e. 11P O"k Nr M- qsr rWq% • 1W 404mm W wow V"01.0* awdiwe r► ILW. Building Contractor Proposal TO: Chris & Michelle Roche 33 Beech Street North Andover, Ma. 01845 From Kevin Murphy CCs Dates 1/2/2007 Jobs Bath Remodel Date of p1m s none Amlteet none Locatknx same Section 1- Work Schedule • 169 Boxford Street • North Andover, MA 01846 • PH: 976.68844 • FAX: 97$-SW?207 ,ml nano #Y prouenw* Contractors arxi subconaadas engaged In Home ftymemern oorlraclSng, unless 14e Iaws � yregisMed rrM ttm Conynar YpdM dMme. bqurm about mgsbaton and Sta n Rodd be made to to Ding, Home "pr—W4 Ca*W Regabaaon, One A*k rlon Place, Room 1301, Boelon. MA 02.108. (617)727 9588 Contractor will begin the wok or order the materials before the thud day follow" the signing of this agreement, unless specified here in writing contractor will begin wok at or about 211/07. Barring Delay caused by circumstances beyond Contactors control, the work will be completed by 3!30107. The owner hereby acknowledges and agrees that ft sc haduling dates are approximate and that such delays that are not avoidable by the Contractor shad no be considered as violations of this agreement. Sey tlon 11- V4wf my The Corttradm t wants that tt>e work furnished herewxier shall be free from defects in maWrials and workmanship for a period of 1 year Mowing completion and shall cornpty with the requirements of tltis Agreement. In the event any deflect in woftnanship or materials, or damage caused by the Contractor, his subcontractor;, employees or agents, is discovered within one year after completion of any job, including cleanup, the Contractor shall, at his own expense, forthwitfl remedy, repair coffee, replace, or cause to be remedied, repaired, or replaced, such damage or such defect in materials or workmanship. The foregoing warranties shall survive any inspection performed in connection with the agreed-upon work. Section 111 -Scope of Work oael�iaii�a9 i; AIWM4iOw 169 Boxford Sheet North Atr ow. NIA 61845 PH. 9786865336 FAX' 9786t36)" Page 2 of 4 General Proposal is to remodel existing first floor bathroom. Building permit will be provided by contractor. General layout of existing bath to remain the same. Dwno i&m Existing bathroom will be completely gutted and disposed of. Frame of existing arch above tub to remain. Building New Harvey replacement type window will be supplied and installed in existing opening. Any framing materials required to renovate bath will be provided. PkMW*V Plumbing required to replace all existing troth fixtures will be provided. An allowance of $1000 has been included for plumbing fixtures. ( $500 for tub, $100 for shower valve, $200 for toilet, $200 for faucet) Ekm*tcai Electrical work required to wire bathroom to meet code will be provided. New fan / light unit will be supplied and installed in ceiling_ Surface mounted fixtures to provided by owner ( vanity light) . HeatinglAw Conditioning Existing cast iron radiator to remain. insulation Exterior wall will be insulated to meet code. Plaster All renovated areas will be blueboarded and skimcoat plastered. Ceilings to match existing, walls will be smooth, closets will be textured. Interior TrknlDoors Existing bathroom door to remain. One new linen closet door will be supplied and installed. Other pre -primed interior trim will be supplied and installed to match existing. Flooring Bathroom floor, tub area, and half walls will be tiled, An allowance of $4 per square foot has been included for file materials. Painting There has been no allowance made for any painting_ O�O{it4 VtiYti{Tilt:{W North Andover, MA 01845 PH: 978688.5335 FAX 97&68 )D= Waste Removal All demolition / construction debris will be disposed of by contractor. Items Not included There have been no akw ances made to supply any cabinets or countertops. Page 3 of 4 aniinioq �iaawiraa:iui 169 Booftd Street Naas ArdMV, MA 01845 PR 97840&8335 FAX 97SM84000( Page 4 of 4 Secltion IV - Prim Schedule - We hereby propose to famish material and labor— complete in Accordance with above specifications for the sum of ..................................... $10,500 Payment to be made as follows: Percenta e4tem D"cripfion Amount 1 Demolition complete $2000 2 Plasteiing complete $5000 3 Job 100% com tete $3500 3 $10,500.00 Notice: No a for Fidite lrnproverr�arM castraping reorlc shall requre a deem P®Ymern is Mow depose) d— Brat -we4 d a1 tre tD W M*aet price d to total OWL" dad dapaela ar payrrwb whid the oorMaela mJ91 ntWnj in ndvanoe, b abler artd otterwge obfah d&Wwyd special crow ffmWft and e"wnent %t*& er s Wearer Contractor: Kevin Murphy 169 Boxford Street No. Andover, MA 01845 Registration No: 101874 Acceptance of Proposal — l have read this document and accept the prices, specifications, and conditions stated. 1 understand that upon signing, this proposal becomes a binding contract You are authorized to do the work as specified. Payment will be made as outlined above. You the buyer may cancel this transaction at any time prior to midnight on the third business day after the date of this transaction cancellation must be done in writing DO NOT SIGN THIS CONTRACT IF THERE ARE ANY BLANK SPACES Date "� Signature Date Dimension Number of Stories: Total square feet of floor area, based on Exterior 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 MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine NOTES and DATA — For department use ❑ Notified for pickup - Date Doc.Building Permit Revised 2007 M 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 L3 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: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks L3 Building Permit Application L3 Certified Surveyed Plot Plan ❑ Workers Comp Affidavit ❑ Photo Copy of H.I.C. And C.S.L. Licenses a 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 o 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 then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: INSPECTIONAL SERVICES DEPARTMENT:BPFORM07 Revised 2.2007 ® MAPFRE Commerce INSURANCE - July NSURANGE- July 15, 2014 The Commerce Insurance Companysm Citation Insurance Com panyw 11 Gore Road, Webster, Massachusetts 01570 508.949.15001 www.commerceinsurance.com BUILDING COMMISSIONER or INSPECTOR OF BUILDINGS TOWN/CITY HALL NORTH ANDOVER MA 01845 RE: Our Insured: MICHEULE P ROCHE Property Address: 33 BEECH STREET Policy#: XT2577 Date of Loss: 07/03/2014 File#: JHTK65-CVXMM2 Board of Health or Board of Selectmen Town/City Hall 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. REBECCA MCGOVERN THERRIEN Telephone: (508)949-1500 Ext: 15189 Sr Claim Representative, Property Toll Free: 1-800-221-1605, Ext: 15189 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. July 15, 2014 CIC 254 (Rev. 4/95) MAEL M33 Commerce INSURANCE - September NSURANCE- September 08, 2014 The Commerce Insurance Company'"' Citation Insurance Companysm 11 Gore Road, Webster, Massachusetts 01570 508.949.15001 www.commerceinsurance.com BUILDING COMMISSIONER or INSPECTOR OF BUILDINGS TOWN/CITY HALL NORTH ANDOVER MA 01845 RE: Our Insured: MICHELLE P ROCHE Property Address: 33 BEECH STREET Policy#: XT2577 Date of Loss: 09/06/2014 File#: JMKK60-CYTAX9 Board of Health or Board of Selectmen Town/City Hall 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 313 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. REBECCA MCGOVERN THERRIEN Telephone: (508)949-1500 Ext: 15189 Sr Claim Representative, Property Toll Free: 1-800-221-1605, Ext: 15189 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. September 08, 2014 CIC 254 (Rev. 4/95) MAIL M33 Location 3,3 Bece A J'No. Date G 16 2 I { TOWN OF NORTH ANDOVER *� 00/19/98 09:23 221.00 PAID �' Div. Public Works Certificate of Occupancy $ `4L Building/Frame Permit Fee $ a sA�►WSE C14U Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ - Water Connection Fee $ TOTAL f$ ` V • 1 (`^^^'^^^--- � Building Inspector *� 00/19/98 09:23 221.00 PAID �' Div. Public Works location t No. F Date NaRTM TOWN OF NORTH ANDOVER f 09 Certificate of Occupancy $ + s ; Building/Frame Permit Fee $ �ss�cHust<� Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ + Water Connection Fee $ —� TOTAL $ I f Building Inspector Div. Public Works r. � E IE"M N 3 n ti z -i z r R Z N o b n z z= ,i — Z z z — m m m �• ^ > Z Z D �j D rni t- G m Y r=, m z m J V' D m V _ z ^ .,.� Z O m � m c m o L/)C Z y — > m Z.�C Gpry n D A O m m ✓ x �. m ` 1 c Ira ri ^r b C2, p O C C D mm m Z � z ~ `i m m z m n z z m VZi Z Z Vf V! LA D Z m R Z p o m m v z vd rr -c z C V. O O r� -� - m W o � � m Z � 1f - D p rr, m, 1 N p C N O ,.y L T. z m O w y C) m CO) CD a Z CD O CZ o. n� 'O o v CD cr CD o a:O co CD CO) CD rI. CO) d d CO) n� C C CO) d C9 CD 0 CD CD CO) CD CO) — 7'0 R� � QLO E; 4 `mc O �• H � Q N d my o ao o n O 'go-*dCl m a CD = y No�o+m y o -� CD m o O OZ N n: W o C =r N = : a CL + ^' m o- CDCA C 7 dam' NMI ;3 Ny3 o D1 N C o .c H � y C/) ... : CD ca b m CA m p �m o 0 mo� G 0 �y� CD �m 0 O � m m m CD 0 cm =o dc CD Rs4 o cn cn t:o X, g, w z T r --,r.1 �z -x v ki rA H 0 Id � Iil:��ii° •: ' JOYCE BRAO� 10 • _ TOWN CLEiK • ', _.,•.' • NORTH ANDOVER TOWN OF NORTH ANDOVER ASC 1 " I I 44 FY 'bu MASSACHUSETTS BOARD OF APPEALS Any appeal shall be filed Within (20) days after the NOTICE OF DECISION date of filling of this Notice in the office of the Town Clerk. Property: 33 Beech St. NAME: Christopher & Michele Roche DATE: 8/13/98 ADDRESS: 33 Beech St. PETITION: 030-98 North Andover, MA 01845 HEARING: 8/11/98 The Board of Appeals held a regular meeting on Tuesday evening, August 11, 1998, upon the application of Christopher & Michele Roche, 33 Beech Street, North Andover, MA., requesting a Variance from the requirements of Section 7, paragraph 7.1, & 7.3, for relief of tot dimension and side setback, and for a Special Permit from the requirements of Section 9, paragraph 9.2, to allow the construction of a proposed 2nd floor addition of a dormer, on a non -conforming lot, in the R-4 Zoning District. The following members were present: William J. Sullivan, Walter F. Soule, Raymond Vivenzio, Robert Ford, John Pallone, The hearing was advertised in the Lawrence Tribune on 7/28/98 & 8/4/98, and all abutters were notified by regular mail. Upon a motion made by Walter F. Soule and seconded John Pallone, the Board of Appeals voted to GRANT a Variance for relief of lot area of 1,000 sq. ft., relief of right side setback North East of 9 feet, and to GRANT a Special Permit to construct a 2nd floor addition of a dormer on a non -conforming lot. Voting in favor: William J. Sullivan, Walter F. Soule, Raymond Vivenzio, Robert Ford, John Pallone,I The petitioner has satisfied the provision of Section 10, paragraph 10.4 of the Zoning Bylaw and that the granting of the variances will not adversely affect the neighborhood or derogate from the intent and purpose of the Zoning Bylaw. Note: The granting of the Variance and/or Special Permit as requested by the applicant does not necessarily ensure the granting of a Building permit as the applicant must abide by all applicable local, state and federal and building codes and regulations, prior to the issuance of a building permit as requested by the Building Commission. BOARD OF APPEALS William J. Sullivan, Chairman /decoct6 r/ Kevin Murphy Buifdiing Contractor 169 Boxford Street NORTH ANDOVER, MASSACHUSETTS 01845 688-5335 Submitted ...:...................... ........ .... ............r PHONE DATE to be performed and materials to Page No. Pages PROPOSAL All home Improvement contractors and sulmontroollo s engaged in home Improvement contracting, unless specifically exempt from registration by Provislons of Chapter 142A of the general laws, must be regiele a with the Commonwealth of Massachusetts. Inquiries about registration and status should be made to the Director, Home Improvement Contract Registration, One Ashburton Place, Room 1301, Boston, MA 02108 (617) 727-8598 JVe NAMt / NU. JOB LOCA ION 'A /" f.. ARCHITECT n ' .................._....!............................`..a..L''.'.._t,.....:........_....................F_.....5.._..................-s__i...L..................._..................._`._ , :..........: .:::,.�J�-- ............. _..._._"{_`,,j .... s . � .. l .�....._.... .....,art. ..............._.............. .: ..... ._.-tiet:.....G-L..�._....'.... •. r .........._.._—._.._.._._ JF• 1 � ...tc.1�. �' ....__.__.w.._._____1r___Y.s_ __..lfLA 1 ,+.__. (... ..... a................................_...... a.:._:1..... .....__....L.:.-,..._..... ....> ....................._........c.....£=-...._...._._......✓:-:,k: ., i —.... .....................i,�..^ ....._...__..4.kc,.._.i__............ �. . � t _........... - ...._....1 WORK SCHEDULE Contra r wl not bgWn pe work or order the materials before the third day following the signing of this Agreement, unless specified h n ting., �Qn actor will begin the work on or about ' I'r (dale). Barring delay caused by circumstances beyond Contractor's control, the work will be completed byl` l' i (date). The Owner hereby acknowledges and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall not be considered as violations of this Agreement. WARRANTY The Contractor warrants that the work furnished hereunder shall be free from defects in materials and workmanship for a period of t ( r� following completion and shall comply with the requirements of this Agreement. In the event any defect in workmanship or materials, or damage caused by the Contractor, his subcontractors, employees or agents, is discovered within one year after completion of any job, including cleanup, the Contractor shall, at his own expense, forthwith remedy, repair, correct, replace, or cause to be remedied, repaired, or replaced, such damage or such defect in materials or workmanship.The foregoing warranties shall Furvive any inspection performed in connection with the agreed-upon work. We Propose hereby to furnish material and labor - complete in accordance with above specifications, for the sum of dollars ($ - (, () Ci (✓ r Payment to be made' -As follow ssf ($ upon signing Contract; ...... _.._......._...._%:.,u...`.....��........ .......+:.....-__......._,? ........_........_ ............................... Name of ConVactoriDesignated Registrant J ($ ) upon completion of Street Address - ($ ) upon completion of shall be made forewith upon ($ ) completion of work under this contract. city/State Phone Registration No. Social Seaxiry No. Notice: No agreement for home improvement contracting work shall require a w down payment (advance deposit) of more than one-third of the total contract pricea °f S esmAn--. or the total amount of all deposits or payments which the contractor must make, in " advance, to order and/or otherwise obtain delivery of special order materials and AuthorizedSignature equipment, whichever amount is greater. U Note: This proposal may be withdrawn by us it not accepted within Acceptance of Proposal - I have read both sides of this document and accept the prices, specifications and conditions stated. I understand that upon signing, this proposal becomes a binding contract. You are authorized to do the work as specified. Payment will be made as outlined above. Vnn Nva R.rrvar maw r -ant -al Chic trancartinn at anv limo nrinr fn mirininht of fhn fh—A h..cim— r"n e4*... &o... -a_•_ _s ` x/ Registry of Deeds Northern District of Essex °"u..' Lawrence, MA 01840 1O/O7/9U JC ROCHE ' Type PLAN 16. 00 # 56 RemTYPE' 1,5O Inst 34003 NOTC 1O OO # 57 Rem Type . Inst 34004 postage 0,32 2 Total 7.S2 4O OO # 58 Payment Cash . 12.18 # 59 Change THANK YOU! Thomas J. Burke Register of Deeds N O i ME — 70 N < N CT) n F- ED =1 Co 70 n m X If 1l 7� H zn� I/ it G,l X C — n V) f, l I D-0� F- IT -< -G O lij 'HE li O (/ Ln :rt D zo TM UL oro wc�-0 o I _ T D mmn X n 70 N C m v; 70 77 _0 T7-1 n LU H DX 0 o_0z m 70 fn G1 70 CW F- ` z _0gym ro F- :E: CT) o D = n H n C) C If 1l I/ it i f, l I I�i�T!T�Ili�l� IT lij 'HE li �, TM UL I III MR Co b r N O Fn3 � D D Fri r7 L4 S O Frl FTI X —I H D C4 H —I F- H Z co - 1 00 I / d C a y z 0 a 019 b b We r -a -- a I I I I I I I I I I CID m O 70 o I o I z I I I I o� I I I I I I + I � n D H H 70 3 � z Fn � I I I I I I L�, I I I I I I CID Ill 0 70 o I 0 3 I I I I I I I I I I � N rn — U f TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVa�ATTE,� �-O,,R^'' DEMrrOLIIySHH ••A ONE OR TWO FAMILY DWELLING ldl<` ♦iTTal.t" aT� ' BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: SLD'I w, Building Commissioner/I for of Buildings 9--j— — - Ir '11 rw V) I SECTION 1- SITE INFORMATION 1.1 Property Address: c 1.2 Assessors Map and Parcel Number: 033 c-639 Map Number Parcel Number 1.3 Zoning Information: Zoning District Proposed Use 1.4Properly Dimensions:/ � _A-A— Lot Area s Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: Public ❑ Private ❑ Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal 0 On Site Disposal System 0 SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record 2 33�.� 'Name (Pri Address for Service /-\ - (�,� ���113 Sig ature Telephone 2.2 Owner of Recorder: ^- 6J" V, 7 Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Vitsed onstruction Superv' Licensed Construction Superviso ~ Addre s ;:�, t/1",G G ? T/ 7� ' �✓ Signatu Telephone Not Applicable ❑ �}� 1 License Number Expiration Date 3.2 Registered Home Improvement Contractor �C 1�S�.�inn, Not Applicable ❑ l Company Name V— Registration Number Addre V--\— Expiration Date — Si nature V YWphone SECTION 4 - WORKERS COMPENSATION MG.L. C 152 6 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. —Signed affidavit Attached Yes .......❑ No ....... ❑ SECTION 5 Description of Proposed Work(check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: v SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by permit applicant ,. „ OFFICI L USE ONLY 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) x (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf, in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, as Owner/Authorized Agent of subject property Herebv declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name Si ature of Owner /A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR T VIBERS 1 ST 2 ND 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 7 aA- Location 3 � j6---Y-c-14No. qCK3 Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 020 d Check # -7cp "' .70t- Building Inspector f TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVATF, OR DEMOLISH A ONE OR TWO FAMILY DWELLING outBUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: vv/' Building Commisiioner/InELwor of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: .5 s �t-- a 33. 0 -- oO3 01 Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: l l"5L Ri�it�.c —n"t l Z, S7j0 125 Zoning Dij-rtict Proposed Use Lot Area Frans ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided r} k,5- ID 1.7 W S ly M.G.L.C.40. 54) 1.5. Flood Zone Infomnation: Zone Outside Flood Zone 1.8 Sewerage Disposal System: Municipal On Site Disposal System ❑ Public Private ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT ",; U1St.nCt: (izS rl�J 2.1 Owner of Record 33 t Nam ( rint) Address for Service ( It, L, �L (-,93-2)0-71 Sig re Telephone 2.2 Owner of Record: Name Print Address for Service: I Signature Tele hone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ GJti t Licensed Construction Supervis : License Number 1 Add ss Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Compalny Name Registration Number i DJ. Addres Expiration Date Signature _ Telephone Ma M ic ..i z O v M t' r Q 1 0 z M 90 0 r M r r 00005z Q IF % SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buiJdmg permit. Signed affidavit Attached Yes ...... No ....... 0 SECTION 5 Description of Proposed Work check so a Hcahte New Construction ❑ Existing Building ❑ Repair(s) 0 Alterations(s) Addition 0 Accessory Bldg. ❑ Demolition 0 Other ❑ Specify Brief Description of Proposed►d Work: *Fl — t S I SECTION 6 - F.STIMATF.n r.nNSTR1TrTinN rncTc Item Estimated Cost (Dollar) to be Completed b permit a licant OFFICIAL USE ONLY 1. Building (a) Building Permit Fee Multiplier SIZE OF FLOOR TIMBERS 2 Electrical (b) Estimated Total Cost of Construction Z.( 3 PlumbingBuilding Permit fee (.) X tnl DINIENSIONS OF POSTS 4 Mechanical HVAC Mechanical 5 Fire Protection .�-- 6 Total 1+2+3+4+5 b j/ Check Number in 1V Dr1 %_VLYIYLE 11:L WkMr4 OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, C'as Owner/Authorized Agent of subject property Hereby authorize �� to act on Myp f, in all tter' relative to work orized by this building permit application. - Sigiiafiure of Owfier Date SECTION 7 OWNER/AUTHORIZED AGENT DECLARATION I, 1' - as Owner/Authorized Agent of subject prope 1 Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief of Owner/ Date NO. OF STORIES SIZE 2J4 $JA BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 Z 3 RD SPAN Z.( DIMENSIONS OF SILLS 'Z — DINIENSIONS OF POSTS M ENSIGNS OF GMDERS I HEIGHT OF FOUNDATION THICKNESS 17 c1 SIZE OF FOOTING X t MATERIAL OF CHlIvINEY 1S BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE tsd- 10 • North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. The debris will be disposed of in: _L , k-kt I Q 'D4- L vaLv NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector r The Commonwealth of Massachusetts Department of Industrial Accidents Ofte of Investigations Boston, Mass. 02111 Workers' Corrlpensa%orf Insurance Alildavit Please Print Location: 73 City ice, ,. J��,.�--, �-.. Pwne e 0 I am a homeowner perforMng all work myself. I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. j -- Ad dress - l b -� '3Y Lt' 1 — w 0 A %--, w t—. Y ( Comoanv name: Address Clay: Phone t PoYcv # Faltura to secure coverage • vequlred under Section 25A or AAOL 152 can lead to the impoaWon of aMnel pe wma d.a Me up to $1,500.00 andfor one years' imprism., nt_as real.as_dhdi,paooffinlnlbsl=EdiSTJDP WOM.01MERAnd.a.fkw d.g1Ao oMAdW agW"_ma 1 understand that a copy of this Esta wrwtt may be forwarded to the Office of Inveatipatlona of the DIA for coverage verfficsdM. I db hereby Print c is bus and call Official use only do not wrfte In this area to be completed by city or town official' City or Town P I ng 2 V6 -- # b LJ -S33 �— []Check N immediate response Deptsponse !s requisd Q Lkens#V Board p Contact personSelectman's Office : Phone 0 Health Department O Other FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. ****APPLICANT FILLS OUT THIS SECTION"************** APPLICANT v LOCATION: Assessors Map Number SUBDIVISION STREETr� OFFICIAL USE ONL RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR -HEALTH DATE APPROVED C v -1J � A� /4-4/7, DATE REJECTED INSPECTOR -HEALTH COMMENTS DATE APPROVED DATE REJECTED PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT PHONE- -S33 r PARCEL_ LOT (S) ST. NUMBER_ FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 Jm M1 CA m m m m m 44 x CA m CA a m CO) CD CZ 0 C36 C) CD CL c 7 C*o "C — CD 0 W W C. 0 CD Cl CD CA O CA Cl) 0 CA C2 CD 0 CD CD CD CA z 0 o cn 0 cn z W 071 ol- C) 6; 0 N2 2 i'i 3 Date .... ....... ..... /l. 7S TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING This certifies that ...... L ...... ......... ...... has permission to perform ...................... 'CA, .......... .................... wiring in the building of .... ).c. z ........................................................ 4 —7 --- 2 ) Q/ - at ...... S41 ................... ....... ......................... . North Andover, Mass. Fee.... Lic. No.'4. D.7............................................................... ELECTRICAL INSPECTOR 08:58 40.00 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer THEC0MV0NWE4LTH0FMAMaRMM / Office Use only DEPARTMENTOFPIIBLICS4MY & Permit No. BOARD 0FFIREPREVEN770NRWMTI0AN5rCW IZ00 JV4 Occupancy &Fees CheckedPPUCATIONFOR PER .MIT TO PERFORM(7ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 3 3 A e To the Inspector of Wires: Owner or Tenant C r; c 4- /-g'; ch .e Ile 4 6i ifl Owner's Address C �, Is this permit in conjunction with a building permit: Yes ® No (Check Appropriate Box) Purpose of Building % Fa .,,, ; /X C/,4 //; u Utility Authorization No. Existing Service Amps / Volts Overhead a Underground M No. of Meters New Service Amps 1 Volts Overhead r --J Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work , - �a� > o�o��,,P r t a�i % a fii,- Irl !7A of Lighting Outlets No. of Hot Tubs No. of Transformers Total `( KVA 1�. of Lighting Fixtures Swimming Pool Above Below Generators K VA ground 0 ground No. of Receptacle Outlets _�7 No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices LocalMunicipal a Other R o. of Dryers Heating Devices KW Connections . of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER• hmr=CoKr� Ptasu3lt1DlheteWu er1sdMmwhB&GmaWLaws IhawaamutLmbtkyhnxaF=P:iicyindudmgC'.Qrtplete ComaWcrAssti�male4uvwat YES ® NO I haeewhmftdvWidpmofofsane1DtheOffoe YES U NO Wymt tdrdWYES�pl mwdc*t clt WofwmaWbydakwtgthe bCDC ISURRAANCE EY BOND OTHER M (PleaseSpefy) EViation Dat Estimated ValuectUxftical Wotk $ WakiDStat f�/S1g hq)mfi rtDaieRe4xsed Ra# Final signed uncierTr Penalties ofpajtey: FIRM NAME 77 /�1� c; /✓! P /�� Cvg _ , • .t/ �, LiomseNa Licatsae Z Po.v a .d A,�i,L `i e / _ Lioa 1,b 4-- -8 . ? t?' 08' n I / BusirmTeLNa 47$ 3_S-6 1710 6 "e3j 41 �d s '74 s wi C !�l , /`!� o�S' g AIL Te1.Na OWNER'S INSURANCEWANER;IamawgeMtheL eo se not thein'srdmamW"s rtiale*rrJatasmWradbyMsmd ensCma'ALzvs anddatmysgnatLeont mpw waimsthisraTmanalt. (Please check one) Owner Q Agent Telephone No. PERMIT FEE v " Datel.! : TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING p8 This certifies that � - "� ..!' fes'. . ''........ has permission to perform ...................... plumbing in qiy buildin s of ......« '---- ................... ti at ..,�.�,..3 ................' ......... North Andover, Mass. o } 2� PLUMBING INSPECTOR 'uLT ID WHITE: Applicant CANARY�Bwldung�pt. PINK: Treasurer (Type or Print)' �1 ,•.:i; ., l G NORTH ANDOVER ,Mass. 1 , a;{: Oate:./�� �3 L G C� Building Location _� ��� h % Permlt.1 1-280� L' Owners Name y< A/,�..�i�lj C'fh ti, v New Renovation Replacement 0 Plans Sybmitted FIXTQRF5' • _z z 4n < z x � M • N W J O O Z ~ W = N Z 4n < lC = 0 S to W 'na. 3 X V Z W .. Cl < O= sC a taG lb O n < ai cc < W of a: J o o J lL W r. W O _J iL X k. AC W <_ 3 Y a Z x )G a O 1' z= < W 4L X • i F- U > t- O N N 0 O O tt1 W f' O V Z • •:: < ~ < < Z — < d O < J J < sr iIG < O < SUS—BS MT. . • BASEMENT IST FLOOR / 2ND FLOOR f r 3Ro FLOOR ATH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR BTHFLOOR (Print or Type) Check one: Certificate Installing Company Name %- 0' �GG�r� C l [� Corp. Addre7*_01 %L Partner. 470___1 ? ;7 C'j Firm/Co._! Business Telephone Z6r3 3 8-0c�o Name of Licensed Plumber: a J — h,4/? Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity 0 Bond Insurance Waiver: I, the undersigned, have been made aware -that the licensee of 1 this application does not have any one of the above three insurance coverages. Signature of ownerlagent of property Owner Agents. (� I booby cclafr Wal all of Ute dclails and infatnsalion 1 ha•c sutomil lcd (at entctcd) in ahu- applicalion ate lute an74ruagetedwbassalwC kawwkdge and" all pluatbing walk and inslallatinns pct(nimcd undo rcrutil ittucd fat this applicalial will be M awtlNiawp tWl s>y pellillit t «`� visia" of she Mas"usclls Sut< numbioj Codc and Chaptcs 142 of tlw (knal La..}A ^ ) By Title City/Town: .A oortrwrn 70FFICF USE ONLYi Signature of Licensed PlumUer ,� .,T�p of Plumbing License License umber ❑ Master Date ...... TOWN OF NORTH ANDOVER PERMIT FOR WIRING C/,/ /-�r,7, This airtifies that .........�.�. ................................ has permission to perform ....... ...... 4 .......... fi wiring in the building of ..... ...... ................................ at .......... g . :3..... ........................... e, North Andover Mass. ........... .......... ...... Lic. NoJ... Check # ELECTRICAL NSPEC-MR 43L 0 T'HECOAMONHEALTHOFA14S'S4CH'USE77S Office Use only DEPARTA1EW0FPUX1CS4FM Permit No. 7t�P'/�.J► BOARD OFFIRE.PRLMM70NREGULAHONS527CA R12W Occupancy & Fees Checked APPUCA77ONFOR PERMIT TO PERFORM ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date s D� Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Number) 33 " C4 Owner or Tenant UNZ Owner's Address sm"%L Is this permit in conjunction with a building permit: Yes© No (Check Appropriate Box) . Purpose of Building S g�z �O.w.i W.L%% Z V% Utility Authorization No. Existing Service Amps / Volts Overhead = Underground No. of Meters New Service Amps / Volts Overhead r --J Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work W lft- QQX!Je. + S�.w�:1� To��+►+ No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total is KVA . No. of Lighting Fixtures Swimming Pool Above Below Generators KVA ground ground No. of Recc,;rtacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Burners No. of Ranges No. of Air Cond. Total FIRE ALARMS No. of Zones Tons No. of Disposals No. of Heat Total Total No. of Detection and Pumps Tons KW Initiating Devices No- of Dishv,Whers Space Area Heating KW No. of Sounding Devices No. of Self Contained Detection/Sounding Devices No. of Dryers y Heating Devices KW Local Municipal Other�� Connections, No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER- Itmua =Covetage, Rustl�ltlt7the�ofMass t>s�tsGerleralLaws IbaveaomutLmbdtyhmaa=Pblicyiidn&gCt CovtWa-itssitsUnt lequivai2t YES NO Ibawsubniwdvafdp oofo(smrtDd&Office YES � If)ouhawd�e 1mdYES, pk3seit &Aethe' Wofcov�by choddngthe__ _ box ���dJl INSURANCE BOND OtII-LEFZ (P9ea9eSvrify) Estun*d VahleofDeariral Wctk $ : 00&0 `VoiklDStalt "pectiorlDateReguesiod Signed underlie Pmahm of pegt>zy. FJIRMNAME Licensee 111 CK �i CQt'lSIVIahue 11111:8./ `J.ttl� LXnWNo �90 e119 L, J n BtmmTel.No- y- 9375 Adck lt �1 (G7 bko'%f— "0 AILTUNo 1W SCYAf D)AII SINSURANCEWAIVII2;IamawarethattheReesedoesnothavetheinszanceoowngeoritsatsmntialegwvaler-tasngmedbyMa%actmezGenedLaws Ind [flatmysignatlue on thispmntapplication waives this Ietluimment Please check one) Owner O Agent Telephone No. PERMIT FEE $ 0 Signature ot Owner or Agent