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210/107.6-0122-0000.0
a
CERTIFICATE OF USE & OCCUPANCY
Town of North Andover
Building Permit NumberQ--.?6z Date
THIS CERT IES THAT
THE BUILDING LOCATED ON �/
MAY BE OCCUPIED AS N ACCORDANCE
WITH THE PROVISIONS OF T E MASSACHUSETTS STATE BUILDING CODE AND
SUCH OTHER REGULATIONS AS MAY APPLY.
MOR7p
0�,,,.. �ti0 CERTIFICATE ISSUED TQ,,-e� 29
ADDRESS
'''`CH"' Building Inspector
u
(h
NORTH
own of QAndover
0
O yO _ �JrL-A E dover, Mass., 19
•' / ! r OM A (� Q p� /L 'Q COC RICHE-ICK
r ORATED P'P -`�
S BOARD OF HEALTH
PERMIT D Food/Kitchen
Septic System
/ BUILDING INSPECTOR
THISCERTIFIES THAT...............................�a&A--i .�1................ ........................................
Foundation
hasp ......... buildings cad l.. . RD
permission to erect...........�.�.�... gs on ............�..�.................:......0./�t.f�... .........�fid...,........
to be occupied as.....................................................�../...x✓..G../.�............�f C!�..1.�(..�/........................................ Chimney
provided that the person accepting this permit shall in every respect conform to the terms i 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. PLUNtBINSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. DLl �( � /
Final/61_
PERMIT EXPIRES IN 6 MONTHS //``_
UNLESS CONSTRUCTION ST TS ELECTRICAL INSPECTO
/ Rou0 3/x
................................... .... ...... . . •••. ........... ..................................
G INSPECTOR / —
Occupancy Permit Required to Occupy Building 6AS INSPECTOR
Display in a Conspicuous Place on the Premises — Do Not Remove Rough
Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector.
Burner
Street No.
Smoke Det. �• �` ��
Location �G /vim (/4
No. Date
NpRTh TOWN OF NORTH ANDOVER;
O? • • pR
� „ Certificate of Occupancy $
4L Building/Frame Permit Fee $
°eine A ft!
,SSACMUsr Foundation Permit Fee $
f
D1her Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL $
y
Building Inspector
LL. J
Div. Public Works
Location ,
No. ' �' � Date
NORTH TOWN OF NORTH ANDOVER
O
Oft�ao ,°,ti
p Certificate of Occupancy $
° �ge �: Building/Frame Permit Fee $
�'�b'^^°•'�t Foundation Permit Fee $
sJACMust
Other Permit Fee $
Sewer Connection Fee $ -�
Water Connection Fee $ 77,�70
TOTAL $
01` ii i g m actor
08/05/% 09:21 r 11077.50 PAID i.-%�� Y,
r; Div.Apfic Works
r
rLocation !+ a
No. Date '
NORTH TOWN OF NORTH ANDOVER
Of Sao a,�0
O? • a O�
„ Certificate of Occupancy $ `
Building/Frame Permit Fee $
.74CHus t� Foundation Permit Fee $
' Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $ T
TOTAL $ '
Building Inspector
,4/05/9&49:22
150,0Q pain Div. Public Works
V
✓
PERcN'T NOL APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1
MAP KdO. LOT NO. 12 RECORD OF OWNERSHIP iDATE BOOK PAGE
ZONE SUB DIV. LOT NO. q q I I �-
LOCATION URPOSE OF BUILDING
1
OWN 'S AM NO. OF STORIES "'r SIZE A
OWN D E S BASEMENT OR SLAB GJ
[j,,q G.1J..4A HITECT'S NAMIk SIZE OF FLOG KERS l'IQ
2N 3RD
BUILDER'S NAME SPAN
DISTANCE TO NEAREST BUILDING ! ter/ t)/) IMENSI S OF IS�l�lt��'V-�/
DISTANCE FROM STREET '^ ",if/Jl_J �'.X "�P'OOSSITS! 1
DISTANCE FROM LOT LINESjZ SIDF&f 1 J REAR ,a�J GIRDERS
AREA OF LOT ?N C' `1 FRONTAGE �I.,Z a./�� HEIGHT OF FOUNDATION '"'7// /. THICKNESS �O�•
IS BUILDING NEW ^ 1,jfJ �+✓ SIZE OF FOOTING / `O /. X
IS BUILDING ADDITION XJ ' MATERIAL OF CHIMNEY B.Cll
IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND C
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE IS BUILDING CONNECTED TO TOWN WATER J
BOARD OF APPEALS ACTION. IF ANY IS BUILDING CONNECTED TO TOWN SEWER
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTRUCTIONS3 PROPERTY INFORMATION
LAND COST
SEE BOTH SIDES
EST. BLDG. COST `7
COST PER 8Q BLDG.
PAGE 1 FILL OUT SECTIONS 1 - 3 EST. '
EST. BLDG. COST PER ROOM
• PAGE 2 FILL OUT SECTIONS 1 - 12
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
mummNO INSP[CTOR
SIG RE OF OWNER OR AUTH RIZE0D AGENT
FEE. OWNER TEL.#
PERMIT GRANTED ^ _ CONTR.TELJ
�?-- � 19 CONTR.LIC.k
H.I.C.#
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 -Z: �
2 FOUNDATION 8 INTERIOR FINISH , �� 1 7,J S
CONCRETE d 11 1? 3
CONCRETE BL K. PINE
BRICK OR STONE HARDW D _
PIERS PLASTER �1 /
_ DRY WALL _
UNFIN. O/
3 EASEMENT I ,6
AREA FULL FIN. B'M'TAREA _
FIN. ATTIC AREA f
NO B M T FIRE PLACES I 3
Zq
HEAD ROOM _ MODERN KITCHEN �'�rj.
ol
4 WALLS I 9 FLOORS
i
CLAPBOARDS B 1 2 3 /�
DROP SIDING CONCRETE � r
_ J, �
WOOD SHINGLES EARTH _
ASPHALT SIDING HARDNIJ D _
ASBESTOS SIDING COMMCN C
VERT. SIDING ASPH. TILE
STUCCO ON MASONRY
STUCCO ON FRAME
BRI K ON MASONRY ATTIC STRS. 6 FLOOR
BRICK ON FRAME
CONC. OR CINDER
STONE ON MASONRY WIRING L' /
STONE ON FRAME
SUPERIOR _59 POOR
ADEQUATE I NONE
5 OF 10 PLUMBING
GABLE HIP BATH (3 FIX.)
GAMBREL MANSARD TOILET RM. (2 FIX.) T/
FLAT SHED WATER CLOSET ✓)
ASPHALT SHINGLES LAVATORY Itf
WOOD SHINGES KITCHEN SINK s
SLATE NO PLUMBING J
TAR 6 GRAVEL STALL SHOWER 1
ROLL ROOFING MODERN FIXTURES , N
f
TILE FLOOR
TILE DADO
6 FRAMING I 11 HEATING
WOOD JOIST PIPELESS FURNACE ]
FORCED HOT AIR FURN. 1;�• 5l
TIMBER BMS. 6 COLS. STEAM -I
STEEL BMS. & COLS. HOT W'T'R OR VAPOR
WOOD RAFTERS AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERSC.1 4G
7 NO. OF ROOMS GAS UU
OIL
B'M'T 2nd _ ELECTRIC
��L 13rd NO HEATING
CMF OIL CO
572,5 96 :2
/ Z " u,p� ' ',5.8
1r: --
A'
LAN
o� N/F N :� ; vel a
�►� n!t , '�•- i �, `°; `� �" OON.4L0 �Pr NA�C'Y J6//NSTOnI DN t `.� " • - 1 �=( Z
L0 N�
NSZ
(Z)�� �>� •. 1 - 4� 145.7
50' PRD �?`cQ
Spy
ZONE OPEN
SPACE
2 F. ✓`SOS �,y� � 96� s
- 4r,
A"LIrI� �� i` (JA �
6a`
�_ � tzs � ��*`.• / ��L _ � t SEPT�C-
N
USE L ' x Z ,c O 7-2 V. �A:. )�\C 5
;T�W�.N�
,50 LL
qN ST
STATS-
BSC/
vJ
Oho C,4 P
\ PaeeEe�
STA Tr �D iZ QST
L OCUS I
SC4LE.• 1"=1000'
f )9
r�`�
. NORTH
Town of 4Andover
o
No. 36 g --_� - �-
o o dower, Mass.,
C OC HIC ME WICK ��'
ADRATED
S BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT............................... .............. ........................................ Foundation
has permission to erect...........0.10JE............ buildings on ............/.!............ ?�O. L.f�... ........l .fid.,........ Rough
to be occupied as.....................................................\3. xl..G..X�_z ........... fel/L4..1. !... /........................................ Chimney
provided that the person accepting this permit shall in every respect conform to the terms�f 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
Final
PERMIT EXPIRES IN 6 MONTHS
ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION ST TS Rough
................................... .... .. ... . . ... ........... .................................. Service
eo
G 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
Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT
Burner
Street No.
Smoke Det.
Growth Management Bylaw Exemption Statement
Town of North Andover Building Department
This form shall be used to assist the Building Department in their determination of exemptions under section 8.7.6 of the
Town of North Andover Growth Management Bylaw. The building applicant shall provide all of the necessary information
as requested below.
ame of Applicant on B ilding Permit(below) Address of Property for Permit(below)
Map and Parcel : Purpose of Application (check below)
Phone Number of Applicant: _Single Family _Two Family
I the undersigned applicant for the above property attest that the attached building permit for which this
form is completed does comply with the EXEMPTION section 8.7.6 of the North Andover Growth
Management Bylaw. I also understand providing this form does not absolve me or any party to this permit
from the requirements of obtaining other permits required prior to the issuance of the Building Permit.
Further 1 understand that my interpretation of the EXEMPTION status is subject to review by the Building
Department and is only officially accepted when the Building Permit is issued.
Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the
above lot, in the building permit application and associated attachments, complies with one or more of the
following sections as indicated by a check mark.
This is an application for a building permit for the enlargement,restoration,or reconstruction of a dwelling in
existence as of the effective date of this by-law,provided that no additional residential unit is created.
The lot(s)were/was created prior to May 6, 1996 are exempt from the provisions of this Section 8.7 of the Zoning
Bylaw.
This application is for dwelling units for low and/or moderate income families or individuals,where all of the
conditions of 8.7.6.c are met and/or represents Dwelling units for senior residents,where occupancy of the unit;is
restricted to senior persons through a properly executed and recorded deed restriction running with the land. For
purposes of this Section"senior"shall mean persons over the age of 55.
This application is a part of a development project which voluntarily agreed to a minimum 40%permanent
reduction in density,(buildable lots),below the density,(buildable lots),permitted under zoning and feasible given the
environmental conditions of the tract,with the surplus land equal to at least ten buildable acres and permanently
designated as open space and/or farmland.The land to be preserved shall be protected from development by an
Agricultural Preservation Restriction,Conservation Restriction,dedication to the Town,or other similar mechanism
approved by the Planning Board that will ensure its protection.
This application represents a tract of land existing and not held by a Developer in common ownership with an
adjacent parcel on the effective date of this Section 8.7 shall receive a one-time exemption from the Planned Growth
Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the
parcel.
This application represents a lot which is ready for building permits,(i.e. ali other permits from all other boards and-
ccnmissions have been received and the project is in compliance with those permits) and the Development Schedule
does not accommodate issuing a building permit in that.Year,one building perm viii!L,issued per Year per
Development uoiii 501:11 time as tl„o Deuelopn ent Schedule accommodates issuing building permits. Applicant must
supply approved form U with this EXEMP f!ON.
Please provide any and all information that would assist the Building Department in making a determination
that your application is allowed one or more of the above EXEMPTIONS.
By signing below I attest to the accuracy of the information provided and that the attached building permit is
allowed an EXEMPTION as cited above. Further I understand that the submittal of misleading and or
inaccurate information, or the checking off of an above item which does not comply,whether done to my
knowledge or not, is grounds for refusal by the Building Department to issue a Building Permit.
Sign ure o O er or Authorized g nt ho ' e the Attached Building Permit to
This form must be attached to the Buildin P rmit upon application for such permit.
—..acted To: 03
DEPARTRENT OF PURIICSAR Y 33542
CONSTRUTTON SIEMER LNENSE
I — - None
caber. Exp'.—,S: Birthdate. Hasonry only
CS 012"128 01111811598 01/18/1934 1," - 1 & 2 Fanly Holies
Restricted To: 00 ?,--.dre to possess a current edition �f ,-be
4,. sac s�setts S'a'e
DC LNKI' F 'OhNETON -,.-usa for revocftion oll,tis
RA K'84E
tJ
Date.......'. ....../:...
NOR7M
TOWN OF NORTH ANDOVER
� A
PERMIT FOR WIRING
SACNUS�
r
This certifies that ......../............ '
Zhas permission to perform I......I...........� �
....... .................................................
wiring in the building of
at../ .........� ...............................`.......,...............z. ,North Andover"Mass.
Fee.�S/..�.......... Lic.No.A....'..; /........ . ...... . .........................
'' EL' ,RICAL INSPECTOR
Check # -
_= l,ommonwea[lk o f MaJJaclLudelts Official Use Only
Permit No.
� y
cc��a.,garintenl.13 ire serviced
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev. 11/99] (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code(NIEC),527 CMR 12.00
(PLEASE PRINT IN INK OR TYPE,-ILL /N/.'ORiIL 17ION) llate:
City or Town of: _4/ 4 �� To the Inspector of FY'ires:
By this application the undersigned give's notice of his or hei ilear tion to perform the electrical work described below.
Location (Street & Number) l,�— (,!o o- i� �( z9
Owner or Tenant _ 051/ l ell 8Telephone No. _1�' /k- P
Owner's Address 551* /Gz I(
Is this permit in conjunction with a building permit' Yes ❑ No (Cltecl:Appropriate Box)
Purpose of Building �,CS,�Q,•t A- 29 C Utility Authorization No.
Existing Service Anips / Volts Overhead ❑ Undgrd ❑ No. of Meters
New Service Anips / Volts Overlicad ❑ Undgrd ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work:
Completion of the foltable may be waived by the Ins ector of Wires.
INONo. of Recessed Fixtures No.of Ceil.-Susp.(Paddle)Fans fr of Total
• ansformcrs KVA
No. of Lighting Outlets No.of Hot Tubs Generators KVA
No. of Lighting Fixtures Swimming Pool Above [IIn- ❑ o.o mergency tg iting
g c b arnd. grnd. Batte Units
No. of Receptacle Outlets 8 No.of Oil Burners FIRE ALARMS No.of Zones
of Detection and
No.of Switches No.of Gas Burners No. Initiating Devices
No. of Ranges No.of Air Cond. / Tons tal No. of Alerting Devices
No.of Waste Disposers Heat Pum Number Tons KW No.of Sell'-Contained
P
Totals: Detection/Alerting Devices
No. of Dishwashers S ace/Area Heating K`V Local Municipal
p g ❑ Connection ❑ Other
4 Heating Appliances KW Security Systems:
No. of Dryers No.of Devices or Equivalent
No. of Nater KWNo.of No.of Daia Wiring:
Heaters Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total I-1P Telecommunications Wiring:
No.of Devices or Equivalent
OTHER:
Attach additional detail if desired,or as required by the Inspector of Wires.
INSURANCE COVERAGE: Unless waived by the o+vner,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 K BOND ❑ OTHER ❑ (Specify:)
(Expiration Date)
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.
I certifj•, raider the pains and penalties of petjmy,that the information on this application is true and complete.
F1101 NAME: LIC.NO.:
Licensee: 262&or Ty Signature LIC. NO.:
(!f applicable, enter "e.re,,rpt"in the license number line.) r Bus.Tel.N o.
Address: ( (�(/CZyQ� /�i�0 S9 Alt.Tel.No.:
OWNER'S NSURANCE 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 ant the(check one) ❑ owner ❑ ow ••s agent.
Owner/Agent
Signature Telephone No. F—Pj-RAfIT FEE: S
PLEASE FILL OUT BACK SIDE