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Miscellaneous - 115 MAIN STREET 4/30/2018 (4)
.s- C. 1{V r i I t �?��� �I1 Location .1�� 1 ti "Sll No. Date '7 NORTH TOWN OF NORTH ANDOVER MP ♦ s Certificate of Occupancy $ CNUSEt� Building/Frame Permit dee $ Foundation Permit Fee $ r Other Permit Fee $ TOTAL $ Check # / Building Inspector RECEIVED TOWN OF NORTH ANDOVER BUILDING DEPARTMENT 6 2001 -0 APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING ,:.g OTHER THAN A ONE OR TWO FAMILY DWELLING 4"... z^�r :: ' as`' ,%1", -:.art '"3.. fThis Section for Official Use Onl �R 6 BUILDING PERMIT NUMBER: DATE ISSUED: SIGNATURE: 7I O O Building Commissioner/Inspector of Buildings to 1.1 Proprt Address: 1.2 Assessors Map and Parcel Number. U? 00-1/� Map Number PMuurkbl Zoning Information: 1.4 Property Dimensions: v Zoning District Proposed Use Lot Area Frontage(ft) m 1.6 BUILDING SETBACKS(ft) Front Yard Side Yard Rear Yard J Required Provide Required Provided Required Provided 1.7 Water Supply M.GL.C.40.§54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal On Site Disposal System ❑ 2.1 Owner of Record _ P ( rint) A dress for Service: �12jr w6 BOR ure Telepho 2.2 Authorized Agent 4g-" .6 . /;:,ax Na e P* Address for Service: Sign ture Telephone m 90 3.1 Li,eensed Construct on Supervisor Not Applicable ❑ )zoki TvR ,,s D S-(o 5 7 Address QLicense Number 0 Licen Constructi S sor: d` 77 ®3 qa 7G[ Expiration Date Signature Telephone , 3.2 Registered Home Improvement Contractor Not Applicable Company Name" Registration Number M r Address r Expiration Date ^^Z Signature Telephone Y/ �a o Workers Compensation Insurance affidavi 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 Yea....... No.......❑ SECTION-5-PROFEMON,, )�tESIG,I�. CDNSTRt7CTIONF S19RV�tC> s > OR,BX D� 9M "1"C ES SUBN .TO " CONISTRIITCnos ED Si'A 5.1 Registered Architect: Name: Address Signature Telephone .5.2 Re,�is�•ed I�rofasston�$ sp Area of Responsibility Name: Registration Number Address: Expiration Date Signature Total Not applicable ❑ Name: Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address r Registration Number Signature , Telephone Expiration Date ' I 0 --4--AL Not Applicable ❑ Compa4y Name: IC-ONJ �y Responsible in Charge of Construction • II l I New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition 0 Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly 0 A-1 ❑ A-2 ❑ A-3 ❑ 1A ❑ A-4 ❑ A-5 ❑ 1 B ❑ B Business ❑ 2A ❑ C Educational ❑ 2B ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ IInstitutional ❑ I-1 ❑ I-2 ❑ 1-3 ❑ 3B ❑ M Mercantile ❑ 4 0 R residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing.Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34: rZ f j. BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floor s Total Area s Total Height ft v-r Independent Structural Engineering Structural Peer Review Required Yes ❑ No SECTION 10a Owner Authorization- TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT R-" 09j� U as Owner of the subject property A.0 Hereby authorize A_ �g! to act on My , ' all matters relative two work authorized by this building permit application Signature of er Date as Owner/Authorized gent declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury / ki Print Name 115-16 SigrAture of Owner/Ager D e Item Estimated Cost(Dollars)to be Completed by permit applicant t 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of Construction from(6) 0-0" 3 Plumbing Building Permit fee (.) X(b) 4 Mechanical(HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) ® Q p Check Number �r � . J.. ♦'� '.Iw a � e ^;: i is> t ri N' tit s f ` � NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TRABERS 1 ST2N 3RD SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS ' HEIGHT OF FOUNDATION' THICKNESS SIZE OF FOOTING X MATERIAL:iQF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE 0� e>''�;, � ITr���12cD2 �c�o� Ory � FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits f4-,m Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICANT FILLS OUT THIS SECTION*********************** APPLICANT PHONE LOCATION: Assessor's Map Number ( PARCEL 6t-4g SUBDIVISION LOT(S) STREET l��tlry �'�. ST. NUMBER L5 *****************************************OFFICIAL USE ONLY*********************************** RECOMMENDATIONS OF TOWN AGENTS: CONSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT IRE DEPARTMENT o RECEIVED BY BUILDING INSPECTOR DATE Revised 9\97 jm +. ��ee -�omvnwnwealt�i o�i�aooa�uaea BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number:,C6 056874 80 . 02/07/1962 4 , ^ Expirpx:0?107/2003 Tr.no: 6582 Restricted To:. 00 RONALD T AUBIN j 103 ST AGNES AVE WOONSOCKET, RI 02895 Administrator The Commonwealth of Massachusetts d Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Name Please Print Name: TEd ' s Construction Co. , Inc. Location:1081 Diamond Hill Road City Woonsocket , RI 02895 Phone # 401-769-4285 I am a homeowner performing all%fork myself. k I am a sole proprietor and have no one working in any capacity } FX I am an employer providing workers'compensation for my employees working on this job. Companyname: TEd ' s Construction Co. , Inc. Address 1081 Diamond HIll Road, P. 0. Box 843 City Woonsocket , RI 02895 Phone#: 40I-769-4285 f j Insurance.Co.. Beacon.-Mutual Insurance Co.. Policv# 0000025515 Com panv.:name.- _ Address . Clt . -- _ Phone.# I.nslllande-Co. :. POlicv..#. Ii 6i to secure cove rage as required under'Section 25A or MGL 1'52 can lead to the iniposilion of criminal penalties of a fine up to$1.50.-OO and/or one years'iniprisonrtaentAs-V&B-as.civ.il.pentties-inihal r nSS .1NDt3K9RE)FJ .grid_.aiiine_of- -O M--ajlayagainstme I understand that a copy of this statement maybe forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under pains and ' nalt" of perjury that the information provided above is true and correct. Signature. Date 7/5/01 Printname Ronald Aubin Phone#401-769-4285 Official use only do not write in this area to be completed by city or town ofricial' City or Town Permit/Licensina El Building Dept ❑Check if immediate response is required 0 Licensing Board p Selectman's ice Contact person: Phone#: Health Department Other Town of North Andover Na�Th �o :6'�tia Building Department o 5•` - „ ' 6 °� 27 Charles Street North Andover, Massachusetts 01845 (978) 688-9545 Fax,(978) 688-9542 -c- ��SSgcuus���y DEBRIS DISPOSAL FORM In accordance with the provisions.of MGL c 40 s 54, and a condition of Building permit-#... � the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, sl 56a. The debris will be disposed of in/at: Facility location Si ature of Ap licant Date NOTE: A demolition permit from the Town of North Andover must he obtained for this project through the Office of the Building Inspector. ,ORT, wM o O' 1 Town of : over oro No. 3 a -= X ° dover, Mass., TT�,! I , �.a•I %p ADRATED S H E BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.S�. ?. '!�k. t ►�'{' �. ��CV%-?% 4hW.'Y/ Ds0. .,Tr/ti?!C'R..•:......... Foundation has permission to an*....... !.!Z............... buildings on .......1.1.5.. .[ .t.ti?..... ......................... Rough to be occupied as..... .!.ae IGC ? !TT�.O..!4?T.. /�J '..�11.J.. ........... ............................. Chimney ........... provided that the person accepting this permit shall in every respect conform to the terms of thea plication 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 �c1v�o�T aD =uaJl�,u►.pe� �w�S VIOLATION of the Zoning or Building Regulations Voids this Permit."%V �;��T, Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR 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 Dec. a._ 3 Town of North Andover E Kos F Office of the Building Department Community Development and Services Division _ William J. Scott, Division Director '►. -� - • 27 Charles Street ��8s D. Robert Nicetta North Andover,Massachusetts 02845 Telephone(978)688-9545 Building Commissioner Fax(978)688-9542 Plain Review Interior Renovations CVS/Pharmacy: 1. Form'(P'to be signed offby Fire Department 2. Work is to be performed on to the vestibule entrance—the entire entrance is to be upgraded to the handl cap accessibility code. See attached drawing. 3. Handi-cap parking signs must be installed in the ground so that they are permanent. C,A pp A ►�cQt Cir ��! l jrCj S Aj h �- A- BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535 521 CNMZ kRCMT-ECTURgL ACCESS BOARD i i i - st. _ T 25.1 GENERAL j q All public entrance(s) of a building or tenancy in a building shall be accessible. public entrances are any entrances that are not solely service entrances, loading entrances, or entrances restricted to employee use only. Y 25.1.1 Service entrances: If the only entrance to a building,or tenancy in a facility, is a service entrance, that entrance shall be accessible. e~�u s 25.2 APPROACH I The approach to an accessible entrance shall be a pavedw alk or ram Interior by steps. Entrance(s) shall have a level space on the inteor'AiLandeext r o plying ofthe surface, f entrance doors comwith Fig.25a and 25b. 25.3 VESTIBULES Between any two}tinged or pivoted doors, there shall be a minimum of 48 inches(48"= 1219mm ` 4• plus the width of any door swinging into the space. See Fig.25a and 25b. ) 4t1' min } 1219 t — ........ �r---- .i Vestibule 1j rQ��I Flgure 25a l j NOTE: Sea Figures 26d and 26e y 60• t 1524 Veatlbula (Alternate Solution) Figura 25b 25.4 MATS AND GRATES ,+ Door trials h inch 13mm)thick ni.— __- . or less shall u Door mato hnr.■,. be srely anchored at all ed¢es to avn;(1 ��:..,.r, ` . L cation N!, Date " NORTH TOWN OF NORTH ANDOVER op _ Certificate of Occupancy $ r + ng/Frame Permit Fee $ h� cHust Foundation Permit Fee $ R Other Permit Fee $ $ .ler Connection Fee $ DEC 2 Water Connection Fee $ TOTAL $ r Building Insr- PER.1fIT NO. rI6 7 APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. il`d//'Y'.�f� f,/, PAGE 1 MAP 4-40. LOT NO. 2 RECORD OF OWNERSHIP IDATE (BOOK :PAGE ZONE I SUB DIV. LOT NO. `LOCATION , 11/� tl ComJ;- PURPOSE OF BUILDING f. a-�YJ� y�) 1 I 1� (per- OWNER'S p+� OWNER'S NAME l'/�J I ` cNO. OF STORIES �l SIZE�y+W OWNER'S ADDRESSD,�E �.J. � �n� BASEMENT OR SLAB - ARCHITECT'S NAME �11} /� V SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME-7-4 , .3 ( �; I�1 SPAN --- GG1�1 n, ..L.l\L 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 KO SIZE OF FOOTING X IS BUILDING ADDITION IDC) MATERIAL OF CHIMNEY IS BUILDING ALTERATION 'r/�''� 7LAAj� 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. COST _ c�51 �)jfj• QCj PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS Y PLANS MUST BE FILEDA p APPROVED BY BUILDING INSPECTOR DATE FILED oZ BOARD OF HEALTH SIG TU O A H=ZED NT FEE af �� OV OWNER TEL.# PLANNING BOARD PERMIT GRANTED C0NTR.TEL.#9°�' 19 - CONTR.UC.# Ot) BOARD OF SELECTMEN �/� BYILDINO INSPECTOR BUILDING RECORD 1 OCCUPANCY 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 RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION —I 8 INTERIOR FINISH CONCRETE 3 1 2 I_ CONCRETE 81.K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ _ DRY WALL _ UNFIN. 3 BASEMENT 11 AREA FULL FIN. B'M'TAREA _ '/. 1/1 1/. FIN. ATTIC AREA _ N_O 8 M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WAILS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING FARD"J'D _ ASBESTOS SIDING COMMC:N VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 8 FLOOR _ BRICK ON FRAME CONC. OR CINDER BILK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH (3 FIX.) GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. d COLS. STEAM STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd NO HEATING FORM U - LOT RKLEASE 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***************** �5�-- 1 bo APPLICANT: V ) t�l - Phone LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) Street Au i St. Number s ************************Official Use Only************************ RECOMMENDATIONS OF TOWN AGENTS: I I Date Approved Conservation Administrator Date Rejected • Comments Date Approved Town Planner Date Rejected Comments i Date Approved Health Agent Date Rejected Comments Public Works sewer/water connections driveway permit Fire Departme t� � �cev' �� 41 /;o 2evf-7, Received by Building Inspector Date DEC 2 81992 r i _ _ I L San LauRealty Trust 109-123 MAIN STREET,SUITE E2 ^ NORTH ANDOVER, MA 01845 TELEPHONE(508)686-8683 FAX (508)681-8498 December 28, 1992 Robert Nicetta Building Inspector Town of North Andover 120 Main Street North Andover, MA 01845 Re : Renovation - CVS Store Dear Mr. Nicetta, Please be advised that this office has granted permission to Consumer Value Stores (CVS Pharmacy) to renovate the store in accordance to the plans dated May 15, 1992 and as amended by the 99 incorporating the adjustments to letter dated December 23, 1 2 p g 7 the front doors. If there should be any questions, please do not hesitate to call me. Sincerely yours, SAN LAU R ALTY RUST Anne M. Messina, Property Manager AMM: lam i i NORTH Town ofAndover o TV% v � * _Y h y 19P.1 4-���ATQr " dover, Mass., flAlrz COC HIC NE WI K �t QA°RT RA-r pP�\ "`C, H BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT......Cj... .. ...�'1.. .J1V............................................................................ Foundation ....................... has permission to Meet../� .�1 .... buildings on ....�.�. .... .) ....... ...T Rough to be occupied as..... . AV.r..A.A,4.AA.....#fjr JV�..vlt .. ...... � Chimney ..�.. .r ' �1T 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 STARTS ELECTRICAL IN ECTOR J'.dL Alto A � Rough ............... Service BUILDING S CTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR gh Display in a Conspicuous Place on the Premises — Do Not Remove F nal No Lathing or Dry Wall To Be Done FIRE DEPARTMEN Until Inspected and Approved by the Building Inspector. Burner 4S.1-1 r PLANNING FINAL ����-� CONSERVATION FINAL street No. ` Smoke Det. ,,.,A-rf-r, MKI A, �_ ,),� hpl\/GIA/QV PKITRV pFRRAIT CERTIFICATE OF USE & OCCUPANCY r Town of North Andover Building Permit Number 569 (1992) Date FEBRUARY 3, 1993 THIS CERTIFIES THAT THE BUILDING LOCATED ON 115 MAIN STREET/CVS STORE MAY BE OCCUPIED AS INTERIOR RENOVATIONS IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. ��"*�+ CVS/SANTO MESSINA Of CERTIFICATE, CERTIFICATE ISSUED TO 231 SUTTON STREET ADDRESS NO,IRT/H' ANDOVER, MA 1d'AC "sBuilding Inspector MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) Mass. Date 3 19 City, Town Permit # Building Owner ' s lug AT: Location Jr ��uI r S j Name_ (� _ Type of Occupancy : New ❑ Renovation Replacement ❑ Plans FIXTURES submitted : Yes ❑ No N Q N Z Y O ZZ W W W Y J N Q V FQ- N O a CC S S N Z N 6 x s N Z O Z_ to a 6 y W N N Y N F' ) W N Y < N U. z a Z3 X $ V m y Q f. N Z k a a Q — Q O \ rL W .F-. F. W Q y Q J N cc J Z O LL O LL Q C W = Q Y O Z Y Y a O H Q Y Q W u. Y W V Y t- O Z CL O V7F- Z O O N Z Z W f. O V x Q H Q Q S N N Q Q O Q J J Q ¢ W Q O Q 1 3 Y J m N O O J LL 0 O O Q 3 Cr ca O Q SUB—BSMT. BASEMENT 1ST FLOOR i 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR (Print or type) Check One: Certificate Installing Company Name C`' (torp. Address /JCe 13 v X % %( El Partnership /` /fi " r S 7"' i / 01 /'—/c r • C'd- G c–%k ❑ Firm/Company I have informed the owner or his agent that I do not have liability insurance, including completed operations coverage. Signature of Owner/Agent I have a current liability insurance policy to include completed operations coverage. I 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 Plumbing Code and Chapter 142 of the General Laws. Name of Licensed Plumber _ lgnature of Licensed Pl ber Type of PlumbingLicense 7 L� 3"� 6 33 %-G/�'� License Number Master ❑ Journeyman Business Telephone { � lJmmor.rralth c''hatsuchasctt • PIVA Qla-td'-ire M fryLF�Y ee„•...:. r:sae r:,:.-:u Mpi S7cN'ti 37 WEST aT 'i : :1F> MANS,F I F.:_j 11: sou..:. ..... IN PLUMBERS AND GASFITTERS ` REGISTERED As A PLUMBING CORP MALBA INC. 1,110909 STEPHEN HACQUEEN PO BOX 1118 MANSFIELD MA 02048-5118„ 1831l `` 05/01/98 148412 IN PLUMBERS AND GASFITTERS LICENSED AS A MASTER PLUMBE;;, F. STEPHEN MACQUEEN PO BOX 1118 MANSFIELD MA 10909 05/01/98 1484i� { . ` . Date. 3277 <" °T:'ti TOWN OF NORTH ANDOVER �r ��'' •� OCL p ' PERMIT FOR PLUMBING �€ ,SSACMUS� 01 This certifies that bx. ... . . . . . . . . . . . . . . . . . has permission to perform . . . o4 ".� . . . .l. .����. . . . . . . plumbing in the buildings of . . .V.S. . . . . . . . . . . . . . . . . . . . . . . . at. ./. ��.G.?!!�1.� . . s.?�- . . . . . . . A North Andover, Mass. Fee.T4, -. Lic. No.. .�. S . . . . . . �/4 i PLUMBING INSPECTOR I t WHITE: Applicant CANARY: Building Dept. PINK:Treasurer Date.... ..�.P... s c9 813 S . F' 4,ppL TOWN OF NORTH ANDOVER PERMIT FOR WIRING f ACMUs� ' This certifies that g a has permission to perform ....... a- ....cx.�...... 4 I wiring in the building of.... ............................................................... M. ..t.Si.�� '19t ................. .North Andover,Mass. l� !i Fee............:....... Lic.No......¢i/.........0................................................................� ELECTRICAL INSPECTOR «t WHITE: Applicant CANARY: Building Dept. PINK:Treasurer 0 f ?� Office Use Only Gibe (tnmmnnuuEniti of sPermit No. �L�TIIIfIittlit ttf J;uhlit -ttfttq Occupancy&Fee Checked BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts EIectrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 9 --x-97 (XK or Town of NORTHANDOVER To the Inspector of Wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) IIS YYA A tyi S fi Owner or Tenant IfS Owner's Address 1 C-VS b hZ I:UUU h).5oc �� 1���' Z fS Is this permit in conjunction with a building permit: Yes .� No ❑ (Check Appropriate Box) Purpose of Buildino Utility Authorization No. r- Existing Service Amos _J Voits Overhead '! Undgrnd 11 No. of Meters New Service Amps _J Voits Overhead _ Undgrnc r No. of Meters Number of Feeders and Ampacity Location and Nature of Pr000sed Electrical Work Hot I No. of Transformers iotas No. of Lighting Outlets i No. of ..ct T.:cs KVA No. of Lighting Fixtures Swimming Pact arra e—in- I Generators KVA No. of Emergency Lighting No. of Recectac;e Cutlets I No. of Oil cumers I Battery Units No. of Switch Outlets I No. of Gas =urners FIRE ALARMS No. of Zones ection No. of Ranges No. of Air C r.c. Ito at;ons NInit ao. ft ngtOeviicesnr Heat Total Total No. of Disposals � No.of?ur^cs `ops K..y No. of Sounding Devices No. of Seit Container No. of Dishwashers ! SOdCerAr@a Heanra K'N Detec:;oniSeunring Devices Heating KW Local - Munic:oat .Other No. of Dryers I 4 .Oev:ces _ Connec:;on No. at No. oT Lc:: Vc:tage No. of water Heaters KW �.5 I Signs Baiiasts Wirnc No. Hydro Massage Tuos I No. of Motors Total HP OTHER: INSURANCE CCVERAGE. Pursuant:o the requirements ;::f '.tassac-L;ser:s ;enerat Laws I have a current Liaoiiity Insurance Policy Including Cbrr.c:etec Ccerattens Coverage or its substantial equivalent. YES NO = I nave submitter vatic brcof of same to the Office. YES 4 NO = If you nave checxee YES. please indicate the type of coverage cy checxing the appy mate oox. INSURANCE BOND — OTHER = (Please (Expiration Dam Estimated Value of Eiec:ncat Work 5 .2 —s—,717 s Nora to Start —`7 7 Insoecuon Date Recues;ec: Rough Final Signed under ;he Penalties of perjury: / FIRM NAME l��'iOvuPt �"t 1C!�t� SO L fD> �H.0 LIC. NO. �fIQaW Licensee /?' n� T"2✓a(^w K/ Signa:ure d LIC. NO. Bus. Tel. No. 1-7 233 23 9-9- Address Alt. Tel. No. OWNER'S INSURANCE`NAIVER: I am aware that the Licensee Cees not have the insurance coverage or its substantial erutvatent as re- ouired by Massachusetts General Laws. and that my signature an .n;s cermet application waives this requirement. Owner Agent (Please checx ones Teiecrone No. PERMIT FE= S iSignature of Owner or Agent) �r \�/ x-5565 Location l Y�Il4 l No. Q Date NaRTM TOWN OF NORTH ANDOVER f p Certificate of Occupancy $ r �'�a ••a°^Eta Building/Frame Permit Fee $ s�CHus Foundation Permit Fee $ Other Permit Fee $ j TOTAL $ Check # 1 15 2 u 3 / Building Inspector 3 : - . . .,� �o Date... ...'....�.............. NORTH O�t.�•o`.41' TOWN OF NORTH ANDOVER p PERMIT FOR WIRING SSACMU`'E� This certifies that ........................................................"....`........:................ has permission to perform ............................................................................... wiring in the building of.......... at../i J — .... ...............'........................................................ ,North Andover,Mass. Fee ..-':............ Lic.No.'..��...:: .r f - o .......:...................................... ELECTRICAL INSPECTOR Check # ///P ,/ WHITE: Applicant CANARY: Building Dept. PINK:Treasurer •\ 27MCVMMONWEALIHOFMASMCHUSEII S Uthce Use only r DEPARTMEVT0FPL7B1JCS4FETP Permit No. BOARDOFFREPREV MONRWMT70NSS27O RI2:00 Occupancy&Fees Checked �0U APPUCATION FOR PERMIT TO PERFORM ELECMCAL 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) Date, I c, 2 611 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) j S �7►�i W S 7 Owner or Tenant� V �rnrr+rl Owner's Address 1 CCAS r WC,r/yt.X�&f- 9-17 02-L95 Is this permit in conjunction with a building permit: Yes 0 No (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Service Amps / Volts Overhead M Underground No.of Meters New Service Amps / Volts Overhead Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work C u i __em t-,, lgd Phil j?kkir u -rg 4m I 0 t_ No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool AboveBelow Generators KVA and ound No.of Receptacle Outlets Zd No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Somers 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 No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal a Other Connections No.of Water Heaters KW No.of No.of L Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER tacrm /reS 1nSII 2 �Uur:�d�S JK/ ��/Jrt�nhC�� - 1r1S'7tbifl Q,L • Pl�italtbtlrtBQl)BHTltil���'mHlt3'd1L3WS _ Iha%eacunatLiabd yhaur =Pblicymc1u g.CanplIe��Ca cr tsatsfal>5aleW valalt YES © NO o Iha%esubrnkcdvandpoofofsame1oftOlhce YES U NO r If}wha,,edvcWYES,pkmircethetypecfw aagebydmktrgtbe 1NSURANC'E F1 BOND [:] GIIIIR r-1 (Plea9eSptxaiy) E*a6cnDak FslJm&dVahtecit kftxal Work$ WaktoSm zUlw Z. al.__ ht)actionDWRaVesWd hough FM SigrxdtaxkrMPdWksofpsjt V. lioa�seNa 1^� I C/G� FIRM NAME G fart c 4rZ Ut CCSvt e —� BisirmTel.Na ? •3 73 M,-" A1tTeLNa OWMRSRgSURANCF-WANFE;I.alnmr=dattbeLioaz',sedoesnot theicsuanew=pcntsakAitatemndatasi8gmWbyMasadxseitsCmxALam aod�atttrysig�seattfuspem�app5c�oltwai�es�lt�cglbarlall: (Please check one) Owner a Agent a Telephone No. PERMIT FEE$ ��. "COMMONWEALTH OF MASSACHUSETTS me]kTj . . OF ELECTRICIANS ;EGISTERED MASTER ELECTRICIAN J ISSUES THIS LICENSE TO d P=AGAN ELECTRICAL SERVICES IN.( . LAWRENCE T FAGAN PO BOX 546 WOBURN MA 01801-0645 lAO06 A 07/31/04 336936 4 L TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING T OTHER THAN A ONE OR TWO FAMILY DWELLING X . z ., +` �''-.:,zr '"s y4, $ "c ,iz-. .Y'-•s 3,`..Y'amu ` ;. ti�`y 3. ,� -;.:Stc „�d h:a This Section for Official Use Onl BUILDING PERMIT NUMBER: DATE ISSUED: � ) la ^ '7 —ac)0 � z SIGNATURE: 0 Buildin&Conunissionerff or of Buildings Date 1.1 Property Address: 1.2 Assessors Map and Pared Number: Ant-nn t g (1l PanPrG c:;,) ✓ V 71 Map Number Parcel Number v 117 Main Street (/d y-���7•/ �11..3 Zoning Information: 1.4 Property Dimensions: �yv Zoning District Proposed Use Lot Area Fronts ft 1.6 BUILDING SETBACKS(ft) M Front Yard Side Yard Rear Yard Required Provide Required Provided R red Provided r 1.7 Water Supply M.G.L.C.40.§754) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public 0 Private ❑ Zone Outside Flood Zone ❑ Municipal On Site Disposal System ❑ }PFJ. 9pSudA�'� ININARW 2.1 Owner of Record U RAST /' I-/�3 �I,�i� .57-t�, ,STS C;?- 0 11 7anj riot) Address for Service: t_ f S (�79 (5 466-3 m �}1vwc— M I� C` C< Nx, Telephone 2.2 Authorized Agent J SAS C As /-e- Z Name Print Address for Service: 0 Signature Telephone m •- INN. 90 3.1 Licensed Construction Supervisor Not Applicable ❑ 72 Evelina Drive; Marl horoug1l MA 01757 #018964 Address License Number 0 Alexander A. Rossi -n Licensed ConstructionS sor: 06/08/02 978 692-0755 Expiration Date Z'kJ-. 02 Signa re Telephone 3.2 Registered Home Improvement Contractor Not Applicable M v Company Name. Registration Number M r Address r Expiration Date /Z Signature Telephone Q i sEC�rbx a `4�+'"ORI�R1� ExsATtt�x•��.�.C� Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yea......k No.......❑ SECTION 5-PROFFW DFMM C,; +lr' NMCT][ON. ERVIC1<IS PF1$t31( Il�t S AICD iia RE5 SCJ .#Jg _TI(3," CON 'DS ACC} 5.1 Registered Architect: Name: Address Signature Telephone .2 Rest a _P�rmfessiiaius ;r , ' Area of Responsibility Name: Registration Number Address: Expiration Date Signature Total Not applicable ❑ Name: Registration Number Address Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number R Signature �y Telephone Expiration Date •4 IMAM 1F i} F> Construction Resources, Inc. Not Applicable ❑ Company Name: Alexander A. Rossi Tel: (978) 692-0755 Responsible in Charge of Construction New Construction ❑ Existing Building 9 Repair(s) ❑ Alterations(s) Xl Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: Remove existing 3'6"x7'0" Hollow Metal door and frame and install a 5'x8' Hollow Metal frame with a VxMil -3/4" Hollow Metal Door (Active leaf) and a 2'x8xl 3/4" Hollow Metal Door (Inactive leaf). 77-1 USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ IA ❑ A4 ❑ A-5 ❑ 113 ❑ B Business 2A ❑ C Educational ❑ 2B ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ IInstitutional ❑ 1-1 ❑ I-2 ❑ I-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R residential ❑ R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 ❑ S-2 ❑ 5B U Utility ❑ Specify: M Mixed Use ❑ Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34: '" BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floor s Total Area s Total Height ft .F Independent Structural Engineering Structural Peer Review Required Yes ❑ No ❑ SECTION 10a Owner Authorization- TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property Hereby authorize to act on My behalf,in all matters relative two work authorized by this building permit application Signature of Owner Date Agent as Owner/Authorized Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury �IVlVe � e,5 IMI Print me S tune of Owner/Agent Date Item Estimated Cost(Dollars)to be Completed b t applicant P Y Perms 1. Building (a) Building Permit Fee $ 5,500.00 Multiplier 2 Electrical $ 1 ,000.00 (b) Estimated Total Cost of Construction from(6) 3 Plumbing N/A Building Permit fee t.l X(e) /f� 4 Mechanical(HVAC) 5 Fire Protection N/A 6 Total (1+2+3+4+5) $ 6,500.00 Check Number ( - t � .� l # a.� l�Y i S 1r T d slF tS�W R,'5 NO. , NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TM4BERS 2ND 3RD SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIIv1ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CBMINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE ,�' .- Y ase Kxt-s> ,?ax yrr`<a. ,Mfi a ,,;3M Town of North Andoverr►ORTH oti,��go .6�tio Building Department o 27 Charles Street * ,� North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 �SSACHUS DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit# the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, s150a. The debris will be disposed of in/at: Bourne, MA Facility location Signat dre of Applica t 11/15/01 Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name: Location: City Phone aam a homeowner performing all work myself. 01 am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. Company name: Construction Resources, Inc. Address P.O. Box 350 City Westford, MA 01886 Phone#: (978) 692-0755 Insurance Co. Acadia Insurance Polic ry#_WCF 0041352-12 Company name: Address City: Phone*- insurance Co. Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby certify under the pains and penalties of ,perjury that the information provided above is true and correct Signature Date 11 /15/01 Print name George M. Gocras, Jr. - President Phone#(978) 692-0755 Official use only do not write in this area to be completed by city or town official' ❑ Building Dept ❑Check if immediate response is required Building Dept ❑ Licensing Board ❑ Selectman's Office Contact person: Phone A ❑ Health Department ❑ Other FORM WORKMAN'S COMPENSATION ` I �� ✓�re�4f/F9ft(s9u!lCCi�l�nr.7�r74N7!�flJC�6 . i BOARD OF BUILDING REGULATIONS �1 License: CONSTRUCTION SUPERVISOR Number: CS 018964 Birthdate:06WI948 - Expires:06/082002 Tr.no: 25593 . Restricted To: 00 ALEXANDER A ROSSI _ 72 EVELINA DR MARLBORO, MA 01752 Administrator ANToW5 CleANerS 17 N)A i N 3 Tr e CST' �1. p Nldo ver- M ✓� �xl��,-►, 3x7° 6Xi54-,`35pl r,`cb ✓'e),iee.� CT follow Me-1a,1 2�oor '7P-) 4oA/Is NN .. ; .. - n coo once C4y .. - �I,K1N B . Scale: �y. _ I . C4 qt nrn aaev New 3'X8° wo//ow» e-fot ago.- NZ'x 8'l�0llow »�e��9/ cloo, Reloc 044 sw:4--hes �- -P)- -P I)?&I T-0 IP v t r.'or �!4/ FlGc�uS .Ga ,r z ao Ln N�' W x o Z • o 00 0 J N N Z V E/eV,4)-_or4(TqT -.o as ec/ _ /�e✓A ;.o±9( 7 0QToxJS Clep4eY-S 117 M,4 i N! 5+r ee'I" IU. Atir�oyev- M l9. !v -z6- Zoo/ CONSTRUCTION RESOURCES, INC. P.O..8ox 350. 288 Littleton Road Unit 17 WESTFORD, MASSACHUSETTS 01886IN l %5fih� F 6 coo al 0 0 SOI - �era _ AAA rrr x ce; t ;Y1 Ex;5,-� t � Tr;rvr (r'erw✓e And replace" i AS Y'e$v;recd New.Gvoo J block:IT _ o►%ehew."a�Pe»%h j N.e 9.e-4 er.: Plywood >✓oiers_ x;s. 4-; Ne") S- x 8 x 5 /,4. )ono_o Ye)leev- - ReJar-k Yr)efA1_ ooY- Fr-RMe A5. Y`eprvred S cTf E 0 N . 119 -- A NORTH E Town of Andover 0 .1 F No. C% - LA Co HIC dover, Mass., 42- TED H BOARD OF HEALTH Food/Kitchen PERMIT T D . Septic System /eea// — BUILDING INSPECTOR 1 .7 Z 0 THIS CERTIFIES THAT... .A..A)...................................... . .. has permission to erect...00 ............... Foundation ............................ buildings on ..... .......InAIA)....&/.................................. Rough to be occupied as..... . A; 4 A AJO'CM W-A)4- Chimney O.D .... .........*'****.. ....... ...... 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 ='2 �/Y'p VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTIgN SWTS ELECTRICAL INSPECTOR Rough ........ Service . ....... ......................... ...Aia .. 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 0 Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det.