HomeMy WebLinkAboutMiscellaneous - 12 ROSEDALE AVENUE 4/30/2018 (2) VENU
/ 12 ROSEDA�E A �/ � ' ( � V
0 C-0035 0000.0 /+
2101 /�
Location
No. 3� Date
MaR,M TOWN OF NORTH ANDOVER
O
f 9
i • : Certificate of Occupancy $
b''•"''�t�' Building/Frame/Frame Permit Fee $
�ss�c ust 9
Foundation Permit Fee $
Other Permit Fee $
TOTAL $ 3�r
Check #
�4
52,
6 2 Building Inspector
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
l
My
BUILDING PERMIT NUMBER: S ` ��a DATE ISSUED:_. a o
U 3
SIGNATURE: ��C
Building Commissioner/I for of BuildingsDate
SECTION 1-SITE INFORMATION
1.1 ProRerty Address: 1.2 Assessors Map and Parcel Number:
M Number
6 r-�„ �� l� MASS��� aP Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
Zonin District Proposed Use I Lot Area Frontage ft
1.6 BUILDING SETBACKS ft
Front"V rd Side Yard Rear Yard
Required Provide Required Providedred Provided
r 3 U 3u a-�k-- 3 o v
1.7 Water SupplyM.GLC.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System:
Public ❑ Private 0 ZOIIe Outside Flood Zone ❑ Municipal ❑ A. On Site Disposal System 0
SECTION 2-PROPERTY OWNERSIIIP/AUTHORIZED AGE?ff
2.1 Owner of Record
Name(print) � Address for Service:
C/ Y -� s -3
Si6ature Telephone
2.2 Owner of Record:
P
Name Print r.� ,-� Address for Service:
— m
i Si nature I Telephone
SECTION 3-CONSTRUCTION SERVICES
i 3,1 Licensed Construction Supervisor: Not Applicable 0
i
Licensed Constrruucttiioiy SSupervisor-
-- cense umber
lddress l• l
3 � Expiration Date
'signature Telephone
3.2 Registered Home Improvement Contractor Not Applicable 0
woo
�ompany Name
Registration Number M
slum
1du=ess
Expiration Date
t nature '1`P1Pll1,IlAP
SECTION 4-WORKERS CO10'1 ENSATION(NLG.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 build1w permit.
Si ned affidavit Attached Yes....... No.......❑
SECTION 5 Description of Proposed Work(check ail aptincable
New Construction ❑ Existing Building ❑ Repair(s) ❑ Aherations(s) ❑ Addition L--
Accessory
l/Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify
Brief Description of Proposed Work:
es '-S
SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar)to be ��`
Completed b permit a licant m� k ; .
1. Building QQU (a) Building Permit Fee X bs__ X 6"5-
Multiplier
2 Electrical -(b'T Estimated Total Cost of
(Q o o Construction
3 Plumb'ng (0 (000 Building Permit fee(a) x (b)
4 Mechanical HVAC) 2060I l I
5 Fire Protection I
6 Total1+2+3+4+5 U V00 Check Number `
SECTION 7a OWNER AUTHOR17A ON TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner/Authorized Agent of subject property
Hereby au nze_� to act on
My behalf ers`relative to work authorized by this building permit application.
Si iafure of Owner Date
SEC(TIIO�N 7b OWNER/AUTHORIZED ANENT DECLARATION
,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
Ty�, V �`�
Print Na.
Si a of Owner/A ent Date
NO. OF STORIES t SIZE U 4-1 �
E
ENT OR SLAB
FLOOR TINMERS IST 'PC v 2ND ,2•� 3RD
SIONS OF SILLS L4,
IONS OF POSTS
IONS OF GIIZDERS
OF FOUNDATION THICKNESS
FOOTING �/'.. /�— X
IAT OF CHIMNEY"ING ON SOLID OR FILLED LAND
ING CONNECTED TO NATURAL GAS LINE y
FORM U - LOT RELEASE FORM /a Kiy
6� riati .
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 or requirements.
*****************************APPLICANT FILLS OUT THIS SECTION***********************
APPLICANT (TJN%,,.- PHONE
LOCATION: Assessor's Map Number PARCEL.1
SUBDIVISION LOT(S)
STREETr�SC' P D
ST. NUMBER /
*****************************************OFFICIAL USE
ONLY***********************************
RECOMMENDATIONS OF TOWN AGENTS:
ONSERVATION AD I ISTRATOR DATE APPROVED
DATE REJECTED
COMMENTS
TOWN PLANNER DATE APPROVED
DATE REJECTED
COMMENTS
FOOD INSPECTOR-HEALTH DATE APPROVED
DATE REJECTED
SEPTIC INSPECTOR-HEALTH DATE APPROVED
DATE REJECTED
COMMENTS
PUBLIC WORKS- SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT n /
FIRE DEPARTMENT ire ' + ' —c d twlr
RECEIVED BY BUILDING INSPECTOR _ .. DATE l
Revised 9\97 jm
RECEIVED Town of North Andover of �&OR711'1
JGYCE BR �#e" of the Zoning. Board of Appeals o� `'�°°�
TQ`'�H .
Hp =�WFy Development and Services Division « i
{u�-Yp�idi Griffin Division Director * •--•--•
ZQQ� DEC I 27 Charles Street cHus�
North Andover, Massachusetts 01845 Telephone D. Robert Nicetta p (97
8) 688-9541
Building Commissioner Fax (978)688-9542
iS to cortify tnai twenty(20)days
,e 4i�psod from date of decision,filen
Any appeal shall be filed Notice of Decision runout filing of an appeal./
within(20)days after the Year 2001. oyce A.B adah us te ?C,
date of filing of this notice Town clerk.
in the office of the Town Clerk. Property at: 12 Rosedale Avenue
NAME: Arthur&Dorothy Pauk DATE: 12/11/01
ADDRESS: 12 Rosedale Avenue PETITION• 038-2001
/ North Andover,MA 01845 HEARING: 12/04/01
The North Andover Board of Appeals held a public hearing at its regular meeting on Tuesday,December 4,
2001 at 7:30 PM upon the application of Arthur&Dorothy Pauk,12 Rosedale Avenue,North Andover,
MA,requesting a variance from Section 7,Paragraph 7.1,7.2,&7.3 for relief of street frontage,front and
right side setbacks within Table 2,in order to construct a second floor and right side addition to a non-
conforming single family residence,and a Special Permit from Section 9 and Paragraph 9.2 in order to
\ j extend a pre-existing non-conforming structure within the R-3 zoning district.
The following members were present: Walter F. Soule,Robert Ford,Raymond Vivenzio,Ellen McIntyre,
. &George M.Earley.
Upon a motion made by Robert Ford and 2nd by Raymond Vivenzio,the Board found that the proposed e,+
change does not encroach on the existing side and rear setbacks. The Board voted to GRANT a
dimensional Variance for relief of front setback of 9.5'and street frontage of 19.85'in order to construct a
second floor,a right side first floor addition,and a farmer's porch all as per the Plan of Land by Findeisen
Survey&Design,87 Indian Rock Road, Suite 7,Windham,NH 03087-1656,PLS,#36869,dated
November 08,2001 and revised 11/19/01. Upon a motion by Robert Ford and 2d by Raymond Vivenzio,
the Board voted to Grant a Special Permit from Section 9,Paragraph 9.2 of the zoning bylaws and that
such change, extension or alteration shall not be substantially more detrimental than the existing structure
to the neighborhood. Voting in favor: WFS/RF/RWEMIGME.
Town of North Andover
Board of Appeals,
Walter F. Soule,Acting Chairman
Decision 2001-038
ATTEST:
A True Copy
own, cleAk
xY_
BOARD uF APPE.-ILS 688-9541 BL7L014G 688-9545 CONSERV ATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
� s
ESSFX NORTH
Qt'�TRN OF P��' 1
14c, Nth • u.,...
LobR' T
q TRUE COPY' hT
rye of e
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:
L. L. & S. waste Wood Lowell Road Salem, NH
(Location of Facility)
Signature of 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
- WOAD STRUCTURES,_INC. '
'„.. DESIGN LOADING: N c
J Q B 4:0 30f13 TCLL/TOTAL (PSF) 40/57 8 24"oc, 50/67 8 19.2"oc, 60/77 @ 16"oc
THIS TRUSS HAS BEEN DESIGNED FOR A 20 PSF BOTTOM CHORD LIVE LOAD, APPLIED CONCURRENTLY WITH ALL OTHER LOADS 1amd
TYPE- - 799 WHEREVER THE CLEAR DISTANCE BETWEEN THE TOP OF THE BOTTOM CHORD AND ANY OTHER MEMBER IS 42 INCHES OR GREATER.
s, OF ' /Q TRS001
THIS•CHECK CONFORMS WI'N B.O.C.A. 1990, SECTION 1106.1.2. TABLE 1106.1. cn
-x4 to cv ► c
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Y
. ��• I�■4 � Z �
5.00 rL2- 1=■4
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3s4 ; 3=4 -�
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J 1 52=E G7<J/.1/L f3ELOi'� �dig Q=
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5-06-02 6-OS-14 24o--
,�FC.' I 24 6-OS-14 5-06-02 w $g:toz
rV C� Ro 2 yo
8e 8-00-00 • 8-00-00 8-00-00 y 2 C-°Q o°Z
t _ .
h 8=nvgO3
' 24-00-00 ° g��9'fou6
> _2
TCLL= Sf 'y4�LNB" SPACING r= 2-0-0-GO REACTIONS-_ KIN L/DEF- 241/0.22'= 999, CAMB- 0 1/8" a �gm�muD
TCDLs 7'SQ �S! fNCR:P=1+.15 L=1.15 ,(LBS);jRG(IN) 20 GA. M20 PLATES 199 PSI GAS (MAX)
BCL L- 0.Q aSF IIUTT�,��UT- 0. ' 1/i" J fly -1589 3.5 S
J Ss 589 3.5 0�`a°ci
acaL= 10.o �sr 2��i v.> 005
MITER: INDUS`�IES, INC. 5+6;..
10/15/91 CONFORMS TO TPI 91 REPETITIVE INCR C gm0sc
TOP C''2WORD - CSR= O.d86----- --- BOTTOM CHORD - CSR= 0.915--- ------- it£ES
CSR- 0.614------- ��Q?E c o. �om0
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----- 2X 4 :aiA 2 SYP ' 2X 4 NO 2 SYP 2X 4 STD SPF S�/CE �I p c.��2
C 1- -2644 C 3- -2367 C 5- 2440 C 6- 1663 C 7s 2450 W 1- -524 H 3. $34
C -2� -2367 C� 4- -2641 W 2- d34 W 4- -524
cc
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7:IACAIX. Zx�/6SoF/.SE ysR SPF �.
I .* NOTE T VFE4aGE DETAIL AT THE HEELS) ITEM C LER ' gg gi-
2. ADDI.T=CONAL iOTTOM CHORD UNI?. RM. LOAD$i' 11.1502 FT - 12.8596 FT - 20.0 PST. . ,�, 2.?11Qa
3 . LEFT c=OE'RHLfG DISTANCE ALONG-14E BOTTOM EDGE IS 2-02-00. /// � ` u g9n„�
4. RIGHT CERHZNG DISTANCE ALONG THE BOTTOM EDGE IS 2-02-00. hs X597 i •3^QE
C�'
.•`�`OF fifi►�"�''•� �.��E OF�jytq�•,�, 11S.oF�� .`'•pF GOI�,yFC Q,�¢ INEb�fE REWSTERED i � o
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STEPHENF 1wm.=;psi s, STEPHEN W. _ CA6LER ,.r ;i ;n•-�� ' SEag=�4
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1850 V�i� 9 9to Fp ¢ Z 0 'S'o. Eqi iE
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FROM THE-COLLINS-CO PHONE NO. Nov. 08 2001 09:46AM P2
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The Commonwealth of Massachusetts
d Department of Industrial Accidents
Office of investigations
Boston, Mas, . 02111
Workers'Compensation Insurance Affidavit
Name i C IN Lotr S Please Print
Name:
Location:
City Phone #
I am a homeowner performing all work myself.
j I am a sole proprietor and have no one working in any capacity
® I am an employer providing workers'compensation for my employees working on this job.
Comoany name: Michael A. Collins DBA: Collins Co, .
Address 429 North Main St. P 0 Box 281
City: . Salem NH 03079 Phone* 603 898-6338
f
'Co., Liberty, Mutual Insurance GrouP PolWC7-31S227489-0201Insurance
Comnany.:name.
Address .
City Phone#:
Insurando_ o. : - Po la
#
dilute to secure coverage as required under Section 25A or MGL 152 can lead ko tha imposition of criminal penalties of,a.firie up to$1,SUb:00
and/or one years'irt►pnsonmient_as_wetl_as.civil-penalties.in2tielnrm-cf-aS.IC]P:1N.S RK_DRU . arid-.afin6_of�$1DO t W_ y�gainstme 1
understand that a copy of this statement may be forwerded`to the Office of Investigations of the DlAfor coverage verification.
I do hereby certify under a pains and naitiesof p N that t e information provided above is true and correct.
t.
Signature. Date
Print name Michael A. Collins Phone# 603 898-6338
Official use only do not write in this area to be completed by city or town official'
City or Town_ Permit/Licensing
0 Building Dept
❑Check if immediate response is required 0 Licensing Board
p Selectman's Office
Contact person: _ Phone A E] Health Department
Other
Ji
1
4'6"
20' 5'6"
BATH
BEDROOM
/ OFFICE KITCHEN
CLOSET I CLOSET
`r DOWN
N
UP
BEDROOM LIVING
ROOM
30'
FIRST FLOOR
EXISTING
(NOT TO SCALE)
DOM
UP
SECOND FLOOR
EXISTING
(NO, TO scALe)
FRONT ELEVATION
EXISTING
(rvor TO scnLe)
SIDE ELEVATION
EXISTING
(rvor TO scnLe)
1
I
4'6"
N 17'6"
PROPOSED ADDITION
20' N 5'6"
BATH
BEDROOM
/ OFFICE KITCHEN
i
i
CLOSET I CLOSET
N
DOWN
UP
12'
BEDROOM LIVING
ROOM
4' x 12' FARMER'S PORCH
30'
FIRST FLOOR
PROPOSED
(NOT TO SCALE)
i
(D O
i
0 C) 0
a
N D
W W
V) IiO O
J J
U U
l
CLOSET CLOSET
30'
SECOND FLOOR
PROPOSED
(NOT TO SCALE)
FRONT ELEVATION
PROPOSED
(NOT ALE)
i
i:.: ''•.'' '' •i.�:F;.>ji, ;,}. :r..4;=ij,:'�::t'}.;�w:'�;.�Y.j?:s,�'_.r,N% :yi':,t.;:1•x,�.:.�.
'..+� �.<.: '� .r' •' '+'':a+;`x;2>>� y s .:c,]•.t.i;;ti..:a Tx":r
X.>d, :�k:.. ";r; :?•'}:%."•%`ik:�J:' :`e�:'S:s`•;i,••• ::.:.::.'.ti::T!*'�•xa<:�•
SIDE ELEVATION
PROPOSED
(NOT TO SCALE)
NORTH
0VM Of E _ Andover
o� coc LA � dover, Mass.,
HIC AERATED p`?���5
S H E
BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
THIS CERTIFIES THAT..... BUILDING INSPECTOR
d .................................................
Foundation
has permission to erect....../.R.X/.Y..............I buildi gs on ....�oZ....I. � a v e—
. .. ./.........�................kd',4.)
Rough
to be occU ied as..VC( 4T4s, d Q�.j. .10A_) 4- (r �/ G �j00/' �! Chimney
p ..�...........o2................................4..01... ..
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. (D O C��s PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Z 0 ,4 J c PERMIT EXPIRES IN 6 MONTHS Final
UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR
Rough
C �
........... ...................... .............. ........................................................... Service
BUILDING INSPECTOR
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Display in a Conspicuous Place on Rough the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
SEE REVERSE SIDE Smoke Det.
t ;
T01IN Or NOR71-1 ANDOtIER PLAN REFERENCE
ZONING BOARD Or APr ALS SIDE VIEW
EX/S77NO (NOT TO SCALE) PROPOSED 1. "KLONDIKE PARK, NORTH ANDOVER, MASSACHUSETTS"
SCALE 1" = 40, DATED 1906, E.GN.R.D. PLAN ,f 0360
NOTES'
20.0= — 19.5' 1. THE EXISTING DWELLING DOES NOT COMPLY TO THE M1N/MUM
15.5' FRONT YARD SETBACK, THEREFORE THE PROPOSED ADD177ON
ESSEX NORTH REGISTRY OF DEEDS i DIRECTLY ABOVE THE EXIS77NG DWELLING WILL NOT COMPLY
L` f�t. TO THE FRONT YARD SETBACK.
-LAWRENCE, MASS. 11.5= — 11.5
A TRUE COPY: ATTEST: 2. DEED REFERENCE. BOOK 6292, PAGE 111
2.5'— — 2.5' 2• THE PROPERTY IS ZONED: RESIDENCE 3 DISTRICT (R-3)
0.D'— _ 0.0' J. MIN/MUM REQUIRED LOT AREA: 25,000 S.F.
1 MAP 60C EXIS77NG LOT AREA: 9,975 S.F.
REGISTER OF IDEEb LOT 38 MAP 60C TOP OF FOUNDA77ON 4. MIN/MUM REQUIRED LOT FRONTAGE.- 125 FEET
N/F LOT 32 GROUND LEVEL EXIS77NG LOT FRONTAGE.- 105.15 FEET
EDWARD J. & N/F
DEBORAH E. MANCHENTON JANICE G. COADY 5. MAXIMUM BUILDING HEIGHT 35 FEET
_ EXISTING BUILDING HEIGHT 11.5 FEET f
FOR REGISTRY USE ONL Y MAP 60C
6. MINIMUM BUILDING SETBACKS: FRONT - 30 FEET
LOT 37 MAP 60C SIDE - 20 FEET
N/F LOTS 33 & 34 REAR - 30 FEET
CHRIS-MICHAEL & \ I.ROD FO N/F 7. THERE ARE NO WETLANDS WITHIN 100 FEET OF THE LOT.
DARLENE JOY CARANGELO JAMES C. NYINAN \
----, 6"
E SUSAN L. WATTS 8. ALL BUILD/NGS WI THIN 50 FEET OF THE PROPOSED
I.ROD(F) s 2 •2 2 5 �,• LROD F CONTRUCTION HAVE BEEN SHOWN OF 7N/S PLAN.
0.00 o .,E , W' 'CAP
MAP 60C o\ 2-72a 56 GRAPHIC SCALE
LOT 35 n s 0.00
rn 1 6 0 40 0 20 40 e0
MAP 60C ( 9,975 S.F. EXIS77NG 1-1/2
LOT 36
_k STORY DWELLING o
N F �z l•PIPE(F) N (PROPOSED ADDI77O1,I PROPOSED\DD177ON
1 HEREBY CER77FY THAT 77-IE PROPERTY LINES JOSEPH A. & m SETBACK �n DlREC7ZY A,Q(.. 4' x`12' FARMERS PORCH
SHOWN ON THIS PLAN ARE THE LINES DIVIDING LINOA A. WEBBER LINE\ � EXIS77NG GARAGE NO. DATE REVISIONS. BY
EXIS77NG OWNERSHIPS, AND THAT THE LINES OF 1� X7.5'
THE STREETS AND WAYS SHOWN ARE THOSE OF o �` - cn 3 7, \ 1 11/19 RE-LABEL FARMER'S PORCH H.P.F.
PUBLIC OR PRIVATE STREETS OR WAYS ALREADY
ESTABLISHED, AND THAT NO NEW LINES FOR TWO TO6 o (n` a, w TAX MAP 60C / LOT 35
PROPERTY LOCATION:
LING
DIVISION OF EXISTING OWNERSHIP OR FOR NEW
WAYS ARE SHOWN. D 261' 12 �\ 12 ROSEDALE AVENUE
\ NORTH ANDOVER MASSACHUSETTS
P c0
20.2
Ln
�. ST. BND.(F)
ALBERT T. TRUDEL P.L.S. # 36869 DATE — _77::7_w_0_9_-224l- W 105.15• - VARIANCE PLAN
1.PIPE(F)
„.r... UNCOVERED STAIRS Wl7H LANDING OWNERS: ARTR'UR H & DOROTHY W. PAuK
I CFR77FY THAT THIS PLAN COMFORMS Wl7H THE 12 ROSEDALE AVENUE
RULCS AND REGULA77ONS OF THE REGISTERS OF
DEEDS OF THE COMMONWEALTH OF LE A VENUNORTH ANDOVER MASSACHUSETTS
MASSACHUSETTS. PREPARED BY:
MAP 47 MAP 47 �'INDZ'ISEN SURVEY & DESIGN
LOT 137 LOT 10
ALBERT T. TRUDEL P.L.S. # 36869 DATE 87 Indian Rock Road — Suite 7
N/F N/F Windham, New Hampshire 03087-1656
XIAOLING LIANG STANKA77S FAMILY TRUST Tel. 603J 898-8516 Fax 603 898-8497
TONG QUANG ZHANG DONALD A STANKA77S, TRUSTEE
SCALE: 1" = 40'1 DATE: 11/0.9/011 DRAWN BY: H.P.F. JOB NO: 501036
y
Date ?. . . . . . .
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
,4 CHUSt, l
. !-�' .
This certifies that . . . . . . . . . . . . . . . . . . . . .
has permission to perform . . .'` ... .*. •.. ..`-. . . . . . . . . . . . . . . . . . . .
` plumbing in .the buildings of . .(ar�,-0.0.. . . . . . . . . . . . . . . . . . . . . . I
at. G. �C.:--a - r_. -P� ��-�^�:J . ., North Andover, Mass.
Fee!�` . . . . .Lic. No.. . . . . . . . . . . . .�. �
PLUMBINGISP,FCTOR
Check # ���� (� (/
5 'i67
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER,MASSACHUSETTS
, � Date
Building Location L� (/1-OwnersName ��y1u A
Permit#
Amount
Type of Occupancy ,.-�
New Renovation Replacement rl Plans Aubmitted Yes � - No
FIXTURES
Ste»
&�SflVIIVi'
IS>C)HL m r
M.]HIaR /
�1HI�It
4M)H DM
SII3)HL M
6M]EI M
7II3)H "
SI>`iHDM
(Print or type) Check one: Certificate
Installing Company Name t Lt-r.4 rvN PRY A-13-6 •'i�4 0 Corp.
Address / GA r9,Z W l—�— q V15 El Partner.
,S /4 Z C M
Business Telephone jO�^ 3 X-4 3 3 `f/ Finn/Co.
Name of Licensed Plumber. � �
Insurance Coverage: Indicate the type of insurance coverage checking the appropriate box:
Liability insurance policy P Other type of indemnity El Bond ❑
Insurance Waiver. I,the undersigned,have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Owner ❑ Agent 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 performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachu etts State Plumbing Cod and Chapter 142 of the General Laws.
By: i�-�%rvv
Type of Plumbing License
[city/Town
itle -1," 7
icense Mumoer Master Journeyman
APPROVED(OFFICE USE ONLY
/ 7
V 7J Date.. ......:. 2.......�.....
NORT"
TOWN OF NORTH ANDOVER
' PERMIT FOR WIRING
�Ss�cwUSE�
This certifies that ...... L:. f 0� ......................
has permission to perform ..... ...... �.,.
wiring in the building of.:. ...:..:!IL 4R.. ...................................................
at .-..........�....`..s.........
.. ............................... .North Andover,Mass.
'y � ti1�' /
Fee Lic.No.
/ \ELECTRICAL INSPECTOR
Check # (/
T1 C0MMON,WEMTHOFM4S affff Office Use only
De.A MFJ1 OFPUBMSFFTY Permit No.
BOARDOFFREPRMEWONRFJgX4UOAiYR70W1 -M '�-
Occupancy&Fees Checked
RAPPLICATIONFOR PERW TO PERFORM ELECTRICAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Ll a
Town of North Andover To the Inspector of Wires:
The undersigned applies for a permit to perform the electrical work described below.
Location(Street&Number)
Owner or Tenant V
Owner's Address
Is this permit in conjunction with a building permit: Yes No (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service .—"/&� -� Amps-44L., �dVolts Overhead Underground No.ofMeters
New Service d Amps
_1�..__ Oi rVolts Overhead Underground No.of Miers t
Number of Feeders and Ampacity 19
_
ti
Location and Nature of Proposed Electrical Work
No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total
No.of Lighting Fixtures Swimmins Pool Above Below Gaffers-7 KVA
KVA
No.of Receptacle Outlets 0 No.of Oil Bunkers Na of Emergency Lighting Battery Units
No.of Switch Outlets
No.of Gas Burners
No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones
Tons
No.of Disposals No.of Hem Total Total Na ofDetectionand
N�aToss KW WdatingDevices
Jp of Dishwashers Space Area Heating KW Na of Sound'
. Devices
Na ofUlfContsined
Detectioa/Soeoding Devices
to.of Dryers Heating.6evices KW LocalMunicipal Oar—
lo.of Water Heaters KW No.of 0 Connections
Sips Bailasis
o.Hydro,Massage Tubs No of Motors Total HP
ratoeCo�e�Rttsuartbtheracpierna>Is�Gt>�taatIaws -
eaaaaltLiabtTty)rtsir=PCr yint3tt3rtg Y NO (�1
esutmittimidpiocfafmriebttteorm YES ND g ay - L,,•,J
BOW.
Inspeclilm
tocafwtades
S�rr > d
durid��iel'�t>brs � Ir•�.�. � -
tNAME �..
LimmNoL
Bus�ssTd IVca _�!3 5 9 3 7
r
AIL TdN0. ,f.�__ g& :P- 7 S
ERSN&IRANCEWANfE;IanawatedmtthelimEe4MBglm"tcim� o-its N&Agtasby �� - -�
tmy en$aspennd c nwaiws .raquilaral
;e check one) Owner Agent Ov
Telephone No. PERMIT FEE
Date. . . .y.- l 1 -U. L. . .
U
OF Np DTN
a� '` TOWN OF NORTH ANDOVER
PERMIT FOR GAS INSTALLATION
s10 a
This certifies that . .�y� � 14�� �c �� (� V AQ-
has permission for gas installation F yr!�a C.'°.
in the buildings of . . r. d v 1
at �OS D 4.1�. . . . . . . . . . . . North Andover,/Mass.. L
Fee. .:3.J . . Lic. No..:3��`. . . . ... ,.. . .�. ... --. .
GAS INSPECTOR
Check#- -z 01
3 : : 3
MASSACHUSEM UNIFORM APPUCATON FOR PERMrr TO DO GAS FnTING
_f
(Type or print) Date p O L
NORTH ANDOVER,MASSACHUSETTS
Building Locations A e– Permit# 5
/ Amount$
Owner's Name
New❑ Renovation �— Replacement ❑ Plans Submitted ❑
�C
t� a O U pq
a w �
SUB-BASEM ENT
BASEMENT
1ST. FLOOR
2ND. FLOOR
3RD. FLOOR
4TH. FLOOR
5TH. FLOOR
6TH. FLOOR
7TH. FLOOR
8TH. FLOOR r
(Print or t)pe) /y� Cmc one: Certificate Installing Company
Name //�Q.C�i Mr/a �✓ (L��, Corp.
Address E 5 5 ❑ Partner.
S A/, )-/
Business Telephone 0a 5 Sj 9 3 4-7 O� ❑ Firm/Co.
Name ofLicensed Plumber or Gas Fitter ��i4�'frJ�ti® y.��A�'s✓eti
"Tt
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. • Yes ❑ Nocr—
If you have checked�,please indicate the type coverage by checking the appropriate box
Liability insurance policy ❑ Other type of indemnity ❑ Bond ❑
V
�;er4'� s;ranc&W I Iware that the licensee does not have the Insurance coverage required by Chapter 142 ofthe
, d t�tafuon."permit application waives this requirement.
Check one:
Signature of Owner or Owner's Agent Owner ❑ Agent ❑
I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Mas to Gas Code and Ch !r142 of the General Laws.
By. Signature o used Plumber Or Gas Fitter
Citle ❑ Plumber 3OC-19/
7ity/Town Gas Fitter lcense NumSer
g Master
APPROVED(OFFICE USE ONLY) ❑ Journeyman
f