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HomeMy WebLinkAboutMiscellaneous - 100 OLD CART WAY 4/30/2018 (2)�i rw..o%s�Atr".:`p ' Date .....�/�� 2695 HORTM °ft``°;•�"� TOWN OF NORTH ANDOVER > PERMIT FOR WIRING SACMUS� This certifies that ....... rsC... t W!......nn.��.S............................. has permission to perform ....................!.....� tj wiring in the building of f c� c 1 t.... ��..t?. C ....4C. at .. �C�............. ......... j.................. ,North Andover, Mass. Fee ..!%..... J .. Lic. No.,r .`I`h ELECTRICAL INSPECTOR GlkI6 15:54' 370. .00 PAID WRITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File ry Office Use Only g, 1: (&1MnWnWf31t4 Iif Sl��usttts Permit No. � 0 ` 1e}t =tnt of Publir *af tg Occupancy & Fee Checked e BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 no peave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL. WOR All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date %* or Town of NORTH ANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number)p Ing ��� � ��� /� Its nL Owner or Te ant AjS 6— `a GO Owner's Address Is this permit in conjunction ith a 1�1�ut.�lding-�permit: Yes No ❑ (Check Appropriate Purpose of Building Utility Utility Authorization No. Existing Service Amps _J Volts Overhead ❑ Undgrnd ❑ i "o. of Meters New Service � Ampsjc �Voits Over ead Undgrnd Lr�,-Y/ No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work 1 No. of Lighting Outlets Total No. of Hot ubs No. of Transformers KVA No. of Lighting Fixtures (� I Swimming Pool gAbove.—, rnd. � � In- gmd. � Generators KVA No. of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners I Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Detection and Total No. of Ranges ` t No. of Air Cond. tons Initiating Devices No. of Sounding Devices No. of Self Contained No. of DisposalsNf Heat Total Total No.of I Pumps Tons KW No. of Dishwashers I Space/Area Heating KW Detection/Sounding Devices Municipal COther Local - Connection No. of Dryers I Heating Devices KW No. of No. of Low Voltage No. of Water Heaters KW I Signs Ballasts Wiring No. Hydro Massage Tubs , No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the reauirements of Mas acnusetts general Laws I have a current Liability Insurance Policy including Co ime d Operations Coverage or its substantial equivalent. YES NO _ I have submitted valid proof of same to the Office. YES NO = If you have checke YE please indicate the type of coverage by checking the aper nate box. � �`\ �v _ _ ) G --p&--796 INSURANCE tR BOND -E OTHER = (Please Soec.fy) ' ` ���44i[yt (Expiration Oates Estimated Value of Electrical Work S Work to Start Inspection Date Requested: Rough Final Signed under the P nasties ury: FIRM NAME ` t z UC. NO. Licensee nature LIC. NO. –AEk6 / Bus. Tel. No. Address / L` 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. Owner Agent (Please check one) 3e Qv Telephone No. PERMIT FEE 5 �(Signature of Owner or Agents Gi x-6565 Location f No. TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ es�ermit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL 11/27% 13-41 ' �2 — �; z5. QO PAID z j -,fJ �! �C Building Inspector Div. Public Works KAREN H.P. NELSON °"r"°' M: :NORTH ANDOVER BCILDING- •ti: ;.oioF CONSERVATION HEALTH 6, PLANNING & CONi M LAITY DEVELOPMENT DATE—A, —()\) LOCATION OWNER'S NAME BUILDER'S NAME CHIMNEY APPLICATION AND PERMIT i �y s` )®USQ, 120 Alain Street. 01845 (508) 682-6483 - PERMIT MASON'S NAMED �t G� IG+�f [n ► 1 V) MASON'S ADDRESS .1--U 5 LE �,` G iv --%SON' S TELEPHONE MATERIAL OF CHIMNE'_' �d^i l i INTERIOR Cc:Ii-4.NEy C/ r^ y �' Lt i( EXTERIOR CHIMNEY�� NL-1BE R A, ID SIZE OF FLUES T:iICEij=SS OF HEARTH /u w i l 1. have DATE chi,: nev or to requirem eats o1 +--',-,e code and rules and recu_atic—ns been received: SIGNATURE OF MASON EST. CONSTRUCTION COST/ CO�+TR.AC= PRICE CONTR. LIC. = 44J CJ 3�ad PER1,1IT GRANTED �L ZZ -V� E 2 S w ROBERT NICETTA, Bi:I-.D;.:G INSPECTED REMARKS a c"'Tn aorCK REQUIRED THIS PERIMIT MIUS T BE DISPLAYED ON THE PREMISES =A ra—M I U i' V Z V C.) O O� C c W L LL z ® o LU _ o a� V LL ui 0 z z � w A 0 U O U dU' � A F � x F dU' � W '0 3 4 vU, F O F v� Q p0 a o� roa V aw D a U O �n O F=4 CN V v --1 LLJ elm w U Q = O J ;fJ � •� O O Cn 7t �- c -i Z �0 o � o �r C h Q � '50 acLL-� R C W ��=aw .mom C V: D c al i Es cm C3 © c E o 0 �m= _ y N A o 3 t V: y J y y R O _ CO CD cm .dC.� m c oa a V y O m V Z O cm t5 .JJa=ac c Q i —�' y m= O p N H co m � LA- O LLA Lj C) oCo= a C/3 m :6 J Z eyp CD H O H CD C .L... Ca � � P 0 9 gm-, 0 n r R Im a, b _ z co Lij Z CD O C _ z F- CO cm w caG '� > Q CD y C� •� cr � W m m z :> CO O a) o co R -a O L O i R o a �c Q z LL - COD Z V Q c CO ; ,z O CL LD Vi - 1 eaCC � 1 W Q� Q VD co 0 z � z � w Cl- Cf) �a d zKic w C:1 aG cn D a w All v G? Q)u c �x �a� cn Vi LLJ elm w U Q = O J ;fJ � •� O O Cn 7t �- c -i Z �0 o � o �r C h Q � '50 acLL-� R C W ��=aw .mom C V: D c al i Es cm C3 © c E o 0 �m= _ y N A o 3 t V: y J y y R O _ CO CD cm .dC.� m c oa a V y O m V Z O cm t5 .JJa=ac c Q i —�' y m= O p N H co m � LA- O LLA Lj C) oCo= a C/3 m :6 J Z eyp CD H O H CD C .L... Ca � � P 0 9 gm-, 0 n r R Im a, b _ z co Lij Z CD O C _ z F- CO cm w caG '� > Q CD y C� •� cr � W m m z :> CO O a) o co R -a O L O i R o a �c Q z LL - COD Z V Q c CO ; ,z O CL LD Vi - 1 eaCC � 1 W Q� Q VD co 0 z � z � w Cl- Cf) Location 1CO 0AU 63QT WAU No. ikate (t Z -�>Aa 776 TOWN OF NORTH ANDOVER Certificate of Occupancy $ EM Building/Frame Permit Fee $ Foundation Permit Fee _ $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $�_ Building Inspector Div. Public Works Locations 4 No. Da e o< M0 T11 TOWN OF NORTH ANDOVER` 4 , Certificate of Occupancy $ " "Building/Frame Permit Fee 'a , $ sncMust Foundation Permit Fee $ Other Permit Fee $ " Sewer Connection Fee $ -*-3� Water Connection Fee $ TOTAL $ p(�' % Iding Ins for ` ' t ,f 2 8399 Div. Pubic Works { Location WIT maj No. Date Ibill 9$- TOWN OF NORTH ANDOVER p Certificate of Occupancy $ --z Building/Frame Permit Fee $ SSAGMU`'t< Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ \ Building Inspector 107792 91:53 7 1, 505.50 PAID Div. Public Works Location, 1W 00 CA 2-T LUAq No. S ( Date`I ict � a 1 f TOWN OF NORTH ANDOVER p Certificate of Occupancy $ ` Building/Frame Permit Fee $ s�cNusE Foundation Permit Fee $ 8 Other Permit Fee $~ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ Building Inspector ' ( 8584 Div. Public Works J PERMIT NO. e 6w APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 ;1112iP 4d0. ' Q I LOT NO. 2 RECORD OF OWNERSHIP DATE BOOK :PAGE — ZONE SUB DIV. LOT NO.��-� LOCATION - voo PURPOSE OF BUILDING OWNER'S NAME /, -7 tri{ d fJ C. t a_ NO. OF STORIES Z SIZE M` -sr- 44' sag ag / M 1�IL OWNER'S ADDRESS . J BASEMENT OR SLAB ARCHITECT'S NAME V Wak SIZE OF FLOOR TIMBERS 1ST Z , ^� 2ND p4,`® 3RD rBUILDER'S NAME Pi�4l/ILL�"/ Gr ,/ SPAN se DISTANCE TO NEAREST BUILDING �S- l DIMENSIONS OF SILLS POSTS DISTANCE FROM STREET r� J`l DISTANCE FROM LOT LINES - SIDES&S- 1 REAR > S-�'(� ` GIRDERS AREA OF LOT!;,q -1 I 1 -t� ,� FRONTAGE ` 1 G] HEIGHT OF FOUNDATION t THICKNESS /� t IS BUILDING NEW 0 �} SIZE OF FOOTING A t ,Z L� X IS BUILDING ADDITION -� MATERIAL OF CHIMNEY -, IL IS BUILDING ALTERATION �- IS BUILDING ON SOLID OR FILLED LAND rQ J WILL BUILDING CONFORM TO REQUIREMENTS OF CODE Ty IS BUILDING CONNECTED TO TOWN WATER �x pJ BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER �_ /o ;Llo IS BUILDING CONNECTED TO NATURAL GAS LINE Aolvx INSTRUCTIONS SEE BOTH SIDES PERMIT FOR FOUNDATION ONLY REGULATED BY PARA. 114.85. B.C. PAGE 1 FILL OUT SECTIONS 1 - 3 PAGE 2 FILL OUT SECTIONS 1-12 .DATE 1t 6k FEE PAID iOC� ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING v lo ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPE NIT FOR FRAMUBUILDING FILED , .DATE: b q'4 FEE PAID• ATURE OF OWNER OR AUTHORIZED AGENT FEE PERMIT GRANTED C r Ld Zg.��- NOV 2 11994 , S, BLDG. PERMIT FEE 4.- �0S a .....�..... LESS FDA FEE. DUE FRAME PERMIT =10. C- Ch 3 PROPERTY INFORMATION LAND COST / ?—S g o'er .s EST. BLDG. COST / ,� ` (j ZiI, may„ An EST. BLDG. COST PER SQ. FT. ddd/iii �-- EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. 4 APPROVED BY wzjo� - su1LD O INsP[CTOR OWNER TEL. N 60gt$ �Z Z,6'- CONTR. CONTR. TEL. # CONTR. LIC. H.I.C. # '7"7b Z -- S 394 — 85B+ - qz1ssue An`ct'r ,or1 a l — Cbiv—* ('oo I OCCU ANCY SINGLE FAMILY FAMILY SiORIESS MULTI. FAMILY OFFICES APARTMENTS CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE _ 3 I 2 3 CONCRETE BL'K.PINE _ BRICK OR STONE PL.4 — — PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B M AREA _ '/. '/v 'h FIN. ATTIC AREA N_O B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �L WOOD SHINGLES EARTH ASPHALT SIDING HARDIV'D ASBESTOS SIDING COMMCN VERT. SIDING ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY BRICK ON FRAME _ ATTIC STRS. & FLOOR . r ra -- "'"" +T' T1 •!i . �f CONC. OR CINDER BLK. WIRING SUPERIORPOOR ADEQUATE I� NONE STONE ON MASONRY STONE ON FRAME 5 R9,PF 10 PLUMBING GABLE I HIP GAMBREL MANSARD FLAT I SHED BATH 13 FIX.) TOILET RM. 12 FIX.) WATER CLOSET ASPHALT SHINGLES WOOD RAFTERS LAVATORY WOOD SHINGES KITCHEN SINK SLATE RADIANT H'T'G UNIT HEATERS NO PLUMBING TAR & GRAVEL STALL SHOWER BUILDING RECORD 12 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.' A. N+'t'J1 "1 I .2,11. l /.cl It 0..):3 I Yflwfl 6 FRAMING IL, 11 HEATING . r ra -- "'"" +T' T1 •!i . �f 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 ELECTRIC B'M'T 2nd _ 1 st 13rd I NO HEATING -331 AG" . _t ilh*, Uq I*i .041 RAC LLI cc ll� Z' C � J 1�i 9i A c J ad :c� Pow �':c�z� :U 0 J O i Q� . a Q �- U7) i - � C) z �Cc mcm :..1 V :�o �o � CA E-- "' c w O cm O w C.3 •m o c G oC Q N SES O y OHO w CD U mm z o © moo. C p S CL-- co m m a LC- C, CA c rr^^ �NO O ; m v/ V V Q V:ev - 4., ca O 7: CO) � O U o � � py cooCc 11� Jy=T C.3 J� z s o os W — O LL. �Q c y Q C Z V Q a c z '_ Z c co z m O a C- o r U y li C." y O i C. O Z O O yr C O C d cm NmC = m a.=-• p N C F- N mom~ m = W ca �a = m :5W C :5 BE Q W c.s�cc c Z V! C3 ac E is - � N CDLU C2 D z � CML3LLJ a g z N p N 32 o..=... Cc a. Cn M r 1 n r KV] ° WW O O x zw w w c � x � z z Un ci ? w w p C7 `i' j a m �C u v = a w v VS w z v o O w 6! cCl)O O O w a U w O w w O c� cn C .Ye w w 7 w LLI cc ll� Z' C � J 1�i 9i A c J ad :c� Pow �':c�z� :U 0 J O i Q� . a Q �- U7) i - � C) z �Cc mcm :..1 V :�o �o � CA E-- "' c w O cm O w C.3 •m o c G oC Q N SES O y OHO w CD U mm z o © moo. C p S CL-- co m m a LC- C, CA c rr^^ �NO O ; m v/ V V Q V:ev - 4., ca O 7: CO) � O U o � � py cooCc 11� Jy=T C.3 J� z s o os W — O LL. �Q c y Q C Z V Q a c z '_ Z c co z m O a C- o r U y li C." y O i C. O Z O O yr C O C d cm NmC = m a.=-• p N C F- N mom~ m = W ca �a = m :5W C :5 BE Q W c.s�cc c Z V! C3 ac E is - � N CDLU C2 D z � CML3LLJ a g z N p N 32 o..=... Cc a. Cn M r 1 n r KV] 1 FORM U - IAT 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. ****************Applicant fills out this section***************** APPLICANT: APPLICANT: Phone LOCATION: Assessor's Map Number / Parcel Subdivision 1� �t fi k_e_-r_ ( G.'q Lots) Street l m+ �_U- St. Number I 60 ************************Official Use Only************************ RECOM19NDATIONS OF TO AGENTS: onsfervation Administrator Comments V!fl� CzkwRe Lu_ Town Planner Comments Food Inspector -Health -J-,4 Septic Inspector -Health Comments Public Works - swater connections - driveway permit Fire Department Date Approved �l Date Rejected Date Approved Date Rejected Date Approved Date Rejected Date Approvedd Date Rejected dV Received by Building Inspector Date Nov 2 11994 Date ..... /J .vv.... TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ` j c�> r has permission to perform ..... ../:..../.:.dd1.................................. I............ wiring in the building of T ' I ............. / .........�:................................ �........ i _ at ..../. ,No�rth�-d ass. . q ELECCRiL4AL INSPECTOR cjf Lf � 3 WHITE: Applicant CANARY: Building Dept. PINK: Treasurer ITHECOWONWE4L7HOFAL4SSACHUSL?7S Office Use only DEPARTMEVTOFPUBLICS9FM Permit No. BOARDOFmEPREVEWONREGUA770AS527CMR IZ�W Occupancy &Fees Checked APPUCATTONFOR PERMITTO 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) Dates Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street & Numbe� r) %/)/) /���% ��,� j� V A Owner or Tenant JOLT ll + % yklyr r� Owner's Address Is this permit in conjunction with a Purpose of Building R permit: Yes lzzrNo [::] (Check Appropriate Box) Existing Service Amps Volts New Service Amps`/ Volts Utility Authorization No. Overhead F-1 Underground Q Overhead r --J Underground Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work 77 7,771777D 027 No. of Meters No. of Meters No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total KVA No. ;hting Fixtures Swimming Pool Above Below Generators KVA ground1:3 ground 171 N-flOutlets No. of Oil Burners No. of Emergency Lighting Battery Units No.t Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones No. of Ranges No. of Air Cond. Total Tons No. of Detection and No. of Disposals No. of Heat Total Total Pumps Tons KW Initiating Devices No. of Sounding Devices No. of Dishwashers Space Area Heating KW No. of Self Contained Detection/Sounding Devices Local Municipal a Other No. of Dryers Heating Devices KW Connections No. of Water Heaters KW No. of No. of Signs Bailasis No. 0;ydro Massage Tubs No. of Motors Total HP OTIAR• --- hsurm>IoeCo�eage: Pt»Raiantbthetacgrilarta>$sel�GeneralLaws Iha%eatamartLmbibiyhsr+n=Ptt ym&&gCat> Ak Co%eaWcritsskst fftdeWiva YES NO Iha%esttbmilGadvalidptoofofsamelDtheOffim YES rJ NO r7 Ifjouha%edwdwdYES,pimemdc*thet wcfa vwWbyd=kirgthe INSURANCE r,&7— BOND OU&R ftmeSpeafj') Eskrmkd VakrclEkcftW Wait $ WdkloSttat hspeWcnD&-RNuesWd Rough U1111 z9c 11 Final SignadundeM of FIRMNAME ��Pne ,L� :e7E"ie Li =NTQ 1 37 ,T� Lim= lb e Aa N Sigwiiule 1Zya=Z Li.,,b BwizmTel.Na .,a ' %$s- S' Xi e --Z; al" IMLE iV5712 AltTdNa OWNER'SINSURANCEWAIVFR;Iamamdr,,tthelimmdmno k!netheicstra=axaaW itsskswtiilla*riwlftasmgmWbyNbzadwsensGmedLaws anddy,tmysgrattaealiSpmnit twai%mthism manart (Please check one) Owner Agent ED �v Telephone No. PERMIT FEE Date... TOWN OF NORTH ANDOVER PERMIT FOR CAS INSTALLATION This certifies that . ;'� . .S.�F �� !� ..°�?�f�. <........ . has permission for gas installation ............ in the buildings of ...f �: �... ....................... at .,f � ' !.. ?f'Z. L. North Andover, Mass. Fee.. ... `. Lic. No.. � V*/... ..... :... C..: % ......... GAS INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK: Treasurer ` MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING Z��— (Print orX4-'6----'MA Date D 13 so QU Receipt# Permit# Building Location OW ca + Owner' ame Ltm)o C -(—b Map: Lot: Zone: ype of Occupancy 1` lOS l ef lCe- NewW Renovation ❑ Replacement ❑ Plans Submitted: Yes ❑ No ❑ (i Installing Company Name EASTERN PROPANE & OIL, INC. Checkone: Certificate Address 131 WATER ST DANV E R S MA 01923 Corporation Estimate Value of Work: ❑ Partnership Business Telephone 800-322-6628 ❑ Firm/Co. Name of Licensed Plumber or Gas FitterI/icJF.. 1Me loa 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 ides, please indicate the type coverage by checking the appropriate box. 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 Mass. General Laws, and that my signature on this permit application waives this requirement. Checkone: Owner Agent❑ Signature of Owner or Owner's Agent 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 underthe permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By Type of License: \[,<.1 ", Plumber Signature of Licensed Plumber or Gas Fitter Title asfitter 9 Master License Number / % L' City /Town Journeyman APPROVED (OFFICE USE ONLY) Revised 05/17/00 .................... Installing Company Name EASTERN PROPANE & OIL, INC. Checkone: Certificate Address 131 WATER ST DANV E R S MA 01923 Corporation Estimate Value of Work: ❑ Partnership Business Telephone 800-322-6628 ❑ Firm/Co. Name of Licensed Plumber or Gas FitterI/icJF.. 1Me loa 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 ides, please indicate the type coverage by checking the appropriate box. 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 Mass. General Laws, and that my signature on this permit application waives this requirement. Checkone: Owner Agent❑ Signature of Owner or Owner's Agent 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 underthe permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General Laws. By Type of License: \[,<.1 ", Plumber Signature of Licensed Plumber or Gas Fitter Title asfitter 9 Master License Number / % L' City /Town Journeyman APPROVED (OFFICE USE ONLY) Revised 05/17/00 O a N z CO) v m n O m v a O O m N N Z N .9 m n O Z f q 4 T O s m c n ; a m s z0 m a m a 9 Z r. On O V a a T m .� o s z � r m M0T v_ c -4 z m O v z aO m O O c a zi O m G o 0 a N T_ o _1 z O v a O O m N N Z N .9 m n O Z f q 4 e 2681 Date. v.-. 4! .. ;)� TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING This certifies that ...��Y` has permission to perform .. ..%Gv..t.GG ........ plumbing in the buildin sof C...•.... �l/1 .......... at./00 [ c�pf .. . .. �. /6.., North Andover, Mass. Fee130. .. Lic. No.. J a . ............................. . (?&r//�D PLUMBING INSPECTOR 11/0945 14:18 130.04 PAID WHITE: Applicant CANARY: Building Dept. PINK: Treasurer GOLD: File ` MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or TWO NORTH ANDOVER, ,Mass. Data�Vto BuQdtng )� Permk # �/ C-14 SY00 Location / SOT /L� NNamera �. �. �1 New f Renovation ❑ Repiacemem ❑ Plans Submitted: Yes ❑ No Aa� FIXTURES Installing Company Name ' ` d --1�1 Address Q /!J 6 ,; Z- 4V1c A'/&G,-Tb A -I "/8�)7 Business Telephone~ Name of licensed Plumber Check one: Certificate ❑ Partnetah ❑ Firm/d6.'- INSURANCE COVERAGE: Cnecxtwf. 1 have a current liability Insurance or its substantial equivalent. Yes . - No ❑ If you have checked y", please tate the type coverage by checking the appropriate box. A Itabilty insurance pdicy Cther type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit appilcatlon waives this requirement. Check one: ITnOwner p Agent;❑ stun o et a Ownet a ent I hereby attify that aA of the detaAs and information I haw submfflad for entered) In above appiicaikm v true and accurate to the best of my knowiedpe and that as plumbing wak and kutaAatlons petfotmed undo the permit I lot a ap tion vAl be in compilance with aA pwtinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of ue TriN q Hansa Numbet Oty/Town Type of P4umbing Ucanse: Mastet E APr rKMO (OFFICE USE ONLY) Journeyman 0 wz oil z � s Id w sue. u a a s r ts- r t ar t w= z s= F u Al o 2 z W" s11 s! 14 � s s e1 = s• s. K a r- u> s a j• s �' i a w w w r I r 3 t• i o w r z o i a w i s o f o s u a Is D aei sus—eswt. aAalYtlMt IST FLOOR 3110 FLOOR alto FLOOR 41H FLOOR aTH FLOOR sTHFL0aR. TTHFLOOR iTH FLOOR — Installing Company Name ' ` d --1�1 Address Q /!J 6 ,; Z- 4V1c A'/&G,-Tb A -I "/8�)7 Business Telephone~ Name of licensed Plumber Check one: Certificate ❑ Partnetah ❑ Firm/d6.'- INSURANCE COVERAGE: Cnecxtwf. 1 have a current liability Insurance or its substantial equivalent. Yes . - No ❑ If you have checked y", please tate the type coverage by checking the appropriate box. A Itabilty insurance pdicy Cther type of Indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit appilcatlon waives this requirement. Check one: ITnOwner p Agent;❑ stun o et a Ownet a ent I hereby attify that aA of the detaAs and information I haw submfflad for entered) In above appiicaikm v true and accurate to the best of my knowiedpe and that as plumbing wak and kutaAatlons petfotmed undo the permit I lot a ap tion vAl be in compilance with aA pwtinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of ue TriN q Hansa Numbet Oty/Town Type of P4umbing Ucanse: Mastet E APr rKMO (OFFICE USE ONLY) Journeyman 0 Tb nee rirL6 ivs�.eb r.�v0 Tti TN.F' dNN,1- T.►i4T 7;VE.PWWC4AW Af IGKLI7"r,0 CTA/ 4,vo r.K4rrroAcs ca✓fat,N M'/rN TiVE ruts. ✓ GV�/�tJ. A.c/Ov � c,<? ZLLV/.VQ .lif'6l�LATirt1�S �t1rdN.tO/.�lC fd rA4C rf OW4,W s f�.�nvcc ci-Wr�.-r r41.1r rr-ir �wrur.+�v rs,vor cnu rEo r.✓ raE SAT CWAFAle- 4.erc.4. �IewK ON f!'M.f cro••...�vv�ry /oevGrC '�' � SGr? �� OGS j C QATcc HOFMANN i 09 #36381`P� C 67.00' - OL c.g,e T wa lJ,�.��✓it/'F4.P LEC/ �ET7-Y .�/E.l.�/.*�GIGt' E.v�.�vL�E•!'.Kf� .lE.�r/!c".f cc r.4,Ce .r7-A-Af 4rr' •I.VOO✓E�, .N•Is.�lvvt�"rT..f' viBiO (i�g- %�� ( =, Location No. 4e -"2c,'fq� TOWN OF NORTH ANDOVER ` s Certificate of Occupancy $ A-11 Building/Frame <� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee TOTAL Check # 15 Gu 2 -' —Building Inspector (j0/Aj C� TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR, RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING 5 BUILDING PERMIT NUMBER: 13 6� DATE ISSUED: SIGNATURE: y Buildin 'Commissioner/I for of Buildings Date SECTION 1- SITE INFORMATION 1.1 Property Address: MoD Old 1.2 Assessors Map and Parcel Number: 1.`% Map umber Parcel Numb 1.3 Zoning Information: Zoning District Proposed Use 1.4 Property Dimensions: Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.7 Water Supply M.G.L.C.40. S§ 54) 1.5. Flood Zone Information: Public ❑ Private ❑ Zone Outside Flood Zone ❑ 1.8 Sewerage Disposal System: Municipal ❑ On Site Disposal System ❑ SECTION 2 - PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record ro h(I erg 0O a� Name nt) Address for Service Ur— Signature �� Telephone • Z_� 2.2 Owner of Record: Name Print Address for Service: Signature Telephone SECTION 3 - CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Licensed Construction Supervisor: Address Signature Telephone Not Applicable ❑ License Number Expiration Date 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name Registration Number Address Expiration Date Signature Telephone 0 Wo M Z O v n M Na. 1 O Z M 90 O Mn r M r _r Z YI SECTION 4 - WORKERS COMPENSATION (M.G.L. C 152 4 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes .......0 No ....... 0 SECTION 5 Description of Proposed Work check au applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) 0 Addition ❑ Accessory Bldg. 0 Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: �c c� /o V SECTION 6 - ESTIMATED CONSTRUCTION COSTS Item Estimated Cost (Dollar) to be Completed by 2ermit applicant • , 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee (a) X (b) cJ 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 Q Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR APPLIES FOR BUILDING PERMIT /CONTRACTOR 1, (�-- `� ,L �/%7� �%'G as Owner/Authorized Agent of subject property Hereby authorize ►aa� �u �drs to act on My behalf, in all ma ers relative to work uth rtzed by this building permit application. t/ all in �— Signature of Owner 1 Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1. as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate, to the best of my knowledge and belief Print Name Si ature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB - SIZE OF FLOOR TITVMERS 1 2 ND 3RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL. GAS LINE Town of Norte Andover Building Department 27 Charles Street North Andover, MA. 01845 D. Robert Nicetta Building Commissioner . (978) 688-9545 978) 688-9542 Fax Please print DATE O r D J09 LOCATION /VO Number "HOMEOWNER 'RESENT MAILING I!E'r b Name City Town HOMEOWNER UCENSE EXEMPTION Street Address 2 0 �(CJ Home Phone r i State map / lot Work Phone Zip Code The current exemption for "homeowners" was extended to include owner-cccupieddwellings of two units or less and to allow such homegwrters to engage an individualfor hire who does not possess a license, provided that the owner acts as supervisor: (State Building Code Sem 108.3.5.1) DEFINITION OF HOMEWOWNER: 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 or two family dwelling, attached or detached sbu tures ac - two -year to such use. andlor fiarm sbvctures_ A person -gip ire ii:ar► one home in a two-year period shall not' be' considered a homeowner 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 No. Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements_ HOMEOWNER'S SIGNATURE " — 511 to 2 - APPROVAL APPROVAL OF BUILDING OFFICIAL s FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*********************** 1 . APPLICANT ---,John LOCATION: Assessor's Map Number 0-7 SUBDIVISIONS STREET D/ T PHONE CI %a _ (6 7—"1&06 PAFE0 I 0 /, 8 -01!5-00(90,71 LOT (S) l ST. NUMBER /©O ************************************OFFICIAL USE ONLY*********************************** ENDATIONS OF,WWN AGENTS: /EONSERVATION ADMIN COMM TOWN PLANNER COMME FOOD INSPECTOR -HEALTH SEPTIC INSPECTOR -HEALTH COMMENTS DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED DATE APPROVED DATE REJECTED PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 jm KR g K7. NO 0 C'` w iy c� ° w CA w° U G w" O � co a a°' w oo� U aW. a x w°' Ch co w x � 1:4 m ii z W w � 2 �, cn o cn C'` T 0 0 O CD Q co s Z m Q. O CO) G C Ico cm C C_ V) 0 Q M� �M�y� •� W W co _cm CD � O � O CD Q O O C. 0. � c4 H C O o C CD 0 CL V CO) O O Q� C Q 0 0 U) LLI U) CCw w CZw VJ c o2 : CD = C2 . c � C2 :�� y O C �: O ; •dam I d C O � L O ® p i m t�Ea 7 � c o o. y �sE c om a y �mm G N N cm C � � y O C m cm C: - JOS L O cm C C Fr.4 c m .c m �i V > Z G v Q moo a c m C •p co L 'W Og L+.�CL Woc DN CL= C Z all a w`r 4D ca o omm .5== 3n4 O CO) m G5m i T 0 0 O CD Q co s Z m Q. O CO) G C Ico cm C C_ V) 0 Q M� �M�y� •� W W co _cm CD � O � O CD Q O O C. 0. � c4 H C O o C CD 0 CL V CO) O O Q� C Q 0 0 U) LLI U) CCw w CZw VJ I 447 �� Icx16 :. wood �aT s y ®7.ae RD�Tv—*Tlilicc, ...a 1 PUR7HER SATE THAT IN MY PROFE=C)NAL .......�,:.'� ��periian �s prepared �. �far fnexgags purposes and is not to oT, cOPINION the principle struature/s and accessory upon as a,stuvsy% FX Sulfty e>�ciptss BUD butbuDdtngs, _ "ryFWiy\ no' rapanasbillty fCW:dWi no es Na 38889 � rrtth the setback requlmmentu of the local r llmoo by dny�ont, other, n the told mortya N >saninq or�dlnono3u, and that no enchroachmw& i.' and (ts v i¢ti In k ectian kith lts proposed . � AECIS1ERi� �a of tilajoY' Mpf^oVemenb eitha�r way aarou� -mortgage. Anartic>�iq to Vald'rnartgagor. ���H�l LAN�6J property lines except as fin. �11Flc^rot� al. Property is not In a Road Hazard Area. PmpThin cwt t is, bossed on the locutlon of �y markers 1 Z Iftfat at it In a Flood kt % Area. of atheeu„ end dons not t�resgnt d prapWAy aKtvsy, therefore R ltttatttt®flan a (h>suttidfr to .siot,�ermtns Flood Hazard. as?f3ats showy are not to be psaed for the sstubilithm. ont of food Hazard det+ep Pen d> 't inat Poddrd flood property llnsst tn»arsranere Bette Map Partd� 2.98-bcoBG �,/alg3