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HomeMy WebLinkAboutMiscellaneous - 12 ELLIS STREET 4/30/2018 12 ELLIS STREET 210/039.0-0025-0000.0 i MORYGAGE INSPECTION FLAN BOSTON SURVEY, INC. 08-06125 P.O.Box 290220 Charlestown,MA 02129 (617) 242-1313 MAIN (617) 242-1616 FAX APPLICANT: WILSON DEEDICERT: 4056-214 LOCATION: 12 ELLIS STREET PLAN REF: 10816 SCALE: finch=30 feet CITY, STATE: NORTH ANDOVER, MA PREPARED: 09-17-2008 CERTIFIED TO: MORTGAGE SERVICE CENTER 6'WOOD 4' CHAIN FENCE LINK FENCE - Z LOT B 12500+/•SF 6'WOOD FENCE LOCATION OF UNDER LOCATION OF NEW 21' GROUND CONDUIT i! DIA. X 54" HIGH POOL u� DECK #12 j 6'WOOD f FENCE 6'WOOD FENCE GARAGE 1.5STORr W/LOCKABLE UP GATE f 42" PVC ELLIS STREET RAILING AND ACCESS EASEMENT GATE ABOVEGROUND POOLLOCATION PLAN 1994(c)8oston Survey Scfty re "�� Y The permanent structures are approximately located on the �rr-S qAccording to Federal Emergency Management Agency � ground as shown.They either conformed to the set ac a s,the major improvements on:his ro ert fall in an r , requirements of the local zoning ordinances in effect a, GEORGE cF P 1 P P P Y aOYyyyOO R the time of construction,or are exempt from violation C a designau d as Zone. l3 FG enforcement action under M.G.L.Title VSI,Chapter COWNS r� �rt*,, ��C p �E'ommunity Panel No. 1/ �'"! -4 �S Section 7,and that there are no encroachments of major No.41784 ; K Z r� r ^0 r Effective Date- I y N 0 A F M improvements either way across property lines except as 9 % Q Z G WIZ I Z �t p D shown and noted hereon. 9 S � PHOT£:Zone C is areas of?`ninimaf tboding(no shadingT. O D° m S U HV This designation is not based on an elevation certificate. m T Z Z O 0 O M � CO)8 m a Z NOTE:This is not a boundary or title insurance survey.This p!a ras prepared in accordance to procedural and technical standards for Mortgage loan Inspections as adopted S < 05 by the Massachusetts Board of Registration of professional e,,ineers and land surveyors,250 CMR 6.05,and use for any other purpose is prohibited.This plan is no!to be used for recording,preparing deed descriptions,or consin Dort. �y ETTS 10 ` J X 0 0 � n D`ziDDO G Z D fD Cl 0) O �Z§m�1ZO � Z n r �1 Z1 O O t7 p O y. 3 » OD�pm0G� /� m z Z D m Z = D j Q "Finsgm- C _.1 � '1 O CO n -i0 D O D � (/) C ZT1X�Cy� "rI = - T O -4 M; M m' rn- N X O Z O C CV'mZmZ`� D < Z m _ is Z�rr�0 0-t D Z D 1-I-1 fit D Q -rI c�D M "M'-'m--'me -1 Z r � = N � =D N -� t N W m{ OZm Z � m -Nn• jD= v,�°' Q � � Zr .ZO] WI rZ0O� O �mmmmm= O H- �tzrn� m C r-oo�om m O v5 CO v 0°M- — mz�zm u,tnzo'm� �7 Z Z tb- m Z r ' Do m m o y mar". D m X -0 to 0 In OLn OAOr10 � O O a°' N v c- 1-11 °°�ov,z pp Z D r r o�"z� Cn ��, i . r Date....... .�36..`/5..:.. � NCA7N TOWN OF NORTH ANDOVER o I * » PERMIT FOR WIRING ss�CHUS� This certifies that ............... ....... .-:-..................... has permission to perform .......... . . . ...... ......J.. 1-- ..................................... wiring in the building of..... )E ......,� � .j L.S d .................................................. I at ......... ........� ...... ..............�.. ................. N:rt A,dover,Mass. Fee.....�J..............Lic. NoA. �...... ��.fl. Gam.............. 2 ELECTRICAL INSPECTOR &eck# // 1 12 35 4 0 Commonwealth of Massachusetts Official Use Only • Permit No. Department of Fire Services ' Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.1/07) peaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN MK OR TYPE ALL.INFORMATION) Date: City or Town of: NORTH ANDOVER To the Inspector of Wires: By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Owner or Tenant W',' -5 Telephone No. Owner's Address Z 1,1c, Is this permit in conjunction with a building permit? Yes No ❑ (Check Appropriate Box) Purpose of Building 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 Ampacity Location and Nature of Proposed Electrical Work: lam'.✓rte vy �r�,L ?a Completion of the following table may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs 'Generators KVA 41 No.of Luminaires Swimming Pool Above- - ❑ o.o Emergency Lighting rnd. rnd. Battery Units yNo.of Receptacle Outlets No.of Oil Burners FIRE ALARMS I No, of Zones `No.of Switches No.of Gns]Burners No. of Detection and Initiating Devices No.of Ranges No.of Air Cond. Total No.of Alerting Devices g Tons No.of Waste Disposers Heat Pump Number Tons J.KW _ No.of Self-Contained p Totals: ............"' Detection/Alerting Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances KW Security Device s or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: (When required by municipal policy.) Work to Start: — ' Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless "the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage' ` orce,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:) I certify,under the pains d penalties ofper�ury,that the information on this application is true and complete. FIRM NAME: . � i IC.NO.: Licensee: Gam, c Signature LTC.NO.: (if ,ent "exempt"in the license mum ne) us.Tel.No.• — '�l a y Address: / v,� Alt.Tel.No.:�s *Per M.G.L c.'147,s.57-61,sec work requires Departmeri f Public Safety/"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent PERMIT FEE: $ 5 Signature Telephone No. ❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance with the provisions of M.G.L.c.143,§3L,the permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166,§32,an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the f' notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall-be limited as to the time of ongoing construction activity,and maybe deemed by the Inspector of Wires abandoned and invalid if he or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008 and extending through August 15,2012. ❑ Rule 8—Permit/Date Closed: ***Note:Reapply for new permit ❑ ❑Permit Extension Act—Permit/Date Closed: Trench Inspection Pass 0 Failed 0 Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: SERVICE INSPECTION: Pass 0 Failed 0 Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: PARTIAL ROUGH INSPECTION: Pass 0 Failed 0 Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: ROUGH INSPECTION: Pass 0 Failed 0 Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: FINAL INSPE ION: Pass 0 Failed 0 Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: ;7 DEB WEINHOLD ...TOWN OF MERRIMAC,MA. .......dweinhold@townofinerrimac.com 1 • The Commonwealth of Massachusetts z Department of IndustrialAccidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 www mass.gov/dia Workers'Compensation Insurance Affidavit:Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Leeb f, ly Name(Business/Organization/Individual): � r Address: i/ z City/State/Zip: f Phone �Jp- 7 Are you an employer?Check.the appropriate box: Type of project(required): 1.❑I am a employer with employees(full and/or part-time).* 7. ❑New construction 2.Q I am a sole proprietor or partnership and have no employees working for me in 8. ❑Remodeling any capacity.[No workers'comp.insurance required.] all work myself o workers'comp.insurance required.)t 9. El Demolition 3. I am a homeowner doing wo y [N p q ] ❑4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. I will 10 Building addition ensure that all contractors either have workers'compensation insurance or are sole 11.❑Electrical repairs or additions proprietors with no employees. 12.E]Plumbing repairs or additions 5.FJ I am a en ontractor and I have hired the sub-contractors listed on the attached sheet. g. 13. Roof repairs • Thes -contractors have employees and have workers'comp.insurance.# J 6. a are a corporation and its officers,have exercised their right of exemption per MGL c. 14.n Other / 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such $Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees.'Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: / Job Site Address: 12— City/State/Zip: Ai t_ Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152,§25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains andp alties of, Wry that the information provided above is true and correct. Signature: Date: G Phone#: i Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall. enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and-phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents foi•confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation'policy,please call the Department at the number listed below. Self-insured companies should'enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents 1 Congress Street, Suite 100 Boston,MA 02114-2017 Tel.# 617-727-4900 ext.7406 or 1-877-MASSAFE Fax#617-727-7749 Revised 02-23-15 www.mass.gov/dia Liberty Mutual. Liberty Mutual Insurance 1�1 1, New England Region Central Property Unit 75 Sylvan Street INSURANCE Danvers,MA 01923 Tel:(800)566-0323 December 8,2014 Town of North Andover Attn: Building Inspector 120 Main Street North Andover,MA 01845 Re: Property Address: 12 Ellis St,North Andover,Ma 01845 Policy Number: H3S21850524540 Underwriting Company: LM General Insurance Company Claim Number: 030917343-0001 Date of Loss: 11/2/2014 Attn: Town/City Official Pursuant to M.G.L. c. 139, § 3B, please be aware that a homeowners insurance claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or causes the condition of a building or other structure to render Mass. General Laws, Ch. 143, § 6 applicable. You are required to notify Liberty Mutual by certified mail in accordance with Mass. General Laws Ch. 175, §99, if you intend to initiate proceedings designed to perfect a lien pursuant to Mass. General Laws, Ch. 139, § 3A &B, or Mass. General Laws, Ch. 143, 5 9, or Mass. General Laws,Ch. 111, § 127B. This letter should not be construed as a waiver or estoppel of any of the terms,conditions or defenses afforded by the policy or applicable law. Please direct your notice to the attention of the undersigned and include a reference to the above captioned property address,policy number,claim number,and date of loss. Sincerely, Liberty Mutual Support Liberty Mutual Insurance New England Region Central Property Unit 1-800-566-0323 Date...A�.-Z.ANA......................... TOWN OF NORTH ANDOVER IIW_ PERMIT FOR GAS INSTALLATION This certifies that ........................ has permission for gas installation .....n. j......... inthe buildings of...... ........................................................... at..........................................................Iz 06 . ....................................... North Andover, Mass. Fee... Lic. No. .)........ GASINSPECTOR Check# 9 w4 9685 MASSACHUSETTS UNIFORM APPLICATION FOR A PERMIT TO PERFORM GAS FITTING WORK CITY MA DATE jt/ 2014 'PERMIT# JOBSITE ADDRESS LLdOWNER'S NAME i S� GOWNER ADDRESS Same TEL FAX TYPE OR OCCUPANCY TYPE COMMERCIAL[] EDUCATIONAL ❑ RESIDENTIAL❑ PRINT CLEARLY NEW:® RENOVATION:❑ REPLACEMENT:® PLANS SUBMITTED: YES❑ NO❑ APPLIANCES 7 FLOORS- BSM 1 2 3 4 5 6 7 8 9 10 11 12 13 14 BOILER BOOSTER CONVERSION BURNER COOK STOVE DIRECT VENT HEATER DRYER FIREPLACE FRYOLATOR FURNACE GENERATOR GRILLE INFRARED HEATER LABORATORY COCKS MAKEUP AIR UNIT OVEN POOL HEATER ROOM/SPACE HEATER ROOF TOP UNIT TEST UNI?HEATER UNVENTED ROOM HEATER WATER HEATER OTHER Re lace Gas Meter s / x and Associa ed Pi in INSURANCE COVERAGE I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 YES Q NO ❑ I IF YOU CHECKED YES,PLEASE INDICATE THE TYPE OF COVERAGE BY CHECKING THE APPROPRIATE BOX BELOW I LIABILITY INSURANCE POLICY ❑ OTHER TYPE INDEMNITY ❑ BOND ❑ OWNER'S INSURANCE WAIVER:I am aware that the licensee does not have the insurance coverage required by,Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. CHECK'ONE ONLY: ,,OWNER ® AGENT SIGNATURE OF OWNER OR AGENT I hereby certify that all of the details and information I have submitted or entered regarding this application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in liance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. G PLUMBER-GASFITTER NAME I Joseeh Marino LICENSE# 8736 SIGNATURE MP❑ MGF❑ JP❑ JGF❑ LPGI❑ CORPORATION❑# 3285C PARTNERSHIP[j# LLC❑# COMPANY NAME: RH White Construction Co ADDRESS 141 Central St CITY I Auburn STATE MA ZIP 01501 TEL 508 832-3295 FAX 508-926-4347 JCELLI 508-832-4614 EMAIL JMarino@RHWhite.com ROUGH GAS INSPECTION NOTES THIS PAGE FOR INSPECTOR USE ONLY FINAL INSPECTION NOTES Yes No THIS APPLICATION SERVES AS THE PERMIT ❑ ❑ FEE: $ PERMIT# PLAN REVIEW NOTES l� r Lq(;ation Nd. Date NORTN TOWN OF NORTH ANDOVER Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ 3 CHUst Other Permit F�e $ �e PA I ° Fee $ Water Connection Fee $ w TOTIA, $ f.t Building Inspector Div. Public Works PER'3tIT Nq l APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. //AGE i MAP 4-J0. LOT NO. 2 RECORD OF OWNERSHIP IDATE BOOK *,PAGE ZONE I SUB DIV. LOT NO. 1 - LOCATION JrZ - -"Jt"j� --_ _.� PURPOSE OF BUILDING 'nglu' AMij"z '&'C/1)il6t — OWNER'S NAME �� �ilrn NO. OF STORIES SIZE `O/Oa OWNER'S ADDRESS /'1 ''� •�i BASEMENT OR SLAB ARCHITECT'S NAME OOL� SIZE OF FLOOR TIMBERS 1ST 2ND ax lO 3RD BUILDER'S NAME SPAN DISTANCE TO NEAREST BUILDING ��t p �i� �v�� DIMENSIONS OF SILLS .� DISTANCE FROM STREET 3/j /'t /1 / POSTS x �^ DISTANCE FROM LOT LINES-SIDES ;�71 REAR y/_' " GIRDERS 0 AREA OF LOT / d2 S�y -ga P'. FRONTAGE 164, /?1 HEIGHT OF FOUNDATION THICKNESS Ii IS BUILDING NEW b IC' /7 SIZE OF FOOTING /a 1) a tJ c �� ' IS BUILDING ADDITION A!; MATERIAL OF CHIMNEY ). "nc IS BUILDING ALTERATION N© IS BUILDING ON SOLID OR FILLED LAND lid WILL BUILDING CONFORM TO REQUIREMENTS OF CODE .p� IS BUILDING CONNECTED TO TOWN WATER \/e s BOARD OF APPEALS ACTION. IF ANY C� IS BUILDING CONNECTED TO TOWN SEWER _ ye IS BUILDING CONNECTED TO NATURAL GAS LINE S INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST O®l� S COST PER R Q. FT. PAGE 1 FILL OUT SECTIONS 1 - 3 EST. V � PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM t SEPTIC PERMIT NO. :2 ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY K ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED -7��/��i,� yt�-- BOARD OF HEALTH iJGNA-fj(REe OWNER OR AUTHORIZED AGENT OWNER TEL.#SDS 6�G�95Y/ F E E D© CONTR.TEL.# _a1�Y�• CONTR.LIC.# 'g? _ PLANNING BOARD PERMIT GRANTED / 19 r is �' t�_ E'• i BOARD OF SELECTMEN 21992 EL iNa INSPECTOR i w 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 I RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION C JPi C ��.//� Hj e 2 FOUNDATION 8 INTERIOR FINISH /l�CIY �Q CONCRETE _I 3 I 2 13 CONCRETE BL K. PINE _ BRICK OR STONE HARDw D PIERS PLASTER _ DRY WALL _ UNFIN. 3 BASEMENT 11 AREA FULL FIN. B M'TAREA J- 1/1 1/1 '/ FIN. ATTIC AREA _ N_O B-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 HARDVJ'D _ ASBESTOS SIDING COMI,ACN VERT. SIDING ASPH.TILE _ STUCCO ON MASONRY _ STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR I_ BRICK ON FRAME CONC. OR CINDER BLK. STONE ON MASONRY WIRING r: STONE ON FRAME _ SUPERI ADEQUATE I� LOOR ONE 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 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 r B'M'T 2nd _ 'ELECTRIC 1st 13rd"-."v;+';``k. NO HEATING a. PLANS J F q o3EWEW/WAT1t_wn of Andover No. 301 " o Y A w-"fi E AY ENTRY PERMIT * =K f k er, Mass.,- 192t. OR pP SS BOARD OF HEALTH P E R LD THIS CERTIFIES THAT.... .I ..`........�.�.. .. ............................ BUILDING INSPECTOR has permission to erect4..'1040.........................IlQM In .......... . �.... ..K...... Rough ••••.••••, Chimney to be occupied as..........,/ ....�..�..)....5.......�. .................................. "' 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 a 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 CONSTRUCTION STARTS Service 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. Building Inspector Town of North Andover BUILDING DEPARTMENT Homeowner License Exemption (Please print) DATE M z__ JOB LOCATION_ ) ,-2 Number Street Address Section of town "HOMEOWNER" 0`rf`1 ��c�'N s S�& ,- Name Home Phone Work Phone PRESENT MAILING ADDRESS �� Cit Town Y State Zip code The current exemption for "homeowners" was extended to include owner occupied dwellings of six units or less and to allow such homeowners to engage an individual for hire who does not possess a license , provided that the owner acts as supervisor. (State Building Code , Section 109 . 1 . 1 ) DEFINITION OF HOMEOWNER: Person(s ) who owns a parcel of land on which he/she resides or intends to reside , on which there is , or is intended to be , a one to six family dwell- ing , attached or detached structures accessory to such use acid/or farm structures . A person who constructs more than one home in a two-year period shall not be considered a homeowner . Such "homeowner" shall submit . to the Building Official , on a form acceptable to the Bulding Official , that he/she shall be responsible for all such work performed under the building permit . (Section 109 . 1 . 1) The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes , by-laws , rules and regulations . The undersigned "homeowner" certifies that he/she understands the Town of North Andover Building Department minimum inspection procedures and jrequirements and that he/she will comply with said procedures and ,requirements . HOHEOWNER' S SIGNATURE APPROVAL OF BUILDING OFFICIAL Note : Three family dwellings 35 , 000 cubic feet , or larger , will be required to comply with State Building Code Section 127 . 0 , Construction Control . I i FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with any applicable local or state law, regulations or requirements. ***************Applicant fills out this sect'on***************** APPLICANT: (�G{?��/ �'" R)i-/1� Phone 6'©� LOCATION: Assessor's Map Number Parcel Subdivision > Lot(s) Street �/ / � St. Number _L2_ ************************Official Use Only************************ RECO DATIONS OF TOWN AGENTS: Date Approved Az 1q: Conservation Administrator Date Rejected Comments i Date Approved Town Planner Date Rejected Comments I Date Approved Health Agent Date Rejected Comments Public Works - sewer/water connections - driveway permit Fire Department Received by Building Inspector Till Date tfi ' EERA R T t� Efia 9 /0 . 7.9 ' TY r } r- f DEC0 j!. - 2 1992 {I _J: V �98� Ll �,voE,e co,vs r,E' Lo.v,ST�P 1 � 1 � 1 EZ-Z-z`5 `57 S .NEREQY CE.�T//�Y TO TyE T/TGE/�f/SU.M.� S✓O RL O/ / `.4& 771 Tf/E dANr T.flgT T,VEO—OZ41mo /S LOIC.ITEO O,t/ Til/E GOT.�s S.fl�Yf'•V ANO TiK.IT/T pAGS CG✓fAe'M //V /Y/Tiy T.vE T��''x!.Airy"j�ts%OG7<'E,,� 2oNivB ,e1�sH[AT.t�vS fWd 4AP1,NS S j-zx4orx F Af L/•vES. S F!/,�TJYG'.C.'CE.�T/.�Y TiV.�1`ri✓/.S G►r7tYL/MC /s�/OT � r v /'// '. LOC,ITEO / 1.�' fEAE.0 aieo .9c•Iz.��o .tel['.+." O.PA/I�iV FO•P r Eta G/9,ey,f !/i.eG//(/�� -� 7�/S o��N,mop �or�g6E P�,��SES-NOT FD.P � Bovvoty gc-rE.r.�i.✓,�rio.✓_ doa4,.4.4. AT/O,(/ 7 4A e-,(/ FSM EX/JT-Ma .ees'L�OS., a , !1 1 � D .0 ` Date. ! � . NORT/� •�,;.,�40 TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING CHUS This certifies that . . . . . . . . . . . . . . . . . . . �l has permission to perform ���' �� �I.l�-L�f�:�C ,� "'� plumbing in , e buildings of :`��,. .'. f.u� r. . . . at ./ . ... . .`��! . . . . . . . . . . . . . . . . . North Andovelmass. Fee...,�V .Lic. No.. . . . . . . . . . . . .iwl . . . . . . . . . . . . . . . . . . � PLUMBING INSPECTOR Check # 6 . MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Print or Type) as,,; Dat g^ Izvo� _ P rmit #Le - N 4 Building Loca on � � wner's Name IES ype of Occupancy_ t + E U Tl New ❑ Renovation ❑ Replace Plans Submitted: Yes ❑ No ❑ FIXT z m Pm H o z US W Y J N Q V N O L7CC N Z O W y x ¢ z z N UJ fa 2d 4 H W Q Z Q m df N W < h N Z d t7 a a < 3 X O O Z ¢ 3 < p a (A Z .a d ¢ O W Q W W < N W N rt J p C �+ IL z x Y 4 O 1- 4C beZ Z a W t� Y W < < s a a a O = ° " ~ ° < J � < ¢ � a V S ¢ m o SUB—BSMT. BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR aTH FLOOR/� Installing Company Name f�0r�iEeT Q- SP(r l,4TAe f) Check one: Certificate Address_ � I"C R c ti ma J ❑ Corporation Al t4 l)t fi t1"I ❑ Partnership Business Telephone_ iq 7 1 2-6rm/Co Name of Licensed Plumber 7- regec") INSURANCE COVERAGE: I have aY usrrel liability insoua ce policy or its substantial equivalent which meets the requirements of MGL Ch. 142. If you have checked ye, please indicate the type coverage by checking the appropriate box. A liability insurance policy Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner'sAgent Owner ❑ Agent El I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations pWormed under the permit issu for this application will be in compliance with all pertinent provisions of the Massachusetts State Plum ' g jeode and Coapter of the oral Laws. � L re of Licensedlum r l �Ayf Type of License: Master ioumeymab❑ AK (OFFICE ONLYT License Number y33 5 BELOW FOR OFFICE USE ONLY • � PROGRESS INSPECTIONS FINAL INSPECTIONS SKETCHES FEE NO. APPLICATION FOR PERMIT TO DO PLUMBING NAME&TYPE OF BUILDING LOCATION OF BUILDING PLUMBER PERMIT GRANTED DATE___19 r f ' PLUMBING INSPECTOR Date�q;p. . . . . . . . . t a "oRTM TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING SSA US A' �s certifies that . . . . . . . . . . . . . . . . . 'L IJ. . . . . . . . . . . . . . . as permission to perfJOj[/� . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buil ' gs of—._. .. . . . . . . . . . . . . . . . . . . . . . at .�� . . . . . . . . . . . . . . . . . . . . . . ._._. . . . . . . North Andover, Mass. OJ _ Fee `_. . ic. No . . . . . . . . . . . . . . . . . . r� V PLUMBING INSPECTOR Check # // G ,i 6934 . .I Date. . ...... .. �. . . .... . Of HORTM ,,'►I . o= TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION �,SS�IC MUSEt This certifies that .k�'. . . . . . . . . . . . . . . . has permission for gas installation . . . . . . . . . . . . . . in the buildings of . . . . . . . . . . ... . . . . . . . . . . . at . . r `. . .. . .-� . . . . . . ., North Andover, Mass. r Fee: �^ Lic. No, . . . . . . . . . . . . . GASA90ECTOR Check# "?:Te- 410d"t or TYpe!—'._ APPLICATION FOR'PERMIT TO 00 GASFITTING has-_ � , Mass. Date Zp Building L tion 2 S1. P rndt j 7 owners Te Type of Occupancy ✓� Nswp Renovation p Replacement/ Plars;Submlt'bed: Yes p No 0 Eaui z cc � 10 o� � U � 1 � _ } J W o: �-X- (09 SUB-BSMT o BASEMENT 1ST FLOOR 2ND FLOOR 3RD FLOOR ' 4TH FLOOR STH FLOOR 6TH FLOOR 7TH FLOOR M FLOOR stalling company name Ap 2tlres Cheek one: Certificate p corporation r stiness Telephonep Partnership 19M of I.leensea Plumber or Cm Fltte;7:���9 �IrCO. NI `Ica COVERAISE: 1 powrequirementsha'�4 curren"lilty Insurance policy or its substantial equivalentNo 0 , which meets the requirements of MGL Ch 742. f'.you have checked yes,please Indicate the type of coverage by checking the appropriate box 1"abllltl/Imurattce policy&- Other type of indemnity p Bond 0 )WMR'S MuRNACE WAIVER: 1 am aware that the licenses does not have the Insurance coverage required by C hapter 42 of the Mass.General Laws, and that my signature on W-ROPMEMMeatfon Walves this requirement gna re ocaner or cane s pen Cheek one: Owner p Agent p erfeby ter@fy that an of the deans end information 1 have submitted for entered!In above a plication are true and accurate to the best of know"dge and that all plumbing work and installations performed under the PW7dt poranentprovlslone of the Mee"CMaetlS State Ga Code and chapter 142 of then r this application be in compliance vrith L A41 8r Type of License: , .ice oGasmber re o cense Plu erorGas F tter o Fitter Ciry/fown p.IlRalttr ,APPROVED(OFFICE usrt ONLY) Memo Number 0 Journeyman __ DELOW FOS 0/i1t. J'DftY FINAL INS►ECT)GUS ( ►IIOOIIESi INSPECTIONS f�EE NOr , APPLICATION►ON PCONIT TO 90►LYWINO NAVE A Trill Or BMLMMG LOU""OF MY m"s ►LYMl11 ��T OIIAfI'RO INO Illt►ECTON