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Miscellaneous - 16 EDGELAWN AVENUE 4/30/2018
A�Dc ' I � � I ti -. Date. y X. of. TOWN OF NORTH/AINDOVER 0 PERMIT FPR UMBING This certifies that . . . . . .... . . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . . . . . . . . .7. . . . . . . . . . . . . . . . . . at . .A'-1 4 . . . . . . . . . .. North Andover, Mass. Fee. Lic. No.. . . . . . . . . ... . . . . . . . PLUMBING INSPECTOR Check # ■ t i 1 1 ) / . ..111 e' Ee �t• RAF •:1111 •' 1'1 v � ' � 111 11 a1 oil nc♦ ■ . / i ``a�it 1 � ���������n����•���������� 1 ' NNW am M am now ......�..■-...�....�.-.WNW .. Now • f fl a L :111- . -11 �. • Itl f::1 � � e 1' /' \ Ill'111■ ■ illi 1 1 :11/•' i1 11� 1 1' :11 �•/.:1 1 e� 1:f ■ 04111 It. •:111 % t 1 /1 {Itll /♦%1 1 111[! I .f ♦ :fl :1 �♦ 11 %I♦ t 111\ /r • ♦ �t 11 1 l♦( 111�/ 1111:.1 f11 'Jll rl /Alis :u.' • / /� 111 311 , r • : 039 .:I I t •.. 11 - •'l l • • 111/:.' /' 1111 1 1{• t':It City/Town :11 It I ■ APPROVED • � 1 111 Il:tl M Y • I Date. .... .. .. to TM x TOWN OF NORTH ANDOVER 11 s a i .t ♦ PERMIT FOR GAS INSTALLATI01!I -I� h �,SSACNUSE4S u This certifies that . . . . . . . !"�. .� . .! . . . .���. . . . . . . . . . . . . . . . has permission for,gas installation . . . . . . . . . . . . . . . . . . . . . . . in the buildings of . . . .� � `.�. `/. . . . . . . . . . . . . . . . . . . . . . . at . . .,���` .�. . .� �:. �`'.``. ". . . . . , North Andover, Mass. Fee. �-�. Lic. No.. .`I.' 5.`./. . . . . . . .s . . . . . . . . . . . a A$ R INSPECTO Check# 7222 MASSACHUSETTS IJI'MRMAPPLICATON FORPERMTT TO DO GAS FITTING (Type or print) NORTH ANDOVER,MASSACHUSETTS Date Building Locations _/C-t �b -- g/`� ��„�✓ �-� ,-- Permit#�� L Z- L oust$ Owner's Name I„O i �y. New Renovation Replacement Plans Submitted El W C O U q W O O O z z h z a cFa z > 0 OW u O0 O> S> wx c SUB-BASEM ENT BASEM ENT f IST. FLOOR 2ND. FLOOR 3RD. FLOOR 4TH. FLOOR r STH . FLOOR 6TH . FLOOR 7TH . FLOOR 8-TH. FLOOR (Print or type) eck one: Certificate Installing Company Name_ 1' )�tf'1 \j `,!� I� '1� � /`r z Corp Address 0 Partner. &Umness Telephone y y�, a"um/Co. Name of Licensed Plumber or Gas Fitter ,v U r i�-, ki 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 [:3 Other type of indemnity 13 Bond 13 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: Signature of Owner or Owner's Agent Owner Agent 0 I hereby certify the all of the details and information I have submitted(or entered)in above appli n are true and accurate to the best of my knowledge and that all plumbing work and in ons perfo ed under Permit Is ed for is application will be in compliance with all pertinent provisions of the Massa c setts tate G d Ch 14 f General Laws. . By. Signature of Li ed Plumber Or Gas Fitter Title Plumber 9 9 p y wn City/fioGas Fitter icense Number Master APPROVED comausEONLY) 0 Journeyman Date. . � .. . . . . 9... . . ,4°RTp °f - �r TOWN OF NORTH ANDOVER O 9 ` • . PERMIT FOR GAS INSTALLATION � �9SS�CHUSEt This certifies that . . . :�-'CF-?'?l. ... . . . . . . . . . . . . . . . . has permission for gas installation !. . . . . . . . . . . . in the buildings of . . . . -��! -�'. . . . . . . . . . . . . . . . . . . . at � '. . . .� �J�- '`� . . ( , North Andover, Mass. Fee. Aa.6 . . Lic: No'.A,?/j . . . `s „" . . . . . . . . . . _G`A�INSP Check# 'V'%y VV 6969 MASSACHUSETTS UNIFORM:-aPPLICATION FOP, PERMIT TO DO GAS FITTING b City(rown:). its` 0'4 V(* MA. Date: 1� Z.� Permit# Building LocationNy Owners Name: f'11c a& rM Type of Occupancy: Commercial ❑ Educational ❑ Industrial ❑ Institutional❑ Residential New: ❑ Alteration: ❑ Renovation: ® Replacement: ® Plans Submitted: Yes❑ No FIXTURES (n vi Q 0 U) _ to Cox x 0 WU' J V ~ U) 00 E W W a Z z o LU D W 0 a l=- w fn W pa O Q a H D W w x Q w = LL > fn 0 W a 0 = LU u l F' L W W U W Z CILLI9 '� H F- O Z J C7 u. _ W z z W �- N Q Q m w O z 0 y > z _ SUB BSMT. BASEMENT 1 FLOOR -7"—FLOOR 3 FLOOR -T"—FLOOR 5 FLOOR 6 IK FLOOR 7 FLOOR 8 FLOOR t- _ (7 Check One Only Certificate# Installing Company Names�,, `� � �i ��. �Corporation Address �t� �ta'le� City/Town c%7�0 to Stater ❑ Partnership Business Tel: �� x'3°1 ��� Fax: ❑Firm/Company Name of Licensed Plumber/Gas Fitter: Q-*C M� M1bXTN9SV1^ INSURANCE COVERAGE: I have a current liabilityinsurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes No El If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy 9 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 Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Signature of Owner or Owner's Agent By checking this box❑;I 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 installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Type of License: By ®Plumber _— ❑Gas Fitter Signature of icensed Plumber/Gas Fitter Title (�Master City[Town/To wn []Journeyman License Number: APPROVED JOFFICE USE ONLY El LP installer FINAL INSPECTION BELOW FOR OFFICE USE ONLY PROGRESS INSPECTIONS) FEE: $ PERMIT# ! APPLICATION FOR PERMIT TO DO GAS FITTING II I , NAME&TYPE OF BUILDING K LOCATION OF BUILDING SKETCFI PLUMBER GASFITTER.LP INSTALLER LICENSE NUMBER:" PERMIT GRANTED DATE: GAS FITTING INSPECTIOR Date.. .��.�� 6 . ... . HORTM 3= �' TOWN OF NORTH ANDOVER p PERMIT FOR GAS INSTALLATION SSACMUSE This certifies ifies that . . . . . . . . . . . . . . . . has permission for gas installation . . . . . in the buildings of . . . . . . . . . . . . . . . at-� . _ Cj . ., North An,�Rd- over, Mass. Fe�. ... . . . Lic. NoVhS . . . . . . . . . . Check# 6968 MASSACHUSETTS UNIFORM A°PLICATION FOR PERMIT TO DO GAS FITTING r - rr`` Cityffown:). KT%4mVe-'r' MA. Date: 2a 0�1 Permit# Building Location?, C�tCKL'1�'�h4 �g Owners Name: Type of Occupancy: Commercial ❑ Educational❑ Industrial ❑ Institutional❑ Residential [� New: ❑ Alteration: ❑ Renovation: ®' Replacement: Plans Submitted: Yes❑ No FIXTURES Cn vi vi Z W Y 2 m 2 O0 � J U U) F- W OO M W IX ZO Z < Z O E.W. D W 0 Q F=- W W W m 0 Q o_ Q in = x W > W U U. w N 0 = w 0 W z W W > U W Z O J H 1- 0 Z J O LL S W EW— Z W >- � N J Q Q 2 0 o o � C9 i = g O a a > > O SUB BSMT. BASEMENT 1 FLOOR 2 FLOOR 3 FLOOR 4 FLOOR . 5 FLOOR 6 FLOOR VH FLOOR 8 FLOOR Check One Only Certificate# Installing Company Name T—� `3 `►' �t *'� 9 �Corporation Address e�+,^�t,(�'tc4t � City/Town �s+� � State: _ ❑Partnership Ni Business Tel:�Ap\ CQ%1N Fax: ❑Firm/Company Name of Licensed Plumber/Gas Fitter: T-qA IL-V INSURANCE COVERAGE: I have a current liabilityinsurance policy or its substantial equivalent which meets the requirements of MGL.Ch.142 Yes:C No El If you have checked Yes,please indicate the type of coverage by checking the appropriate box below. A liability insurance policy ( Other type of indemnity ❑ Bond ❑ OWNER'S INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Massachusetts General Laws,and that my signature on this permit application waives this requirement. Check One Only Owner ❑ Agent ❑ Si nature of Owner or Owner's Agent By checking this box❑;I 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 installations performed under the permit issued for this application will be in compliance with all Pertinent provision of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws. Type of License: By ® Plumber _— ❑Gas Fitter Signature of censed Plumber/Gas Fitter Title 5 Master ❑Journeyman citylTown El LP Installer License Number: APPROVED OFFICE USE ONLY FINAL INSPECTION BELOW FOR OFFICE USE ONLY PROGRESS INSPECTION(S1 FEE: $ PERMIT# APPLICATION FOR PERMIT TO DO GAS FITTING d NAME&TYPE OF BUILDING i LOCATION OF BUILDING SKETCH PLUMBER GASFITTEIL LP INSTALLER LICENSE NUMBER: PERMIT,GRANTED E] DATE: ` GAS FITTING INSPECTIOR a rlNORT H Town of 0 C,o :_: E = dover, Mass., l0 .-` _i?00 COC MIC ME WICK RATE D P'P�\ �� BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System THIS CERTIFIES THAT-jAPA(� . ... .. ... .. � .........rAA0-0U.Q$g):.........,,,Auo• • Foundation UI BUILDING INSPECTOR has permission to erect RRCo+��,.................... buildings on .....A.7. .(.P......E.01A.!f W[D ......WN)II& .0� *.*bs �VI'� 861r Chimney to be occupied`as ................................. .. ............. provided that the person accepting this permit shall in every respect conform to the terms of the application on file in this office, and.to the provisions of the Codes and By-Laws relating to the Inspectio , Alteration and Construction of Buildings in the Town of North Andover. .�p �'v Cr ING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough _ PERMIT EXPIRES IN 6 MONTHS Final C UP.0%4*V "CINLESS CONSTRUCTION TARTS ELECTRICAL INSPECTOR Rough %14 !!... 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. R 1,�.. . 4. .v1. N2 33 r' Date.. ... Nor+rM G TOWN OF NORTH ANDOVER OL FO P PERMIT FOR WIRING �,sSACHUSEt This certifies that ... 4,/ has permission to perform . C..4.. fir..........s//..5 ....................... c wiring in the building of...... >>. �f?.. /............................................... at....1.� ......1,'....`.. ........R ,North Andover,Mass. i Fee- —.'.dq.. Lic.No.f�.. 7�......... .... .......eCTOR ............ 5—C,/7 ELECTRICAL INSP Check # _.��—L--! WHITE: Applicant CANARY: Building Dept. PINK:Treasurer Commonwealth of Massachusetts Official Use Only Department of Fire Services Permit No. 3 9 BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Chemed (Rev.111991 cave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(Iv1ECI 527 12-00 (PLEASE PRINT IN INK OR TYP FO T1011f7 Date: City or Town of: - To the Inspector f Wird. By this application the undersi es ce of his err her intention to orm the electrical work described below. Location(Street&NAmber Owner or Tenant Telephone Na Owner's Address Is this permit in conjunction with a building permit.' Yes ❑ No� (Check Appropriate Boz) Purpose of Building Utility Authorization Na Existing Service Amps / Volts Overhead❑ Undgrd❑ Na of Meters New Service Amps / Volts Overhead❑ Undgrd❑ Na of Meters t Number of Feeders and Ampacity Location and Nature of Proposed Electrical Wo& I Camoletion of the followinc tanie may be waived ov the:rmector of;Virez. No.of Recessed Fixtures INo.of Cal-Susp.(Paddle)Fans (Na of Total (Transformers KVA No.of Lighting Outlets INo.of Hot Tubs Generators KVA No.of Lighting Fixtures (Swimming Pool Above ❑ !n- ❑ a.of mcrgcnc. t;nung rnd. Frnd. Battery Units No.of Receptacle Outlets INo.of 00 Burners FIRE ALARMS ,Na of Zones Na of Snitches INo.of Gas Burncrs No.of Detection and Initiatint,Devices ` No.of Ranges INo.of Air Cond. Tota Na of Alerting Devices No.of Waste Disposers (HeatPump u s- Number Tons KW No.of Self-Contained TotDetectionlAiertinQ Devices No.of Dishwashers Space/ArmHeating, KW � l C3 Municipal C1 Other Connection No.of Dryers Heating AppliiancesK-W becunty Systems. Na of Devices or Eauivalent of Iva o No.o Heaters arer rINo. Si--ns Ballasts Da No.of Devices or Eauivalent No.Hydromassage Bathtubs No.of liotocs Total HP Telecommunications Wiring: No of Devices or Eauivalent OTHER Atradi additional detail iidesired or as required by the Inspector of Ifires. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licenser provides proof of liability insurance including"Completed operation" co mP p coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has chibited proof of same to the permit issuing CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (specify:) >~ non Date Estimated Value of E ;cal Work (Whey required by municipal polity.) ( ) Woik to Start: Inspections to be requested in accordance with NEC Rule 10,and upon completion. 1 certify,under eArns a&penalties of perjury,that the information on this applimdon ittrue and complete. FIRM NAME: ADT Security Services -.Dr, .. of lis.. Illi 03049 LIC.NO.: I533C Licensee: John S.Bassett Signatu C.NO.: 1533C (If applicable,enter"eumpt'in Lite license number line) Bus.TeL No.:J03 594-5900 Address: Alt.TeL No.:_603 594-5928 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)C3owner EDowner's at'ent. Agent Skmatu5c ienaturc Trtrnhnnn Nn PFRMTT FFF• Location No. c7 S Date Y 0 Z �aRTM TOWN OF NORTH ANDOVER f � 9 i s i Certificate of Occupancy $ CHU �i7s', Eta Building/Frame Permit Fee $ S s�cHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # � A l 556 Building Inspector L �J TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING M BUILDING PERMIT NUMBER: J_ �— DATE ISSUED. /�, ` OIL, M SIGNATURE: 144 /(fit' Building Commission r2 for of Buildings Date Z SECTION 1-SITE INFORMATION 0 1.1 Property Address: 1.2 Assessors Map and Parcel Number: 4'— JAct�iV cS2 3q Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: Zoning District Proposed Use Lot Area Frontage ft 1.6 BIJU DING SETBACKS ft Front Yard Side Yard Rear Yard R red Provide Required Provided Required Provided Q i 1.7 Water Supply KG.LC.40.1 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: a Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSIIIP/AUTHORIZED AGENT M 2.1 Owner of Record Name(Priv Address for Service: Signature Telephone 2.2 Owner of Record: Name Print Address for Service: z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.1 Licen d Construction Supervisor: Not Applicable ❑ fu T Jz� 5 Licensed Cert .tion Supervisor: L ` /� O A- (564 License Number mn Address ''ff &A W( Expiration Date Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable Company Name M Registration Number rw Address z Expiration Date G) Signature Telephone a a 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 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: re-V_00� SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost Dollar to be ' (Dollar) , ` �OITIC�L TJSE OI+lI F 04 § � 5 Completed by permit applicant taw 1. Building (a) Building Permit Fee Multiplier r 2 Electrical (b) Estimated Total Cost of Construction 3 Plumbing Building Permit fee tel x(b) 4 Mechanical HVAC 5 Fire Protection �•5 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 SECCTIION 7b OWNER/AUTHORIZED AGENT DECLARATION (�,o L, ViO % , c ( � Z 9S;tee' ��"C� l Res. 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 � Prin am _ I k7� 5 [0a Si ature of 6wrW6en Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS I ST2ND 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATF,RL41,OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE b r t I ��'' rYd .,. � ✓1re-�aivnzayu�,eixl�l: a�:.���rawrt�/uiael�d BOARD -F .WIL`DINGiREOUL TICIN$ -. License , ONSTi#UCTIO. SUPEWSOR a Number.'CS 075259 •r. ,� ,Fxprresi 12Jf41tf02 Tr..no: 75.259_ r fi estncteaITO: 00 BRA©LIs,Y J S, tZ 7 e .»a PINE HILI,I�OAI? I SWAMPSCOTT, MA 01907 AdminhArator S : r The Commonwealth of Massachusetts Department of Industrial Accident s t t Office of Investigations t Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name: Location: CRY Phon© (—`7 am a homeowner performing all work myself. DI am a.sole proprietor and have no onb working in any capacity MWNMM l am an employer providing w. orkers'compensation for my employees working on this job. Come- Address C ft Li ultra 01�6Z Phone# 15�i 3-C� OG I sui Ce GQmtetiv ttarne: Address City; Phone#- IM .��. 0C jr?q 56 i �aFhrre to sects coverage as required under Section 25A or MCL 152 can tattle ikon d cskninal des,ota fine to 1 500.00 and/or one years'imprisonmant as"gas CIO penalties to th6 mr or a= A►oFiiC D and afire d �f OQ up, � understand that a copy of this statement may be forwarded to the Offk*of I X a� t . h .or the tN/t for coverage vErtfirapoR: . I do herby certify under the p hs j atlas of perfwy that the f� AZ '�:h� Sem`c�S, lf%C. P rdedaboveins6�ueariloonrect Signature Pres Date 5 a o Print name tco'l,e. . Scr` . Phoria 3W Official use only do not write in this area to be completed b or town ' Y city ofFiaal' 0 Building Dept ©Check if immediate response is required Building Dela 0 Licaltsing Bold Contact person: Phone# 0 SetectrnaWs 0fric&0 Health Department 0 Other WORKMAN'S COPPi NSATI0R a Q North Andover Building Department Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit Number is that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c11, S150A. The debris will be disposed of in: (Location of Facility, Stx-,xces, Inc, S ature of- rmit Applicant S Z oZ Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector N�R �M L ' E r To'"M of .. over No. ON�.� CHIC LA y doves, Mass., Z xA �V do RATED BOARD OF HEALTH Food/Kitchen PER M IT-- T Septic System THIS CERTIFIES THAT.... . ..r..........�� o N 60"" BUILDING INSPECTOR� tt � C has permission to erect. . �`�. buildings on. .�: .� , 4'j�G �t,�IV Foundation to be occupied as 7t Rough C. . .......n........... . .. ....... .. . • 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 Insp ction, Alteration and Construction of Buildings in the Town of North Andover. 03 Y'- 3 OW PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EMPIRES IN 6 MONTHS Final UNLESS CONSTRUC'T'ION STAR S ELECTRICAL INSPECTOR ..... /� ........... Rough ................................ Service BUILDING INSPECTOR Final OCCUPan y .Permit Required t0 Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT o Burner Street No. SEE REVERSE SIDE Smoke Det. Qrre" F�vrvood AveLocation - 4 ,�.. No. % F r p LW 44 ) Date r{ % F�ry tadOa N�RTh TOWN OF NORTH ANDOVER = 0 • C� r 9 " Certificate of Occupancy $ ;�s'• E<�' Building/Frame Permit Fee $ + Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 1, 1;MOP Check # �—I 18774 (-re I)d bro,*A 19", Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING T OTHER THAN A ONE OR TWO FAMILY DWELLING /v k t s 2e u ������3 - `�""`��� ,��} °��� - This Section for Official Use Onl BUILDING PERMIT NUMBER: ` DATE ISSUED: ..� � O SIGNATURE: Builth% Commissioner or of Buildings Date 1.1 Property Address: 1.2 Assessors Map and Parcel Number: y— - _ Ito j i4 V e, f Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: v Zonin District Proposed Use Lot Area Frontage ft 1.6 BUILDING SETBACKS(ft) m Front Yard Side Yard Rear Yard Required Provide R Provided Required Provided 1.7 Water Supply M.GI-C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public ❑ Private ❑ Zona Outside Flood Zone ❑ Mmmicipal On Site Disposal System ❑ %Lc�- N 0 'c; isinct: Yes No 2.1 Owner of Record klz� Name(Print) Address for Service: Telephone n utho k ///, ,//""-��, r"&" N e n t f Address for Service: Si afore Telephone / m 90 3.1 Licensed Construction Supervisor Not Applicable ❑ SSSl(er © a -51 Address License Number RUCY' ins S Li ction Supervisor: t — ?� 2 p Expiration Date Signature Telephone r 3.2 Registered Home Improvement Contractor Not Applicable ❑ v -::Z-V C 0'br'-�r", 7 of`7 S b � Company Name r Registration Number 5� k\,V e-y-?-9 re RA' i l eitcz Address J/T /( f r - L!o - 'Q00 r Expiration Date Z - — Signature Telephone 1> 12 �'O �/� t O/C as Owner/Authorized en ereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Sunder the pains an penalties of perjury Prot Name Si tore of Owne en,t Dat IMF VIPW- 13-1 Items Estimated Cost(Dollars)to be # Completed by P t applicant 3..' 1. Building (a) Building Permit Fee o0C3 .� � Multiplier 2 Electrical (b) Estimated Total Cost of O Construction from(6) 3 Plumbing C:) Building Permit fee (a)X(b) �V 4 Mechanical(HVAC) O 5 Fire Protection O 6 Total (1+2+3+4+5) �( Check Number ?S coo d e)C-) . �,t 53��/1 p�j��YAr t1�'S:.m�`��ax ..,'-' ' vr',�E�'"a.�t•,`'Ij+5h��la,'J�4y'£� � Jbn��t 1 �>".,}S 2:�'.-�'� ^i`:-"# t d Lug i'�4i,P p1t. tt,, �f �,. 5 t �i ,3 <, 1 a 3r- tr.#:z. "rY.�� :. - �'t,�� ..tt��.. .rh. �rN.. .t:tau� ��-....<r�>��...,4 w�. ,t�+,s.,:.���yf`�',., *, m ;s`n„? �..v�i, Y�.-�z��m`'.'�3� i�...�xu�'ws.r,.✓-.-rsr,s �. 5.... NO. STORIES SITE BASEMENT OR SLAB SITE OF FLOOR TWBERS I Sr 2ND 3 RD SPAN -DEMENSIONS OF SILLS DEMENSIONS OF POSTS DMIENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHBANEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE ,.?, 10" '' f}' '` ',,� s•a - e"' s:s t}„" - 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 Yea....... No.......❑ s> c°>r�orl s . �lcx �u,n� zl � cl +r slc>sc � � its s � ' C 5.1 Registered Architect: Cn L e: Address Signature Telephone �f �� c�V�C� c o ( r � 1 i�S Area of Responsibility N e: cI Registration Number Address: Expiration Date Signature Total Not applicable ❑ Name: Registration Number Address Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date C.4)Y" T_ll L Not Applicable ❑ CORIPMY Name: ti C,be?r /'1G Responsible in Charge of Co tion o fit} e a New Construction ❑ Existing Building 0 Repair(s) Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: 93 USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly ❑ A-1 ❑ A-2 ❑ A-3 0 IA ❑ A4 ❑ A-5 0 IB ❑ B Business ❑ 2A 0 C Educational ❑ 2B 0 F Factory ❑ F-1 ❑ F-2 ❑ 2C ❑ H High Hazard ❑ 3A ❑ IInstitutional 0 I-1 0 1-2 ❑ I-3 ❑ 3B ❑ M Mercantile ❑ 4 0 R residential R-1 ❑ R-2 ❑ R-3 ❑ 5A ❑ S Storage 0 S-1 ❑ S-2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use 0 Specify: S Special Use 0 Specify: COMPLETE THIS SECTION IF EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34: F � , BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floor s Total Area s Total Height ft Independent Structural Engineering Structural Peer Review Raluired Yes ❑ No ❑ SECTION 10a Owner Authorization- TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, as Owner of the subject property Hereby authorize to act on My behalf,in all matters relative two work authorized by this building permit application Signature of Owner Date Replacement Windows Snow Plowing Seamless Gutters Remodeling Vinyl Siding Renovations f r i i J&C CONTRACTORS, INC. I Bob Ings Cell:508-574-3588 Office/Fax:978-667-8014 f i J & C CONTRACTORS, INC. s15 RI'✓EREDGE RD. PH. 978-661-8014 31LLERICA, MA 01862 DATE PAY -�7 eTo y 0HOER OF r ENTEJ�PRISE BANK Al D TRUST COMPANY FOR , 11'00590511' 1:0LL3027421: 850146964711' i Location ' t No. # Date MOAT" TOWN OF NORTH ANDOVER Of��.�e :�1'y 1 f Certificate of Occupancy $ CMU stt''' Building/Frame Permit Fee $ Foundation Permit Fee $ Other Permit Fee $ TOTAL $ Check # 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 or requirements. APPLICANT FILLS OUT THIS SECTION APPLICANT `'` `"' S D(' PHONE LOCATION: Assessors Map Number PARCEL Y SUBDIVISION LOT(S) STREET l7—`6 F6& W A j - ST. NUMBER OFFICIAL USE ONL OM TI TOW G NTS: CO SERVATION ADIMINISTRATOR DATE APPROVED DATE REJECTED n / COMMENTS 00Q TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED . COMMENTS PUBLIC WORKS -SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT DECEIVED BY BUILDING INSPECTOR DATE R60W"T Im r 617 'Cow�Y109Lt�!P.CDI.I./L-4 ✓!?.lX4d[LC�LfI4 i BOARD OF BUILDING REGULATIONS r License: CONSTRUCTION SUPERVISOR t Number: CS 072629 Birthdate: 05/03/1954 Expires:05/03/2006 Tr.no: 22998 Restricted: 00 ROBERT G INGS 85 RIVEREDGE RD N BILLERICA, MA 01862 Actingro Ca mis !oner ✓fie T9anvnzo�ausec��o�,/�aaaacfucarka Board of Building Regulations and Standards {. HOME IMPROVEMENT CONTRACTOR Registration: 127563 Expiration: .11/1612006 j Type: Private Corporation J&C CONTRACTORS INC ROBERT INGS 85 RIVEREDGE RD � ,i BILLERIC/k MA 01862 Administrator NORTH ANDOVER BUILDING DEPARTMENT Tel: 978-688-9545 DEBRIS DISPOSAL FORM In accordance with the provision of MGL c 40 S 54, a condition of Building Permit at: — - that the debris resulting from this work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL c 11, S 150 A. Also, note Permits are required under Fire Prevention laws Chapter 148 Section 10A. The debris will be disposed of in: V- - (Location of acility) Signature of Permit Applicant Fire Department Sign off: Dumpster Permit Date Department of Industrial Accidents Office ofInvestigations kqip 600 Washington Street Boston,MA 02111 www.massgov%dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electridans/Plumbers Applicant Information _ Please Print Lep-ibly Name (Business/organization/Individual): h Address: ;, City/StateMVp,; t-e-Y � o .L E •n t&G�- Phone#: �- 7 ti- 3 s�-��l Are you an employer?Check the appropriate box: Type of project(required): I.❑ I am a employer with 4. ❑ I am a general contractor and 1 6. ❑Nyw construction 2.❑ employees(full and/or part-time).' have hired the sub-cowactors 7. rL�-Js/Rermdclin I am a sole proprietor or partner- listed on the attached sheet. g ship and have no employees These sub-contractors have S. ❑ Demolition working for me in any capacity. workers' comp. insurance. 9. ❑ Building addition [No workers' comp.insurance 5. ❑ We are a corporation and its . required.] officers have exercised their 100 Electrical repairs or additions 3.❑ l am a homeowner doing all work right of exemption per MGL 11.❑ Plumbing repairs or additions myself. [No workers' comp. c. 152,§1(4),and we have no 12,❑ Roof repairs insurance required.]t employees. [No workers' comp. insurance required.] 13.0 Odier 'Any aWlicant that cbeds box#1 mutt also fill out Wse e ction below sbowing Weir worker'oompeoaation policy infomration: t Homeowners who submit this affidavit indicating they are doing an work and Wen biro outside coubacum must submit a new affidavit indicating much tContracmrs that check this box neat sttacbed an additional sheet showing We name of We sub-contractors and Weir workers'm policy infomwhon. I am an employer that Is providing workerscompensation Insurance for my employees Below Is the pdky and job site information. Insurance Company Name: Policy#or Self-ins.Lic.M Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as requiref under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year en%as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the pains and penakks of perjury that the information provided above Is true and correct Signature: Date Phone#: Offlcial use only. Do not write in this area,to be completed by city or town offleiaL City or Town: Permit/Ucense M Issuing Authority(circle one): 1.Board of Heakh 2.Building Department 3.City/Town Clerk 4.Electrical Inspector S.Plumbing Inspector 6.Other Contact Person: Phone 0: lniormatiun ailu 1115LI U%,LIiVJL13 Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees, Pursuant to this statute, an employs is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the aNidaviL The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured competes should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant Please be sure to fill in the permit/liccnse number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit t� been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid a is on fie for future permits or licenses. A new affidavit mast be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone ad fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-NIASSAFE Fax#617-727-7749 Revised 5-26.05 www,mm.gov/dia FROM NEVE-MORIN GROUP (WED)SEP 14 2005 16:37/ST. 16:35/No. 6802445832 P 2 "Proposed Balcony Replacement Sketch," Scale: 1" = 40' Proposed qo Balcony tV a ►� ti b 3 QO W � r Prgvosed "`' � 2 Silt Fence •M r, ('� ,� t00et � .r 'b A I I Wf 84 / �•`wF 86 Edge of Wetland FROM NEVE-MORIN GROUP (WED)SEP 14 2005 16:35/ST. 16:35/No, 6802445832 P 2 "Proposed Balcony Replacement Sketch-" Scale: 1" = 40' Proposed 1 Balcony p o ►� p !qq 0 m 9 3 00 � Proposed # r Silt Fence •� r, ri �—t1-13 60 Wetb�d B tfQ' •.� r� � e WF 84 ��� 86 Edge of Wet/mrd 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 or requirements. APPLICANT FILLS OUT THIS SECTION APPLICANT v pc CPHONE-!� ���- �` LOCATION: Assessor's Map Number PARCEL SUBDIVISIO1n kut- LOT(S) STREET_ja �r r✓ o�� I�V ST. NUMBER OFFICIAL USE ONL RE 10 TO NTS: CONS RVATION ADMINISTRATOR DATE APPROVEr' - o-- DATE REJECTED COMMENTS TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS PUBLIC WORKS-SEWERIWATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE Associated Employers Insurance Company Burlington, Massachusetts NCCI NO 40959 (800)876-2765 POLICY NO. I WCC 5003615012004 PRIOR NO. I WCC 5003615012003 ITEM 1. The Insured J&C Contractors Inc Mailing Address: 85 Riveredge Road Billerica MA 01862 (No. Street Town or City County Slate Zip Code ❑ Individual ❑ Partnership ® Corporation ❑ Other FEIN 04-3014138 Other workplaces not shown above: 2. The policy period is from10/03/2004 to 10/03/2005 12:01 a.m.standard time at the insured's mailing address. 3. A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation Law of the states listed here; MA B: Employers Liability Insurance: Part Two of the policy applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury by Accident$ 500,000 each accident Bodily Injury by Disease $ 500,000 policylimit Bodily Injury by Disease $ 500,000 eachemployee C. Other States Insurance: See Endorsement WC 20 03 06 A D. This policy includes these endorsements and schedules: SEE SCHEDULE 4. The premium for this policy will be determined by our Manuals of Rules,Classifications,Rates and Rating plans. All information required below is subject to verification and change by audit. Classifications Premium Basis Rates Estimated Per 5100 Estimated Code Total Annual of Annual NO. Remuneration Remuneration Premium INTRA 254745 SEE EXTENSION OF INFORI 4ATION PAGE Minimum premium$ 486.00 Total Estimated Annual Premium $ 951.00 As indicated,interim adjustments of premium shall be made: Deposit Premium $ 984.00 ® Annually ❑ Semi Annually ❑ Quarterly ❑Monthly MA Assessment Chg. $676.00 x 4.9000% $33.00 This policy,including all endorsements,is hereby countersigned by 08/17/2004 Authorized Signature Dale GOV GOV KIND PLACING CLAIM NAME SAFETY STATE CLASS AUDIT OFFICE OFFICE CHECK GROUP Malcolm&Parsons Insurance MA 10042 7 1505 1 1 Agency Inc 6 Freeman Street-P O Box 527 WC 00 00 01 A(11-88) Stoughton, MA 02072 Includes copyrighted material of the National Council on Compensation Insurance. used with its permission. Town of N. Andover Massachusetts DEPARTMENT OF INSPECTION SERVICES CONSTRUCTION CONTROL AFFIDAVIT As Per 780 CMR- Sixth Edition BUILDING PERMIT # PROJECT/OCCUPANT Heritage Green Apartments PROJECT LOCATION/ADDRESS: North Andover,MA PROPOSED WORK: Unit 14-16& 85-87 Balcony Repair. IN ACCORDANCE WITH SECTION 116.0 OF THE MASS. STATE BUILDING CODE, I_STEPHEN F. ONDRICK JR TELEPHONE NO. 617-472-1800 REGISTRATION NO. 39029 BEING A REGISTERED PROFESSIONAL ENGINEER HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT ARCHITECTURAL__ STRUCTURAL_X_ MECHANICAL FIRE PROTECTION ELECTRICAL OTHER(specify) FOR THE ABOVE-NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEDGE, SUCH PLANS,COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE MASS. STATE BUILDING CODE AND OTHER,ACCEPTABLE ENGINEERING PRACTICES AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AS OUTLINED IN SECTION 116.2.2 OF C.M.R. CODE AND BE PRESENT AT INTERVALS APPROPRIATE TO THE STAGE OF CONSTRUCTION TO DETERMINE THAT THE WORK IS PROCEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT. I, OR MY REPRESENTATIVE,FURTHERMORE AGREE TO SUBMIT PERIODICALLY, AN INSPECTION REPORT TOGETHER WITH PERTINENT COMMENTS TO THE NORTH ANDOVER BUILDING COMMISSIONER NOT LESS THAN SEMI-MONTHLY. UPON COMPLETION OF THE WORK,I SHALL SUBMIT A FINAL REPORT AS TO THE SATISFACTORY COMPLETION AND A�DINESS OF THE PROJECT FOR OCCUPANCY. N OF Mgrs STEPHE g ONDRI o ##39029 -+ " STRUCTURAL ATURE& STAMP(NO FACSIMILE) sS�ONALG Town of N. Andover Massachusetts DEPARTMENT OF INSPECTION SERVICES CONSTRUCTION CONTROL AFFIDAVIT As Per 780 CMR-Sixth Edition BUILDING PERMIT # PROJECT/OCCUPANT Heritage Green Apartments PROJECT LOCATION/ADDRESS: North Andover,MA PROPOSED WORK: Unit 14-16& 85-87 Balcony Repair 1N ACCORDANCE WITH SECTION 116.0 OF THE MASS. STATE BUILDING CODE, I_STEPHEN J WESSLING TELEPHONE NO. 617-773-8150 REGISTRATION NO. 4191 BEING A REGISTERED PROFESSIONAL ARCHITECT HEREBY CERTIFY THAT I HAVE PREPARED OR DIRECTLY SUPERVISED THE PREPARATION OF ALL DESIGN PLANS, COMPUTATIONS AND SPECIFICATIONS CONCERNING: ENTIRE PROJECT ARCHITECTURAL_X_ STRUCTURAL MECHANICAL FIRE PROTECTION ELECTRICAL OTHER(specify) FOR THE ABOVE-NAMED PROJECT AND THAT,TO THE BEST OF MY KNOWLEDGE, SUCH PLANS,COMPUTATIONS AND SPECIFICATIONS MEET THE APPLICABLE PROVISIONS OF THE MASS. STATE BUILDING CODE AND OTHER,ACCEPTABLE ENGINEERING PRACTICES AND APPLICABLE LAWS AND ORDINANCES FOR THE PROPOSED USE AND OCCUPANCY. I FURTHER CERTIFY THAT I SHALL PERFORM THE NECESSARY PROFESSIONAL SERVICES AS OUTLINED IN SECTION 116.2.2 OF C.M.R. CODE AND BE PRESENT AT INTERVALS APPROPRIATE TO THE STAGE OF CONSTRUCTION TO DETERMINE THAT THE WORK IS PROCEEDING IN ACCORDANCE WITH THE DOCUMENTS APPROVED FOR THE BUILDING PERMIT. 1, OR MY REPRESENTATIVE,FURTHERMORE AGREE TO SUBMIT PERIODICALLY, AN INSPECTION REPORT TOGETHER WITH PERTINENT COMMENTS TO THE NO ANDOVER BUILDING COMMISSIONER NOT LESS THAN SEMI-MONTHLY. UP yeti ¢J. aR�'�'i COMPLETION OF THE WORK, I SHALL SUBMIT A FINAL REPORT AS TO THE J SATISFACTORY COMPLETION AND READINESS OF THE PROJECT FOR OCCUPANCY. QUtNCY 1 �6o MA � �U` ;RE& STAMP(NO FACSIMIL k NORTH Town of 0 . . No. Z�j —1Sods LA dover, Mass.,04 Od COCMICHEWICK y�. RATED p'P� �� BOARD OF HEALTH Food/Kitchen PERMIT T D Septic System . r '040 �� Azso BUILDING INSPECTOR THIS CERTIFIES THAT.Wopt. .. . ........�. ........ ............................ 4r..r................ Foundation p g A.7.(�...... .x.has ermission to erect ..R�o!!!fi.................... buiidin s on ..... !�. .. .,±V'!!�......�#7100&� Rough to be occupied ask ~ � :0*41coolv ��~Talos C � S1l r Chimney ......................y... ........................ .. .... ................................. 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 Inspectio , Alteration and Construction of Buildings in the Town of North Andover. OCC CSCF 1` PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final C VAO%40604wft"'JNLESS CONSTRUCTION TARTS ELECTRICAL INSPECTOR Rough ....�%!r .l. ............................ 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 (Nall To BeDone FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det.