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HomeMy WebLinkAboutMiscellaneous - 137 ANDOVER STREET 4/30/2018 (3) J 137 ANDOVER ST 210/059._=0000.0 '// h l r i� I j �� North Andover Board of Assessors Public Access Page 1 of 1 f K r ,kORTp North Andover Board of Assessors t _ � roperty Record Card Click Seal To Return Parcel ID:210/059.0-0017-0000.0 FY:2013 Community:North Andover SKETCH PHOTO Click on Sketch to Enlarge Search for Parcels Search for Sales o i ctu q Summary Available Residence Detached Structure Condo Commercial Location: 137 ANDOVER STREET Owner Name: TRUSTEES OF RESERVATIONS Owner Address: 572 ESSEX STREET City: BEVERLY State: MA Zip: 0191.5 Neighborhood:6-6 Land Area: 16.56 acres Use Code: 905-CHARITY-PROP Total Finished Area: 7616 sqft ASSESSMENTS CURRENT YEAR PREVIOUS YEAR Total Value: 1,175,800 1,039,900 Building Value: 848,900 714,700 Land Value: 326,900 325,200 Market and Value: 326,900 Chapter Land Value: LATESTSALE Sale Price: 0 Sale Date: 01/01/1000 Arms Length Sale Code: N-NO-OTHER Grantor: Cert Doc: Book: Page: http://csc-ma.us/PROPAPP/display.do?linkld=2253833&town=NandoverPubAcc 3/26/2013 i Residential Property Record Card PARCEL_ID:210/059.0-0017-0000.0 MAP:059.0 BLOCK:0017 LOT:0000.0 PARCEL ADDRESS:137 ANDOVER STREET FY:2013 PARCEL INFORMATION Use-Code: 905 Sale Price: 0 Book: Road Type: T Inspect Date: 1 012 6/20 1 1 Tax Class E Sale Date: 01/01/00 Page: Rd Condition:_ P Meas Date: 10_/_2.6/_2011 Owner: TRUSTEES OF RESERVATIONS Tot Fin Area: 7616 Sale Type:- Cert/Doc: Traffic:------- M Entrance: D Tot Land Area: 16.56 Sale Valid: N Water: Collect Id: RRC Address: Grantor: Sewer: Inspect Reas: C 572 ESSEX STREET BEVERLY MA 01915 Exempt-BIL% / Resid-B/L% / Comm-B/LP/o Indust-B/L% / Open Sp-B/L% / RESIDENCE INFORMATION LAND INFORMATION Style: CL Tot Rooms: 10 Main Fn Area: 2729 Attic: NBHD CODE: 6 NBHD CLASS: 6 ZONE: R4 Story Height: 2.50 Bedrooms: 4 Up Fn Area: 3351 Bsmt Area: 2693 Seg Type ' Code- Method Sq-Ft- Acres Influ-YIN Value Cless Roof. G Full Baths: 2 Add Fn Area: Fn Bsmt Area 1 P 901 S 43560 1.000 208,621 R Ext Wall: WS Half Baths: 1 Unfin Area: Bsmt Grade: 2 R 901 A 0 15.560 118,256 R Masonry Trim: Ext Bath Fix:' 0'- Tot Fin Area: 7616 DETACHED STRUCTURE INFORMATION Foundation ST Bath Qual: T RCNLD: 649862 _Str Unit Msr-1 Msr-2 E-YR-Bit Grade Cond%Good P/F%E/R Cost Ctalis -- - -- Kitch Qual: T Eff Yr Built: 1993 'Mkt Adj: SE S -1440 0.00 1981 A A ///79 "18,100 1 Heat Type: ST Ext Kitch: Year Built: 1778 Sound Value: GR S 1314 0.00 1981 A A ///79 40,400 3 J Fuel Type: O Grade: V Cost Bldg: 649,900 SE S 1012 0.00 1981 A A ///79 12,700 1 Fireplace: 3Bsmt Gar Cap: Condition: V Att Str Vail; _ GR S 140 0.00 1981 A A //179 6,900 3 Central AC: N-,' Bsmt'Gar SF: Pct Complete: Att Str Va12- Att Gar SF: %Good P/F/E/R: M92 VALUATION INFORMATION Current Total: 1,175,800 Bldg: 848,900 Land: 326,900 MktLnd: 326,900 Porch Type Porch Area Porch Grade Factor Prior Total: 1,039,900 Bldg: 714,700 Land: 325,200 MktLnd: 325,200 P 283 W 120 P 154 SKETCH PHOTO 5 1 QF Ft Sk lh MMML �6 FU FM/Bi ct u naftL 1287! q.Ft 33 33 Availabl= P FU/FM/B/FU".5 256 Sq.Ft 1376 Sq.Ft 32 32 32 r.2i 41 EWi�Ft Ft Parcel ID:210/059.0-0017-0000.0 as of 3/26/13 Page 1 of 1 Date. NORT .te TOWN OF NORTH ANDOVER 0 0 PERMIT FOR WIRING "SAC US This certifies that ........... ............. Cry© has permission to perform .............................................................4r.P, 57e�('e&� 70 4.4i�.Af ............... wiring in the building of....................................... at...........AV 5 r North Andover,Mass. Fee.. Lic.NCVq ............... LEC-CRICAL NSP I ? Check # �?tb 7905 (� Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit N°.- BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked [Rev. l/07] (leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 1 .00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: 'Z Z 0 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) S4CU-p-VI S R(ac C Owner or Tenant Telephone No. 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 / Volts Overhead❑ Undgrd❑ No.of Meters New Service L/"r- Amps /20 / i'�C1 Volts Overhead❑ Undgrd No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: E- FEE p L SCC_ r Cu Completion of the ollowin tabl may be waived by the Inspector of Wires. No.of Recessed Luminaires No.of Cell:Susp.(Paddle)Fans No.of Tota Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In- El Battery o mergency ig mg rnd. rnd. Batter Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones No.of Switches No.of Gas Burners No.o Detection and TotInitiating Devices No.of Ranges No.of Air Cond. Tons No.of Alerting Devices No.of Waste Disposers eat Pump Number Tons KW No.of Self-Contained Totals: ..I...... _......- � ......." Detection/Alertine Devices No.of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other Connection No.of Dryers Heating Appliances Kms, Security Systems:* No.of Devices or Equivalent No.o WaterNo.KW No.of No.of Data Wiring: Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: 2 tri n� 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 is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE Zj BOND ❑ OTHER ❑ (Specify:) I certify,under the pains and peva ies of perjury,that the information on this application is true and complete. FIRM NAME: Iva I-0,/ch e e 1Zf,--1,r/C a ccvy ` LIC.NO.: Licensee: cS ht'p1-I.p,V\ -:Y NG1r&+P Signature LIC.NO.•Pt Oct (If applicable,enter`exempt"in the license numb r line.) Bus.Tel.No7 Address: 10(5t,tJ,yt< l��S e� Alt.Tel.No.: *Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lie.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 Signature Telephone No. PERMIT FEE: $ /-Z S Date.. . .. ... .. .. . .. .. . ... p ao ,° h° TOWN OF NORT.ANDOVER O 9 • - PERMIT FOR GASINSTALLATION ; S^CMU5E� This certifies that .0 4i?'! . . ,. . . . . . . . . . . . . has permission for gas installation . . .r. .!`r. -!.. . . . . . . . . . in the buildings//of . . 944?, - at . . . .1545 . . .�7.eA 14 . , North Andover,`Mass. Fee. .�� . . Lic. No.. .1. . . . . . . . . . . . . . . . . . . . . GAS INSPECTOR Check# C> 6289 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GAS FITTING City/Town:E North Andover Date: 01/02/2008 permit# t Building Locatio 137 Andover St Owners Name. Trustees of Reservations Type of Occupancy: Commercial Educational Industrial Institutiona[L Residential New:Lj Alteration: - Renovations Replacement: Plans Submitted: Yes No �I FIXTURES j LU w to W Z to tU Q o 0 H M Z 0 LU W V U) ~ y W W W Z F- O Ix ' 0 H 0 Z j UJI Lu > y MI Z N W C7 O W iL ~ 2 Cj d X W U) O LL it X > V Lu Z L7 J H H O Z J (� LL N = W W W W 0 25 lz n a W w w 00 > 00 a 00 W z w a a a 0 0 o LL 0 0 x x O IL ►- > > O SUB BSMT. BASEMENT 1 FLOOR j 2 N u FLOOR- ----3 R o FLOOR 4 1HFLOOR WH FLOOR 6 FLOOR 7 FLOOR 81HFLOOR Ht _•-_ _...� Check One Only Certificate# Installing Company Name: Climate Design Heating A C L L.0 121 Corporation 2884C Address:E5 South Summer St City/Town BradfordState: MA p Partnership ! ._� , Business Tel:1978 37.2-9999 Fax i - - jFirm/Com an Name of Licensed Plumber/Gas Fitter E Glenn Bosteels INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes'l„, Nd-i If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policyD Other type of indemnity 1-iBondLJ 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 Owner7j Agent Signature of Owner or Owner's Agent Ll By checking this box❑;1 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 in tallations perfor d u er the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plu ing Code and apter 1 f the General Laws. Type of License: By ��Plumber Gas Fitter Title; , naWre of Licensed Plumber/Gas Fitter Master City/Town�, Journeyman APPROVED OFFICE USE ONLY LP Installer Ll License Number: 19875 Date.///.� .F. ,OR TOWN OF NORTH ANDOVER- t PERMIT FOR PLUMBING ,SSAC14US� This certifies that . . . . . . . . . has permission to perform . . . . .P. r: . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . (7G .`-' . c/�``'�/��'�' at. . . . . . . . . . . . .. North'Andover, Mass. Fee Lic. No..q.5 .2). . . . . . . . .�7.7. . �.�. . . . -1 . . . . . PLUMBING IN;PoR Check ,'f /7 5 / L 7624 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING Cityffow,JWorik Andover....... ?ermit# Date:i 01/09/2008 L7e.4,1= Building Location-1.1 37 Andover St Owners Name: Trustees Of Reservations Type of Occupancy: Educational Commercial'ILI Industrial Institutional L] Residential I New:0 Alteration: Renovation:: Replacement:F�_(j Plans Submitted: Yes L 67- No 00 FIXTURES 2i z cn 0 W zrn U) W (n U) >- _j xCP W U) CL z �e < co Q U Lu W Z z U) z W W V) 3 U) 0 H: U) X 0 < — I- W 2 W W (L U) U) y U) _j 0 M Cn >_ Me U) U) 0 %j LA_ _j :D Lu C Z W LL LL Cn W a 0 a W W _5 0 Z LL _J 0 se < Lu UJ LU I-- X a. CO F-- 0 Z U) 0 0 0 _j 0 0 = _j 9 F- U) CO) 0 SUB BSMT. BASEMENT 15' FLOOR 1 -iffly-F—LOOR 3"FLOOR 4"'FLOOR 5"'FLOOR _jTF F-FLOOR 7"'FLOOR 8"' FLOOR Check One Only Certificate# Installing Company Name:E�Eate Design Heating A C L.L.0 Corporation Address:[5:Sout Su' I Bradford e:' City[Town,5Stat Partnership F__ [i78--�72-9999 Fax: Business Tel: Lj Firm/Company Name of Licensed Plumber:LG�Lle�LBo:!Lteels INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes[✓]NoD If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policyLVj( Other type of indemnity L] 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 -Signature of Owner or Owner's Agent Owner Agent Lj I hereby certify that all of the details and information I have submitte (or entered)rega n are true and accurate to the best of my 1j11F'fAootrrt4wZ�gj'pp I ic�utio tion n will be in compliance with all Knowledge and that all plumbing work and installations performed u der the permi.t i r�I I Pertinent provision of the Massachusetts State Plumbing Code and er 142 of h eneral L �1� \A Type of License: n TitlePlumber niS gtu4'c License umber Master Cityffown�... Journeyman -7�,, -'License Number: 9875 APPROVED(OFFICE USE LY) i Location No. D Date /0-oP b d "ORT" TOWN OF NORTH ANDOVER 3 • OL N � 9 Certificate of Occupancy $ CMU E� Building/Frame Permit Fee $ Foundation Permit Fee $ b Other Permit Fee $ TOTAL $ q� f Check # + { Building Inspector i T I TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. DATE ISSUED: c5 � SIGNATURE: �C -- Building Commissioner/I for of Buildings Date Z SECTION 1-SITE INFORMATION O 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 17 — Map Number Parcel Number l 1.3 Zoning Information: 1.4 Property Dimensions: (� Zoning District Proposed Use Lot Areas Frontage ft W 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide RNWred Provided Rapired Provided v 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information_ 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT rn 2.1 Owner of Record Name(Print) Address for Service: Signature Telephone N 2.2 Owner of Record: Name Print Address for Service: O Z Signature Tele hone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construction Supervisor: C7�-7 O Y) License Number Address 4IZ`2 2c»'L q7"8- `?3(Z- Expiration Date z Signature Telephone r i 3.2 Registered Home Improvement Contractor Not Applicable ❑ v Company Name OR Registration Number r 1 r_ ddress 1 Z xpiration Date Signature Telephone Y/ Y SECTION 4-WORKERS COMPENSATION(XG.L C 152 § 25c(6) it 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 permit. 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 El Specify Brief Description of Proposed Work: ori CFS pto— �F c--,K CX SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee © Multi lier 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)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,Kd9<;rJ-- A(AJ­iQZq s 0-0e r as Owner/Authorized Agent of subject property Hereby authorize to act on Mye f,ni ll m4irs relative to work authorized by this building permit application. SiSi n Owner I Date SECTION 7b OWNER/A/U�THORIZED AGENT DECLARATION I, As Owner/Authorized Agent of subject prope ty Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief 1_ r J d�T f`k 6 — Pri t e fi (/ h-7/�Q Si ature of Owner/Agent Date i NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR MMERS 1ST2ND3 SPAN DMT-NSIONS 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 Town of North AndoverF NORTH aqti �ttL c "6"6 Q �� h..•. Building Department 0 27 Charles Street North Andover,Massachusetts 01845 (978) 688-9545 Fax(978) 688-9542 °4 -1— K. n°44ron PPP�.(� I 9SSACHUSE DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit 9 the debris resulting from the 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/at: i 1Q �b . c:'4- Facility location Signature of Applicant Date NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name: 4�V �• ��� Location: 1003 CiPhone R-715 - $(�2 d 3 t Z am a homeowner perfo ing all work myself. ®I am a sole proprietor and have no one working in any capacity a1 am an employer providing workers' compensation for my employees working on this job. Company name: Address City: Phone#: Insurance Co. Policy# Company name: Address City: Phone# Insurance Co. Policy# Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 andlor one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of($100.00)a day against me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do herby cert under the pains pe afti f perjury a ation provided above is hue and correct Signature Date a� Print name Phone# T7 F 3 t 2- Official Official use only do not write in this area to be completed by city or town official' ❑ Building Dept ❑Check if immediate response is required Building Dept ❑ Licensing Board ❑ Selectman's Office Contact person. Phone#: ❑ Health Department ❑ Other FORM WORKMAN'S COMPENSATION �."'»�'e,. ��fv aa3=�„��.�,.:��+� ��i ��o.°�:,1[lldkr<•l(.(JczlJ 3> Of MWING REGULATIONS ` SUPERVISOR Tr.no: 18760 I administrator o HONE IHPROVEHEHT CONTRACTOR Registratiaa- lOdD54 Ezpi�at ion: 07/2112002 Type: Individual DAVID C. YEBB David Yebb Gee +•o W Hay Street "°'"""'`BATOR McNburY !1A 01951 �rtf i i � I C ARLSN e REAL ESTATE �jaHomeso SCHRUENDER DIVISION 73 Chickering Road(Rt. 125/133),North Andover, MA 01845(978)685-5000 Fax: (978)685-5900 j September 27, 2000 Building Inspection Town of North Andover North Andover, NA 01845 TO WHOM IT MIGHT CONCERN: Please be advised that replacing the roof at the Steven Coolidge Place does not need approval of the Historical Commission. Section 6 B I&B 6 exempts Roof replacements from the bylaws_ It therefore does not need approval from the Olde Center Historical District Commission. Any questions please call me at 978 685 5000. Sincerely, George H. Schruender, Jr. Chairman North Andover Historical Commission I I i i T40RTH o o6 - ®ver�, �' { 0 No. 0 dover, Mass., RATED Cl) H BOARD OF HEALTH Food/Kitchen PERMIT T Septic System THIS CERTIFIES.S THAT.'Tr.q uA&es o � BUILDING INSPECTOR ......................................................................................... ............. Foundation has permission to erect....S!f P�AP............ buildin s on....L3.0(....... S........ Rough to be occupied as...40......................*4.00...IL wvv......................................... .1 1�........................ Chimney ....... ... ........ ..... provided that the person accepting this permit shall in every respect conform to the terms the application an file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Q Buildings in the Town of North Andover. ts%bcr PI r? .*acm PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION ST S ELECTRICAL INSPECTOR A Rough Service ........................%NOP.01..ft 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. i MASSACHUSETTS UNIFORM APPLICATION FOR PE T TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS U ,r / Date �d Building Location / � 7 ��U 4ets Name Sfy✓-eu `eOy/t c �i�z Permit# Amount Type of Occupancy Jew:-C.`�7.t-( New [3-' Renovation r-1 Replacement Plans Submitted Yes No FIXTURES rn > rrw a F En Q w w a � A SLBlM BASEM t' M IInR t MRax 3MRIM 4MRM 5MROCR 6M HDM 7MRaR MRO (Print or type) c Check one: Certificate InstallTing Company Name -�.i } ) / � '� �� 1 Corp. Address SY U J3 !) Y-1"6 A--J- S 7 El Partner. Tusiness Telephone �(/._ 0 Zy �Firm/Co. Name ofLicensedPlumber. D Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box Liability insurance policy ©' Other type of indemnity F-1 Bond InsuranceWaiver. I,the undersigned,have been made aware that the licensee of this application does not.have anyone of the above three insurance Signature Owner Agent E 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' ons performed under Permit Issu for this application will be in compliance with all pertinent provisions of the Massach S lambing C e and Ch 142 0 General _Laws. By: rgna o rcens um T e ofPlumbing License Title �° 3.6 City/Town we i um er Master �' Joumeyman APPROVED(OFFICE USE orrr.Y Date:/O. , N° 4339 TOWN OF NORTH ANDOVER ' PERMIT FOR PLUMBING '4 ,SSACMUS� This certifies that . `.'. . .,C : . . ':-. .'�. . .` >~- tir"j '.. . . . . . . . . . . U has permission to perform, / � ._-.!: . . . . . . . . . . . . . . . . plumbing in the buildings of . .? .. .'. . . . . . . . . „North Ar" dover, Mass. Fee,,!!.&1. . .Lic. No!2' . . . . . . . . . . . . . . PLUMBING INSPECTOR WHITE: Applicant CANARY: Building Dept. PINK:Treasurer Location 3 f7 AA)dot,,e r- S No. ---7— Date `3 O y .� ti MORTo, TOWN OF NORTH ANDOVER N?•a • L 1 ` Certificate of Occupancy $ SAtNue MUS tis Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Feer-v"A' $ 30 TOTAL $ Check # 1 a 3-0�f r AM 17344 Building Inspector t TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: a DATE ISSUED: _ e © Y SIGNATURE: 'Vt Building Commissioner/1222sixtor of Buildings Date SECTION 1-SITE INFORMATION 1.1 Property Address: 1.2 Assessors Map and Parcel Number: -. -i37 AN001/2,rL Vr, 5 / 4Pjh,6-v&ft—j h44 Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: �Q Zoning District Proposed Use Lot Area Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Repired Provided 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M 2.1 Owner of Record ���SSS e-�' ,/Zf s���r�`Ti a o✓� .i?a �S S�� ST �f L�x�t/, •�,4 I Name(Print) / r Address for Service: r (!V 1AA77z A GT 4�,j ` Signature Telephone 2.2 Owner of Record: dame Print Address for Service: z _ M & nature Tele hone SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ ,W,4X A-' T1L41A,A, P£TF<d 10 A/ PAS eM9Z1'Z— Licensed Construction Supervisor: /f'9 10640-Z-19-- rLicense Number /T% S/TiyQA�4J vt/y-�• G'd/i/1/�'iS� �4' /� AIM License Address 71--1— Expiration Date rM ignature Terephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name M Registration Number �a f Address \ z * Expiration Date Si nature Telephone s ' SECTION 4-WORKERS COMPENSATION(NL G.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 permit. Signed affidavit Attached Yes.......K No.......❑ SECTIONS Descri tion of Proposed Work check all applicable) New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify ott�/li/1?!yt. dHf Brief Description of Proposed Work: l �i1 PC r✓' � �X G!� j 7�l12a��N.e4rl y ,�r'i(iT �r� G��/a z! �y-�T SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be 'I,-OFFIGIAL;USE QNLY- Completed by permit applicant 1. Building (a) Building Permit Fee Multiplier 9 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee(a)x(b) 0�_ 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5) Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN 1 I OWNERS AGENT OR CONTRACTOR APPLIES FOR BUIIAING 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 A I, R?xw-s-tAi Avery ee6,vi'E1,_ 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 N e iature of Owner/A ent Date � NO.OF STOFJES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1 ST 2ND 3PLD SPAN DIN ENSIONS OF SILLS E DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X I MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE The Commonwealth of Massachusetts - LZDepartment of Industrial Accidents , . 01YIceo/IavesUgaUaas 600 Washington Street Boston,Mass. 02111 Workers' Compensation Insurance Affidavit IOlC1 4C1IIJ 4II --•� +-s lASe' e'1'1 ra... ,,, name: location: ciry nhenc r � I am a homeowner performing all work myself. C] I am a sole proprietor and have no one wocicing in any capacity C�rl am an employer providing workers'compensation for my employees working on this job. icidriess: 13 S'�v�N��/ .ST �! rN• !V/^An*T z ,IZ tn4 zit i/L) ahgne N: 78/ ?,24- 7d Dy insnnntx co. /`� �' poficrN 7,0/0/1/,& 6 (] I am a sole proprietor,general contractor,or homeowner(circle one) and have hired the contnctors listed below who have the following workers' compensation polices: ' campanv ntrnc• ;cdsiress: city: phone N fnSut'a nee e4, policy N cominnv name: address: city: phonC K insurance co. yolicxN Attac 'a arnoaa s Lstaetenan Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to 51,500.00 and/or one yeah'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of 5100.00 a day against me. 1 understand that a copy of this statement may be forwarded to the Ofrice of Investigations oqf the DIA for coverage veriGntion. 1 I do hereby certify under the pains and penaUies of perjury that the information provided above is true and correct. Signature Date Print name �/yf 1)l4YJ4 6/yS — Phone official ust only do not write in this arca to be completed by city or town official city or town: permitAicense M f Building Department Licensing Board D check if immediate response is required OSeleetmen's Office 0Health Department eonuct pcnon: phone a; rlOthcr r� t---e IRS►IAI BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number: CS 060219 Birthdate: 04/27/1954 Expires: 04/27/2005 T r. no. 9542 Restricted: 00 MARK TRAINA _ 33 HANFORD RD C � STONEHAM, MA 02180 Administrator Q rTr�{F.. 7 ' .r IMPORTANT DOCUMENT tot " a erdtfirate of ISSUED BY, REGISTERED ' ARUOAT1 ' M E .: INDU6TRIES NG. ,. . EVANSVILLE, INDIANA 47711th6r,� F03 P } MANUFACTURERS OF THE RNISHED TENT PRODUCTS DESCRIBED HEREIN i is, to certify, t the materials described ve been AA rn' e-rotarda' are inherently rola l ars were supplied to, Al z ` PETERSON PARTY CENTER INC 139 SWANSON ST WIMOHESTER FSA 01890 ,, i , ; IMPORTANT DOCUMEN,T WE tfiratr ert of r .6j: Oatof : APPLICATIONNUMBER r +ANSVIi-LE,INDIANd d t i' to ' M 'ACT TENT PRoDuCTS DESCRIBED HEREIN ' This fy that the material's described have been, f ' are, h 'thy h ninflammable) and were 657150 PETERSON PARTY CENTER INC ` 139 SWANSON ST WINCHESTER MA 018qok Certification fgg treated with a flame-retardant piproved }tTho articlev d6scribed on this Certificate have .. chemical the f say chemical f tiMarshal code, equal to d 701, CPAI 84, ULC 164. The f chi c ' s: Ser: , 92,71 t43 h Description of Item cetlified,, . „ 1 tN MID Ct2,1LJ °. ... 01 Flame Retardant Process Used Will Not Be Rem ved: By Washing And Is Effective For The Life Of The Fabric: 00RAC " s,. _. Sig .4: j . Name of A pts`c t6,of Fliame Resistant Finish �� TENT DEPARTMENT—ANCIHOR,INDUS R NO. L�. Ik t 3" '{4 z�� r 3�Ataz'( � ` e tk;�'�'�+••.•� i f. �� r, .a�`,�� � X�i`a �"` � ,c� t }` � L.�1�•�xk,L a .bx _ ,�- k ar f x'i'a `�t � ''V C y �} ; � sr.-- � s � ...r 'f a"`�h�� �,?s4} i. sit_• r .. 3 a .!# � {y t �'r �j �a y{f' tomo- � 4.pµ r cfw ''� i I `„��Y t' � • .fj- ��. t€r `. � ��� '„�'K�i� �°j.rrx t k a ,31r e f [ ti r h i.. a �4'�,-yt ^� � 3�' t�E y. -T' � :��'�� .4`� � tfj� i "-h".,��"- :R,C'7t•`,y r r r. C �}t t.r � I � �3 1;.�,`�v"�� P � ��..d�: --''� y h>4��t �`'. y°,��t +�s-'�` _ i".`'�' F.�i•r. � ��.%r t.n 1-.. � ,� '�+�:3 I � s 3` `"' � �r �is i E-. �.�•, s - 4 .� Tei t�� r�-. t 5 -x..: : � � .d , r � 1 r _ �e a • �l���d_. s,}_ irr .. � fir. }t*� r :3f"'.. �"4 � qtr � � i - r: t. tiA c 4 •t st.Y'aS "f* -rr ��,� Fh` ,+3 §`r n"F4�' �yY x` auS �1f-s. ��r,.:i �'f'�'"'�`y' a�r,�'�� ¢.'§i t3'. �-#A , � �4 .,a h 4}N�` '�:•��.� � � -x `- , ;. '�T,[.+f�d. '.���,\•.V_ -i-a § -.�r{ � r �} trSt,u,rys,`J fdx' � .t`fTb,i1"•f � ^� xtt �i t�t�� y 'z, 4�'"Cq !a per s �4p_ �T SZ � s-`Gs ,z s.x, !. v !!r� 3�k:ryrx 1���' �•-r Tn�� �' � . � 's- �� Gp.�' 1 'a •� r�r� - a i�"Z o�7� � Ir. � � R:,.� ,•,� s 'M5+ Ya� �1rH {�r Y e5 �1�6n . �{ :� A� 4`f � �.e a a`s,J'• M a '#a' � '�-� -'�'�,, �kr�r �'�t tt k..,- �sN- r�� � _ `x�x r r, s z` t'�{'r"�? s i,- m� v �•k .� l��S + 1..�y' ,xt 3 �.rd� y it Yf� s `i .. 5i _ 'e.. 1J. 'i`' L `�,'a•s x,.7� -,wi ^�✓j . rr 1 - 1 7-7 tz h �'•r_.: �. .. .•. r,. .� AFnijOt,����..,i{.{T�-k.��•;'t=J� ��.1`a;'.�5 ht .�.t,..-h !. -�- NORTH Town of 6Andover No. gal 0 LAK 10 '� dover, Mass., 6 3 d COCHICHEWICK 7�ADRATED S U BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR .I.� THIS CERTIFIES THAT..... D.h .M ........ . ............. rM... ./...�. ...I. .. .v..... ......4........................ , j< . .. � . ..... Foundation has permission to erect.....� .....�.... 00.... buildings on ......�3�......� NeloVrn ` Rough to be occupied as .........(AW.. 1-6 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 I spection, Alteration and Construction of Buildings in the Town of North Andover. / /1 4) r PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS e. Rough .....MOM.. .................................... .t.........:::...............— Service BUILDING;INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and-Approved by the Building Inspector. Burner Street No. . i SEE REVERSE SIDE smoke Det' j 1