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I"� w - , . -g, A .5 *v",N;P,�,,,`�O " . �.............� �vl, ,w " 1. ::: -� ; ," ��;jife ,, ffi,�TN -11 . � I , :: � ,,&&�, - �,�,�,� A I*. ,` , Z'�' -#,�, ,-��,,,;�*1,;"�r-��.,�."7,,��T-.�;��t-.,�-X . -, Z I. �'�U§t I �Y, �M,,'R , I IRM � �, , � :!! ,IS I,, ww�.......--.M 9 � IRVIN' __ :, I If cl e I" d M0117M,� O� 1 CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number 495 (1/12/06) Date: March 8. 2006 THIS CERTIFIES THAT THE BUILDING LOCATED ON 1160 Great Pond Road MAY BE OCCUPIED AS School— Handicap Bath & Shower IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Certificate Issued to: Brooks School 1160 Great Pond Road No 1 dov r aO1 .00C&4Av,a- Building Inspector NORTH f T0 0 s _ Andover No. Ila z LA dover, Mass., COCHICKEWICK 7,9 A�RATED PAIL �5 `s BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System i i BUILDING INSPECTOR THIS CERTIFIES THAT... Vii. ►.. .'T.........s-&-1 -41............................................................... ..... Foundation has permission to erect........................................ buildings on.//,C..*......&Am ....�!!!I..�...... �- to be occupied as............................. ,�I1�. �.`....... s►.... .......4..... ... . r/� ; imney provided that the person accepting this permit shall in every respect on orm to the terms of the application on file in anal this office and to the provisions of the Codes and By-Laws relating to the Inspection, AReration ad-ConsT ction of Buildings in the Town of North Andover. g :..� '- PLUMBING INSPECWR 4':-` ?L G < VIOLATION of the Zoning or Building Regulations Voids this Permit. , f o PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION ARTS ough . . ................. .................. Service BUILDING E p Finall 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. EEE REVERSE SIDE Smoke Det. e Location No. 6/3 Date 117 NORTH TOWN OF NORTH ANDOVER Of� •1O :•',hC 3? ° • OL Certificate of Occupancy $ �7s'•°'E<�' Building/Frame Permit Fee $ SACHUs ` Foundation Permit Fee $ Other Permit Fee $ t TOTAL $ l`✓ � SU Check # i L j ! Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REP RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING '�. ' BUMDING PERMIT NUMBER: DATE ISSUED: M ic SIGNATURE: -aI Building Commissioner/InEewtor of Buildings Date z SECTION 1-SITE INFORMATION 1 O 1.1 Property Address; 1.2 Assessors Map and Parcel Number: 1L� d �iQ�z f f2b &,' -- ��d�� Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area Frontes ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Re red Provided v 1.7 Water Supply M.G.L.C.40.t 34) 1.3. blood Zone brformation: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside blood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of ecord Name(Print) Address for Service Sigfiiture Telephone 2.2"Owner of Record: Name Print Address for Service: M Signature Tele one 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: 410 License Number Address Expiration Date RC ,%gnature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ ,5G(VV CQVO —PYQTcI�A f X92 R p� Company Name 1�� Nr� Registration Number r rAddres 3-S9s�=G�423 �' lav Co z (La Expiration Date /'� Si nature Telephone V I SECTION 4-WORKERS COMPENSATION(M.G.L. C 152 § 25c(6i77 Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......0 No.......❑ SECTIONS Description of Proposed Work check aH a cable New Construction ❑ Existing Building ❑ Repair(s) [j"'` Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify r Brief Description of Proposed Work: l l SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant 1. Building 0-0 (a) Building Permit Fee ��✓� Gf� Multiplier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)x tbl 4 Mechanical HVAC .5&//e-/7�- 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 I• as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date " SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are Lrue and accurate,to the best of my knowledge and belief 5�f rq,2 �t v GCC° Print Nam ature of Owner A ent Date NO. OF STORIES SIZE fi BASEMENT OR SLAB SIZE OF FLOOR TUABERS1' 2� 3ku SPAN DIMENSIONS OF SILLS D N ENSIONS OF POSTS DIN ENSIONS OF GIItDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHEVMY 1S BUILDING ON SOLID OR FU-LED LAND IS BUaDIN 1 CONNECTED TO NATURAL GAS LINE NORTH own of _ 4 over LA�o dover, Mass., COCKICKEWICK y` �d ADRATED S ` BOARD OF HEALTH PER IT D Food/Kitchen Septic System .... ........................- 0- BUILDING INSPECTOR THIS CERTIFIES THAT ................................. .. Foundation ...R1. .......................... has permission to erect...........w.......................... build! ..R.6..0.... ...... ........... ugh to be occupied as . ....... .. .......... ..........-# Ch' e .. ............... ........................................ unn y provided that the person accepting this per shat in every re act conform to the ter the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, A ration 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 CONSTRUCTIONS T � 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. IFSEE REVERSE SIDE Smoke Det. ✓2� � �Hg ReA 8ad Stxu& Board of ' ns HOME IMPROVEMENT CONTRACTOR F'sgistration. 142928 Expiration: 61112006 Tipc D8A S.G.M.CONSTRUCTION' r �` SERGE MICHAUD � c..% 2 TATE ST AdmIOC HUDON,NH 03051 v� North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be id waste disposal facility as defined by MGL rl licen sed sol p disposed of in a properly c 11, S 150 A. The debris will be disposed of in: (Location of FacHity) Signature of Permit Applicant Y ��S� Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector a Certificate of Liability_Insurance Date of Issue 0113=06 i Producer This Cerflficitle is Issued as a matter of Information fApplef�ee Irwuratloa only and confers no rights upon the certi/ioafe holder. 1 This ceriiflcatl3 does not amend,extend or atter the coverage afforded by the policies below. -- 1 CampbsM Ave Hudson,NH 03061 Companies Affording Coverage 6038819900 Company PENN AMERICA Insured SGM CONSTRUCTW_ ComPm►Y HANOVER INSURANCE SOM CONSTRUCTION Company 2 TATE ST. c0f nPany HUDSON,NH 03051 company UBER1Y MUTUAL �y...... Company ,Coverages This is to certify that the pokles of Insurance ftled below have been issued to the Insured named above for the policy period Indicated, nolmAhetandinp any requirement.Mon or condition of any contract or other document with respell to which this certificate may be IUU$d or may ,pertaln,the insurance afforded by the potkles decrlbed herein Is subject to all the terms,exclusions And conditions of such policies limits show may 1have been reduced by pall daims. Co Type of lrwurancA Policy Number Policy Effective Policy Expiration Ltt i Date Date I General Us Mily — Gema,A 'r Ulm),0:: i A Commercial General Llability I PAC63M91 03M20" 0312/2005 Pmduct*CornPVpAgg In- Cialma Mad W ommnm Personal&Adm hrj►vf $1.000.000 Owners A Convames Prot I Each 0cmNmnes :1,0001000 1 t"ire Dimeae(erns ane lfie iso 000 '�EkPtAnyone wi1.000 Automobile UoblMty Combkxrd Skov omit e Any Auto• ABV717319500 0312/2005 03M212006 $300,000 F]AN owned Autos I F reoN Ischeduled Autos �Hired Auto* lNurys ❑Non-Owned Autos (AaddeM --- --� �► ra�Map s. C I Garage Uabillty i Aumoniy-EaAoadern _...._.__ (�Any Ado carer Then Aub only Fach Alft Excess Liability ' ' Eadr Oomurano%_ _ D Umbrella Form (]Other Than Umbrella Form Exa Ea U_ E wo*mCompone"on 91N-04180W06036r I 0114120M 0011/3006 W.Wcst � and i _ — — ThePMpltetodPnloerhmeral [] Ind L E1.01semAo-PEOd _ 1 I s' " 100000 Executive Oers aro: 011ie D�awription of Operations&ocationWehiclawSpeciel hems Cernflcael''Holder - Cancellation Should any of the above described polioles be ovnoellod before tho BROOKS SCHOOL e*iration thereof,the issuing companywill endeavor to mail 10 1160 GREAT POND RD. days written notice to the certlk;ft holder named to the left,but Nre to mail such notice shall impose no obigaGon or liability of any- company.Its agraWwasentalives, NORTH ANDOVER,MA 01848 AuMorlrad ' ^' _ Location �`/ ' -�` —• \-A No. Date /4 )l MORTil TOWN OF NORTH ANDOVER O F w 9 Certificate of Occupancy $ f i Building/Frame Permit Fee $ JwCMus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # X66 _ ._ Building Inspector a TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. DATE ISSUED. _ I Ot _ 3 X SIGNATURE: Building Commissioner/Inspector of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 1100 (-Ar 000-b 12oAb Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use f Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided v 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT Historic District: Yes No rn 2.1 Owner of Record --J?j�bOVS 6�4,-RAlb Name(Print) Address for Service: Signature Telephone 2.2 Owner of Record: W Naiq Print Address for Service: O Z rn Si a,jre Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: ' /7 License Number O 12 47� � Ad ?�, > 6010%1-070 Expiration Date tgnature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name Registration Number r Adaress r Expiration Date ^� Signature Telephone YI 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 permit. Signed affidavit Attached Yes.......❑ No.......®" SECTION 5 Description of Proposed Work check all applicable) New Construction ❑ Existing Building Repair(s) I►3' Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: (1 ,, Aq'D/V6 � ?1Or��n i�� 4� �lCl ge(*M, 9W770 -L 1(JCA-& (00AM /fir ✓VLa SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant 1. Building a (a) Building Permit Fee Multi Tier 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 BUH.DING PERMIT 1, &40K5 as Owner/Authorized Agent of subject property Hereby authorize to act on My b calf,in all matter rel i work authorized by this building permit application. / g/0 3 Si i t e of r Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, As Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Signature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TINMERS 191 2ND 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS DIGHT OF FOUNDATION THICKNESS ` SIZE OF FOOTING X MATERIAL OF CHIMNEY f 1S BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE J _ w The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations ,w Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Name Please Print Name: Location: ` City Phone # I am a homeowner performing all work myself. I am a sole proprietor and have no one working in any capacity 1 am an employer providing workers'compensation for fry employees working on this job. Company name: Address /�eAheZ© 04 City: KFtM�J I (11 A M478 Phone#. & NQJ Insurance:Co. Policy#Ne, S(94 S g Company name: Address City Phone#: Insurance Co. Policy# Failure to secure coverage as required.under Section 25A or MGL 152 can lead to the imposif on of criminal penalties o f a fine up to$1.500.00 and/or one years'imprisorxnentas_v WLas_ciAjwnaHies in2heSm -c(ABTDP1l1t'ORKDR)PRvW-afm-&A$1MM)aiajrAgainst me 1 understand that a ccov of this statement may be forwarded to the office of Investigations of the DIA for coverage verification. 1 . I do hereby eertily pains nal' pegwy the inforrnatiorr provided above is true and correct. Signature pate1-0057-5 4 Print name F lc)+A?t Pborle# Official use only do not write in this area to be completed by city or town offiaar City or Town awmM icensipg _ ❑ Building Dept []Check if immediate response is required .0 Licensing Board ❑ Selectman's Office Contact person: phone# L] Health Department ❑ Other NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in properly licensed solid waste disposal facility as defined by MGL Chapter 111, S 150 A. The debris will be disposed of in: IVA (Location of Facility F Signature of feinnt App ant b/03 Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector Page No. of Pages. Hyde 2153 QQ R. W. Hyde Construction Inc. 556 TPELO ROAD BELMONT,MAASSSACHUSSETTS 02478 PROPOSAL FE6FEIXIN6 Rfill. (617)489-6470 FAX(617)489-3484 email:rwhyde@ix.netcom.com PHONE DATE TO _ Brooks School Jb6 A bcxTt6 Attn:Normand Grenier 1160 Great Pond Road Farm House Repair North Andover Ma 01845 JOB NUMBER JOB PHONE We hereby submit specifications and estimates for: Dear Normand, Please find the following budget price to repair the basement to your existing Farm House, This work is to be completed on a time and material basis because the exact amount of work needed is unclear. All electrical and plumbing work needed will be coordinated through our company but contracted through Brooks School. Please find the following labor rates. Mott $50.00/hour Carpenters $38.50/hour Laborers $25.00/hour All material will be at our cost plus 15%for general contractor overhead and profit. Budget to complete this work $20,000-$30,000 WE 1PIP®jP®0(B hereby to furnish material and labor—complete in accordance with the above specifications,for the sum of: dollars($ ). Payment to be made as follows: Progress payments due net 30 All material is guaranteed to be as specified.All work to be completed is a professional L If 1 t/—\_ manner according to standard practices.Any alteration or deviation from above specifica- Authorized (l ►`../�fv tions involving extra costs will be executed only upon written orders,and will become an Signature—_ Ltextra he over and above the estimate.All agreements contingent upon strikes,accidents or ond our control.Owner to carry fire,tornado,and other necessary insurance.Our Note:This proposal may be fully covered by Worker's Compensation Insurance. withdrawn by us if not accepted within 30days. �&ltl(�E ®T QIP®�®Q&Il —The above prices, specifications itions are satisfactory and are hereby accepted. You are authorizedSignature work as specified. Payment will be made as outlined above. Signature ceptance: i � i j,. � �fze �amirreau*iea/� �,/�aaaac�zuaeba r =r BOARD OF BUILDING REGULATIONS License: C.ONSTRUCTIOWSUPERVISOR Number:,..CS 003637 ` = Birthtla ;03/05/,1.9,45 Exp�re :_03/05/2004 E Tr.no: 20387 { - -- Restrrctiid-X00. q RICHARD W HYD.E:IR 33 CHURCHILL AVEC ARLINGTON, MA 02174 Administrator . I ' e NORTH Town ofAndover O •, �. lit ..Z ON o " * dower Mass. COCHIC CR 1 f �A0RATE BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System a I / BUILDING INSPECTOR THIS CERTIFIES THAT..... �.C.................................e ��.C�!�C ..... B rd.�.�S....... ........ .... Foundation /� 4 has permission to erect....` .N... ...1.... ......... buildings on .. ......... ......... Rough /'Q+B I"i4 / X1 0 oPo-V ./.e 00 S b lm [' tor e- Chimneyto be occupied as......:.......................................................................... ........................................................................ 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. 4 G C/to 3/a'5-4-a 8 � 02-a 0 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. 1" Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS 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. Bumer Street No. SEE REVERSE SIDE smoke Det. Location ) 1 Vr o G 0A ��k -2� No. Date Com^a U 0 �aRTM TOWN OF NORTH ANDOVER Oi« u .�,h•C 0 9 +4L Certificate of Occupancy $ sACNUS t� Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 3 Check # 3 C2—�� 5 6 4 u Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH-A ONE OR TWO FAMILY DWELLING ;ate z "1` 13gO1 R BUILDING PERMIT NUMBER. / DATE ISSUED. ` .� X SIGNATURE: Building Commissioner/12SWor of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number LVA 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided ReqWred Provided a 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Infomnation: 1.8 Sewerage Disposal System: Public ❑ Private 0 Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record y,zo S&)W� ywo Name(Print) Address for Service: 7 Signature Telephone 2.2 Owner of Record: Name Print Address for Service: O Z rn Signature Telephone 90 SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: p License Number Address s—LV Expiration Date Signator Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name rn Registration Number r Address r 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 buil 'npermit. -Signed affidavit Attached Yes.......Y No.......❑ SECTION 5 Description of Proposed Work check au applicable) New Construction ❑ Existing Building Repair(s) Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description(of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by perrnit applicant 1. Building (a) Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of I I� Construction "l 3 Plumbing Building Permit fee(8)X (b) 4 Mechanical HVAC 3 r a 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, as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION 1, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Si nature of Owner/A ent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TEVMERS iST 2 ND 3 RD SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS FH=.IGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAI,OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name: Location: t Ci �AL2CSr' Phone am a homeowner performing all work myself. �I am a.sole proprietor and have no one working in any capacity F�7f1 am an employer providing workers'compensation for my employees working on this job. Comp-gay name- Address C Ph—one ! ce Co. ti e. . Comcartiv name: Address City: Phone* ' hone#- i sur nce:co. OII . P.-tura to eecuro coverage as required under section 25A or MGt_1;=tead to the l itlon of cry pena8es.ora fine up to$1.500.00 and/or one yeas'imprisonment as well as civil penalties in the form of a STOP WORK t 2iOM and a fine of($100.00)a day against rne. 1 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 andpenatfes of pediffy bW the ftbiwatro»provided above is bue ani!-correct Signattlr Print name �� -��f�Cc.J . Phone# 4.`� Official use only do not write in this area to be completed by city or town official' 0 Building Dept " OCheck if immediate response is requbed Building Dept [I Licensing Board p SelectManIs ice Crnrtact person Phone# 0 Health Department ❑ Other ?114 WORKMAN'S COMPENSATION North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: S I sa.�(L cation of Facility) ignature of PermitApplicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector UO' 4:)/ ZL)U1 11:00 17jld4OyJugdd 01 AC_ ORO CERTIFICATE OF LIABILITY INSURANCE 0an9` ""U= 979/4S9-077S FAX (979) 4S9-0493 q+zrtONLY ER �OWEIM NO RF3UFb A3 AK a' � C i L Insurance Acy, Inc. HOLDER.THIS CERTIMATE DOES NOT AMEND,EXTEND OR 6 Courthouse Lane Suite 14 ALTER THE COVERA09 AFFORDED BY THE POLICIES BELOW. Chelmsford KA 01324 trlsuRERS AFFORDING covETuGE -P-- A p rw Enviromental wiSUNIDIA: Zurich American Insurance CQmjmtny 21 Progress Avenue Unitl rawerRa American Zurich insurance Company C}wlnsford, KA OU24 .SURER C: srsup."Or. RKUAGR L COVERAGES THE POUC3ES OF V"URA 4a USTED BELOW WIVE BEEN ISSUED TO THE W4VP1D NAMED ABOVE FOR THE POLICY PERIOD INDICATED.NOTYKTHSTANOCHO Amy REOIFRDAENT,TERit OR CONDMON OF ANY CONTR=OR OTHER DOCUMENT WITH RESPECT TO VftOCH THIS CERTWCATE WAY BE MUM OR WAY PERTAllN.TKE INSURANCE AFFORDED BY THE POLICIES DESCRMW Ht RLW t$SUBJECT TO ALL THE TERMS.EXCLUS)ON3 AND CONDn)OK3 OF SUCH DOUCICS.AGGREGATE LATS SHOWN WAY HAVE BUM REDUCED BY PAID CLAMS. TYPE Of w4URA4M POLICY NU110EJ1 LWRS C8,19ML LAN UTY EACH OCCUR'RDA= s 1000 X M.wJ>�AL c;LwuRAI uAeam Floc DAUAO=lA^r a�Tw) i so 1 000 W44 MADEoccua -2975679-01 07/13/2001 07/13/2002 ecp u„r o.P.,wa s S A X Includes Lad PEPMOIALEAOY►uURY >{ 1000 GeNEML A'GnGATE Z 000 GEWL AGCRMATE UWT APPLX3 FM PROM Cn-COWYOF AGO f Z,000, X KLCI °"¢ lot .urowow-e LARRY coveReD MAIE LMR ` ANY AM a'@O*WM All 01�AUTOS 6001LY MIAJRY sC�E.DL4.E0ALfTOS NP-PW" Y WteD AVT03 GODLY IIJURY f wowowmw AUT06 (P-iaodwq CPW 902" GAP.4 WI LAaKJ'TY AUTO ONLY-GA ACCDENT L AMY AUTO OTMCR Tww G ACC 6 AUTO MY. ^00 $ EXCEU LJAnuTY LACI 0CCURPZ4Ct i OCCUR CtArp Wce AGGREGATE t Deoxnml rlsTT©cna+ 6 6 TH- WORIDd noN AND X ER uw4.ayuw LA/SITY WC 2975634-01 03/19/Z001 03/13/2002 EL EACH ACCW f { 100 e LL DRFASE-EA EWLOYee 6 100 EL D"'S -POLICY LANT i S00 OTlYE11 'This certifiate is for SaWle Purposes Only" CERT LATE HOLDER Aoaflol+Al rwirJJtL'D;rMwJaR L[TYER CAHCELLAPON swouLD AwY Of TW Arrow 000M6ED POUQ s es CAN==ROOK nW Drwr,ATrow CATs Tmwsor.rwa Ks w a cowwr wa.L UIDsAwa TD mAL " DA7e war mx NO=To no cea*cAn wL=maw To TwE LrcT. Wf rJULua TO"L e11D11 Nona WALL rose NO 00LXK 1011 OR L"UTY OF Off KW LW M TW COINANY,ITS A*Un OR R MC3WtAWM --FOR DFOMATIONAL PURPOSES ONLY", RUM"TATPM rfA AG 263JVT(T ~.f� CACOAD CORPORAT101i 1"4 and of Building Regulations and Standards One Ashburton Place — Room 1301 Boston , Massachusetts 02108 Home Improvement Contractor Registration ! i Registration= 117689 Expiration= 11/03/2002 �o«« uyl� Type= Private Corporation ONE IMPROVEMENT CONTRACTOR ALPINE ENVIRONMENTAL INC V egistration: 117689 zpiratioa: 11/03i2002 RONALD PEIK 1ype: Private Corpontio 21 PROGRESS AVE #1 CHELMSFORD MA 01824 I ALPINE ENVIRONMENTAL INC ! A,D NISTRA,ORR�OGRESS AVE tl CHELMSFORD MA 01821 �� GTS � .�...__._...........-..._.......�,. _.,,:,.... anv�no�uuea/�i o ✓G/,a�rac�ivaeCta �..'. BOARD OF BUILDING REGULATIONS ' License: CONSTRUCTION SUPERVISOR Number:CS, 069549 Bfrthdate 03/1.3/1,968 F�cplres 03/1,3/2003 Tr.no: 7975 Restricted To:-,00 TODD J DREW 236 PHINEAS ST DRACUT, MA 01826 � /� . Administrator NORTH Town of Andover No. ~ - - CN baool �v � z= o dover, Mass., ' I� COCHICHEWICK V 7� 0RATED BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System b O C `. O O ' BUILDING INSPECTOR THISCERTIFIES THAT.... ..................................................................................................... Foundation 0 has permission to erect......I..�. ... � buildings on .....l..I..L..�.....�.r ... d .....'Q •... Rough to be occupied as �it Pj.Alt*..M4#0* w 1. w1 I�/♦/ .. r 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 Laws relating to th Inspection, Alteration and Construction of Buildings in the Town of North Andover. 101/ 10 3 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTOR C Rough ........ ... ................................ .................. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in ,a Conspicuous Place on the Premises -- De 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. T_ E Town odove r � '.J- tri ` �;,.. � � iP No. 318 4'. ^ mover, Mass., J ILA Q f1� UqA rOk Gj H BOARD OF HEALTH 1 � Ford/Kircher Septic :System PERMIT T i I t� BUILDING INSPECTOR THIS CERTIFIES THAT .. I .... .. 5, ✓ ... 5.� �... � Foundation has permission to elm . '.�+.Q. a.�. ......... building/on ....1.. x...4.0........ - ...e , Rough i p �e..�b0A—L L....... Chimney �� ......... .... . ..................................... hi ., ey j to be occupied as . .. .............. ... provided that the person accepting this permit shall in every respect conform to the terms of the application on file in FiMal ) 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. PLG/MBING IN PECi'OR VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT ETRES IN 6 MONTI-IS _ ELECTRICAL INSPECTOR= ' UNI-ESSC ONS fRUC.TION STil RTs • • � � trough-� / i, .l Taw►�� 'z'� G%0"0& i Service �Cr BUILDING INSPECTOR L C C)c(-j.! ung. Pcrinit ReuttiirecI toy Ocaq)n ��31�i�clin�t NSPECTOR Rough j Display in a Conspicuous Place on the Premises — Do Not Remove No Lathing or Dry Wall To Be Done - --- — DIRE DEPARTMEN"I' ► Until Inspected and Approved by the Building Inspector. t�urnct /f 1 d Location 1Z.4.6 ,1� 24! j' 1 No. _ Date TOWN OF NORTH ANDOVER � „ Certificate of Occupancy $ # Building/Frame Permit Fee $ 4 �� M�S��' Fo ndat' n�P,eyrmit F .±�i��.$ emit Fee I'-`% - $ �� y Sewer Connection Fee $ Water Connection Fee $ TOTAL $ ZS w iff 0612443* 00 lBuilding Inspector yO SPA14n8v_ . Div. Public Works PERMIT NO.- 7, 3 _ APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE ; y MAP 4-40. LOT NO. 2 RECORD OF OWNERSHIP DATE BOOK ;PAGE ZONE I SiJ6 DIV. LOT NO. — _.. LOCATION - :.. . v PURPOSE O BUILDING - - OWNER'S NAME 9e _., O. OF BTORIEB 4 &#*e •I - OWNER'S ADDRESS BASEMENT OR SLAB ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND ARD BUILDER'S NAME SPAN DISTANCE TO NEAREST B' ILDING DIMENSIONS OF SILLS DISTANCE FROM STREET POSTS DISTANCE FROM LOT LINES — SIDES REAR GIRDERS AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS IS BUILDIMG NEW SIZE OF' FOGTING X 18 BUILDING ADDITION MATERIAL OF CHIMNEY 19 BUILDING ALTERATION y IS BUILDING-ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE 18 BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER IB BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS a PROPERTY INFORMATION LAND COST SEE BOTH BIDES 221- .. .. .. tST. OIDG. COST .� s� PAGE 1 FILL OUT SECTIONS 1 - 9 EST. BLDG. COST PER Q. FT, PAGE 2 FILL OUT SECTIONS 1 12 EST. BLDG. COST PER ROOM ' ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING SEPTIC PERMIT NO. .4 APPROVED BY S ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED ■ ILDING INSPiCTOI SIGNATURE CTF OW ER OR AUTHORIZED AGENT 4 .1 F E E Z 7I OWNER TEL N R PERMIT GRANTED CONTR.TEL N ( " Yl O CONTR.LIC.1 H.I.C./ �r BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILYSTORIL ES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY OFFICES OT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS ( RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION ES IIINTERIOR FINISH CONCRETE CONCRETE BL K. PINE BRICK OR STONE HAROW D PIERS PLASTER_ _ .DRY WALL UNFIN. ' 3 BASEMENT AREA FULL FIN. W V AREA _ g 71 y, FIN. A,IIC:AREA _ N_O B M'7 FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WAILS I 9 - FLOORS 9 CLAPBOARDS B 12 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH ASPHALT SIDING HARD"/D ASBESTOS SIDING COMIAGN _ VERT. SIDING _ ASPH. IIIE� _ j� STUCCO ON MASONRY STUCCO ON FRAME ATTIC STRS. 6 FLOOR I_ BRICK ON FRAME CONC. OR CINDER SLK. STONE ON MASONRY WIRING STONE ON FRAME SUPERIORPOOR _ ADEQUATE I� NONE 5 ROOF 10 PLUMBING GABLE HIP BATH 13;FDf.'1 GAMBREI MANSARD TOILET'RM. Q FIX. 1 FLAT SHED WATER 'CLO ET = ASPHALT SHINGLES 4,e LAVATORY , WOOD SHINGES KITCHEN SINK SLATE NO PUJMBING _ TAR b GRAVEL STALL'SHOWER — ROIL ROOFING MODCRN FIXTURES TILE FLOCK' TILE DADO- g FRAMING 11 HEATING WOOD .JOIST PIPELESS FURNACE FORCEO'HOT AIR FURN. TIMBER BMS. b COLS. STEAM STEEL BMS. 6 COLS. HOT W'T'R..OR VAPOR WOOD RAFTERS _ AIR CONDITIONING RADIANT H' 'G UNIT,HEATERS - 7 NO. Of LOOMSOIL t B M 7 2nd _ EIECTRIC 13,d I NO ' EATING y: ,F I: it j ,j•, 1 NORTIy F TO%VM of OL L over No. 283 _ AM" dower 'Mass.,br 19Q� COCHICHEWICK A \ A ORATED 1 S BOARD OF HEALTH PERMIT Food/Kitchen Septic System THIS CERTIFIES THAT. . . BUILDING INSPECTOR . .... .......... ' `!�GG4......... ......... ..................... Foundation 14has permission to e�eet.. ... ... ........ ... buildings on ....... .... .. ,�':!..... Rough to be occupied as...... ... .....I.............................. ... . ... ....... .. .................... Chimney provided that the person acceptingthis rmit shall in every respect confor to the terms of the applica'sion on file in Final this office, and to the provisions of the odes 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 Fina' j1NLESS CONSTRUCTION STAR ELECTRICAL INSPECTOR Rough ........................................................................................... .................... Service BUILDING I1SPECTOR a Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove.,, Rough Finals' No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. Smoke Det. ✓1 C/76J Noll, rUPO� n OEPARfNENf OF ' PUBIIC SAFETY .? tirense: CONSTRUCTION SUPERVISOR i Nuttier, Expires CS 040329 11/03/1996 eirthGate E' .: 12/03/1944 CHARLES S NIERS 21 NEST SHORE RD - COMMIsslop4E NINOHgN, NH 03081 !i T 1 HOME IMPROVEMENT CONTRACTOR Registration 112613 TYPe - PRIVATE CORPORATION Expiration 04/13/91 IERS SON INC GGw,,3,r� C STEPHEN; MIERS X11 W SHORE RD d nonniNis�AnmR WINOHAM NH 03081 i. Location (00 No. Z-- Date 2� `C- NaRTM TOWN OF NORTH ANDOVEF Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit_Fee $ s�cHusE Other Permit Fe $ 2 Sewer Connection Fee $ Water Connection Fee $ TOTAL CP$ z 1 Building Inspector Tc Div. Public Works 3' t 5� APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 ,- 4-40. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK :PAGE )NE SUB DIV. LOT NO. I 1Z)CATION PURPOSE OF BUILDING OWNER'S NAME NO. OF STORIES SIZE 1 OWNER'S ADDRESS / Qj �pp rf�J BASEMENT OR SLAB _ ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME SPAN 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 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 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 -� DTE FILED 0 SUILDING IN/PRCTOR SIGNATURE OF OWNJFR OR AUTHORIZED AGENT , Y c FEE 4j OWNER TEL.# PERMIT GRANTED CONTR.TEL.# 4 hU-d / 4 ,9 CONTR.LIC.s o yc' H.I.C.a �/j aG i3 Ric BUILDING RECORD ` 1 OCCUPANCY 12 INGLE FAMILY I I STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM s MULTI. FAMILY OFFICES _ LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES. GA- APARTMENTS I I RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION —I 8 INTERIOR FINISH CONCRETE B 1 2 13 CONCRETE BL K. PINE _ BRICK OR STONE HARDW D i _ PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT AREA FULL FIN. B'M'T' AREA _ Y. 1/1 '/. FIN. ATTIC AREA _ N_O B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH ASPHALT SIDING HARD1r✓'D ASBESTOS SIDING _ COMMG'N VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. 8 FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE HIP BATH 13 FIX.) _ GAMBREL MANSARD TOILET RM. (2 FIX.) FLAT SHED WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK J� SLATE NO PLUMBING fj TAR 8 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 OIL B'M'T2nd _ ELECTRIC 1st 13rd NO HEATING NORT Town Iy of rAndover _ O ;. .j No. 152 art " over, Mass., p 2t Z�_ _19q � ,( T O -�A 1t /� C6C KICHE MEWICK �DRATED cs . H E BOARD OF HEALTH Food/Kitchen PERMIT Septic System n BUILDING INSPECTOR p01 S aG+400 ��Lt� P THIS CERTIFIES THAT...I�l�........................................4�.......... . ..................�.�:.�.+1?i4►�... ...............n...�...................... Foundation has permission to weet+.. .A.L."C{is. L.... ...... buildings on.�.f..4.p.....sP4PA ........c ltd..=.••.•W•••=••_......•_•••• Rough .1 t0 be Occupied 8S... 4 �..V, 440�.. .AAPRZOX......S ..5q. .�'.. YLT. !e............ Chimney I provided that the person eptIng 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 Final PERMIT EXPIRES IN 6 MONTHS T�. LESS CO U S S ELECTRICAL INSPECTOR �, U l r 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 Inspected and Approved by the Building Inspector. FIRE DEPARTMENT Until Ins P Burner PLANNING FINAL CONSERVATION FINAL street No. Smoke Det. SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT *fir sd� •vF* _ ..- -. - �•� +- ,ec.�'��yr�s�n�s.na>aer -� ,*.� (� ✓i�e 7Do9w,xaxr,��`�� R V... -- � - - � HOPE IMPROVEME#T CON�RAGfD Registration 112613 s _ Type - PRIVATE CORPORATION , /13/47; ll C 3 MIER$ SOS INC n �� RDbi „DMINIST-r1ATOR i�iYO-HAR C!n VJO�tS/ - r-'- --�•,• �- • HAREES r w So • L' IN -wr INS: 00 lie 1C M{i• - -. 4�. DEPARTMENT OF PUSLIC :AFEiY 00 Non@_ lA - Masonry only License: CONSTRUCT ;N :U?E3VISGR IG ! a 2 Fatily Hoes Nuiber. E a 3ir.aaate - — - ? CS 040329 -= .... �._ CHARLES : ,41;3: 11 WEST SHORE AO ... _� ... WINOHAM, dH ;?0S7 �� 'v � � �- �� 7 Location—.// No. Date I NORTN TOWN OF NORTH ANDOVER Oit�ao :a,ti0 O •...' a OA A Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation' rPEl ft _AV s�CHust P ' tOther Permit Fee "'I" �' �? Sewer Conneci4Wee, $ Water C aeUpFee $ TOTAL � Ilercoll eor r :7-. Building Inspector r Div. Public Works PEb►:htlTeNO. APPLICATION FOR PERMIT TO BUILD NORTH ANDOVER, MASS. - MAP 4J0. LOT NO. 2 RECORD OF OWNERSHIPDATE BOOK PPAc,�'r-1_ _ i ZONE SUB DIV. LOT NO. F— - LOCATION �� f� _ _ / � PURPOSE OFA rz T f OWNER'S NAME —T NO. OF STORIES OWNER'S ADDRESS BASEMENT OR SLAB — ARCHITECT'S NAME 1�G- iT ��GOG SIZE OF FLOOR TIMBERS IST 2ND 3RD L/dUILDER'S NAME/7 r/ SPAN DISTANCE TO NEAREST BUILD G 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 BU ' ILDING ALTERATION -V`Q IS BUILDING ON SOLID OR FILLED LAND 1 � lLL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER V ARD OF APPEALS ACTION. IF ANY ,� /O Alr- IS BUILDING CONNECTED TO TOWN SEWER �a9 IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES ST. 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 a P S MUST BE FILED AND APPROVED BY BUILDING INSPECTOR - DATE FILED L �' r BOARD OF HEALTH SIGNATURE VOWNER OR AUTHORIZED AGENT S FEE PLANNING BOARD PERMIT GRANTED�' q BOARD OF SELECTMEN J Jr- BUILDING INSPECTOR S2Z� BUILDING RECORD 1 OCCUPANCY 12 , SINGLE FAMILY S.-ORIEs 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 _ll 3 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW'D PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT 11 AREA FULL FIN. B'M'T' AREA _ 1/1 1/1 '/ FIN. ATTIC AREA _ N_O B M FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH ASPHALT SIDING HARDVJ'D _ ASBESTOS SIDING _ COMMCN _ VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR H POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH (3 FIX.) _ GAMBRELMANSARD TOILET RM. (2 FIX.( FLAT I SHED _ WATER CLOSET _ ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK 't SLATE NO PLUMBING _ + TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES _ TILE FLOOR i TILE DADO 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 _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS 7 NO. OF ROOMS GOAL B'M'T 2nd _ ELECTRIC 1st 13rd NO HEATING F HOw IH OFFICES OF: � m °<z Town of c)Main 12ain Street APPEALS NORTH ANDOVER North An(lover, BUILDING o' s MiiSSiICI ItISC(IS O 1845 CONSERVATION DIVISION OF (61 7)685-4775 HEALTH PLANNING PLANNING & COMMUNITY DEVELOPMENT KAREN H.P. NELSON, DIRECI-OR In accordance will, the provisions of MGL c 40, S 54, a condition of Building Permit Number 1,03 is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c ill, S 150A. The debris will be disposed of in: (Location of Facility) ,� / �/ Signature I Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. 0 (w SEv�`�'ATiuvi- iN19, L S EE R ��T �.��.�®®FINAL _PLANNING INAL own o � 6 ndover No. 203 L'J'AIVEWAY ENTRY PERMIT M ss. 1 19 MEr��do e , a oRF Pa F 4 BOARD OF HEALTH PERMIT LD 0 %THIS CERTIFIES THAT................... SeeI> ..... BUILDING INSPECTOR has permission toast ... buildings on ... .I A".. .��. . . p�... Rough AIL' �. ��• AAZ�40.1 ��Q ... � �e Chimney to be occupied as..... .... .... .. .... •••• 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 IN 6 MONTHS ELECTRICAL INSPECTOR ' \ Rough UNLESS CONSTf�I..J � � 'j • Service tjt Final ..... . .. .. .... ..... .. ...... ........... BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to. Occupy Building Rough Final 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 Det. Ogg 'S Building Inspector I Location No. ' I Date r � N°RT" TOWN OF NORTH ANDOVER 3?O',,`,D ',•,BOO � e A Certificate of Occupancy $ e # * ° = • Building/Frame Permit Fee $ s" E Foundation Permit Fee $ ., � sACHus t `y)/;. C � Othe Permit Fee kr- C'c,�$ � " r Sewer Connection Fee $ Water Connection Fee $ :TOTAL $ Building Inspector Div. Public Works PERMIT NO. /;_0 I APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE i MAP KJO. LOT NO. 2 RECORD OF OWNERSHIP "DATE BOOK "PAGE ZONE I SUB DIV. LOT NO. LOCATION `/ _ _ .L �i,n. / PURPOSE OF BUILDING OWNER'S NAME) J��-'Cf/ NO. OF STORIES OWNER'S ADDRESS 4 V BASEMENT OR SLAB ARCHITECT'S NAME �[ -f�--C.t..w" / c ��-vim /Jl��-///�"•-- SIZE OF FLOOR TIMBERS IST 2ND 3RD r BUILDER'S NAME r y SPAN DISTANCE TO NEAREST BUILDINff 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 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 PAGE t FILL OUT SECTIONS i - 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 `FI`LED AND APPROVED BY BUILDING INSPECTOR DATE FILED LS' / / BOARD OF HEALTH SIGNATURE OF GWNER OR AUTHORIZED AGENT FEE PLANNING BOARD PERMIT GRANTED - 19 BOARD OF SELECTMEN MAY 1 4 �� 1 OWNER TEL.# CONTR.TEL. BUILDING INSPECTOR CONTR.LIC. BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY S.ORIEs I 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 Q FOUNDATION 8 INTERIOR FINISH CONCRETE _ 3 1 2 13 CONCRETE BL'K. PINE BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL _ • UNFIN. 3' BASEMENT AREA FULL FIN. B'M'T" AREA _ v, 9 /, 1/1 FIN. ATTIC AREA _ NO B M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE �_ WOOD SHINGLES EARTH _ ASPHALT SIDING HARDW D _ ASBESTOS SIDING COM/JACN VERT. SIDING ASPH. TILE _ STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STIRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIOR I� POOR ADEQUATE NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH 13 FIX.) _ GAMBRELMANSARD TOILET RM. 12 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 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 OIL B'M'T 2nd _ ELECTRIC 1st 13rd NO HEATING own of6 ', OL over No. 201 o : ,.0 .,.. ��'— waw W $ E��FI`T Y P E R M I� -- � �K er, M A ass., ® 19 / -- --- C+ ME w oR QR SS PERM BOARD OF HEALTH IT T L THIS CERTIFIES THAT.............. ........ ............................................ P g ••• •• •••ao RoughUILDING INSPECTOR has permission to�.... �. ... �uildin son • to beo .�:�. gple.�.i ,,,��`�, Chimney RC 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 IN 6 MONTHS ELECTRICAL INSPECTOR Rough UNLESS CONSTRU TAR Service Final ........... .... .... .. .... ........................... BUILDING INSPECTOR GAS INSPECTOR Occupancy Permit Required to Occupy Building Rough Final Display in a Conspicuous Place on the Premises Do Not Remove Burner FIRE DEPT. No Lathing to Be Done Until Inspected and Approved by Smoke`e°' Building Inspector °i N°nrp� � .• OFFICES OF: o °� TONVII ofI�ri ; l�iiii ti1i�• 1 At'PEALS _ NORTH ANDOVEllBUILDING r:""I' •`"`1"`' ', CONSERVATION �s °"° I rn'ISION(W 1 1 t;ttC I;, • HEALTH PLANNING PLANNING & COMMUNITY UI'sVE1,01't111?NT KAItGN 11.1'. NI:.I.SO N, 1)IIWC]( )It In accordance with the provisions of MGL c 40, S 54, a condition of Buildini; I'ctniit Numbero� is that the debris resulting from this wort: shall he disposed of in a properly licensed solid waste disposal facility' as defined by NIGL c 11 I, S 150A. The debris will be disposed of in: (Location of Facility) I Si6natur ul 1'ctntit Applicant Uate NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector.