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HomeMy WebLinkAboutMiscellaneous - 143 MILL ROAD 4/30/2018 143 MILL ROAD 210/107.C-0003-0000.0 r 4 PO Box 55098 8aston,MA 022055098 Form of Notice of Casualty Loss to Building Under MASS. GEN. LAWS, Ch. 139, Sec. 3B To: . Building Commissioner or Board of Health or Inspector of Buildings Board of Selectman City Hall City Hall NORTH ANDOVER, MA 01845 NORTH ANDOVER, MA 01845 I -RE: , - Insured:. __ ELIO NICOLOSI and DANIELLE NICOLOSI - Property Address: 143 MILL ROAD,NORTH ANDOVER, MA Policy Number: HMA 0373091 Claim Number: BOS00054641 Date of Loss: 3/8/2015 Company: Safety Indemnity Insurance Company Claim has been made involving loss, damage or destruction of the above-captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass. Gen. 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 number. Blake Wilder Claim Examiner 3/11/2015 Safety Insurance.Company Homeowners Claims Unit P. O. Box 55098 Boston, MA 02205-5098 Phone: (617) 951-0600 EXT 3547 Fax: (617) 531=6653 Email: B1akeWilder@Safetylnsurance.com Date... ....rI.. ` .............. �10RT TOWN OF NORTH ANDOVER, ° �, p PERMIT FOR WIRING sSACHUs� This certifies that .ACa'`V ..... . has permission to perform .r .� ........... 'l C- ........... wiringin the building of.......................U..1 ............................................................................... t ...............1.4.3........... .' ..... .'.................................., o h AndtMass.Fee:.. ........Lic.No. i # ...... ....................ELECTRICAL INSPECTO Check# Y1 12731 l,ommonwea&o f i"!'/amachaaettd Official Use Only 2cc{� Permit No. � epartment o f ire Serviced —I Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev. 1/07] leave blank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TrPE 44LL INFORMATION) Date: �. City or Town of: Au^WPk&- To the Inspector of Wires: Q. By this application the undersigned gives notice of his or her intention to perform the electrical work described below. Location(Street&Number) Owner or TenantTelephone No. X30 Owner's Address F' Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box) Purpose of Building go&tj `/,� Utility Authorization No. Existing Service_L0_ Amps 1201 240Volts Overhead ❑ Undgrd r7 No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity 2 � I 1 Location and Nature of Proposed Electrical Work: YYNIh + Completion ofthefollowing table may be waived by the Inspector of Wires. No:of Recessed Luminaires 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.o Emergency Lighting rnd. rnd. BatteKy Units r No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No.of Zones 1 No.of SwitchesNo.of Gas Burners No.of Detection and Initiatin Devices No.of Ranges No.of Air Cond. Tonsl No.of Alerting Devices No.of Waste Disposers Heat Pump Totals: Number. TgnLKW No.of Self- ontained 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 Equivalent No.of WaterKms, No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent ^ No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring.: ) No.of Devices or Equivalent ='�' OTHER: Attach additional detail if desired,or as required by the Inspector of Wires. Estimated Value of Electrical Work: �� (When required by municipal policy.) Work to Start: Inspections to-be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE 06 BOND ❑ OTHER ❑ (Specify:) I certify, under the pains and penalties of perjury,that the informado on this application ' ue and complete. FIRM NAME: LIC.NO.: Z(k(nr Licensee: Signature LIC.NO.: 918A (Ifapplicable, enter "exempt"in the license number line) Bus.Tel.No. 1118 75Q(o4o0 Address: 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 a ent. Owner/Agent Signature Telephone No. PERMIT FEE. $ i I �- v l �/ �, i t The Commonwealth of Massachusetts Department of Industrial Accidents Ofj`!ce ofInvestigations 1 Congress Street,Suite 100 Boston,MA 02114-2017 www.masagov/dia Workers'Compensation linsurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Lezibly Name(Business/Organization/Individual): Cranney Companies Address: 10 Rainbow Terrace City/State/Zip:Danvers,MA 01923 Phone#:800-559-7000 Are you an employer?Check the appropriate box: Type of project(required): 1.FE I am a employer with 72 4. ❑ I am a general contractor and I employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction 2.❑ I am it sole proprietor or partner- listed on the attached sheet, 7. ❑Remodeling ship and have no employees 'These sub-contractors have g• ❑Demolition working for me in any capacity, employees and have workers' [No workers' comp.insurance comp.insurance.t 9. E]Building addition required.] 5. ❑ We are a corporation and its 10.[iol Electrical repairs or additions 3.[:11 am a homeowner doing all work officers have exercised their I Ln Plumbing repairs or additions myself. [No workers' comp. right of exemption per MGL 12. Roof insurance required.]t c. 152,§1(4),and we have no ❑ repairs employees. [No workers' 13.❑Other comp.insurance required.] *Any applicantthat checks box#t must also fdl out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that check this box must attached an additional sheet showing the name of the gab-contractors and state whether or not those entities have employees. N the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation Insurance for my employees. Below is the policy and job site information. Insurance Company Name:New Hampshire Employers Insurance Policy#or Self-ins.Lie.#:ECC60040004772014A Expiration Date:03/25/15 Job Site Address: �� City/State/Zip: �f I a Attach a copy of the workers'c mpensation 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 cerdfy under the pains and penalties of perjury that the information provided above is true and correct Si suture: Date:03/27114 Phone • 9070021 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/I,icense# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector G.Other Contact Person: Phone#: - H17SETT _ • • ■■ S7 r. LC .F -11®R; _ I C F Afil iQ RA .EY l.. -tP RN 13 • � _ - =.�a':y:-`i3� FTI" � ` � 7aI a�/3l% 2-7863 a °' SUSOE_Li1�IFNC ftgE AS, - - ° :: . °fir' 44 Y ELECT �..- _RI C' b�li'ANY. AICA t yam. �._��...:...-. s 'V 77 :r='-moi".«.,o;" -a ID 918 : x..07%3�l; i ;z78G2 Date. t "o oT:A TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSACNUSE� / This certifies that w/ G. . . . .,1.�� ! . . . . . . . . . . . . . . . . has permission to perform . . . . lili ./. . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . / ./.Cry<U s.l... . . . . . . . . . . . . . . . . . . at . . ./�!-7. . .`fir��.1. . /?G�. . . . . . . . . . . , N_ rth Andover, Mass. e� Fee.;. . . . . . Lic. No j? �.`?. . . . . . . . . PLUMBING INSPECTOR Check # "7 k,!_ 8590 MASSAGHuSET3-S UNIFORM APPLICATION FC3R PERIi+11T TO DO PLU—MBING - CitylTowrt MA. Data., Permit# Building Lacatlon 1 ��,�� � Owners TWne: , Type Of Occupancy: commercial!� Educational 0 industrial❑ Institutional❑ Residential New.-❑ Alteration-❑ Renevation' I •D Replacement: Plans Submitted: Yis❑ Na FIXTURES - Z 67 a i Q _f!1 U to tit +� LU O w 41 w us 'a 07 sh O a to a Cl ru z U. z � a Z M m n a a` .� c o o z a16- z FLOOD 3 FiOpR � 4 Fit10R _ I 5'FLOOR & FLOOR f f T FLOGLOO installing Company h`?rets: r 1 '' Check One ON l Address.�.i_Iyi1 �-.CIVrowtt_ State; E IvCorporauoll i? Business Tei: %:"• =%� =� `�,'=f, 1=asc —� Q Partnership Name of L! sed Plumber, ` Q FirmfCarttpany _ ��'.•- !J�� _ill/'✓\ INSURANCE�OVFRAGE: I have a current i€ Ulkinsumrce policy or its substzntlal equivalent which meets the If you have checked in�lic�eine ape of coVera'ae h Gtt..Cltial file �Pretrtetsts of MCL Ch.442 Yes .Yes lase p- y a _q aPproptiate box below. A liability insurance policy [.��� Other type of indemnity ❑ Band ❑ _OWNER'S MSURANCI:w-41v=R;lam aware that fha licensee rifles not(rave the insurance &%swchusetts general Laws,and tlsat sl _ coves e my gttattln ort this permit application mattes this 9 requteed by Gf�apter142 ofthe requirement. s Check Oiee only Si afore o,Qnsror 0vrmrs Agent ©vainer ❑ Agent ❑ I Y thatallofthedefaiisartdiafarmattonthaves�rnttted(arenferei Kin is igl Plumbing Work and lnsftllations oa ff red tmderthe rant iss }mss� 1 Pe2tltzgrtLprQt alrttt fll`t&e iiTassa�lrtssetts atatr:Pl:rt=rbirg Carte and Chapter pe;nft i a�urafa 2a the bit of my C tai Laws, P-- Or.wHl be in compliance with all By TYpe of Licattsw: Title --- PI tuber Signature of LIt:EifSA i]Fl2EtET r CItylTaavrt � s5r 1APPROVim foFRCaUSECNLYi 1 ❑Journsynien License Number. Location {� ��I�[. C f��• No. ✓ ��� % 9 Date _5��1�. TOWN OF NORTH ANDOVER • O'tt� ° �,yo Certificate of Occupancy $ --�� } +99' aC Building/Frame Permit Fee $ 1 :3 J, Foundation Permit Fe I r�$ ACMu i C%Jther Permit Fee $y0v-Connection Fee $114� 41p � W ate ection Fee $ I lc/I�1�Zl J 1 aoL y �AL $ D. Vhq Building Inspector Div. Public Wore _ � _.. ��...,r...�mow,._ .c,,,.�.. i_,,•,.r; . y,. ;,,r•.,:j }; .. � 1. � =•: Location No. Date NaRTM TOWN OF NORTH ANDOVER �f « e y1ti Milli Certificate of Oc ancy $ .� + ; Building/Frame Permit Fee $ s"""° Foundation Permit Fee $ s�CHuso Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL Building Inspector 08/94 49:35 50.00 PRID 7061 Div. Public Works . A Location t' A / / /&-4 /�/D- (I"i �t Date -3 /18 a No. v� Z � (��L�,,,� ") NOR*� TOWN OF NORTH ANDOVER O��t�ae ,a1y0 - p Certificate of Occupancy $ ` , ` Building/Frame Permit Fee $ 1ss'4". th T� F_oGnd tl pp Permit Fee $ CH ``��� "S1 M --"•-tb r'Permit Fee $ Sewer Connection Fee Water Co% tion Fee $ y Building Inspector 7 Div. Public Works Ala y da / PERJt17-qz0. e-41 lf ip APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. f/�/IJ Y Z PAGE 1 NIA$KBO. LOT NO. 2 RECORD OF OWNERSHIP (DATE BOOK " LPAGE .ZONE I SUB DIV. OT NO. II LOCATION /t3 A/ / ) / 0 PURPOSE OF BUILDING h L'..J fa.9 � 1or OWNER'S NAME ]/�' /(N p l�r�G�� Ant %�- � NO. OF STORIES /✓ /( ,/SIIZiE' s u„l�V�J37R3I�Po rte` OWNER'S ADDRESS l fs,[CJ!'c wje r,))?) 16 BASEMENT OR SLAB - ARCHITECT'S NAME �r�s,.�p� ^ �5� SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME n dIVV�Q � /1 iJ� n B / d c� SPAN DISTANCE TO NEAREST BUILDING J'isU– l��D _,0,4 go DIMENSIONS OF SILLS DISTANCE FROM STREET =.7�{(O 7— - POSTS DISTANCE FROM LOT LINES–SIDES jO REAR :s"�ate` GIRDERS AREA OF LOT J Lf 2 ! J FRONTAGE J�.`S b HEIGHT OF FOUNDATION THICKNESS T IS BUILDING NEW V'�r' [' SIZE OF FOOTING X J �) IS BUILDING ADDITIO jv () MATERIAL OF CHIMNEY IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND WILL BUILDING CONFORM TO REQUIREMENTS OF CODE i/ IS BUILDING CONNECTED TO TOWN WATER BOARD OF APPEALS ACTION. IF ANY MIS IS BUILDING CONNECTED TO TOWN SEWER Ks J IS BUILDING CONNECTED TO NATURAL GAS LINE INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES EST. BLDG. COST PAGE 1 FILL OUT SECTIONS t - 3 EST. BLDG. COST PER OQ. FT. EST. BLDG. COST PER ROOM .� PAGE 2 FILL OUT SECTIONS i - 12 ♦ SEPTIC PERMIT NO. ' ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY t ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED/AND APPROVED BY BUILDING INSPECTOR DAllE FILED ,P (// e-cif BOARD OF HEALTH `a SIGNATURE OF OWNER OR AUTHORIZED AGENT FEE OWNER TEL.# -v // PLANNIN42 BOARD PERMIT GRANTED CONTR.TEL.# ,S 19 CONTR.LIC.# y` BOARD OF SELECTMEN BUILDING INSPECTOR BUILDING RECORD 1 OCCUPANCY 12 (._ SINGLE FAMILY STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND.DISTANCE FROM MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF 'BUILDINGS. WITH PORCHES. GA- APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT,PLAN. CONSTRUCTION 2 FOUNDATION _ 8 INTERIOR FINISH CONCRETE B 2 I_ CONCRETE BL'K. PINE BRICK OR STONE HARDW D —_—— PIERS PLASTER _ DRY WAIL _ UNFIN. 3 BASEMENT I `\ ` 1 AREA FULL FIN. B M TAREA _ 'L '/r '/. FIN. ATTIC AREA N_O B M T FIRE PLACES _ HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 2 3 DROP SIDING CONCRETE --�_ - \ WOOD SHINGLES EARTH ASPHALT SIDING HARDI!✓'D ASBESTOS SIDING COMMGN VERT. SIDING ASPH. TILE STUCCO ON MASONRY STUCCO ON FRAME BRICK ON MASONRY ATTIC STRS. & FLOOR _ BRICK ON FRAME CONC. OR CINDER BILK. STONE ON MASONRY WIRING STONE ON FRAME Ilk 1 SUPERIOR I-I POOR ADEQUATE NONE ' 5 ROOF 10 PLUMBING GABLE I HIP BATH (3 FIX.( GAMBRELMANSARD TOILET RM. (2 FIX.( FLAT A SHED WATER CLOSET ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK SLATE NO PLUMBING TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES _ TILE FLOOR TILE DADO 6 FRAMING 11 HEATING - WOOD JOIST PIPELESS FURNACE FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM STEEL BMS. &COLS. _ HOT W'T'R OR VAPOR 1 WOOD RAFTERS _ AIR CONDITIONING RADIANT H'T'G UNIT HEATERS t 7 NO. OF ROOMS GAS OIL B'M'T 2nd _ ELECTRIC 1st 13rd NO HEATING 1 +N Location No. Date NORT" TOWN OF NORTH ANDOVER F :misfimMllkp Certificate of Occupancy $ J© � rS :; Building/Frame Permit Fee $ SCHU -Foun�d►atnlPermit Fee $ Othery�Per)& Fee $ 'Sewer Connection Fee $ f Water Connection Fee $ TOTAL?-,, X99' $ V / Building Inspector 6320 Div. Public Works Location J No. o Date N°RT„ TOWN OF NORTH ANDOVER ,. 9 Certificate of Occupancy $ Building/Frame Permit Fee $ Foundation Permit Fee $ s,+cMust Other Permit Fee ` $ Sewer Connection 4Fee PcA $ 1Yd r�r Connection,Fee / NOV 2 TOTAL $ //00- 00 ®• ��', Building Ins 68 -or �Oy 011ector .01 r Div. Public Works - 7-- / flf NO. ©�� "''APPLICATION FOR PERMIT TO BUILD — NORTH ANDOVER, MASS. `/-��O PAGE 1 T � y MAP KVO ' L'_ LOT NO. 2 RECORD OF OWNERSHIP DATE BOOK 'PAGE ZONE I SUB DIV. L NO. !l 1 Z(pJulJgl LOCATION N( LL ��� U1,143 ) PURPOSE OF BUILDING QECJfo � OWNER'S NAME fFAArWC6,5CA * A,I.I-7GjNL0 t*3C"L45;j NO. OF STORIES !/ SIZEM I�W OWNER'S ADDRESS 48 5�IL ®2LV r . 2� �j N BASEMENT OR SLAB 5A:FlWgAf-r (�� ARCHITECT'S NAME J D5gn P. �k,A- �." SIZE OF FLOOR TIMBERS IST 2ND 3RD BUILDER'S NAME +� kj(p l [{eG6t&5i SPAN DISTANCE TO NEAREST BUILDING coo_.Z© �r DIMENSIONS OF SILLS DISTANCE FROM STREET 7 r' POSTS DISTANCE FROM LOT LINES-SIDES ( REAR I GIRDERS AREA OF LOT 431 &e l? FRONTAGE is-01- s-01 - HEIGHT OF FOUNDATION THICKNESS IS BUILDING NEW 1FGSIZE OF FOOTING X IS BUILDING ADDITION ` N- MATERIAL OF CHIMNEY 82CG� IS BUILDING ALTERATION t-J'O IS BUILDING ON SOLID OR FILLED LAND -50 WILL BUILDING CONFORM TO REQUIREMENTS OF CODE �G7 IS BUILDING CONNECTED TO TOWN WATER /N Eis BOARD OF APPEALS ACTION, IF ANY �fati,f�. IS BUILDING CONNECTED TO TOWN SEWER Maj IS BUILDING CONNECTED TO NATURAL GAS LINE �S INSTRUCTIONS 3 PROPERTY INFORMATION LAND COST SEE BOTH SIDES PERMIT FOR FOUNDATION ONL EST. BLDG. COST �1 7 2 PAGE 1 FILL OUT SECTIONS 1 - 3 REGULAT D BY PARA: 112.7 S.B aST. BLDG. COST PER SQ. Ff. PAGE 2 FIL� OUT SECTIONS 1 - 12 GATE: Z FEE PAID: O EST. BLDG. COST PER ROOM SEPTIC PERMIT NO. ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR DATE FILED BOARD OF HEALTH SIGNATURC�6F OWNER OR AUTHORIZED AGENT C! e t. OWNER TEL.# -ell 7o<;/-/ F E E %1,3'4p , D D CONTR.TEL.#_.. CONTR.LIC.# PLANNING BOARD PERMIT VRA --- 19 --19 w larom m Q /�O I Q L9 BOARD OF SELECTMEN PERMIT FOR FRAME/BUILDING LESS fm FE DUE ffoE PrEnnidri DATE: FEE PAID:��(:._. _ ��, BUILDING INs cR _VfV J Tic. # Ivo 3- y 37- o fit/ / 0610, BUILDING RECORD 1 OCCUPANCY12 fri SINGLE FAMILY Si OkIES / .....-��� vxr`.�+,•_ f THIS SECTION'MUST•SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM MULTI. FAMILY♦ OFFICES —y — LOT LINES' AND: -EXACT DIMENS10Na5 OF BUILDINGS. WITH PORCHES, GA- APARTMENTS, RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN. CONSTRUCTION 2 FOUNDATION I 8 INTERIOR FINISH CONCRETE �_ _ B 11 2 13 CONCRETE BL K. PINE _ BRICK OR STONE HARDW D — PIERS PLASTER ,FURY WALL _ UNFIN. 3 BASEMENT AREA FULL [' FIN. B M AREA _ '/ '/x �/ FIN. ATTIC AREA _ NO BM'T FIRE PLACES HEAD ROOM MODERN KITCHEN 4 WALLS I 9 FLOORS CLAPBOARDS B 1 22 J 3 DROP SIDING CONCRETE I/ (— WOOD SHINGLES EARTH ASPHALT SIDING HARDW D ASBESTOS SIDING ��.__ COMMON _ VERT. SIDING ASPH. TILE STUCCO ON MASONRY + STUCCO ON FRAME �" 1 1 BRIC K ON MASONRY ATTIC STIRS. & FLOOR _ BRICK ON FRAME k ' } + •�, CONC. OR CINDER BLK. _ STONE ON MASONRY WIRING STONE ON FRAME _ SUPERIORI� POOR — ADEQUATE / NONE 5 ROOF 10 PLUMBING GABLE I HIP BATH )3 FIX.) GAMBFEL MANSARD TOILET RM. 12 FIX.) ' FLAT SHED WATER CLOSET "y ASPHALT SHINGLES LAVATORY WOOD SHINGES KITCHEN SINK ,. — 1 SLATE NO PLUMBING _ TAR & GRAVEL STALL SHOWER ROLL ROOFING MODERN FIXTURES 1 TILE FLOOR _ - TILE DADO �. 6 FRAMING I 11 HEATING WOOD JOIST PIPELESS FURNACE _ FORCED HOT AIR FURN. TIMBER BMS. &COLS. STEAM, STEEL BMS. & COLS. HOT W'T'R OR VAPOR WOOD RAFTERS AIR CONDITIONING i RADIANT H'T'G _ UNIT HEATERS- v 7 NO. OF ROOMS GOAD V l 'MIT 2nd ELECTRIC - 1't 13rd I NO HEATING R E � ; i< CERTIFIED FOUNDATION LOCATION i _ PLAN LOCATED IN: )U0..27771 . . . 9 G SCALE• /" _ J ZMTE_ a ; -7 CHRISTIANSEN e SERGI, INc. => 160 SUMMER ST. HAVERN/LL, MA. 0/830 9 • z ?z� CLIENT. � d. . . . /U/.�-D. S /. . . . . . . . . . . . 3 z ¢ TH/S CERTIFICATION /S MADE AND L/"/TED TO TME ABOVE CL/ENT. 0 vD s�r o' I CERT/FY THAT THE STRUCTURE SHOWN CONFORMS 4 f'. ,( �' TO 71 E DIMENSIONAL REQUIREMENTS OF THE ZON/NG BY-LAWS OF THE 77 0:� ✓./�,% . . . . . . OF WREN CONSTRUCTED. OFFSETS SHOWN ARE FOR.ZONING DETERM/N.4770N OftY AND ARE NOT TO BE L/.SED TO ESTABL/SN PROPERTY.L/NES OR TO DETERMINE L0C.4T/ONS OF BUIL DING ADD/TIONS. ^ co T TO.THE BEST OF MY KA10MLEDGE .AND BELIEF THE PR/MARY`STRUCTURE SHOWN ON TN/S PL4N o r L /S NOT LOCATED W/TH//V A FLOOD /IAZARD ZONE �A N AS SHOWA ON DEPARTMENT H.LID. FEDERAL T �S M INSURANCE ADM/N/STR.4T/O/V M,4PS. COMMUNITY NUMBER: j o D -DD:! . . . . . . . DATE:. . OF M MICHAEL cy� o J. SE I H 71 No. 91 c si 9F STEREO [ l`ANo f r. f a - Town of North Andover BUILDING DEPARTMENT Homeowner License Exemption (Please print) DATE JOB LOCATION 143 A-lrl-Z Number Street Address Section of town 'r 'HOMEOWNER" Name Home Phon Work Phone PRESENT MAILING ADDRESS /`U 3CepoC" . City/Tow-11 State Zip code The current exemption for "homeowners" was extended to include owner -occupied dwellings of six units or less and to allow such homeowners to engage an individual for hire who does not possess a license , provided that the owner acts as supervisor . (State Building Code , Section 109 . 1 . 1) DEFINITION OF HOMEOWNER: Person(s ) who owns a parcel of land on which he/she resides or intends to reside , on which there is , or is intended to be, a one to six family dwell- ing , attached or detached structures accessory to such use and/or farm structures . A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner" shall submit to the Building Official , on a form acceptable to the Bulding Official , that he/she shall be responsible for all such work performed under the building permit . (Section 109 . 1 . 1 ) The undersigned "homeowner" assumes responsibility for compliance with the State Building Code and other applicable codes , by-laws , rules and regulations . The undersigned "homeowner" certifies that he/she understands the 'Town of North Andover . Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements . HOMEOWNER ' S SIGNATURE kPPROVAL OF BUILDING OFFICIA vote : Three family dwellings 35 , 000 cubic feet , r 1 ger , will be required to comply with State Building Code Secti 27 . 0, Construction zontrol . • I FORM U TOWN OF NORTH ANDOVER , z LOT RELEASE FOM ' , SUBDIVISION -rur-4a , r%RM i Al / ASSESSORS MAP / (?7 C - 3 SUBDIVISION LOT(S) Lot 1(0 PERMANENT ADDRESS (ASSIGNED BY D.P.W. STREET M v L L (Loq.p APPLICANT Nwo Nicob :; PHONE 44.3 7-6411 DATE OF APPLICATION TOWN USE BELOW THIS LINE PLANNING,,BOARD ooiy DATE APPROVED TOW PLANNE A�A _ Iqo DATE REJECTED CONSERVATION COMMISSION DATE APPROVED /l- ' CONSERVATION ADMIN. DATE REJECTED BOARD OF HEALTH x DA'Z'E APPROVED HEALTH AN T RIANsr-mf -s DATE REJECTED lw DEPARTMENT OF PUBLIC WORKS 0/ �{�q DRIVEWAY PERMIT t9,z� Q4,A10t &aWtt /WATER CONNECTIONS --PO V1114 FIRE DEPT. RECEIVED BY BUILDING INSPECTION DATE II' ► This form shall be signed by the agents of the Planning and health Boards, . the Conservation Coiiunission prior to the issuance of any building permits ' for the subject lot. This form shall not releive the applicant from the compliance of any applicable Town requirement or Bylaw. +� !! jaw t Y ' ~ T f i n w� f • l N L Vi PLANNING .avae&'a .7;a. FINAL • — SER/1NATER16�AL own ofc naover N6. 5OZ DRIVEWAY ENTRY PERMITK o, er Mass. 19 �A C �ME WICK\� � � , PERMIT T 0"? PP � 1 LD BOARD OF HEALTH THIS CERTIFIES THAT ............. ® ...............%fir...... .. ... ic . a . BUILDING INSPECTOR . ... . ..���j . ....... ........... has permission to er . .. . ..~uildings /8/j on /' Avop m3 Rough AA to be occupied as bI . F nia ney provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMBING INSPECTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of Rough Buildings in the Town of North Andover. PERMIT FOR FOUNDATION ONLY Final VIOLATION of the Zoning or Building Regulations Voids this Permit. REGULATED BY PARA: 112.7 S.B.C. PERMIT EXPIRES I N &0 -TFH DATE: 'ZZ'q/ FEE PAID:100- ELECTRICAL INSPECTOR Rough UNLESS CONST CTS Service PERMIT FOR FRAMUBUILDING Final . . .... . . ............ . DATE: 2 7-fEE PAID• ��. _ BUIL NSP OR GAS INSPECTOR Occupancy Permit Required to Occupy Build*n - cam' Rough W&M Am�� ' . � � '� �✓ Final Display in a Conspicuous Place on the Mas- 3 FIRE DEPT. Do Not Remove Burner No Lathing to Be Done Until Inspected and Approved by S oke Smoke Building Inspector Location ��_� ✓l/f I`4o. �4 Date O „oRTN +OOTOWN OF NORTH ANDOVER C? •�t�ao /•, A , Certificate of Occupancy $ + : Building/Frame Permit Fee $ Foundation Permit Fee $ s�cNus _ #her Permit Fee $ 5 - d U 0 pNAAS ewer Connection Fee $ p,�C;ex � 1 Water Connection Fee $ Ozj 2 OVAL $ N� Pn Building Inspector c. Div. Public Works a Town of ., A-I'I()N \' I I\'I`:I,IN(11' 11 i 1 i 1 it1!i•Iii!i `r• I'I.i\NNIN(� 111,ANNIN(; Y� (,On1f1111N1 1'1" U1:�'1;LU1'L\11�N 1 ' KAI fl: 11.1 '. NI:I.ti( )N. I )II(1:(:1 CHIMNEY APPLICAIIOIJ AND PENA111' DATE /'/� —� — ��- --- 1'L'11 Il17'. LOCATION� 3 /��" 4NER'S NAME:—.' y� A// MILDER'S NAME: �j�1 ��/� /��i c v1/ (ASON'S NAME:_ /' Al MON'S ADDRESS: 'ASON'S TELEPHONE: ATERIAL OF CHIMNEY: NFERIOR CHIMNEY: LXILIZ IOR CHIMNEY: UMBER AND SIZE OF FLUES: HICKNESS OF HEARTH: • ili clLunney an. OvAepCnee ean()lanul tO 4he. u() .this code curd Ilc(ve -u(Ce3 ( ►Id eguiatiow been aeeeZued: AT.E:Cw IGNATURE OF MASON: ERMI r GRANTED: /* FLL JBERT NICETTA ' UILDING INSPECTOR wSPECTEO: EMARKS: SOLID BLOCK HE'Q U1KG1) THIS PERMIT MCIST C;L: DISPLAYED 014 11IE I'KLIM SES Y .:i. k .-.. ,,,, - � '" •'}" .:r .,.. `v i,i Y. +� 'C '�- i p" u �+ � .yew r Id MR TANNA pu S.4D r�^r�� w ., s� aim t ✓ w "''� 'k`4}� a�'� �� '•�+ i5 -�F .^" � ,s nln � �''rll�an�ae. r+Q s 4#kti,« -n OIAM P-1,96, e40 Y�t�•'� ;u+. `�, �' Wur � '""`,'^' .� a .h=j .r^�'v •,rttxa.. F t.. a�.+� r7+-� . ,"-.. M " � R � ` •a� I"ME 's�! 4"Ma ,� alperso' ns ,iaw�i ��v,�• Ah y ..£ s,,, -,r S MR ,^' ' ,:y���. pertaUing("to Ceonstruct�onaiteratlons o rep rson a ml " 's�y , .p.�A,r. L known ash 3- ri;;�= W4 1 77 k �" ;.y�'.ipadr'�ir[w k .,f.,, 3 y'3::. .,t„ s °�'.�r '�,4,`. a ..,tq•'' v�'�v '°`-tom;�'P' ,y�G vii" 4 All erfons actin thif order ori rem or mutat n m this �notic's are Ilable' to ' Tros�Jwt = . ntra YCh wado ,tf SY�thOrlZe�l,, d A e:w 9 ° g 9 _ t ^Yr ► r o ''.' t ,�`�,tr. � "i'r'' x ,. � �� .K:"' �#z m��r� ����,• ' ^.' "�,�rti� ""`r �8�1�LD�MO OiFF '��'�,���.`�`�`r��".��""' '-�°�„. k. '� .- , . � �f-, �'pj`,�'��i ..•!.: 'wM. rl�.. '. yr3 �� 'P.� ;'S�� "�1a'u`c+„w Joseph D. LaGrasse & Associates Inc. . Architects • Engineers • Land Planners 1 Elm Square Andover,Massachusetts 01810-3609 '- Phone: (508) 470-3675 J March 8, 1993 Building Department Town of North Andover 120 Main Street North Andover, MA 01845 RE: Structural Certification Lot 16 Mill Road I. Joseph D. LaGrasse, of Joseph D. LaGrasse & Associates, Inc. have reviewed the structural wood framing construction of the residence on Lot 16 Mill Road, North. Andover, MA. I certify the building wood frame construction as completed conforms to the Architect' s drawings and the State Building Code. This certification will not be valid if any additional plumbing or electrical roughing requires cutting or drilling holes into the wood structure. �vr�ZEttc i7 ti`�yA r Submitted by: No. 4153 ; E '{? PAZTHUEN, cr oseph D. LaGrasse, AIA Joseph D. - LaGrasse & Associates, Inc. iR f 0 199' ` f BUILDING DEPARTW,F:P� S � •� NORT►-� ToVM of F over f- 4�' No. 50 1 COCMI �o - C EWA�ToICK r dower, Mass., / 19913 DRATED P' C H f4 BOARD OF HEALTH Q Food/Kitchen PERMIT D Septic System THIS CERTIFIES THA ...... �� I �.a.I.... ..., ........ ..� ..... .... ••• .. S•/ oundation BUILDINGINSPECTOR F has permission to erect........ gs on ... ...�......I ,.�r!<w..� .....� �� Rough ....... buildings g to be occupied as..... IV .......... ........ .. .... .... .. 1..................................................... Chimney provided that the person acceptingthis permit shall in every respect conform to the terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PLUMBING.INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR Rough .... .......... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove F na h 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. QCIAM0 /AAiATI:R FINAI DRIVEWAY ENTRY PERMIT ' CERTIFICATE OF USE & OCCUPANCY Town 0f North Andover Building Permit Number 502 1991) Date AUGUST 9, 190)3 THIS CERTIFIES THAT THE BUILDING LOCATED ON 143 Mill Road (Lot #16) MAY BE OCCUPIED AS SINGLE FAMILY DWELLING W/ 2 CAR GAMGFIN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. NORT oQ ,ya CERTIFICATE ISSUED TO Francesca & Antonio Nicolosi 48 Scenic Dr. O 9 ADDRESS DerrT, N. H. �'s,°"„scBuilding Inspector I I I .iv' "`e n i N °. :4A*31 , PLANNING 4kAL SE ER/DATE L , ;3 FINAL Town oq� l o n over O �:j tip. . 114i � . ua g J N� 7 f . r '1'd k { j`in DRIVEWAY ENTRY PERMIT 0i'��„ f� ,�Zxder, Mass. AjoRf ?� BOARD OF HEALTH I LD PERMI 0 THIS CERTIFIES THAT ........... ..... ...... :. .�.4:. . .'�"` S'.. .. • .. � ••• / •.••ty"WIP••....•..xa",- 1 BUILDING INSPECTOR has permission to er .. � uildings on Rough to be occupied asSl . ®® �.... P. Of �1IVs9►................... Chimney Final provided that the person accepting this permit shall in every respect conform to the terms of the application on file in PLUMB 7�qGSPH CTOR this office,and to the provisions of the Codes and By-Laws relating to the Inspection,Alteration and Construction of pp� / ,_y) ` Buildings in the Town of North Andover. PERMIT FOR FOUNDATION ONLY �^ I? 7 f r�� VIOLATION of the Zoning or Building Regulations Voids this'Permit. l REGULATED BY PARA: 112.7 S.B.C. A PERMIT E3C F I R E S I 1�I I O NT FI S DATE: "21-21 FEE PAID:100• � ELECTRICAL INSPECTOR Rough l��fll._ESS CONS] CT J . TARTS Service PERMIT FOR FRAME/BUILDING Final . . .... .. .. ..... ... . .. . . .. ...... SP DATE: Z 7—FEE PAID' BUIL NSP OR G S 114SPEgTOR Occu anc Permit Required to Occupy Budde. ' c1 �3 Y6 nal 7 7 Display in a Conspicuous Place on the 3 RE DEPT. Do Not Remove Burner STREFCT Nv ` No Lathingto Be Done Until Inspected and Approved by Smoke Det �l� C..a_e.A . e,o - BuildingInspector r7 CERTIFICATE OF USE & OCCUPANCY T(owri , of North ikip Building Permit Number 5 Date THIS CERTIFIES THAT THE BUILDING LOCATED ON MAY BE OCCUPIED AS IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO ADDRESS Z-Z,4 Al Building Inspector 9 � O R T F-{ , , ® o o' over so ANorth dower, Mass., 41993 F, J� l 0?gTED P'VaL C�. M H rf BOARD OF HEALTH PERMIT Food/Kitchen LDSeptic System THIS CERTIFIES THA ..... gyp. .. ... 4� ,�sBUILDING INSPECTOR Foundation has ermission to erect...... buildings on ... ... ...... Lt.tW . �p / . ... ....I Rough 3 tobe occupied as.....0 . ............. ..�.... .... .. ......................................... ............................... chimney��< (;� - provided that the person accepting this permit shall in every respect conform to the terms of the application on file in Fin this office, and to the provisions of the Codes and By-Laws relating to the Inspection, Alteration and Construction of Buildings in the Town of North Andover. PL IN INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. o FTRMI I~XPIRF_S IN 6 MONTHS ma U NL JS �..,L_)���� ,�. ��L,I C_ ' l(� ,moi I &10, ELECTRIC INSPECTOR Rough tJ ... ...............................r........... Service BUILDING INSPECTOR Occupcir lcy I'm reit Rcgi t.ircd to Occuj?y 131 tddir lgi ----------- -- –-- — --- -- ----- --- --– ---- ASI SPE TOR Display in a Conspicuous Place on the Premises — Do Not Remove 5gV3 3d Final No Lathing or Dry Wall To Be Done FIREDEPART Until Inspected and Approved by the Building Inspector. MENT - -� Burner 6/-:., ��L,�2 Street No PLANNING CONSERVATION FINAL . 4�' �FWFR /WAT Smoke Det. FR�i,� 7-X13 FINAL DRIVEWAY ENTRY PERMIT(i.,�: