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HomeMy WebLinkAboutMiscellaneous - 10 SUMMER STREET 4/30/201815 " � /4" Date. .......) ...... TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ...................... ..................... has permission to perform ......... : ............................ plumbing in,the buildings of ... at ..... ........ ........ ....... North Andover, Mass. ... ... Fed .......... Lic �Z Ire— _:�il ' * ' * * * ' ' * PLUMBING INS'�ETOR Check " ��7 8525 MASSACHUSETTS UNIFORM "PLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER, MASSACHUSETTS Date 9 lG Building Location Permit # ?77,,5 II Amount Owner New Renovation ❑ Replacement Plans Submitted Yes No FTXTI TR Fc (Print or type) Installing Company Name Ac Lck Q Address ! W�4 Ovt/ l vl C G (� A er I b n / Check one: Certificate ® Corp. Partner. i \ 0 Firm/Co. Name of Licensed Plumber: IM Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ElBond Insurance Waiver: I, the undersigned, have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent rl 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 Mass= ass Sta Code and Chapter 142 of the General Laws. By:Signature o rc Title ens urn Type of Plumbing License Cit PROVED (OFFICE USE ONLY rcense um er Master Q Journeyman /[ APPRO I* The Commonwealth of Massachusetts Department of Ladustrial Accidents Office of (investigations 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Leaibiy Name (Business/Organization/individual): Address: 2. wUooG L Qcvt% City/State/Zip:n��t�/�Z � Phone #: Are you an employer? Check the appropriate box: L ❑ I am a employer with 4. ❑ I am a general contractor and I employees (full and/orpart-time).* 2. &1 have hired the sub -contractors am a sole proprietor or partner- listed on the attached sheet. I ship and have no employees These sub -contractors have working for me in any capacity. workers' comp. insurance. [No workers' comp. insurance 5. ❑ We are a corporation and its required.] 3. ❑ 1 am a homeowner doing all work officers have exercised their right of exemption per MGL myself. [No workers' comp. c. 152, § 1(4), and we have no insurance required.] t employees. [No workers' comp. insurance required.] Type of project (required): 6. New construction 7. ❑ Remodeling 8. ❑ Demolition 9. ❑ Building addition 10. ❑ Electrical repairs or additions 11. Plumbing repairs or additions 12. Roof repairs 13. ❑ Other :u: uui me section eeeo7, saov n� +i war' coWpensa ioe,rii y information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. $Contractors that check this box must attached an additional sheet showing the name of the sub -contractors and their workers' comp. policy information. I am an employer that is providing workers' compensation insurance for my employees. Below is the policy and job site information. el\ Insurance Company Name: 101 at M PSVpj — W 0 Policy # or Self -ins. Lic. #: U © a'l 0A d Expiration Date: Job Site Address:- 0 �v Vvt wr ef' S City/State/Zip:—AL lug Attach a copy of the workers' compensation policy declaration page (showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to $1,500.00 and/or one-year imprisonment, as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to $250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the D1A for insurance coverage verification. I do hereby c�� u der the painso penalties of perjury that the information provided above is true and correct 3t auire;­— — Date.: 1 Phone #: Official use only. Do not write in this area, to be completed by city or town officiaL City or Town: Permit/License # Issuing Authority (circle one): 1. Board of Health 2. Building Department 3. City/Town Clerk 6. Other Contact Person: 4. Electrical Inspector 5. Plumbing Inspector Phone #: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute, an employee is defined as "...every person in the service of another under any contract of hire, express or implied, oral or written." An employer is defined as "an individual, partnership, association, corporation or other legal entity, or any two or more of the foregoing engaged in a joint enterprise, and including the legal representatives of a deceased employer, or the receiver or trustee of an individual, partnership, association or other legal entity, employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein, or the occupant of the dwelling house of another who employs persons to do maintenance, construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6) also states that "every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally, MGL chapter 152, §25C(7) states "Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely, by checking the boxes that apply to your situation and, if necessary, supply sub-contractor(s) name(s), address(es) and phone number(s) along with their certificate(s) of insurance. Limited Liability Companies (LLC) or Limited Liability Partnerships (LLP) with no employees other than the members or partners, are not required to carry workers' compensation insurance. If an LLC or LLP does have employees, a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial be for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should Ue. returned to t' -c city or town &mt, the application for the pernait 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 bum leaves etc.) said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address, telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 021.11 Tel. # 617-727-4900 ext 4.06 or 1-877-MASSAFE Fax # 617-72.7-7749 Revised 5-26-05 www.mass.gov/dia N22233 Date ...... Y/�A�...... '.<``° TOWN OF NORTH ANDOVER p PERMIT FOR WIRING This certifies that ............. ?� 1....�.�..t.�X..f.V�....,,.�7:. �. �..'t.............a .................. has permission to perform ......: .�.C..4,. ..c.A........�..t..� l ................... wiring in the building of ...... pjr-A..LU L. ..... .l.� GC '.& .5 .................... at ....... U....... .......:a.... .................. :North Andover, Mas l r" Lic. No..... s .... . Fee ...<! . �.:.....`� ... � � .......... . ��...... .... .... /.� ELECTRICAL INSP CTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer (fll mmonwealth of Maa�aclmdelfj 2eparfnteaf o`}ire Semicee BOARD OF FIRE PREVENTION REGULATIONS Official Use Only Permit No. Occupancy and Fee Checked (Rev. 11/991 (!cave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (i',tEC), 527 ChIR 12.00 (PLEASE PRhVT IN INK OR TYPE,,ILL iNFOR ,17ION) Date: q _ L — 2 - City or Town of: Al, R /fit D 6 U f' p= To the Inspector of !Vires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street &' Number) SO M M E iZ 7`- Owner or TenantL-D,,5-j2 Telephone No.C� ;2 32 ej Owner's Address Is this permit in conjunction with n building permit? Yes F!:!fr No ❑ (Check Appropriate Bos) Purliose of Building s r����L�� Utility Authorization No. Existing Service Amps / Volts Overhead ❑ Undgrd ❑ No. of lIeters . New Service Amps / Volts Overhead ❑ Undgrd ❑ No. of Meters. Number of Feeders and Ampacity No. of Receptacle Outlets No. of Oil Burners FIRE ALARtIIS Location and Nature of Proposed Electrical Work: No. of Switches No. of Gas Burners No. of Detection and st ccul No. of Recessed Fixtures _.. _.. _, ..._ ,,..........� No. of Ceil.-Susp. (Paddle) Fans ...,�.c ..wy uc nut �"l'u Oy Ute I L[or of !r'lres. No. of Total Transformers KVA No. of Lighting Outlets No. of blot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool a bore ❑ ln- ❑ t o. o mergency rg ttmg rnd. rnd. Batte Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARtIIS No. of Zones No. of Switches No. of Gas Burners No. of Detection and st Initiating Devices No. of Ranges Total No. of Air Cond. Tons No. of Alerting Devices a No. of Waste Disposers Heat Pump "Number 'Pons K�V - No. of Self -Contained Totals: Detectiort/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑ Municipal Connection ❑Other No. of Dryers Heatinh Appliances KW Security Systems: No. of Devices or Equivalent No. of Nater KiV No. of No. of Data Wiring:heaters Sins Ballasts No. of Device s or Equivalent No. Hydromassage Bathtubs No. of i\lotors Total 111? Telecommunications Wiring: No. of Devices or E uivalent OTHER: / Attach" additio/ral detail if desired, or as required by the Inspector of MI -es. INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including "completed operation" coverage or its substantial equivalent. The undersigned certifies that such coverage is iii force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Pr BOND ❑ OTI'IER ❑ (Specify:) " Estimated Value of Electrical Work: g%� Q (When required by municipal policy.) (Expiration Date) Work to Start: C/_ (o ��� Inspections to be requested in accordance with MEC Rule 10, and upon completion. I certif}', tinder the pains and penalties of petjury, that the information oil this application is Imre and complete. FI12t\I NA1IE:S(� j�jVO^ �n> �f AIZZr& �, n LIC. NO.: Licensee:j0�/�teir� SignatureXp� (If applicable, eutcr e-ri-ntpt' in the license number line.) Address: v7 �• Le-6 i OWNER'S INSURANCE WAIVER: I am aware that the Licensee des required by law. By :ny signature below, I hereby waive this requirement. Owner/Agent Signature Telephone No. LIC. N0.:.,,2 o2gW Bus. Tel. No.: 2-6 y2Y 7 Alt. Tel. No.: not have the liability insurance coverage normally I am the (check one) ❑ owner ❑ owner's atent. Pi'RillIT TE- L• : S I N2 2305 ORT 0 Date ....... VA. �A.C) TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ..... ........... ....... LJ .. ... ... .. q. tA .A ........ f -C hasermissito perform .......... M -,.,j k . ............................. P wiring in the building of .....Co. ton.!.C'a..... j ............ at ....../..0...... ................. North Ando er, Mass. (j .. . ..... Fee..,1'.,............... Lic. No. ............. ........... ............. ................... ELECTRICAL INSPECTOR Check # !!T — & �< WHITE: Applicant' CANARY: Building Dept. PINK: Treasurer `I TIMOOMMONHE4LTHOFM4S5ACHUSE477S Office Use only / � -` W DEPARTA&WOFPVBLICSAFETY Permit No. �`� BOARD OFFMEPREVEMONREGM770AN527CMR120 Occupancy &Fees Checked UAPPUCATION FOR 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) Dat �Z�/,Xo 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) / U S CJ yJ /h rl— J— Owner or Tenant C 04' Al i AL ✓/ L (- -f6 Owner's Address JO cf 7 17 Z, w t"I ,Ll S Is this permit in conjunction with a building permit: Yes �No (Check Appropriate Box) Purpose of Building Aja ��A t Cy dw LL �. A16 Utility Authorization No. �4o? Existing Service Amps Volts Overhead a Underground No. of Meters New Service a7 Do Amps i) /d yv Volts Overhead Underground No. of Meters Number of Feeders and Ampacity Y,ocation and Nature of Proposed Electrical Work -T 1Yfi'ZL I,L4 ,• - _ _ _C --W S,A& ' No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. of Lighting Fixtures Swimming Pool Above BelowGenerators 1-1 KVA groundg1:1round No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting Battery Units No. of Switch Outlets No. of Gas Bumers 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 t Detection/Sounding Devices Local [71 Municipal Other No. of Dryers Heating Devices KW Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. Hydro Massage Tubs No. of Motors Total HP OTHER - htst==CowW. Rttsuant oftmgtm T=Zdvl GmeralLaws Iha%east=tLiabt1ityirwm=Plicyni&9Car#Ale • CmeagcrtsWmtff ta aRvalat NO IhaNesthnftdvMpmcfofsatnebtheOfoeYES NO If}outtneclvdaedYES, plemnk;theiypeoo.VaaWbydv�dmgthe W" bcoL INSURANCE BOND 011-M ft=Spa*) E�p6a>irnDate E&ritltadVakxdUedncal Wade $ WorktoStattt h pm iwD*ReWested Rough Final FIRMNAME r L ` LioenseNa Lioatsee:f� ./d1 i4 3 �- -��ry Sigr>awte - Busi=Tel.Na — .�1 JbGL L77 WO/W &1deVZ AI.TeLN6. 1rry.i� �`�r OWNER'S INSURANCE WAIVER; Iam awareltratthel.joaiselhe instaanoem�eageerds sta�iai egtivaiartas raqu¢adbyMassacfels GataalLaws aod8�atrrs}rsg�ltaerntttispt� wai�stttisragtmanerd. (Please check one) Owner Agent Telephone No. PERMIT FEE „ Locatiofi d � _ ,.f . r�o —.40 - No. ..4 - No. 0 9 Date Check # TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ 0 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ i 13621 44 Building IdS p`ector C rs C O ' V)j , L E— C C rs C O ' C C C C C rs C O ' rs Growth Management Bylaw Exemption Statement Town of North Andover Building Department This foram shall be used to assist the Building Cepartment in their determination of exemptions under section 8. 7.6 of the Town of,North Andover Growth Management Bylaw, The building applicant shall provide all of the necessary information as requested 'below. Name of Applicant an cuiiding Permit (below) Address of Property for Permit (below) -G ito Af,r6 V io Sur�,ne►i �� Map and Parcel :(,T' Zz Purpose f Application (check below) Phan u 0 er f pplicant: Single Family _ Two Family 1 the undersigned applicant for the above property attest that the attached building permit for which this form is oompleted does comply with the EXEMPTION section 8.7.6 of the North Andover Growth Management Bylaw. I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the wilding Permit. Further I understand that my interpretation of the E{EiNiPTiON status is subject, tc review by the Building Oepartment and is only officially_ accepted when the Building Permit is issued. Based an section 8.7,6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot, in the building permit application and associated attachments, complies with one or more of the following sections as indicated by a check mark. This is an application for a building permit for the enlargement, restoration, or reconstruction of a dwelling in existence as of the effective date of this by-law, provided that no additional residential unit is created. The lot(s) were/was created prior to May 6, 1996 are exempt from the provisions of this Sect:cn 9.7 of the Zoning Bylaw. This application is for dwelling units for low and/or moderate income families or individuals, where all of the conditions of 8.7.6.care met and/or represents Dweiling units for senior residents, where occupancl of the units is restricted to senior persons through a property executed and recorded deed restriction running with the land. For purposes of this Section "senior' shall mean persons over the age of 55. This application is a part of a development project which voluntarily agreed to a minimum 4011, permanent reduction in density, (buildable lots), below the density, (buildable lots), permitted under zoning and feasible given the environmental conditions of the tract, with the surplus land equal to at least ten buildable aces and permanently designated as open space and/or farmland. The land to be preserved shall be protected from development by an Agricultural Preservation Restriction, Conservation Restriction, dedication to the Town, or other similar mechanism approved by the Planning Board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel an the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit an the Parcel. This application represents a lot which is ready for building permits,(i.e. all other permits from all other boards and commissions have been received and the project is in compliance with those permits), and the Development Schedule does not accommodate issuing a building permit in that Year, one building permit will be issued per Year per Development until such Ume as the Development schedule accommodates issuing building permits. Applicant must supply approved form U with this EXEMPTION. Please provide any and all information that would assist the Building Department in making a determination' that your application is allowed one or more of the above EXEMPTIONS. By signing below I attest to the accuracy of the information provided and that the attached building permit is allowed an EXEMPTION as cited above. Further I understand that the submittal of misleading and or inaccurate information, or the checking off of an above item which does not comply, whether done to my knowledge or not, is grounds for refusal by the Building Department to issue a Building Permit. //Z 7oa +gna ure of Own4r or Authorized Agent who signed the Attached Building Permit Otite This form must be attached to the Building Permit upon application for such permit. t 4 Ng 6860 TOWN OF NORTH A NDpVER MIE-�Capl This certifies that orf. f7. . has Paid .. :................ for ..G✓` dll` 1 .......................... Received''J ... �''� 1© S eParCment .. .. G......... .......... 1`C......... .......................... WHITE: Applicant �o'..�� , FVCANARY: Deps.ent ..... .. PINK: Treasurer Dc. 16�I� MAScheck COMPLIANCE REPORT Massachusetts Energy Code MAScheck Software Version 2.0 f CITY: Lawrence STATE: Massachusetts HDD: "6235 CONSTRUCTION TYPE: 1 HEATING SYSTEM TYPE: DATE:` 1-26-2000 or 2 family, detached Other (Non -Electric Resistance) DATE,OF PLANS: 1/26/00 TITLE: 10 Summer Street, COMPANY INFORMATION: ,Barreer tt Development Co, Inc COMPLIANCE: PASSES Required. UA = 359 Your.Home = 323 Permit # Checked by/Date Area or Insul Sheath Glazing/Door -----------------------------------Perimeter_-R_Value-R_Value- U_ValueUA ------- CEILINGS 992 38.0 3.0 27 WALLS: Wood Frame, 1611 O.C. 177.6 15.0 3.0 119 GLAZING: Windows or Doors 266 0.500 133 FLOORS: Over Unconditioned Space 936 19.0 44 HVAC EFFICIENCY: Furnace, 86..0 AFUE -------------------------------------------------------------------------------- COMPLIANCE STATEMENT: The proposed building design represented in these documents is consistent with the building plans, specifications, and other calculations submitted with the permit application. The proposed building has been designed to meet the requirements of the Massachusetts Energy Code. The.heating load for this building,, and the cooling load if appropriate has been.determined using the applicable Standard Design Conditions found in the Code. The HVAC equipment selected to heat or cool the building shall'be no greater than 1255 of the design load as specified in sections 780CMR 1310 _4nd J4.4. Builder/Designer DateZQ I_ X �1 t4 N L U = o C % ,n �� vim! ► �+c •= _ _ — ;n �n �n •A �A I �1 t4 L L U = C % ,n �1 t4 L L U = L C ,n I/ D 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 frcm compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS APPLICANT 4- G.9 ,"I e it r — PHONE LOCATION: Assessor's Map Number w PARCEL Z 2. SUBDIVISION c LOT (S) STREET /D SUM o77 B/- fS � ST. NUMBER/O ****************OFF 1 C lA L USE ONLY**************************** RECOMMENDATIONS OF TOWN AGENTS: C NSERVATION ADMINISTRATOR DATE APPROVED Z COMMENTS E /DATE REJECTED j %✓� C��S I7 ✓�.l 0%— COMMENTS FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH COMMENTS DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED Gd PUBLIC WORKS - SEWER/WATER CONNECTIONS o4 <7 DRIVEW Y PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 im �' ✓%e �i an�rruyruueu� o�.��Z:rarac�ivae��a ., BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR . Number: CS 052241 Birthdate: 10/10/1952 I}' P Expires: 10/10/2001 Tr. no: 7876 Restricted To: 0 WILLIAM K BARRETT. _ 1049 TURNPIKE ST " u N ANDOVER, MA 018 t 45 Administrator xv� w d m G x u o U. v cn u 0. i) ° w z z Q ira ° ro T1 [i G on ' v G " iv C w w �' �' C °° 0 0: iro C w o w u U W , a W s a0 0L u cn C ti x O U s n4 7 rL G w z Q w w y G m ° z v) D .x ° to 2E E . o CO CDci ff c ` O y rd C O So :.Q=9 =.o co 7 m o L V CD y :EE m L Q 0 rn n S E y y :CD3 w m C O L L = C CA A �E " CD mo 0 dC3 �: m y m CD cc 2: LL O cm U C c �'a : n c L �� m or m v y o L c- o _c a IN ® C C _ m O N :a L t/� c �v L m W o 'o � .� F. N G. L O = Z +- oc E o m m c �m o.m c g COD a m— O C 06, CM N H G� L O C O CD 0 m WE 0 CD C. ti C CD Q� C C O m m W O CO ~�-• Cn 3 W U) CD Lli 0 O L— CL C' LULU r-" Q W CO r C 1 ` —i O • CO C. CO) C �+ G9• U� {� cr LLJ L+ 1 Co -j Cl V- s 3 F° 957 N 6 z Z � z ® � w Z05 t FaFM um c, ww s o L ai r o °' LL 4 t t w a t 01 o Mc O .0 +- Y-0 Ln LU o� 3 y o cu -� Ln E_ �Q1Tn C Cf U rn cu o a� M ° u rn ai a° p o m c ate, `49)d N C Qa V p - o m s tm o ° �cc _ E Q�1 ui a&-�- o a)- NU_ a`�WL) a saQ kn N y ,0 L ��. f w O ZaJ lL g 0 m �- L U O C/l) Li.J O i N C Q F— m 'l S}' i. ak n ; II VNN O I I z !r II !I I! II !I II 4 . I' i; 3 n II II II f ' II II II II I .I ; I I s _ CTC v. < I I II II IL------ H I! WL-L-SAM 13ARPr--`0"l- mo,fcfMr: SALEM 511?��� xW: I/81I_1�,�II VArt: 9f9r; Dy. 51M EL�VAION5 1',G,N, ���5: i 9-2 ow 9'-0" 2a. -o.• Ro rcf TME: 5CA.E: DAZE: �Ef: � L- L-�^m II 6�1� �'�` SALEM 51 �i 1/811--11-011 PU LPF-p Or- FINF- HOMF-S 5ftfflu: �I.AN DP.ANN6Y MV15ION5: A 5 �Ip51' �I.00p i Igo �crnn�: 5A FM 51MF1' % 5FCON12F OOPMAN 1',G,N, r ki . I k t i� W a Y !� N N 5� b a 0 b 0 8'-6" - b � { i Igo �crnn�: 5A FM 51MF1' % 5FCON12F OOPMAN 1',G,N, v j 1 LocationA) No. -' 4/a Date ' TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ I� Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check #%G'- fill- 67—Building �Z� r /" 6665 ` t - 7 Building 16ector S\ Z7 u �-► 1�1 Ez �rrw r I EMBY CSRrIFY W MR {jvVr ocNDovE¢ Ems- Derr: mr rHa rano, Is LocArSD ox THS Lor AS SHOIN AND rHAr Ir DOaS CONFORM a WITH r" 'two OF Of, APWC-'Z SOMINO REc[lIArIONS RBaARDING SarBACKS FROM sm arS & Lor mm I FURnm CSRPIFY nur rm fbQWmTont IS Nor r LOO"WD IN rHR FBDSW FLOOD EWAD AREA AS SNOWX ON FS1lA PANEL # Z 5 0 o g 0 aoo�c z o0 JJAIW �'"o S �����` xor Fain BOUNDARY Dara BomvnmY INFORMitmm rAMN FROM M7SrXQ ACCO DS. PLOT PLAN IN ' d0v-'1'0 esti-)00vEi2 . �-K*611 DRAWAT POR t7EV, Gv. ISG. o I Turzo P, 1%,r �7 YRRW"CK VN0ZHRRR/NG SMICIUS BB PARK STRRBr "DMA. YASSACNumrrS mato CERTIFICATE OF USE &OCCUPANCY Building Permit Number THIS CERTIFIES THAT Date / `,:- I? ,F — 690 THE BUILDING LOCATED ON /,�' `P/e MAY BE OCCUPIED AS � �/4dldle° 05lez IN,ACCORDANCE WITH THE PROVISIONS`OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO ADDRESS SV IW,�W ems S ''^cmus`` Building Tnspector 4 ' m C c �+ O N � O CLC • L O o • o `o a PC N �1CD u co m CON W T.Nf T N W E CD N Ilk •® O CL C.3 ® i W v : OCL U O 0..-C O nCOD p F- W •+ N m C A � =.s O LM.E LLo o �, c .. .y '=.= to C -N Afflbk W w��m • C. m o C p a o OU ani Q �' J� = to 0 YID = r�° cn m 0 w W ° G a°' o cin cn ' m C c �+ O N � O CLC • L O o • o `o a PC N �1CD u co m CON W T.Nf T N W E CD N Ilk •® O CL C.3 a — v v cm ca G '� O M E m m w a� o CD CL C/) � w 3 C/) ®oo > CD w �- w w ca CD c ev CJ -Jw w •caCDC CD � C cc H CAJ ca i C 1061 : OCL LELM= O 0..-C O nCOD p F- W •+ N m C A � =.s O LM.E LLo o �, c .. .y '=.= to C -N Afflbk W w��m • C. m o C p a o CO2 o .' = to 0 = a — v v cm ca G '� O M E m m w a� o CD CL C/) � w 3 C/) ®oo > CD w �- w w ca CD c ev CJ -Jw w •caCDC CD � C cc H CAJ ca i C 1061 H0RTh ol O A� TOWN OF NORTH ANDOVER APPLICATION FOR CERTIFICATE OF OCCUPANCYIINSPECTION ADDRESS/LOCATION OF PROPERTY :IO Som mfr S� DATE REQUESTED FILED/READY FOR INSPECTION CLOSING DATE ON PROPERTY: 1-30 oo FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE 1S REQUIRED ALL WORK AND PERMIT SIGN -OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME. A RE -INSPECTION FEE OF TWENTY DOLLARD $20.00) WILL BE CHARGED IF E STRUCTURE DOES NOT MEET ALL APPLICABLE CODES": SIGNED ROUTING CONSERVATION PLANNING DPW - WATER METER NOTE: DPW MUST INDICATE THAT WATER METER HAS BEEN INSTALLED PRIOR TO SUBMITTAL OF THE OCCUPANCY/INSPECTION REQUEST DPW Signature