HomeMy WebLinkAboutMiscellaneous - 123 MARBLEHEAD STREET 4/30/2018 123 MARBLEHEAD STREET
210/009.0-0045-0000.0
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3463 Date..�!�..�S. . .........
NORTH TOWN OF NORTH ANDOVER
3? �� PERMIT FOR GAS INSTALLATION
f ' D
• a' _ a
t�9SSACMUSEt
This certifies that . . .� ll". '1.1. �. . . . ./. . .
has permission for gas installation . . . . . `. . .`
in the buildings of ;.`1:� . . . l .ice. '. :-1 . • . • . . . . . . . . . . . . . . •
at North Andover, Mass.
4 �
Fee. j.0 : : . Lie. No.. . J.�. �. ` .. .Ci_.r�. .�c. . . . . .
GAS INSPECTOR
WHITE:Applicant CANARY:Building Dept. PINK:Treasurer
I
1
Y MASSACHUSETTS UNI'ORM APPLICATON FOR PER7Permitg
FITTING
T
ype or print) � 1it7i.
NORTH ANDOVER, MASSACHUSETTS
Building Locations 3
Amount S 3Q i-
Owner's Name
E1
New❑ Renovation Replacement ❑ Plans Submitted ❑
n
;2 ;W ri
n m Z vi
C Z
Z Z
Z
SUB -BA SEM E :NT
BA SE .vi E NT ! /
1ST. FLOOR
r 2:N D FLOUR
3RD . FLOOR
4T II . FLOGR
Tr if FLO O R
6TH . FLOC? R
7T It . F L O O R
3 T 11 F L O O R
(Print or type)/' 1 Check one: Certificate Installing Company
Name C ,I L%=j 0) h ❑ Corp.
Address 6o r t ❑ Partner.
Business Telephone_t,,h--9"—&3'� ® Firm/Co.
Name of Licensed Plumber or Gas Fitter-
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑
If you have checked yes,please indicate the type coverage by checking the appropriate box.
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: El
of Owner or Owner's Agent Owner ❑ Agent
hereby certify that all of the details and information I have submitted for entered) in above application are true and accurate to the
best of my knowledge and that all plumbing work anU"16to l ions pertormed under Pe it l ued for this application will be in
compliance with ail pertinent provisions of the Masset
..tate Ga Cod d Ch ter 2 of the General Laws.
Bv: Signature ofc nsefi Plumber Or Gas Fitter
Title Plumber fG 3G
City/Town ❑ Gas Fitter LiEnse i umoer
Master
APPROVED wFr•icE USE ONLY) ❑ .Journeyman
Date. .
N° 4389
TOWN OF NORTH ANDOVER
° PERMIT FOR PLUMBING
I'SSACMUs�
Y
This certifies that . .� /./.?'A. �. . . . . .f�. ` • . . . . . . . . . . . . . . .
has permission to perform . . . . . . . . . . . . . .
a
plumbing in the buildings of . . . . . . . . . .
at . . . . . • North Andover, Mass.
Fee.C,.S r ' Lic. N o.1. . . . . . . . . . .
PLUMBING INSPECTOR
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer
.MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print)
NORTH ANDOVER,MASSACHUSETTS – l _Date ?666
/
Building Location Owners Name NC �ount��6
J1.9
Type of Occu an , -
New Renovation r% Replacement [3 PlSub ' ed Yes No 0
FIMTLWS
w
Cr At
w
w
SWC
BtS1 Eq 9
1ST Hsi
MOW= r /
A
Mff-aR
4MHDM
smna]R
'nsH m
1=KaR
(Print or type) Check one: Certificate
Installing Company Name 61 V' '�' [ 0 Corp.
Address '` r D Partner.
M ® Firm/Co.
Business Telephone Lj-
Name ofLicensed Plumber.
Insurance Coverage: Indicate the type of insurance coverage by checking the appropnate box
Liability insurance policy rM Other type of indemnityEl
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
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 an 'ons perfiarm Permit Issued for this application will be in
compliance with all pertinent provisions of the Mass Phdhb' C e and Chapter 142 of the General Laws.
By; Yl—gna-Im ol Li ea rmnloer
Type ofPl ing License
Title 103Q, ❑
City/Town icenseum er Master Journeyman
APPROVED(OFFICE USE ONLY
Date.......7 � �d!N° 23Q9 . . l.
AOR,
°f�"`° '•'"° TOWN OF NORTH ANDOVER
= PERMIT FOR WIRING
CHUSEt
This certifies that
...... . ..... .... .........................
has permission to perform ... .Q. N.+d.P.... �f.:.................................
wiring in the building of....M. !� ........................................
at...Z...............1!� .. .2.�?........,� q... :., orth Andover,Mass,v
-
Fee....7�t.�U. Ltc.NoJ...../.lf�..............�;.. .. .. . -�.......!............. ...
(ELECTRICAL INSPECTOR
Check #
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer
7hE60MMOAN AL7NOFMAMORSE77S Office Use only
DEPAR73fflWOFPUBLICS4FM Permit No. 930
BOARD OFF7REPREVEMONREGUMMAS527CMR12*00
Occupancy&Fees Checked
CVJPPUCATTONFOR PERMU 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/ -Y a O
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) i upble
Owner or Tenant M °L.
Owner's Address 61
Is this permit in conjunction with a building permit: Yes[2 No (Check Appropriate Box)
Purpose of Building ���(J`j Utility Authorization No.
Existing Service Amps Volts Overhead o Underground Q No.of Meters
New Service Amps Volts Overhead Underground No.of Meters "
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
11�.
N6.of Lighting Outlets No.of Hot Tubs No.of Transformers Total
�1 KVA
A.of Lighting Fixtures Swimming Pool Above Below Generators KVA
ground ground
No.of Receptacle Outlets No.of Oil Burners No.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 Heat Total Total No.of Detection and
Pumps Tons KW Initiating Devices
No.of Dishwashers Space Area Heating KW No.of Sounding Devices
No.of Self Contained
Detection/Sounding Devices
No.of Dryers Heating Devices KW Local Q Municipala Other
Connections
No.of Water Heaters KW No.of No.of
Signs Bailasis
f_
Jo.Hydro Massage Tubs No.of Motors Total HP
OTHER
h>,strmroeCo�erag�Pr>tsuat�thetagtrita� sel�GataalLaws � Q
IhmeaametLi bildyhtstr&=Pdlicymdu&ECat> W C maWcrits afiv� YES NO
Iha%embmftdNWpro*fsa=1ot4eO roe YES rJ NO M Ifjcuha%edvdWYE'S,plemmdc*theMmofwmaa rbydiadmgthe
b
INSURANCE [;Z BOND OSIER (t' weSpe fy) EViratim Dat-
y ^ 4CJ� c>f!mfr cal Wak$
WakoSlmt 2���_ D* ...._"7 .2- Final
Signadutxlas ry. )ec U=WNT0. l V
FIRMNAME U �— °
Lioa>,see Y 1/'tel �'e��V 1/J Sigtr�ae 'G'�" —fit Lioa�eNo
�• EwhsTd.Na _
AILTd
OWNER'S WSURANCEWANER;IamamthattheLioar domnut atoem�er�eadssui�a�ial astecAmedby'M�dn>s C Laws
2ndtllattriy9g7ii�i9EQ11IflSp�n4aj7p�iVJBlS��1518C(LHHYIe:rd. �y
(Please check one) Owner a Agent ,/i�/
Telephone No. PERMIT FEE ��
Location /
No.
Date
�ORT� TOWN OF NORTH ANDOVER
3? ' O[
+
Certificate of Occupancy $
�'�s''•°'Eck Building/Frame Permit Fee $
s�cNus
Foundation Permit Fee $
Other Permit Fee $
r
TOTAL $ '
J �
Check # I
bbb
Building Inspector
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR,RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING
a�..� .��1�
BUILDING PERMIT NUMBER: 06 DATE ISSUED: 3
SIGNATURE:
L
Auildinig Commissioner/In for of Buildings Date t3j I ILI
SECTION 1-SITE INFORMATION
1.1 Property Address: JJ 1.2 Assessors Map and Parcel Number:
AJ0 _n P,), /v,9 Map Number Partel umber
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning Dish c—t Proposed Use Lot Area(so Frontage ft
1.6 BUILDING SETBACKS ft
Front Yard Side Yard Rear Yard
Required Provide Required— Provided Required Provided
1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System:
Public 0 Private 0 Zone Outside Flood Zone 0 Municipal ❑ On Site Disposal System 0
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT
2.1 Owner of Record J / /
.10�IV Yin e2r�vE r�1 �f�,;,,c.� /.GS MA2� r-1t.*� Sf
Name(Print) Address for Service
/9.2/
Sig&e Telephone
2.2 Owner of Record:
Name Print Address for Service:
Signature Telephone
SECTION 3-CONSTRUCTION SERVICES
3.1 Licensed Construction Supervisor: Not Applicable
Licensed Construction Supervisor:
License Number
.i
Address
Expiration Date
Signature Telephone
3.2 Registered Home Improvement Contractor Not Applicable ❑
Company Name M
Registration Number
Address
Expiration Date
Signature Telephone G)
SECTION 4-WORIERS COMPENSATION(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 building rmit.
Signed affidavit Attached Yes.......❑ No.......❑
SECTION 5 Description of Proposed Work(check all applicable)
New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) Addition ❑
Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify
Brief Description of Proposed Work:
�T o e�p� Poo 07 S
1/L
SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar)to be � 3F)FICIAL>(TSE ONLY
Completed by permit applicant
1. Building (a) Building Permit Fee
Multiplier
2 Electrical (b) Estimated Total Cost of lid a
Construction J
3 Plumbing Building Permit fee(e)X(b)
4 Mechanical HVAC
5 Fire Protection
6 Total 1+2+3+4+5 Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
I, ,as Owner/Authorized Agent of subject property
Hereby authorize to act on
My behalf,in all matters relative to work authorized by this building permit application.
Signature of Owner Date
SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION
I, as Owner/Authorized Agent of subject
property
Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief
Print Name
Signature of Owner/A ent Date
M-IMM-M93MM 1. Im BMW
NO.OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TIMBERS 1 2ND 3RD
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CHIMNEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
NORT11
Town of
O TO
No.
�- L A O dower, Mass. oho a d
COC HICHEWIC 11 ' '
AD'S A T E D
`s BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
C, BUILDING INSPECTOR
THIS CERTIFIES THAT. .�..... ..... .................. t !...
" Foundation
has permission to wrct.. �.w.0. .:.... buildin on ...... .......... .... ...............� .r..
r .. Rough
Chimney
to be occupied as....., ........................................ ...... ..&............ !►. ..�I..................................................................
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
� ELECTRICAL INSPECTOR
P
&(,5 UNLESS CONSTRUCTION ST TS AA Rough
.......... ............................... .... ............. ......
40009W .... ......:. .... Service
r BUILDING INSPECTOR
Final
Occupancy Permit Required t0 Occupy Building GAS INSPECTOR
Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
SEE REVERSE SIDE Smoke Det.
Location 2-,z ^' k Z-s-
No. kos Date
A
a
a
„ORT„ TOWN OF NORTH ANDOVEN
t??O'tt`•D I•,�O0
p Certificate of Occupancy $ 9;
^o _ ,, ; Building/Frame Permit Fee $
'- •"`cy
'Ss�cMusEt Foundation Permit Fee $ ti
Other Permit Fepg.. $
Sewer Connection Fee $
Water Connection Fee $
a
TOTAL $
Building Inspector
�•={g 1.6
Div. Public Works
y`
-82
PERXiIT NO.(v✓ APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1
MAP K40. LOT NO. 2 RECORD OF OWNERSHIP DATEBOOK ;PAGE
ZONE SUB DIV. LOT NO.
LOCATION v ! PURPOSE OF BUILDING
OWNER'S NAME V �r NO. OF STORIES SIZE'
w OWNER'S ADDRESS BASEMENT OR SLAB
ARCHITECT'S NAME SIZE OF FLOOR TIMBERS IST 2ND 3RD
BUILDER'S NAME fy r`. SPAN
DISTANCE TO NEARESyrBUILDING DIMENSIONS OF SILLS
DISTANCE FROM STREET "" POSTS
DISTANCE FROM LOT LINES-SIDES REAR GIRDERS
AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW SIZE OF FOOTING X
IS BUILDING ADDITION MATERIAL OF CHIMNEY
IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS 3 PROPERTY INFORMATION
- /
9
: C
SEE BOTH SIDES LAND COST EST. BLDG. COS .:�"�oD/�VJ
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 FILED
• aalafoz
NUILDING INGPECTOR
SIG A URE OF OWN OR AUTHORIZED A 9 ENT f� '7
F'E E Z C30 OWNER TEL.# �`v/��/�
PERMIT GRANTED CONTR.TEL.# `e I+ u zz 7
I9 l CONTR.LIC.# ®� Y��
2 �
H.I.C.# ��✓
BUILDING RECORD
I 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 RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
a
CONSTRUCTION
2 FOUNDATION 6 INTERIOR FINISH
CONCRETE _ d t 2 I3
CONCRETE BL K. PINE _
BRICK OR STONE HARDW D
PIERS PLASTER
_ DRY WALL _
UNFIN.
3 BASEMENT
AREA FULL FIN. B'M'T' AREA _
'/ 1/7 l/, FIN. ATTIC AREA _
NO B M T FIRE PLACES _
HEAD ROOM MODERN KITCHEN
4 WALLS I 9 FLOORS
CLAPBOARDS B 1 2 3
DROP SIDING CONCRETE �_
WOOD SHINGLES EARTH _
ASPHALT SIDING HARDV✓'D _
ASBESTOS SIDING COMtAGN
VERT. SIDING ASPH. TILE _
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY ATTIC STIRS. 8 FLOOR _
BRICK ON FRAME
CONC. OR CINDER BLK.
STONE ON MASONRY WIRING
STONE ON FRAME _
SUPERIOR I� POOR _
ADEQUATE NONE
5 ROOF 10 PLUMBING
GABLE I HIP BATH 13 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
1
M_
6 FRAMING I 11 HEATING
WOOD JOIST PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER BMS. &COLS. STEAM
STEEL BMS. & COLS. HOT W'T'R OR VAPOR
WOOD RAFTERS AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS -
7 NO. OF ROOMS GAS
OIL
B'M'T 2ndELECTRIC
1st 13rd NO HEATING
OFFICES OF: �r� �" Town of
a 120 Main Street
APPEALSNORTH ANDOVER North Andover,
BUILDING '`: _ Massachusetts O 1845
CONSERVATION �""g64 DIVISION OF
HEALTH
PLANNING PLANNING & COMMUNITY DEVELOPMENT
KAREN H.P. NELSON, DIRECTOR
In accordance with the provisions of 4IGL c =0. S 54, a condition of Building Permit
Number 3,j— kos is that the debris resulting from this work shall be
disposed of in a properly licensed solid waste disposal facility as dcGned by MGL c III, S
150A.
The debris will be disposed of in:
(Location of Facility)
Signatu a 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.
Location �a IPA �2 Of {I f 4a S t
No. Date d ��
TOWN OF NORTH ANDOVER
3 �L
� 9
' Certificate of Occupancy $
�'�s'•°•'<�
Building/Frame/Frame Permit Fee $ �1
s�cwust 9
Foundation Permit Fee $
t
Other Permit Fee $
TOTAL
Check # Q
13574
Building Inspector
PERMIT NO. 0!0 APPLICATION EOR PERMIT TO BUILD******** RTII ANDOVER, NIA
MAP NO. LOT NO. 2. RECORD OF OIVNERSIIIP DATE BOOK PAG E
ZONE SU11DIV. LOT NO.
LOCATION x
3 - /-25-
/-2MA(-`J 2
5- 1e eQ t PURPOSE OF BUILDING /
` _ � PMS ✓1 puSe- � h.9•�
OWNER'S NAMEo f NO.OF STORIES � SIZE
�o��e2;v� M
OWNER'S ADDRESS cSC11�f�� BASEMENTORSLAB
ARCHITECT'S NAME SIZE OF FLOOR TIMDEfl$' 1 2ND 301)
BUILDER'S NAME SPAN
DISTANCE TO NEAREST BUILDING, DIMENSIONS OF SILLS
DISTANCE FROM STREET DIMENSIONS OF POSIS
DISTANCE FROM LOT LINES-SIDES REAR DIMENSIONSOFGIRDERS
AREA OF LOT FRONTAGE HEIGHTOFFOUNDATION TIIICKNESS
IS BUILDING NEW SIZE OF FOOTING
IS BUILDING ADDITION fiIATERIALOFCIIlA1NE1'
IS BUILDING ALTERATION IS BUILDING ON SOLID Olt FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTS TO TOWN WATER y
BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTMTIONS 3. 1`110PEI1TV 1NFOliNIATION LAND COST
EST.BLDG.COST
PACE l FILt.OUT SEC"TIONS 1-3 EST.BLDG.COST PER SQ. FT. OD law'
EST.BLDG,.COST PER ROOM
ELECTRIC METERS MUST DE ON OUTSIDE OF BUILDING SEPTIC PERMI r NO.
i
ATiACIIED GARAGES MUST CONFORM TO STAII-F FIRE REGULATIONS 4. APPROVED BY C
PLANS MAST 111.1'ILI:D AND APPROVED BY BUILDING INSPECTOR HOILDING INSPECfOII
DATE FILED' 4p 0 Oii'NERS TEI.H O 1,' C
l
CONTR.TELH
g
LFEE $
F-OWNER OR AUTHORIZED AGENT
CONTR.LICH
1l.LC.Hl"ED / O
Revised 5/5/99 JM
BUILDING DEPARTMENT
DEBRIS DISPOSAL FORM
In accordance with the provisions of.MGL c 40 S 54,a condition of Building Permit Number
Is that the debris resulting form this work shall be disposed of in-a properly licensed solid waste disposal facility as
defined by MGL c 11, S 150A "
The debris will be disposed of in:
Location of Facility
Signature of Permit pplicant
i Date
NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of
the Building Inspector
f
,, r
�J
�ofrk TOWN OF NORTH ANDOVER,MASSACHUSETTS
DIVISION OF PUBLIC WORKS
STREET OPENING PERMIT AND
PERFORMANCE BOND AGREEMENT
01/06/00
��AC#1iS`3�
On this day in compliance with North Andover Town Bylaw Chapter 161-3 Street excavation Permit,and subject to
all the terms,conditions,and restrictions printed or written below and/or attached,permission is hereby granted to:
John McElhiney 123 Marblehead Street,North Andover,MA 01845
to enter upon: place dumpster @ 123 Marblehead
for the purpose: demolition of building
mes Ra Jr for of Engin nng
Division of Public Works,North Andover,MA
WHEREAS Pursuant to the provisions of Chapter 161 Section 161-3 of the North Andover Town Bylaws, the Grantee agrees.to
provide a plan and a bond in the sum of$10,000.00 bound unto the Town of North Andover and an additional refundable* amount
of$ to assure proper performance and completion as defined in the conditions below or as attached.
The Grantee must notify and receive approval from the Police Department to block or alter traffic and must notify the Fire
Department,Postal Service and School Bus Company if a roadway will be closed because of the proposed excavation.
In 'tness whereof the gran ee(s)have here unto executed this agreement.
John McElhinev
S' ature Print name
Signature Print name
978-687-0908 978-688-1721
Day time telephone Emergency(24 hour)telephone
1.Dig Safe Number:
2. Certificate of Insurance on file Yes
3. Expiration Date of Paper Bond: None
4. Amount of Cash Bond: $500.00 Check Number:2648
5.Person whom Cash Bond will be returned to: Same as above
North Andover,MA 01845
Place dumpster just off sidewalk,rope area during working hours,clean area daily and remove snow if necessary.
CAWORMSTOPENINGSTERM WLTRRO
:.d ,
s .. � .._ v
.. ,. � 4
1 + , Y
, f t.
.. 'I ., .�
. +. ! .. �.
Town of North Andover t NORTh
OFFICE OF 3�0`,,,�o ,,�y0
COMMUNITY DEVELOPMENT AND SERVICES
o
p
140 .
27 Charles Street
North Andover, Massachusetts 01845 �4 ^ .,o•�•'`�y
WILLIAM J. SCOTT s A<HUSti�
Director
(978) 688-9531 Fax (973)638-9542
HOMEOWNER LICENSE E.'=MPTICN
Please print.
DATE Z C- U `)
JOB LOCATION
/Number Street address Section of town
„HO�tEMV-N-EP, �6 L A i✓!�_Iki✓ l X`Z 70)Z J-2 ' U 9 o
Name Home phone Work phone
PRESENT MAILING ADDRESS 22Y/4 �'''%^���� S/
City/Town 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 Sec-
tion 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 dwelling, attached or detached structures ac-
cessory to such use and/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 Building 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 No. Andover
Building Department minimum inspection procedures and requirements and that he/she will
comply with said procedures and requirements.
HOMEOWiNTRTS SIGNATURE
6/1
APPROVAL OF BUILDING OFFICLU
Note: Three family dwellings 35,000 cubic feet, or larger, will be required to comply with
State Building Code Section 127.0, Construction Control.
BOARD OF APPEALS 683-9541 BUILDING 683-9545 CONSERVATION 683-9530 HEALTH 688-9540 PLANNING 683-9535
NORTH
own, 0 _ :..: . Andover
No. 10 10
0%
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COC
HICHEWICK '
A0"SATED 5
1 S BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
��� e BUILDING INSPECTOR
THIS CERTIFIES THAT......�!!�.�..�.�............f......... ...�.... Ow.. .......... ... ....... ................
Foundation
has permission to e�i..�. r�r r.
building on .,.. ...�� ......� ..... � .. / Rough
to be occupied as �. O.. #040 ,�� • FA�� 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
rn Final
PERMIT EXPIRES IN 6 MONTHS
g4r ELECTRICAL INSPECTOR
10 UNLESS CONSTRUC Rough
.. ...........A
........................................................................ Service
op'ro�w
BUILDING INSPECTOR Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
SEE REVERSE SIDE Smoke Det.