HomeMy WebLinkAboutMiscellaneous - 104 BROOKVIEW DRIVE 4/30/2018 (2)r E eo7)Ma/M15/iU 7 &5 7x4sswerru5,5775
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00
Office /Use Only
Permit No_ / l
Occupancy & Fee Checkedc �
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the
(Please Print in ink or type all information)
Town of North Andover
Massachusetts Electrical Code 527 CM 12:9p��
Date `/
To the lnspdctor of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location (Street & Number L -U IoL /,� ;0z le) el- /J �Oti' k- y/ -C
Owner or
01
Owner's Address e C1 1 d i
Is this permit in conjunction with a building permit Yes No ❑ (Check Appropriate Box) �
Purpose of Building� Utility Authorization No. _707 V
Existing Service Amps Voits Overhead ❑ Undgmd ❑ No. of Meters /
New Service c�-O U Amps a 1 - Voits Overhead ❑ Undgmd 01.� No. of Meters L�
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
OTHER:
INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws
1 have a Current Liability Insurance Policy including Completed OpRpuons Coverage or its substantial equivalent YES = NO =
have submitted valid proof of same to the Office YES = - f you have checked YES please indicate the type of coverage by checking the appropriate box
INSURANCE = BOND = OTHER = (Please Specify)
(Expiration Date)
Estimated Value of I cal Work$ J vel L%
Work to Start ��G�$_ Inspection Date Resquested Rough Final
Signed under the Penalties of perjury:
FIRM NAME IWIC- iitP L ��dp✓r}!�k/-C �� p�A rCv-p�' �C//✓� (} LIC. NO.
Licensee L Signature '�dl��r (f T OC X Gc-.C. LIC. NO.
fBus. Tel No.
Address ga �UtH�� 5 h CJS i Irk 1 Alt Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts
General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one)
Telephone No. PERMIT FEE $�-
(Signature of Owner or Agent)
Total - -
No. of Light8ng Outlets
No. of Hot fuse
No. of Transformers KVA
Above ❑
In ❑
No. of Lighting Fixtures
Swimminq Pool gmd ❑
gmd ❑
Generators KVA
No. of Emergency Lighting
No. of Receptacles Outlets
No. of Oil Burners
Battery Units
No. of Switch Outlets
No of Gas Burners
FIRE ALARMS No. of Zone
No. of Detection and
Total
No. of Ranges
No of Air Cond
Tons
Initiating Devices
Heat Total Total
No. of 01poaal
No. Pumps
Tons
KW
No. of Sounding Devices
No./ of Self Contained
No. of Dishwashers
Soace/Area Hearing
KW
Detection/Sounding Devices
❑ Municipal ❑ Other
No. of Dryers
Heatinq Devices
KW
Local Connection
No. of
No. of
Low Voltage
No. of Water Heaters KW
Signs
Baiiases
Wiring
No. Hydro Massage Tuds
No. of Motors
Total HP
OTHER:
INSURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws
1 have a Current Liability Insurance Policy including Completed OpRpuons Coverage or its substantial equivalent YES = NO =
have submitted valid proof of same to the Office YES = - f you have checked YES please indicate the type of coverage by checking the appropriate box
INSURANCE = BOND = OTHER = (Please Specify)
(Expiration Date)
Estimated Value of I cal Work$ J vel L%
Work to Start ��G�$_ Inspection Date Resquested Rough Final
Signed under the Penalties of perjury:
FIRM NAME IWIC- iitP L ��dp✓r}!�k/-C �� p�A rCv-p�' �C//✓� (} LIC. NO.
Licensee L Signature '�dl��r (f T OC X Gc-.C. LIC. NO.
fBus. Tel No.
Address ga �UtH�� 5 h CJS i Irk 1 Alt Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts
General Laws. And that my signature on this permit application waives this requirement. Owner Agent (Please Check one)
Telephone No. PERMIT FEE $�-
(Signature of Owner or Agent)
N2 166'14
Date...
'AYMNY'N OF NORTH ANDOVER
PERMIT FOR WIRING
CULLEM "?
This certifies that ........................................................
. ........
Dhas permission to perform ...........................................................................
wiring in the building of ... .............
at ... -/ ....... / ..... C ......... ....... ................... . North Andover, Mass.
Fee ........ Lic. No.&//
............. ...............................................................
ELECTRICAL INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
3 1 2 0 Date. 3.:. /.. � ? ........
TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
S
This certifies that ..'S.c, ... l L.-�7 f .?l .. - ' . /......... • .
has permission for gas installation ..A/5 , �-c.-../7ios/; ,c..........
in the buildings of ..1�°c k ' T �
at �! `.! . /3!3 c c `.b' .`. ........ , North Andover, Mass.
Fee. 7'.r.'.. Lic. No..
03/09/99 12:12RRIsPECTOR /
r
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
C-1
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(Pflrtt tw Type) /
Date 0 19 ...�...-..
Building o Permit # 3 z
Location t 4H '�'`�� �`eQ -
Owner's
Name ev .nn Ieire�
1 Plans Submitted: Yes c3 No 0
a. y
+ ,l,� t pj` ,:�+ ��£ .3 �`a�.. '! k .i�. „t �fY'�' ":. Yk�� ay � v p t., �. �"'*•�.3` �#{� �# t
1 �i
Installing Company Name
Address
Check one:
❑ Corp.
❑ Partnership
\ ° IAt�: M a O.3 W6�4 p Firm/Co.
Business Telephone .... 1z. 3 M—YE7
Nome of Licensed Plumber or Gas Fitter
Certificate
INSURANCE MIRAGE: Check one
I have a current liability insurance policy or its substantial equivalent. Yes O No ❑
If you have checked yes, please indicate the type coverage by checking the appropriate box.
A liability insurance policy O Other type of indemnity ❑ Bond C7
OWNER'S INSURANCE WAIVER: l am aware that the licensee dotes not have the insurance coverage required by
Chapter 142 of the Mass. General Laws, and that my signature on this permit appiicotion waives this requirement.
Chetk one:
Owner D Agent 0
Signeiure of Owner or Owner's Agent
I hereby certify that all of the details and information 1 have submitted for entered) In the above application are true and oceureta to the tad of r
knowledge and that eB plumbing work and instsilatiore performed under the permit Issued for this opplieallon will be M campllance with all pertine
provisions of Mae Masad+nsstts State Gas Code and chapter 142 of the General laws.
Fee
Check #
Delle
APPROVED (Office Use Only)
Type of License:
q13 -lumber !L't
E3 Gastitter Signature of Licensed Plumber or Gases Fitter
0tllaster
E3 Journeyman License Number
5
4
z
W
yr
z
rZu
;
� i_..:i
I
BASFMErrr
1 S1' FLOOR
I
!
I
I
F-1
1
1 E
2Nd FLOOR
�`'
RID i°1.00R
R
mRR
r
I
I
I
1
1
I
I
��I
I
Installing Company Name
Address
Check one:
❑ Corp.
❑ Partnership
\ ° IAt�: M a O.3 W6�4 p Firm/Co.
Business Telephone .... 1z. 3 M—YE7
Nome of Licensed Plumber or Gas Fitter
Certificate
INSURANCE MIRAGE: Check one
I have a current liability insurance policy or its substantial equivalent. Yes O No ❑
If you have checked yes, please indicate the type coverage by checking the appropriate box.
A liability insurance policy O Other type of indemnity ❑ Bond C7
OWNER'S INSURANCE WAIVER: l am aware that the licensee dotes not have the insurance coverage required by
Chapter 142 of the Mass. General Laws, and that my signature on this permit appiicotion waives this requirement.
Chetk one:
Owner D Agent 0
Signeiure of Owner or Owner's Agent
I hereby certify that all of the details and information 1 have submitted for entered) In the above application are true and oceureta to the tad of r
knowledge and that eB plumbing work and instsilatiore performed under the permit Issued for this opplieallon will be M campllance with all pertine
provisions of Mae Masad+nsstts State Gas Code and chapter 142 of the General laws.
Fee
Check #
Delle
APPROVED (Office Use Only)
Type of License:
q13 -lumber !L't
E3 Gastitter Signature of Licensed Plumber or Gases Fitter
0tllaster
E3 Journeyman License Number
J
N2 2263 Date ..... ..A.f .. //..
TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
This certifies that ..... I ........ ...................
has permission to perform ......... k.:( ... .............................................
...... C R ...............................
wiring in the building of ...... .......
at ...... ......1 .: (?.fe. f. ............... North AndoverNass.
Fee ....... ........... Lic. No. ............... ..............
..... .........
EiLIE ICAL PECTOR
02/23/99 10:35 PAID
WHITE: Applicant CANARY: Building Dept. easurer
./ �• i #I A IN
BOARD OFFLREPREVEWON
Office Use only
Permit No. �3
IJO
Occupancy & Fees Checked
APPUCATTONFOR PERI ff TO PERFORM ==CAL 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
Town of North Andovei To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location (Street & Number) za / `), � e°� eXfjl",„/ � yy� `o, V
Owner or Tenant 6: %-, jt/ [ jre;V7 4" ?/'
Owner's Address e-11
Is this permit in conjunction with a building permit: Yes L� No u (Check Appropriate Box)
Purpose of Building pfd Cr"gA QZ-- 1i/4,J� Utility Authorization No.
Existing Service J vee, Ampsolts Overhead r7Underground " No. of Meters
New Service Amps / Volts Overhead ❑ Underground ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
�Jo. of Lighting Outlets
No, of Hot Tubs
No. of Transformers
Total
KVA
No. of Lighting Fixtures
Swimming Pool Above
Below
Generators
KVA
ground
ound
o. of Receptacle Outlets
No, of Oil Burners
No. of Emergency Lighting Battery Units
No. of 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
❑
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
r
OTHER
Ira arreCa,t� Ptast tothecagtmHna� ;sei�C�at�alLaws
Iha,veaauatLiabtbtyhmsanxPobymAdTCmpldcCoAmaWcr�sablatialegavaiert YES ❑ NO ❑
IhavesubrnthodmWptoofofsarnemtheOffKr- YES a If}cuhmetftedcedYES,pkasese5c@Wthetypecfcowra@ebydrdangthe
INSURxE
Al CE ❑ BOND ❑ MHR ❑ Pease Spe*
ETiratimLw-
% % Estm'at� Vahtec#f]earical Wodc $
WodcmSlatt ` ��/ � h> pecumDaleRpiested Rough
Sigreduttder�ieP�fies /
FIRMNAME
Fmal
Lio�TseNa %= g `'f -zoo
Lim
Bus ressTel. Na C,/sYjr- -?a /G
A' f-. a .+�.� .1 L AILTUNa
OWNER'SINSURANCEWAIVER, Iamawat dAtheLic=does�the i amlcecoke�txisabsLair�egivalatasm4medbyMassalxretCeeralLam
aodi"sg33�iecnt mpetappfimbmvrAstzcew*mTent C
(Please check one) Owner ❑ Agent ❑l — �Iv
Telephone No. PERMIT FEE $ J (/
Location
`No.
Date
i
NpRT1y
TOWN OF NORTH ANDOVER
0AL
9
Certificate of Occupancy $
+ ; ;
Building/Frame Permit Fee $ '
�'�s',•°•t<�'
s�cMus
Foundation Permit Fee $
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
4�
_-
TOTAL $
/QGO
%Building Inspector
r� 02/23/99 10:33 65.00 RAID
G
Div. Public Works
-1t
0m
1
00
-1t
0m
0
y
C
d
z
V,
>
V.
Y
V•
Y
Z
m
Z
m
Z
m
z
z
Z
��
z
z
c.
-
z(��
'�J
- l0
-
V-
z
V,
Z
D
�
v
m
oJ
m.
7
m
1
U
z
z=
J
V
A
Z
q
Y
z
z
T
p'
i
m
Z
'
-
�
C. "
(off
�1
z
z-
Q
^
^
m
D
)J
r
m
C
W
2
y
Z
z
�
"W
O
kA
o
N
v
C
_
MQ
Z
Z
7
�
^
=
�
vZzi
V
V
•�•'
r�1°
z
Z
Z
Z
_�
_
Z
Z
Z
C
m
m
m
D
?
r^
rr,
Z
�
ti
y
z
V
www
G,.
T
M -W
D
m
\�
_
I
z
o
e%
�
o
X
:j
N
L
A
a
�
z
0
V
i
� I ��ie G%azrzmzo�zrueall� a��-��izJJnc/ruJetlJ
DEPARTMENT OF PUBLIC SAFEfY
i CONSTRUCTION SUPERVISOR LICENSE
F
. Numberi _::.:.. Expires: Birthdate:
CS.,':t 665693.;'01/13(2000 01/1311954
Resthl ted Toi 00
I
i
DAVID fA': KINDRED
30 MILL POND POB% 531 1
N ANDOVER. MA 01845
156635
Restricted To: 00
00 - 35,060 cf enclosed space
(MGt C.112 S.60L)
I 1A Masonry. only
I 1G - 1 6 2 Family Homes
(� failure to possess a current edition of the
Massachusetts State Building Code 1
is cause for revocation of this license.
v.
C �
CO) Cl)
10 0
CD
n Z y
Cp O 'C
a. r �•
CU
O
d =• CO)
,00
v CD
CD o
CL
cr
c d CD
CD O CCD
C O V�•
CD
a O y
tG CCD
� v
y O
'CD Z
O
a O a
o
CD0
C
CD
O
b'
W-
�
I%
Crr7
1.3
CD C3 � z
rnO -• N c Q N
�1 O m O C-11, (7
A O
Cl d 2 m
0 z cc -4
, ^•' O '� m o M W
CD d m O y
m
-40
c=c, y C
O ? m m
> > m C .mei
o c H• co, �V
co • m -�
y ' O
a S
aim 1 :
CS
m m y
�o= c`
CD
y d y Q
5.
o c �V�a
a
CD d CO2 Cl)
N t
)
cos 0OW
m
Z
'
CD m
m ti m>
CD
CD
�CD::�
ate• : CL
o
o �
7
CA
1
0
m
�
z
z
^n
a
o
n
°
o
-p�'
o
n
ro
p
a
o
r
C)
rfj
O
?�
n
e
o
:0.
Ocn
C
z
cn
O
a
n
cC/)7C
rD
o
r)p
x
n
y
0
0
I
c Locatidn %O }� r- �r•ry2 �Z '
�j
No. � �7, � Date
rV `
f tORTq TOWN OF NORTH ANDOVER
a Certificate of Occupancy $
+ ; ; Building/Frame Permit Fee $ j
s�CMUs c <Foundation Permit Fee $��
-other Permit Fee $
r Sewer Connection Fee $
a >v , got Water Connection Fee $ /DgZ,cxJ
TOTAL $ r CD
BIII Ins e^ctgr,
4311. o
545. M PAID
fag,^ , GtC�
�.-b
Div.A5u6lic Works +
I
1 ;1
= 0 0
m
f0
H
A
nai
a y
m
O
O
ml
0I
c1 mm
r
r
r
N
.��
A
;I
i !
m
r
D"
C
C
>
0
z
ti
>
r
n
-r
oQ �
Z
n
Z-0
0
0
m
c
0
0
0
0
a
z
n
m
z
n
m
z
n
r°n
A
z
z
a
a>
a
m
L
0
>
r
°
z
0
i
0
z
0
r
0
A
0
a
i
0
>
0
Z
30
z>>
O
z
A
0
A
0
J
Z
>
0
o;
m
>
n
W
j
m
f
;
r
A
> > fan
fl 0 m
A m m
N - 0
r Z
r r m
0 0 0
i i a
IA a
_j _-4
0 0
z z
W a
W
N
A
a
m
r
n
0
7
A
A
g
E
Z
N
M
C
0
1
0
z
N
w
M
m
f0
H
w
'
>
of
•i
x
0
t�
D
N
GA
m
f
H
w
N
>
of
O
O
ml
>
0
0
r
N
m
r
C
C
C
>
i
>
1
>
ti
>
r
n
-r
z
Z
n
Z-0
0
0
m
c
0
0
0
0
a
z
n
m
z
n
m
z
n
r°n
A
m
n
z
a
a>
a
m
L
0
>
r
°
z
0
i
0
z
0
r
0
A
0
a
i
0
>
0
Z
z>>
O
z
A
0
A
0
Z
>
0
o;
m
>
n
r
-f
O
0
m
f
;
r
z;
A
z
m
m
y
fill
Z
x
>0
_i
0
i
i
A
m
•�
`I.
o
>
•1
0
Z
r
m
i
Imll
A
jm
0;
Z
W
Z
,�
c
4
r�
ul
r
?
0
V
a
I
o
C'
z
C
0
+�
>
n
0
a\
W
H
O
a
el
Z
<z
c
in
m
`s
v
rl
z
t
4z>
o
-A
a
2
a r.►
c
z0
y
0
Q
a
^l
^f
n
n
A
lij
O
0
m
0
Z
A
m
>
0
A
a
m
a
a
m
a
>
N
m
o
9
C
N
m
>
Q
m
N
m
m
m
=
Z
Z
A
m
A
r
0
r
0
r
0
r
0>„
A
0
i
0
a
0
w
„
m
z
m
to
A
t,
p
m
Z
0
Z
0
2
O
z
0
r
0
0
0
'n
r
z
a
r
0
i
0
0
A
w
r`
i1
0
o
o
o
Z
n
z
0
c
0
A
A
a
w
c_
%,
m
O
z
Z
z
z
Z
z
0
0
x
a
0
z
0
9
0
a
^C
i
;
>
r�
a
0
m
n
n
i
i
n
r
a
z
>
X
m
0
a
r
a
m
z
0
m
'0
i
m
O
m
0
A
p
z
z
a
z
a
0
t?
Z
0
0
0
r
4 t
m
>
0 0
0q
r
.6
c�f
Z
z
U
�\
m>
z
y>j
Z
x
i
0
y
�.
">
m
x
M-1
111
�
W
;K
O
m
I
y
V
10,
0
c�
0\
'*
(
m
•i
x
0
t�
D
N
GA
m
tm
160
I ✓�ie 'Lnamnaarzureall� n� ;��J:faGt.UJefIJ li
f
DEPARTMENT OF PUBLIC SAFETY
CONSTRUCTION SUPERVISOR LICENSE
_ Number ;., Expires: Birthdate:
CS ;..;905693 �01/13/2000 - 01/13/1954
Re5tri6ted To: 00.
DAVID A'" KINDRED
30 MILL POND POB% 531 1
N ANDOVER, MA 01645
4
156635
Restricted To: 00
t
00 - 35,000 cf enclosed space
(MGL C.112 S.60L)
l
IA - Masonry. only
1G - 1 6 2 Family Homes
Failure to possess a current edition of the
Massachusetts State Building Code l
is cause for revocation of this license.
N
Growth Management Bylaw Exemption Statement
Town of North Andover Building Department
This form shall be used to assist the Building Department 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 on Building Permit (below) Address of Property for Permit (below)
A1CUQL'11tiW 611',vTel #d ie $
Map and Parcel: P poseo(Application (check below)
Pho�ng Number f Applicant: - _ Single Family Two Family
—'ASs1 —
I the undersigned applicant for the above property attest that the attached building permit for which this
form is completed 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 Building Permit.
Further I understand that my interpretation of the EXEMPTION status is subject to review by the Building
Department and is only officially accepted when the Building Permit iq issued.
Based on 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.
9 The lot(s) were/was created prior to May 6, 1996 are exempt from the provisions of this Section 8.7 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."re met and/or represents Dwelling units for senior residents, where occupancy of the units is
restricted to senior persons through a properly 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 40% 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 acres 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.
adjThis application represents a tract of land existing and not held by a Developer in common ownership with an
acent parcel on 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 on 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 time 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
knowle o ot, is ground r tusal bthe Building Department to issue a Building Permit.
2 2
ig re o Owner or AuthorTzed Agent who signed _t7e Attached Building Permit Da tfa
This form must be attached to the Building Permit upon application for such permit.
FORM U - IAT RELPI ' 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: 600 ru/. e ed vw J ---'0Z' Phone
LOCATION: Assessor's Man Number Parrim 1
Subdivision 'Re"61rW 7-,1 -7-e- $ Lot (s)
Street ,Poo (r&-, e /�E'iu St. Nu-.=er
x*tOfficlal
RECOMHENDATI NS/'OF TOWN AGENTS:
d
C0 S on Ad.._. istrazcr
Cc=erz- j / �OJ� �o K
Use 0nly*******************w****
Date Approved
Daze Re; ec ted
6W±A�� ca�(A Date Aunroved q qt
Town Planner Daze Re;eczed
Ccnr er. is
Food n-zeoz„_ --ea 11.-h
Co-..........._
Daze Auoroved
Daze Re-iec=ed
Date Appro•.,e•d
Daze Re,ecz=_
WcirL:s - sel:ier, Water connec.._ons
Fare De=ar,=e.^.z a
Received by Building Inspector Daze
H° 801
APPLICATION FOR WATER SERVICE CONNECTION
North Andover, Mass. P �` fi 19
Application by the undersigned is hereby made to connect with the town water main in
subject to the rules and regulations of the Division of Public Works.
The premises are known as No. / G ei l�j /y� ��-
Street
or subdivision lot
lot no. I L
Owner
Contractor
6ee - 5g
R9 �c �4A
Address
Addr s c
Ap 'cant's Signature
PERMIT TO CONNECT WITH WATER MAIN
The Board of Public Works hereby grants permission to L/[eu) co C//?
to make a connection with the water main at roc? �y (-'e tt) �- UQ�
subject to the rules and regulations of the Division of Public Works, Street
Inspected by
Date
Board of Public Works
By
1(2
See back for rules and regulations
RULES AND REGULATIONS GOVERNING THE INSTALLATION OF WATER SERVICES
1. No persons shall tap or in any way tamper with water mains which are part of the distribution system of the Town
of North Andover without a valid permit from the Division of Public Works.
2. All water services shall be installed a minimum of five feet below the finish grade.
3. No water services shall be backfilled without inspection by a representative of the D.P.W.—Telephone 687-7964.
4. Service connections shall be 1" type k copper tubing.
5. All fittings shall be brass flange type Mueller or equal
H 15202 Corporations
H 15212 Curb stops
H 15402 Three part unions
H 8185 stop and waste valves
6. Curb boxes shall be installed at the property line and shall be of the Erie Type with 41/2 foot rod and brass plug
type cover.
'1D0'JER, P:1ASSA+ '' JSE' 7S
DIVISJO'N' OF PUBLIC WORKS
384 OSGOOD S iREET, 01845
GEORGE PERNA Telephone (508) 685-0950
DiRECV)� Fax (508) 688-9573
15 ACP IH 9
io
1? O
• c
4SSAc`NUSEt
DRIVEWAY PERMIT
Date:
LOCATION:
BUILDER: phone:
OWNER: 6cookvt'ej �o,,4 phone:
The North Andover Superintendent of Highway Utilities & Operations MUST be notified of the
grade and set—back from street established in any driveway entry onto any street or way maintained by
the TOWN. Call the Highway Superintendent's Office, before finish grading and surfacing for approval
of such entry.
FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT.
■ Remarks:
Approval:
v
H
C �
ca CM)
CD
O Z y
CL O �•
w, C
O
CL CO)
a�
� o d
o v CD
CDCL
O
Q
CD
CD O CD
O CD
co.
a v ,CA
—• O
O ,)
t0
CD
v
y O
CD
o CD
C
CD
cn
VJ
n
O
cn
O
C
C 2:21 O
Ot
=
�='�''
W O Q
FO So
to
y
S
m CaC
�
m
Z
y �
' ?m
N
a'
�
�.
,',• w m
rn
o
T
CL
\
� CL
�� m d
o
y
o
CA
IEmm
m
a
O
�0 O
CS
O
O y C'!
CD.
C
?O %:
W
fG
On Er :
r�
O O ti
co
1
C
0 CD
d
N
{�
dCL
Q
1
N
H
CD
co) �
A
y
A
cy
w y
V
A
O Cc)
_T
+►
.0
TV
0.
CD
St
N
�
,o
C;
�q
CL's
0
c=
�='�''
v ,
�
5
ot •1 .f
ro
�='�''
v ,
5
ot •1 .f
ro
�='�''
�
�°'
�
p
�,
C
`�°'
r
C/I
�'
a'
�
4oa••
w
o
Gd
C
C
�
yg
CL
\
x
CS
O
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING
(Print or Type)
l NORTH ANDOVER Mass. Date���
4uilding Location 12(OY�loax[/re�✓ ksc4r•_5 Permit
•� Owners Name d�a/
/t ,'e
• New novation Replacement Plans SubmittedEl
FIXTUPFS
(Print or Type)
Installing Company Name #4,14A -e,1
Address /�-Y IJ, 'nnnA,,-
Business Telephone:
Name of Licensed Plumber or Gas Fitter
Insurance Coverage
appropriate box:
Liability insurance
Indicate the type of
policy&T--Other type
Check one: Certificate
Q Corp.
Partner.
�6rm/Co.
insurance coverage by checking the
of indemnity 0 Bond 0
Insurance Waiver: 1, the undersigned, have been made aware that the licensee of
this application does not have any one of the above three insurance coverages.
Signature of owner/agent of property Owner ❑ Agent El
1 hereby certify that all of the details and information 1 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 Massachusetts State Gas Code and Chapter 14I of tho General Laws.
By
Title
City/Town:
APPROVED (OFFICE USE ONLY)
TYPE LICENSE:
Plumber
Gasf' r ignature of Licensed
M ter P10 Qr Gasfitter
ourneyman l G-
License Number
V
•
■rrrr
ONE
rrrrME
rrrrrrrrrrr■
rrrrrt�rr�r�rrrrrrrrrrrrrrrrr
..
nrrrrrrrr�rrrrrrrrrrrr�rrrr■
. 29 -DI;
rrrrrrrrrrrrrrrnrrrrrrrrr
Inall...
rrrrri�rrrrrrrrrrrrrrrrrrr■
.. -
■rrrrrrrrrrrrrrrrrrrrrrrr■
...
■rrrrrrrrrrrrrrrrrrrrrrrrrr
. ...
■rrrrrrrrrrrrrrrrrrrrrrrrr.
...
■rrrrrrnrrrrrrrrrrrrrrrrr
..-
rrrrrrrrrrrrrrrrrrrrrrrrr■
(Print or Type)
Installing Company Name #4,14A -e,1
Address /�-Y IJ, 'nnnA,,-
Business Telephone:
Name of Licensed Plumber or Gas Fitter
Insurance Coverage
appropriate box:
Liability insurance
Indicate the type of
policy&T--Other type
Check one: Certificate
Q Corp.
Partner.
�6rm/Co.
insurance coverage by checking the
of indemnity 0 Bond 0
Insurance Waiver: 1, the undersigned, have been made aware that the licensee of
this application does not have any one of the above three insurance coverages.
Signature of owner/agent of property Owner ❑ Agent El
1 hereby certify that all of the details and information 1 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 Massachusetts State Gas Code and Chapter 14I of tho General Laws.
By
Title
City/Town:
APPROVED (OFFICE USE ONLY)
TYPE LICENSE:
Plumber
Gasf' r ignature of Licensed
M ter P10 Qr Gasfitter
ourneyman l G-
License Number
2053 Date
ra
&ORT#1 TOWN OF NORTH ANDOVER a
0
PERMIT FOR GAS INSTALLATION
cc
This certifies that ................ ........ ...
./;o .....
has permission for gas installation ............... R
in the buildings of
at ....... North Andover, Mass.
Fee. ..... Lic. No�f�1,9 ... ..........................
GAS INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
CERTIFICATE OF USE & OCCUPANCY
Town of North Andover
Building Permit Number 67
THIS CERTIFIES THAT
THE BUILDING LOCATED ON 104 Brookview Drive
Date July 15, 1998
MAY BE OCCUPIED AS Single Family Home IN ACCORDANCE
WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND
SUCH OTHER REGULATIONS AS MAY APPLY.
cq "O oT CERTIFICATE ISSUED TO Brookview Country Homes
PO Box 531 >. Andover MA 01845
ADDRESS
u in pector
v
O
FMM4
N"
;Mmm
LLJ
Z4 am
O
E
"N"
O
0
v E
u
p
or.
w
\
O
a
S 2
a
w chi
v
0
w° °
U G
O
a
O
° G
a4
z
°
�•. cn
H
O O
�E
m m
CD
cn
;Mmm
LLJ
Z4 am
O
E
O
�
w
Z
a)
a
O
y
C
I
CD CM
O
CD
._
H
O O
�E
m m
CD
0 CD
a�
CD
CD
L
o
m
a
CL
a
�
� C
C2
O
•d
Oam
..
cCDy
Z
V
t/�
C
C
CL
CO2
% -46"1
MASSACHUSETTS UNIFORM APPLICATION FOR PE
ype or print)
NORTH ANDOVER, MASSA SETT'S
Dunding Locations 6� �� dS' �/I,itt., Pte' X57 -f'c S
/&&V/f- �/(Q ` t -, fr`-�5 Owner's Name
New_ Renovation M Replacement 0
FIXTURES
Plans Submitted L
TO DO PLUMBING
Date �11,
Permit #�-3 (�,
Amount 777 %_
(Print or type)^ t � Check one: Certificate
Installing Company Name ��Utlt P� TZ , 'nre S H 11 Corp.
�b
Address 4 (�-y ri T)eitZ,!:�: /\1 & C12,%,3,&- Partner.
Business Telephoney3- �s�3 - 2 7 Y /
Name of Licensed Plumber:
Insurance Coverage: lndica the type " surance coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity Bond ❑
Insurance Waiver: 1, 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 F1
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 installs ions performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massach to Pring Code and Chapter 142 of the General Laws.
By:ure o icense um er
Type of Plumbing License
Title ' 3�?aCity/Town kenser Master Journeym a4a
APPROVED (OFFICE USE ONLY
t., o, . mmmmmmmmmmmmmmmmmmmmmmmmm
t,-mmmmmMMMMMMMMMMMMMMMMMMMM
MMMMMMMMMMMMMMMMMMMMMMMMM
F1,17AI:
.,:mmmmmmmmmmmammmmmmmmmmmmm
�,•MMMMMMMMMMMMMMMMMMMMMMMMM.
(Print or type)^ t � Check one: Certificate
Installing Company Name ��Utlt P� TZ , 'nre S H 11 Corp.
�b
Address 4 (�-y ri T)eitZ,!:�: /\1 & C12,%,3,&- Partner.
Business Telephoney3- �s�3 - 2 7 Y /
Name of Licensed Plumber:
Insurance Coverage: lndica the type " surance coverage by checking the appropriate box:
Liability insurance policy Other type of indemnity Bond ❑
Insurance Waiver: 1, 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 F1
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 installs ions performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massach to Pring Code and Chapter 142 of the General Laws.
By:ure o icense um er
Type of Plumbing License
Title ' 3�?aCity/Town kenser Master Journeym a4a
APPROVED (OFFICE USE ONLY
142 - 3693
t MORTM
O A
,SSACNUS�
Date!, :o?�
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that ...................
01
has permission to perform --�.--../ .......
plumbs/ng to th6bb' dtngs of ........ / ......... -" .
`.................at...North Andover, Mass.
Fee-`.Lic. Na--�3.7�� ..... ..........................
PLUMBING INSPECTOR
04/30/98 14:28 339.00 PAID
WHITE: Applicant CANARY: Building Dept. PINK: Treasurer
E`4 3959
Date3.-.
3:. ...� . .
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
This certifies that�..� ............
has permission to perform ... . F t'`..f1 c, `: S ...............
plumbing in the buildings of .. G'/?.���;�".
at.,North Andover, Mass.
Fee o2.� �� .. Lic. No. ��.... ...\'
PLUMBING INSPECTOR
WHITE: Applicant 12gfPARY: Bui$5gfhept�ID PINK: Treasurer
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Print or Type)
NQ �P.t• , Mass. Date L._.� 14! '
City, Town Permit #
Building t�ff O owner t
W. AT: Location �, �.� GcruV fit„ Name
Type of t) CllJ)anr:Y:_»__
New ❑ Renovation Replacement
Plaits ❑
FIXTURES Submiti.et:1: Yes ❑ No
(Print or Type)o
Installing Company Name. ❑ Corp. _
Address
❑ Partnership
_ '�JtS .,�, i(�,f�} b�'Gs ❑ Firm/Company
Business 'Telephone G���sYS 7 Name of Licensed Plumber or Gaslitter
Certificate
1 hereby certify that all of the details and information t have submitted (or entered) in above application arc 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
previsions of the Massachusetts State Gas Code and Chapter 142 of the General Laws.
I have informed the owner or his agent that I do not have liability insurrnce including completed operations covtragc.
SiSmime at Owned Agent
I have a current liability insurance policy to include completed operations coverage. ❑
4-1
By
Title
City Down
APPROVED (OFFICE USE ONLY)
Signature of Licensed Plunther
Type of I'lumbi g license
2 Master ❑ Journeyman
License Number
Y
ZN
Z
W
H
N
to
W
O
V
Z
0
0
W
CC
W
IC
W
N
SL
Z
N
J
4
th
Q
C
h
a
O
a
a
IL
OC
<
W
CA
INC
to
d
d
d
au
d
K
X
a
m
RICCC
W
w
Y
a
s e+
x
a
u°Ci
x
a
x
W
3
19
a
a
z
>?
:x
o
r z
x
d
w
u
x
m
U
y
h
o
x
a=
N
t
x
a
0
0
W
r
o
v
x
X
J
(d
YJ
o
a
J
=
f-
to
fL
O a
O
Oe
M:0
sus—BS IIT,
BASEMENT
1ST FLOOR
kit
2ND FLOOR
3RD FLOOR
4TH FLOOR
STN FLOOR
6TH FLOOR
7THYLOOR
8THFLOOR
(Print or Type)o
Installing Company Name. ❑ Corp. _
Address
❑ Partnership
_ '�JtS .,�, i(�,f�} b�'Gs ❑ Firm/Company
Business 'Telephone G���sYS 7 Name of Licensed Plumber or Gaslitter
Certificate
1 hereby certify that all of the details and information t have submitted (or entered) in above application arc 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
previsions of the Massachusetts State Gas Code and Chapter 142 of the General Laws.
I have informed the owner or his agent that I do not have liability insurrnce including completed operations covtragc.
SiSmime at Owned Agent
I have a current liability insurance policy to include completed operations coverage. ❑
4-1
By
Title
City Down
APPROVED (OFFICE USE ONLY)
Signature of Licensed Plunther
Type of I'lumbi g license
2 Master ❑ Journeyman
License Number
h
v