HomeMy WebLinkAboutMiscellaneous - 14 CRICKET LANE 4/30/2018 C 14 CRICKET LANE %
' 210I10?.A-0167-0000.0
AMERICAN CLAIMS SERVICE
MULTI-LINE ADJUSTERS
Letter 143
January 17, 2018
Town of North Andover
Building Department
120 Main Street
North Andover, MA 01845
Attention: Building Inspector
Board of Health and/or
Board of Selectman
Insured: Conte
Location: 14 Cricket Lane North Andover, MA 01845
Policy: PHO 0100 82 8 13
Loss Date: 1/4/18
Loss Type: Ice Dam
ACS File: 180053
Dear Sir/Madam,
Claim has been made involving loss, damage or destruction of the above captioned property,
which may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143,
Section 6 to be applicable.
If any notice under, Massachusetts General Laws, Chapter 139, Section 313 is appropriate,
please direct it to the attention of the writer and include a reference to the captioned insured,
location, policy, loss date and file.
On this date, January 17, 2018, 1 caused copies of this notice to be sent to the persons named
above at the addresses indicated above by first class mail.
Unless a response is received within the next ten days we will not be obligated to pay any
portion of this claim to you.
Respectfully submitted,
J Brigida
Claims Representative
7 KIMBALL LANE BUILDING C LYNNFIELD, MA 01940
PHONE 781-245-9516 FAX 781-245-1077
claims.acs(a-verizon.net
AMERICAN CLAIMS SERVICE
MULTI-LINE ADJUSTERS
BUILDING INSPECTOR/COMMISSIONER,
BOARD OF HEALTH AND/OR
BOARD OF SELECTMAN
Building Inspector
Town of North Andover
1600 Osgood Street Building 20, Suite 2035
North Andover, MA 01845
INSURED: Edward & Threse Conte
ADDRESS: 14 Cricket Lane North Andover
POLICY: PHOO100828813
LOSS DATE: 02/15/2015
LOSS TYPE; Ice Dam
ACS FILE: 31144 PD
Claim has been made involving loss, damage or destruction of the above-captioned
property, which may either exceed $1,000.00 or cause Massachusetts General Laws,
Chapter 143, Section 6, to be applicable. If any notice under Massachusetts General
Laws, Chapter 139, Section 3B is appropriate, please direct it to the attention of the
writer and include a reference to the captioned insured, location, policy number, date of
loss and claim file number.
Craig Gillespie
Claims Representative
On this date, I caused copies of this notice to be sent to the persons named above at
the addresses indicated above by first class mail.
Unless we hear from you within the next 10 days, we will not be obligated to pay any
portion of this claim to you.
Date 02/17/2015
7 KIMBALL LANE,BUILDING C,LYNNFIELD,MASSACHUSETTS 01940
TELEPHONE(781) 245-9516/FAX(781)245-1077
E-MAIL—daims.aes@verizon.net
7577Date.�1� .. .. .. ..... .
NONTH
'4, I�
TOWN OF NORTH ANDOVER
-,z PERMIT FOR GAS INSTAL 1ON
S.
�,SSACNUSEt
This certifies that . . �O.P 14Vit. . . . . . . . . . . . . . . . . . .
has permission for gas installation . . .l,( l . . . . . . . . . . . . . . . . . . .
in the buildings of . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
at . . .j ��. C. /.� �. .�!`. . . .l . . . . . ; North Andover, Mass.
Fee-TC-.c. Lic. No.2.`(i.1. . . . . . . . . . . .i.Ju. sry. . . . .
GAS INSPECTOR
Check# ZO / /
M.1
pcc%f
AMERICAN CLAIMS SERVICE ASSOCIATON
INDEPENDENT INSURANCE
MULTI—LINE ADJUSTERS DJUSTys
DEDI(A TO
BUILDING COMMISSIONER OR BOARD OF HEALTH OR
INSPECTOR OF BUILDINGS BOARD OF SELECTMAN
120 Main Street
N. Andover, MA 01845
RE: INSURED: Edward and Threse Conte
PROPERTY ADDRESS: 14 Cricket Lane, N. Andover, MA
POLICY NUMBER: PH0O100828813
LOSS OF: 10/24/11; Damage to retaining wall
FILE/CLAIM NUMBER 29761 PD
Claim has been made involving ,lossdamage or destruction of the
g
above-captioned property, which may either exceed $1, 000 . 00 or
cause Massachusetts General Laws, Chapter 143, Section 6, to be
applicable. If any notice under Massachusetts General Laws,
Chapter 139, Section 3B is appropriate, please direct it to the
attention of the writer and include a reference to the captioned
insured, location, policy number, date of loss and claim file
number.
John Caldwell
Claims Representative
On this date, I caused copies of this notice to be sent to the
persons named above at the addresses indicated above by first
class mail.
Unless we hear from you within the next 10 days, we will not be
obligated to pay any portion of this claim to you.
November 29, 2011
Date
7 KIMBALL LANE, BUILDING C, LYNNFIELD, MASSACHUSETTS 01940
TELEPHONE (781) 245-9516 - FAX: (781) 245-1077
MASSACHUSEITS UNIFORM APPLICATON FOR PEIRWr TO DO GAS FITTING
(Type or print) Date c2-J-//
NORTH ANDOVER,MASSACHUSETTS
Building Locations 1 Y zity?l/-e%.. `i✓ Permit
Amount$
Owner's Name
New❑ Renovation ❑ Replacement Plans Submitted ❑
U z�w
zG 2 a - o H w
�
z O - � a
y
10
SUB-BASEM ENT
BASEMENT
1ST. FLOOR
2ND. FLOOR
3RD. FLOOR
14TH. FLOOR
STH. FLOOR
6TH. FLOOR
7TH. FLOOR
8TH. FLOOR
(Print or
type
Name T y�G L O r/a�'✓ n��� one: Certificate Installing Company
Corp'
Address d 13 O X S-•7 aZ ❑ Partner.
G/}WRPrt/lP 44 - /1'/�' �L _
Business Telephone 7 7,Y Z YS- 51-5-0 y ❑ Firm/Co.
Name of Licensed Plumber or Gas FitterLly
INSURANCE COVERAGE Check one:
I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No Q
Ifyou have checked-Yes,please indicate the type coverage by checking the appropriate box
Liability insurance policy Other type ofindemnity ❑ Bond ❑
Owner's Insurance Waiver. I am aware that the licensee does not have the Insurance coverage required by Chapter 142 ofthe
Mass.General Laws,and that my signature on this permit application waives this requirement
Check one:
Signature of Owner or Owner's Agent Owner [IAgent ❑
t hereby certify that all ofthe 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 ofthe Massachusetts State Gas Code pV Chapter 142 ofthe General Laws.
�-
Br Signature ofLicensed Plumber Or Gas Fitter
Title ® Plumber a_4f 33
City/Town ❑ Gas Fitter License Number
er
❑ Master
APPROVED(omcE usE oNLY) ® Journeyman
Date.3. .!. .G.!. . .
No 1-9- 74. 5
"pR'M
tiTOWN OF NORTH ANDOVER
p� i.•°;•'sp
TRW
PERMIT FOR PLUMBING
,S3 USES
t' This certifies that . . .t. . . . . . . !.`. .: ./. . `. . . �! .!. . . . . . . . . . . . . .
has permission to perform . . . e�. r.``. . ��` ``:
plumbing in the buildings of . . . . . ./. . . . . . . . . . . . . r. . . . . . . . . . . .
at. .L. . . . ... . . . . . . . .. . . . .'. . . . . . . .G ,.North Andover,Mass.
Fee.;.) Lic. No.. . ... . l . . . .
PLUMBING INSPECTOR
Check #
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer
Location[�' 1'�,1�
1�
No. :213 Date
NORTH TOWN OF NORTH ANDOVER
Of�.�•o yeti°
Certificate of Occupancy $
'� 1'�S'••• Ecn Building/Frame Permit Fee $
s <Mus
Foundation Permit Fee $
Other Permit Fee /Jod�, $
TOTAL $
Check #
15 6 U Building Inspector
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
This"S&fib6 for Offidad'Use`Oily:
BUILDING PERMIT NUMBER: I DATE ISSUED:713 rn
SIGNAc �
TURE:
Building Comrnissioner/I for of Buildings Date
SECTION I-SITE INFORMATION Z
I.1 Property Address: 1.2 Assessors Map and Parcel Number: O
Map Number Parcel Number
de
1.3 Zoning Information: 1.4 Property Dimensions: t ``
Zoning District Proposed Use Lot Area(so Frontage R) V�
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 1
Zone Outside Flood Zone 0 Municipal 0 On Site Disposal System
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT m
2.1 Owner u^C�Recurd911
Na e(Print) Address for Service:
n �
Signature Telephone O`
2.2 Owney of Record: /
Name Print Address for Service: O
z
Signature Telephone �rny,
SECTION 3-CONSTRUCTION SERVICES
3.1 Liccrised Construction Supervisor: Not Applicable 0
License's Construction Supervisor: O
License Number
Wdress
Expiration Date
:ignature Telephone
r
.2 Registered Home Improvement Contractor Not Applicable 0
ompany Name
Registration Number r�..
ddress r
Expiration Date ^`
enature Telephone y,
SECTION 4 -WORKERS COMPENSATION(M.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.......0 No.......0
SECTION 5 Description of Proposed Work check all applicable)
New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) 0 71tion ❑
Accessory Bldg. 0 Demolition ❑ Other ❑ Specify
Brief Description of Proposed Work:
SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar)to be � ' �' OCIAI CISE(} �
Completed
by permit applicant
1. Building - (a) Building Permit Fee
Multiplier
2 Electrical (b) Estimated Total Cost of
Construction
3 PlumbingBuilding 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
1, 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
1, Gr/ thorized Agent of subject
pro erty
Herebv declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and belief
Print Name
ti
Si ature of Owner/A ent Date
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TI HERS 1 2ND 3RD
SPAN
DIMENSIONS OF SILLS
DIMENSIONS OF POSTS
DtTENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF Cl-HMNEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
FORM - U - LOT RELEASE FORM
INSTRUCTIONS: .This form is used to verify that all-necessary approval/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve the
applicant and or landowner from compliance with any applicable requirements.
............................................................................
APPLICANT tI�=i/ �Q/��� /`PHONE � ;7f
ASSESSORS MAP NUMBER �� / LOT NUMBER 16
SUBDIVISION LOT NUMBER
STREET...:. .,.�� ....1 A,�.� ........STREETNUMBER...—
......... .... OFFICIAL USE ONLY...........................
RECOM�EKLATION6S F TOWN AGENTS
// /�i "�/ DATE APPROVED (� Z
1 CONSERV AD TRATOR
DATE REJECTED
CON M ENTS (�/U✓� C�'�E �� ��
DATE APPROVED
TOWN PLANNER
DATE REJECTED
COMMENTS
DATE APPROVED
FOOD INSPECTOR-HEALTH DATE REJECTED r
Ff Ih*� �_Cj-�-S� DATE APPROVED
SEPTIC INSPECTOR-HEALTH
DATE REJECTED
PUBLIC WORKS-SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
DATE APPROVED
FIRE DEPARTMENT
DATE REJECTED
COMMENTS
RECEIVED BY BUILDING INSPECTOR DATE
�0"Ck ?Oct 31 - QF
FORM - U - LOT RELEASE FORM
i
INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve the
applicant and or landowner from compliance with any applicable requirements
APPLICANT C& TE'lf� �r / r 2( 7//
� � 't/� �� �� PHONE (1�0
ASSESSORS MAP NUMBER/eW 1, LOT NUMBER A;U
SUBDIVISION LOT NUMBER
r
STREET/ /��C/CC' ��7i�' STREET NUMBERA4)Z , /1CYC711 `��
OFFICIAL USE ONLY
RECOMMENDATIONS OF TOWN AGENTS
...........................................................................
CONSERVATION ADNM41STRATOR DATE APPROVED
DATE REJECTED
COMMENTS
DATE APPROVED
TOWN PLANNER
DATE REJECTED
COMMENTS
I
DATE APPROVED
FOOD INSPECTOR—HEALTH
DATE REJECTED
--,4-J / 5L,� DATE APPROVED
SEPTIC INSPECTOR—HEALTH
DATE REJECTED j
COMMENTS /9/%1-2 G%f -)r=c) K"
PUBLIC WORKS—SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
b
FIRE DEPARTMENT DATE APPROVED
DATE REJECTED
COMMENTS
RECEIVED BY BUILDING INSPECTOR DATE
y
f
C
CERTIFIED
OC�ATEDINt
SCALE:1"=40'
n Scott L.
Uv 50 Deer
North A
CRICKET LANE
{
f
k
i
44'
46' D=88 58' 05'
L=38
T.O.W.=110.35 - - - -
EXIST, FOUND.
LOT 3A
431 �h� cp 43,846 S.F.
F:
OF
t I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE
o
.' THE OFFSETS OF THE BUILDING INSPECTOR ONLY
k SHOWN COMPLY AND SUCH USE IS FOR THE U i 872
I WITH THE ZONING DETERMINATION OF ZONING ER
BY LAWS OF a��L LA0
CONFORMITY OR NON-CONFORMITY
NORTH ANDOVER ,MA. WHEN CONSTRUCTED.
WHEN BUILT
11 /29/95
E F
t
t: 4
,
h
E .... _- _._.............. ..........., .. ,. ..,.:... .::..-:... r.-nrK... s - .bs --n,., ..'i•'s ,.. ..e .. .'�'a,i:, r.....,
NORThq
Town of Andover
No. "7 1 3 _ -
s 6 019 002
o A o dower, Mass.,
COC NIC HE WICK V
ADRATED
S BOARD OF HEALTH
Food/Kitchen
PERMIT T D Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT..0.wa"#...4#Thlef W..
C)Aff,g
............ .........S I&.................................................................................. Foundation
has permission to erect . �x. 0....... buildings on .... .q......Crt..C.. <.6 t .v............ Rough
V
to be occupied as..j4 . '.....GMAWAPA po• l 1 N r S i r 166 A G 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-Law7116
lating to the Inspection, Alteration and Construction of
Buildings in the Town of North Andover. j D/, � 1 Also SawPLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
(1') A 1 N'fi a 1^-> ) 0 ' Final
�,..o � ►,�m-� L I�e s PERMITEXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION ST
Rough
........................................ ........... ... .... Service
61000 0
......... ... .. .... . ..... .... ..
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'
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
(Type or print) t`� kx-a & -
v F ASSWHUSE ' Date A..�.��
Building Locations G� ��c.�_ '�P?eratit �,, 7 �j
Amount , ??,
.n
± Owner's Name
New Renovation13 13
Replacement Plans Submittedri
FIXTURES
d w
a
z w w x a
o' z S�
�. F � d
SiB®NC
•r
LSC FLOIR I
raRffR
V 3MRf
4M Rf=
` sm F.XR
` 6M ROR
7MRIM
M RIM HIE I I I
(Print or type) Check one: Certificate
Installing Company Name Galinsky Plumbing & Heating Inc. Corp. 1906
Address P.0_Rnx1701 Have rhi 1 _ MA n1 wu Partner.
Business Telephone 978-374-1743 Firm/Co.
Name of Licensed Plumber: Stephen C Gal'nskv
Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy MX Other type of indemnity 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 0
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 installati ns perform"gd
ermit Issued fbC this application will be in
compliance with all pertinent provisions of the Massachusetts mbi Ch ter 142 of the General Laws.
By: Signature 5yuLqFR&@q-t:Tum6er
Type of Plumbing License
Title
City/Town Icen mer '-�� Master ® Journeyman
APPROVED(OFFICE USE ONLY
`y MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBINQ
(Ptint or fypsl ��,
NORTH ANDOVER. Masa. Dated _lo
Bunding ol Permit
Location e
Owne la
Name �'i I ell i A,A.
New [�, Renovation ❑ Replacement Q Plans Submthed: Yes❑ No ❑
(/ FIXTURES
st w
_ w = -< «
f• w
w
} V < = y r
w i w a i yr k' s c w a
J re tY w M = w Fh u r w s w � = a f-
:� as
i = s • i
s>, w �' fe w a w ewr awi
b r O
1- O w 7 N t~ = O Q w = ! .4 V
sua—sxNT.
si►aar NNT
1sT FLOOR I
sr~o FLooR I_ LI L /
3140 FLOOR '
I
4TH FLOOR
STH FLOOR ' I
sTH FLOOR
ITH FLOOR
STH FLOOR — 1
lCheck one: CartWIcate 1
Installing Company Name 'C
❑Corp.
Address 7 L +, ❑Partnership
E t ❑Flrm/Co.
Business Telephone bl�Z l
Name of Ucensed Plumber
INSURANCE COVERAGE: Checx one
1 have a current IlabiRy insurance polr.1 or Ks Substantial equhralent Yes ❑ No ❑
It you have checked yej, p(esse..indicate the type caverage by checking the appropriate box
A IlablRy insurance peiicy Other type of k-odemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the Insurance coverage required by
Chapter 142 of the Masa. General Laws, and that my slgrature on this permit appilcation walves this requirement.
Check one:
Owner ❑ Agerst ❑
S4natuts of Ownet or Owner s Agent
1 hereby certify that alt of the details and information I hays aubehmsd for sntws4 In above appkatbn are true and sccwats to the bast of my
knowledge and that ail ptumbinq wak and InslaAatlons Wormed under the psrmA Iswsd Ws ap rrti bs In campAana with 0
partlnent provisions of the Massachusetts State Ptumb4ng Cada and maptw 112 0l tM laws.
Till*
na • sea c*r
Ctty/Town Ucens•Humber
-- Type of Plurnbtnp License: Master ❑
ArrnrJWD (OFF)CE USE ONLY) Journeyman 0
Date,!9 I./g 41" . .
TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
,SSACMUS�
This certifies that .�, . . . . .Q G . e . . . . . . . . . . . . . . . . . . . . . . . . . .
has permission to perform . . A).f.L'. ./�/O.H-t..... . . . . . . . . . . . . . . . .
plumbing in the buildings of . . . . . . . . . . . . . . . . . . . .
at C9 !Clic .� .l. h. . . . . . . . . . . . . . North Andover, Mass.
'I
Fee.36.?.7.Lic. Nou24/.3. .3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
PLUMBING INSPECTOR
02/07/% 11:35 363,00 PAID
I WHITE: Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File
The Commonwealth of Massachusetts O::lee Use Only
(a%�Pernle No.
. Department of Public Safety
Occupancy i Fee-Pwcked
BOARD OF F1RE�.FREVENTION REGULATIONS S27 CMR 12:00 3/90 (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All umrk to be periormed in accordance with the Massachusetts Electrical Code. 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL NFOR1=ON) Date C— IQ _q
City or Town of�, � (°Jj f �/� To the Inspector of Wires:
The undersigned applies for a'permit to perform the electrical work described below.
Location (Street & Number) r� Circuit #
Owner or Tenant
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 ElNo. of Meters
New Service Amps / Volts Overhead 1:1Undgrd ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work LOW VOLTAGE ALARM SYSTEM
No. of Lighting Outlets No. of Hot Tubs No. of Transformers Total
KVA
No. of Lighting Fixtures Swi�aing Pool Above In-
grnd. ❑ grnd. ❑ Generators KVA
No. of Receptacle Outlets No. of Oil Burners No. of Emergency Lighting
NBatte Units
No. of Switch Outlets No. of Gas Burners FIRE ALAKIS No. of Zones
No. of Ranges INo. of Air Cond. Total No_ of Detection and
tons Initiating Devices
No, of Disposals No. of Heats Total Total No. of Sounding Devices
Tons KW
No. of Dishwashers Space/Area Heating KW ITO. of Self Contained
Detection/Sounding Devices
No. of Dryers Heating Devices KW Local❑ liunicipal Other
Conner oil
No. of Water Heaters KW No, of No. of Low Voltage: urgqlar Q .Fire
Signs Ballasts WiringoCard Access r_7 CCTV
No. Hydro Massage Tubs No. of Motors Total HP
OTHER:
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts General Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or-its substantial
equivalent. YES Z NO ❑ I have submitted valid proof of same to this office. YES Q NO
If you have checked YES, please indicate the type of coverage by checking the appropriate box.
INSURANCE Ia BOND E] OTHER ❑ (Please Specify) ROYAL INSURANCE COMPANY 10/8/96
• (Expiration
Estimated Value of Electrical Work S
Work to Start Inspection Date Requested: Rough Final
Signed under the penalties of perjury:
FIRM NAMESecurity Systems Inc. d/b/a Sentry Protective Systems LIC. NO. 1109C
Licensee JAMES W LEES Signature LIC. NO.000080 (
Address 110 FLORENCE STREET, MALDEN MA 02148 Bus. Tel. No617-388-9700
Alt. Tel. Nog00_445-4505
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its sub-
stantial equivalent as required by Massachusetts General Laws, and that my signature on this permit
application waives this requirement. Owner Agent (Please check one)
G # Telephone No. P£RMIT FEE S
6D G�4V Signature of Owner or Agent
' n Date. ..
Tn 2905
� �aORTM
°ft"`°:•-14,° TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
,SSA:"USES
This certifies that ......, C'.t!.7 tf..... ja.k. .if.1....S
... .. .. ..
.............................
has permission to perform ....... .........
wiring in the building of.......�=.A.......(.QG!J.�. ...........................................
at......� ........L.U..................... .North Andover,Mass.
Fee..�....� ... Lic.No. /d /. ...............................................................
ELECTRICAL INSPECTOR
C Ci tt Q� cj�' 3/07/96 13:15 35.00 PAID
WHITE:Applicant CANARY:Building Dept. PINK:Treasurer GOLD: File
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTI ' t
(Print or Type)
NORTH ANDOVER Mass. Date Z-, '2
s ' {huilding Location y G y L�f y) Permit # /p /
Owners Name
P_ffl 1� �•
- New 'T Renovation D Replacement Plans Submitted D
FIXTUo-c
as
m Cq
tt
N C9 V Cr G1 .
Cf
W ur G O VF-
O .AUA z t7! O Z trs
C t:- < y- O t- G
tL m W 6 to W O O a G W 4
tt! rL N a U W as '� K Q O q y tst
W tu W J = Q n= G G tit W
O t- .1 f- �.. us O ? tz t.- U -A I.- to
d W G C F- }- v! m = O = W O N 2
Q ,ra > G W < C < Q O O to G O W t-
Q O 0 = t:. q n O -4 o. t- O
BASE141ENlT
'ISTFLOOR
2MOFLOOR
3RQ FLOOR
4TH FLOOR I I I I I I I I I I I
STH FLOOR ( ( ( I
6TH FLOOR
TT)t FLOOR ` }
STH FLOOR
(Print or Type) Check one: Certificate
Installing Company Name gyp, ��/�d`/l Q Corp.
Address -23 f-72 Partner.
Firm/Co.
Business Telephone:
Name of Licensed Plumber or Gas Fitter ,��,� ��„�.✓
Insurance' Coverage: Indicate t:^e t:/pe of insurance coverage by checking the
appropriate box:
Liability insurance policy Other type of indemnity 0 Bond
Insurance Waiver: I , the undersicned, have been made aware that the licensee of
this application does not have any one of the above three insurance coverages.
Signature of owner/agent of property OwnerAgent
1 hereby certify that all of the details and information 1 have submitted (or entered)in&Love application are true and arcuate to the best of my
knowledge and that Q plumbing work and lnstatlations performcd under-Permit issecd fo: this application will-be in compliance with ad pertinent
provisions of tho Massachusetts state Cas trade and Chapter I4'.cf tae General Laws. '
By YPE LICENSE: �J
Title Plulriber Si nature of Licensed
Gasfitter 4
City/Town: Master Plumber or asfitter
ourneyman Z JJ
APPROVED (OFFICE USE ONLY) License Number
� �. ,
U
� /L�v
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO GASFITTING 1
(Print or Type) /
t NORTH ANDOVER Mass/. Date Z-. -2
7
I uilding Location y Cy [J/� G Permit # a ID /
Owners Name
- New 71 Renovation Replacement Plans Submitted D
S FIX,T(_to_c
� v
� W N
G1 Z M (A W W m e o o m �- I s as
W
r
N a in W 1° °� o > w
w z v W '- at � a a F-
tyr W Q� J Q C �+ C Q W W
= W 0 0
0 W
p is t% O t�1 -fit V C y G n0. FW- O
BASEMF-MT
ZST FLOOR
2ND FLOOR
3RD FLOOR !!
4TH FLOOR I I I i
STH FLOOR ( 1 ( E y
6TH FLOOR f
TTHFLOOR ' I
STH FLOOR ( I
(Print or Type) 1 Check one: Certificate
Installing Company Name Q,/ Q Corp.
Address---2 3 Partner.
z G Firm/Co.
l
Business Telephone:
Name of Licensed Plumber or Gas Fitter Z-14,11 „�
Insurance Coverage: Indicate t`'e type of insurance coverage by checking the
appropriate box:
Liability insurance policy Other type of indemnity Q Bond Ej
Insurance Waiver: I , the undersicned, have been made aware that the licensee of
this application does not have any one of the above three insurance coverages.
Signature of owner/agent of property Owner 17 Agent
I heteby ecrtify that all of the details and information l have submitted (or entered)in above application are true and accurate to the best of my
knowledge and tlsat all ptumbi" work and Installations ;.erforsted under-Ptrmit iuced fo:this application rill-be in eompGanos with all pertinent
provisions of tho Massachusetts State Cas Cude and t3apter 141 ct two General Lars.
By YP� LICENSE: �J
Plumber
Title PlumbGasfiter Signature of Licensed
Master Plumber or asfitter
City/Town: Z �
APPROVED (OFFME use ONLY) ourneyman License Number
ata21 a l. . ..... ..
of N0 RT e ,ti TOWN OF NORTH ANDOVER A
PERMIT FOR GAS INSTALLATIOIF
s o� _„_ �a � •
�9SSACNUSES
This certifies that . . . G V.t --p . . . . . . . . . . . . . . . . . . . . . . . . I
has permission for gas installation
in the buildings of . . . . . . . . . . . . . . . . . . . . . . . .
.
at .�.4 ��.`� %�!f.% -.?`�` . !'�-. . ., North Andover, Mas.
Fee. Lic. No..?.Y-%' .3.
GAS INSPECTOR
WHITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD:File
4
(S IL (�IIIITIIIIII mzan III �1ZtL� � Petmd Notttcs Use CMI i� i'i (� !�
ft=== of�;Uhrlr Cc=pancI&Fee C.lecMd
q
SCARO OF FIRE?RE'ieMCN REMLATIMS =- VIR 12:00 3190 peeve blank)
APPLICAT ION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in at wrdance with tre Massacrusetts S:ec ricai Cede. 527 CMR 12:00
(PLEASE PRINT 1N INK OR TYPE ALL INFCRLIATION) pate 2-
aYv or Town of NORTH pyDOV E R To the Inspector of Wires:
The udersigned acpiies for a permit to pertorrnz=e eiec=cat •Norio described detow.
ti
Locaon G
(Street 3 Numcer) 12.(
Cwner or Tenant
Cwner's Adcress l3 G,�- +'��� l3dxA)
Is this permit in cCn•Iunc:ion 'Kith ouilr,ir. ;erllt: Yes NO tC`.eck AC^.rCCrtaie ECXj
Fur^cse of Ouiicir.c_ ��Q �y Utility Aumcrization No.
c..is;nc _cerrics Ar„es ' �-/7,�1l��,/'� 1
`/c:a Cverneac _ Unc_r ro ��Nc. of Meters
Ne"� = ^JIc? _Amcsl�r-1L=/tits Cvernea_ _ l;. _ NO. Of Meters
Numz:ar zf =eecers ar.c Ar^cac:ty
��52� -� GU(/L e &2 DC-w Q 2 —�fii c �i
ar.= N a-_;, _. . _ -
.0;at
No. _. _ - nng __.:ets •c. -. -c. -== No. 'ans:ormers S.A
No. c. _:g-t:ng =x::res 2� Sw.r..mtng
�T_`_e_ cM _ I Generators KVA
- No. at Emergency '�gnttng
No. a -----ac:e =ut••ets No. =
CJ _.rays _ ..ari units
. Swoon C-avets j No. =. Sas E_.-_._ I • L>?.MS / No. et -7_res
:a: No :t _et_c::cn arc i
No. ang=_s 1c. =• ;:r =-• c. :rs I tr.:ttating7evtces
a14 c. ea: _:at oat I
No. .r sccsats - pu,-_s -a-_ No. zr Scurc rig Zevtces
No. cr Sed Coniatnec
No. --r _isnwasners SaacsrArea -__..r- f:t Cetec=,Sounctng Cevtces l
Muntc:cat -7C:ntar
No. cr �^jers '•-!eat-- =ev:ces [:J I -=cat Cannec::crt
No. =r +o. _ I _.vv `Jcaage
No. :r •.Vater -teasers !C:! S:cas =-a..-_. _
No. =vcro .tassaceacs NO. _. .e._._ -.-. --
i
NSL;„sNCS "'JE=AGc. ?_rsuant:a the recuuemems ;er.erat Laws _ _
: rave a current t_.aetiity insurance ?alit', •nc:.;Cr..9 C` Y',fisc C_era:cns Coverage cr ;;s suas:annai ecutvatent. YES _ NO _
^•ave st�mtree vatic c et of same :o :no C!tice. YES Nc = �t-,cu nave c-ecxec `•'ES. :tease incicato ::+e tyFe at a:veraSs _v
necxtng :rte acc:v- to oox.
INSL:RANCE 3CNo = OTHER = tPlease S_ec`,f
_ (Excitation _asst
=s::nates".(at et E:erseat((w�arK 5
:Dern :o Star. J ' / l (, tnscet~_an Cavi -ee_as:ec: ncugn ( / ;r+nat
SSgaec :moor no Perattest of et7ury:
R!.t NAME �i2/1l�I uC. VO.�Z`71t�)
_consee �_� , /S S:grat-:reCNO.
I Bus. :at. No. S� tlO'o✓ZD 7 3
ACCress r'COpt6/'1 .alt. :el. No.
CwNER'S tNSUSANCE WAIVER: t am aware a:at Te :_-c-^See_ccs -ct rtave :ns nsurarce overage or its suostanttat taurvaunt as re-
eutreo 7y uassacnusatts Gonerat laws. ane mat :-Ty s:s-3:,r* =n -:s :erm:t aC ttCaticn warvas iflti feeutfem�nt_ tiMTef Agent
.Please cnecx ane►
i,ecncr.e No. PERMIT FE= S
iS;gnatwe of Cv.ner=r Agent► -
n 867 Date.....
f NORTH
" TOWN OF NORTH ANDOVER
0
PERMIT FOR WIRING
SSACMU
I
h
This certifies that .... A.z....... ���?.��.�5.!................................................
' has permission to perform 1��..s. 1........... �� }
wiring in the building of.........la.�?............. .............................
at../Y......... .�. ..... lu...................... .North Andover,Mass.
i' �
�� v ' 5 ��
Fee. .......... ..... Lic.Not.....I . . ...................... .ICA..NS ........TO .................
ELECTRICAL INSPECTOR
i 14
��JJ
17
02/13/V124 362.04 PAID
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File
^ •• - Office Use Only i
_•��� C�omntnnw�ttl B1tH>`1 Permit No. if V
�?7 �
lepmt1timt of JIuhuC *afdV Occupancy A Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS.527 CMR 12:00 3M rt peeve blank) -. f
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 IN INK OR TYPE ALL INFORMATION) Date /7
T& or Town of NORTH ANDOVER To the Inspector of.Wires:
The udersigned applies for a permit to perform the electrical work de sc ibed below.
'2L Cc7�r"e St�ruvte c �lCt;r�
Location (Street & Number) -
Owner or Tenant ( iA
a Owner's Address
Is this permit in conjunction with a building permit: Yes CLQ No ❑ (Check Appropri-a7te Box)
Purpose of Building 0`11107 ���'�•� Utility Authorization No. SO / ��
3
Existing Service Amps —J Volts Overhead � Undgrnd ❑ No. of Meters
New Service Amps -LZ:�JZY1A Volts Overhead ❑ Undgrnd ❑ No. of Meters
Number of Feeders and Ampacity
l
Location and Nature of Proposed Electrical Work r eyt� r✓ v ��
No. of Lighting Outlets i No. of Hot Tubs I No. of Transformers Total
No. of Lighting Fixtures ISwimming Pool Above— In- i1
grnd. _ grnd. I Generators KVA
No. of Emergency Lighting
No. of Receptacle Outlets I No. of Oil Burners I Battery Units
No. of Switch Outlets I No. of Gas Burners FIRE ALARMS No. of Zones 1
No. of Ranges No. of Air Cond. Total No. of Detection and
tons Initiating Devices
No.of Heat Total Total
No. of Disposals Pumps Tons KW No. of Sounding Devices
No. of Self Contained
No. of Dishwashers I Space/Area Heating KW Detection/Sounding Devices
No. of Dryers I Heating Devices KW Local �7 Municioal EOther
Connection
i No. of No. of Low Voltage
No. of Water Heaters KW I Signs Ballasts Wiring
No. Hydro Massage Tubs I No. of Motors Total HP
OTHER: // �(�n
t
INSURANCE COVERAGE: Pursuant to the requirements of Massacnusetts general Laws
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES = NO _ I
have submitted valid proof of same to the Office. YES t---5-0 = if you have checked YES. please indicate the type of coverage by
checking the appropriate ox.
INSURANCE ND -- OTHER = (Please Specify)
(Expiration Date)
Estimated Value of Electrical Work S
Work to Start Inspection Date Recuestec: Rough -` J Final
Signed under the Penalties of perjury: (�
FIRM NAME �l�t2 21 S I LIC. NO.
Licensee 6 f Signature LIC. NO. 2
Bus. Tei. No. Sb 7
Address Alt. Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re-
quired by Massachusetts General Laws. and that my signature on this permit application waives this requirement. Owner A nt
(Please check one)
�-
Telephone No. PERMIT FEE S
(Signature of Owner or Agent)
x-5565
Date....�.2. .�.�.�..`��.....
T' 2752
t NortrM 1
+ TOWN OF NORTH ANDOVER
p PERMIT FOR WIRING
♦ " i A
'r► wOwwr�o�P"qh Q
,SSACHUS� OL
O
This certifies that ........� ....... .... ......... .......................................... In
has permission to perfor�npl_ "... . ..................................
wiring in the uilding of....:.... ...�f..r.l!%Q: .............................
at..1. 4° �.. ..:....................... .North Andover,Mass. Ln
Fee....�...n... Lic.NO421- leU..............................................................
ELECfRI�L INSPECTOR� �j
WRITE:Applicant CANARY: Building Dept. PINK:Treasurer GOLD: File
I
Location ep,,c m
No. Date B q
pf NpRTM TOWN OF NORTH ANDOVER
-
F. p Certificate of Occupancy $ —
*} ° Building/Frame Permit Fee $
Foundation Permit Fee $
*CMUS
Other Permit Fee $
1 Sewer Connection Fee $
Water Connection Fee $
TOTAL $ Z5
Building Inspector
ff p / /95�3:12 154.40 PAID
- 8803 Div. Public Works
i
lO 2�
Location
No. S Date
VA T1l TOWN OF NORTH ANDOVER
Of'1600 "
Certificate of Occupancy $
• : . Building/Frame Permit Fee $#
s'ATOO Foundation Permit Fee $
Other Permit Fee $
Sewer Connection Fee $
�90 Water Connection Fee $ 1677.50 °
,i
TOTAL $
���� Bu' g l Alp r
40919. iah•i l i,an.so gainOlt
(� !,6 f Div. Pu is works
ni �AqE�Locatiom {40z4c --�T
—No.
Date 1:�6x
H°RTN TOWN OF NORTH ANDOVER
„ Certificate of Occupancy $
Building/Frame Permit Fee $ 14
73 -
!i SSACMUSEt� Foundation Permit Fee $
d Other Permit Fee $
i
Sewer Connection Fee $
Water Connection Fee $ '—
TOTAL $
Building Inspector
_
12/18/9514:37
8809 Div. Public Works
f
i,ARMiT NO. 9sq APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVEW, MASS. / PAGE 1
MAP K40. /o I LOT NO.- 2 RECORD OF OWNERSHIP IDATE (BOOK ;PAGE
ZONE SUB DIV. LOT NO.O O,
LOCATION �4 PURPOSE OF BUILDING �1/ir /L/�y/� —� �I�Q �r�
���-lCe� ' LA O
OWNER'S NAME /�/I/. x 1 f NO. OF STORIES Qi1 SIZE /�� 2 w / ep
OWNER'S ADDRESS/���c/�� �C..4�JUe� BASEMENT OR SLAB �b�F�F���
ARCHITECT'S NAME e1,,ry, N ,./ 1 SIZE OF FLOOR TIMBERS 1157 IJ2ND Z�/IO 3RD
1 BUILDER'S NAMEcs/ vIi SPAN
DISTANCE TO NEAREST BUILDING (501,
D DIMENSIONS OF SILLS 2-x (o
DISTANCE FROM STREET q,,/ POSTS
DISTANCE FROM LOT LINES-SIDES�k I REAR / 0 "" GIRDERS '� 2 -z-
AREA
z-
AREA OF LOT (,/L/ U FRONTAGE 2 I HEIGHT OF FOUNDATION Q THICKNESS /d I/
IS BUILDING NEW jT ea L SIZE OF FOOTING �} V �V X
IS BUILDING ADDITION ,116 MATERIAL OF CHIMNEY S($rV1 A
IS BUILDING ALTERATION /�to o IS BUILDING ON SOLID OR FILLED LAND►7 sQ 3 /10
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE yes IS BUILDING CONNECTED TO TOWN WATER `j ct-
BOARD OF APPEALS ACTION. IF ANY Al A IS BUILDING CONNECTED TO TOWN SEWER Ala
IS BUILDING CONNECTED TO NATURAL GAS LINE ,Y
INSTRUCTIONS 3 PROPERTY INFORMATION
SEE BOTH SIDES
PERMIT FOR FOUNDATION ONLY LAND COST /Z2-,
REGULATED BY PARA. 114.8-S. B.C. EST. BLDG. COST !,1 •a-� �J/I III O
PAGE 1 FILL OUT SECTIONS 1 - 3 EST. BLDG. COST PER SQ. FT. ycl ,G L
PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM 7�
pAip V�J� SEPTIC PERMIT NO. �
ELECTRIC METERS MUST BE ON OUTSIDE OF BUILDIN PATE [n1 ^ q APPROVED BY
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
DATE FILED I (1
V;�MUILDING INiP[CTOR
SIRE OF OWNER O_ R AUTHORIZED AGENT
F`E E �5�3 �' OWNER TEL.# -W6-4;d`-&7k92,
Zr
PERMIT GRANTED qj Ya PERMIT FOR FRAME/BUILDING CONTR.TEL.#
19 -- DATE: fEE PAID CONTR.LIC.# 442 I.S
H.I.C.#
mum
SEP 7 � I,�P
3 . g8C'.�
of f�Pa_
Q f
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY STOHIES 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
2 FOUNDATION I 8 INTERIOR FINISH
CONCRETE d t 2- I3
CONCRETE BL K. —{ PINE
BRICK OR STONE HARDW D
PIERS PIASTER
_ DRY WALL _
UNFIN.
3 BASEMENT
AREA FULL FIN. B'M'T AREA _
'/ 1/7 '/ FIN. ATTIC AREA
NO B M FIRE PLACES T
HEAD ROOM MODERN KITCHEN
4 WALLS I 9 FLOORS
CLAPBOARDS A B 1 2 3
DROP SIDING CONCRETE �_
WOOD SHINGLES EARTH _
ASPHALT SIDING HARDVJ'D _
ASBESTOS SIDING _ COMIACN
VERT. SIDING ASPH.TILE _
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY ATTIC STRS. & FLOOR _ ^,
BRICK ON FRAME I r• l t
CONC. OR CINDER BLK.
STONE ON MASONRY WIRING
STONE ON FRAME _
SUPERIOR I� POOR _ �,. •A
ADEQUATE NONE -`
5 ROOF 10 PLUMBING
GABLE I I HIP BATH (3 FIX.)
GAMBRELMANSARD TOILET RM. 12 FIX.)
FLAT H SHED WATER CLOSET
i
ASPHALT SHINGLES LAVATORY _
WOOD SHINGES KITCHEN SINK
SLATE NO PLUMBING
TAR & GRAVEL STALL SHOWER T
ROLL ROOFING MODERN FIXTURES
TILE FLOOR
TILE DADO
6 FRAMING I 11 HEATING
WOOD JOIST PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER BMS. &COLS. STEAM
STEEL BMS. 8 COLS. _ HOT W'T'R OR VAPOR
WOOD RAFTERS _ AIR CONDITIONING
RADIANT H'T'G •+..i.•-e«-*,.,.....:+a .._�,. _......s•..-. •+ f
UNIT HEATERS
7 NO. OF ROOMS GAS
OIL
B'M'T 2nd _ ELECTRIC � � �y•
1st 13rd I NO HEATING
°R y
� yLocation
No. � Date
NORTIy TOWN OF NORTH ANDOVER
O'tt�•o ;•'1�.0
Certificate of Occupancy $
+ ; Building/Frame Permit Fee $
Nis<� Foundation Permit Fee $
~Permit Fee $
Sewer Connection Fee $
I,
Water Connection Fee $
TOTAL $
I
�,� X30/96 16:44 25.0 wilding Inspector
9537 Div. Public Works j
i
_y
H.P. NELSON Town--of 120 Mak st. 01845
Dinvo, !n : - . --- (508) 682-64M
-
BUILDING ' 41NORTH ANDOVER
CONSERVATION ^' ommoxof
HEALTH
PLANNINGPLANNING & COI�BIL-IN= DEVELOPMENT
-: CHIMNEY APPLICATION AND PERMIT
A rJ C
, PERMIT J 7 S
DA.,AE
LCCXTT-ON Z 8-F' 3 e C R )
OWNER I S NAIME
BUILDERS NAII2T ffz7-SS! 'y,4 -
MASON I S NAME
m.kSON IS ADDRESS
- �_.t2.S,^..N I S TEL.EF:ONE
HATERZ'17. OT
IiTERIOR c::I:�aiiE t S7"�jv� E:{TERIOR C---7
A:TD SIZE OF :
-H7C'-^rES�Z of HEART:
Will - ?;ney or f..= _� co-: ._. �:. -e��ire�ents of t .e cote a-
V..al
have rides and red ____..::s oee.. rscei�'�ed
DATi
SIGI;AT'URE OF MASON �LG_�� <���n CONTR. LIC.
• EST CONSTRUCT1.0'll
' PE-RI:TT GRk ITEE) -
ROBERT NIC-1TA' , LL.+..J—. ` _•.�.re.�VR /�� �Cip
INSPECTED
REXARRS
-� �^TC7 Rz'r1UIREn
THIS PE_RY-IT MUST BE DISPLAYED ON THE PR.ZXT-SES
r
//tut[+ItN+G'R(/li [l, l rL1Jrlr'�rrJc«J
DEPARTMENT OF PUBLIC SAFETY 1
CONSTRUCTION SUPERVISOR LICENSE '
Nusber: Expires: Birthdate:
CS 042529 12/16/1995 12/16/1955
Restricted to: 00
Co d ARMANDO PI220
lk 153 PIIn AN ST
y
ss�°lkl, METNUEN, MA 01844
A
f
1 4
CERTIFICATE OF USE & OCC 1 . -
Q
4/7 -
Building Permit Number / S Date -_
THIS CERTIFIES THAT
THE BUILDING LOCATED ON I
MAY BE OCCUPIED AS
WITH THE PROVISIONS OF THE MASSACHUSETTS STATE B iJ ? .
SUCH OTHER REGULATIONS AS MAY APPLY.
CERTIFICATE ISSUED TO —'
.' ADDRESS _
Aw
N) :
Tovm
No. " 57Z
ZE--�' '-- -- --- -- -
S
111
PERMIT ..iM: - � r /•1
II
THIS CERTIFIES THAT.1je=LYSE,4..... ........Q........................... _
has permission to erect- .... ..tCMYZ. buildings on ,.14.......' tc t"......
to be occupied as`, LW—'.LC..... 1Aii11p`eiit
1.x.1 � J ......z...4d.Q....provided that the person accepting this shall in everyyrespe t conform to the teras �; :...
this office, and to the provisions of the Codes and By-Laws relating to the Inspectio� E,i .
Buildings in the Town of North Andover. --
VIOLATION of the Zoning or Building Regulations Voids this Permit.
PL_ __ . .�u .. iGI . . ,N..
JN' ' �,r
PERMIT FOR FRAMUBUILDING y - ,
...
DATE: Z ��FE SAID•
:".quirc_'J to Occupy
Display in a Conspicuous Place on the Premises — L
No Lathing or Dry Wall To Be Done
Until Inspected and Approved by the Building &: :: .
PLANNING UL FINAL CONSERVATION_:
SEWER/WATER_ `1^_i J FINAL DRIVEWAY EN7,; ,
PHONE CALL
A.M.
FOR DATE TIME P.M.IN
M 09
PHONED
OF
RETURNED
PHONE YOUR CALL
AREA CODEBER E>VPNSION
MESSAGE PLEASE CALL
WILL.CALL
AGAIN
GPME TO
5.�E YOU
WANTS TO
SEEYOU,
SIGNED TOPS sy,
FORM 4003
NORTH A.
0� 6 �,Y0 •
�l CLAKE \
T �� COCMICMEwICK v
ORATED PPS ��
�SSAC HUS��
APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION
ADDRESS/LOCATION OF PROPERTY:_r, ¢
/
DATE REQUEST FILED/READY FOR INSPECTION: b
CLOSING DATE ON PROPERTY: Z �o
FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED._
ALL WORK AND SIGN-OFFS MUST BE COMPLETED WITHIN THIS TIME FRAME.
A RE-INSPECTION FEE OF TWENTY DOLLARS ($20.00) WILL BE CHARGED IF
THE STRUCTURE DOES NOT MEET ALL APPLICABLE CODES.
SIGNED•
NORTH
Town of 41 b Andover
0 ,
No. Iq
4 5
I -
C) E ATor ndover, Mass.,
COCMICHEWICK
°RATED PPP '��
'9S BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT.1jMiT4 ...1�1.�.
�.. VeU-fhe4 �QT........ .................................................... _o�,nd�ti t2CgtS'f
has permission to erect.. '....-1?OIIII'Z. buildings on .14..... 4! F.. ........�40E......---...................... Rough
to be occupied as�l F�F�1 �1 . ..�1!�J�] �U�. �......�...�.e.... .QAQ4P ............................ Chimney
provided that the person tin this err�it shall in everC res eQt conform to the terms of the application on file in
p p accepting P Y p Final
this office, and to the provisions of the Codes and By-Laws relating to the InspectiokA fti 1D"i9N0
Buildings In the Town of North Andover. REGULATED BY PARA. 114.8-S. B.C. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
PERMIT EXPIRES IN 6 MONS FEE PAID Final
UNLESS CONS Q T'� ELECTRICAL INSPECTOR
Rough
... . ... ....... ... .. ..... ... . ... Service
B ILDING P�i� TOR0C?
Final %�"zi /
Occupancy Permit Required to Occupy Building "I , GA'W&'1KCTOR
Display in a Conspicuous Place on the Premises — Do Not Remove o`�� Fi ughQQ�Q
Lathing Dr Wall To Be Done
No Lat g or y Q6�� FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector.
. Burner
PLANNING FINAL CONSERVATION FINALIr�� street No.
Smoke Det.
SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT
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: ACV-, eve Phone 420 -gTof�
LOCATION: Assessor's Map Number Parcel 1-1
Subdivisions 2 Lot(s)
Street St. Number 14
************************Official Use Only************************
RECOMNSENDA IONS OF WN AGENTS:
/ Date Approved v II gS
Conservation Administrator ( lDate Rejected
Comments
3
Date Approved Q qe5-
Town Planner Date Rejected
Comments
Date Approved
Food Inspector-Health Date Rejected
_ ��
AtJf Date Approved
e�S ptic Inspector-Health Date Rejected
Comments
Public Works - sewer/water connections
- driveway permit _ Ll
k) 8-9 �f
Fire Departmentaav,4,
Received by Building Inspector Date
SEP 7
CERTIFIED PLOT PLAN
LOCATED IN NORTH ANDOVER , MA.
SCALE:1"=40' DATE:11/29/95
Scott L. Giles R.P.L.S.
50 Deer Meadow Road
CRICKET LANE North Andover, Mass.
44'
4s-
N D=88 5 = 25.00,
L-38.82'
T.O.W,=110.35 W
EXIST, FOUND. LU
LOT 3A C0
431 43,846 S.F. Ix
W
()
I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE �tl1 OF
THE OFFSETS OF THE BUILDING INSPECTOR ONLY ��� s
SHOWN COMPLY AND SUCH USE IS FOR THE t 4
97
WITH THE ZONING
DETERMINATION OF ZONING <" CrgtERE Qg`�
BY LAWS OF CONFORMITY OR NON-CONFORMITY �< LANA
NORTH ANDOVER ,MA. WHEN CONSTRUCTED.
WHEN BUILT
11 /29/95
NpRT1y
Tomin t of over
0
No. 430 -
C,o - �A - O: dover, Mass., g N
COC MIC ME WICK V
ADRATED
S H BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
eaI WA R 61 * �V0P V It CO M� BUILDING INSPECTOR
THIS CERTIFIES THAT.......................................................................................................... Foundation
. .........
Oje
0
has permission to erect... ........!3�....... buil 'ngs on ...41 ......................................................... Rough
,r
t0 be OCCUpled as �.�. r........ .............� ..... �• Chimney
..................�. . . . ................
provided that the person accepting this perm' h I in ev aspect conform to the terms of the application on file in Final
this office, and to the provisions of the Code By- relating to the Inspection Iteration and ktrution of
Buildings in the Town of North Andover. ' a PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations yids thi Per . Rough
�
v41A.JS,V„..-10 Final
PE E S 6-'MONTHS
v1— 0 OO ELECTRICAL INSPECTOR
-ESS cfis S
Rough
f:......
............................................................. Service
BUILDING INSPECTOR
Final
Oc a cau p e uired to OBuilding GAS INSPECTOR q � g
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.
GENERAL BUILDING NOTES/CHECKLIST- NOT LIMITED TO ITEMS BELOW
POST ALL LOT NUMBERS,ADDRESS, AND PERMIT(COPY OK)..or no inspections
INSPECTIONS: (Minimum) Excavation , Footing, Foundation, Frame, Insulation, Final.
FOOTINGS: Continuous Full 2x4 Keyway
Continuous strip footings for interior columns
FOUNDATION: Rebar as required
Anchor bolts or straps
Damproofing
Foundation drain-pipe/stone/fabric filter/cover and outlet connection.
FRAME:Fireblock-over girts/plates between floor joist
Penetrations for plumbing, heat, elec, etc.
Walls at stair stringers.
Windbrace corners and center bearing partitions.
Size ridge to provide full bearing at rafter cuts.
Hip and Valley rafters-watch bearing at walls.
Ridge&Hip-Provide proper connections.
Cathedral roof rafters provide proper connections and use"Hurricane Clips"tie to plate.
Stair stringers-watch cuts and heal support.
Joist hangers-fully nailed w/hanger nails.
Sill plates 2-2X6(1 PT)w/sill seal.
Girls-solid brick or steel plate bearing at foundations
'/2" air space at sides in foundation pockets.
Lateral bracing at ends.
Certified calculations. required for Beams/LVL's Trusses.
Solid bearing support for Headers/Beams etc.
Check headroom clearances-stairways, under beams
Attic Access. (min.22x30 w/3' headroom above).
Crawl space access. (min. 18x24).
Bath exhaust fans to have metal duct to exterior(not in soffit).
Firecode S/R wood frame of"0"clearance fireplaces&stoves
Window Schedule or Every Habitable Room Must Have:
Natural light equal to 8%of floor area.
of required glazing shall be openable.
Bedrooms required min. 20x24 egress window or door.
Vent attic spaces-"proper vent", soffit and required ridge vents.
Firecode under stairs if used for storage
FIREPLACES: Separate permit required.
Inspections at Footing-Smoke Chamber- Finish
Smooth parging, clean joints, 8"solid @ combust. Surf.
DECKS: Separate permit required:
Lag to house, provide flashing.
Rails min. 36" high, Baluster max space 5"on center.
Over 8'above grade, use 6x6 posts w/lateral bracing.
Lag all posts and rails.
Pier footings down 48", Conc. pad at stair base.
FINISH: Handrails returned to wall/newall post.
Guardrails required alongside open cellar stairs.
Exterior grading complete.
Certificate or occupancy required prior to occupying structure.
Temporary Stairs required for inspection.
Re-inspection fee-$25.00(Be Ready).
Certificate of occupancy required prior to occupying structure.
i.
d
1
CERTIFIED PL
LOCATED IN NOS
SCALE:1"=40'
Scott L. Gi
50 Deer M
North And(
` CRICKET LANE
44'
461 D=88 58' 05"
.4 L=38.8
T.O.W.=110.35
EXIST, FOUND,
i
AcK .£a Nb
LOT 3A
p 43,846 S.F.
43' l b' 11,30` p
-2 PCs-bl�
Oi
I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE �S�
THE OFFSETS OF THE BUILDING INSPECTOR ONLY o0
SHOWN COMPLY AND SUCH USE IS FOR THE J
972
WITH THE ZONING DETERMINATION OF ZONING ��" GSTEa���
BY LAWS OF CONFORMITY OR NON-CONFORMITY Dkd( LAOS
NORTH ANDOVER ,MA. WHEN CONSTRUCTED.
WHEN BUILT 11 /29/95
f
.. ...-... ...,..: .-- ,.... I'..r:-'K.,.;.YS..: ....r'.,•fF-.4 .V..X..:, ..,•� n t ..r.s.::i .:..
TOWN OF NORTH ANDOVER
BUILDING DEPARTMENT
APPLICATION TO CONSTRUCT REPAI RENOVAT OR DEMOLISH A ONE OR TWO FAMILY DWELLING
..r.w�"M%"
BUILDING PERMIT NUMBER. 3A DATE ISSUED: A �
X
SIGNATURE: _4M/# W, —1
Building Commissioner/I for of Buildings Date Z
SECTION 1-SITE INFORMATION 0
1.1 Property Address: 1.2 Assessors Map and Parcel Number:
6011
14-
Map Number Parcel Number
1.3 Zoning Information: 1.4 Property Dimensions:
O
Zoning Dis_tiic_t Proposed Use Lot Area Frontage ft
1.6 BUIIAING SETBACKS ft
Front Yard Side Yard Rear Yard
RegWred Provide Required Provided Recmired 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 ❑ Municipal 0 On Site Disposal System 0
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M
2.1 Owner of Record 00
Nam rint) Address for Service
twill,
Signature Telephone
2.2 Owner of Record:
Name Print Address for Service: O
Z
M
SiSpature Telephone
SECTION 3-CONSTRUCTION SERVICES 90
3 l Licensed Construction Supervisor: Not Applicable ❑
Licensed Construction Supervisor: O
License Number
Address
Expiration Date
Signature Telephone r
3.2 Registered Home Improvement Contractor Not Applicable 0 v
Company Name
Registration Number M
Address _r
Expiration Date ^z
Signature Telephone Y♦
SECTION 4-WORKERS COMPENSATION(M.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.......❑ No.......❑
SECTION 5 Description of Proposed Work check au applicable)
New Construction ❑ Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition ❑
Accessory Bldg. ❑ Demolition 0 Other ❑ Specify
Brief Description of Proposed Work:
SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar)to be OFFICIAL USE QNI:Y
Completed by permit applicant
1. Building �q (a) Building Permit Fee
Multiplier
2 Electrical (b) Estimated Total Cost of
Construction
3 Plumbing Building Permit fee tel 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
NO. OF STORIES SIZE
BASEMENT OR SLAB
SIZE OF FLOOR TIMBERS iST2ND 3 RD
SPAN
DIMENSIONS OF SILLS
DIIv1ENSIONS OF POSTS
DIMENSIONS OF GIRDERS
HEIGHT OF FOUNDATION THICKNESS
SIZE OF FOOTING X
MATERIAL OF CHININEY
IS BUILDING ON SOLID OR FILLED LAND
IS BUILDING CONNECTED TO NATURAL GAS LINE
( 5Y30 1) 60---e GOA-14 POal -7-3( - Qc-3
r
FORM - U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve the
applicant and or landowner from compliance with any applicable requirements.
APPLICANT&C? ��� ���lF' PHONE 6j'4 ;'y���
ASSESSORS MAP NUMBER(/ & LOT NUMBER Aa'
SUBDIVISION LOT NUMBER
STREET/Y(7/
OFFICIAL
E i'7p � STREET NUMBER_ ���u1l/e�, ,
OFFICIAL USE ONLY
.RECOMMENDATIONS OF TOWN AGENTS e
. .......................................................................
DATE APPROVED4-6W V
CO ERVATION ADMINISTRATOR
Q \ L r DATE REJECTED
COMMENTS V>
DATE APPROVED
TOWN PLANNER
DATE REJECTED
COMNIENTS
DATE APPROVED
FOOD INSPECTOR-HEALTH DATE REJECTED
---�J / �C�L/ DATE APPROVED 3/ 10
SEPTIC INSPECTOR-HEALTH
DATE REJECTED
commENTs
PUBLIC WORKS-SEWER/WATER CONNECTIONS
DRIVEWAY PERMIT
DATE APPROVED
FIRE DEPARTMENT
DATE REJECTED
CONMENNTS
RECEIVED BY BUILDING INSPECTOR DATE
f
f
8
f
1
i
105.U
t
CERTIFIED PL LOCATED IN NOI0�
SCALE:1"=40'
Scott L. Gi
50 peer M
North Andy
. CRICKET LANE
44'
46' D=88 58' 05"
L=38.8
T.O.W.=110.35
EXIST. FOUND,
N6 LOT 3A
�ha�Gsp CQ 43,846 S.F.
43'
l
:S
OF
{ I CERTIFY THAT OFFSETS SHOWN ARE FOR THE USE
'( THE OFFSETS OF THE BUILDING INSPECTOR ONLY c
;! OR THE SHOWN COMPLY AND SUCH USE IS F
t 972
WITH THE ZONING DETERMINATION OF ZONING `� G/STEa���
`E BY LAWS OF CONFORMITY OR NON-CONFORMITY
'€ NORTH ANDOVER ,MA. WHEN CONSTRUCTED.
WHEN BUILT 11 /29195
t
�r
x
x
4
,t
A �--__- ..,'r':. t',x.t•9!'.,. hh'r i:.-fJ71..:rJi,;.3 e.1...P '..'A'.K'.'#J i'r.:.`....o'/:a..
NORTH
TOx over
® - „
O
No. y 3 0
0 t�- L Ao over, Mass.,
COCMICKEWICK V
ADRATED P? C2
S H BOARD OF HEALTH
PERIV IT T Food/Kitchen
Septic System
R 61 � BUILDING INSPECTOR
THIS CERTIFIES THAT e.wa �1s N
Foundation
has permission to erect........
buildings on � �I� g
AX X....o ...Al. ................�......�..................... ......r.............. Rough
to be occupied as......A-4.0_40.4......co.. ;2010.1 Ar a•60% + Chimney
:...... ....�.............. y.................................:..
. . . . . .. . . .
provided that the person accepting this permit shall in every respect conform to the terms of the application on flle in Final
this office, and to the provisions of the Codes and By-Laws relating to the Jos�Lolteration and Constru ion of
Buildings in the Town of North Andover. ��� 0 ; PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
PERMIT EXPIRES IN 6 MONTHS Final
UNLESS CONSTRUCTION S ELECTRICAL INSPECTOR
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 FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
SEE REVERSE SIDE Smoke Det.