HomeMy WebLinkAboutBuilding Permit #398-2017 - 48 CAMPION ROAD 10/13/2016 _ ✓ N ORTH
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a2ll� A44 P4 A0 U� BUILDING PERMIT
TOWN OF NORTH ANDOVER 3 "
APPLICATION FOR PLAN EXAMINATION
Date Received 1 `0 10 � DAATEDPermit No#: �9' CHl^`Q�Na�
T '
I
Date issued:-LO- ( 6
IMPORTANT: Applicant mu'stt coimplete all items on this page - z�
LOCATLON
PROPERTY OWNERI�'n )
V Ont 100 Year Structure, yes. no
MAR _ PARCEL -Cl._�' ZONINO DISTRICT _ _Histone District yes
�-- -� - - Machine Sho _ Villa e. es
9� _Yf- -
TYPE OF IMPROVEMENT PROPOSED USE
Residential Non- Residential
❑ New Building ❑ One family
❑Addition ❑Two or more family ❑ Industrial
❑Alteration No. of units: ❑ Commercial
❑ Repair, replacement ❑Assessory Bldg ❑ Others:
❑ Demolition ❑ Other _ _-
0 Septic. N p Well. Flgodpla�n, k0 Wetlands _❑ Watershed D strict
DESCRIPTION OF WORK TO BE PERFORMED:
Identification- Please Type or Print Clearly
OWNER: Name: Phone:
Address: -
_�
Contractor,eNarne
4 T-
-�2
Address:; _ �_,/�
Sup;ervls.or s Construction L"-- � _ Exp tDate
�H.orne Jm� ovement�.License -
.. _,F ��_�.
ARCHITECT/ENGINEER Phone:
Address: Reg. No.
FEE SCHEDULE:BULDING PERMIT:$12.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$125.O�S.F.
a
L... FEE: $
Total Project Cost: $ 7
/ ��-
Check No.: G 3 x k Receipt No.: 6
NOTE: Persons contracting with u r gister contractors do not have acc s t guaran fund
i nature of contract _
Signature.of.Agent/Owner_
i
Location
No. 39t5 a�t? Date /d•/3' �d0
• TOWN OF NORTH ANDOVER
Certificate of Occupancy $
Building/Frame Permit Fee $034
Foundation Permit Fee $
Other Permit Fee $
TOTAL
3�
Check:# _
G
V Buildinb9 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 Reviewed On
Signature_
COMMENTS
I �
CONSERVATION Reviewed on Signature
r'OMMENTS
HEALTH Reviewed on Signature
COMMENTS
Zoning Board of Appeals: Variance, Petition No: Zoning Decision/receipt submitted yes
Plar:;ning Board Decision: Comments
Conservation Decision: Comments
Water & Sewer Connection/signature& Date
Driveway Permit
DPW Town Engineer: Signature:
IFFRE DEPAR MENT 'Tem Dum st2� d-_384 Osgood Street
Locate
.,p ,P.. onsite eyes,
sLocated a=124Main Street
r�e'Departmentsignatuxe/date_
NORTH
own n over
111- !n
No. Ocj J .M.'I
p
oh ver, Mass, 10 - 13
A_ C OCMICNl WICK yt'
7�A�RATE0
s V
BOARD OF HEALTH
Food/Kitchen
,,PERMIT T LD Septic System
HIS CERTIFIES THAT �N BUILDING INSPECTOR
R .. ... Foundation
{las permission to erect .......................... buildings on ...... ......lC'..1q.1:!'.!. ��. ..........
Rough
Dbe occupied as ......... ... .4�.. ......... .............III......... 0. ......................................................... Chimney
0 F►rovided that the person accepting this permit shall in every respect conform to the terms of the application Final
in file in 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
Rough
fIOLATION of the Zoning or Building Regulations Voids this Permit.
Final
PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION START
Rough
Service
........ .... .... . .. .. ..................... Final
BUILDING INSPECTOR -
GAS INSPECTOR
Occupancy Permit Required to Occupy Buildinz Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner,
Street No.
Smoke Det.
ON
0 •
JkLL 71foofing=wtLin 1E �' 6
Chimneys Residential & Commercia
Siding CHIMNEYS POINTED-REBUILT-CAPPED All Types Of
g
Mass Toll Free Expert K Roof Leaks Experts �� x P Masonry Work
1-800-WAIT-4-US Locatty Owned& Operated Since 1976 Licensed& Insured
(924-8487) IKU® Czee ?ZOZW oz qohwLicense#034200
We Work Year Round
Proposal To:
P N�ew England Shed Date 10/22/2013
Street: 48 Campion Rd.
N.Andover, MA
'9IR,o Roof proposal
�� Labor
1. Extra caution will be taken to protect house 12. Removal of all work related debris. Planks will be
exterior and landscaping as best as possible. placed under dumpster to prevent any damage to
(tarps etc.)Magnets run at final clean up. driveway.
2. Remove all layers of shingles from entire house. 13. Building permit included.
3. Inspect and re-nail any loose or lifted plywood. 14. Contractor workmanship warranty: 10 years under
Any compromised plywood will be replaced at an normal wind and rain conditions.
additional cost$55.00 per sheet of 1/2" cdx fir.
4. Install aluminum drip edge to all eaves and Total roof labor cost: $ 14,500.00
rakes. • This proposal includes all nails and fasteners
5. Install 6' of ice and water shield along all eaves needed.
and top to bottom in all valleys • All materials excluding nails and fasteners will
6. Install underlayment to remaining sheathing up to be supplied by homeowner.
ridge.
7. Install all new pipe boots. *Note*: Please be advised if applicable, valuables in
8. Install starter shingles to all eaves. the attic should be moved or covered due to minor
9. Install architectural shingles to entire main house. debris, dust and asphalt particles that will accumulate
All shingles will be installed and fastened during the stripping process. All Under One Roof not
according to mfg. specs. responsible for any damage or clean up that may
10. Counter-flash chimney lead with ice and water occur in attic.
shield, tie into new shingles and seal
11. Install ridge vent to entire ridge capped with col-
or matched hip and ridge cap shingles. Balance don completion
References available upon reauest
Highly rated member of the accredited BBB and
An ie's List
Thank
i
Acceptance of Proposal—The above prices, spec—ifici tions and conditions are satisfactory and are herb
accepted. You are authorized to do the work as specifi A. Payment wi ade s outlined above. y
Date of Acceptance: . 2 Signa
�\ The Commonwealth of Massachusetts
Department of Industrial Accidents
I Congress Street,Suite 100
Boston,MA 02114-2017
www.mass.gov/dia
Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers.
' TO BE FILED WITH THE PERMITTING AUTHORITY. '
Applicant Information Please Print Leeibty �
Name(Business/OrpnizationnMividual):
i
Address: �v %-o►-w,�� �/?t�{-e— #vO A f1
City/State/Zip: Phone#: 917J- ?1r-1 71
Are you"employal(beck the appropriate box: Type of project(required):
t.D I am a employer with employees(fun and/or part-time).* 7. ❑New construction
2.]I am a sole proprietor or partnership and have no employees working for me in 8. C]Remodeling
any capacity.[No workers'comp.insurance rcquired_I
9. El Demolition
3.[:]]am a homeowner doing all work myself[No workers'comp.insurance required.]t
10 Q Building addition
40 1 am a homeowner and will be hiring contractors to conduct all work on my property. I will
ensure that all contractors either have workers'compensation insurance or are sok 11.1 Electrical repairs or additions
proprietors with oo employees.
12.Q Plumbing repairs or additions
540 1 am a general contractor and I have hired the sub-contractors listed on the attached sheet.
These subcontractors have employees and have workers'comp.insurance.t 14.D dtheRoorepairs i
6.E]We are a corporation and its officers have exercised their right of exemption per MGL c. 14.[ then G7 /
152,§1(4).and we have no employees.[No workers'comp.insurance required.]
*Any applicant that checks box#1 must also fill out the section below showing their workers compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
:Contractors that check this box must attachod an additional sbeet showing the name of the sub-contractors and state whether or not those entities have
employees. If the sub-contractors have employees,they must provide their workers'comp.policy number.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.#: Expiration Date:
``
Job Site Address: ` ;? 2 aVA of -Vt City/StatetZip: '
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to 51,500.00
and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to 5250.00 a
day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance
coverage verification.
I do hereby certify - s and alties of perjury that the information provided above is true and correct
Signature: :
1 0/,.-
Phone#: 4 �' 3 l
Oftial use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees.
Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire,
express or implied,oral or written."
An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more
of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the
receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house
or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer."
MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or
renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any
applicant who has not produced acceptable evidence of compliance with the insurance coverage required.-
Additionally,
equired"Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance
requirements of this chapter have been presented to the contracting authority."
Applicants
Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if
necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of
insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the
members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial
Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should
be returned to the city or town that the application for the permit or license is being requested,not the Department of
Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers'
compensation policy,please call the Department at the number listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom
of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant.
Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit.
The Department's address,telephone and fax number:
The Commonwealth of Massachusetts
Department of Industrial Accidents
I Congress Street, Suite 100
Boston,MA 02114-2017
Tel. #617-7274900 ext. 7406 or 1-877-MASSAFE
Fax#617-727-7749
Revised 02-23-15 www.mass.gov/dia
From:Universal Insurance To:19789750481 07/15/2016 14:45 #715 P. 02/002
ACO d CERTIFICATE OF LIB DATEt",
11001YYTY)
�..� LIABILITY INSURANCE
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HO DER.ITHIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER($),At THORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER.
i IMPORTANT. If the certificate holder Is an ADDITIONAL INSURED,the poliey(los)must bs endorsed. If SUBROGATION IS WAIVED subject to
the terms and conditions of the policy,certain policies may require an endorsement. A statement on this Certificate does not confer rights to the
certificate holder in lieu of such endorsemen s.
FROM
UNIVERSAL INSURANCE AGENCY PHONE Leandro Gulmaraes F
508 752.8333
leandro2universalinsagency.com
374 BELMONT ST. Anngr
WORCESTER INSURER AFFORDINOCOVERAGE Macs
MA 01804 ws neRA: ACADIA INS CO
01supm 31325
MGG CONSTRUCTION INC nNsuReta
INSURER C I
INSURMO:
12 WATER STREETAPT 1 aNSURERE
MILFORD MA 01757 INSURERF:
COVERAGES CERTIFICATE NUMBER: 89377 REVISION NUMBER.
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
i INDICATED. NOTWITHSTANDING ANY REQUIREMENT.TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO I IHICH THIS
? CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL 7 4C TERMS.
} EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
i INSR TYPE OF INSURANCE P EFF PO EXP
F ►DLI D LONITB
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s} EACH OCCURRENCE i
CLAa�MADE
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GENLAGGREGATEUMITAPPUESPErC GENERALAGGREGATE b
POLICY JEC7 LOC
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ANDEMPLOYERSLIAINUTY YIN X
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(Yw4tary In NN) MAARP301454 05120/2018 05!2012017
Myr OI riDeul.dN E.L.DISEASE.EA EMPLOYEE b 1. .000
DEB IPfIONOFOPERATIO I ELOISEASE-POLICY L"r 1000.000
NIA
DESCRIPTION OF OPERATIONS)LOCATIONS I VENICM(ACORD 101.AddlUmrtdu
onel ReSChedWe,may be eleew a,nore ePeee p,pvMd)
Workers'Compensation benefits wid be paid to Massachusetts employeas only.Punuant to EndorsemeM VNC 20 03 08 B,no authorization is givei i to pay
Claims for benefits to employees M states other than Massaehuestia If the insured hires,or has hired those employees outside of Massachusetts.
This csrtlacate Of Insurance shows the policy in force on the date that this certificate was issued(unless the expiration date on the above policy pre. es the
Issue date of iNS certificate of insurance). The status of this coverage can be monitored daffy by ecoessing the Proof of Coverage-Coverage V on
Search tool at www.mass.govllwd/workers.componsagonArwe&Ugatfonsf.
CERTIFICATE HOLDER CANCELLATION Dati
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CMCEII 10 BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DEL VERED IN
ALL UNDER ONE ROOF ACCORDANCE WITH THE POLICYPROVIaIONS.
30 TEMPLE DR
AUTNDR¢ADREPRESENTArnE i
METHUEN MA 01844
Daniel M ?�
CPCU.Vice President—Residual Market—W IBMA
2014101
ACORD 23 ®1958-2014 ACORD CORPORATION. All righ a reserved.
( ) The ACORD name and logo are registered marks of ACORD
I
ACORD CERTIFICATE OF LIABILITY INSURANCE i
r� GATE(MM/DDIYYYY)
THIS CERTIFICATE Is Issu0012812010
t:D As A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICA E 128
HOLDGR T
ceanFlcarE DOER NOT AFFIRMATIVELY OR"NEGATIVELY AMEND, EXTEND, OR ALTER THE COVERAGE AFFORDED
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE IssuINQ INsuREa s THIS
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER, SY THE AUTHORIZED
IMPORTANT: 4 )r AUTHORIZED
If the certificate holder is an ADDITIONAL INSURED,the poll tea mu
the teens and eondiUons of the policy,certain policies may require an endorsemeL A statement on this certificate does not c nfer rights to the
cY( )must be endorsed. If SUBROGATION IS AHED subject to
certificate holder in 110111 of such endorsement(s).
PRODUCER 02051-001
Perry I •C Branch 2051-1
Insurance A ency LLC
622 Chickeringq�
RA AIC.No.; (g 8)687-0149
North Andover,MA 01846 � S�ss:
INSUREDINIAIRrRA6 A.I.M.Mutual Insurance Company
All Under one Roof I
i
C/O John Lanzafame
30 Temple Drive
Methuen, NA 01844
INSURFOR P.
COVERAQES CERTIFICATE NUMBER:
THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BE REVISION NUMBER.-
INDICATED. NOTWITHSTANDING ANY REQUIREMENT, LOW HAVE BEEN ISSUED TOTHE INSURED NAMED ABOVE FOR TH1E
CERTIFICATE MAY BE ISSUED OR MAE , THE EN UROARNGE AFFORDED BY THE POLICIES EOTHER
RIBED HEREIN 8 WITH
O CT T LWICY PERIOD
m ICH TERMS,
x�EXCLUSIONS AND CONDITIONS OF SUCH PERTAIN,
LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
'LTrt LIABILITY
OF INSURANCE I yPR vyw POLICY NUMBER �j � w � ( LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE
CLA IMS.MA06 M OCCUR 's
MED EXP(Any one person) $
PER30NALa,ADV-INJURY S
ENLAGGREGATEUMIT/1PPUEBPER GENERALAGGREGATE $
OUCY RO' 0 PRODUCrs.COMP/OPAGO 1$
AUTOMOBILE UABIUTY
ANYAUTO fE2S
ALL OWNED SCHEDULED 80DILY INJURY(Per Denson) 13
AUTOS AUTOS
UR
HIRED AUTO& NON-0WNED BODILY INJURY(Pa soddent)
AUTOS
UMBRELLA LIAS OCC
EXCESS WAS CLAIMS MADE EACH OCCURRENCE E
�y�RKDgEDRRETT�ENTIONN i AGO ATE
$
ANO EM�LOYERS'LIAB�QTY X S ER
A "V
9�'d�Pr 'P ItlF> �"'E '
ManeY NIA AWC400-7009404.20ioA 1119,2016 11/9,2016 e'`'�HA�'D� 3 '100,000,00
1(trddste�osoryrin�lNu�nHAd)
SAM R' 5P RATIONS betow E 1.DI8EA3H•EA EMPLOYEE 100,000.00
E.L.DISEASE.POLICY LIMIT S 600,000.00
DESCRIPTEON OF OPERATIONS/LOCA710N5/VEHICLES(gtteeh ACOR 1101,Addld00e1 Remarks 8ChedUIt,1(nlore ipeCe Is'required)
I
i
The workers compensation policy does not provide coverage for John Lanzafame
CERTIFICATE HOLDER
'" CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL. BE; DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS. i
AUTHORIZED REPRESENTATIVE
505,20 0 CORD CORPO ION.-Al I lightes reserved.
e registered marks of ACORD
Massachusetts.De,:artment or,u„:t;5a•e;
Beard of Building Regulationu a"star,:a.�r
CunitrUCtfun SUpcITWir
License: CS-009120
W
30 TB
U D
?an=NMA 01844'
�omm;ssiona� 04/03/2017
?P
Office of Consumer Affairs and Business Re l�
10 Park Plaza- Suit Regulation
Boston, Massachusetts 02116
Home Improvement Contrac
34,7E',® tor Registration
Registration: 137057
ALL UNDER ONE ROOF . Type: DBA
JOHN F Expiration: 10/2/2018 Tn# 291333
166 A MERRIMACK ST '{.-
METHEUN, MA 01844
SCA 1 0 20M-05m Update Address and return card,
Address ❑ Renewal Mark reason for change.
((fyll//IRIIIIlry , r,jj ❑ Employment ❑ Lost Card
Office of Consumer Affairs&Busi��ness Regulation"f/1
HOME IMPROVEMENT CONT
Registration valid for individual use only before the
r( g 137057 Registration: RACTOR expiration date. If found return to:
P4
Ex iration: T072/2018 Type'
F DBA Office of Consumer Affairs and Business Regulation
ALL UN"'} 10 Park Plaza-Suite 5170
DER ONE ROOF
Boston,MA 02116
JOHN LANZAFAME
166 A MERRIMACK ST
METHEUN,MA 01844
dersecretary
Not valid without signature
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
I
NOTES and DATA— (For department use)
I
I
I
i
❑ Notified for pickup Call Email
Date Time Contact Name 3
Doe.Building Permit Revised 2014
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 pp 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 red p
roduct
s
i
for to issuance of Bldg Permit
NOTE. All dumpster permits require sign off from Fire Department pr 9
i
Addition Or Decks
❑ Building Permit Application
❑ Certified Surveyed Plot Plan
❑ Workers Comp Affidavit
❑ Photo Copy of H.I.C. And C.S.L. Licenses
❑ Copy Of Contract
❑ Floor/Cross Section/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 ConstructionSin le and Two Family)
� g
❑ 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
sign off from Fire
NOTE: All dumpster permits require s Department prior to issuance of Bldg. Permit g
p
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:Building Permit Revised 2014
Location
No. 26 2 Date
NORTH TOWN OF NORTH ANDOVERp
A Certificate of Occupancy $
i # Building/Frame Permit Fee $
. i
Foundation Permit Fed, $
s�cHusE �-�
Other Permit Fee $
is
Sewer• Connection Fee $ —
Water Connection Fee $
TOTAL $ �
�a 1
Building`Inspector
3 U
_ _ /4 Div. Public Works
PER'.=NO. .� CJ 2 APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. 0 PAGE 1
MAP -NO. /„/� I LOT NO. 90 2 RECORD OF OWNERSHIP ID AT92 IB�l� ;PAGE Q
ZONE �v SUB DIV. LOT NO. / p
LOCATION ��� 17/Q� /IO PURPOSE OF BUILDING ®�.f `� 3�y/ /�� F I C16/
OWNER'S NAME v0L%c1 /�` '�'zQ/i-„•�'+�vC1 NO. OF STORIES Y SIZE l�
OWNER'S ADDRESS fnf�lJC&�'/ijqTTNn/D� V� �/7 BASEMENT OR SLAB _
ARCHITECT'S NAME L� Y'' SIZE OF FLOOR TIMBERS IST 2ND 3RD
BUILDER'S NAME 4-/pv 14-Y ?70-e-91- SPAN
DISTANCE TO NEAREST BUILDING - / DIMENSIONS OF SILLS
DISTANCE FROM STREET ��'O/' POSTS
DISTANCE FROM LOT LINES - SIDESf J'6/ REAR GIRDERS
SCJ r
AREA OF LOT AAl, 7�1 �"� �/ FRONTAGE23p/ HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW '7” ,' 7ff ?'r 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 t FILL OUT SECTIONS 1 - 3 '
EST. BLDG. COST PER SQ. FT.
d
PAGE2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.
r 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 FILED 44
BOARD OF HEALTH
SIGNATU
,77#iNE)(0r-fH49RIZED AGENT
FEE
OWNER TEL.#--! ' 77 PLANNING BOARD
PERMIT GRANTE t. CONTR. TEL. #
19 -2Y ,rNJTR. LIC o
BOARD OF SELECTMEN
91
v"1 BYILDINO INSPECTOR
• y
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY STORIES 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 3 t 2 13
CONCRETE BL K. PINE
BRICK OR STONE HARDW D �f� Ti
PIERS PLASTER _!
_ DRY WALL _
UNFIN
3 BASEMENT
Y
AREA FULL FIN. B'M'TAREA
V. '/r ', FIN. ATTIC AREA
BMT FIRE PLACES
HE `QT
HEAD ROOM MODERN KITZ`MEN
4 WALLS I 9 FLOORS /
CLAPBOARDS B 1 22 f 3 (j
DROP SIDING CONCRETE
WOOD SHINGLES EARTH
ASPHALT SIDING HARD"✓D J
ASBESTOS SIDING COMf.AON
VERT. SIDING ASPH. TILE `
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY ATTIC STRS. & FLOOR _
BRICK ON FRAME
CONC. OR CINDER BILK.
STONE ON MASONRY WIRING +�
STONE ON FRAME �y
SUPERIOR -yI POOR _
ADEQUATE I I NONE 1�
1r
5 ROOF 10 PLUMBING b
GABLE HIP BATH (3 FIX.)
GAMBREL MANSARD TOILET RM. (2 FIX.) _
FLAT SHED WATER CLOSET _
ASPHALT SHINGLES LAVATORY
WOOD SHINGES KITCHEN SINK `1' !� f
SLATE NO PLUMBING `Yli
TAR & GRAVEL STALL SHOWER
ROLL ROOFING MODERN FIXTURES _ A
TILE FLOOR
TILE
i
6 FRAMING I 11 HEATING
WOOD JOIST PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER BMS. & COLS. STEAM r
STEEL BMS. & COLS. HOT W'T'R OR VAPOR
WOOD RAFTERS AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS I
7 NO. OF ROOMS GAS
OIL
B'M'T 2nd ELECTRIC u
1st -1-3rd I NO HEATING W
FORM U - IAT RRTFASF 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 local or state law,
regulations or requirements.
****************Applicant fills out this section*****************
lr--�
APPLICANT: 06F_00 Phone Cv87�a x'79
LOCATION: Assessor' s Map Number 62— Parcel g®
Subdivision Lots)l
�---Street 46 67,1/y/010A) 90 St. Nunber
************************official Use Only************************
COMMEND IONS OF TOWN AGENTS:
Date Aueroved
c Conservation Administrator Date Ren ectad
Comments
Date Approved
Town Planner Date Rej ec ted
Corr , ents
Date Approve:
Food Insrec":oorr- ealth Date Resected
."1 ,c/1/G// /J/( Date Apprcve^ 1", /;�
Sem-::.c Inspec:or-Health Date Re;ec-ed
COP'u:.en:s
Public Wcr::s - server/water connections _
- driveway pe=it
Fire Deoart-Ment
Received by Building Inspector Date
CERTIFIED FOUNDA j�j
T/ON'PLA
LOCATED/N No.�4NDOVR:
/" 4O'
= DATE
SCALE:
Scoil L. Gi/es R.L.S.
50 Deer Meadow Rood
North Andover M
ass.
t a
`Ny i
� t
Lu
ZA
j •;;cit:.
l .''b • i., :� ;-•; 1, r 1,
r3'
��. (max°(SS,`3� n/�� •I ' • , .. ' � _ '�',� s �. V;.c
CAMPION ,r
/ CERT/FY THAT OFFSETS SHOWN ARE FOR;THE;USE h ' f
THE OFFSETS OF THE SU/L D/NG INSPEC TOR=ONLY .
SHOWN COMPL Y ; AND' SUCH USE/S FORHE
T Y� ��
WITH THE ZON/NG DETERM/NAT/ON OF ZONING
BY LAWS OF CONFORM/T Y OR NON-CONFORM/TY
t A
WHEN CONSTRUCTED, �+
WHEN SUIL T. t ,
t
_` J S x+1 tom', ,• -. ,.' y } kxs � '� !,
J fi
Y
�R - FAMILY Pools & Patios, Inc.
{ ,t Sales • Service • Supplies
' r 92 So. Broadway • Lawretice, Massachusetts 01843
Telephone: 688-8307
.tr.
a,
DAT 19
.,
1 ADDRtSS r'
C11��'-'• STATETELEPHONE !�` ��' Res.
*PROPOSAL*
44�
Ne propose to�furnish and in tall one f >
iril rlih�'pool'#br,the sum of
t I
I C`�pMce for normal Installation.consists of:
� t t t
V
Six (6) ho4s"digging time + Installation of pool with filter and wall skimmer • Backfilling and rough
fy;,,'- .._grading around pool not to exceed six (6) hours or one(1) trip.
The.price does not include:
i ,
Any,electrical work • Excavating over six (6) hours • Backfllling and grading over six (6) hours or one (1) trip
�t Blasting or Jack hammering for removal of ledge or large rocks • Re-seedina of nracc aenund_1--- -
-•Trimlearl In .....a.... _ n_.,._.--- -
i
it
GErr��`�r���•
FAMILY Pools & Patios, Inc.
Sales • Service • Supplies L �_
92 So. Broadway • Lawrence, Massachusetts 01843
Telephone: 688-8307
.
NAME— Of/� - i .t, r i /
DATE f/ iJ� 19
'..' ADDRESS
r
4 CITY % ' �-� ' STATE �� ;-r� TELEPHONE Res.
Wk.
i44
( 4
f
*PROPOSAL*
We propose to furnish and install one
swimming pool for the sum of
1�Ijhe price for normal installation consists of:
Six (6) hours digging time• Installation of pool with filter and wall skimmer • Backfilling and rough
grading around pool not to exceed six (6) hours or one (1) trip.
The price does not include:
Any electrical work • Excavating over six (6) hours • Backfilling and grading over six (6) hours or one (1) trip
. i Blasting or Jack hammering for removal of ledge or large rocks • Re-seeding of grass around pool
Trucked In water • Patio-around Boni nr anv nr rncenrine nvrc.,f no n^fted k-1—, . w.+.+a,.--1 9111.
• N0RTI-r
Tovm of 0 ove
No. 7
y
O L A- dover, Mass., .ti/AIis 1940y
T �.
�J COCHICHEWICK
'7,p ADRATED PPS\
S BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT.............riosep4......oo. o •l�.f ......•.•..••••....••••.••.•... Foundation
has permission to erect...rw.�............... buildings on ....y1f...�-ramoowom...xv.*......... Rough
to be occupied as .1106 .r.r � .I. �. 1 _4j �1Chimn y
e
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 an onstruction of
.
Buildings in the Town of North Andover ` PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
IT EXPIRES IN 6 MONTH
�� D ERM S Final
ELECTRICAL INSPECTOR
it . UNLESS CONSTRUCTION STARTS
Rough
w � ...............'U ;4 ..... ......... ............................................... Service
BUILDING INSPECTOR
Final
Occupancy Permit Required to Occupy Building cAs INSPECTOR
la in a Cons icuous Place on the Premises — Do Not Remove Rough
Display y � p Final
No Lathing or Dry Wall To Be Done
Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT
Burner
PLANNING FINAL CONSERVATION FINAL Street No.
Smoke Det.
CCIAICR /IAIATCR FIK141 DRIVFWAY FNITRY PERNAIT
L9cation _ -
Aj
f
No. Date
„ORT1y TOWN OF NORTH ANDOVER
O?O•4f`•o I•1�o n
;E
p Certificate of Occupancy $
`f � ; ,' Building/Frame Permit Fee $
CNUC Eta'« Foundation P mit Fee $
S
Other Permit r��'"Fee 0
Sewer Connection Fee $
Water Connection Fee $, f�--
TOTAL
F '
,�- Building Inspector
RAID
Div. Public Works
Location
{ Date
No.
t , 40RTM TOWN OF NORTH ANDOVER
60
Certificate of Occupancy $
•L ; Building/Frame Permit Fee $
•
�'�s''•'•�t�' Foundation Permit Fee $
sACHUSE
Other Permit FeeCHiMNt y $ �S•S�
Sewer Connection Fee $
Water Connection Fee $
TOTAL $
lJ
G #/S�2-7 Building i spector
.4i 6 9133 1 i L. Div. Public Works
Location
y � -
Ro. t , Date
i
N?O��NO p7.,tio TOWN OF
NORTH ANDOVER
3 0
A Certificate ofpccupajcy, $
a s '�l� <
+ ; , Building/Frame Permit Fee �•av
"'^°' �' Foundation Permit Fee
s�CHU
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL
Ar Building�lnspector
•">}
6623 Div. Public Works
Location �r. '�u�x-�
No. Date
gORTof TOWN OF NORTH ANDOVER
3?O:t .ao i
' p Certificate of Occupancy
Building/Frame Permit Fee
ITS CH Eta Foundation Permit Fee $
ITS CH 'l /
Other Permit Fee $
Sewer Connection Fee $
Water Cpnnection Fee
t TOTAL' $ �.�-�6 d
Building Inspector
'•'' V 5 L Div. Public Works
(&f
r� X06 'g a
PER-litT NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. a? 70C,
MAP dad. �Z LOT NO. 2 RECORD OF OWNERSHIP (DATE BOOK 'PAGE —
ZONE I SUB DIV. LOT NO.�f-
LOCATION [ i 9�C„ `d PURPOSE OF BUILDING
OWNER'S NAME `I GZS �^[(-, s NO. OF STORIES Z SIZE /Q .C'
OWNER'S ADDRESS J�I Q 1� BASEMENT OR SLAB J
ARCHITECT'S NAME / C,V-t5_I _.^i..�.� �t^S SIZE OF FLOOR TIMBERS 1ST e7c �d 2ND Z)<(ED 3RD
BUILDER'S NAME ( {�� 1�w CSI CDD ctV ;,X CZE I� SPAN `/`
DISTANCE TO NEAREST BUILDING '7� DIMENSIONS OF SILLS
V '7x
DISTANCE FROM STREET /) ( ,a-, POSTS L-
DISTANCE FROM LOT LINES-SIDES `3 � REAR " " GIRDERS
AREA OF LOT Lf7,(5&0 cFRONTAGE { 7� HEIGHT OF FOUNDATION f THICKNESS /�'ff�1Z
IS BUILDING NEW J P/�� ` SIZE OF FOOTING /Z� X �Z
IS BUILDING ADDITION �J/I 69 MATERIAL OF CHIMNEY /�`
kt IS BUILDING ALTERATION ,/uo IS BUILDING ON SOLID OR FILLED LAND �-�
WILL BUILDING CONFORM TO REQUIREMENTS OF CODES IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER
O IS BUILDING CONNECTED TO NATURAL GAS LINE /u O
INSTRUCTIONS 3 PROPERTY INFORMATION
BLDQ FIRMIj ` F LAND COST /QQ�4:pt SEE BOTH SIDESjj
ESS MA EST. BLDG. COST zd p 0
` �ic t EST. BLDG. COST PER SQ. FT.
PAGE 1 FILL OUT SECTIONS 1 - 3 DUE
' MME PeAs EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 �O
o. v
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 FILED
WARD OF HEALTH
SIGNATURE OF OWNE OR AUTHORIZED AGENT
v
FEE
PLANNING WARD
PERMIT GRANTED OWNER TEL.0 /
CONTR,TEL.#
CONTR.LIC.
BOARD OF SELECTMEN
71
/� /( /��� 111 SUItrDINQ INSPECTOR
v s/ (/lJ/ll (1 I�T
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY STORIES 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 I RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
CONSTRUCTION
2 FOUNDATION _I 8 INTERIOR FINISH
CONCRETE CJI 3 2 y3
CONCRETE BL'K. I PINE
BRICK OR STONE HARDW D
PIERS PLASTER
_ DRY VJALL _
UNFIN.
3 BASEMENT
AREA FULL FIN. B'M'TAREA _
1/1 1/7 % FIN. ATTIC AREA _
NO 8 M'T FIRE PLACES _
HEAD ROOM MODERN KITCHEN
4 WALLS 9 FLOORS
CLAPBOARDS 8 1 2 3
DROP SIDING _ CONCRETE
WOOD SHINGLES EARTH
ASPHALT SIDING HARDN4'D _
ASBESTOS SIDING COMMON
VERT. SIDING ASPH.TILE _ R
STUCCO ON MASONRY _ t
STUCCO ON FRAME Nl� (JI
V ' •':::;.ISS
BRICK ON MASONRY KATTIC STRS. & FLOOR _
BRICK ON FRAME
CONC. OR CINDER BLK.
STONE ON MASONRY WIRING +1bAa�r�`err _
STONE ON FRAME
SUPERIORPCIOR
ADEOUATE NONE
5 OF 10 PLUMBING {
GABLE V HIP BATH (3 FIX.)
GAMBREL MANSARD TOILET RM. (2 FIX.)
FLAT SHED WATER CLOSET _
ASPHALT SHINGLES LAVATORY
WOOD SHINGES KITCHEN SINK T
SLATE NO PLUMBING
TAR 3 GRAVEL STALL SHOWER
ROLL ROOFING MODERN FIXTURES _
TILE FLOOR
TILE DADO a R
6 FRAMING 11 HEATING O V
WOOD JOIST PIPELESS FURNACE i
FORCED HOT AIR FURN.
TIMBER BMS. 8 COLS. STEAM T
STEEL BMS. 8 COLS. _ HOT W'T'R OR VAPOR
WOOD RAFTERS AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS
r
CPA
7 NO. Of ROOMS GAS
_ OIL
2 AN EL TR
1st rd _ IN22 NG
FOM U
TOWN OF NORTH ANDOVER `
LOT RELEASE FORkI • -�`
SUBDIVISION
ASSESSORS MAP
SUBDIVISION LOT(S)
PERMANENT ADDRESS (ASSIGNED BY�D.P.W. ) -
STREET
APPLICANT G�-- l� PHONE
G �
DATE OF APPLICATION
TOWN USE BELOW THIS LINE
PLA NN NG BOARD
DATE APPROVED • LD •� Z..
TOWN PLANNER DATE REJECTED
CONSERVATION COPIr1ISSI��ON� v ��d�,(� �„-� -•�,,,�1 g.��,
APPROVED �� 2 QZ
CONSERVATION ADMIN.
DATE REJECTED
Br OF HEALTH r�'
04AI 0 o6wa. DATE APPROVED
HEALTH SAN I TARIAN DAI-E REJECTED
DEPARTMENT OF PUBLIC WORKS
DRIVEWAY. PERr1IT 2 7 yZ
SEWER/WATER CONNECTIONS I
TIRE DEPT.
RECEIVED BY BUILDING INSPECTION
DATE
This form shall be signed by the agents of the Planning and Health Boards ,
the Conservation Commission prior to the issuance of any building permits
for the subject lot. This form shall not releive the applicant from the
, compliance of any applicable Town requirement or Bylaw.
i
Town of North Andover
BUILDING DEPARTMENT
Homeowner License Exemption
(Please print)
DATE
JOB LOCATION y9
Gc v i o12
Number ,Street Address Section of town
"HOMEOWNER" v�L�`� y�`7` �Gl�`� L�'E��Z -77
Name Home Phone Work Phone
PRESENT MAILING ADDRESS Z ��-��� k/
�• cue
City Town State Zip code
The current exemption for "homeowners" was extended to include owner
occupied dwellings of six units or less and to allow such homeowners to
engage an individual for hire who does not possess a license , provided
that the owner acts as supervisor. (State Building Code , Section 109 . 1 . 1)
DEFINITION OF HOMEOWNER:
Person(s) who owns a parcel of land on which he/she resides or intends to
reside , on which there is , or is intended to be, a one to six family dwell-
ing , attached or detached structures accessory to such use and/or farm
structures . A person who constructs more than one home in a two-year
period shall not be considered a homeowner. Such "homeowner" shall submit
to the Building Official, on a form acceptable to the Bulding Official ,
that he/she shall be responsible for all such work performed under the
building permit . (Section 109 . 1 . 1)
The undersigned "homeowner" assumes responsibility for compliance with the
State Building Code and other applicable codes , by-laws , rules and
regulations .
The undersigned "homeowner" certifies that he/she understands the Town of
North Andover Building Department minimum inspection procedures and
,.. requirements and that he/she will comply with said procedures and
requirements .
HOMEOWNER' S SIGNATURE
APPROVAL OF BUILDING OFFICIAL
Note : Three family dwellings 35 ,000 cubic feet , or larger, will be
required to comply with State Building Code Section 127 . 0, Construction
Control .
�J �
CERTIFIED FOUNDA TION PLAN
LOCATED /N NO,ANDOV ER.f M^-
SCALE:
^,SCALE: / = 44 DATE: 2:11'95
Scott L. Giles R.L.S.
50 Deer Meadow Road
North Andover,Mass.
S 4s iti
0A,0,
3A-A `
a
M
Ler 7A
♦ N '
1
O 1
1
1
t j
L.�(sags R 3 �3 0 OCT f 21993
CAMPION
/ CERT/FY THAT OFFSETS SHOWN ARE FOR THE USE i
THE OFFSETS OF THE BUIL DING/NSPEC TOR ONL Y ,��'E�
SHOWN COMPLY ANDO'SUCH USE IS FOR THE
WITH THE ZONING DETERMINATION OFZONING M
SY LAWS OF CONFORMITY OR NON-CONFORMITY
WHEN CONSTRUCTED. um
WHEN BUIL T. t
. -Town NORTH
of r R over
O �rY IIN11i
No. 397 '' `�
o 0 �L NAE dower, Mass. 19
COCHICHEWICK
ADAATED PPS\ "`C
'9S H BOARD OF HEALTH
low
PERMIT T D Food/Kitchen
Septic System
�� ILDING INSPECTOR
THIS CERTIFIES THAT................. .... .. .. :.. .......... '...A_#... ..Ago � * Foundation
has permission to erect. ..�.*00". . tiildings on ... "'. ,:4# .ev4- .. ............. Rough
to be occupied as /AV 1A _ himney
provided that the person accepting this permit shall in ever `respect conform to.the terms of the application on file in Final
this office, and to the provisions of thb Codes and By--Laws relating to the Inspecg �,rao� of
Buildings in the Town of North Andover. ore 8 Pte• 114.x. �.L►r PLUMBING INSPECTOR
REGULA? X
VIOLATION of the Zoning or Building Regulations Voids this Permit. ��g/a^y s� v Rough
../ PAIS' Z4 d Final
PERMIT EXPIRES IN 6 MOSo,r,v a lew
ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION S �S Rough
:`�'#:RMIT.FOR FRAMUBUILDIN Y' `� `
Y. ... ti , Service
.....�.. .. .............. ..... .. �. ........ ..........
"'FFF••' ,� DING INSPECT
FEE PAID C) Final
..' DATE ery r
Occupancy Permit Required. to Occupy Building GAS INSPECTOR
la n a . Cons icuous Place on the Premises — Do Not Remove Rough
Display Y ip Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector.
Burner
PLANNING FINAL CONSERVATION FINAL street No.
Smoke Det.
SEWER /WATER FINAL DRIVEWAY ENTRY PERMIT
�)t�l�ic•t��c)t�. u
c_c)NI:1NORTH ANDOVE It
IV� TION I IIVINIl 1N i 11' 11.1 ') aa! •1
I IIALTI1
1'I.ANNINc; 1'I.ALNN1NG. (;t)I11lrIl!NI'I'1' I)l;�'I:1.()I'l111:N'1'
I.I'. NI:1.( )N. 1 )I1 ii(A( )I It
' CHIMNEY APPLICAf1014 ANO 1'L'1311I'
ATE /Z PL)trli'r. # s5? .7
)CATION Z-J% i1-
LINER'S NAME: ,Q,�%/ 4
1ILDER'S NAME: � L
SON'S NAME: . 7 Ci ( I 'A10Ff C-6
kSON'S ADDRESS: S� (j� N��-1� S� CCflZyy .
'.SON'S TELEPHONE:
m
JERIAL OF CffIMNEYSl (�'T-�,Lyc/L S SNC
ITERIOR CHIMNEY:_x — EX1 LRIOR C11II,INLY: vt_-
11%1BER AND SIZE OF FLUES:
IICKNESS OF HEARTH:
cfvullney O/L 0iolLepcace c011(ual to Vie nefiublemell.ts u() .the cufle cul{f flave :1uCe.5 am(
:gu,e.ati.ull,6 been acccZved:
.T6: Z /
.GNATURE OF MASON:
:Rt,{IT GRANTED: / /�3 F LL
IsER;' NICETTA
J LDING INSPECTOR
SPECTEU: --
MARKS: -
�� �I^I`^�t`� SOLD BLOCK RLQUIRED
Ckl lS.27 cs�—
THIS PERMIT I.IUSF GE UISPLAVU) 014 ME I'IZLIAI<L_,
mV 1 l ()f ... .,.. , .
Nr L'ltAUWATION
11.
i
1 II\•I: I IN 1 q •
Ilil illi((!i•li i!i
111,YkNN1NG. & cOAjrjILINI'1'1' U1sV1;1.U1'l111 N 1'
NFI.SON. DIltl:(:*I( m
CHIMNEY APPLICS -1014 ANI) I'L131I1•
------------------
ATE
PEK1,111'. # 1197dw -
)CATION
ZpT
)NER'S NAME: ------------
'ILDER'S NAME: S tq 21 G
SON'S NAME:_ "� ; C x D i P,fi
SON'S ADDRESS: Iz/L)
SON'S TELEPHONE: i 92 _z
TERIAL OF CHIMNEY: �21
>-ERIOR CIfIAINEY: _ EXl LRIOR C1IIMNLY:
FIBER AND SIZE OF FLUES:_
I CII14ESS OF HEARTH:
'.L cllZiney ca OiAep.ence cu11(unur to 41te 1cqu.u1e111ell.t.5 ur .f.lte cure and have :utCe.S nll�t
3u,eatiow been neeetve(j:
_E1'2JI
:
NATURE OF MASON:
:hIIT GRANTED:_
-;ERT NICETTA
'LDING INSPECTOR
PECTEO:
ARKS:
SOLID BLUCK RE'QUIRE )
THIS PERMIT 1,1(IS r G1= V ISPLAYL U 014 ME
CERTIFICATE F
. j
. O USE & OCCUPANCY
l
Town of North Andover
s I
Building Permit Number 397 (1993) Date
APRIL 27,1 994
THIS CERTIFIES THAT
,i
! THE BUILDING LOCATED ON 48 CAMPION ROAD (Lot #3A)
H , MAY BE OCCUPIED AS SINGLE FAMILY DWELLING W/3 CAR GARAGYN ACCORDANCE
7. & DECK
WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND
A SUCH OTHER REGULATIONS AS MAY APPLY.
pOM7M ,hOL CERTIFICATE ISSUED TO Joseph Bartolotta
1925 Great Pond Rd.
° ADDRESS North Andover, MA
3A;;'t Building Inspector
I
I
I
i
I
I
"A
® ON41e1C�F�l F1
ortiAndover
VV`n f V ' ) ,
0
NO. .49 7
�V, dover, Mass., 19 Ott
0
AO�Acoc-C
T E 1)
BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System AeOx
. ,
THIS CERTIFIES THAT...............V-40..S.4for-14........... BUILDING INSPECTOR
Fould
has permission to erect.W.#.*Of�OA*V*,Oil4fuildings on ...V T?XA#f#44f W. ..4p.ro............. Rough
to be occupied as„ !? ....... wo
V.......P .....0. - himney
*'**it ” ieif-tespect conform to th
provided that the person accepting this permshall invere terms of the'application'on file in Final
this office, and to the provisions of the Codes and By-Laws relating to the Inspec 01
'y
Buildings in the Town of North Andover.
REGULATED BY PAW 114J-& MC. PLUJBIXG INS
VIOLATION of the Zoning or Building Regulations Voids this Permit. e, C.) E9 ry I�OyvCT -
.
PPAID
AT ,
�—o. e e&eel ELECfRIC'A0
T TkIl i :(ti S (q- _ -S NSPECTOR
6
PERMIT FOR FRAME/BU! Rough
.................. Service
DIN
4- FEE Final
toBitmilig GAS INSPECTO
Display in a Conspicuous Place on the Premises — Do Not Remove Rough
Final
No Lathing or Dry Wall To Be Done
aspis
ected and Approved by the Building Inspector. FIRE DEP RTMENT
Burner
74
K Street• et No. q4
-EWER WATERE1Au V Llu (HNAL CONSERVATION Smoke Det.
DRIVEWAY ENTRY PERMITk