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HomeMy WebLinkAboutMiscellaneous - 109 CHADWICK STREET 4/30/2018 109 CHADWICK STREET 210/080.0-0001-0000.0 I Of NORT1y, oc 10 TOWN OF NORTH ANDOVER APPLICATION FOR PLAN EXAMINATION ,SS.ICHU`�E� Permit NO: , Date Received: �'• d Date Issued: IMPORTANT: Applicant must complete all items on this page LOCATION �/_1 9 ad &V/C/< S ,71 Print PROPERTY OWNER Pri t MAP NO.: PARCEL: ZONING DISTRICT: TYPE AND USE OF BUILDING HISTORIC DISTRICT YES ❑ TYPE OF IMPROVEMENT PROPOSED USE Residential Non- sidential 11 New Building Re ❑One family ❑Addition eTwo or more family ❑Industrial ❑Alteration No. of units: Repair,replacement ❑Assessory Bldg ❑ Commercial ❑Demolition ❑ Moving(relocation) ❑Other ❑ Others: ❑Foundation only DESCRIPTION OF WORK TO BE PREFORMED s. Identification Please Type or Print Clearly) OWNER: Name: � � -7- hone: _6f0 Signature Address: CONTRACTOR Name: Phone: Address. s �� Supervisor's Construction License:(S, �� � Exp. Date: / �! dg- #JI Home Improvement License: Exp. Date: ARCHITECT/ENGINEER Name: Phone: Address: Reg. No. FEE SCHEDULE:BULDING PERMIT:$10.00 PER$1000.00 OF THE TOTAL ESTIMATED COST BASED ON$ 25.00 PER S.F. Total Project Cost :$__ 7220 x10.00=FEE:$ Check No.: a2 t Receipt No.: /-bZ- Page I of 4 1 TYPE OF SEWARGE DISPOSAL Swimming Pools701 ❑ Tanning/Massage/Body Art ❑Public Sewer ❑❑ Tobacco Sales Food Packaging/S Well El❑ Permanent Dumpster on Site Private(septic tank,etc. NOTE: Persons contracting with unregistered contractors do not have access to the guaranty fund Signature of Agent/Ownezg:: r Signature of Contracto Plans Submitted ❑ Plans Waived ❑ Certified Plot Plan ❑ Stamped Plans ❑ THE FOLLOWING SECTIONS FOR OFFICE USE ONLY INTERDEPARTMENTAL SIGN OFF-U FORM DATE REJECTED DATE APPROVED PLANNING & DEVELOPMENT ❑ ❑ ❑Water Shed Special Permit ❑ Site Plan Special Permit ❑ Other COMMENTS DATE REJECTED DATE APPROVED CONSERVATION F1 El COMMENTS DATE REJECTED DATE APPROVED HEALTH ❑ ❑ COMMENTS -1 Zoning Board of Appeals:Variance,Petition No: Zoning Decision/receipt submitted yes Planning Board Decision: Comments Conservation Decision: Comments Water&Sewer connection signature '&/date Temp Dum�p�s�ter o�site yes_no k Fire Department signature/date Building Setback(ft.) Front Yard Side Yard Rear Yard Required Provided Required Provides Required Provided DIMENSION Number of Stories: Total square feet of floor area,based on Exterior dimensions. Total land area, sq. ft.: NOTES and DATA—(For department use) I J Page 3 of 4 Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Crewed 1MC.Jan2006 Building Department The following is a list of the required forms to be filled out for the appropriate permit to be obtained. Roofing, Siding, Interior Rehabilitation Permits ❑ Building Permit Application ❑ Workers Comp Affidavit ❑ Photo Copy Of H.I.C.. And/Or C.S.L. Licenses ❑ Copy of Contract ❑ Floor Plan Or Proposed Interior Work Addition Or Decks ❑ Building Permit Application ❑ Surveyed Plot Plan .� Workers Comp Affidavit l { ❑ Photo Copy of H.I.C. And C.S.L. Licenses ❑ Copy Of Contract ❑ Floor/Crossection/Elevation Plan Of Proposed Work With Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Mass check Energy Compliance Report (If Applicable) New Construction (Single and Two Family) ❑ Building Permit Application ❑ Certified Proposed Plot Plan ❑ Photo of H.I.C. And C.S.L. Licenses ❑ Workers Comp Affidavit ❑ Two Sets of Building Plans (One To Be Returned) to Include Sprinkler Plan And Hydraulic Calculations (If Applicable) ❑ Copy of Contract ❑ Mass check Energy Compliance Report In all cases if a variance or special permit was required the Town Clerks office must stamp the decision from the Board of Appeals that the appeal period is over. The applicant must then get this recorded at the Registry of Deeds. One copy and proof of recording must be submitted with the building application Doc:INSPECTIONAL SERVICES DEPARTMENT:BPFORM05 Page 4 of 4 Location No. Date K f 14ORT4 TOWN OF NORTH ANDOVER 3 _ o� s a ^° ; • Certificate of Occupancy $ Building/Frame/Frame Permit Fee $ 3ACHust 9 Foundation Permit Fee $ Other Permit Fee $ TOTAL $ � Check # Building Inspector NORTH '9 TO" Oft Andover N o. 1l C, Oover, Mass., � T COC MIC ME WICK y^ ARRA TE D PPS\ ,�� `S BOARD OF HEALTH I Food/Kitchen PERMIT T , Dr Septic System � ��..��. BUILDING INSPECTOR THIS CERTIFIES THAT./.. . . .���....CA10. ......1... ..................................... Foundation has permission to erect........................................ buildings on .. a¢.. .t ........... .. .... ........ W Rough to be occupied as....... ... . .. .... ........ ........ t.I.�. .. .......e�_f Chimney ...... .........arovided that the person accepting this permit shall in every respect conform to the terms of the apps' tionile in Final this office, and to the provisions of the Codes and By-Laws relating to the specton, Alteration and Constructi of Buildings in the Town of North Andover. S� PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. ' Rough Final PERMIT EXPIRES IN 6 MONTHS '0' ELECTRICAL INSPECTOR UNLESS CONSTRUCTION TS Rough bd - �.. Service WING INSPECTO. Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done TIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. i it d.r, t g° Y � h " � dr wnh ,t �^{''S�t ti a;••,g'� "SN �i'"M:TM n�Fy .-.q � i�;., �µ ;Pu, t( Jd AJ 770 ' I Lf J 1� �! 1 o- Q s�IT Aol r i � b/� ✓fze toomznta�uuea/�i o�✓vuraaac�tuael�b BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 018403 Birthdate: 04/01/1951 Expires: 04/01/2006 Tr.no: 23474 Restricted: 00 FRANK A ROSSI 20 CYR DR LAWRENCE, MA 01843 Acting C mis oner I' Page 1 of 1 r• v� urxve,,m \ M3 3 a a a �^ `-4 77 . ...... -71 F! a a P + 109 -111 CHADWICK STREET http://csc-ma.us/NandoverPubAccftmg/iMG0002.CPC/00020070.JPG 2/26/2006 Page 1 of I 25 S9 PIP'q1 13 U"0.35/FU/B/FM 1413 Sq.R. 15 54 10 18 is P/P Z 7 105 Sq.Pt. httrr//c-,c-ma.ii,; NandnverPlihAcc/gervletlshnwSketchVector?size=500&flcnrs=a&gketch=lT*0.35f3VF... 3/13/2006 j Date. HORT1y 3? O TOWN OF NORTH ANDOVER 9 • PERMIT FOR GAS INSTALLATION �1S SACH This certifies that . . . . . . . . . ... . . has permission for as installation'. . .-.� . P g �� G ` . . . . . . . . . . . . . An the buildings of i>.` . . . . . . . LL_. . . . . . . . . . . . . . . . . . ... . . ate :.®v . . . . . . ?lu: `` . ' TNorth j ndover, Mass. Fee. ``7r . Lic. No.. . . . . . . . . . . . :._ . Check# . . . .t�:`. GAS INSPECTOR�� ��� v 6 ii Z4,. 6 MASSACHUSETTS UNIFORM APPUCATON FOR PERMIT TO DO GAS FITTING (Type or print) Date o� 8 NORTH ANDOVER, MASSACHUSETTS Building Locations 7 "—� � .UI Permit# G4/4/G Amount$ .5 Owner's Name New Renovation Replacement Plans Submitted 14 � w W I - .wa m w [r r Z0 VI , c a F �• V w x Z E- a a > d w w v. d x x a w A H Z > Q a ' E, yr Z p F w F w w > w z c z o x d x o x 3 c a ° � > z a H o SUB-BASEM ENT BASEMENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . FLOOR 6TH . FLOOR r 7TH . FLOOR 8TH . FLOOR i (Print or type)/+ DIV Check one: Certificate Installing Company Name '"�. Lu /1/ UC, u p0 Corp. Address O f ! O Elci � �oZ a. Partner. usmess a ep one — p . 10-7Q, Firm/Co. Name of Licensed Plumber'or Gas Fitter INSURANCE COVERAGE Check one: '*have a current liability Insurance,policy or it's substantial equivalent. Yes ©'� If you have checked es lease indi the NO �,p type coverage by checking the13 Liability insurance policy Other type of indemnity appropriate box. Bond 13 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. Check one: Signature of Owner or Owner's Agent Owner 13 Agent 13 hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachuse State Gas Code and Ch ter 142 of the General Laws. By: S' nature of Licensed Plumber Or Gas Fitter Title Plumber City/Town, [3Gas Fitter License Number Mr-master APPROVED(OFFiCE USE ONLY) Journeyman 1 ,Yi ,ni 'V V Date yy 1,o J i !�.4............... 1 riORTF� °f<�``°:•1"° TOWN OF NORTH ANDOVER S PERMIT FOR WIRING � '•'•,TIG��"� �SSAcMusE� This certifies that T� �` ,= �.� � '2 ` ......: .....................}............. ......................................(.......... h`�14 � ' Q �/ C 1 ,2 C l 11 1 has permission to perform ...... ....... !. ..J............../......................................... Lzk wiring in the building of.... ..... �..... ..:�..✓. /Z.1 ............................ ST at.... ......................................................... .. . od r,Mass. vJ Fee....3v.:. .... Lic.No, 43.73 3...... .. ..................... /�`LECTRICAL INSPECTOR Check # ' 3� �/ WHITE: Applicant CANARY: Building Dept. PINK:Treasurer oz \t _ C'MrAon"111114 o�/I/addac�udelfd cc�� Official Use Only 2epartmed o`,}ire serviced Permit No._ oC BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev, 11199] (leave blank) ��— APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WOR All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYI'G:ILL iNFORVIATION) Date: City or Town of: To the Inspector of Wires: By this application the undersigned gives notice of his or her inteAwi;:n to perform the electrical,work described below. Location (Street SC Number) Owner or Tenant _ � / � 10r Telephone No. Owner's Address 57- Is 7Is this permit in conjunction with a building permit? yes ❑ No Purpose of Building (Clceck Appropriate Box) _ 2 �,l/t7/L �/ Utility Authorization No, Existing Set-vice Amps / 1'olts Overhead ❑ Und°ru ❑ leu.of Meters . New Service Antps / Volts Overhead ❑ UlldgrdNo,of tInrPrc' Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: LG S C/2Cu/T S T Completion o0he follouinQ table may be waived by the hts cctor of►Vires. No.of Recessed Fixtures No.of Ceii.Susp.(Paddle)Faits No.of Total Transformers "A No. of Lighting Outlets No.of blot Tubs Generators KVA No. of Lighting Fixtures Swimming Pool Above ❑ In- ❑ 1 0.o mergency-Lighting g °rnd• rnd. Battery Units No.'of Receptacle Outlets No.of Oil Burners FIRE ALAILIIS No.of Zones No.of Switches No.of Gas Burners 2 (-Ed,�j� Yo•of Detection and Initiating Devices No. of Ranges No.of Air Cond. Tot Tons al lvo,of Alerting Devices No.of Waste Disposers Heat Pump Number "Tons_ KW No.of Self-Contained Totals: ._ - -- Detection/Alertin°Devices No. of Dishwashers / Space/Area Heating KW Local 11CtiIunicipal Connection Other t No. of Drvers Heating Appliances K�j: Security Systems: No. of Water No.of Devices or E uivalent KW i`o.Si \o.as Data Wiring: I-Ieatcrs Sins Ballasts b• No.of Devices or'ruivalcctt No.Hydromassage Bathtubs No.of Motors Total IIP '1'elecontmunications Wiring: No.of llevices or E uivalent l0 T B.ERZ: Attach additional detail f desired,or as required by the Inspector of(Vires. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may isaue unless the licensee provides proof of liability insurance including"completed operation"covers,=e or its substantial equivalent. 1'lte undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURE\NCE 9 BOND ❑ 91.1-IER ❑ (Specify:) T7A!/1�u��.i /// (E.xpiration Date) Estimated Value of Electrical Work:* (When required by municipal policy.) Work to Start: Inspections to be requested in accordance v6di MEC Rule 10,and upon completion. I cet•tif}•, tinder the pains and penalties of perjuq•,that the information on this application is true and completer. FI1L'NI NAME: LIC.NO.: Al -' Licensee: SIR.R. i%V /� i/"�,e Signature L1C.irO.: (If applicable, ezzter '•exempt"in the licence numb lige.) Bus.Tel.No.:6,fr3 -irk Address: S�ej n-11c/ee'e//1lc /�.b /9��rJ�:t� Alt.Tel.No.: OWNER'S INSURANCE. WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below, I hereby waive this requirement. I am the(check one) ❑ owner ❑ owner's agent. Owner/Agent Signature "Telephone No. I'1:R:1fIT FL•.L•': S Date. . ` . . . .. . . .`. No J NORTH TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACNUS� This certifies that . . . . ... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . . . . . . . . . . . . . . . . . . at . . . . r. . . . . .�. . ... ... . ... . . . . . . . . . . . ., North Andover, Mass. Fee. . . :. . . . .Lic. No..? :. r. . .1. . . . . . . . . . .. . . . . . J. . . . . . . . . J PLUMBING INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FO RMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date S�2� f 60 Building Location /'0 °/ C�/�Oc✓i t�/l $�Owners Name `j.�/T{�✓ �/}i"7 {� Permit J�— Amount Type of Occupancy G l j i Nc New ri Renovation Replacement ® Plans Submitted Yes ElNo ny FIXTURES W`+ 04 mi a x a w d W z w A d a pG 9z r4 rA HCN ZZ a A x �lA A a dC 99 M1 C EA SLRER 9C BASBM X M HJOO[Z M HDM 3M HIM 01 HLM SM 11aR 6TH ROM 7IH FIDOR SIH FIDCR (Print or type) Check one: Certificate Installing Company Name J&/J044^-1 Corp. Address P 0'. Q 0 r-- S-72— Partner. Business Telephone 6 6�'�SD rf Firm/Co. Name of Licensed Plumber. Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy [- Other type of indemnity M Bond ❑ Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts to rlumbing Code and Chapter 142 of the General Laws. By: Signa of Licensea rlumSer Type of Plumbing License Title a4$ ?3 City/Town License Numoer Master Joumeyman APPROVED(OFFICE USE ONLY Date... e.. ... . ......... ,�ORTN TOWN OF NORTH ANDOVER 0 pp PERMIT FOR GAS INSTALLATION SSACHUSEt This certifies that . . . . . . . . . . . . . . . . . has permission for gas installation . . . . .'. . . . . . . . . . . . . . . . . . . . . in the buildings of . . . .. . . . . . . . . . . . . . . . . . . . . . . . . at . . .�%. . .: . . . . . . �.�':. . .: . . . . . . . . . . .. North Andover, Mass. Fee. . . I. . . . . Lic. No.1. `Q . . . . ; . . . . . . GAS INSPECTOR �. WHITE:Applicant CANARY:Building Dept. PINK:Treasurer NNE 1 � MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTING Type or print) D e5�� Z r®Q w 2 o o p NORTH ANDOVER, MASSACHUSETTS Building Locations /0 Permit# / Amount S l `i /I�,+IreN G_}/'9,5go/!T Owner's Name = � New❑ Renovation ❑ Replacement M Plans Submitted G y rA Cn _J1 A y = n Z C Z =t - =r - :. n = Z C - t z SUB -e:>, SENI ENT xn HASE .-M ENT 1sT. FLOG R 2ND . FLOUR 3RD . FLOOR Tr if FLOG R ST if FLOOR 6T 11 . FLOOR 7T 11 . FLUOR ST If F1, 00R (Print or type) Check one: Certificate Installing Company Name HA110n4,-,1 PW.,tdia!iC ❑ Corp. Address o. 3 z3K S WL ❑ Partner. W R .v ce M . 019` Z— Business Telephone F-1 Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ® No❑ j If you have checked yes,please indicate the type coverage by checking the appropriate box. r, Liability insurance policy ® Other type of indemniry ❑ Bond ❑ :I 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. Check one: ❑ Signature of Owner or Owner's Agent Owner ❑ Agent 1 hereby certify that all of the derails 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 pertormed under Permit Issued For this application will be in compliance with all pertinent provisions of the Massachusetts State Gas /�Code and Chapter 143 of the General Laws. Bv. Signature of Licensed Plumber Or Gas Fitter Title ❑ Plumber A e.S 33 City/Town ❑ Gas Fitter License 1Numoer ❑ Master APPROVED mi i fcE USE ONLY) p7< Journeyman Location No. &-S Date NORTH TOWN OF NORTH ANDOVER 3? • • OL � F Certificate of Occupancy $ Mus t1�' Building/Frame Permit Fee $ s�c Foundation Permit Fee $ Other Permit Fee $ `} TOTAL $ _S Check # j Building Inspe o PERMIT NO. _APPLICATION FOR PER4YIIT,TO BUILD,*xKx*x**NORTH ANDOVER, MA " N1APN0. LOT NO. / 2. RECORD OF011NERSUIP DATE BOOK PAGE ZONE SU13DIV. LOT NO. I 1 LOCATION 6 GJ-`/� PURPOSE OF BUILDING /fj^��</��. C✓�,/,� Q�� O\1'NER'SNANIE NO.OF STORIES f SIZE ! 1 01VNER'S ADDRESS / / �" BASENIENTOR SLAB IlY r �l i ARCIIFPECT'S NAME S17-E OF FLOOR TIMBER$`, I 2N4 } BUILDER'S NAME SPAN g ¢ DISTANCETONEARESTBUILDING `1 DIMENSION§OF SILLS DISTANCE FROM STREET DIMENSIONS OF FOSTS �, i DISTANCE FROM LOT LINES-SIDES REAR DMIENSIO SZFGIRDERS All EA OF LOT FRONTAGEIIEICIITOF FOUNDATION I 1 �I��CICNGSS !. IS BUILDING NEW SIZE OF FOOTING' X IS BUILDING ADDITION `! MATERIAL OF CIIININEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE. IS BUILDING CONNECTED TO TOWN}NATER BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER I IS BUILDING CONNECTED TO NATURAL GAS LINE 1NSTUCTIONS 3. PROPERTY INFOIWATION LAND COST ' EST.BLDG.COST PAGE I FILL OUTSECTIONS I-3 EST.BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM El1ECTRIC METERS MUST BE ON OUTSIDE OF BUILDING SEPTIC PERMIT NO. it t ATTACHED GARAGES NIUST CONFORNI TO STATE FIRE REGULATIONS 4. APPIIOVED BY: f PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR BUILDING INSPECTOR DATE FILED 1( u OWNERSTEL/I �'�� O"C J CONTR.TELI/ CONTR.LICN SIGNATURE OF-OIVNER OR AUT'IIORIZF.D AGENT FEES ILLC.N r�� `� , PERMIT GRANTED ry / I9 7 Revised 5/5/99 ,TNI , 67 (Policy Provisions: WC 00 00 00 (NM ONLY) , WC 00 00 00 A) vM INFORMATION PAGE•WCIP wz WORKERS COMPENSATION AND EMPLOYERS LIABILITY POLICY INSURER: HARTFORD UNDERWRITERS INSURANCE COMPANY HARTFORD PLAZA, HARTFORD, CONNECTICUT 06115 NCCI Cdnpow Number: n MIE Camp"Code: 6 HARTFORD co O C> wmx CDP LARD iIENWAL r POLICY NUMUN: 72 W7_ n3 4 Prevbus POIky"U"A r: 1. Nanwd k wjvd and ftlift Address: NORMAN GAY DHA ALL UNDER ONE (No.,Street,Town,Stats,Zip Codo) ROOF/PEST IN PEACE N ' O c 70 JEFFERSON STREET M FEIN Number: 028349269 NORTH ANDOVER, MA 01845 � Stade IdsnlMiostloe�Number(s): i The Named Insw a is: INDIVIDUAL WNW Illushmae o/Nalrad Insured: ROOFING tI• puller wor*iaoss not shown above: 70 JEFFERSON ST. , NORTH ANDOVER, MA 01945 2. Polley Period: Fran 11/09/98 To 11/09/99 12:01 a.m.,Standard time at the insured's mailing address. ee■i S Produoses NO MASS WORK COMP A R DIRECT LE NOX INSURANCE AGENCY ® PO BOX 462 LYNNFIELD, MA 01940 Producer`s Cods: 083477 heu"Olfles: THE HARTFORD 4801 NORTH WEST LOOP 410, SUITE 200 ® SAN ANTONIO TX 78229 w (800) 852-7991 rr fill i no policy w not timing um6"cown;ofs-gnea by oar outhonzed representative. eas Auvorized RepreserwsalMe Form WC 00 00 01 A Printed in U.SA Paps 1 (Continued on next page) r p.•+ ..s";... }j+yiyt e..,y,ra c..>i�t,,".:':3'..:':•. .:.t ! ; .,'}j r.,r'r�P�: ".ti`'^A' •..iJ a! -tr {?s d; 3:'; f3}.. P„ 4tq}:3aiE'.. '.a's: !• t. :r,x,}3. .x .tl,i.r �: j.�i. , , }I . 1 t,, ;}y.Sf y} t}.Aj :e �.I:!"�c Alt 41 $ € ,.e#ut i•1 ! . - y`'`s,t In, q, '(TIP; {n .{.' 't r..,'l'r >:. t .t•c r."•5,. - S`r r r : y -i bill 1.1: ra, w.•.t J r.,t.. iter.} r, a,•c. 3. - � i"Jt '{.l.i G 6.: ,ltil 1•. 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'.t'. i, ..;t' 1 rrA:sn':�s � lti.19;:4�ti �i :}11+n+jj :�•-rit F'4���, s,..:a._ p /� �,/� �� � ��.si}t ja3F-jt t? rk;y x_s t1 - - > .- ,,. r iia �r } fft ryiE-'+dr {nom if, s j t jI - v/07)7/IY0002C(1P,2GL/L O�.-�6 GCCJOCL!,17.lA.QC�bf a` t s 51 4 r t .. 3 t7 r -i. t BOARD OF BUILDING REGULATIONS ha , } v } IE �rc-#=I i3 r t itrlj� 'L 't } y,t License: CONSTRUCTION SUPERVISOR Number: CS 034200 ?. r r{" n ft t a ylt,-K r .i!Y� !,�'.'r 'a+'f, Birthdate::09/30/1945 - ' a I'tt y�FF1: acFt +tY t 'I 5 r „i t 5 r gyp} Expires: 00/30/2001 Tr.no: 5943 y yt ' Restricted To: 00 '1,!'�a-31 '} NORMAN GAY 70 JEFFERSON ST G��avti`E� t f I ! 72 N ANDOVER, MA 01845 : `,� St Administrator ,t jq jf Sr 5 �itF Cy - .. 11A" rrf' f �t {.fe•'j� ' f,.. _ e•� i ' 9 r+ t;r i FSS s/iH ' , _ .. r .. - �, ' � •ill - - , _ - e, 5 ea rl ka 1 1 G?�t;Jlfi. •1 �0�� .,.. • ,�k t , OVKEN� OwTitACTOR r MIKE7136 ORA : TYPa 10103!00 1 EXPirat'ion tr fE• fs e i a AL'LI UNDER ONE ROOF—RESIN PF x f 3jtt ' NOaNAN GAY f y r ;ja�gf *4EF.fERSON ST; i k }r j1r+,3 s 'NORT” ANDOVER' MA.A1845 x F i 1 - ,. - .. - >Ss.' s+ !/,3 t� '' 'd{ f ",:,:v���r',pi�,,vay,:ng�.tt-S?.i.::P �r,iyt.tgt •s:'� 5 ;•,ir IsGt r x(3iR nz <:.i x - - - .• - .. t ! •;s..,.f..,rt� t} ..dd�� .t ti � .?'y'Y .�t�"�Y7 ?k -rlll�,i- ars a F`3 3 f kn z .}t..'... # t.i'{t,•f� tr�k-!<}� .3 `i{�ss c�.',4i.-tx:sr� x - ''k. "iltlii, I aI`tl"#.>p� s tEa-;17.r1•#� 'IF.BaPi rf, 3. ll_ _„rt� ire'-s. €Vii;� r�•���t ._.f teY �4�r=.:- €F 'kgs t,. :�s , . J9J1 }'rrt t r t i i t r ..' :' .- a'. - '- ,:>, t 7 i Ort S �iyl}, y s. :}5°t'-�a a„•, r s- _ `' -.�t - - ' tf' ¢ 3?sat}f y -..- -� : _ - -• t� �'Ai V ` r.'G HT1 _i!F t ' - _ . e fi zlE M1 r _ .. - s - ( !i t 's� E�Yz�;#f# fwY cT ` r..- •�i i y r , .- �, - - . a 1 f i t jdi iyi�}i rk " F k i i t is 5 � r tt ' S i - f � .j .1 `11'�!'t{ar 1{f, ,C�' t fi } 1• y� , .. _ - _ NORTH Town of Aindover 0 No. 00 C.C.":Mprt dover, Mass., A� 0RATED H BOARD OF HEALTH Food/Kitchen PERMIT' T D Septic System THIS CERTIFIES THAT...... BUILDING INSPECTOR Foundation ............................. ........................... Rough has permission to erect.... 040 A buildixs on.../409"WI/I tobe occupied as......... ................../.................4...V4....1.4. ......................................................................... Chimney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION T, S ELECTRICAL INSPECTOR Rough .... ................ ...................... ....... ..... ...... .. ........A...... ..... Service asj BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. PERMIT NO. APPLICATION FOR PEIZMIT.TO BUILD,-*,*******. I�ANDOVER, MA f I? tip AIAPNO• LOTNO. / 2. RECORDOFOR'NERSUIP DATE, BOOK PAGE ! ZONE SUIT DIV. LOT NO. LOCATION PURPOSE OF BUILDING OWNER'SNAAI •f/ SIZE E NO.OF STORIES F6 OIVNER'SADDRESS BASE61ENTORSLAB j It1f i i ARCHITECT'S NAME SIZE OF FLOOR TINIBEfW. 2ND I I ¢ ail — Rllll-DER'S C SPAN DISTANCE TONEAREST Bl11LDING DIAIENSION§OF SILLS v. jqDISTANCE FROM STREET DIMENSIONSOFFOSTS DISTANCE FIIOA1LOT LINES-SIDES REAR DIMENSION$OFGIRDERS 1 ;. AREA OF LOT FRONTAGEi z IIEIGIIT OF FOUNDAT16N1�CICNGSS T.1 "Y IS BUILDING NEW SIZE OF FOOTING' x ' IS BUILDING ADDITION AtATERIALOFCIIIA[NEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND 11'll.L BUILDING CONFORM TO REQUIREMENTS OF CODE. IS BUILDING CONNECTEp TO TO%17J NATER HOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEIVER 1' IS BUILDING CONNECTED TO NATURAL GAS LINE 1NSTUCTIONS 3. PROPERTY INFORMATION LAND COST EST. BLDG.COST PAGE 1 FILL OUT SECTIONS 1-3 EST.BLDG. COST PER SQ. FT. EST. DLDG. COST PER ROOM ELECTRIC METERS MUST DE ON OUTSIDE OF BUILDING SEPTIC PERMfFNO. • ATrACIIED GARAGES MUSTCONFORAI TO STATE FIRE REGULATIONS 4. APPIIOVED BY: ` 'L f '" t r PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR BUILDING INSPECTOR D.ITEFILED 011 Hs-os � (.J ERS TELN CONTR.TELI( j J; J gulf r, SIGNATURE OFCONTR.LICII O\VNER OR AU111ORIZF.D AGENT FEE 1I.I.C.11 Vv I PEll A1rr GRAN'I-E1) 19 Revised 5/3/99 JAI � Qr ;