HomeMy WebLinkAboutMiscellaneous - 140 BRADFORD STREET 4/30/2018 (3) 140 BRADFORD STREET
210106_1�00000 }
Date.....
40RTH
It
3?�e`�`��'•°'�.��0� TOWN OF NORTH ANDOVER
o p PERMIT FOR WIRING
US
This
This certifies that ...... ..... ........
has permission to perform ............ f�. ....... >,vR!��...... .. �C
. ...........
wiring in the building of �
lab
................v................... ....................�.J�� ass.
at North Andover M
Ziw
Fee.. .... Lic.No.
3 9�'Sy�
F., ......... ......... . . ..........CA ..............
ELECTRICAL INS�PE
4
Check # "
659
Commonwealth of Massachusetts Official Use only
BE
Permit No.
Department of Fire Services
Occupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev.9/05] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: W- ;)\- p (Q
City or Town of: N. %Sr��Ue,�— To the Inspector of Wires:
By this application the undersigned gives notice of his or her intention to perform the electrical work described below.
Location (Street& Number) 1y Q'��—� O C Q St
Owner or Tenant0CK�TNPx\� C., cnvA11,e,rv-� Telephone No.—J a
Owner's Address S`PtV�
Is this permit in conjunction with a building permit? Yes Rr No ❑ (Check Appropriate Box)
Purpose of BuildingejNt\!�,\s '13-vi eh* Utility Authorization No.
Existing Service Zdd Amps /Z.> / '?,'VO Volts Overhead Undgrd❑ No.of Meters l
New Service Amps / Volts Overhead ❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity 1
, �
Location and Nature of
Proposed Elect 'Cal Work: �` --� 0.`Doy.� q`.,pu� a 00 l
Completion of the following table may be waived by the Inspector of Wires.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.o Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above �ll In- ❑ o.o mergency Lighting
X
rnd. rnd. Battery Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. of Zones
No. of Switches No.of Gas Burners No.o Detection and
`P�o q Initiating Devices
No.of Ranges No.of Air Cond. Tota - No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.o Self-Contained
Totals: Detection/Alerting Devices
No. of Dishwashers Space/Area Heating KW Local❑ Municipal ❑ Other
Connection
No. of Dryers Heating Appliances KW Security Systems:
No.of.Devices or E uivalent
No.of Water KW No.o No.of Data Wiring:
Heaters Signs Ballasts
a
No.of Devices or Equivalent
YTelecommunications Whin
No. Hydromassage Bathtubs No.of Motors Total HP No.of Devices or Equivalent
OTHER:
Q Attach additional detail if desired, or as required by the Inspector of Wires.
Estimated Value of Electrical Work: _I 00 (When required by municipal policy.)
Work to Start: 2o0(, Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVERAGE: Unless waived by the owner, no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force, and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this applicatio is tr a and complete.
FIRM NAME: u "' LIC. NO.:
Licensee: Signature 1,AQA10, LIC. NO.:30/ScSL/E
(Ifapplicable, enter "exempt"in�/�lie license un erline.) Bus.Tel. No.�1�'1'$S$-9b'o`tq
Address:37 C�tj Xy— Y � do V&F- AIS 6�e��� Alt.Tel. No.:
*Security System Contractor License required for this work; if applicable,enter the license number here:
OWNER'S INSURANCE WAIVER: 1 am aware that the Licensee does not have the liability insurance coverage normally
required by law. By mysignature el , I eby waive this requirement. I am the(check one) owner ❑ owner's agent.
Owner/Ag
Signature -)Q = Telephone N079)—$5$-9829 FPERMITFEE.- $
n
Date �5 . .�
3
"oa,M TOWN OF NORTH ANDOVER
p PERMIT FOR PLUAM1WG
A us
This certifies that . . �r`�. . . . . .
has permission to perform . . . ./e
plumbing in the buildings of . . . 0 /{o. i�? ... . . . . . .
at. flfCcl. . .. . "s—. . . . . . . ., North Andover, Mass.
Fee$. . . Lie. No. M. . . . . . . . . ... . . . . . . . . .
PLUMBING INSPECTOR
Check # �
7747
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING
('Type or print)
NORTH ANDOVER,MASSACHUSETTS
t 2 �
Building Location I`7 6 `�'L�t�S/ Date !J.Owners Name
Penni
Type of Occuvancy Amount
New Renovation Replacement ' Plans Submitted Yes
❑ N0 ❑
FIXTURES
O >
U
O
rAO
W E~ rA
STgg41� A .a rn Ca O �q
' BA% E-.T
lS)r FI�Qt II
Z FI�t
3M FUM
4MFLOCIR
sm ROM
6IIiFI�t
9MM M CR
(Print or type) A1 � Check one: p
Installing Company Name ,A — Ov� ( � �,,,��e� S Certificate
❑ Corp. l..re
j Address 3 / i
0 Partner.
Business elephone9Lt
7 _ ri Firm/Co.
Name of Licensed Plumber:
Insurance Covera e• Indicate th pe of insurance coverage by checking the appropriate box:
Liability insurance policy Other type.of indemnity ❑ Bond ❑
Insurance Waiver: I, the undersigned,have been made aware that the licensee of
three insurance this application does not have any one of the above
Signature Owner ❑ F1Agent
I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the
best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in
compliance with all pertinent provisions of the Massachusetts State Plumbing Code and Chapter 142 of the General Laws.
By:
Signature Ul ucenseclrjum
Title Type of Plumbing License
City/Town
icense
APPROVED umber Master ® Journeyman ❑
(OFFICE USE ONLY
Date.... .:..
r
AORTOI
TOWN OF NORTH ANDOVER
40 o p PERMIT FOR WIRING
ss�cmutl
This certifies that
.Oo';Thr! .....t,?.�!..j.. �..............
has permission to perform .......... � G �
.... .............................................................
p
wiring in the building of t ......... .....✓....:. . .... ............................. .....
�" �
�..f-^ 0... ...... ...... t. . S............Q....... ,North Andover,Mass.
at......
Fee.`~a. ..- .`.. Lic.No..�'............. .!'...........J.. .. ...
1 ELEcrRicAL INSPEOR
Check #
8057
' Official Use Only
Commonwealth of Massachusetts
NEWDepartment of Fire Services Permit No.
\V�tjOccupancy and Fee Checked
BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] (leaveblank
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date: -Q
City or Town of. NORTH ANDOVER To the Inspector of Wires:
By this application the undersigned gives notice of his or her int nti
on to nerfiorm the electrical work described below.
Location(Street&Number) I'A'Oc�-
Owner or Tenant D O fyN \ C, V 1` iYt\ Telephone No.
p 78 i-ass�s-9�raq
Owner's Address 0��"C.C�.FoIr S�' mol-�-� o ver-
Is
erIs this permit in conjunction-with a building permit? Yes 2 No ❑ (Check Appropriate Box)
Purpose of Building ► '\�kA+ Utility Authorization No.
Existing Service Z 0O Amps / Volts Overhead ❑ rd Und
g ❑ No.of Meters
New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
Completion o the olloMn table maybe waived by the Inspector of Wires.
i No.of Recessed LuminairesI. No.of Ceil:Susp.(Paddle)Fans No.of Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- ❑ o.of Emergen-ey-L-igl-Em-g
rnd.
gr-d. BatteEX Units
No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No. of Zones
No.of Switches S No.of Gas Burners No.of Detection and
Initiatine Devices
No.of Ranges No.of Air Cond. Tons No.of Alerting Devices
No.of Waste Disposers .Heat Pump Number ,Tons KW No.of Self-Contained
Totals: - ..
Detection/Alerting Devices
l No.of Dishwashers f Space/Area Heating KW Local❑ Municipal El Other
Connection
N No.of Dryers Heating AppliancesKW Sectio. Systems:
Devices s or Equivalent
No.of Water No.of No.of
Heaters KW Data Wiring:
Signs Ballasts.
No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications iring:
No.of Devices or Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: t (When required by municipal policy..)
Work to Start:3'a s" �� Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless
the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The
undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: LIC.NO.:2)9 $Sy E
Licensee �+�
OM °Lil\C� V V Signature LIC.NO.:
(If applicable, enter -exem t' n the lice s number 1'ne.) Bus.Tel.No.-71) SSS-9�faq
Address: 1c�ar.57- - sit N• �n veer Vino Alt.Tel.No.:
*Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Lic.No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally
required by law. By my signature below,I hereby waive this requirement. I am the(check one) ❑owner ❑owner's agent.
Owner/Agent
Signature Telephone No. PERMIT FEE:$
r �
:57 �z ��
.44
o 7-
d
�r
r The Commonwealth of Massachusetts
ki ! Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston, 112A 02111
www.nxass.govIdia .
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Lea-ibly
Namte(Business/Organization/individual):
Address:
City/State/Zip: Phone #: .
Are you an employer?Check the appropriate box: Type of project(required):
1.❑ 1 am a employer with 4, Q I am a general contractor and I 6, Q New construction
employees(full and/or part-time).* have hired the sub-contractors
2.❑ I am.asole proprietor or partner- listed on the attached sheet.2 7• ❑ Remodeling
ship and have no employees These sub-contractors have 8. Demolition
working for mein any capacity, workers' comp. insurance.
�' 9. (]Building addition
[No workers'comp,insurance 5. ❑ We are a corporation and its 10 Q Electrical
required.] officers have exercised their repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL 11.Q Plumbing repairs or additions
Y myself,[No-workers'comp. c. 1.52, §1(4),and we have no 12.Q Roof repairs
insurance required.]t employees. [No workers'
comp.insurance required.] 13.Q Other
*Any applicant that checks bo>,r#l must also fill out the section below showing their workers'compensation policy information,
t Homeowners who submit this affidavit indicating they ate daring all work and then hire outside contractors must submit a new affidavit indicating such.
4contractors that check this box must attached an additional sheet showing the name of the sub•conttactots and their workers'comp.policy information.
1 am an employer that is.providing workers'compensation insurance for nq employees: Below isthe policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.#: Expiration Date:
1
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 required 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 imprisonment,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 andpenalties ofperjury that the information provided above is true and correct
Signature: Dom.
Phone#:
Official use only. Do not write in this area,to be completed by city or town official
City or Town: Permit/License#
Issuing Authority(circle one):
1. Board of Health 2. Building Department 3.City/Town Clerk 4. Electrical Inspector 5.Plumbing Inspector
6.Other
Contact Person: Phone#:
Information and Instructions
Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees.
Pursuant to this statute,an employee 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'€oregoing 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-contractors)name(s),address(es)and phone number(s)along with their certificates)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 affidavit. The affidavit should,
be returned to the cityor 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 companies 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/license number which will be used as a reference number. in addition,an applicant t
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 ofthe affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for fixture permits or licenses. A new affidavit must be filled out each j
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 and fax number:
The Commonwealth of Massachusetts
Department of Industria! Accidents
Office of Investigations
600 Washington Street
Boston, MA 02111
Tel. # 617-7274900 ext 406 or 1-8.77-MASSAFE
Revised 5-26-05 Fax#617-727-7744
www.mass.gov/dia
I
Date. ell.. .... ..
NORTH
Of �.to .6'fti0
TOWN OF NORTH ANDOVER
. :
• PERMIT FOR GAS INSTAL _.ION
a°,`-�-.1.�°•,.,�y
V.—
SACHU
This certifies that . . . . . . . . . . . . . . 9
has permission for gas installation .FG./t rt eq `. . . . . . . . . . . . . .
in the buildings of . . . (? �. . . . .. . !. . . . . . . . . . . . . . . . . . . . . .
at North Andover, Mass.
rDFee. .�P. . . . Lic. No.. . . . . . . . ��, - . . . . . . .
GAS INSPECTOR :
Check#
57 .. .i'
X06 06:22p Dan Sedens 7812337530 _ p•1
MASSACHUSETTS UNIFORM APPUCATION FOR PERMIT TO DO GASFJTTING
(Print or Typel
KN y e'z° Mass. Date 10-�O` f3 Permit
Building ��Location LyC-O A- S'rOwner'.,NameC...—
,, Type of Occupancy 'Z`�s
New ❑ Renovation ❑ Replacement ❑ Plans Submitted: Yes❑ No
a
rr
H W W
rn ai O � r s
o su. m Z x c
r < = O t' w
y W o ¢ C28
W W W t S W ¢ 1Y ~ W 1 = C
d r. at .at j r z F' t*- > rn � z a z � o a i
x < ec W Z < CG < < O O W S o •t r
SUB-8SMT.
BASEMENT
1ST FLOOR
2ND FLOOR
P 3RD FLOOR _
4 . 4TH FLOOR
STH FLOOR
6TH FLOOR
7TH FLOOR'
STH FLOOR
Installing company Name Sedens Plumbing and Heating inc. Check one:
Address 5 Eustis St. ® Corporation 2734C
Saugus, MA 01906 ❑. Partnership
Business Telephone 781-233-7500 ❑ Firm/Co.
Name of Licensed Plumber or.Gas Fitter Dan Sedens
INSURANCE COVERAGE:
I have a,current liability Insurance policy or its substantial equivalent which meets the requirements of MGL Ch. 142.
Yes X No ❑
If you have checked yes, please indicate the type coverage by checking the appropriate box.
A liability insurance policy C4 Other type of indemnity❑ Bond ❑
OWNER'S INSURANCE WAIVER: i am aware that the licensee does not have tine Insurance coverage •equired by
Chapter 142 of the Mass. General taws. and that my signature on this permit application waives this requirement.
Check one:
Owner❑ Agent❑
Signature of Owner or Owner's Agent
I hereby certify that aU of the details and information I have submitted for enter application true and accurate to the best of my
knowledge and that all plumbing work and installations performed under the rrni!isw for this ap 1 be in reliance with all
peffi"t prcrisions of the Massachusetts State.Gas Code and Chapter td2 the General ws
BY
Tme of license: Z✓'
Plumber nature of Licensed mbar Gas er
Title Gasfitter
Master License Number M 12884
t]tyRown Journeyman
APPtiWivD I
L_
.Location 1v -1r'ari��O✓i) � t� l '
No oL7f� Date "
�oRTM TOWN OF NORTH ANDOVER
9 Certificate of Occupancy, $
Byilding/Frame Permit Fee $ �—
cMust` Foundation Permit Fee $
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL $
GBuildin c or
!rl4R 9 4 26.00 PAID
NIR a r�416 Div. Public Works
PERMIT NO. 7c) APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1
MAP h40. LOT NO. 2 RECORD OF OWNERSHIP :DATE BOOK :PAGE
ZONE ,y SUB DIV. LOT NO.
LOCATION �-
LOCATION /,�� �/�/1 0�A /1 PURPOSE OF BUILDING�r�-/�,y� �1/y_ 6 O�t,, t.
OWNER'S NAME T v (fc^�-fJ J /VJ NO. OF STORIES I/'J•` `SSIIZZE�
�f3 2-T 4-.-zi�l V 2c
OWNER'S ADDRESS l !gn2 /a y� s� ,er—�,�� BASEMENT OR SLAB _
ARCHITECT'S NAME �•Ji�,/7 f/-7tJ SIZE OF FLOOR TIMBERS IST 2ND 3RD
BUILDER'S NAME C+� SPAN '
DISTANCE TO NEAREST?BUILDING DIMENSIONS OF SILLS
DISTANCE FROM STREET POSTS
DISTANCE FROM LOT LINES—SIDES REAR GIRDERS
AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW SIZE OF FOOTING X
IS BUILDING ADDITION MATERIAL OF CHIMNEY
IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS 3 PROPERTY INFORMATION
LAND COST
SEE BOTH SIDES
EST. BLDG..COST
PAGE 1 FILL OUT SECTIONS 1 - 3
EST. BLDG. COST PER 8Q. FT.
PAGE 2 FILL OUT SECTIONS 1 - 12 EST. BLDG. COST PER ROOM
SEPTIC PERMIT NO.,
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
:.� PLANS MUST BE FILED AND APPROVED BY
BUILDING INSPECTOR
DATE F 9
BOARD OF HEALTH
SIGNATURE OF OWNER OR AUTHOFTIZED AGEN
FEE
OWNER TEL.#-.L6-6 v PLANNING BOARD
PERMIT GRANTED CONTR.TEL.#
19 CONTR.LIC.# !S 7-F- ~
BOARD OF SELECTMEN
tA
w79-tle�,
� BUILDING INSPECTOR
Zo
BUILDING RECORD
1 OCCUPANCY r 12
SINGLE FAMILY sioRits 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 3 1 2 13
CONCRETE BL'K. PINE
BRICK OR STONE HARDW D
PIERS — PLASTER — —
DRY WAIL
UNFIN.
3 BASEMENT
AREA FULL FIN. B M'T AREA _
V. 1/2 1/1 FIN. ATTIC AREA _
NO BMT FIRE PLACES _
HEAD ROOM MODERN KITCHEN
4 WALLS I 9 FLOORS
CLAPBOARDS B 1 2 3
DROP SIDING CONCRETE
WOOD SHINGLES EARTH _
ASPHALT SIDING HARDI'JD _
ASBESTOS SIDING _ COMMGN
VERT. SIDING ASPH. TILE _
STUCCO ON MASONRY
STUCCO ON FRAME
BRICK ON MASONRY ATTIC STRS. 8 FLOOR _
BRICK ON FRAME
CONC. OR CINDER BLK.
STONE ON MASONRY WIRING
STONE ON FRAME
SUPERIOR I� POOR
ADEQUATE NONE
5 ROOF 10 PLUMBING
GABLE I HIP BATH 13 FIX.)
GAMBREL MANSARD TOILET RM. (2 FIX.)
FLAT SHED WATER CLOSET _
ASPHALT SHINGLES LAVATORY
WOOD SHINGES KITCHEN SINK
SLATE NO PLUMBING _ a-
TAR & GRAVEL STALL SHOWER _
ROLL ROOFING MODERN FIXTURES _
TILE FLOOR
TILE DADO
6 FRAMING I 11 HEATING
WOOD JOIST PIPELESS FURNACE .M�_Y.
FORCED HOT AIR FURN. w_
TIMBER BMS. &COLS. STEAM
STEEL BMS. &COLS. _ HOT W T'R OR VAPOR �~
WOOD RAFTERS _ AIR CONDITIONING
7
RADIANT H'T'G
UNIT HEATERS
7 NO. OF ROOMS GAS
OIL
B'M'T 2nd ELECTRIC
1st _ 13rd• I NO HEATING
a
Town of IY L - - Andover
No. 270
Tort Andover, Mass., r94LY S _
O
•`� ADRAT D PP 'C� f
�S t
7 L BOARD OF HEALTH
Food/Kitchen
k
Septic SystemPERMIT TO iLD
E
r
BUILDING INSPECTOR
THIS CERTIFIES THAT..........................i�'� ���..........'I"I .1.N.�► �
..................................................................
Foundation r
f
has permission to ant....A.Lt= ........... buildings on ......1J.0... et.N.o.1oA. ......v.1......`. Rough
to be occupied as....................C " mm.....�Ih4a.6 GYM' �..... ........................................ imney
provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Final
this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of C
Buildings in the Town of North Andover. PLUMBING INSPECTOR I
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough "
FinalF`'
PERMIT EXPIRES IN 6 MONTHS '
ELECTRICAL INSPECTOR _
UNLESS CONSTRUCTI TARTS
Rough
BUILDING INSPECTOR
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR w
Display in a Conspicuous Place on the Premises — Do Not Remove Rough
P y P Final
No Lathing or Dry Wall To Be Done
Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT
Burner
PLANNING FINAL CONSERVATION FINAL Street No.
Smoke Det.
SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT
— ���
A
Location
No. 7 Date
r r
2
TOWN OF NORTH ANDOVER `
0
F R
P
i $
+ i ; 4 Oertificate of Occupancy
Building/Frame/Frame Permit Fee $ fid• ��
s�CMust 9
Foundation Permit Fee $
Other Permit Fee $
i
TOTAL $
Check #
CP
1 9 1 4 8 uiiding Inspector