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HomeMy WebLinkAboutMiscellaneous - 1160 GREAT POND ROAD 4/30/2018 (10) f � CS * '4v Y6 sc ,d• o / Li A;/. BUILDING FILE l r, i , </yo/ Date.... Ot NORTI{1+ TOWN OF NORTH ANDOVER IO- 9 * _ � PERMIT FOR WIRING ,SSACMUSE� This certifies that " n �ca Z�r T-/,.,.c C l .h. .�.i....... . . .................................................. has permission to perform ......�..�-a...........:.��. �..rn La wiring in the building of......... �C7"� .................................. at....., .......L —:�?....,North Andover,Mass'' Fee. : .J AAic.No.Z. 5 .... ...... .:{���-4r.;.!��`............. i ELECTRICAL INSPECTOR Check A 0P WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Rough Service Final Z 011 hr (fommonwrait4 of filassar4usttts Office Uw Only Kali Department of Public Safety Permit No. V 1 BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Occupancy 6 fee t]setkcd 3/90 tkave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusens Electrical Code. 527 CMR 12:00 r/7�{J (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) ,at, F — / IV 0 i2`�► �y� City or Town of 7o the Inspector of Wires The undersigned•applies for a permit to periorm the electrical work described below. /� Location (Street b Number) I ` 6 0 &-Vc� "be6 t2e GL Owner or Tenant d pt,,S S C 4_0,i Owner's Address l bW Is this permit in conjunction with a building permit: Yes 14 No (Check Appropriate Box) Purpose of Building �uc016-ji) I Utility Authorization No. Existing Service Amps Volts Overhead ❑ Undgrd ❑ No. of Meters New Service Amps Volts Overhead ❑ Undgrd ❑ No. of Meters Number of Feeders and Ampaciry r location and Nature of Proposed Electrical Work V'fJs� Of l/ TOTAL No. of lighting Outlets No. of Hot Tubs " No. of Transformers KVA i Above In- No. of Lighting Fixtures 7 Swimmintt Pool Rrnd. ❑ arnd. ❑ Generators KVA No. of Emergency Lighting No. of Receotacle Outlets Z No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones y i otal No. of Detection and No. of Ranges No. of Air Conditioners Tons Initiating Devices Heat Total --Total No. of Sounding Devices. P No. of Disuosals _ No. of Pumos Tons KW No. of Self Contained _ Detection/Sounding Devices No. of Dishwashers Soace/Area Heating KW Municipal ----- No. of Dryers —' Heating Devices KW Local❑. Connection []Other No. of No. of Low Voltage No. of Water Heaters KW Signs Ballasts Wiring No. Hvdro Massage Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE. Pursuant to the requirements of Massachusttes General Laws I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent.YES❑ NOD have submitted valid proof of same to this office. YES U NO U If you have checked YES, please indicate the type of coverage by checking the appropriate box. INSURANCE ® BOND ❑ OTHER[:] (Please Specify) (DIV &te (Expiration Date) Estimated Value of Electrical Work $ (51 D00 Work to Start Inspection Date Requested: Rough Final Signed under the penalties of perjury: FIRM NAME Wk,��' S 1 2'Lt 1 of r. LIC. NO. Licensee (�( 3 �wnlA Z U Signature LIG NO. ^� Address (9 i LR15V h L f, ah t !oft �� — Bus..Tel. No. lLaOIY �nQ"6'7�fl d AIL Tel. No. OWNER'S INSURANCE WAIVER:I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as required by Massachusetts General.Laws, and that my signature on this permit application waives this requirement. Owner Agent (P!ease check one) OU �� I Telephone No. PERMIT FEE $ t (Signature of Owner or Agent) a1ZCX' (barn ecru-0p., MAP 4p Town GL _ PARCEL NORTH ANDOVER w� f6cu;L 672 BUILDING PERMIT INSPECTION REPORT PERMIT NO.: PROJECT:00"(31�e L rf V� INSPECTION DATE: UNIT NO.: FLOOR: WING: BUILDING NO.: REMARKS: ' vim, �c� �e d� �'• Sys 1 M.C. ANDREWS CO., INC. GENERAL CONTRACTOR -CONSTRUCTION MANAGEMENT-DESIGN / BUILD-ENGINEERING June 12, 2001 Mr. Robert Nicetta Building Inspector Town of North Andover N. Andover, MA 01845 RE: Brooks School ���� ✓� `-'�'t`e�V Computer Lab Renovations Dear Mr. Nicetta: Enclosed you will find the Architectural Field Reports, as you requested. Sincerely, Andrew C. Matses President 200 Sutton Street-North Andover, Massachusetts 01845 -Tel: (978) 557-7532-Fax: (978) 685-2357 CHARLES GOLDSTEIN AWARC'HITECTURAL ENERGIES 200 Sutton St.North Andover,MA 01845 TEL 978-681-0055 FAX 978-681-1144 June 11, 2001 Mr. Robert Nicetta Building Inspector Town of North Andover North Andover, MA Re: Brooks School Computer Lab Renovations Dear Mr. Nicetta, In accordance with the Commonwealth of Massachusetts Building Code,6th Edition, as regards Control Construction, please accept this periodic report relative to the above noted Project. This writer has inspected the work in progress from its inception. As of this date,the work has been completed as follows: Demolition: All walls and ceilings scheduled to be removed to facilitate new work were removed without incident Walls: All new stud and drywall work has been installed as per the approved Construction Documents Ceilings: All new ceiling work has been installed as per the approved Construction Documents. Doors/Frames:All new doors/frames have been installed in accordance with the approved Construction Documents. Utilities: Electrical (95%)and HVAC work (100%) have been installed in accordance with the approved Construction documents. Remaining: Remaining to be done are counter and cabinet Installations and under (wall) cabinet lighting. As the renovation nears completion, I am pleased to write that all work to date-has been installed to the highest standards of construction. If you have any questions, please do not hesitate to contact this writer. Resp9stfru ily submit ed, C Goldstei / hitectural Energies Pa ' n AIA B g tered Architect No. 2547 FORM - U - LOT RELEASE FORM �rp 9;04 �r�v •off � + C&')41•Pullat /-&rAb 7. ND EI TL�Li6/Z [.cam�0 `J INSTRUCTIONS- This form is used to verify that all-necessary approval/permits from Boards.and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. i.■t......—..9...e....■......................■�.■.............................■ PHONE ASSESSORS MAP NUMBER 13 LOT NUMBER SUBDIVISION LOT NUMBER STREET ",--) �J STREET NUMBER ........................................................................... OFFICIAL USE ONLY bongos.......................■................................................ . RECOMMENDATIONS OF TOWN AGENTS DATE APPROVED CONSERVATION ADMINISTRATOR DATE REJECTED COMMII ITS DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS DATE APPROVED FOOD INSPECTOR-'HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR-HEALTH DATE REJECTED CON*AEN'TS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT '' s ���6 r Ih ���r��DATE APPROVED 17 FIRE DEPARTMI NT ,�F A �.,��.?�/j•� DATE REJECTED CONOAENTS RECEIVED BY BUILDING INSPECTOR DATE --�.�� � a r- APR 5 2001 Irl ' BUILDING DEPT. S '1�1 1 M M . C . ANDREWS CO . INC . GENERAL CONTRACTOR - CONSTRUCTION MANAGEMENT - DESIGN / BUILD TRANSMITTAL LETTER Date: Q,� $ _ L'A- -7 r -O / Job: /'4. GpG ,.� Architect:To: � CT Trade Contractor. WE ARE SENDING HEREWITH ❑ WE ARE RETURNING HEREWITH ❑ FOR APPROVAL ❑ FOR FIELD USE ❑ FOR REVISED APPROVAL ❑ FOR YOUR FILES ❑ APPROVED ❑ FOR PROGRESS-ORDERING C3 APPROVED APPROVED AS NOTED �AS PER YOUR REQUEST ❑ RESUBMIT FOR APPROVAL ❑ RESUBMISSION NOT REQUIRED THE FOLLOWING(DraNNings-Specifications-Schedules): 2 COPIES RE11v1ARKS: G. A� VERY TRULY YOURS, M.C. ANDREWS CO.,INC. 200 Sutton Street North Andover,Massachusetts 01845-Tel: (978) 557-7532-Fax: (978)685-2357 CHARLES GOLDSTEIN AWARCHITECTURAL ENERGIES 200 Sutton St.North Andover,MA 01845 TEL 978-661-0055 FAX 978-681-1144 May 1,2001 Mr. Robert Nicetta Building Inspector Town of North Andover North Andover, MA Re: Brooks School Computer Lab Renovations Dear Mr. Nicetta, Please be advised that I have designed the above noted Project and will be responsible for inspections and required reports in accordance with the Commonwealth of Massachusetts Building Code, 6th Edition,Section 116 as regards Control Construction. Res tfully su ed, CEO 4 Ch rle Gold in IA/Architectural Eti, a e o t�' AIA NCARB 2547 y BOSTON, $ !: chusetts eg1 eyed Architect 547MA Pr cipai )'HOF t#PSS + a 1,1 CHARLES GOLDSTEIN AIA/ARCHITECTURAL ENERGIES 200 Sutton St.North Andover,MA 01845 TEL 978-681-0055 FAX 978-681-1144 May 1, 2001 Mr. Robert Nicetta Building Inspector Town of North Andover North Andover, MA Re: Brooks School Computer Lab Renovations Dear Mr. Nicetta, Please be advised that I have designed the above noted Project and will be responsible for Inspections and required reports in accordance with the Commonwealth of Massachusetts Building Code, 6'h Edition,Section 116 as regards Control Construction. Res tfully su ed, RED Ch rlel Gold in AIIA/Architectural Ecy�•. 0` lF� a e o ten AIA NCARB q No.254 l • chusetts egi ered Architect aosrorv. �, 547ti�A Pr, cipaI qt>N of oaas�'a II Y r. r. T �/� �41JLlI[4I1lOE4ll� Cwlt/Q,J;JQ� BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 055435 Birthdate: 09/23/1965 t Ex i r es• P . 09/23/2 i 002 _ Tr.no. 828 i Restricted To: 00 ANDREW C MATSES f 200 SUTTON ST (� ! N ANDOVER, MA 01845 Administrator Office of Investigations Boston, Mass. 62111 Workers'Compensation Insurance Affiday.:' Please Print Name C �ti�iti°W cc ��vC_• Location: 2 UCS U TT'On! S i r2LZ-7- City -,-w A/uz--,ovc-p, 018 Phone '7-78 - S S-r7 -7E 3 am.a homeowner performing all work myself. A' I am a sole proprietor and have no one vrorking in any capacity aI am an employer providing workers' compensation for my employees warkire Cr, this job. COmpan name: S ,SV tc"�2 S � AJ S l.t'�f�vC.C' �C7MP9�lJ y C'-�f�ILq.V�j �'VS Lr�f2•c <= Address CiVtirJn PC? 14 �,aAJ5q5 Phone#: '5e-7U 0(0 Insurance Co S'7tWev`t> I v SL)rn Co . Policy.# W C_ 0 -7 Company name- Address Cit, Phone m Insurance Co Policy 9 Failure to secure coverage as required under Section 25A or bIGL 152 can lead to the imposition cf criminci:enalties of a fine up to s1,5c-o.00 and/or one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a Fire '51 c0.00)a day against me. I understand that a ccpy of this statement maybe forwarded to the Office of Investigations of the DIA for cc.: :;a veri;ication. I do herby certifl under the ns acd _naYies of perjury that the in�rmalron provided above is true and M-== 01 Signature Print name G ""� Pt:c.-=_ �f -S�S�--7 C n ial use only do not v,rte in this =rea to be ccmcleted by city or town cff:ci i' ❑ Building Deo:` eq,;r- Budding r �-�rr imrvdi�t., rssoonse is r,.�� _� ng Dep. Licensing , Ch_ ❑ g So_ Selectman'; C' Corr_ct Fpr;on'_ ehons ❑ Health DeDa,, . ^1 Other RC:CEIVED APR 2 5 2001 BUILDING SEPT. r ?'oyez of $ull � . �nd0�'er d�no De l�oh 27 Charle Partmen't (g78 ` ndover s Street o f Noarh I 688'954- 1�Fsachusetts 01845 0 s 6,a do (978) 688;9542 y„ QAr P, ^ � V1` �� AP .CHUSO-(5 r Ar DBBIS DISpO I In accOr SqL FG1 d Building ice with t ofin a pro emit k e Provisions of, lk L rhe P rlY licensed solid the de 40 S 54, and waste dis debris resulti o a condition debris will be disposedPosal facilit o= no from t ofin/at: Y as defined by wor.;sba!! be MGL c 11, sl Spa POSed Facility locatio � � � �Ignature°f !. -- `gPpliccc I: Date 4.2-' d T Pro thAi- demolition °ugh the Dec°f theperTn't Frm the 2'°ivn °f "wilding ZnspeN°°rth over must ^ 6e`=�=1ne d for this APR 9 t� 2Up� Putt r o NORTH Town of . .4 over P- 11% No. Y �, h A o dover, Mass.,A r'Q'sc .1Q 62sx l Aj/� COC MIC KE WICK oI'?ATED P'P ' Cl H BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT........ .2 t g....S'4- -�A1�.4�... A!eE?! ... I.= ......................................... Foundation has permission to eaW....Re%*Vr Tzrx ........... buildings on....1..1...10 ...44. 47W '...0?;.:W.,r>.. ............... Rough to be occupied as............Resaay. .. .!s?'t - QF�C�... 'Tv....GQ !7t ....�r4�3.......................... 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 Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION STARTS CONTROL ELECTRICAL INSPECTOR CONSTRUCTIONough D M i�o2 two gT2t.�'ti.��2A� \ Z.1.s121o2 1�c"7K�..C.'T.:iv T ->�t�J�"D ............. .....`.... . .. ................ 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 +C•g.��-Eat©�J��'3� I 97 Q- Street No. \ SEE REVERSE SIDE T Smoke Det. M . C . ANDREWS CO . , INC . GENERAL CONTRACTOR - CONSTRUCTION MANAGEMENT - DESIGN / BUILD TRANSMITTAL LETTER �l � € a Date: 5 , 2-.61 Job: Architect: 4 Trade To�j WJ .r /64,. , tractor �WE ARE SENDING HEREWITH ❑ NVE ARE RETURNING HEREWITH ❑ FOR APPROVAL ❑ FOR FIELD USE ❑ FOR REVISED APPROVAL ❑ FOR YOUR FILES ❑ APPROVED ❑ FOR PROGRESS-ORDERING C3 APPROVED APPROVED AS NOTED �- AS PER YOUR REQUEST ❑ RESUBMIT FOR APPROVAL ❑ RESUBMISSION NOT REQUIRED ❑ THE FOLLOWING (DraNNings-Specifications-Schedules): COPIES ��� ` ��� c-f': REMARKS: r VERY TRULY YOURS, M.C. ANDREWS CO., INC. 200 Sutton Street North Andover,Massachusetts 01845-Tel: (978) 557-7532-Fax: (978)685-2357 ..... OFFICE OF BUILDING INSPECTOR TOWN OF NORTH ANDOVER CONSTRUCTION CONTROL ss ,� PROJECT NUMBER: n PROJECT TITLE: �e-ooKS ( ,o��1�t)i�L� L{��• ) 1r c) PROJECT LOCATION:_1 1 (-00 NAME OF BUILDING: Aym%t4• NATURE OF PROJECT: t2eNc>y, r"I,P4 . IN ACCORDANCE WITH ARTICLE 116 OF THE MASSACHUSETTS STATE BUILDING CODE, I, CRAM �- 4OLD5112N REGISTRATION NO. 2541 BEING A REGISTERED PROFESSIONAL ENGINEER/ARCHITECH HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT a ARCHITECTURAL STRUCTURAL"�' MECHANICAL FIRE PROTECTION ELECTRICAL OTHER(SPECIFY) FOR THE ABOVE NAMED PROJECT AND THAT, TO THE BEST OF MY KNOWLEGE, SUCH PLANS, COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISION OF THE MASSACHUSETTS STATE BUILDING CODE,ALL ACCEPTABLE ENGINEERING PRATICES. AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AND B EPRESENT ON THE CONSTRUCTION SITE ON A REGULAR AND PERIODIC BASIS TO DETERMINE THAT THE WORK IS PROCEEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT AND SHALL BE RESPONSIBLE FOR THE FOLLOWING AS SPECIFIED IN SECTION 116.0 1. Review, for conformance to the design concept, shop drawings, samples and other submittals which are submitted by the contractor in accordance with the requirements of the construction documents. 2. Review and approval of the quality control procedures for all code-required controlled materials. 3. Be present at intervals appropriate to the stage of construction to become, generally familiar with6the progress and quality of the work and to determine, in general, if the work is bein performed in a manner consistent with the construction documents. p.9ED ar� PURSUANT TO SECTION 116.2 .2 1 SHALL SUBMIT WEEKLY , A PROGRESS RE O TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDIN I$d NaM91_ ti v BOSTON. UPON COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO T MA SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OC PA of NATURE SUBSCRIBED AND SWORM TO BEFORE ME THIS DAY OF 200/ NOTARY PUBLIC MY COMMISSION EXPIRES COMR©L CONSTRUCTIOldi TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING for Official Use Onl ---� �.�:-.z. ����.�"•" .`�`�4,. � � ''�� .yt,��' �.. BUILDING PERMIT NUMBER: DATE ISSUED: /77 ray C 3e- A Z SIGNATURE: ` BuildiU Commissioner/Inspector of Buildings Date 1.1 Property Address. 1.2 Assessors Map and Parcel Number: �O 1 lr►1ZWE?• / 02) A8 O ' " /� MA. Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: v C—Z l4T u!� c!W-kI I�u-g Zonin District Proposed Use Lot Area Frontsge(11) m 1.6 BUILDING SETBACKS(ft) Front Yard Side Yard Rear Yard kk Required Provide R uired Provided Required Provided tT%t 5 1-1 N 4 ('wS 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 Je On Site Disposal System ❑ 2.1 Owner of Record �+ I I (0O t2b H 0 Name(Print) Address for Service Signature Telel3honc 2.2 Authorized Agent Name Print Address for Service: Z } Z Signature Telephone ' m Au0 9 3.1 Licensed Construction Supervisor Not Applicable ❑ t.o J . . osS�- Address --� License Number 0 h'4 P- n I struction Supervisor: • Z • o Z. Expiration Date U r tgnature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ vs Company Name,• Registration Number m r Address M r Expiration Date ^^Z Signature r Telephone * Y I, as Owner/Authorized Agent 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 At,,arzi�yv G. g4T-s>as Imee of Owner/Agent Date Item Estimated Cost(Dollars)to be b Completed applicant P Y permit PP 1. Building (a) Building Permit Fee +=-,;.I � OoO i Multiplier 2 Electrical ' (b) Estimated Total Cost of 15 , O O O Construction from(6) 3 Plumbing _ O _ Building Permit fee (a)X(b) q.Z ,ce 0 4 Mechanical(HVAC) O 04 5 Fire Protection 1 �� 6 Total (1+2+3+4+5) 6. O©0 • Check Number So b ,b'r=ts m,,.�...m'a;3z}5 ��tr s s if tt'4r)a x rvd �? b1 ✓c i..,7 i� �+.. �+y4y�.f : f %t t vt�Y��i Y: ✓ '� 1 'lal tti v �t tt+ ��`.:.Y- h�`tfi3t ' �v,1t §v.. +t S ,.t �rt �vAiV �' i3�a�ru ti`C n� t 1 .,} �� .,\t-• :...... _ .. P.�1y r. � nu,� ,h/ {.+ •. -.J. .. Jir�2. � r�.q y�lu.k t Sc... ,.. F.'. T.$hra. :Y..i. _.i (�. 1.I,.�it /)Y trvJs t z'Y:Y NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 2 No 3RD i SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHRvINEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE L iL 5�+�'!`�C�,+S�''�1�'"I",�t3►N!��'�QI�> „� � � apPtacable� ;'. New Construction 11 Existing Building "t Repairs) ❑ Alterations(s) Addition 11 Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: �rv04't'G t ca Urt L'. . co USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 ❑ IA A4 ❑ A-5 ❑ IB ❑ B Business 2A ❑ C Educational 2B ❑ F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ IInstitutional ❑. I-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 Floors Total Area s Total Height ft Z . Ma Independent, Structural Engineering Structural Peer Review Required Yes ❑ No Le SECTION 10a Owner Authorization- TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT G (Jy It S J Gkby ,as Owner of the subject property C Hereby authorize M • G• A N b 21CW �✓ �a• .Zl`�G to act on My behalf,in all matters relative two work authorized by this building permit application _ C= C 0 Z. o ,` of Si ture of Owner” Date 4 ICTIax a-WORIMS C 0s► tal : �. . >«ry Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the �I issuance of the building rmit. ` Si ned affidavit Attached Yea..... No .0 SECMN SSi© A .bESMI NII STRUC' t N 1G�RVIC. S 1 OP-8 Nd " A COlySTBiTC if 1fCDN Ct3Al[RdL PIRA ' T� t +rra11�1TTA + T11 "��r�=Ot ED 5'Al } 5.1 Registered Architect: I Ne: v 6 , A7NoY Address Signator Telephone I S.?:„ Wit€�'t^t►fessa©n� �eis� � o(�� f � vG • Area of Responsibility Name: Registration Number - ddress: Expiration Date Signature Total Not applicable ❑ Name: Registration Number Address Signature Telephone Expiration Date Name Area of Responsibility 1 Addres Registration Number i Signature Telephone Expiration Date Name Area of Responsibility I Address Registration Number Signature Telephone Expiration Date G• �� S CO . Not Applicable ❑ i C.', vS'Sg35 nsible m Charge of Construction 91241409— Location J No. / ag Date M'I'L ;J I MORTh TOWN OF NORTH ANDOVER 3j • OL F � 9 ' Certificate of Occupancy $ • r 00HU Building/Frame Permit Fee $ C sAMUs Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 17? U Check # !�Ic:` •� r/ I� r Building Inspector �� G� O �� �,�h CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number / Date THISCER S THAT THE BUILDING LOCATED ON 114,0, -ei - MAY BE OCCUPIED AS I&N ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. Aw.CERTIFICATE ISSUED TO a •• O ADDRESS r 'lit SACHU`�� Building Inspector t t NORTH NIT /03 4 Town of over No. /If o �== o dower Mass. Aii"asc � �1 COCMICKEWICK V ' ADRATED P -`Cl S H BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT !3.2 5.... 4%4?Emr-/A- f�,......................................... Foundation lw swot , has permission to ....R�dv*Tzr............ buildings on ....1..1... ...x... kRou� .•'�............... �h— ,7 G to be occupied as............Ria.�,ov'[ .. c;sTjr..QF�� ... 'T, .... ,< .... i3.......................... 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. s W 4.,da PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. t� z� Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRIC 6tStRUCtiOiJ Rou lv �.1a1�Yt/o/L Ac-1rta. -p .... .... . . ................ BUILDING INSPECTOR Fi 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 Until Inspected and Approved by the Building Inspector. Burner DEPARTMENT street No. SEE REVERSE SIDE Smoke Det.