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HomeMy WebLinkAboutMiscellaneous - 100 MARBLERIDGE ROAD 4/30/2018 (4)0298 Date.... l..... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ....... ........ /f ...... e..( ............................................... has permission to perform ...... 4�.14'0 ...... 1-7 ...................... .............................. wiring in the building of .............................................. at .......,,ll. 41 .......... /........ . North.Ando ass. ....... ...... Fee....,;.Q .......... Lic. No. .. .. .. ............. . ............................ ELECTRICALXNSPIECTOR Check-,#, 21�7 I-,4'k -- dit a A tG rt_ G ON •Mi, O M w'O r o � w O 0 0 r0.� p O� CD �wom a CD:� CD C: •C,' `c Ua o o y 1�, � rt O' M L7 x n � ,ni O N 'O•h J ryOp' Mp CD (� t H n O Y � p ��-. '" � N too C �'�•' '�'7'.'cca � N P. rn Ny g nrr' 'a� ° a o N a p RR, 00 N a' N >CD o' w a cro o o o ���o c 0 pb o. ❑wco cs�b poo co "O o a° - ti y ao �b f b ;0w�cLo OR O F+ CD r�Y rn m co ra �- to wrn r 0 ti N f•y " °n' a w °, 5 CD CD a C Commonwealth of Massachusetts Official Use only Z 2z Department of Fire services Permit No. �U Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code (MEC), 527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: r " Z0 —` City or Town of. NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location (Street & Number) Owner or Tenant Telephone No. Owner's Address Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building / Existing Service AmpsVolts Overhead LJNew Service Amps Utility Authorization No. Number of Feeders and Ampacity Volts Overhead ❑ Location and Nature of Proposed Electrical Work: Undgrd ❑ Undgrd ❑ No. of Meters No. of Meters Completion of the %llowinQ table may be waived by the Inspector of Wires. No. of Recessed Luminaires No. of Ceil.-Susp. (Paddle) Fans No. of Total Transformers KVA No. of Luminaire Outlets No. of Hot Tubs � Generators KVA 1o. of Luminaires Swimming Pool Above ❑ In- ❑ o. o mergency Lighting rnd. rnd. Batter Units o. of Receptacle Outlets No. of Oil Burners FIRE ALARMS No. of Zones No. of Switches No. of Gas Burners No. of Detection and Initiatin Devices No. of Ranges No. of Air Cond. Total No. of Alerting Devices Tons No. of Waste Disposers Heat Pump Number Tons KW No. of Self -Contained Totals: �� ��� . �� � �. .��������.......... Detection/Alerting Devices No. of Dishwashers Space/Area Heating KW Local ❑Municipal ❑Other Connection No. of Dryers Heating Appliances KW Security Systems:" No. of Devices or Equivalent No. of Water KW No. of No, of Data Wiring: Heaters Signs Ballasts No. of Devices or Equivalent No. Hydromassage Bathtubs No. of Motors Total HP Telecommunications Wiring: No. of Devices or Equivalent Attach additional detail if desired or as required by the Inspector of Wires. U - Estimated Value of Electrical Work: 7� (When required by municipal policy.) Work to Start: Inspections to be requested in accordance with MEC Rule 10, and upon completion. 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 in force, and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury, that the information on this application is true and complete. � FIRM NAME: VGtJK- &#% G, �C LIC. NO.: ol Licensee: �- Signature NO.: fawC ��; LIC. -2Y 3 (If applicable, enter "exe in th license umber 1' e.) Bus. Tel. No.: Address: % 2 ���� Alt. Tel. No.: *Per M.G.L c. 147, s. 57-61, security work requires Department of Public Safety "S" License: Lic. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my si ow, I hereby waive this requirement. I am the (check one) ❑owner El owner's Owner/Agent Signature Telephone No. FPERMITFEE. OTHER: $ T ."d The Commonwealth of Massachusetts I Department of Industrial Accidents Office of Investigations qV 600 Washington Street Boston, MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name (Business/Organization/Individual):' e, Leo, dp#-' Address: / IFJa1-4 4f I ev4-- City/State/Zip: �J_ 1164• i9/eZ&Phone #: Are you an employer? Check the appropriate box: L ❑ I am a employer with 4. ❑ I am a general contractor and I mployees (full and/or part-time).* have hired the sub -contractors 2. I am a sole proprietor or partner- listed on the attached sheet. $ ship and have no employees These sub -contractors have working for me in any capacity. [No workers' comp. insurance 5. required.] ❑ I am a homeowner doing all work myself. [No workers' comp. insurance required.] workers' comp. insurance. ❑ We are a corporation and its officers have exercised their right of exemption per MGL c. 152, § 1(4), and we have no employees. [No workers' comp. insurance required.] Type of project (required): 6. ❑ New construction 7. E Remodeling 8. ❑ Demolition 9. ❑ Building addition 10.❑ Electrical repairs or additions 11.❑ Plumbing repairs or additions 12.❑ Roof repairs 13.❑ Other *Any applicant that checks box # 1 must also fill out the section below showing their workers' compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors 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. 41 AAte�- L Insurance Company Name: Ad, �%�"!/ eJ O J W20/i 2Policy # or Self -ins. Lic. #: /�� 7 / Expiration Date: Job Site Address:__) City/State/Zip: A_aV _ 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 DIA for insurance coverage verification. I do hereby certify un4VAt pains and penalties of perjury that the information provided above is true and correct. ?0/I 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 4. Electrical Inspector 5. Plumbing Inspector 6. Other Contact Person: Phone #: Safety Insurance Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: Building Commissioner or Board of Health or Inspector of Buildings Board of Selectman City Hall City Hall N ANDOVER, MA 01845 N ANDOVER, MA 01845 RE: Insured: KIMBERLY N4ELCHIN"arid JONATHf1N M-Eii CHIN - Property Address: 100 MARBLERIDGE RD, N ANDOVER, MA Policy Number: HMA 0262564 Claim Number: BOS00036476 Date of Loss: 3/11/2013 Company: Safety Indemnity Insurance Company Claim has been made involving loss, damage or destruction of the above -captioned property, which may either exceed $1,000.00'of cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass. Gen. Laws, Chapter 139, Section 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim number. Justin Woodworth Claim Examiner Safety Insurance Company Homeowners Claims Unit P. O. Box 55098 Boston, MA 02205-5098 3/12/201.3 Phone: (617) 951-0600 EXT 3317 Fax:. (617) 5311-6655 - Email: JustiriWoodworth@Safetylnsiiraiice:com 91 '12 Date.. . . M,Go - • OOL TOWN OF NORTH ANDOVER it � ,, . PERMIT FOR PLUMBING ,O•r,o •�`•l'7 SSA US This certifies that .. !�, . •. e� � !... ev �!C........... has permission to perform .../..:'� ". p l- %L?.? ......... . plumbing in the buildings �/of................ . at . ................ , North Andover, Mass. Fee OP. Lic. No. N. /OG/��.����/.�,���� ...... . PLUMBING INSPECTOR Check # y�� MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING City(Town:f/��iJJt�/ MA. Date: Perrnitd g ��� / Owners Name: e/;, i Building Location: 1164 ,1 61? -J /� I Type of Occupancy: Co,rnmerdai Educational Industrial InstitutionalRes dent i iNew: Alteration: Renovation: Rlacement: Plans Submitted: Yes © i I:IXTI IRFC 1 i l �' I , i i z' I Lu I 11 �? t ? �' in Q� Z 0»! 11 NI ; �ILI; = Q� H w' (n Y vz < 4 raon 01 a0 I 0 ® 1 �Y.I ri a�; � � 4a wai �a i SUB BSMT. BASEMENT 1'FLOOR -------- 2 NFLOOR i I --i 1—'- 3 FLOOR I 4 FLOOR 5 j 1— I �' � -1--- _FLOOR fi FLOOR i ; ( � 7'" FLOOR FLOOR ! �_.._' I I � ---;•--= i __. `- , Installing Company Name ; L, L(/� G r :::;7,..e— Check One Only Certificate # _.. Address: 3 o/j/� ✓ �� City/Townis.tl� State ' y/ Corporation Business Tel: �lj —�% Fax: Partnership Name of Licensed Plumber: Firm/Company i INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL. Ch. 142 Yes No if you have checked Yes, please indicate the type of coverage by checking the appropriate box below. A 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 Massachusetts General Laws, and that my signature on this permit application waives this requirement. Check One Only _ .......:.. - . i. Signature of Owner or Owner's Agent OwnerAgent I hereby certify that all of the details and information I have submitted (or entered) regarding this application are true and accurate to the best of my ..� Vu al. illaaq N ul luMV wurn artu insiauanons perrormea unaer the permit is is application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of�General Laws. By. ` Type of License: e '.l 11S'_ ;I f.. -e i f-.:: �!, e.. i. J }(•:.. �Cni?.i 'vi i—IV VIIVIi Iii 1 - - - R3��mhPr . I CityTov,n Master APPROVED (OFFICE USE ONLYI Journeyman License Number: DATE.- T0 .- Inspectional Services FROM- City "Treasurer y~ . ~� � LnweU'\|A0|85l I -97K '030 " F: 976.446.7l03 xnn Loxr\i\i� RE: Confirmation all taxes are -current As requested, please be advised of 'the tax status ofthe above listed property: All Property Owner: Property Address: OTHER: OFFICE USE ONLY Taxes uecurrent onthe property . Customer has made apayment plan and iscurrent onpayments Customer isinTAX TITLE and has NOT made any payment plan with the Treasurer Water and Sewer are current nnthis property Parking Tickets/Excise Tax onthis customer are current � ����'y Y/»/ The Commoliwealth ofalassuchusetis Department ofln(lustria/. Ircirlcnts Office of Int'esti,ations GOO 1'i'ashut,ton Street Boston, :11.4 02111 tt HIV.mass. of/din Workers! Compensation Insurance Affidavit: Buil(lers/Contractors/I:lectt•iciat)s/Plumbet•s Al)plicant Information Please Print Legibly �c t1i11e tii,,Is:mss r^ :Address: ----- - - --- - - City/State!Zip: (4v -e jl /!21 k'1'I Pllane Are you an employer'? (:heck the appropriate box: I. �I an1 a employer \\'itil y---- 4. ❑ 1 and a general contractor and I -- cI?1p10\'ees (full hied 01' part-time have hired tele Sllb-C(-S �. ❑ 1 :-1111 a sole proprietor of partllel'_ listed on the attached sheel. ship and have n0 c111p10\'ecs Mese sub -contractors have � \\'ore:ing for me in an\ Clp, cit\. employees and have \\orkers' [No workei'S' CO 1111P. IllSlll'allce comp. Insurance. I'egUll'ed] �' J Ej We are a corporation and its 3. ❑ 1 all', a 110111eownel' doing all \\'ork officers have exercised then' i myself. [No workers' comp. fight of exemption per MGL ! IllStil'a11Ce required.; c. 1522: § 1(4). and we Have no employees. [\o workers' comp. insurance required.] 'hype of project (required): 6. N;'1011 Construction %. �V' 1`ZIniOClehllQ S. ❑ Demolition 9. ❑ Building addition 10. 7" Electrical repairs or additions 1 i.� lI Piunlbing repairs or additions 12.❑ Roof repairs 1 3 Other `Ail\ applicant that checks box.: I must also ;ill out the section belo\c show;n their \corkeirs' compensation poli(\ infonnalion. Honlzo\cnzrs \\'ho submit ti:is afli:iacii indiCatine the( are doing al \cork vtd ;hen hire ot:uide Conaetors must submit a nz\\ affidavit indicating such. -Contractors that check this box must attached an additional sheet silo\cing the name of the sub -contractor, and stale \vileihe: or not those entities have employees. If the sub -contractors have employees. the\must provide their \corkers comp. poliCc number. ! am an enrploYer that is ln•ori(lin workers' cony)ens(rtiorr insur(mee for im, eml)1orees. Below is the police' and joh site info 1.11 la tioll. Insurance Compan\ \ante:__ !���' �;Iz X Com, Policy : or Self -ins. Lic. Expiration Date:___— — e. Job Site Address: Cit\ State:7_ip: A"Oev ""C'. Attach a copy of the workers' co►upensation policy declaration page (showing the policy number and expiration (late). Failure to secure coverage as required under Section 25A of NIGL c. 152 can lead to the imposition of criminal penalties of a File up to S1,500.00 and/or one -rear imprisonment, as \yell as civil penalties in the form of a STOP WORK ORDER and a fine of up to S250.00 a day against the violator. Be advised that a cope of this statement may be forwarded to the Office of Investiloations of the IDIA for insurance coverage verification. ! (to her•eh), certifj• r Tains arr(l p nalti , my that the information provide(/ above is true and correct. Sit7natlu'C: -- Dat Phone ;.... �%..� f '_ 2 Y` ............ ............ Official use onlj'. Do not write in this area, to he completed ht' city or tolrrr o�ficial. Cit' or Town: Permit/License # Issuing Authority (circle one): 1 rd'of 1lcaltb. 2 rz ,,,: 1- n�„ f I e:r r !n.•j: , .- - _ Contact Person: Phone ii: Information and Instructions MmssaciiusettS'vcli ;i f_a\\S chllptcl .` !'c .';Ill es all cillpi0\ers t0 i rI ' i .�� � pl'0\ ;C.e \\ `1, 1 ': fl"1' TilCli' e,lli lo\ cj. �t11SUaf1T t0 TMS S, � gel's coli UcnSatlO, ) Ce s. ar employee l { . 'lei as ...:'\'CI"\" l)ers0li ill the St1'\'iCe Clf2110i!iei' Uildc;i' all\ Coi'?i"tic; 0': hi express Or iniplled . oral 0;" \\ret?CII.,, A11 ei11j7l01'el' IS C'1 fllleC QS ail iliCli\iClilin, 'Ci,shil). assocmtlon. corporation, Or Other let)al entity. or all\ t\\ 0 01' Il 0;'e Of Till' f01'en01n enga`'ed I11 a �oinl ellierprise. and i!iC UCl!li`' elle ll'`al t'ep!'e SCIlTati\es Ot a C!eCCasCCI C!ilplo\'el'. 0!";hl' I'ecel\"el' Or' trustee of all Inde\ Kennan, partllCFSLl"i). association Or Other let -al entity, etl"l)10\";;ice eillplo\'eeS. }-lowcvel- the Owner of a d\1"elll!1`1- hoose iia\ 111`' IIOt illore `iia€1 three apartments al1CI \\'h0 i'esldCs tliel'cil;. Ol'tlie oCCUpaili Ot telt d\\"eliill2 house of another who Cillplo\ j oe;'SOI;c to C10 I11a111tellallCC. COi1Stl'tICTl011 Or re Dail' \\'Orli ore such t7\\ cl:ia house Or Oil tine `aI'OttIiCIS of bU11dl!1`? al)p-Lirtell3llt T11C1'et0 Sllal] ilOt because of SUCIi elllplo\'meat be deemed to be all e111U10\'el' MGI, chapter 152. §25C(6) also states that' eNery state or local licensing agencN. shall \\ ithhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the conu1,011wealth for any applicant who has not produced acceptable evidence of compliance �\,ith the insurance coverage required." Additionally. MGL chapter 152. §25C(7) states ••\either the conllnorl\vealth nor any of its political subdivisions shall enter into any contract for the performance of public worn: until acceptable evidence of compliance \\ itil the. insurance requirements of this chapter have been presented to the contracting authority.,. Applicants Please fill out the \\"orkers� compensation affidn it completely. by checking the boxes that apply to roto' situation and. if necessary, supple sub -contractors) nallne(s). address(es) and phone rlunlber(s) along with their certificate(;) of insurance. Limited Liai)i!ity Companies (LLC) or Limited Liability Partnerships (LLP) witil 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 police is required. Be advised that tills 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 II1dl1St1'lal Accidents. Slnoll!d \'otl !iaVC a!1\' questions regardina the law or if VOLT are requireCI to obtain a workers' compensation police, please call the Deparpnent at the number listed below. Self-insured companies should enter thele' self-insurance license number on the appropriate line. Citi' 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 \rou to fill out in the event Tile Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which \\'ill be used as a reference number. In addition. an applicant that 111nSt Slibllllt 11ntlltlplC' pel'lllltr liCeliSe applications Ill any given year. need only subunit one affidavit indicating current policy information (if necessary) and under ",lob Site Address" the applicant should write''all locations ill (city or town)." A copy of the affidavit that has been officially stamped or marked by the cite or to\\"11 nlay be provided to the applicant as proof that a valid affidavit is oil file for future permits 0 -licenses. A ne\v affidavit must be filled out each year. dog Ii a home o\vner 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 isNOT required to complete this affidavit. The Office of Investigations would like t0 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 Corn.monwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston. \/1A 02111 2 J- 7�I--rUV - Revised 4-24-07 Fax 'r 617-727-7749 \� �\-w-.mass.go�•/dig BOARD PL TYPE -M 756565 BOARD TYPE -J 756564 Fold, Then Detach Along All Perforations IMPORTANT NOTICE PERMITS FOR PLUMBING AND GAS FITTING INSTALLATIONS ON STATE OWNED OR USED FACILITIES MUST BE FILED AT THE OFFICE OF THE STATE BOARD. IMPORTANT NOTICE PERMITS FOR PLUMBING AND GAS FITTING INSTALLATIONS ON STATE OWNED OR USED FACILITIES MUST BE FILED AT THE OFFICE OF THE STATE BOARD. IMPORTANT NOTICE PERMITS FOR PLUMBING AND GAS FITTING INSTALLATIONS ON STATE OWNED OR USED FACILITIES MUST BE FILED AT THE OFFICE OF THE STATE BOARD. Fold, Then Detach Along All Perforations COMMONWEALTH OF MASSACHUSETTS` REGISTERED POARD AS A PLUMBING -.CORP ISSUES THIS LICENSE TO TYPE STEPHEN WEBSTER FRED L WEBSTER CO,.INC> -C 306 WALKER STREET ice; LOWELL MA 0185.1-1848. 754083 1885 05/01/12 754083. LICENSE NO. EXPIRATION DATE SERIAL NO. Fold, Then Detach Along All Perforations IMPORTANT NOTICE PERMITS FOR PLUMBING AND GAS FITTING INSTALLATIONS ON STATE OWNED OR USED FACILITIES MUST BE FILED AT THE OFFICE OF THE STATE BOARD. IMPORTANT NOTICE PERMITS FOR PLUMBING AND GAS FITTING INSTALLATIONS ON STATE OWNED OR USED FACILITIES MUST BE FILED AT THE OFFICE OF THE STATE BOARD. IMPORTANT NOTICE PERMITS FOR PLUMBING AND GAS FITTING INSTALLATIONS ON STATE OWNED OR USED FACILITIES MUST BE FILED AT THE OFFICE OF THE STATE BOARD. Date .,� . j ,1�...... . O D ti� TOWN OF NORTH ANDOVER O � 9 PERMIT FOR GAS INSTALLATION •' h CMUSEtt This certifies that .. , & � -f "� I..................... has permission for gas installation,/? !? ................. . in the buildings of . .. ....................... . at ........... North Andover, Mass. Fee...) . Lic. No.C--), ......... ......... �6ASINSPECTdh Check # % 5427 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING print or Type) i Jass. Oats ,� Z0�_ Permit Building LocatlOn ` wners me ' Type of Occupancy New❑ Renovation ❑ Replacement/ Plans Su tted: Yes ❑ No I W C �2 12 c o ~moo=$ LLJ 4a11 O C7 S D O C7 0 O SUB-BSMT BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STNR6TH ETi- 8TH FLOOR ns tailing Company Name Check one: Certificate 4ddress ❑ Corporation 3usiness Telephone __/ _U ❑ Partnership dame of Licensed Plumber_ or Cas Fitter �rm'to• INSURANCE COVERAGE: I have a current 11 blllty Insurance policy or Its substantial equivalent, which meets the requirements Yes 1No ❑ of MCL Ch 142. If you have checked yes, please indicate the type of coverage by checking the appropriate box. A liability Insurance policy 0/ Other type of indemnity ❑ Bond OWNER'S INSURNACE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142. of the Mass. General Lavas, and that my signature on tai sPe mit application valves this requirement S gna reo Owner or Owners Agen Check one: Owner ❑ Agent ❑ IieknovA edge and reby Certify that all of the details and Information I have submitted for enteredl In above application are true and accurate to the best of /Pertinent ProvisionstofiPlumbing the Massachusrk and Insetts S tate Glations Performed as Code and Chapteunder the ethe Ge t Is ` r this application be in to with Type of License: By ❑Plumber Title S gn re of L tensed Plu ber or Cas F tter ❑Gasfitter City/Town 'L � VED (OFFICE USE ONLY) ��� APPRO(OFFICkenSe Number . p Journeyman L A s O s * � Z O C t O o e o f O • C A s O \ Office Use Only ✓ fV �_ - --- u Tommunwrato of Aasoar4ugP1#fi Permit No. Bepartment of Public -*afetu Occupancy & Fee Checked - BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3i90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 r (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date ¢0* or Town of NORTH ANDOVER _ To the Inspector of Wires: The udersigned applies for a permit to perform theglect;,ic',al work described below. Location (Street & Number) n©� '"` Owner or Tenant 608 /me's� �-^ A ' /��, , Owner's Address eO S— w! A- f e2 S r /y ' \;o t Ae--/Z Is this permit in conjunction with a building permit: Yes No ❑ (Check Appropriate Box) Purpose of Building o-yu e— ' Utility Authorization No. Existing Service, Amps _J olts Overhead ❑1Undgrnd ❑ No. of Meters . New Service 1,,}�� _ Amps Volts Overhead t—�-+� Undgrnd ❑ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Complete Operations Coverage or its substantial equivalent. YES = NO = 1 have submitted valid proof of same to the Office. YES _ NO If you have checked YES, please indicate the type of coverage by checking the approprjato box. INSURANCE BOND = OTHER :: (Please Specify) (Expiration Date) Estimated Value of ElectricalWorrk --$ Work to Start �— 21 r� 3-- Inspection Date Requested Signed under thee Penalties oLperjury: FIRM NAME i /t R -P [ 5 Rough / 2 / 9j Final LIC. NO. 424211170 Z1170 ` q Licensee Signature Ute'' LIC. NO. f�l� ��iK.GSt Bus. Tel. No. 6eZ e Address �S �� eO t=om I ' '6 Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Own Agent (Please check on � - Telephone No. PERMIT FEE $ (Signature of Owner or Agent) x-6565 C� 1G90�/% Total No. of Lighting Outlets No. of Hot Tubs No. of Transformers KVA No. of Lighting Fixtures 1 000 SwimmingPool Above In grnd. 11grnd. ❑ Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Total Ranges No. of Ran 9 No. of Air Cond. tons Initiating Devices No. of Sounding Devices No. of Self Contained No. of Disposals / No.of Heat Total Total Pumps Tons KW No. of Dishwashers r Space/Area Heating KW Detection/Sounding Devices Local Mon e'ctaion El Other No. of Dryers Heating Devices KW No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hydro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws I have a current Liability Insurance Policy including Complete Operations Coverage or its substantial equivalent. YES = NO = 1 have submitted valid proof of same to the Office. YES _ NO If you have checked YES, please indicate the type of coverage by checking the approprjato box. INSURANCE BOND = OTHER :: (Please Specify) (Expiration Date) Estimated Value of ElectricalWorrk --$ Work to Start �— 21 r� 3-- Inspection Date Requested Signed under thee Penalties oLperjury: FIRM NAME i /t R -P [ 5 Rough / 2 / 9j Final LIC. NO. 424211170 Z1170 ` q Licensee Signature Ute'' LIC. NO. f�l� ��iK.GSt Bus. Tel. No. 6eZ e Address �S �� eO t=om I ' '6 Alt. Tel. No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re- quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Own Agent (Please check on � - Telephone No. PERMIT FEE $ (Signature of Owner or Agent) x-6565 C� 1G90�/% Date... NORTH TOWN OF NORTH ANDOVER 0 PERMIT FOR WIRING S �,SSACMUSES This certifies that ...... . ....................... f ......... has permission to perform ..... ............... wiring in the building of ......... ............................... at ..../1 . ........ North Andover, Mass. Fee AI.7'!P. Lic.No.:/..."��-O........................................................ ELECTRICAL INSPECTOR WHITE: Applicant 01/23/9513:01 CANARY: Building Dept. I "111111=11.11CI PINK: Treasurer GOLD: File c %� Location . � 7��h'�� I �� ,f Ft No. Date Ot,t�to TOWN OF NORTH ANDOVER ,a,h° ' A Certificate of Occupancy $ * > Building/Frame Permit Fee $ CH�S �� Foundation Permit Fee $ Other Permit Fee it)&Wo $ �c Sewer Connection Fee $ Water Connection Fee $ TOTAL $ S OV ) 11/29/9415:16. I�r 06 Building rasp 52.00 PAII? �' Div. Public Works �I r PFR -111T NO. !979 1 APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE, 1 MAP 440. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK PAGE ZONE SUB DIV. LOT NO. 1 Y-OCATION& . _/f�JN� r //7//" h , l/lCV ��S PURPOSE OF BUILDING ( � u w� �O ER'S NAM�CE//A&(fSSI � C-4 1/, NO. OF STORIES SIZE WNER'S ADDRESS Q/l'C N . t /v C` IP 1 . /s.�, W ( BASEMENT OR SLAB ARCHITECT'S NAME - SIZE OF FLOOR TIMBERS IST 2ND 3RD yl:rlLDER'S NAME nq eSil ,z, V I ` J 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 .(j� SIZE OF FOOTING X IS BUILDING ADDITIONJ`V� 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 CArt I `ODRpuslAJ SEE BOTH SIDES 0 PAGE 1 FILL OUT SECTIONS 1 - 3 ��{ PAGE 2 FILL OUT SECTIONS 1 - 12 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILE AND749 PROVED BY BUILDING INSPECTOR ATE F /�� � c/ 3 PROPERTY INFORMATION LAND COST iV T. BLDG. COST�/00 �� EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY BUILDING INSPECTOR SIGNATURE OF OWNER QR AUTHORIZED AGENT .i F E E OWNER TEL. # PERMIT GRANTED CONTR. TEL. # O�• 19 LL CONTR. LIC. #. H.I.C. N BUILDING RECORD 1 OCCUPANCY 1-:12 SINGLE FAMILY S-ORIES MULTI. FAMILY OFFICES APARTMENTS CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH 3 1 2 13 PINE CONCRETE CONCRETE BL K. BRICK OR STONE HARDW D PIERS PLASTER DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'TAREA '/, 1/2 1/1 FIN. ATTIC AREA _ NO 8 M T FIRE PLACES _ _ HEAD ROOM MODERN KITCHEN 4 WALLS II 9 FLOORS CLAPBOARDS DROP SIDING WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING VERT. SIDING _ B 1 _ 2 �_ 3 _ CONCRETE EARTH HARDW'D COMMCN ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME _ BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIORI� POOR _ ADEQUATE. NONE 5 ROOF 10 PLUMBING GABLEHIP GAMBREL BATH (3 FIX.) MANSARD TOILET RM. (2 FIX.) FLAT 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. & 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 B'M'T 2nd ELECTRIC _ io ( 3rd NO HEATING THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS, WITH PORCHES. GA- r RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. 0 ? O z�-d = rm —� fA O Q a o � m N y (n G / CO) CD�„ C d •C m 1 ?'Ogo M C� V J O T y � O 0 0z y 0 0 0 p CL r C7 > CD N M 03 � == O O �p 0 CO) m o W C OZN'Cj O m O 7. v CD o CD "C CL cr rF CD C) CD o CD zoo m ao � CL v CD� CA C� c� ON o CD I z — 0 CA � 0 1 CD Z o CS � O C CL -rt CD z O C D ? CD 0 CC ? O z�-d = rm —� fA O Q a o � m N y (n G / CD�„ 0=0 0. m 1 ?'Ogo M C� V J O .-► PO m CL i '17 m 0 CD d 01 O = m N 0 p 2 > > CD N cn CC ? O m = CD —� fA O Q a o � m N y < G n CD�„ 0=0 � m Z ?'Ogo M V! N C/) O .-► PO m CL '17 m CD d 01 O = m N O y ? m p 2 > > CD N O �p 0 m T W C OZN'Cj O m O 7. T fl:aCA � CL m o CD co) m m � cis C O co CL c� ON m 3 = N Y^__ E �/ N CS � C CL W— o ' NCCco ? C9 N CO) N m � W O A w N C2 1 CD O _ 1 N m =�NII ;w co) G CD o X11 CD and o� a O ' y C oma: C 7r C (DQ? d ►� < G n "ti p� Q �. a C r "� C/) x O G tri 9 onq 0 9 O C . O,aONiM ,y KAREN H.P. NELSON ar' �°� Town of 120 Main Street, 01845 Director (508) 682-6483 BUILDING s, ,:;, o >-,y NORTH ANDOVER CONSERVATION ""�s` DIVISION OF HEALTH PLAN\I\G PLANNING & COMMUNITY DEVELOPMENT DEMOLITION OF BUILDING AFFIDAVIT DATE f OWNER'S NAME & ADDRESS Mn S f N ig a -P u, - z -A/ C, OS (1) l cv+eir S�r e of nom+ &k)6 OU Py t� ' LOCATION OF PROPERTY TO DEMOLISH /OD 111_yw ,L Q'dq DESCRIPTION 34X2-9 91N Sl Q P_A uti t t a rr'' ct vl.� e ZS /QLD n DEPARTMENT SIGN -OFFS DEPT. OF PUBLIC WORKS - WATER:. KL %/"/"�¢ SEWER:�!/t! POLICE��� FIRE & )D 1i1 LVS Td kv, A4,1-� 4,? EXTERMINATOR Z.� -7, 6, DUMPSTER - ON/OFF STREET_ DIG SAFE NUMBER -')fi h,-. A DATE RECD BLDG. INSPECTOR .' 1,1,5"4 —2 '3— 9,4 WED 12:06 DAY ^T . GAS--L-AWRANCE �0 Bay State Gas Company November 9, 1994 Messina Development TO WHOM IT MAY CONCERN: This is to inform you that the service indicated below has beer: cut on the date(,$) indicated, a.nd. the buildi-ng relay he demolished. Address 100 Marbleridge Rd., N. Andover Date Service Cut 11-2--94 Very truly yours, BAY STATE GAS COMPANY—LAWRENCE DIV. Wil.l.i_am J. W e Supervisor, Distribution Post -It"' brand fax tr:ansrnittaf memo 7671 r or pa9�s ► �.J co CO/V- Faxk .r77Vi:f;lof11 rl1. �,tf>;<hf6y 1..7W'�nCn. IL1n ��IO+.•GJ�C wt�•vv:. ��� ....� 1875 Cj IV, W E D 1 2 06 BAY ST. GAS--L-"WRANQE etch: too ine of Main . ...... estorati'OnDsla, Permit Data: Oonc ;and ;ravel lase Coat 'old Patch -lot Patch. !.mulslon nfra4l.ed ,oncrete Loarli & teed Other Date Dont Size 2 Dig Safe: 'Ticket # Date EfTectivic Notification: Permit Required, Dim Sent Date Rec'd pormil # Town El . ....... State Water Notification: Date Cftlf�d S 'ewer Notification: Dot,-, COM pletion-pata: Comment$: j., 2 Dig Safe: 'Ticket # Date EfTectivic Notification: Permit Required, Dim Sent Date Rec'd pormil # Town El . ....... State Water Notification: Date Cftlf�d S 'ewer Notification: Dot,-, COM pletion-pata: Comment$: j., OFFICES OF:.�' .,awry 1 ..• °L° 4 Town of APPEALS12o IWILDINC', �! -� = :' • NORTH ANDOVER twain Sireet North A11,0vcr. (:()NSL:1tVA•1 tUN �t='""'"` MitStiFlrtlustatSUlfi4 i HEALTH DIVISION d)1: ((i 1 i) (im n-•177 , PLANNING' PLANNING & COMMUNITY DEVELOPMENT KAREN H.P. NELSON, D1REC'1'011 In accord n witl 'he �¢ ovisions of MGL c 40, S 54, a condition of Building Permit Number C31 disposed of I ro a licensed olid waste disposal fais that the debris cility as d Gncdulting from tb MGL cis work ull be 150A y 111, S 'lite debris will be disposed of in: Signature of Pertttit Applicant Date NOTA': Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. a z99 ¢ Za 2 \ 7ZZ , z ® . mom z mo $ z t § . C/) ` i m $ 000 c -"I K/$2 m m 30 �)m§ 0§$ » P e -AT ®§i -q 2 ■ z )|2z w • @$ c Cl -6 0 0. r! . _ _>010 . ■oo 2, mm 22 r 'D \�? �\ ozm f.0»� - ¥ m L4 < « z14 _ ~ �� ; X0 2 2�> oo §\ y ° s o Vrlw ®n2Z-5 cm f t \ q < m § . m = ®&$�� , m _ # n_ �( ��= 9 =m m `q ■ tom- ;� ' 24� ■ ■ X_ g § z < k° / ® 2 » sm4» r § 02 ¥ rn �■� ��� dam} _ |§ \�4. § _ 4s L »q<>_j t0■*tl co �z0 �t#% - C =rte C m \ co . �e■- �z�\ �-zz fir- >>\m �� §§ Eƒ-\ ommo ■$ ,_. z �ƒ z z < ` 0/ M -:r 3 /E 3/ $�■ ..� ¥ . Location 4,1-> hi 6oer3LC jE�>, (A(. No. Date „aR,M TOWN OF NORTH ANDOVER 3? ' 0 A Certificate of Occupancy $ + ; { Building/Frame Permit Fee $ Q no'��� Foundation Permit Fee $ m Other Permit Fee $ ^' Sewer Connection Fee $ Water Connection Fee $ � U� TOTAL $ a - �- � srxZ Building lnlWcTor r ° 75'78 '- �— Div. 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O v CL C7 CD 0 ff-w- w• Mm CO) 'v CD O ) CO) O O 0 CO* 0 O CO2 d n CD 0 r� CD CD 3. y CD 0 O CD 0 CD NJ J VJ G_ co O Z 0 CD 0 _ _ cc 0 c a ca CD O N G 0 CL N CD W rr,2 g = -4 — WO Q d0 C O m0 �c2o.cc) .._a N 0 -a ism: =m o 0 Z�•.A O N C�9 moCD =r 7 o m OCL N 0 CD O d N CL coCCDd m N m m P� `R _CD 0 CD 73 CD � O Cl) m: W: A CD N 4 omf IO CL -O Z �"� z 0 0; C� 0 m = N CO2 CD C) 3 m Lo'. m = CO) O � n _ :L .R�. C C O _ :C 1 z 0 -p► ..0 Cn d �a to z otr 4 1 O '?7 CD O M ?7 23 O r r ?1 (� O C McnM a`, 0 x n eD Cn d (n o to z 71 O '?7 CD O M ?7 23 O r r ?1 (� O C McnM C y 0 x n eD tz O • y 0 CONTRACT FOR ROOFING JOB: 420 MARBLERIDGE ROAD, NO. ANDOVER, MA. Estimate for removal of old shingles from, and application of new shingles to approximately 13 plus squares of roof. $3500.00 This includes primed clapboarding of 2 small dormers, new copper flashing where needed, aluminum drip edge, wind and ice shield, and all asphalt shingles. It also includes clean-up and removal of all roofing materials. This estimate does not include replacement of roofboards. Should this be necessary, it will be covered at cost plus $25.00 per hour. The job will take between 10 and 15 fair weather working days. It will be paid for as follows: $1000. due at start of job $2500. due on completion Signe James Knowlton, Contractor, License # 062790 Frank Piekarski, Homeowner �� ✓f2� Ln0'))UI)24')2CI1C2G�� UL��, l �11U.C�U:iC�1 DEPARTMENT OF PUBii"' SAFETY �—� licerne; CONSTRUCTION SUPERVISOR Number Expire °irthdate '; @6279@ @5;'0R!i990 O�f88ii94o AMES A KNOWLTON 42 CURTIS STREET ROCKPORT, MA 01966 .fv 1 Y KAREN H.F. NELSON, DIREC'l-OR a 120 Main Street North Andover, Massachusetts 01845 In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 111, S 150A. The debris will be disposed of in: Sell ` VC f ?'`Pr- MA 6 (`7 3Q (Location of Facility) Signature of Pdrn�h Applicant 1611 ra9 Dat NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. ti I °F "oan, Town of OFFICES OF APPEALS NORTH ANDOVER BUILDING s@A CONSERVATION HUS DIVISION OF HEALTH PLANNING PLANNING & COMMUNITY DEVELOPMENT KAREN H.F. NELSON, DIREC'l-OR a 120 Main Street North Andover, Massachusetts 01845 In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 111, S 150A. The debris will be disposed of in: Sell ` VC f ?'`Pr- MA 6 (`7 3Q (Location of Facility) Signature of Pdrn�h Applicant 1611 ra9 Dat NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. ti I Location t06 06ff. No. S Date Z r. ry oT ; �4, TOWN OF NORTH ANDOVER c 2 7'766 • " p Certificate of Occupancy $ Building/Frame Permit Fee $ I Z��� ss�cMuS E � Foundation Permit Fee $ � t Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector Div. Public Works Location -�� No. 5 � � Date "ORT" TOWN OF NORTH ANDOVER °L F % Certificate of Occupancy $ 5� 41 s Building/Frame Permit Fee $ s' "'O' a JACMUS t Foundation Permit Fee- $ ..• Other Permit Fee $ Sewer Connection Fee $ t'c Water Connection Fee $ ,CCj• is TOTAL 5 1,1l02l944 09:18 q Building Inspector ijo a '+ 7765. 150,00 PtiID Div. Public Works t Location LD No. Date NORT1y TOWN OF NORTH ANDOVER O'�«•o •,ti0 p Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ sACMus Other Permit Fee $ Sewer Connection Fee $ 0-&0 '!$Z Water Connection Fee $ TOTAL $ wilding IA `pector f Div. Public Works PERatCT NO. J APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. Y PAGE 1 MAP d-40. LOT NO. 2 RECORD OF OWNERSHIP iDATE BOOK 'PAGE ZONA / SUB DIV. LOT NO. -I LOC TAOUL rj%a 1-1g� �. p F _.9p�� PURPOSE OF BUILDING DW 1 e LL 1#J C.' W ( OWNER'S NAMEMg is `� u e I'm P o * ,� 'v !� Citi NO. Of STORIES SIZE 3 S/ X � 4 �/ I Ci �GJ' Cc l ) I ` I f f- i- OWNER'S ADDRE S FOS- C� lVl�� v� l '�/ J 1� � I ' Af . A • BASEMENT OR SLAB d -(-- 3 �^C/� �, T s& Mf N GA! .Yx /zc4R ARCHITECT'S NAME SIZE OF FLOOR TIMBERS --�- IST 2 X Io 2ND 2 )(10 3RD /l BUILDER'S NAME r ss: 1 C'' p OV SPAN j $ DISTANCE TO NEAREST BUILDING Geo 0 DIMENSIONS OF SILLS 2 X 6 P -1L . DISTANCE FROM STREET V / �� POSTS ! [ Y 3 O�Z �� 11411V 601 DISTANCE FROM LOT LINES - SIDES ��`�' REAR v 22 �V / GIRDERS p x 16 AREA OF LOT IBX FRONTAGE `C�JV J ` HEIGHT OF FOUNDATION QO THICKNESS G, IS BUILDING NEW SIZE OF FOOTING /'o X .2D f f IS BUILDING ADDITION /� �� ,V MATERIAL OF CHIMNEY ,it ASO / V 1 A r1l IS BUILDING ALTERATION O IS BUILDING ON SOLID OR FILLED LAAN/Dsa `o WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER -..f es BOARD OF APPEALS ACTION. IF ANY P/14 IS BUILDING CONNECTED TO TOWN SEWER es IS BUILDING CONNECTED TO NATURAL GAS LINE -es INSTRUCTIONS 3 PROPERTY INFORMATION PERMIT FOR FOUNDATION ONLY LAND COST S,S-i601 SEE BOTH SIDES REGULATED BY PARA. 114.8-S. B.C. EST. BLDG. COST /� c PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT PAGE 2 FILL OUT SECTIONS 1 - 12 DATE Z L FEE PAID LV6 I/ EST. BLDG. COST PER ROOM ,�7� p��SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING J� !r 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS (/`' PLANS MUST BE FILED AND APPROVED BY BUILDING INSPBCiMIT FOR FRAMUBUILDING DA�IL/ED �� 'a fr, w„ DATELZ -z,> FFF Pain. IZB �— a SIGITATURE OF OWNER OR AUTHORIZED AGENT FEE t3 t�V 046 OWNER OWNER TEL. # �sS PERMIT GRANTED 711. CONTR. TEL. # esz:- ' 7 $"S' Z i 191-4 CONTR. LIC. #-d -� ' DM PERtAIT FEES �� NOV 2 81994 LESS FDA DUE f MM POliff t 2 3 PLANNING BOARD BOARD OF SELECTMEN BUILDING INSPw y BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY S'ORIES MULTI. FAMILY OFFICES APARTMENTS _ CONSTRUCTION 2 FOUNDATION X 8 INTERIOR FINISH CONCRETE PINE d 1 2 I3 CONCRETE BL'K. BRICK OR STONE HARDW D_— PIERS PIASTER DRY WAIL _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ '/, 1/1 14 FIN. ATTIC AREA _O B M T N HEAD ROOM FI RE PLACES MODERN KITCHEN ¢ A 4 WALLS I 9 FLOORS CLAPBOARDS DROP SIDING WOOD SHINGLES ASPHALT SIDING ASBESTOS SIDING VERT. SIDING B _ 1 2 �_ 3 _ _ _ _ CONCRETE EARTH HARDW'D COMMCN ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME —14� BRICK ON MASONRY BRICK ON FRAME ATTIC STRS. & FLOOR I_ CONC. OR CINDER BLK. WIRING STONE ON MASONRY STONE ON FRAME SUPERIOR I�POOR _ ADEQUATE NONE 10 PLUMBING 5 ROOF GABLE C HIP BATH I3 FIX.1 Z - GAMBREL MANSARD TOILET RM. 12 FIX.1 FLAT 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 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN, TIMBER BMS. & COLS. STEAM STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS 7%- AIR CONDITIONING RADIANT H'T'G UNIT HEATERS GAS 7 NO. OF ROOMS OIL B'M'T 2nd _ 1st I Td ELECTRIC NO HEATING THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. 1r1 •T•z '+ .: �.'!Rq/.�'.M[wc^Ta..u.+A M f fit: --(i 6 �•;h3 ��. VV Cn m � z Z � z CIO m C — H C'7 n Z w -0. T CD O z wCL r W CZ —' C y C-) CD CD O CL CD CD O CD m z. m C CD co) < C fl. y mcc z p O CD < z - CO) v O m CD a Z a O CD T 0O z D CCD I— U. v S Crrl m rn A v C C ? O go = O aNcC N y �amC m c) O N m Z CL m Er- H m O.� d y W -4 O O N O o gm C a > >.0o CR -� �c ooh o Z�.0 O N C7 W • m C � ca a �• C,- u 13 CD CD D C 1 0 CL13 COD N / N CL d D _ o .c 7 0. N C 4% tO ..► m N ? 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C C m= z z CO CD — � < CO) O 10 CD z � O CD T z O r CD z Com/) I pi O� 0 9,�� apt m m T. v foo Q to So < 0 = Vs »mc a C-3 o ca 9 Z Vl _I O G T �a�a m m H O o i?coo coo eo �CD o 0 CO2 0 CD C ?y >O� C=L=t um 0= E- DCOD 1:D a�`� yC3 W� Co C& H 75o. �� m .rt N CA C y if— ... 3 �m� C.) : • � 0�' CDoi{ 53h H = ? m o c° : • c rn wy C m D cl...+ O o �• W C G WP � C CLM Cr o cn CD o = C2 M� m cn ro d cn 0 oy :; gi r O "ll C n 91 x r" n It �' '� r GOD M () 7d IC/) a o. QJ �CA 0 y 0 ?C Gd O x �yy W )mi 0 9 O C FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ****************Applicantfills out this section***************** APPLICANT: AeSS IBV Onz .6 s LOCATION: Subdivision Assessor's Map Number :� 7 8 Phone GAS K %TE Parcel Lot (s) Street s) Street mg A Aun3ttt P-I0C,P Rb` St. Number 960 _ ************** *********Official Use Only************************ RECOMMENDA SOTO GENTS: Date Approved A Conservation Administrator Date Rejected Comments Q Town Planner Date Approved a Date Rejected Date Approved' Food Inspector -Health Date Rejected "„ :ZziL z Date Approved / s _�ptfc Inspector -Health > Date Rejected Comments-�-v�_ ��`e✓ ��w�'� Public Works - sewer/water connections - driveway permit Fire Department� 'a.tcl Received by Building Inspector 93 rr3 r. Date CERTIFIED PLOT PLAN LOCATED IN NORTH, ANDOVER, MASS. SCALE: 1'=40' DATE: 12/94 Scott L. Giles R.P.L.S. 50 Deer Meadow Road North Andover, Mass. NOTE: SEE PLAN BY J. CURRAN, DATED: JAN. 1992 NOTE: THIS LOT IS NOT IN A FLOOD HAZARD ZONE. 0'+0.0 1 U UUHNER- I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE or THE OFFSETS OF THE BUILDING INSPECTOR ONLY4` SHOWN COMPLY AND SUCH USE IS FOR THE WITH THE ZONING DETERMINATION OF ZONING .13972 +� fCrSTEpE��`' BY LAWS OF NORTI I DOVER CONFORMITY OR NON -CONFORMITY ��gIAL LApp� WHEN BUILT WHEN CONSTRUCTED. .�*ry ^'J ,fir'"`" �. ,,'ry. .t f - � !. � �ti rte. i t • :..;IsBv r:SWeOt: isID M'AYs^: v'Rtlt9w+L'�'�'1TGIl1�Cf�!�' ks. t C J 4 _- Petition of .. Jean. 1,. Pray B13657" I r a, 29'7 ..PRIX" 4, 0. Any appeal shall be filed f raa4 . wTlin I?rn :: "er the �4'cnust G i3 i'Xtice In the'o-Ice of the Town TOWN OF NORTH ANDOVER MASSACHUBE'M Clerk. A Il'�AjtD iF APPEALS NOTICE Of DECISION z Date ...February .14,. 18.92...... Petition No... 005-92 Date of Hearing...Eeb> uaxY..11..1992 Premiese affected .100,Marbleridge.Road ................................................. Cj Referring to the above petition for a variation from the requirements of the Section. .7...... -;�b' Paragraph. 7...1 .and. 7..3, .Table..2 .of. the .Zoning. Bylav ................................ so at to permit the. sub -.division of. land .into. two .lots... Lot . #L requires. a .aide-. . line dimensional variance of 23 ft and area variance of 23,838 sq.ft. Lot f)2 requires • a •sideline. dimensional •variance -of• 25 .£t...• a .frontage •variance •of. 18.7 ft.- and t.-and area variance of 47,742 sq. ft. After a public hearing given on the above dab, the Board of Appeal voted to . PPANT ... , . the variances , , , ... . ................... and hereby authorize the Building Inspector to issue a, N. permitto ..Jean I,.rr.ay............................................................... for the construction of the above work based upon the following conditions: ca The zone noted on the plan be changed from R-2 to R-1. i r w �c TTAe Is to certify that Nelly (20) days : have elepsW from date of dedsim filed / w eeegYl� Of Z- j.,L,illj., ' -'� p�� .•.'.'. Fran S io, Jr., a rman Town Cledc Walter Soule, Clerk John Pallone Robert Ford Louis Rissih Bomd.d Appy SL 9 ESSEX NORTH RFGe,�ffll , �vr I)SN'Zo 4 Ty '1/�— I.-AWRENCT, MASS.- .."CMUE C;C)?Y: ATTEST: REGISTER OF DEEDS .d ..........., . �._.. ,.�.:..,.� B g 36 5 7 ..�.o.s.�. 29� Any aPPea' MO�fM ,yO wlt',In f?" rr1 e ,• ' '• � �a;;: � � . .,:lice in the Orrice of :he Town Clerk, •t 1 �J. f MYyJ� .a TOWN OF NORTH ANDOVER t MASSACHUSETTS BOARD OF APPEALS * Jean I. Gray * Petition 1005-92 100 Marbleridge Road * CECIZI01; North Andover, MA 01845 * ♦*******tat********a***** The Board of Appeals held a public hearing on February il, 1992 upon the application of Jean I. Gray requesting a variance from the requirement of Section 7, Paragraph 7.1 and 7.3, Table 2 of the Zoning Bylaw so as to permit the sub -division of land into two lots. Lot #1 requires a sideline dimensional variance of 23 feet and area variance of 23,838 sq. ft. Lot #2 requires a sideline dimensional variance of 25 feet, a frontage variance of 18.7 feet and area variance of 47,742 sq. ft. on the premises located at 100 Marbleridge Road. The following members were present and voting: Frank Serio, Jr., Chairman, Walter Soule, Clerk, John Pallone, Robert Ford and Louie Itissin. i The hearings was advertised in the Eagle 'Cribune on January 30 and February 5, 1992 and all abutters were notified by regular mail. Upon a motion made by Mr. Pallone and seconded by Mr. Soule, a majority of the Board voted to GRANT the variances with a condition that the zone noted on the plan to changed from It -2 to R -1. --The vote went as follows: for; Serio, Soule, Pallone and Ford, against; Rissin. The Board finds that the granting of this variance will not adversely affect the neighborhood or derogate from the intent and purpose of the Zoning Bylaw. Dated this 14th day of February, 1992• BOARD OF APPEALS Fra�ik Serio, Jr. �—' Cha..rman Qc__.A 4--1 E 4 A til vast 5e— L-- C—. G S. �c.�P-'t�,A flame 2n -a n N N 7* m 4O .'Z LO 00 On Z --l' ' O ma .+ Z c` D NO m 10 vt m9y Op m m = m S co W IgZ C � A( m m H 9� m 0 m y l ri 4 C 2 m �myi j D Z y p T Z CD -40 Z?0m :l 3Nil ONolV OIOd m m z 2 �oxr m ° coom n H Z m m° c 1 m Lq G= oc scm ..s m � Z �; v m ' w;: '. m O iU G'} C1 O Z :1 1� m ,., ; o C m W m 'uz r� C 5 .. OpW a "p #ti4 z rsn us to r m m rn CA m m A r { zMV4 � 1 A T m w m `n o ; o ?.rnb NJ °W O ■■ m m < J T m T S, 3NuNOly mo:i 4W tiM z O w� T co �20 lbi ~IL M �• • e CC MMM y(n `IF✓ o C -I OW��� xZTo S• a+ •lbt� �:a -, rJ Z— Z- Dnp cm -T/CO n • v �'N nTm� 1 c i� m Q-)�M mO=Z 1 � S C Bit Z W =-D-I fzm-�jD s: tvm�n)-O p m D = D CD m� Co -i I i KAREN H.P. NELSON Director BUILDING CONSERVATION HEALTH PLANNING j Town of NORTH ANDOVER BecHus°4 DIVISION OF PLANNING & COMMUNITY DEVELOPMENT Ms. Jean Gray 96 Marbleridge Road North Andover, MA Dear Ms. Gray: 120 Main Street, 01845, (508) 682-6483 - September 30, 1994 Re: Structure at 96 Marbleridge Rd. In accordance with Section 123.0 of Massachusetts Building Code regarding unsafe structures, please be advised that you are required to immediately make subject premises safe by securing doors and windows in a satisfactory manner. A follow-up inspection will be made. Please notify this office of your action. urs truly, n Richard Colantuoni, Assistant Building Inspector RC:gb c/Wm. V. Dolan, Fire Chief D-..Robert=N-icetta,_—Bldg sInsp. Vz:) T/o t Z� 1 ca O� NWS 2 Lb 6a Co -of, oaa-�e Pa Pp, akgLkuw 'fb s � t Sane Q�IJ� Secuak' 7D vl�l t i kwCbti� W CL 5:A- WARS . P ccs r f '=6=jaw=motx�tiA t4ORT�y F q eo ..� NORTH ANDOVER FIRE DEPARTMENT * Z. CENTRAL FIRE HEADQUARTERS x'40^ •°•�� (, 124 Main Street North Andover, Mass. 01845 WILLIAM V. DOLAN Chief of Department Tel. (508) 686-3812 (508) 689-4350 To: Robert Nicetta , Building Inspector From: Fire Chief Dolan RE: Structure adjacent to 96 Marbleridge Rd. Date: 10 August 1994 Attached is a copy of a memo from me to the fire lieutenants regarding the structure adjacent to 96 Marbleridge Rd. and a copy of Lt. Melnikas' report to me on the structure. I am requesting that you review the condition of the structure relative to your authority under section 108.3 Building notices and orders of the building code. Lt. Long or myself would be available to accompany you, if you wish. Z�& - William V. Dolan Fire Chief s AUG 1 2199A R "SMOKE DETECTORS SAVE LIVES" I WILLIAM V. DOLAN Chief of Department NORTH ANDOVER FIRE DEPARTMENT CENTRAL FIRE HEADQUARTERS 124 Main Street North Andover, Mass. 01845 To: Shift Lieutenants From: Chief Dolan RE- Dangerous condition in structure Date: 1.0 August 1994 Tel. (508) 686-3812 (508) 689-4350 .Please read the attached report from Lt. Melnikas regarding a structure to the right of the dwelling located at 96 Marbleridge Rd. Conditions in the adjacent dwelling would be hazardous to fire personnel responding to a fire in this structure. Therefore, if we respond to a fire in this structure we should be prepared to operate in a defensive mode and protect the exposures. Fire officers must insure they have the proper information prior to establishing a defensive operation. If there is a civilian life safety hazard within the structure, fire suppression efforts must directed towards rescue and life safety of those individuals while maintaining a safe operation for fire personnel. 1. Nearest hydrants are at 55 Marbleridge and corner of Dale & Marbleridge 2. ENGINE THREE SHALL RESPOND IN ADDITION TO ENG 2, ENG 1, LADDER CAR 8 AND CAR 1. 3. Is there any possible human life safety hazard in the building at the time of the fire? 4. Are all the residents of 96 Marbleridge Rd. accounted for at the time of the fire? We will report this structure to the building inspector in an effort to have it declared a hazard and taken down. In the meantime, please familiarize your personnel with the structure as a means of pre -fire planning. AUG 1 21994 t . cc: R. Boetcher R. Nicetta William V. Dolan Fire Chief ''SMOKE DETECTORS SAVE LIVES'' i AUG 12 81 Location 160 _ " No. 0 ` Date TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ jPermit Fee $ Cis 0V Sewer Connection Fee $ �- Water Connection Fee $ TOTAL To 7883 Building Inspector' Div. Public Works " KAREN H.P. NELSON Director BUILDING CONSERVATION HEALTH PLANNING .. � Town of NORTH ANDOVER �ss•cwust` DIVISION OF PLANNING & COMMUNITY DEVELOPMENT CHIMNEY APPLICATION AND PERMIT DATE 1 OWNER'S NAME— 61 6 120 Main Street, 01845 (508)682-6483 PERMIT # BUILDER'S NAME S.4F1 MASON'S NAMEal4 w ' aza MASON'S ADDRESS MASON'S TELEPHONE - O MATERIAL OF CHIMNEY G/aL INTERIOR CHIMNEY ST0tvp EXTERIOR CHIMNEY !3 e h c NUMBER AND SIZE OF FLUES _L S'cX 1:2 ` THICKNESS OF HEARTH R `` Will chimney or fireplace conform to requirements of the code and have rules and regulations been received: DATE SIGNATURE OF MASON ri CONTR. LIC. # D �2 EST. CONSTRUCTION COST/CONTRACT PRICE 4 PERMIT GRANTED --/k5 FEE ROBERT NICETTA, BUILDING INSPECTOR �— INSPECTED REMARKS SOLID BRICK REQUIRED THIS PERMIT MUST BE DISPLAYED ON THE PREMISES �� �`� � Restricted W 00 1 DEPARTMENT OF PUBLIC SAFETY 00 - None CONSTRUCTION SUPERVISOR LICENSE 1A - Masonry only Expires' Birthdate'. • Nu�ber: 16 - 1 8 2 faiily Hoes CS 042529 12/16/1995 12/16/1955 i Restricted. To' 00 y �- ARMANDO PIZZO 153 PITMAN ST 01844 ' r F t ; tialya�t.? • it _ �- le t�r,)i v=' t yF1 �Y'•M1 ky}� rte r\lF % k '•.� �.Htk?,`yj t.� 'it `• t.' ��t ;! i`� t t .,Y\i��c. 1`�.rZ pZ Y•.a .4, tt'�ti +t��� t'• ,:. t4i �t�li='+lad.\\ n r{�.: �T �t �;L t�"�' t t�� 'ii c1 TT�S� a,`t �s'', to ♦'r ` ; `, _ � t ) + !i t` t`b i �1=�F''ri��t! •Nv "1� e4 t � ! t t � t � r :'`t � M .�` � � �li`'ti Z), \ .. 4:. i rt � � \ l , ;l a '?,L ntUy. �•,�., ��, `?t�a dS. >A�. 1- t a4E. <! ',cs, rt ,� �� y .�ii� t -i. •'. 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Partner. Firm/Co. Business Telephone:_�Z` - Name of Licensed Plumber or Gas Fitter e Insurance Coverage: IndicVders e type of insurance coverage by checking the appropriate box: Liability insurance policyOther type of indemnity Q Bond Ej Insurance Waiver: 1, the uigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. Gasfitter Owner 0 Agent 0 Signature of owner/agent of property Journeyman #L Li �mm�o�n�n���nn�� MEN son 0 ONE EMENEREEKEEK Check one: Certificate Q Corp. Partner. Firm/Co. Business Telephone:_�Z` - Name of Licensed Plumber or Gas Fitter e Insurance Coverage: IndicVders e type of insurance coverage by checking the appropriate box: Liability insurance policyOther type of indemnity Q Bond Ej Insurance Waiver: 1, the uigned, have been made aware that the licensee of this application does not have any one of the above three insurance coverages. Gasfitter Owner 0 Agent 0 Signature of owner/agent of property I hereby certify flat 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 aU plumbing work and installations perfomted under Permit isseed fo: this application wW be in eompiiance with all pertinent provisions of tho Massachusetts Slate Cas Code and Chapter 142 of tho General Laws. By Title City/Town: APPROVED (OFFICE USE ONLY) YPE LICENSE: Pluir�ber Gasfitter Master�,pl, Journeyman #L Li e—e€:1�icensed or Gasfitter cense Number t Date. ........ h; F ,.prrTM TOWN OF NORTH ANDOVER kJ h� a p` 3? p .. T p PERMIT FOR GAS INSTALLATION SSACHUSE _. 1nORl� This certifies that ...... S !.' .................... C . has permission for gas installation ....:...................... . in the buildings of..1......... :............................... at ..?................................ . North Andover, Mass. Fee......... Lic. No...... �... . .......................... GASINSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File