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Miscellaneous - 111 CAMPBELL ROAD 4/30/2018
111 CAMPBELL ROAD 2101106.B-0037-0000.0 JJ� Date ` 1 412 6 3? NOpTM,�OOL TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING CHU This certifies that .................................... . . ........... ............ .. ..... ............................. has permission to perform.................. .......... ...... plumbing in the buildings of..... ..e.�4...4�' /I.. ................................................. A ..................................... ............ North Andover, Mass. Lic. No. .43 .. ................................................................................. PLUMBING INSPECTOR Check# I MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM PLUMBING WORK I CITY MA DATE PERMIT# JOBSITE ADDRESS OWNER'S NAME POWNER ADDRESS TEL iFAX — TYPE OR OCCUPANCY TYPE COMMERCIAL 0 EDUCATIONAL Q RESIDENTIAL PRINT CLEARLY NEW: Fi RENOVATION: REPLACEMENT: LQ PLANS SUBMITTED: YES E11 NO01 FIXTURES 7 FLOOR--> BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BATHTUB CROSS CONNECTION DEVICE DEDICATED SPECIAL WASTE SYSTEM DEDICATED GAS/OILISAND SYSTEM DEDICATED GREASE SYSTEM DEDICATED GRAY WATER SYSTEM DEDICATED WATER RECYCLE SYSTEM DISHWASHER DRINKING FOUNTAIN f .-----_i ----- ___---f i I I __._...__{ -._-- --. ► ____.--F FOOD DISPOSER FLOOR/AREA DRAIN i ..__._._) __-_-! � -.- ( -.._-_.! -__—.-.! ._...._1 --.--.j .___._l --.! INTERCEPTOR(INTERIOR) KITCHEN SINK LAVATORY ROOF DRAIN SHOWER STALL SERVICE/MOP SINK TOILETi J URINAL WASHING MACHINE CONNECTION WATER HEATER ALL TYPES { # € f 1 k f I _ 1 . _ ___3 _ _ WATER PIPING -f OTkfER _ I € I ) -_-._._..J [ € INSURANCE COVERAGE: 1 have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch.142. YES NO IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW LIABILITY INSURANCE POLICY 0 OTHER TYPE OF INDEMNITY © BONDE1 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: OWNER _1 AGENT 10 SIGNATURE OF OWNER OR AGENT 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 knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance 'th all Pertinent provisipp of the (Massachusetts State Plumbing Code and Chapter 142 of the General Laws. PLUMBER'S NAME ut LICENSE# . �✓� : I SIGNATU n (VIP or JP 0 CORPORATION)#=PARTNERSHIP LLC COMPANY NAME �,� % �,, t P4 "0 € ADDRESS STATE „�}_� ZIP �J `/ —( TEL FAX r� �_� CELL S'12 EMAIL ROUGH PLUMBING INSPECTION NOTES BELOW FOR OFFICE USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# j PLAN REVIEW NOTES Date............................................. r►ORTF/ TOWN OF NORTH ANDOVER 002 PERMIT FOR WIRING g`QgCHU55 G //�� This certifies that ...................................................� ......................................... has permission to perform ......v`..!..!........................... ......................................... wiring in the building ....................................................... of. /��G- .............................. at .......l..{..�.......:�p�1' �� North Andover,Mass: 7 Fee....._.......................Lic.NoJ`../. . .... ....... 41EZ2......................................... ' ELECTRICAL INSPECTOR Check# .? 6, 1 --� DQ/// of Q��Ma66ackWetf6 Official Use Only C/�omffwaweallh cc�� cc77 Permit No. 2epartment ol5ire Serviced . Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/071 (leaveblank)' APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC) 527 CA—zo, 12.00/ (PLEASE PRINT IN INK OR TYP__ L FO TION Date: Z, Z 14 City or Town of: /�/1) / To the Inspect&ofWires: By this application the undersi=iKCA(ZD of his o ,tier intention perform th e ectrical work described below. Location(Street&Number) 11 r/ �� Owner'or Tenant t�t'e '13'yycc,c— T—A Telephone No. Owners Address Is this permit in conjunction with a building ermit? Yes E;--o'No ❑ (Check Appropriate Box) /dyiZt Utility Authorization No. Purpose of Building 2, le Existing Service Amps / Volts Overhead ❑ .Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: Completion of the following table maybe waived by the Inspector of Wires. No.of Total No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators Kid` Above In- o,o Emergency Lighting . No.of Luminaires Swimming Pool rnd. ❑ rnd. ❑ Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Detection and No,of Switches `(P No.of Gas Burners Initiating Devices Total No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers _ Heat Pum p Number Tons„__•.KW No,of Self-Contained Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ MunicipalConnection [I Other Heating Appliances KW Security Systems:* No.of Dryers No.of Devices or Equivalent No.•of WaterKW No.of No. of Data Wiring: Heaters . Signs Ballasts No.of Devices or Equivalent Telecommunications Wiring: No.Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent OTHER: , Attach additional detail if desired or as required by the Inspector of Wires. Estimated Value of El ctrical Work: (When required by municipal policy.) Work to Start: Z Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COV RAGE: 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 cover a is in force,and has exhibited proof of sa e the�t issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) o this lication is true and com let I certify, under the pains d enalties(of erju?y that the i ,Form pp P /— FIRM NAME: `e /? fC LIC.NO �� I O. Signature � LIC.N Licensee: Signa. (If applicabl , ter "g�� pt"i jhe license numbe l ) Bus.Tel.No.: Address' : l/ t fi t ' 41 N" Y- VAlt.Tel.No.: 7 ` �— 7j� *Per M,G.L. c. 147,s.57-61,security w k 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 signature below,I hereby waive this requirement. I am the(check one) ❑ owner ❑owner's agent. Owner/Agent PERMIT FEE: $ lid Signature Telephone No. r � PNDpvER l,\ pF ND pR V�tRtN •�; v0 le A�p7M AN eo .eye 00, 4 OV- $SAC eek 140vt to ot the I-C 140. Ir Cheek \ i r ,,NNA\-Te, P,99 InP-LA-A1Y11Y1V1Vrr1-eM-1X2UPI 1IJ UiilccUNCUuly DEPART1 LEATOFPUBLICS4FETY Permit No. BOARD OFFIREPREVEV77ONREGUL477ON,S527OfR 12:00 r� ' Occupancy&Fees Checked APPLICATION FOR PERART TO 6 ,L=C L WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 � ftI O0 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date ds Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) C& Owner or Tenant CO C k rhT. CL Owner's Address llQ6K-nL Is this permit in conjunction with a building permit: Yes L,.Qi No ® (Check Appropriate Box) i Purpose of Building ��r1G e �.�,� y ��}{,\\.+�Q( Utility Authorization No. Existing Service IC) Amps Lau Overhead Underground ® No.of Meters New Service AmpsVolts Overhead ® Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work QOM�G\n oo= 7 a e 5-77 (/ 7b �1✓� �® V No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below. Generators KVA ground 1:1ound No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices 'f No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local ® Municipal ® Other � Connections No.of Water Heaters KW No.of No.of Signs Bailasis No Hydro Massage Tubs No.of Motors Total HP OTHER h>saart�Co Ptastm�lQthetatgmana�ts�Ge�a-alLaws IhawaaxreriLiabilityhnm=PblxytrtdLOwgCa CuArd ecrdsst lc4 valtt YES NO Ihmesth imdvandpoofofsa=iDtheOffi=YES NO ® IfyuuhmeduJWYES,p(easemdr;4ethet pecfwMagebydaki gthe INSUFANCE M BOND OTIC ® ftase ) Expi4mDaie Estimated ValuedEki ical Wok S WC[ktDSU. -7 buUU - hq)eMonD*Rquo0d Ra# W\\ CE. l 119 Signed taxiriePalaltiesofpajtay. FIRM NAME Ulo nseNa 77ri- � C 2��.q Business Tel.Na i t_(- 7(�0 i srt Mrd-eh ✓�14 AkTdI at- OWNER'SINSURANCE WAIVER,lam awatefiat drLx=dom to the a»o or-ils abstangial e*vakrtasragraedbyMassadas&GalealLam aod�mysigrr�aewithspeul>$ thisracptitentag. (Please check one) OwnerED Agent Telephone No. PERMIT FEE$ V _ f Date. .. .. . .... ........ R HpRT�y TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION 090 .� • '9SgACMUgEt This certifies that . . . . . . . . . . . . . . . . . . . . . . ._ . . . . . . . . . . . . . has permission for gas.-installation �. . l "".!. . . . . . . . . in the buildings�of . . . . . . . . . . . North Andover, Mass. Fee. . . . . . . Lic. No.,?)—'/7 . . . . . . . . . . . L, GAS-ItJNSPEC�T�SR WHITE:Applicant CANARY:Building Dept. PINK:Treasurer s > MASSACHUSETTS UN FORM APPLICATON FOR PERMIT TO DO GAS/FT ING ype or print) ate 19 NORTH ANDOVER, MASSACHUSETTS s Building Locations C- ��yj /i7G l/ Permit# Amount S Owner's Name �� New n / Renovation ❑ Replacement ❑ Plans Submitted ❑ Cn 92 cn w C G n _ z ._ Cn W z rn cn z — t w C w z SU 8 -3A SEY1 E :NT BASEM ENT I S r. F L O O R 2N D . FLOG R 3 R D . F L O O R 4'r 11 . FLOG R 5'r 11 . FLOO R 6T 11 . FLOOR 7T 11 . F L O O R ST 11 . F L O O R (Print or type) ��� �g-� . Check one: Certificate Installing Company Name Ja l/ /[ /� ❑ Corp. j Address G�` ❑ Partner. Business Telephone l ,o E--�-rm/co- Name of Licensed Plumber or Gas Fitter f C C. 1�f� 0 INSURANCE COVERAGE Check one: I have a current liability Insurance poiicv is substantial equivalent. Yes ❑ No❑ If you have checked ves,please ind' to the type coverage by checking the appropriate box. Liability insurance policyCO' 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 vlass.General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent 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 instailatio performe under P it Issued for this application will be in compliance with all pertinent provisions of the Nlassach e St e Gus 142 of the Genera Laws. By. Signature of Licensed Plu er Or as Fitter Title ❑ Plumber �I City/Town ® Gas Fitter7—cense i-4umoer ❑ Master eyman APPROVEDrt�rrici USEOmi.Y) j I Date. N°- 44, OJ ? "OR'" TOWN OF NORTH ANDOVER p4 ,�•o;•1h0 ° PERMIT FOR PLUMBING '! cNusf� This certifies that . . .. . . . • . • . . has permission to perform . . . , �'. :'� .'?.?(�.` . . ' plumbing in the buildings of . . . k 5z� . . . . . . . . . . . . . . . . . . Forth Andover, Mass. Fee. Lic. No.. . . . . . . . . .':� . .���. :� . . . . . . j PLUMBING INSPECTOR Check # V WHITE: Applicant CANARY: Building Dept. PINK:Treasurer % III MASSACHUSETTS UNIFORM APPLICATION FOR PER TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date Building Location/// 112. _L L X0 Owners N e� - y e-h� Permit _ y L Amount Type of Occupancy New Renovation in Replacement Plans Submitted Yes ❑ No ❑ FIXTURES Wx a a Cr a w FCn Cn a W a w d W A W a s A a L z F a Cn a a a Cn d Cn d a H 4 SLRBM BASE M M FIDQ2 t 21`II FIOQt ) ► 0 1 � 3M FUM 4IH FIOQZ 5MROM 6M FIOCR 7MKaR 9M Rfm (Print or type) Check one: Certificate Installing Company Name 2 p Corp. Address /Os �d r� Jc �r� ❑ Partner. Business Telephone _ 2-�T--- Firm/Co. I ' Name of Licensed Plumber. Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity ❑ 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 submitt r 'tered)' above appli true accurate to the best of my knowledge and that all plumbing work and installation ed er P for this app ' 'on will be in compliance with all pertinent provisions of the Massachusetts S to mbin e r 142 of th neral ws. By: _7 auire of Menseerriumuer Type of Plumbing License Title 0 9l Q City/Town License Number Master Journeyman ❑ APPROVED(OFFICE USE ONLY Location No. Date 40RTN TOWN OF NORTH ANDOVER f � 3? � 1- • OOL Certificate of Occupancy $ + o,�____. '�• �j fid• �--- �'+s'•••''E< Building/Frame Permit Fee $ swcMus 7; Foundation Permit Fee $ Other Permit Fee $ TOTAL $ oZ ` Check # ��3 ILA 13 7 9 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAI RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING T� BUILDING PERMIT NUMBER. DATE ISSUED: ^�/ �.., J� X to I ic SIGNATURE: M eAd oil,10 ON ic Building Commission for of Buildings Date Z SECTION 1-SITE INFORMATION IO 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard jSide Yard Rear Yard Required Provide R r Provided Required Provided p _ / 1.7 Wat S ly M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Wa'�ZPublic Private ❑ Zone Outside Flood Zone Municipal 11 On Site Disposal System SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record e(Print) Address for Service Signature Telephone sA V1, p 2.2 Owner of Record: Name Print Address for Service: O Z M Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Lifensed Construction Supervis O License Number A less b T/ `533 3 Expiration Date Signature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ 0 Company Name D M V-- Registration Number r Address S� V\,t Expiration Date Z� Signature Telephone V SECTION 4-WORKERS COMPENSATION(M.G.L. C 152 § 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 rmit. Signed affidavit Attached Yes...... No.......❑ SECTION 5 Description of Proposed Work(check au a Ucable New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: f (2,— J Z?—'- 41-.�) A" ay , ` n ✓L^��Ri Y/ SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIALUSIu OL�t Completed by permit applicant y` 1. Building (a) Building Permit Fee Multiplier . 2 Electrical (b) Estimated Total Cost of Construction 3 PlumbinE Building Permit fee(a)X (b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5) Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT 1> V,L ��v� r� C ,as Owner/Authorized Agent of subject property ' Herebuth ize E' l~ to act on My b ha . 1 all m4tt rs Two,% ,rk authoriz d bf4his building permit application Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, ��. -w 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 elief Pint _. . Signature of Owner/A ent Date NO.OF STORIES Z SIZE X r' BASEMENT OR SLAB C a4-..,. t S A LS__ SIZE OF FLOOR TEVIBERS 1 2ND 3RD SPAN /1 DINIENSIONS OF SILLS '2,—Z DINIENSIONS OF POSTS ilk/G DINIENSIONS OF GIRDERS ��✓��. HEIGHT OF FOUNDATION THICKNESS V SIZE OF FOOTING X 2—t MATERIAL OF CHIMNEY �---'— IS BUILDING ON SOLID OR FILLED LAND V-�' IS BUILDING CONNECTED TO NATURAL GAS LINE (�/ FORM U - LOT RELEASE FORM INSTFcUCT1CNS: This form is used to verify that all nec:.ssary 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 SECT1cN APPLICANT �� �—��c f• 54 PFiCNE � � �� LCCATICN: Assessces Map Number PARCS_ SUEDIVISICN LOT (S) STRE=ii ST. NUMEE c� I� OFFICIAL USE.CNLY RFC MENDATIONS OF TOWN AGENTS: CONSERVATION AOMIN STRATOR DATE APPROVED DATE REJECTED TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATEAPPROVED DATE REJECTED ,Sc?T INSPECTOR DATE APPROVED / ZZ�a o DATE REJECTED / COMMENTS << :� PUELIC WORKS -SE"NER/WATER CONNECTIONS -DRIVE"WAY PERMIT FIRE DEPARTMENT RECEIVED E'( EUILDIAIG ;INSPECTOR DATE Revised 9197 im CERTIFIED PLOT PLAN LOCATED IN NORTH ANDOVER, MASS. SCALE:1"=30' DATE:3/7/2000 Scott L. Giles R.P.L.S. �l ' Frank. S. Giles ` Q 50 Deer Meadow RoadP► ,.�, \ North Andover, Mass. �O CAMPBELL 33•43 37.851 8.56' es- U1 O ti 31,+/ 43'+1- PROP, 5X20' 6) EXIST.NSE. o ADD. N 9 uj FND. M M _ 14' TO BE ENCLOSED EXIST. DECK LOT#5 1.05 ACRES PLAN#5166 N,E,R.D. 141.45' I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE ` THE OFFSETS OF THE BUILDING INSPECTOR ONLY ���P`pi or y SHOWN COMPLY AND SUCH USE IS FOR THE O yr, WITH THE ZONING DETERMINATION OF ZONING S H BYLAWS OF c 3972 NORTH ANDOVER CONFORMITY OR NON-CONFORMITY CaCONFORMITY WHEN BUILT WHEN CONSTRUCTED. ��� NORTH Town of Andover z,.,. 0 No. �- � odover, Mass., COC MIC ME WICK � /gip ADRA TE D p'P�,��� S BOARD,OF HEALTH PERMIT . T D Food/Kitchen Septic System THIS CERTIFIES THAT. 11 / N Q, BUILDING INSPECTOR ..i.......................... 4,P�tC.. ...L'a. o .............. 41 :. Foundation GWf 1 has permission to erect....... . ............. buildings on .....1//.....ICA"A ......ll....��,,,,..,. . Rough to be occupied ....'....................... . .. . . ... � ..........�...... 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. ♦ 60-0 r ONedof PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. 14P4 00 07 Rough PERMIT EXPIRES IN 6 MONTHS c��a Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTIO T T Rough ............... ..... ........ .................... Service 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. Z7, Fs ' 77, 5 ' . oFN�o N�o� GpQ A - l 3 - 75 0 G -l� s nLAn� As �3u, T • pvT o ,CMZ 5oa ' � q5' oF, 45, o lv I V _ e THIS PLAN SUBSTANTIALLY CONFORMS wE�� TO THE Ply ��:5,,,? REVIOUSLY APPROVED lig �Q'� �acLL �04� o ..,.. STEVEN J. D URS 5 T A z- ENV IROMENTAL DESIGNS • _ . C'ow r. �o SAN " 22 LILLY POND RD: BOXFORD, MA . 01921 �ETNtJE� 508- 3 3 2-987 Location Jz z i - No. :2, J f Date NORT1y TOWN OF NORTH ANDOVER .�.0 p Certificate of Occupancy $ d 'd J Building/Frame Permit Fee $ Zi sACMUSEt� Foundation Permit Fee $ Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ -- } TOTAL / Sd Building Inspector "0 V3'°.0 O Div. Public Works PERJiIT NO. �2- APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE I MAP KrVO. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK PAGE ZONE I SUB DIV. LOT NO. LOCATIONr 1 1 co^ m^ bC 11 Rc-k PURPOSE OF BUILDING^1�,�r OWNER'S NAME ` +I'7Q..oQjr9C `�- III j 'C �i?c -% A NO. OF STORIES ,��"lv SIZE OWNER'S ADDRESSnl,n I_ .I BASEMENT OR SLAB -- ARCHITECT'S NAME ff__ �•7 (J SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING I N 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 SIZE OF FOOTING X IS BUILDINGADDITIONMATERIAL 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 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COSTCJ.At111 PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. Vl1 PAGE 2 FILL OUT SECTIONS i - 12 EST. BLDG. COST PER ROOM -� SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY c ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS I PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED 67—(:p —94 BOARD OF HEALTH SIGNATURE F WNER O A ZED AGENT FEE CS v PLANNING BOARD PERMIT GRANTED 19 OWNER TEL.#4%? S 2Y BOARD OF SELECTMEN CONTR.TEL.#j6,-D` a0 CONTR.L!C. I. xfel� /�f BUILDING INBPECTOR s s. BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY - STORIESTHIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY QFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS.-WITH' PORCHES, GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION —I 8 INTERIOR FINISH CONCRETE 3 I ? I— CONCRETE BLK. PINE BRICK OR STONE HARDW D _ PIERS PLASTER _ _ DRY WALL UNFIN. 3 BASEMENT AREA FULL FIN. B M AREA _ 1/1 1/2 1/1 FIN. ATTIC AREA _ N_O B M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE ��_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARD"✓D _ ASBESTOS SIDING _ COM/+ICN VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY STUCCO ON FRAME, BRICK ON MASONRY ATTIC STIRS. 8 FIOOR _ BRICK ON FRAME CONC. OR CINDER ELK. STONE ON MASONRY WIRING s. STONE ON FRAME _ SUPERIOR POOR ADEQUATE "- ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE HIP BATH (3 FIX.) _ GAMBQEI MANSARD TOILET RM. (2 FIX.) _ FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK .J 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 IL O B'M'T 2nd _ ELECTRIC ` 1st 13rd I NO HEATING 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: Phone (off 1 -aq R LOCATION: Assessor's Map Number Parcel Subdivision / Lot(s) Street j ( ) �,c.liy)ob�J 1 al, St. Number ` ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: Date Approved Conservation Administrator Date Rejected Comments Date Approved Town Planner Date Rejected Comments Date Approved Food Inspector-Health Date Rejected Date Approved Septic Inspector-Health Date Rejected Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Date .1062. KEEN CONSTRUCTION CO. PROPOSAL. 1 a 21 HEWITT AVENUE NORTH ANDOVER, MA 01845 508 691.5201 N A R I® All home improvement contractors and subcontractors Tel: ( ) M E M B E R engaged in home improvement contracting, unless Fax: (508) 682.3231 specifically exempt from registration by Provisions of Chapter 142A of the general laws,must be registered with Submitted , �n ( � the Commonwealth of Massachusetts. Inquiries about To: C f~i f `.*.Pr`Y....Lr, it ►J..v..0 '�.A registration and status should be made to the Director, s ( Home Improvement Contract Registration,One Ashburton l _� ......... 1_(n�..... L 1..�____....1`L`....._ __ .... Place, Room 1301, Boston, MA 02108 (617) 727-8598. Owners who secure their own construction related �.fi(��&�� Lr1 i'J f Y� y � permits or deal with unregistered contractors will be excluded from the Guaranty Fund Provision of MGL c. 142A. PHONE DATE - REGISTRATION NO. " 09 . ,39 2 S `� -Q6 _c� y MA. H.I.C. 108383 JOB NAME/NO. JOB LOCATION We hereby submit specifications and estimates for work to be performed and ma rials to be used: a u ASS c , 0 51. r . .. ..... ..... �} ...........� y.. -X 6,`1.................f ► �. �: ....7, a_rL ... . .....- 1. ..__..... t+ _ S. .. .� Lir ....L►c�..hT ._t4`._�.a�w+E do csFT.....L� 1a.i 1,. ._ ........_. .. )►:Z _i ...1..._� 1 _._.....-. .U....l............ N. ... .ci__...... �....1......IJ ............................. _...... r. .. Tc j �.._LLt. f �T..... C E . C .......�.... . �.) A.. ( i.... ..........._.......................................... ... .__ ........ ......... ......... ...... ......... ........................ > Construction related permits: f _..._........,_................................ .L...,i ._1......+w.�,.,.l.l /...... .._.....................C.�....t. .-. . ..........................._, _........................................_.............................._,..,,.........,....,.......................................................-................................................................................ .. WORKSCHEDULE .............................._.............._........_....................................._,.-..._......_.........._..._..._..._. Contractor ill t b gin the work or order the materials before the third day following the signing of this Agreement.unless specified herein writing. Contractor will begin the work on or about (date). Barring delay caused by circumstances beyond Contractor's control,the work will be completed by (date). The Owner hereby acknowle ge and agrees that the scheduling dates are approximate and that such delays that are not avoidable by the Contractor shall not th co idered as violations of this Agreement. WARRANTY The Contractor.warrants that the work furnished hereunder shall be free from defects in materials and workmanship for a period of following completion and shall comply with the requirements of this Agreement. In the event any defect.in workmanship or materials,or damage caused by the Contractor,his subcontractors,employees or agents,is discovered within one year after completion of any job,including cleanup,the Contractor shall,at his own expense,forthwith remedy,repair,correct,replace,or cause to be remedied, repaired,or replaced,such damage or such defect in materials or workmanship.The foregoing warranties shall survive any inspection performed in connection with the agreed-upon work. We Propose hereby to furnish material and labor-co�mp�lete in accordance with above specifications,for the sum of pIILl` --�j NC'l �! L'4 1 ►�L�� r) 3 00 �! f1C tr?1 f J dollars($ b ). Payment to be made as follows: OD(f =_ 'upon signing Contract; KENNETH B. KEEN Z)oTIrJ Name of Contractor/Designated Registrant - �rc>•n t F % ($ Com') upon completion of �a�trnt.4zoc,L Elul 21 HEWITT AVE. T Street Address - % ($ ) upon completion of NO. ANDOVER, MA 01845 " - city/State % ($ C -� � rnmllnlp Inn of vu rt(Wnilpr th c rnntrnrt 508.691.5201 508-682.3231 OR Town 0f over s o r4 No. 210 70 o 1_ dover, Mass., 19 } A- COCMICNEWICK 0Rg TED C'P` C M f BOARD OF HEALTH Rr, � Food/Kitchen Septic System IT . PERMIT T D BUILDING INSPECTOR ,THIS CERTIFIES THAT......... �II .... ..... . ...... .v. .. ................... Foundation has permission to erect.$4014 104. buildings on .##//..tNr �. ... ......... Rough to be occupied as� 1j1. AfAIR-0-40-AN-4 .... Chimney provided that the person accXprig 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 o4 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 ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS � Rough . ............... .. ........................ Service 0BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner PLANNING FINAL CONSERVATION FINAL street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT e a y t N-NIO "Voi over tg o o No. 210 o dover, Mass., .��I�� 19. COC Ni C 11E-ICK GG s �r RATED P �. t BUILD BOARD OF HEALTH Food/Kitchen PERMIT To t~ Septic System BUILDING INSPECTOR BU N THIS CERTIFIES THAT.........� ••""""""""' Foundation '.bias permission to erect.041MI.A.M . buildings on . Al;AN.rWMA...440......... Rough ,a to be occupied asgvi/ I/ •••�L.0A.40w►AA ,Aft4r 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 IT EXTI1ES All 6 .lV ON 1. 1—IS Final ` T TA T7 T _ i _�7 7 Y7 ELECTRICAL INSPECTOR V 1�I A ESS �Ol`d�� �V�� 10�! Srr.!"�T�' • Rough y ,i .............. ... ....... Service ................ ,? BUILDING INSPECTOR / Final Occupancy Pel iit Required to Occispy Building GAS INSPECTOR F; Rough ,. Do Not Remove Final Display in a Conspicuous Place on the Premises — No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner PLANNING FINAL CONSERVATION FINAL Street No. Smoke Det. �'` ,Fu/FR /WATFR ___-. FINAL DRIVEWAY ENTRY PERMIT 1 CERTIFICATE OF USE & OCCUPANCY �il'or' h Andover Building Permit Number 210 Date AijaiiST �n_ 199 THIS CERTIFIES THAT THE BUILDING LOCATED ON 111 CAMPBELL ROAD MAY BE OCCUPIED AS INTERIOR REMODEL: 2 BEDROOMS IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO Caroline & Mark Buchta 111 Campbell Rd. ADDRESS No. Andover, Building Inspector r � P Location No. cQ' Date °RTh TOWN OF NORTH ANDOVER O „ Certificate of Occupancy $ + Building/Frame Permit Fee $ cNuFoundation Permit Fee $ J� S Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ t TOTAL $ Building Inspector 06/11 96 13:48 25.00 PAID t 9p O 5 4 Div. Public Works " - :�.�. ',,,.f f. PER111T NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP 4-40. I LOT NO. Q0 37 2 RECORD OF OWNERSHIP DAT�IBOOK ;PAGE— — ZONE !Q SUB DIV. LOT NO. LOCATION 1I1 am b Clk TZ A PURPOSE OF BUILDING LW,&L,&e Lah4 Wil II OWNER'S NAME /fid& OI "C� �n2 , `` 06,1/1 NO. OF STORIES •' + Z 7, -/ s�x ,q OWNER'S ADDRESS 1fi `' I_01 21 ,-7 - BASEMENT OR SLAB ARCHITECT'S NAME � r`,�12 1-11 �� SIZE OF FLOOR TIMBERS IST 2ND �g��' BUILDER'S NAME F 1/ ,Etj _u SPAN -- /_J • 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 SIZE OF FOOTING X IS BUILDING ADDITION MATERIAL OF CHIMNEY IS BUILDING ALTERATION 6 o A���^1 IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREM NTS 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 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED BUILDING INSPECTOR A SIGNATUR OF WNER O O ZE GENT Q — 2 4-en "-t Z 4 y F E E OWNER TEL.# O PERMIT GRANTED 'C CONTR.TEL.#19 CONTRAICJ.#. d S Z L J H.I.C.# ,y BUILDING RECORD OCCUPANCY 12 r ? 51LE FAMILY P1 ES - .. THIS SECTION MUST SHOW EXACT DIMENSIONS OF�LOT•AND.�DISTANCE FROM M Ti. FAMILY ' _ OFFICES - __ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- AP;',RTMENTSi. ' RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOTS PLAN' CONSTRUCTION FOUNDATION —I 8 INTERIOR FINISH - ._! • - CCb CRETE 8 I 2 13 rt C , CRETE BL K. INE BRK OR STONE HARDW'D PI 14S PLASTER _ _ DRY WALL UNFIN BASEMENT 11 AlNE FULL FIN. B M AREA _ ,/. 11 /, /. FIN. ATTIC AREA _ N B M T FIRE PLACES _ HE D ROOM MODERN KITCHEN WALLS I 9 FLOORS C PBOARDS 8 1 2 3 - D P SIDING CONCRETE �_ W-OD SHINGLES EARTH _ A HHALT SIDING HARD"✓'D _ A I ESTOS SIDING _ COMfdON Vtj T. SIDING ASP11 TILE _ Sg CCO ON MASONRY ST''CCO ON FRAME BRI, K ON MASONRY ATTIC STRS. & FLOOR _ 80IIkK ON FRAME CO C. OR CINDER BLK. ST NE ON MASONRY WIRING STS NE ON FRAME _ SUPERIOR POOR ADEQUATE MN ADEQUATE NONE ROOF 10 PLUMBING GO LE I IP BATH (3 FIX.) G° BREL MANSARD TOILET RM. (2 FIX.) FN T SHED WATER CLOSET _ AHALT SHINGLES LAVATORY V OD SHINGES KITCHEN SINK _ SL TE NO PLUMBING _ T4k & GRAVEL STALL SHOWER R,tb'LL ROOFING MODERN FIXTURES _ TILE FLOOR i.._ -.TILE DADO - MN �_ Y FRAMING I 11 HEATING V✓ OD:JOIST' FOELESS FURNACE - FORCED HOT AIR FURN. tiA,ASER BMS. &COLS. .. STEAM VlEEL BMS. & COLS. r HOT W'T'R OR VAPOR JVbOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G fN UNIT HEATERS FI NO. OF ROOMS GAS OIL 'T 2nd _ ELECTRIC 1'�t 13rd I NO HEATING NORTIq F dover p No. ort dover, Mass., 19 COCMICMEWICK ADRATED P �C SF BOARD OF HEALTH Food/Kitchen PERMIT T Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.....................................MAr- C �� ............................ .. ............................................ ............................ Foundation has permission to ... ............... buildings on ....... ... . .......CA ...'!�l..P..���1.......�J..�`'�•••....•• Rough to be occupied 1s..................................................... I. rT..�. ......................................... 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 MONTIJS Final UNLESS CONSTRUCTION S T ELECTRICAL INSPECTOR Rough SAT ... ." ....................................................... Service LDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough p Y p Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke-,Det- _ i No. / 2 f Date? MORTM TOWN OF NORTH ANDOVER fit F p Certificate of Occupancy $ Building/Frame Permit Fee $ CN Foundation Permit Fee $ Other Permit Fee $ Q Sewer Connection Fee $ - hater Connection Fee - $ Building InspectorLIP 1I Div. Public Works ,_,� r.�� .� ;t,- . .-e. + a �, _ PER311T NO. � APPLICATION FOR PERMIT TO BUILD —NORTH ANDOVER, MASS. /PAGE 1 MAP i-40. LOT NO. 2 RECORD OF OWNERSHIP IDATE (BOOK :PAGE ZONE I SUB DIV. LOT NO. LOCATION PURPOSE OF BUILDING I.CIL-, ,-5c-P e"!te OWNER'S NAME �� k D _ , 1.,���Q /� NO. OF STORIES / SIZE l fl V OWNER'S ADDRESS /•,v /Yc�CLV� !1 �a/�.-._] BASEMENT OR SLAB .j�.�,,, �O�a�/` ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IS'T�)x/o 1�2ND T�J3RD_ 1/ BUILDER'S NAME ���, C+ _ C`r/5pLr, SPAN ---�' DISTANCE TO NEAREST BUILDING / 0~01 1 ( SJR DIMENS ONS OF SILLS DISTANCE FROM STREET Cot '" POSTS C4,14-22 DISTANCE FROM LOT LINES—SIDES ,�D R It "" GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW �/J� SIZE OF FOOTING /% X I� IS BUILDING ADDITION 4�.`� MATERIAL OF CHIMNEY IS BUILDING ALTERATION `1[wv IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO Rff6UIREMENTS 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 INSTRUCT``IIONSA A3 PROPERTY INFORMATION !U ZVC� �li�l�' f►fQlh Ho,) s�4 LAND COST SEE BOTH SIDESF Asr GJQ�`. EST. BLDG. COST �/27e�ott� QOtcQ Srl� f� PAGE I FILL OUT SECTIONS I - 3 �.�*C3'l Iiµ A1404 Homos a EST. BLDG. COST PER tQ. FT. PAGE 2 FILL OUT SECTIONS 1 - 12 AW Ali^-W Q.k�i1cC ISCMek ett �Ck EST. BLDG. COST PER ROOM - SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING Q APPROVED BY - - ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AN13APPROVED BY BUILDING INSPECTOR DATE FILED $ 2P AP BOARD OF HEALTH SIGNATOR OF OWNER R A THORIZED AGENT + �$ / OWNER TEL.# F E E 3Q ' tY0 CONTR.LIC.# &3l PLANNING BOARD PERMIT GRANTED Z z-19 9 Z ' BOARD OF SELECTMEN k y 1 f[' APR22 '. BUILDING INBPRCTOR SUILt�Ek`G DfEi . . ._. u_ f_9__.,. J i BUILDING RECORD i OCCU,PANC 1 12 SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS IRAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE _ 3 I 2 13 CONCRETE BIL K. PINE __ _ V' BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL UNFIN. 3 BASEMENT I L�".�„ ��/�!•r �� .. i �,• Y(�! l),—C L AREA FULL FIN. B'M'T' AREA 1/1 1/1 '/ FIN. ATTIC AREA NO 8M'T FIRE PLACES HEAD ROOM _ MODERN KITCHEN — - j i rr 4 WALLS I 9 FLOORS CLAPBOARDS DROP SIDING CONCRETE — WOOD SHINGLES EARTH ASPHALT SIDING HARDVJ'D - ASBESTOS SIDING COMMON VERT. SIDING ASPH. TILE i-' - - —' Wit', `C'' I;` STUCCO ON MASONRY yL� STUCCO ON FRAME BRICK ON MASONRY ATTIC STIRS. & FLOOR BRICK ON FRAME CONC. OR CINDER BILK. I STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I--I POOR'` ADEQUATE NONE t 5 OF 10 - PLUMBING GABLE HIP BATH Q FIX.( _ GAMBREL MANSARD TOILET RM. (2 FIX.) `—"`"-""—""—"—'—"---�'•--"""_'_ I �, FLAT SHED WATER CLOSET _ .c,• r)%�' ,� ASPHALT SHINGLES LAVATORY �• /I i�w 0 WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING I ✓C.G' j TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES +%' •moi TILE FLOOR TILE DADO 1'u 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 t AIR CONDITIONING RADIANT H'T'G UNIT HEATERS _ 7 NO. OF ROOMS GAS f OIL B'M'T 2nd _ ELECTRIC t... 1st ' 13rd I NO HEATING 4" i > �0RTFj � own of � = 6 ndover 0 2 L. L •.�p, 4 1. 1` Y P E �.-. •-. --- y ' l DRliiE�' tl" � � ME���o er, Mass —I!f2 ooRF ? F BOARD OF HEALTH PERMIT T LD 0. THIS CERTIFIES THAT. .................... �! . .. ..... ...................,... .. BUILDING INSPECTOR .do .... Rough has permission to erect ......................... buildings on ..... g Chimney to be occupied as;.?OC A&A" Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough Buildings in the Town of North Andover. Final VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES b O N T H S ELECTRICAL INSPECTOR Rough UNLESS CON RUC -,1 ST T Service Final BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building ugh _ f Final i Display in a Conspicuous Place on the Premises FIRE DEPT. Do Not Remove Burner No Lathing to Be Done Until Inspected and approved by Smoke Dot. (57--�6 Building Inspector n DEPARTMENT OF PUBLIC SAFETY >a COMMONWEALTH 1010 COMMONWEALTH AVE OF BOSTON,MASS.02215 ENCLOSE CHECK OR MONEY ORDER MASSACHU*TTS LIENSE� FOR REQUIRED FEE, CONSTR, UPE VISOR MADE PAYABLE TO EXPIRATION DATE 6 EFFECTIVE DATE LIC NO. -,COMMISSIONER OF PUBLIC SAFETY" 07/31 /1994 RESTRICTIONS j08/01 /i 991 056324 NONE } (DO NOT SEND CASH). jRICHARO J GRIMES 5344 CHICKERING RD SS 0 011-51-7425 N ANDOVER MA 01845 PHOTO(BLASTING OPR ONLVI FEE: 0 00 N01 VALID UNTIL SgNEO BY LICENSEE AND OFf ICIAILV 1 HEIGHT: STAMPED-OR'SIGNATURE OF THE COMMISSIONER _ DOB: - Dp OT DETACH LICENSE STU9 11/0211960. 2` SIGN NAME IN FUILABOVE SIGNATURE LINE THIS DOCUMENT MUST BE ggM7UIf OF LICENSEE CARRED ON THE PERSON OF! OMMISSIONER THE HOLDER WHEN ENGAG- OTHERS-RIGHT THUMB PRINT ED IN THIS OCCUPATION 20OM•2-87.81429 L-,. l� Building Location ��/ C'hI��� Permit � Owner's New Name7z)est,—A go Renovation p Acpiscemer>t �/ . Plane Submitted: Yee Q No 0 C Jr< K O O M K oil f3 ZO • .er > K F y f,ft 0 It K r = p d Z < a t O 26 , D It, o u 0 O K C O 4; ILIii 0 • •A/eMAkT for FLOOR ISAID FLoOk SROFLoOR i ' STK PLO01t ITH FLOoR tilt FLOOR ?Tit FLOOR , tTH FLOOR hutalling Com pang Name �i4c s y�Ldsy,,�i,�ps Check Address 2 one: ke r � Certgtute Gi Ae , P Corp. 4M, D/cQ 2�' ' Bwineae Telephoned Partnership Q 78 - �� 7 Q Firm/Co. NMO ce Licensed Piumber or Gas Fitter INSUgAAICEC© I have VEgaGE:: E current liability Insurance K You have checked ye t. please Policydicate r substantia! a Check one typethe covers quivalent. Yes Cl Ifabllty Insurance sae by checking thea No ❑ Policy Q' � appropriate box. 3*11 INSURANCEOther type of �emnhy p "apter i« WAIVER: t ani aware that the licensee dos Bond Ij °E the Mass. General Lawa. and that m rI7Y signature on fhls the insurance Covera 9natura o met Permn application watvee this�e requited by or Owner7s ent Check one: Qubement. Owner p it by carllty that aft Agent (� . �d0a and that al!ha defalis and Inlor 'IkNnf ' afE plumIII work and Insi.11eliwiy have Hi 6d ovlsfons or Iht Mases ed for entered)In a d►usetis State pas _ Performed under the permff i'sfwvs apDlfcatlon �bds and C aptK I42 of t�p� � IOr this applat#es �i and aCCUISIc to Iha buE of my T ws. In oompllanca rrlih aft f�nsc; Plumber GAS(Ions urs o nse um afar ar as (OfFICE USE ONLY) Joumeymen Ucense Number of%9753 I �. �., I i � -� Date... ... ....... ........ A of No FT era TOWN OF NORTH ANDOVER 0_ PERMIT FOR GAS INSTALLATION + r 9SSACMUSEt O O This certifies . . . . . ... . . . . . . < . . . .,�,. . has permission for gas installation _ : . . . . . . . . . . . . . . . . . . . . in the buildings.of . �°`t . - . . '.. . . . . . . . . . . . . . . . . . . . . . . . . ., North Andover, Mass. l ?. . . . . . Lic. No.. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . GAS INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer r ,�