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HomeMy WebLinkAboutBuilding Permit #401 - 461 STEVENS STREET 11/20/2009 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION Permit NO: 0 / Date Received Date Issued: -47 IMPORTANT:Applicant must complete all items on this page LOCATION rint PROPERTY OWNER Print MAP NO: PARCEL: ZONING DISTRICT: Historic District :yes s nod Machine Shop Village no TYPE OF IMPROVEMENT PROPOSED USE Resid n ' I Non- Residential New BuildingOne family Addition Two or more family Industrial AI ion No. of units: Commercial e ' re lacement Assesso y Bldg Others: Demolition Other Septic Well Floodplain Wetlands Watershed District' Water/Sewer DESCRIPTION OF WORK TO PERFORMED: 14)AW8 7>41, C Id tifieatin Please Type or Print Clearly) OWNER: Name: Phone: Address: lie, is 2:1� CONTRACTOR Name: Phone: Address: 4112 Supervisor's Construction License: Lot Exp. Date: t r ^l Home Improvement License: -::2Exp. Dater A:a ARCHITECT/ENGINEER Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASE ON$125.00 PER S.F. Total Project Cost: $ l i� FEE: $ �_ Check No.: ( Receipt No.: NOTE: Persons contracting with unregistered contractors do not have access to guar ty fund Signature of Agent/Owner Signature of contractor Plans Submitted Plans Waived Certified Plot Plan Stamped Plans TYPE OF SEWERAGE DISPOSAL r Public Sewer Swimming Pools Tanning/Massage/Body Art Well Tobacco Sales Food Packaging/Sales z Private(septic tank,etc. Permanent Dumpster on Site THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF - U FORM k ! DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT COMMENTS CONSERVATION Reviewed on Signature COMMENTS HEALTH Reviewed on Signature COMMENTS 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 DPW Town Engineer: Signature: Located 384 Osgood Street FIRE DEPARTMENT - Temp D.umpster on site yes no Located at 124 Main-Street Fire Department signature/date COMMENTS 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 No MGL Chapter 166 Section 21A—F and G min.$100-$1000 fine 11 NOTES and DATA— (For department use r r s 1� awl s �� 1-t wLV Ir I ❑ Notified for pickup - Date �I .............................................__..._......._.....................................__.............................................._..............................................................._............._....................................................._..................__..._..._....................................................------....._...............----....................................................__ . Doc:.Building Permit Revised 2008 I� I I J 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: All dumpster permits require sign off from Fire Department prior to issuance of Bldg Permit Addition Or Decks o 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 then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc: Doc.Building Permit Revised 2008 r - _ F t%0RT#j { To" Of .. t: �r 4 over . No. 40 _ 1.0 dower, Mass., O - LAKE COCHICHEWICK 7�p A0,1? S BOARD OF HEALTH PERMIT T Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT......... ... ..... �z-.......... �vr-a.h.................................... ....................................................... Foundation has permission to erect. g (. t5 lb Rough buildin s on .... / � to be occupied as....... �. ..... �'`- ..!..............':'�...�.v.!!v J......:-..............-..................................... chimney provided that the perso c opting this p rmit 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRLISTARTS Rough ---__- ............... ... ........................................ ..................... Service BUILDING INSPECTOR Final Occupancy Permit Required to 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. . \ 1 fY� ',l�(1li'1.m��','i�U'Ci '• Of �✓ i Qs<�d�i�.r1.�J'2rtJ \ T� �cr_',1fI,`�1Pi1:Gf fil�idSLf1G. C �- r, I\1aTne (Business/Organization/lndividual): — --- Address: City/State/Zip- Afl4 � Phone.#-. Are yo an employer? Check the appropriate box: FE] pe of project(required):. 1.Lam a employer with (Z 4 ❑ T am a general contractor and I Q New construction employees(full and/or part-time).* have hired the sub-contractors Remodelinglisted on the attached sheet. . 2.❑ 1'am a-sole proprietor or partner- 'these sub-contractors have 8.*.E]Demolition ship and have no employees - working for me in any capacity. employees and have workers' 9 ❑Building addition comp. insurance,t [No.workers' comp.insurance 10..[]Electrical.repairs or additions required.] 5. ❑ We area corporation and its officers have exercised their 11.❑Plumbing repairs or additions 3.❑ I am a homeowner doing all work office of exem tion per MGL myself. [No workers' comp. right p p 12.❑ Roof repairs insurance required.]t _ c. 152, §1(4) and we have no 13 cher employees. [No workers' comp.insurance required.] Any applicant that checks box ill must.also fill out the section below showing their workers'compensation policy infor riation. 'Homeowners who subrnit this affidavit indicating they arc doing all work and then hire outside.contractors must submit:-anew affidavit indicating such. tContractors 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 pro'vid'e their workers'comp,polidy number. I am an employer these is providing workers'compensation insurance for my employees: Below is the pofccy and�Job site information. . Insurance Comp.anyName: U Expiration.Date: Policy#or Self-ins.Lia:-#; Job Site Address: `--t 4.o � rev v >1 City/State/Zip: At a copy of the workers' compensation policy declaration page'(sh.owing 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 $1,500.00and/or one-year impri . sonment-a T , -.Af., CT _ of up to$250.00 a day against the violator. Be advised that a copy of this statement maybe fogwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certi un r e p s an penalties of perjury that the information provided above is true and correct. Si estate: Date: 07 — f Phone 'Oficial use only. Do not write in this area, to be completed by city or lowti off ciaL City or Town: PermitlLicense# Issuing Authority (circle one): 1.Board of Health 2.Building Department 3. City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6- Other y ----------- i RAON i ,�::r ,x,y �e - Z _,.;}s:r- �i. _ 'w L,.�$x-.r�-.,�•' `�G-,.sem�»_ ''..7'�`�=''''.-,•p-('`C :-k��1. •.a X-....- .�r`,��t,;a..,. ,a.�.��s..., � P_tr �•s:�;t:`�x:'pa..� ^� �_•_r_•.+:.=._�.�. ENERGY - �•+�r-i;,?�'CR!y'c Rf:7�1�Ih,+31�Ya'?'L �Cztx'•7i�C7 .. . U-Factor SolarWeatGain Coefficient F*cxrU Cva�dateCur�ndadtErgryia olar /0 . 32 1 . 8 29 ADOFTIONAL PERFORMANCE RATINGS . e�raluaoH wv�,�xr�+u oe c�o+ua>Jrr� Vsi ble Transmittance %nanhlon dt Lux V1 Die 0 . 52 Un c4nr OPAMN ft fto ritanp t m T*Ltb M:pc proodrm rar aeanntQ 4DW 7nllct parte r*=L We C&O"d.rTftk) d tar 1?bad rt of w0 www.ate"a m cft paa ld 16.WX dose rot'bMn U 1.M Fry R erti die rt wvrvrt Stiilta swk d 871 Md d,br arr Vedtt ude rr a 03w wxA c Uv'1!mean fa c w pm&Q pfftmorsa . - t+icrtra0rn wv.crrrtuo - Eft,tiGrt mM(A qx sms 4Axu aanol mr b i pmom*rtwitr v4abb2 do MSC pn detem kz d rw+$riffft bol dd qba la Able uects pa hll c sn demm,tvds pa in aav rrb^o ds caxg�aw Frblersale f un*rwv de pn>&cx �ecela td AC to r—nlrn a 4W 7iodvn'/-W-tL3 a.d p, a& ?Jeiam,para un uo epw.lem CarwA mn d _. me.b od Nort*Mn d uo'grwbao de sb Radom v*%tA ttrD UnLt crlaLLfLes foc e?JcRCY 9L1R cggLon(i) : Uoctnacn, Noctn . Cant.al, .9o�Ln Central, loath:.n. " ckf W.r VAA C� unclad o�LL11ca a.a li � _ P cc?lOr%(xr) M4WkQT 3Tbft: ►Jocta, Noctt Cantcal, '3 c Can tcil, 9uc •' IND: fta1n.00/CLaae J/32"/H—RU . ' 7 " Laittd 9L:t: 31' x 93' I40: flsfutc:o 00/VLd<10 1 .31 xn/H,R43 DP.: L4SL- 45 7ixa,Aa pcobado: 91./ cn ><"190 C-t' : 1 E�9�C9C�C1 10773 . Ila Koff*-an 2931120. Lrp f 8 bW fir pall FlILF6T SUr abates.To(Km mon 0 ww.mugrftgw. Ward.Isla *iE para pow rra&o u 0iuG.T tm comer rrm aarm be a1o. )II rwoLinuqtt r( ✓/ce Lommarzcaectl�i o�,��ilaaaac�waett "F Board of Building Regulations and Standards "I HOME IMPROVEMENT CONTRACTOR Registration:, 126893 Expiration813/2010 Type: Supplement Card The Home Depot) t Hom6 Service RICHARD FALLONE 2690 CUMBERLAND PARKWAY S AtR`A,GA 30339 Administrator J ATE(MMIO0lyYYY), AC-ORP, CERTI'FiCATIE: OF LIABILITY INSURANCE D02/20/09 a 0 C,UC E,, f'HIIS CERTF(,1:7E: IS ISSUED ASA MATTER OF INFORMATIOI,l UFOIN hl- CER`,�'i,�71CATE s h U S A, 2:n ONLY A,4D CONFL�11_7 HOL��_R, THIS CEq.TlFiC.--\Tl_7 DOES NOT AMEND, EXTE�;O_ OR AI_Tr�R CO� m SY _jl;­I___, CA'- 353-1� NNI R R S 4 TD v ....... ............. cl_ 7 ri.5 Co 5:t il, 1A :,So cumbIchit-2, URYOti FiRF: IITS (7�) OF Pltl'�; .4 5 ISuite 300 lAtIanta , CA 30339 INSUIRERD:New Hampshire Ins Co 23841 INSURER E:Illinois Natl Ins Co 23817 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTWITHSTANDING ANY REQUIREMENT,TERM OR,CONDITION:OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH TH-IS CERTIFICATE MAY BE ISSUED-OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED By PAID CLAIMS. INSR ADO' POLICY POLICY EXPIRATION LIMITS LTR [NSRC�) TYPE OF INSURANCE POLICY EFFECTIVE DATE MM/DO DATE IMMIDOfYY) GENERAL LIABI LITY IPR 3757 608-02 .03/01/09 03/01/10 EACH OCCURRENCE $4,000,000 DAMAGE TO RENTEO X COMMERCIALGENERALLIABILITy LIMITS OF POLICY ARE EXCESS PREMISES(Ea occurence) $1,000,000 7 CLAIMS MADE M OCCUR "OF SIR: $1,000,000 PER )CC" MED EXP(Any one person) $EXCLUDED PERSONAL&AOV INJURY $4,000,000 GENERALAGGREGATE 54,000,000 GENI AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG s4,000,000 PRO- X1 POLICY JECT LOC * AUTOMOBILE LIABILITY BAP 2938863-06 03/01/09 03/01/10 COMBINED SINGLE LIMIT $1,000,000 X ANY AUTO (Ea accident) ALLOW NEO AUTOS BODILY INJURY S SCHEDULED AUTOS (Perpe(son) HIRED AUTOS BOOILYINJURY $ NON-OWNEDAUTOS (Peraccidenl) RSELF INSURED AUTO PROPERTY DAMAGE PHYSICAL DAMAGE (Peraccident) GARAGE LIABILITY AUTO ONLY-EA ACCIDENT 3 ANY AUTO OTHERTHAN EAACC $ AUTO ONLY: -AGG S * EXCESSWMBI`�:LLA LIABILITY IPR,3757 608-02 03/01/09 03/01/1. 0 EACH OCCURRENCE S 5,000,000 7X OCCUR �CLAIMS MADE AGGREGATE 55,000,000 S DEDUCTIBLE RETENTION $ * WORKERS COMPENSATION AND 3566916 (CA) 03/01/09 03/01/10 X TIC ITATU-, TH_ ORY L""T CER EMPLOYERS'LIARILITY 3566915(AOS) 03/01/09 03/01/10 E.L.EACHACCIDENT 11,000,000 ANY PROPRIETORIPARTNERJEXECUTIVE Z OFFICERIMEN18ER EXCLUDED? 3566917 (FL) 03/101/09 03/01/10 E.L.DISEASE-EA EMPLOYEE 51,000,000` [(yes,describe under SPECIAL PROVISIONS below E.L.DISEASE-POLICY LIMIT $1,000,000 OTHER D Workers Compensation 3566918 (KY, MOI NY, WI, 03/01/09 03/01/10 F TX Employers Excess TNSC45694422 (TX) 03/0-1/09 03/01/10* Occurrence/SIR 25M/2M C _L Workers Compensation 480132.3(QSI) 03/01/09 03/01/10 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES/EXCLUSIONS ADDED BY ENOORSEMENT1 SPECIAL PROVISIONS RE: EVIDENCE OF INSURANCE CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBEO POLICIES BE CANCELLED BEFORE THE EXPIRATION THD AT-HOME SERVICES, INC. DATE THEREOF.THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT,BUT FAILURE TO 00 SO SHALL 2690 CUMBERLAND PARKWAY IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,ITS AGENTS OR SUITE 300 REPRESENTATIVES. ATLANTA, CA 3,0.33,9 AUTHORIZED REPR ESENTATIVE USA ACORD CORPORATION 1988 I Massachusetts - Department of Public Safety Board Of Building Regulations and Standards F Construction Supervisor Specialty License License: CS SL 99124 - Restricted to: .WS. JOHN AMERO 12 CARRIAGE CHACE LANE ATKINSON, NH 03819 Expiration: 7/16/2012 ('m11111iissi4 oner Tr#: 99214 i i 3 ,r3 4 Date.AU, HORTM TOWN OF NORTH ANDOVER ,e,tipL PERMIT FOR GAS INSTALLATION � F o 'i SSAcmUSES This certifies that . . . .... �. . . . •:�'�• �. . . . . . . . . . . . • • • • • has permission for gas installation . . . . . . . . . • • . . • • • • • • • • in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . at . . .`!(. f . . . . . . . . , North Andover, Mass. Fee. .. : . . . Lic. No./.o`.!9.t . . . . �: . . . . . . . . . . . GAS INSPECTOR WHITE:Applicant CANARY:Building Dept. PINK:Treasurer a MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING Cir � ��Type or print) Date 10—If 2p©z� NORTH ANDOVER, MASSACHUSETTS Building Locations yk / 5/ Permit# 3 ) Y yy� Amount 2.;-!aA:- j Owner's Name New❑ Renovation ❑ Replacement Plans Submitted ❑ n vi :G n cn Z C Z Z C Z :s] GCn r n L v i�j - n Z %f C n W Z - as - - -c % v� p z - 5 L St1B -BASE .NI ENT - - - - — BASE .vI ENT IST. FLOGR 2ND . FLOOR 3 R D . F L O O R 1T 11 FLOOR 5T If F L O O R 6 T I1 F L O O R , T 11 F L O O It 9T 11 FLO G R .1 (Print or type) (� I Check one: Certificate Installing Company Name 1z g f- ►-£- I 1, .-., :d,fp £ Ilk-41 46 ® Corp. Addresst �u i G it N3(9hi C/ 1✓o ❑ Partner. /t til,i 15 o.5. IY714- P19-2-3 Business Telephone q 2- _ h-,-1- :74,Z Z ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy orit's substantial equivalent. Yes rM Nom If you have checked ves,please indicate the type coverage by checking the appropriate box. Liability insurance policy Other type of indemnity ❑ Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of.the Mass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ AQent ❑ 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 Vlass usetts State Gas Code zWd Chapter 142 of the General Laws. Bv: Signature of Licensed Plumber Or Gas Fitter Title ®- Plumber CitviTown ❑ Gas Fitterrcett� seITrriner _Master . APPROVED(l)FFIC}:USE ONI.Y) ❑ Journeyman LocaAon No. DIG C Date A T' ti NORTH TOWN OF NORTH ANDOVER p Certificate of Occupancy $ * Building/Frame Permit Fee $ A4. "=- �'�s'"" Foundation Permit Fee $ SII 1ACMU5 Other Permit Fee $ !� Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector 25.00 MID Div. Public Works ' PERMIT NO.� G7 �" APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP K40. QQ� I LOT NO12 RECORD OF OWNERSHIP IDATE BOOK ;PAGE — ZONE /! SUB DIV. LOT NO. LOCATION d/' C �S J CPURPOSE OF BUILDING �.y l one s l a. OWNER'S NAME „� 7 NO. OF STORIES t� S&IZE OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME 70llsSPAN -- DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET '" POSTS DISTANCE FROM LOT LINES-SIDES REAR " GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATIONI'1 ! IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST PAGE I FILL OUT SECTIONS I - 3 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 i� SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE F ED BUILDING INSPECTOR SIGNATURE OF OWNER O - AUTHORIZED AGENT F E E _cT� OWNER TEL.# PERMIT GRANTED Q-� CONTR.TEL.# �9 �T- tt CONTR.LIC.# 0/ �Z�7 t H.I.C.# ( ! �� C � RT Town of No.,-;C5 * dover, Mass., Fem . i S. 19� COCMIC ME W ICK 'q AAAA r E D�APP`y S BOARD OF HEALTH U PERMIT -T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT �A'1 'T1tc'te ... ... .................. -,4-GG o�,,..... Foundation has permission to MW....�'t-M72............. buildings on .. 1... .1� ... ......... Rough • 1 •..... ........ Y to be occupied as........ ! ...I......Rimri;���.....��.,�.:Sl.�C ....� c�vez...5...�./A��"� Chimney provided that the person accepting this permit shall in every respdct conform tot a 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. PLUMBING INSPECTOR Vlq,LATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO T Rough ................... .................. 1�................... Service BUILDING INSPECTOR Final 4 Occupancy Permit Required to Occupy Building GAS INSPECTOR E Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Burner Street No. Smoke Det. i e. t t r r xr LL ; p, F1 TIS" '5-0a _ 9 x # 4 r+a X 6r�C is; .a19 4-31. 6. i i [ HOME IMPROVEMENT CONTRACTOR . Registration 116499 Type :,INDIVIDUAL 1, Expiration . 06/21/98 K 1 - GALLOWAY CONTRACTING I -TIMOTHY E. GALLOWAY &lits 6MMER ST ADMINISTRATOR METHUEN MA 01844 7• �f _ -_-----_ - --,:/>'ie "[Oonvirtoauueacu2 o�✓liGaddcicszctde�l` OEPARTMENT OF PUBLIC SAFETY CONSTRUCTION SUPERVISOR LICENSE Nulber: Expires: Birthdate CS 047954 11/23/1997 11/23/1958 Restricted To: .00 rrl TIMOTHY E GALLONAY 20 SUMMER ST METHUEN, NA 01844 Location CO No. Date Np^'M TOWN OF NORTH ANDOVER „ Certificate of Occupancy $41 ; Building/Frame Permit Fee $ ,SSACMUSFoundation Permit Fee $ Other Permit Fee'�ta $ ZSR" Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector 11/30/95 11:18 25.00 PAID 9427 Div. Public Works Location No. Date Z TOWN OF NORTH ANDOVER 1 p Certificate of Occupancy $ * Building/Frame Permit Fee $ C Eta' Foundation Permit Fee $ s�cMus Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector C 3I/d" 11:01 25.00 PAID a Div. Public Works t ftRAtIT NO. 4?t o APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 MAP i-40. / LOT NO. O 2 RECORD OF OWNERSHIP IDATE (BOOK PAGE ZONE I SUB DIV. L NO. LOCATION An PURPOSE OF BUILDING c E` 7s "r¢ OWNER'S NAME 4 1C (- NO. OF STORIES S _ qp E � OWNER'S ADDRESS 2,// ) . S BASEMENT OR SLAB 2-1 ARCHITECT'S NAME !L O[[ SIZE OF FLOOR TIMBERS QTV 2ND 3RD BUILDER'S NAME SPAN -- DISTANCE TO NEAREST BUILDING `"'x'•7`7 DIMENSIONS OF SILLS DISTANCE FROM STREET1'7 _/ G POSTS DISTANCE FROM LOT LINES-SIDES /, REAR \ GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION " Q IS BUILDING ON SOLID OR FILLED LAND AMD y- WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY /i,�f. o IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. `ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DA FILED [L� SUILDING INSP[CTOR I AT R OR AUTHORIZED AGENT Q� E E OWNER TEL.# w �Q r PERMIT GRANTED CONTR.TEL.# 19 CONTR.LIC.rr r H.I.C.11 TOWN of NORTH ANDOVER AFFIDAVIT Hme hpmumazt Capt=bx Law applema , to Lit M�c. 142 A regAzes that the ' altpr;jtian, renowatim, zEpEdr, , carman, imprvvenazt, rem�al, denoliticn, or of an a th tinn to any pre- eedstIIg b ld- irg cmtgmrg at least ane bit not=re dmfar dwelling units.." to sb=ttes 4rich are adjam-it to su.h residence or hAldirg"be drne by registered contmctom, -vdffi certain alag idth othEr req-*Xenmts. Type of Work: � L6 O57&-)4 (01 YLCtl ",4Est. Cost Address of Work t/61 � 1�1 s7 Owner Name: 2g-�*e)"Y't_f Date of Permit Application: Zo/(?6 I hereby certify that: , Registration is not required for the following reason(s): For office Lice Only Work excluded by law Rmmit No. Job under $1,000 bite Building not owner-occupied Owner pulling awn permit Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERM17 OR DEALTM WITH UNREGISTERED CON'IRACIORS_- FUR APPLICABLE HOME DfiWJE EW WORK DO NOT HAVE ACCESS TO THE ARBITRA- TION PROGRAM OR GUARANTY FUND UNDER NSI. c. 142A. Sued u-d-- pff-alties of perjury: I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR: Notwithstanding the able noti e, I hereby apply for a permit as the owner of the above prot ® 96 "Date,er Na , I q 1 _ lio � � � i j � !- BUYER: 1011. 4 X10 + t \V o�p A ------ 1crr .C to�•� , 05 S TO THE ( '�Q AND ITS TITLE INSURERS. MORTGAGE INSPECTION PLAN 1 CERTIFY THAT THE BUILDINGS SHOWN DO ( ) CONFORM TO SETBACK REQUIREMENTS LPCAIM IN r- I.E. (FRONT. SIDE, ! REAR SETBACK ONLY) OF No, tP- dl WHEN CONSTRUOTED. OR ARE EXEMPT FROM VIOLATION ENFORCEMENT ACTION UNDER MASS. C.L. 117LE VII. CHAPTER 40A. SEOTION 7, UNLESS OTHERWISE NOTED. MAWACHUSMS 40UTSIc>49- I FURTHER CERTIFY THAT THIS PROPERTY ISLF00E k LOCATED IN 114E ESTABLISHED FLOOD HAZARD AREA.OOMMUNITY PANEL NO.:2C;00cj 0.ocxi6C DATE:.(,,-2-,93 DEED '2-1� THIS COMPANY IS NOT RESPONSIBLE FOR ANY INDENTURES MADE SUBSEQUENT TO THE RECORDED BOOK -_ DATE OF THE LATEST DEED OF RECORD. PACE WHENEVER BUILDINGS ARE SHOWN LESS THAN ONE FOOT FROM THE PROPERTY UNE IT IS ADVISED CERT. NO. THAT A MORE PRECISE SURVEY BE MADE TO VERIFY THESE MEASUREMENTS. THS ISCERTIFICATIONIS BASED ON THE LOCATION OF SUR �'4 OTHERS, AND DOES NOT PLAN 8K. PAGE REP T A PROPERTY SURVEY. VERIFICATION OF SUR . 'f� vs "D 1`jFj AA(�iII((EERR D OFFSETS, AS SHOWN, MA BE ACCOMPLISHED ONLY BY AN ACCURATE. INS E0 <'..''.�'`� PLAN + 33207 DATED-L!5—;'- THIS ATED THIS CERTIFICATION TO BE USED FORMORefGAGE PUR� ONLY. UNI= 30 , �995 OFFSETS AS SHOWN Alt: 140T,10 BEN'. SCALE: t'- zp USED FOR THE ESTABLISHMENY_0 !PROPERM-11 r BRADFORD ENGINEERING CO. P.O. 80X 1244 JAMES W. BOUGIOUKAS R.L.S. #9529 AT 508) 373 2396 b NORTFI Town of dover No. y2o r: ti - 2 � � o `j-J L- K rt " doVer, Mass., 19 . COCMICK _'CK iA AD RA TED 1 S BOARD OF HEALTH PERMIT T Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.............................. .(..C..�71f�.�C.17............ .7` .� �. ........................................ Foundation has permission to erect...P.C.".4c;. ........... buUdinys_on .............`f .. ........ .c.1.rg.ct?..S........................ Rough / .. Chimney to be occupied as ..........................................................�.1..,`'.G�.-�........t� .f.l. .............................................. provided that the person accepting this permit shall in every respect conform to the tms 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. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STAR S/ ELECTRICAL INSPECTOR Rough .......................... Service B ING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. • If PERMIT NO. APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1 f4AP i-40. LOT NO. 2 RECORD OF OWNERSHIP IDATE (BOOK '.PAGE ZONE I SUB DIV. LOT NO. .CATION RPOSE OF BUILDING 0OWNER'S NAME n0 �� NO. OF STORIES SIZE ful ooAWNER'S ADDRESS %//'j c -E v-t•�us S � BASEMENT OR SLAB — ARCHITECT'S NAME J � SIZE OF FLOOR TIMBERS IST 2ND 3RD 64MILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES-SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY .jF BUILDING ALTERATION Allo D IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES u . BLDG. COST ` + PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR ✓-eDE /�j F zoa A9 51-, C*OaL SUILDING 1NSPZMR IGNATURE OF OWIZ, 01VA6TH69ZED AGENT 'F E E Z� OWNERTEL.# PERMIT GRANTED ONTR.TEL.N SZ -6 8� 77 CONTR.LIC.# MMMA H.1 4,Uo r m s BUILDING RECORD , 1 OCCUPANCY 12 SINGLE FAMILY SiOR1Es THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM Q MULTI. FAMILY _ OFFICES _ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS I RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE B 1 2 13 CONCRETE BUK. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY VJALL UNFIN. 3 BASEMENT 11 AREA FULL FIN. 8'M'TAREA _ 1/1 1/2 14 FIN, ATTIC AREA _ NO 8 M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN -77 4 WALLS I 9 FLOORS CLAPBOARDS B 1 22 J 3 DROP SIDING CONCRETE I_ WOOD SHINGLES EARTH ASPHALT SIDING HARDIVD ASBESTOS SIDING _ COMMON VERT. SIDING ASPH.TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 8 FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIOR I I POOR _ ADEQUATE I NONE 5 ROOF 10 PLUMBING GABLE I -t flP BATH (3 FIX.) GAMBRELMANSARD TOILET RM. 12 FIX.) FLAT A SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. R COLS. STEAM STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL 8'M'T 2nd _ ELECTRIC 1st ------ 3rd NO HEATING NORTH i own of d o. �( _0-�• lgrt dover, Mass.,1,o�(�� 19`��� T O K C OC HIC HE WICK ADkATED P '' J BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT7T�4.C.1-� 1� BUILDING INSPECTOR ....... .1. ....................................................................................... """"" Foundation has permission to arae#-...Jd ? ,......•......... buildings on ..' .�......��- .......5 '\ ................................... Rough to be occupied asRf�.P4ACA....' .kZtt�. �*1� (2&,o 4.....swot .4a.-... ..�...s tL �................ Chimney provided that the person accepting this permit shall in every respect conform to the terms oft ppiication 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. PLUMBING INSPECTOR i' VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXP 6 MONTHS Final UNLESS CO S U O S ELECTRICAL INSPECTOR Rough Service BUILDIN NSPECTOR Final Occupancy Permit Required to 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. s F- Smoke Det. y x o 4b _. TOWN of NORTH ANDOVER AFFIDAVIT thre kFMOUlt Cantraotor Ian aRAma t to lit 1f pliratim M3.c. 142 A raquites that t'he ' alt®tiai, M=&kli, rq�r, , aanc�son, iu¢vvenent, rewml, dmblidm, cr castartim of an afflitim t0 any ge- ekdsb%o brild- irg cantainirg at least ane bit rnt more du afar dwell rg units...or to starbx-es 4nich are adjaoent tD such recidE rre or hn1d1rg"be dx a by r%isteLs oanttactots, i&th oertain eceptiom, alag ith othEr Type of Work: �� C.C- '7 bf rvC L Est. Cost 16 YO 0' Address of Work L 6 f Owner Name: d?%C1-f19j29 Date of Permit Application: I hereby certify that: Registration is not required for the following reason(s): For office Use Qtly Work excluded by law Fa3dt ND. Job under $1,000 Date Building not owner-occupied _Owner pulling own permit Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED OONIRACTORS_- FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE ACCESS TO THE ARBITRA- TION PROGRAM OR GUARANTY FUND UNDER MGI, c. 142A. Signed uar'er penalties of perjury: I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR: Notwithstanding the above notice, I hereby apply for a permit as the owner of the above prop t n 112 V/9� ' C__ Date Owner Name ,. y Location . No. U Date ?o N°RT; o TOWN OF NORTH ANDOVER t 3 c p Ot p Certificate of Occupancy $ s s ," • Building/Frame Permit Fee $ •o* O ""°' � Foundation Permit_Fee $ u' sACMUSE Other Permit Fee $ S y Sewer Connection Fee $ Water Connection Fee $ TOTAL $ 5 m 0 Building Inspector 8643 Div. Public Works PEa)tIT No. 4APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP KJO. I LOT NO. 2 RECORD OF OWNERSHIP :DATE BOOK :PAGE ZONE SUB DIV. LOT NO. (� LOCATION c PURPOSE OF BUILDING evl OWNER'S NAMENO. OF STORIES SIZE a< 1 , U OWNER'S ADDRESS yG f � � BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME NI` Neveu SPAN DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS DISTANCE FROM STREET "' POSTS DISTANCE FROM LOT LINES-SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT' PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR D T FI ED BUILDING INSPECTOR I N O NER O AUTHORIZED AGENT E E ��� " OWNER TEL.# "' F6--607,9 PERMIT GRANTEE CONTR.TEL# t7l� 19 CONTR.LIC # H.I.C.# r BUILDING RECORD >, 1 OCCUPANCY 12 SINGLE FAMILY I_ S-ORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES, GA- APARTMENTS RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE d 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT AREA FULL IN. B'M'T AREA _ '14 1/2 FIN. ATTIC AREA _ NO BMT FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARDW D _ ASBESTOS SIDING _ COMIACN — VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STIRS. 8 FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIO_ ADEQUATE I--� NONE 5 ROOF 10 PLUMBING GABLE I I HIP BATH 13 FIX.) GAMBREL MANSARD TOILET RM. 12 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ y ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. & COILS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMSGAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd NO HEATING ORT ' o Of over , 384 ; t rt.� �[ dover, Mass., uG 8 19c.C7-; jF( LAKE T f [ tY 0.� COCKICMEWICK %AERATED PPS BOARD OF HEALTH s . H t r• S PERIMI.IT Food/Kitchen Septic System ., BUILDING INSPECTOR THIS CERTIFIES THAT � i�t........ . . ,t ' . . ..... . ... .... ............................................................. ....................... Foundation � k , on...... ....C,"1t (. . ►.... ................................has permission to�ereet !�.4t(16.v". ulidingsRough $ t4r !�! li�'.�'.:. Q.. .�.�1Nt• 1 � ..Y� .�. Chimney ip Ay .... ,.........to be occupied as. .. ••provided that the perso accepting this permit shall Inarespect confor to the to ms of the application on file in Final I this office;Iand to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR r VIOLATION of'the Zoning or Building Regulations Voids this Permit. Rough Final y PERMIT EXP S IN MONTHS ELECTRICAL INSPECTOR . UNLESS CO TRANT T Rough .......................................... Service I BUILDING P CTOR s Final Occupancy Permit Required to Occupy Building GAS uvsPEcroR Rough Dis"pay m a Conspicuous Place on the Premises — Do Not Remove Final r r a No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. f. Burner PLANNING FINAL CONSERVATION FINAL Street No. { Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT t 5 � TOWN of NORTH ANDOVER AFFIDAVIT ItNe kRVVMEnt Gxdxmt w taw avpiEmi to Fennt tq licatim M�c. 142 A regimes that tine ' , altsatirn, rmxatam, repair, ®dmnzatim, cmmmim, igxux nait, r=wal, danollitsm, or cast<ir�at of m admit im to any per- eestirg a nw-ooa.ped birild- irg cmtairdr at least me bit mt mxe dmfar dellirg units...or to str rthice;4nich are adjaoait to ach residE Ce or hrildiW'be dee by r%isterad oat wwrs, idth certain a ceptiuls, slug with otter Type of Work: ACL Est. Cost' ) /6c) Address of Work q61 So- Owner Name: RCHA rLO A7W 6-'Z-L e� Date of Permit Application: / 7/95 I hereby certify that: - Registration is not required for the following reason(s): Rcr office Use Qtly Work excluded by law Famit Nb. Job under $1,000 Date Aluilding not owner-occupied Owner pulling own permit Other (specify) Notice is hereby given that: OWNERS PULLING THEIR OWN PERMIT OR DEALING WM UNREGISTERED CONIRACIORS:.- FOR APPLICABLE HOME IMPROVDM WORK DO NOT HAVE ACCESS TO THE ARBITRA- TION PROGRAM OR GUARAkY FUND UNDER MGL c. 142A. Signed Lader penalties of perjury: I hereby apply for a permit as the agent of the owner: Date Contractor Name Registration No. OR: Notwithstanding the above n e, hereby apply for a permit as the owner of the above proper Date Own Nigrfie r, .�. . � r— iocation No. Date 1 • - TOWN OF NORTH ANDOVER Lb.7Gy . Certificate of Occupancy Building/Frame Permit Fee $ Foundation Permit Fee $ r` Other Permit Fee $' TOTAL $�, Check#_7 J r 29853 Building Inspector r� c �� � _ �w ., ��' Location No. Date . - TOWN OF NORTH ANDOVER • {TEED jUy�' • r 3 • °rt " Certificate of Occupancy $ Building/Frame Permit Fee Foundation Permit Fee $ < < 1 Other Permit Fee TOTAL $ Check# 8 5 Building Inspector I