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Home My WebLink AboutMiscellaneous - 120 GRAY STREET 4/30/2018 120 GRAY STREET 210/107.D-0120-0000.0 I I I I Date G/. `. MORTM �? TOWN OF NORTH ANDOVER • PERMIT FOR GAS INSTALLATION 5 SACMUSEtt This certifies that �`. .`. .'. . 1 �/�r�'d�'. . . . . . has permission for gas installation . . . . . . . . . . . . . in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . at . 1,2(_�. .�f? ' . .� . . . . . . . r., NVoTfth Andover, Mass. Fee Lic. N0". 3l�1 I/ . . y!.�. . t�. :1 . . . . . . . GASINSPECTOR Check# 6965 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) ;!_� ? — NO. ANDOVER NOV. 5 09 ;I, Mass. Date 20 Permit# '' Ic Building Location 120 GRAY ST Owner's Name ERIC DEMERS Owner Tel# NO TEL# Type of Occupancy RESIDENCE New 7 Renovation❑ Replacement o Plan Submitted: Yeo No❑ FIXTURES F UCl) ce) W W C) OV g H x x h y V a ¢ z z o H W In W N 0 U W x N z a 0 q > W z W W U) J Z ¢ x a c4 W W F U x U) a ^� S s 0 = O 0 2 3 A C¢7 a z Lu a > A 12.O N o 3 J1 I SUB-BSMT BASEMENT 1sT FLOOR 2"D FLOOR 3RD FLOOR 4T"FLOOR 5T"FLOOR 6T"FLOOR 7T"FLOOR 8T"FLOOR Installing Company Name Eastern Propane & Oil, Inc Check one: Certificate Address 131 Water Street Corporation Danvers, MA 01923 Partnership Business Telephone# 800-322-6628 Firm/Co. Name of Licensed Plumber or Gas Fitter JACK COOMBS INSURANCE COVERAGE: I have a curM liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142. Yesl ✓ I No ❑ If you have c ecked yes,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: Owner ❑ Agent ❑ Signature of Owner or Owner's Agent 1 hereby certify that all of the details and information I have submitted(or entered)in abo a pli ion a tr rat the best of my knowledge and that all plumbing work and installations performed under the permit issued sap n pliance with all ertinent provisions of the Massachusetts State Gas Code and Chapter 142 of the General s By Typ of License: umber Sign re of Licen d Plumber or Gas Fitter Title -Gas fitter ?D /� • -Master License Number J (p City/Town •-Journeyman APPROVED(OFFICE USE ONLY) Date. pORTI, S ,°,'�'O 3� •° TOWN OF NORTH ADO R O D • PERMIT FOR GAS INSTA LATION . � ACHUSEt This certifies that . . . ... .`.".`. . . . . . . . . . . :. has permission for gas installatio :.:. . . . . . in the buildings of ... .: `<' !. . . . . . . . . . . . . . . . . . . . . . . . . . . . . at� . . . . .:':.�.... . . . . . . orth Andover, Mass. Fee,—. � . . . . . Lic. No.L-. . . . . . . . . . . . .r GAS:CNS CTOR Check# 5785 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING (Print or Type) 4/10,0y ev-L , Mass. Date — 20 Q o Permit# Building Location J-10 444 Owner's Name b P-gy7 e..LS Telephone c171— b(o p g' Type of Occupancy )4 o,�n,� New ❑ Renovation Replacement 0 Plans Submitted: Yes El Noc] m In d d Y L d r+ = E d L C d d +5 O V to E 2 (� O Im IMas cC `'? O � O C N _� d d = d r' i O > d d d N ea Z L 0L >_ y- d V N L Mw > d L. N O C 0 O N = W 2 O 2 LL o O -j V W m o LL i' O SUB-BSMT. BASEMENT 1 ST FLOOR 2ND FLOOR 3RD FLOOR 4TH FLOOR 5TH FLOOR 6TH FLOOR 7TH FLOOR 8TH FLOOR Installing Company Name EnergyUSA Propane,Inc. Check one: Certificate Address 100 Myles Standish Blvd.,Suite 101 X❑ Corporation 132 C Y Taunton,MA 02780 Partnership Business Telephone (800)822-1300 X8055 Rick Rousseau C(603)231-2702 Firm/Co. Namg of Licensed Plumber or Gasfitter William Kent Corson(800)822-1300 X8051 Cell (508)294-6660 INSURANCE COVERAGE: EnergyUSA Propane,Inc. has a current liability insurance policy or its substantial equivalent,which meets the requirements of MGL Ch.142. Yes El No If you have checked yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy X❑ Other type of indemnity 1:1 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: Owner Agent Signature of Owner or Owner's 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 the permit issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Code and Chapter 142 of the General Laws. Type of License: By Plumber Title X❑Gasfitter Signature of Licensed Plumber or Gasfitter City/Town XX Master APPROVED(OFFICE USE ONLY) nJourneyman License Number 3707 BELOW FOR OFFICE USE ONLY FINAL INSPECTION SKETCHES PROGRESS INSPECTION FEE NO. APPLICATION FOR PERMIT TO DO GASFITTING NAME &TYPE OF BUILDING LOCATION OF BUILDING PLUMBER OR GASFITTER LIC. NO. PERMIT GRANTED DATE 20 GASINSPECTOR PER.311T NO. APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. PAGE 1 MAP KVO. �' I LOT NO. 2 RECORD OF OWNERSHIP iDAT�IIP — ZONE SUB DIV. LOT NO. LOCATION 6yZr V S1. �� h PURPOSE OF BUILDING ]IO�'Ij� •XI�tw� OWNER'S NAME pl w NO. OF STORIES SIZE ovi OWNER'S ADDRESS �. /1 �� BASEMENT OR SLAB ARCHITECT'S NAME v , SIZE OF FLOOR TIMBERS 1STUS- F 2ND 3RD BUILDER'S NAME M411 �� SPAN 16 L, -�+—[7 - DISTANCE TO NEAREST BUILDING �V a.�,.. DIMENSIONS OF SILLS DISTANCE FROM STREET t„ L "x POSTS DISTANCE FROM LOT LINES -SIDES REAR `� 'X/O GIRDERS AREA OF LOT C, v VFRONTAGE lJ HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW SIZE OF FOOTING -� X IS BUILDING ADDITION MATERIAL OF CHIMNEY .IS BUILDING ALTERATION � , �.1 uIS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER + tS BOARD OF APPEALS ACTION. IF ANY vl IS BUILDING CONNECTED TO TOWN SEWER `I No IS BUILDING CONNECTED TO NATURAL GAS LINE Nd, INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER W FT. EST. BLDG. COST PER ROOM PAGE 2 FILL OUT SECTIONS 1 - 12 SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILEDANDAPPROVED BY BUILDING INSPECTOR DATE FILED 9 BUILDING INSPECTOR SI TO`RE-O-F OWN OR AUTHORIZED AGENT F E E OWNERTEL.# J?7 OjSE PERMIT GRANTED CONTR.TEL.# I✓�� Gy,� 16 �1q n COV�T�R..yLIC.# Q� 7-a- ` H.I.C.# BUILDING RECORD 1 OCCUPANCY 12 INGLE 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 I RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION 8 INTERIOR FINISH CONCRETE 3 1 2 13 CONCRETE BL'K. PINE _ BRICK OR STONE HARDW D PIERS PLASTER _ DRY WALL _ UNFIN. 3 EASEMENT I tt��Y r AREA FULL FIN. B'M'TAREA '/. '/i FIN. ATTIC AREA \t` :•�� NO BMT FIRE PLACES" HEAD ROOM MODERN .KITCHEN `x, S`�j •� I 4 WALLS I 9 ' FLOORS CLAPBOARDS 8 1 2 3 DROP SIDING CONCRETE _ J WOOD SHINGLES EARTH 1 __ _ ASPHALT SIDING HARD%V D ASBESTOS SIDING COMMON f VERT. SIDING ASPH.TILE . y STUCCO ON MASONRY i STUCCO ON FRAME i BRICK ON MASONRY ATTIC STRS. is FLOOR BRICK ON FRAME I 11 i { /SLQ'S4' f l� 1 r CONC. OR CINDER BLK. Q, /�r `•Q9yC� f STONE ON MASONRY WIRING H,lt��""-). STONE ON FRAMEvc - SUPERIORPOOR I I� 11,ADEQUATE I-1 NONE ,j I t 4 1 5 ROOF 10 PLUMBING 1 f� GABLE I HIP BATH (3 FIX.) GAMBREL MANSARD TOILET RM. 12 FIX.) FLAT SHED WATER.CLOSET ASPHALT SHINGLES LAVATORY. {VVV WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING r TAR 8 GRAVEL STALL SHOWER, Q ROLL ROOFING MODERN/FIXTURES ` f ♦ T/ TILE FLOOR - TILE DADO 11 6 FRAMING I 11 HEATING 1 +� WOOD JOIST PIPELESS FURNACE # 1 s . •+'� FORCED HOT AIR FURN. . e TIMBER BMS. 3 COLS. STEAM 11 -"- STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING � ••� <f S- RADIANT H'T'G �,- ♦ UNIT HEATERS ` s ••C♦r�l GAS f •`fiY. 7 NO. OF ROOMS OIL B'M'T 2nd ELECTRIC 1st 13rd NO HEATING r OR Town of over No. 3/ * _ 7.f- over, Mass., 19 COCK ICANEWICK W4 r Ls BOARD OF HEALTH Food/Kitchen P. ERMIT T D Septic System BUILDING INSPECTOR THIS CERTIFIES THAT...............................................0 A/k.C.5.............. A& ..k. ....................................... Foundation ............... has permission to erect......A,41..i._�(.O�Q... buildings on .....L-Z...0..........G.KA_.�............. ..... . ..... Rough to be occupied as.................................... ............ Chimney ...........P.O.kc/�. ............................ 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 MON 0 Sj ELECTRICAL INSPECTOR UNLESS CONSTRUCTION S S' ELEC 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 96FIRE DEPARTMENT Until Inspected_ i ted and Approved by the Building Inspector. Bumer Street No. Smoke Det. I .. GN�It NA�c�y Cp ,�ao LL P �-A GTPA S T• /Vo, looec# �y, �, /� ' w/o�E,✓ ISA VT ; )Klj 5,012t' WONk r • I I i Q ��x/G" M•CFO P. Q o prr 4 h al to 1ri11 NY` r �xQ Ib" oc , 1 , • as ' Zx14 3/,�4 sKy c'�T� } BOSTON : STREET CERTIFIED PLOT PLAN (PUBLIC - WIDTH VARIES) LOCATED IN S 3316'19"W 84.64' NORTH ANDOVER, MA. SCALE:1"= 40' DATE: 7/25/96 SEPTIC 10/8196 Scott L. Giles R.P.L.S. 50 Deer Meadow Road 'po North Andover, Mass. o� j M LOT 3 LOT 1 46,079 S.F. i.. ' V�•ICVy ` V • w � kn Ex1817'N,�r. - 38' --- ---- O •W • 42'_ _ -- 215.32 z LOT 4 LOT 2 h? M N 10/8/96 a( TABLE OF ELEVATIONS z OUT OF HSE.=212.02 IN TANK =211.33 OUT TANK =211.09 IN BOX =210.74 OUT BOX =210.63 o #1 END =209.91 N44os7,s2��E "� 42 END =209.92 G.� T I 158.07, 10/8/96 S T.�JOE I HEREBY CERTIFY THAT I HAVE INSPECTED THE CONSTRUCTION OF THIS DISPOSAL SYSTEM AND THAT THE CONSTRUCTION AND THE FINAL GRADING HAS BEEN IN ACCORDANCE WITH THE DESIGNERS INTENT AND THAT THE MATERIALS USED CONFORM TO THE PLAN SPECIFICATIONS AND 310 CMR 15.00. I CERTIFY THAT OF SHOWN ARE FOR THE USE THE OFFSETS OF THE BUILDING INSPECTOR ONLY K �� SHOWN COMPLY AND SUCH USE IS FOR THE WITH THE ZONIN DETERMINATION OF ZONING BY LAWS OF CONFORMITY OR NON-CONFORMITY 13072 3� NORTH ANDOVER,MA. WHEN CONSTRUCTED. �a° WHEN BUILT. LAIM 7/26/96 10/8/96 Location Q ' No. Date 7/6 I MORTIy , TOWN OF NORTH ANDOVER Certificate of Occupancy $ �-- Building/Frame Permit Fee $ l 7 Foundation Permit Fee $ _ Other Permit Fee $ ' Sewer Connection Fee $ Water Connection Fee $ $ �-z- +' TOTAL Inspector 15 1,251.24 RAID { M6 Div. Public Works PERMIT l�J� -•� ^moo PERMIT TO BUILD — N RY � _ O H ANDOVER, MASS. PAGE 1 Mk, LOT NO. BOOK PAGE –� 2 f COR OF OWNERSHIP iDATE - _ ZONES I SUB DIV. LOT NO. — i LOCATIONoo PURPOSE OF BUILDING OWNER'S NAME / J/� r �t �/ y� NO. OF STORIES SIZE OWNER'S ADDRESS / BASEMENT OR SLAB 46,4 A4 heV ARCHITECT'S NAME !' r ��✓ SIZE OF FLOOR TIMBERS 1ST ,N 2ND 3RD BUILDER'S NAME +, SPAN DISTANCE TO NEAREST BUILDING C«'J DIMENSIONS OF SILLS DISTANCE .FROM STREET • "'L� POSTS DISTANCE FROM LOT LINES—SIDES f• jrdi`33I REAR � I / �'"FFx/O GIRDERS AREA OF LOT �j' 'lG• � /j FRONTAGE �,, HEIGHT OF FOUNDATION 71 �4 THICKNESS �� IS BUILDING NEW ((PA 6/ f Ja""� SIZE OF FOOTING y x d IS BUILDING ADDITION �,I,,q MATERIAL OF CHIMNEY a IS BUILDING ALTERATION AXI IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE kr j, IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION, IF ANY VV IS BUILDING CONNECTED TO TOWN SEWER IS BUILDING CONNECTED TO NATURAL GAS LINE f�« INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST ,y®4 4/' 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 DATE FI ED �1 BUILDING INSPECTOR SIGNATURE OF OW ER O UTHORIZED AGENT F IF E OWNER TEL.# 61-41' G��I 49 PERMIT GRANTED CONTR.TEL.#(�� 09Q� I—lq 19 BLDG. PERMIT F C TR.LIC.#_: LESS FDA FEE . H.I.C.a DUE FRAME PERMIT$ JAN I I Imo' BUILDING RECORD 1 OCCUPANCY 12 SINGLE FAMILY _ S�)RIES 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 -.3 w 1�, 2 FOUNDATION 8 INTERIOR FINISH CONCRETE d 23 CONCRETE BL K. _ f�� (� BRICK OR STONE � PINE D — —_ PIERS PLASTER ` _ DRY WALL _ _ �L 0-7f •` UNFIN. l/ ` 3 BASEMENT `� i AREA FULL _ FIN. B M AREA _ 'fin 1/ 1/1 1/ FIN. ATTIC AREA 01J N_O B M T FIRE PLACES HEAD ROOM _ MODERN KITCHEN 4 WALLS -9 FLOORS CLAPBOARDS 1 2 3 DROP SIDING CONCRETE WOOD SHINGLES EARTH ASPHALT SIDING HARDVJ 0 _ Paeµ ASBESTOS SIDING _ COPH 1��- VERT. SIDING ASPHTILE STUCCO ON MASONRY _ STUCCO ON FRAME �� BRICK ON MASONRY ATTIC STRS. BRICK ON FRAME I �� CONC. OR CINDER BLK. y STONE ON MASONRY WIRING �� STONE ON FRAME _ SUPERIOR I� POOR _ }� ADEQUATE NONE 5 ROOF 10 PLUMBING 3Er' GABLE I Pl HIP BATH 13 FIX.) GAMBREL MANSARD TOILET RM. 12 FIX.I 0 i '� Q �� FLAT SHED WATER CLOSET T �•L• ASPHALT SHINGLES LAVATORY !_ J� a qw- WOOD SHINGES KITCHEN SINK 7 + o� �P v SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER _ ROLL ROOFING MODERN FIXTURES TILE FLOOR TILE DADO �� t 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 CT RADIANT UNIT HEATERS / � GAS 7 NO. OF ROOMS IL B'M'T2nd _ ELECTRIC 1st 13rd NO HEATING -- Location €' No. Date C ' "ORTM 1 O, t's° . TOWN OF NORTH ANDOVER, o? ' _ ` �0 p Certificate of Occupancy $ ` Building/Frame Permit Fee $ +,^°•''tom Foundation Permit Fee $ s�cMust .� Other Permit Fee $ Sewer Connection Fee $ �� J Zp Water Connection Fee $ TOTAL $ d Cn� ce, o �luil .':g dlns�cpctw r 8950 Div.Plubtfc Works it i ' Msa�� •:-1 i i Sl-iN� d-11 1144 •T a N AImOWN MA. 11 NS-ia:M f� COMMONWEALTH - OF I DEPARTMENT OF PUBLIC SAFETY MASSACHUSETTS ONE ASHBORTON PLACE BOSTON, F'�'f�r�loRascc:aacarfsur MA 02108 _XPIRATION DATE I LICENSE j ceiss�r�s��ls8�;;�sys TR. r21/18/1996 SUPERVISOR o ..N EONS E N O ICTIONS EFFECTIVE DA CAUTION NONE UC-N0. FOR PROTECTION AGAINST 06/30/199301242$ THEFT, PUT RIGHT THUMB u DONALD JOHNSTON PRINT IN APPROP `SF R 0 0 6�- J O H N S T O A BOX ON LICENSE. TE 30-4504 x114 D0STON ST F N A N VER MA 01 84 S F LASTING OPERATORS f b.Q. DO MUST INCLUDE PHOTO. HEIGHT: I STTAWEDUo-RL D 8V u ENSEE AND OFFIGAUY :• ` \``�A DOB: T1lRE OF THE OOMMISSSONER , . )/18/1934 PAM �:YHIS DOCUMENT MUST BE }" y5 °.. CARRiEDONTHE PERSONOF I �� _ i IS-RIGHT THUMB PRINT GAGED NTH'SOCCUPATION I� JUL1993. THE WHEN EN. SIGNATURE LICENSEE i ''�'�NM1E W FU4 ABOVE SJGNATURE LINE _ M�SS�ONER Dop i r .. I I The Commanwea&h of ytassachuse= DeparmLent of Induszral Accidem= —_ a �dtliQs 600 Washin on Seer P. BOr.On,:Plass 0_111 Worken, Comaessarion Insurance Affidavit r - � 7F 1c �1 ' I = a hotneow- er r'or•ning all wor.:Wvse�. I ala a Soie �rC=-;e:or and have no ore wc=. z :- -Y t' (�I arr.an empiover-rovi.=a workers' cotr.e :^ca :ar Wv _:cv'ezS--von—i-an=s,00. ' `�� 1 (Z • . � � :._:;-.. �� l�/.Y� :..:. ..bene� 1�� ^ t�C%U�� C!'��.r:: insnrsnce co. Q), 7%hiirr3 - F-`^i��(•i� 1 Vis I a^., s�o�e _rocr_.or. general contnc:or. r ^.O.^..CJ�►'er , _= J1S2; =a.'-,ave =c C.-n= c:crs be-ow wrlo nave tht—0110wing workerscomeersation:occ s. com02nv npme'i nddr_se- I�henv d- insunnr_ co. ^f)r-v it cemTL"113mr addre-e• --•:..:::::. _ -- -- ei.y. .... _..... ... - ..7hone - ... . . . . .._... insrsc-cp .. ... nnneitcv ' czic�ataonafsoe-^ ^r�sary Failure:o secure covers-ge as required under Secnon a aC MGL L-nn.ea me:tnoostaoo of cnmtnat penatnes of a une up to Sl_OO.UO analor one years'imprisonment as well as civil penalties in :.fie:ora of a .OF WORK ORDER and a:int oCSIDO.DO a day_ agzimt-ne. I understand;ha:a copy oC:his statement may be forwarded to the Office oC:2vei,a3ons of: e:)LA£or coverage�c ..Beacon. I do hereby ter. A�under the pains and pertaLdes -t=:,4e:ITiorn='On prmided soave sager and.arre= Print na.•ne M d ?'sone#. ny• 11'1�--/G r official use only do not write in this area to be compiead 57 Fir►or ars oLrieial city or town: pe-siLticf^Y= -Building Department g [licensing Board C cheek m if immediate response is required C�eleeten's Office [=Health Department contact person: -Other JAN 1 0" . 0 t over . No. + - -- — - - �� - - dower Mass. / 19� 4 _ O� COCHICHEWICK ' ' ADRATED "'?1L C2 BOARD OF HEALTH 00, PERMIT D Food �- ��, Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.... .01A....... ' . .... ... .. 1 1 o t' .... 'has permission to r�rect....:..:: - . buildin s on ... a ...�¢ (. •.......... ...... - - tobe occupied as.::...:........ ..... ... ....... . ...... ................. ✓.:.................:.....:............................................... .. . Chimney .provided that the person accepting t per shall n every respect onform to the terms of the application on file in this office, and to the provisions of a 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. ' . Oh �e.P PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTIONS ARTS ELE TRI SPE _ R ou ....................... /Z.....�:.... .. ...................................... e ' ING INSPECTOR _. m Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises - Do Not Remove Rough Final 1 No Lathing or Dry Wall To Be Done FIRE Until Inspected and Approved by the Building Inspector, DEPARTMENT, Burner ': ie - / Street No. 10749 GAA)' sr Smoke Det.O V. ` CERTIFICATE. P- USE .& OCCUPANCY Town of North Andover Y - Building Permit-Number 11 -Date MRIIARY•� I9 ? { HIS CERTIFIES TTHAT a _ F THE BUILDING LOCATED ON 120 GRAY STREEI'_�(Lot #3) iq1 MAY BE OCCUPIED AS SINGLE FAMILY DWELLING ' ` IN ACCORDANCE � IONS OF THE MASSACHUSETTS ST � O ... f.. �...... � _.:: -. -.-._ '--f .:. ..;- - '-..- � _ +-:L+.,.....F � ffi�. ,a rte,..tY�v_3rr.1�w�. n. ., ni.• ' �� WITH THE PR ��._�.r.. . VISATE BiTILDING OODE�AND' � 3 SUCH OTHER REGULATIONS AS.MAY APPLY." ) o';;+,o CERTIFICATE ISSUED TO 120 Gray St. - .,;.ADDRESS t.ADDRESS `North -dower, MA 01845 t'VACN11s t, - i Building Inspector. F s„ 1 r A 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 section***************** APPLICANT: . Phone LOCATION: Assessor's Map Number Parcel Subdivision Lot(s) 3 Street ';Y St. Number iZO ************************Official Use Only************************ RECOMMENDAT ,ONS /OF TO AGENTS: L Date Approved A 1 Conservation A�yd}niilanis rtor Date Rejected/I Comments �CZO""L /S(/N'N �J {�11� � AATC�9_O Date Approved Z Town Planner Date Rejected Comments V — ' Date Approved Food Inspector-Health Date Rejected _ 'I /XJ/C{/L� Date Approved Septi—c Inspector-Health Date Rejected Comments Public Works - sewer/water connections - driveway permit -TT0 9- Fire Depar ment a:-� Received by Buildin Inspector Date 7-he Commonwealth of_ fassachuse= Depar=umf of Lsd=zr. l.4ccideJzu l?!!bC?digs c a' 600 Washing on Sweet Boron,Ilett. 0:111 �~--� Workers' Compensation Insurance Affidavit MMWi n lbsk n i am a oreowne performing all work I an a soie crccre:cr and have no ore•.vcr;:..s =v ==— 1 arm.an cmpiover providing workers' cotace^_sar on :or Wv --::epees Wor5ci:.g on yn :.s;cb. dd .....::.. . . i crv• ✓\r I (�' --�-�- �^ yf' (`�J.FiL L-2-2ll/yJ phone X �! U t rV'l l �-n1 -DD9 77 I ar: a soie^rocr:_.or. general coatrnc:or. _r;oWeow-ser __ ane; ane:ave....__ below wto :ave a:t'oilowing wor<e.-• compensation poucts: company name• adr ss C.ry insunnr eo COMOn nv n address- . . . ...... . . ... ... .... ddr ss- .: . 7nOtlt insarane C'0, eoiicv '�t�aers3�nonauae sr�sary Failure:o secure coverage as requirea under Section Z5A aC>tG:. ::_=n.eta a me:mpostaon oC cnmmat penatncs of a ripe up to sl_.00.u0 anaror one!ears'imprisonment as well as civil penalties in :,be'or=of a S'.OF WOR`ORDER and a fine oCS100.00 a day against mc. I understand:.1a:a copy oCthis statement may be forwarded to the OtAce o Izve--;—,ndoas of.e D Ga:or coverage ventinnon. I do herebv cer: v under the pairs and penalsia?tpe'-�Lk=:he:MiorrncoR provided above 3 z.re and corrv= _ Sig:tatttrc �i•�i�� „� �/�`��t� Oye ��—f�`Y� Print aline I )L%�1�i L�� f V1��L'11 ?':one '? Ll? f _ l � o(ricial use only do mot write in this area to be conpietrd b7 city or tows oL=cal F city or town: s —Building Deaarsment CUccasing Board Lr1che"ck mediate response is required [Seieetmea's Office [Health Department n- phone y: —Other • t/..,w m at.0 JAN 1 Y � atrlt:e use On,, 2 r � u�lr �;QQnW2t�l � t�111u3�1L� Permit No. GAJ ilepartrunt Rf'ilublic _FftafEttl i Occupanc/& Fee Checked �d BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 3/s0 (leave blank) rjzj APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT dN INK OR TYPE ALL INFORMATION) Date QM or Town of NORTH ANDOVER To the Inspector of wires: The udersigned applies for a permit to perform the electrical work described below. Location (Street & Number) L,OA -*3 C, reLt,► s-t- 14 o Owner or Tenant OtV �?SO S10 J Co , Owner's Address ( LL\ CC7`�'TC� N g� ' J I I�V-( oo VC-A Is this permit in conjunction with a building permit: Yes W No (Check Appropriate Sox) Puroese of Suildine V-) � Utility authorization No. 620 Existing Service 051W Amps' / Vcits Overread _ Uncgrnd No. of Meters New Serlice Amos 1 a'�0loits Overhead Uncgrno (_ No. of I\,teters Numcer of Feeders ana Amcacity L ccaticrt ane Nature of Prcposeo Electncai :^/crx i Total No. at Lignting Outlets Ln No. a, - bs No. at Transformers K`JA Above— In- — No. of Lichc,ng Fixtures i Swimminc -cal grnd _ crr,e. I Generators KVA I No. of Emergency Lighting No. of Recectacie Outlets S(��1V No. of Cil Burners a+ i 3anery Units No. of Swncn Outlets No. or Gas Surr,ers I FIRE ALARMS No. of Zones Total /, -� No. of Cecection and No. of Ranges I No. ct Air Canc. I tons `1 S initiating Cavtces neat Torai Total No. of Oiscosals I No.af Pu_ys Tans KW No. at Sounding Devices i No. of Satf Container No. of Cisnwasners - ScaceiArea Heaur.a KV1 Owect:bniSounaing Oevices Municioai —,other i No. of Oryers I Hestina Oev:ces KW :coat Connec::en No. at No. of ` Low Voltage No. of 'Vater Heaters KW I Sicns Sailasts I Wirmc NO -iycro Massage tubs 1 i No of motors ota: HP INSURANCE COVERAGE. Pursuant :o the recuirements of :tassacnusa-s general Laws I have a current Liaaiity Insurance Potic•/ inciucing cornc:etee OCerauens Caveraae or -ts suos:antial ecuivatent. YES have suominea valid proof of same to the Office. YES �?- NO _ If you nave cnecKea YES. please indicate :he tvoe of coverage cy cnecxtng the aO,p�eriate box. INSURANCE X SONO = OTHER = (Pease S=ec:hp (Exotrauon Oatel Estimated value of E!eetncal Work S Inscec;ton Oate Aacues;ec: Rough Ftial Worx :o Start / Signed unser ;he Penaitiees at p UC. NO. ` d3 FiFINA NAME �� t'� ^ $igna;cre LIC. N Licensee O. /n_ G \ ` c DA t 1 PCJ J Bus' ;at. No. Address 5 �� .��. ,�.(L,)�DCRO'n.� Att. Tel. ^to. OWNERS INSURANCE WAIVER: I am aware that me i:censee Coes not nave the Insurance coverage or its suascanuat eaurvatetA 9ent autrea ov Massachusetts General Laws. ane :hat my signature an :n:s =ermtt aopuca2ion 'awes this reouirement. Owner (Pease checx ones –etecnone No. _ - PERMIT FEE 5 (Signature of Cwner or Agenti `�'"� Date.. .... .... f2 439 NORTH 0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING CHUS� This certifies that ...... ..e. ,,.......!...... ..1.r. C. . . ............................... has permission to perform .t: :�r, .—. --,—`l(.!�:�.l..l..t. �................ wiring in the building of .. k ............... at.....�.��...��.1� G .. . .......................... . ..............� .... ,North Andover,Mass. ......................... . ........ . .......... ELECTRICAL INSPECTOR 09/ /% lfi: 271.00 PAID / WHITE:Applicant CANARY: Building Dept. PINK:Treasurer