HomeMy WebLinkAboutMiscellaneous - 15 GROSVENOR AVENUE 4/30/2018 15 GROSV�VENUE r _
210/052 0-0011-0000.0
NEW ENGLAND CLAIMS SERVICE. INC.
Incorporated 1985
Reply To Reply T
pY epY o
Mansfield, MA 02048 ii!
131 Dodge Street, Suite 6
P.O. Box 345 Beverly, MA 01915
TEL. {508}337-8058 TEL. {978}927-3000
FAX{508}339-5835 FAX {978}927-3002
wrandall@newenglandclaims.com
Form of Notice of Casual Loss to Building
g
Under MASS. GEN. LAWS, Ch. 139, Sec 3B
To: Building Commissioner or
Inspector of Buildings
City Hall
N. Andover, MA
RE: Insured: 15-17 Grosvenor Ave Condo Trust
Property Address: 15-17 Grosvenor Ave,N. Andover
Cause of Loss/Date: Ice Dam/2-21-15
File or Claim No: BOS053807
Claim has been made involving loss, damage or destruction of the above captioned property,
which may either exceed $1,000.00 or cause MASSACHUSETTS GENERAL LAWS,
CHAPTER 143, SECTION 6, to be applicable. If any notice underMASSACHUSETTS
GENERAL LAWS, CHAPTER 139, SECTION 3B is appropriate,please direct it to the attention
of the writer and include a reference to the captioned insured, location, policy number, date of
loss and claim or file number.
Section 3B. No insurer shall pay any claims (1) covering the loss, damage, or destruction to a
building or other structure, amounting to one thousand dollars or more, or(2) covering any loss,
damage or destruction of any amount,which causes the condition of a building or other structure
to render section six of chapter one hundred and forty-three applicable,without having at least
ten days previously given written notice to the building commissioner or inspector of buildings
appointed pursuant to the state building code, to the fire department or arson squad of the city or
town and to the board of health or board of selectmen of the city or town in which the same is
located. If at any time prior to payment the said city or town notifies the insurer by certified mail
of its intent to initiate proceedings designed to perfect a lien pursuant to section three A, or to
section nine of chapter one hundred and forty-three, or section one hundred and twenty-seven B
of chapter one hundred and eleven, the said payment shall not be made while the said
proceedings are pending; provided,however, that said proceedings are initiated within thirty
days of receipt of such notification.
Any lien perfected pursuant to section three A, or to section nine of chapter one hundred and
forty-three or section one hundred and twenty-seven B of chapter one hundred and eleven, shall
extend to and may be enforced by the city or town against any casualty insurance policy or
policies covering any loss, damage, or destruction pursuant to which the proceedings to perfect
the lien were initiated.
No insurer shall be liable to any insured owner,mortgagee, assignee, city or town, or other
interested party for amounts disbursed to a city or town under the provisions of this section, or
for amounts not disbursed to a city or town under the provisions of this section.
On this date, I caused copies of this Notice to be sent to the persons named above at the
addresses indicated above by First Class Mail.
Y.osh
TlYours j
ntieri
732-330-4295 cell
y I
ta�cu�bt
CERTIFICATE OF USE & OCCUPANCY
CY
. .
TOWN OF NORTH ANDOVER
Building Permit Number c Date: /b /3
THIS CERTIFIES THAT
THE BUILDING LOCATED ON Z=!L /f7 61'6 S 0'e ti c)r Ay
l -e c.c
/�
Y
MAYBE OCCUPIED AS a I"A tit� ` y � IN ACCORDANCE ,WITH THE
PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER. `
REGULATIONS AS MAY APPLY.
RIMCA. ISSUED TO:
��
Building Inspector
l
j
own ot over
No. =�
o -= A K E -0 dover, Mass., 4C `l
C OC MI C. WICK
ORATED p? 60
7�l U BOARD OF HEALTH
PERM : 1 Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT.........
cc .... Foundation
f�-``
has permission to erect... . buildingson...�. :!......... ..... .s ......................................... Rough
......... ............
,�� � ,�iAl r o%/iir� ry/�r c E'�� f �%� � W �
to be occupied as ,� 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 Inspection, Alteration and Construction of 13 o
Buildings In the Town of North Andover. a2FA M, /y toN t+ �.�O R r#h R jN q� 1 PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. A Jr-4 MI u
is
PERMIT EXPIRES IN 6 MONTHS
ELEC`TRICA_1N§FtC7bR
UNLESS CONSTRUCTION ST T
y
.. .. ............. ........ j. Service
BUILDING INSPECTOR
Occupancy Permit Required to Occupy Building GAS SPE R
Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Fina,
No Lathing or Dry Wall To Be Done
Until Inspected and Approved by the Building Inspector. Burner DEPARTMENT
Street No.
SEE REVERSE SIDE Smoke Det.
w .
v
\ � Office Use Only-7,rl
- 014C �';I1MMVnlUr# of Permit No.
3epartment of Public —Aafetu Occupancy& Fee Checked
.g
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 390 (leave blank)
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date a— ��—Cn
(%* or Town of NORTH ANDOVER To the Inspector of Wires:
The udersigned applies for a permit to perform the electrical work described below.
i
Location (Street & Number) �D '`V�b O
Owner or Tenant +►t�' �i� LI`r,�,
Owner's Address Vol Lw
Is this permit in conjunction wit) a building permit: Yes EI-K- No ❑ (Check Appropriate Box)
Purpose of Building ��� �� � r Utility Authorization No.
Existing Service Amps _J Volts Overhead ❑^/ Undgrnd ❑ No. of Meters
New ServiceC`CL-, Amps\fib a400 Its Overhead Undgrnd ❑ No. of Meters
Number of of Feeders and Ampacity
Location and Nature of Proposed Electrical Work UA fLip: A,
Total
No. of Lighting Outlets I No. of Hot Tubs No. of Transformers KVA
No. of Lighting Fixtures Swimming Pool Above In-
grnd ❑ grnd ❑ I Generators KVA
No. of Emergency Lighting
No. of Receptacle Outlets No. of Oil Burners Battery Units
No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones
No. of Air Cond. Total No. of Detection and
No. of Ranges tons Initiating Devices
Heat Total Total
No.of
No. of Disposals Pumps Tons KW No. of Sounding Devices
No. of Self Contained
No. of Dishwashers Space/Area Heating KW Detection/Sounding Devices
Municipal Other
No. of Dryers Heating Devices KW Local ❑ Connection
No. of No. of Low Voltage
No. of Water Heaters KW Signs Ballasts Wiring
No. Hydro Massage Tubs I No. of Motors Total HP
OTHER' E� PZ,C A,1 S
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws _
I have a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent. YES _ NO I
have submitted valid proof of same to.the Office. YES = NO :: If you have checked YES, please indicate the type of coverage by
checking the apppro ate box.
INSURANCE ': BOND �_ OTHER _ (Please Specify) (Expiration Date)
Estimated Value of Electrical Work $ ,zoce
Work to Start �'��— Inspection Date Requested: Roug Final
Signed under the Penalties `perjury: C
FIRM NAMEQ1.-C) LIC. NO. :
Licensee Signature LIC. NO.
�.'
Bus. Te No.
Address \ L\ Alt. No. fns
OWNER'S INSURANCE WAIVER: I am aware that the Licensee d es not have the insurance coverage or its substantial equivalent as re-
quired by Massachusetts General Laws, and that my signature n this permit application waives this requirement. Owner Agent
(Please check one) tec
Telephone No. PERMIT FEE S \Q u�
(Signature of Owner or Agent) x-6505
I
rr
Date: .
a � 75 y
NORT"
°f�^' TOWN OF NORTH ANDOVER
p PERMIT FOR WIRING
,SSACMus�
This certifies that .....k.e.S.... -_te .....�
........ ...:..
has permission to perform .....�.� �.T� r1.........
1:'t.,�
M1
wiring in the building of....... .�..� lr{ ..: <!P S.. ..... .....:: ......
at....`.,. .r.1c3=.1).eh .....A e.:................. .North Andover;Mass
�Fe , ,t.. L)... Lic.No. .A6..o................. ...:. .... .... :..:... ...... ......
ELECTRICAL INSPECTOR- ?
z
20/97 16:12 40.00 PAID
WHITE: Applicant CANARY: Building Dept. PINK:Treasurer
r%jn r
•••••�••••••••--• ..+ vr��fvr7M Mr1'L/Vr1i�Vr`e LnAnts sw NV rs.urtirurrsv
•. ' (Print or Type)
NORTH ANDOVER, . Mass. Date Z- '/ _IO W tv
Z � 0
Building Pertnit 4,
Location
Owner's
Name
New ❑ Renovation Replacement ❑ Plans Submitted: Yes❑ No.❑
FIXTUA E$
s >t < »
M � A • X s � s
a = s r s s ur s ° s s • °
16 1 11
w w t-
• H
U06 s a� a
�
ss a s
4 y � a Y a o s o $ s s o u s
sua-9614T.
BASEMENT
1sT FLOOR
SHO FLOOR
SRO FLOOR
ITN FLOOR
STH FLOOR
STH FLOOR.
TTH FLOOR
STM FLOOR
• - Check one: CertificateInstalling Company Name �i� ❑Corp.
Address Z IPWb,7-0--V ❑Partner ahip
Business Telephone 0G3 �,
[Firm/Co.
Name of Ucensed Plumber
INSURANCE COVERAGE: ec one
1 have a current liability Insurance policy or No substantial equivalent. Yes,6� No ❑
If you have checked y", please Indicate the type coverage by checking the appropriate box.
A liability Insurance policy 4 . Other type of Indemnity ❑ Bond ❑
OWNER'S INSURANCE WAIVER: I am aware that the liceniee does not have the Insurance coverage required by
Chapter 142 of the Masa. General Laws, and that my signature on this permit application waives this requirement.
Check one:
Signature of Owner or t]wnN s Agent
Owner ❑ Agent ❑
1 hereby certify that all of the details and Information t have submitted for enteredl in above application are true and accurate to the best of my
It and that a1 plumbing work and Installations performed under the p nM Issued for thl pkation wi/ all
pertinent fps
of the Massachusetts Stale Plumbing Code and Chapter, ij2 of the
Bnce y By
Title gna ure at nse er
um
City/Town
lJcense Numbeir
Type of Plumbing license: Master ❑ /
APPrKMD(OFFICE USE ONLY) Journeyman /Q
;=4
Date
To
HORT" TOWN OF NORTH ANDOVER
PERMIT FOR PLUMBING
SSACMus -
This certifies that . . .
has permission to perform
plumbing in th bui
Idings of . . . { . :�
at. . . . � , North Andover, Mass.
Feae . . . Lie. Nodes.-. . . . . . . . . . . . . . . . . . . . . . . . . . .
PLUMBING INSPECTOR
---C/2o&7 16:08 40.00 PARI
WHITE: Applicant CANARY:Building,Dept. PINK:Treasurer
Location 4ti`r Iry CU
No. M Date _a
"ORT" TOWN OF NORTH ANDOVER
f �
OjO�`..�n ,•• hie
O
a Certificate of ccu ncy
41
B g/Fra Per it Fee $ a�
and tion rmit e $
AMUS
er ermit ee $
ewe Conne tion e
r Connection Fee $ _
/ TOTAL $
13128
Building Inspector
t
Div. Public Works °
3 **** ***
-PER-MIT NO. � 8 � APPLICATION FOR PERMIT TO BUILD NORTH ANDOVER;•MA .
N1:11'NO. LOT NO. /1 2. RECO'D OF O%VNERSII lP DATE BOOK PAGE
LONE SIM DIV. LOT NO. L' � ���e� �� i9k. 1�2 �,� 8 1 7Z�
LOCA ION G PORP 'E OF BUILDING
O\V'NE[ 00001, WNW Wr NO.If
STORIES SIZE
O\VNER'S ADDRESSUl BAS MENTOR SLAB
ARCIlincl''S NAME SIZE OF FLOOR TINI BERS IST 2ND 3RD
BUILDER'S NAME SPAN
DISTANCETO NEAREST BUILDING �) DIMENSIONS OF SILLS
DISTANCE FROM STREET1 1 DI TENSIONS OF POSTS
DISI'.ANCE I'110Nt LO'I'LINES-SIDES 311 11 REAL DIN 'NSIONS OF GI S
AR EA OF LOT FRONTAGE IIEI IIT OF FO11N A ON THICKNESS
IS BUILDING NEW SI"Z.E F FOOTING
IS BUILDING ADDITION NIA IAL OF CIIININE
IS 11111L.DING ALTERATION , A, Ln L IS BAIT ING ON SOLID OR LED LAND
\VILL.11 tiILDING CONFORM O REQUIREMENTS OF CDE e S IS BLIII, i'G CONNECTED T NVN WATER
all
BOARD OF APPEALS ACTION IF ANY IS BUILD 'G CONNECTED TO O\VN SEINER
IS BUILD11t,
CONNECTED TO t,
I'll RAL GAS LINE
INS'FIlC`FIONS 3. PRO1'ERT 'INFORNIA'f1ON LAND COST'
ST. BLDG.COST'
i� PAGE I FILL OUT SECTIONS 1-3 T.BLDG.COST 1'.
T. BLDG.COS"f P ROOM T 44
ELECTRIC NIE"PERS Nill$T BE ON Ol SIDE OF 13UILDIN P"f[C PERMI"I'NO.
ATT':\CIIEP GARAGES NIIIST CONFOR TO STATE:FIRE -GULATIONS 4. APPROVED I31'.
I'l..%NS MUST IIF.FH.ED:\ND APPRO\'EDB BUILDING li 'PECTOR BUILDING INSPECTOR i
k
DA'Z'E FILED OWNERS TEL# 2 "•� /y -•�
AAw.
•��/ �� CONTR.TEL# a //
SIGMA"f1IRF.. OF OR'NE12 OR AUTHORIZED AGENT 4
FEE
PERMIT'GRANTED
Revised 5/5/99 JNI
� I
x
s
w.
cu
"IN
_ a
a
j
FORM U - LOT RELEASE FORM
INSTRUCTIONS: This form is used to verify that all necessary approvals/permits from
Boards and Departments having jurisdiction have been obtained. This does not relieve
the applicant and/or landowner from compliance with any applicable or requirements.
*****************************APPLICA-NT ftLLS OUT THIS SECTION***********************
APPLICANT -tLk 1 41,4A 50 K P S PHONE 7
LOCATION: Assessor's Map Number S Z PARCEL
SUBDIVISION LOT (S)9—
STREET_ ,�� SV E��IC�2- LIV E L ST. tVUAABER �
USE ONLY*********************/2,e p l w-- /ov KJA,
N
'
RECOMMENDATIONS OF TOWN AGENTS: 7JeC K f SfArrs
CONSERVATION ADMINISTRATOR DATE APPROVED 17
1 HATE REJECTED
COMMENTS N 0 \JP Q- '�.e k�
TOWN PLANNER DATE APPROVED
DATE REJECTED
COMMENTS
FOOD INSPECTOR-HEALTH DATE APPROVED
DATE REJECTED
SEPTIC INSPECTOR-HEALTH DATE APPROVED_
DATE REJECTED
COMMENTS
PUBLIC WORKS - SEWERIWATER CONNECTIONS
DRIVEWAY PERMIT •_
FIRE DEPARTMENT
RECEIVED BY BU1LDMG INSPECTOR DATE
Revised 9197 jm ,
Sent by:G Apr-01-99 09:06 front'.978372396019.786851495..... . Page 2i 2
147,0'
I LO T E-2 l
A
ASSESSORS MAP 42 y
LOT 11 Tox$
43.7'
0
ASSESSORS MAP 52 a EXISTING DWELLING ASSESSORS ASSESSORS MAP 52
LOT 24 LOT 29
�" TWO STORY DUPLEX
• 20.3.
EASEMENT
I
147.0'
GROSVENOR AVENUE
R£f£'R£NC£ PIAN:
N.E.R.D. PLAN #8731
STRUCTURE' LOCATION PLAN i-cNomZo r,"Or
sari cKARr mcmrs ftf o D°,�cAl s r0
-_ APPUCA"ZONNC 8Y-LAWS IN EnWi' WHEN CONSTRUCM0.
(mis Cl'mr-AR0N Dots Hot C01+510ER ANY OTNER
RCSTRcnoms SUCH As COVCI4A)vrs.wr LtNOS.cksBMfNI-4.
CUENF: RICHARD F. JONES ORDERS or cJNOATONs.rrc.1
TMS DRA*WC SNA NOr Of USED BY ME CUENT EOR ANY
THIS CERTIPICATION !S b1ADF AND 'IMITED Pu�c orwEa THAN TNAr oonwo Asovr rxcrrr w m ruf
WWnrN PfRWS:/" OF CNR/STYANS£N t S6RQ INC.
TO THE ABOYC CLINT. rineywRiam Tx1S vvow1G is W COPMC'(rD PROPtR71le
Of CURZ17AMSLW .t SER04 WC. AND ANY UN rHORW USE
IS PRONMUTO t SCAC) 'AkCS NO RESPOKVOWY
FOR THC UNAVP4fi/Zf0 USE or THIS DRAWING OR ANY W09-
t:AT10M 03NWWO MER60.N.
LOCATION: 15-17 GROS1 ENOR A VENUE .
NORFN ANDOVER, MA
t
OF,
hs c
SCALE: 1" 40' DAM JANUARY 29, 1999 ° MI Si
3
CHRI STIANSEN &SERGI PLAW SVRVrYOft
160 svwrR Sr 14VMM&LmA. 01450 ML 976-373-0310
... ®f Y99 8Y CNRlSTLON3iEN t..S.fR@1 llfC. - -
ORA WINO No: 99006001 ---- -_---
x
v .J�//�� ��77 uiea pp/l�aalccc/auaeLGi I`
26 TDd/)7//92Ory! p/
it
SAF ,t.._ C
tic nutt
Bgpires: Birthdate
-A
1
9
T
Town of North Andover E NORTH
OFFICE OF ��o "
COMMUNITY DEVELOPMENT AND SERVICES p
27 Charles Street :�o
North Andover, Massachusetts 01845 X94 o
°AT.
0
WILLIAM J. SCOTT 9SSACHUS�t
Director
(978)688-9531 Fax(978)688-9542
HOMEOWNER LICENSE EXEMPTION
Please print.
DATE_�M A cn 11 1999
JOB LOCATION 1rl _mPoe
/ Number Street Address Section of Town
"HOMEOWNER bgk- Z� 7 p 1 L h Aa- 10 I C S
Number Home Phone Work Phone
PRESENT MAILING ADDRESS 28 (1)0 Y-1'�'l Z te0 L4 A&
SPX- m e- c-
ity Town 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 HOMWOWNER:
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 dwelling, attached or detached structures ac-
cessory to such use and 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,
a form acceptable to the Building 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 No.Andover
Building Department minimum inspection procedures and requirements and that he/she will
comply with said procedures and requirements.
HOMEOWNER'S SIGNATURE c
APPROVAL OF BUILDING OFFICIAL
Note: Three family dwelling 35,000 cubic feet, or larger,will be required to comply with
State Building Code Section 127.0 Construction Control.
BOARD OF APPEALS 688-9541 BUILDING 688-9545 CONSERVATION 688-9530 HEALTH 688-9540 PLANNING 688-9535
Town of North Andover F NORTN
OFFICE OF 3�O at as yo L
COMMUNITY DEVELOPMENT AND SERVICES
27 Charles Street
North Andover, Massachusetts 01845 "SsgcHus�`�h
WILLIAM J. SCOTT
Director
(978)688-9531 Fax (978) 688-9542
In accordance with the provisions 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 c 11, S
150 A.
The debris will be disposed of in:
(Location of Facility)
/77 l d d Le 7-0,,7 r�/}-S.S`
Signature of Permit Applicant
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
thisJ �9hect ro thro the Office of the Building Inspector
p
BOARD OF.APPEALS 688-9541 BUILDING 688-9545 CONSERVA-TION 688-9530 HEALTH 688-9540 PLANNING 688-9535
' r
N4 RT
own p ' OL dover
o�A�o��� dover, Mass.,
ORATEDPPS t 2
�S SG�_`
4 BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
1 BUILDING INSPECTOR
THIS CERTIFIES THAT...�1.C�.^.i r 70 t' S
.......... .... ........................... Foundation
has permission to erect.... � on .... . m.NN�MtO.......... .
......... Rough
t0 be occupied aS46 .3c
..... . ... i N... O.N4TilMs t Iy�t
..... .... ...... . .fi ....... ............ 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 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
-?,Cc � PERMIT EXPIRES IN 6 MONTHS Final
1 3 )a 8 ELECTRICAL INSPECTOR
UNLESS CONSTRUC S
Rough
........... .......... .. .... ... ...... ........................................................ Service
BUILDING INSPECTOR
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Display in a Conspicuous Place on the Premises — Do Not Remove RoughFinal
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.
. . �
. �«� .
�� � .
» � .
- , �
��. � \ - � )� 2 _ , -
___ � ` ! �
z \\/ Z/ , � \\��\ �y ��/:
��� 2222 • y . w gj#[��� \ y
�� . .�� .
� � � y � -�
_�� � ` ^
� \ � f � , <
\ ^ � .
PERMIT NO. C APPLICATION FOR PERMIT TO BUILD********NORTH ANDOVER, MA
MAP NO. l LOT NO. 2 2. RECORDOFO%VNERSIIIP DATE BOOK PAGE
"LONE Still DIV. LOTNO. ` If mA (,o 12,87-�X 8 I 7Z�
LOCATION 2 PURPOSE OF BUILDING 2 e
OWNER'S NAME \ Ozsje� NO.OF STORIES SIZE
O11NER'S ADDRESS BASENIENT OR SLAB
ARCHITECT'S NAME SIZE OF FLOOR TIMBERS ]slr 2 D 3RD
BUILDER'S NAME C SPAN
DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS
DISTANCE FROM STREET 1 DIMENSIONS OF POSTS
DISTANCE FR0111 LOT LINES-SIDES 1'REAR DIMENSIONS OF GIRDERS
AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS
1S BUILDING NEW SIZE OF FOOTING x
IS BUILDING ADDITION NIATERLU OF CHIMNEY
IS BUILDING ALTERATION 'e IS BUILDING ON SOLID OR FILLED LAND
S � -k- 1-
\VILL BUILDING CONFORM TO REQUIREMENTS OF CODE Q IS BUILDING CONNECTED TO TOWN WATER
BOARD OF APPEALS ACTION,IF ANY IS BUILDING CONNECTED TO TORN SEIVER
IS BUILDING CONNECTED TO NATURAL GAS LINE
INSTUC.TIONS 3. PROPERTYINFORINATION LAND COST
EST.BLDG.COST
PAGE 1 FILL OUT SECTIONS 1-3 EST.BLDG.COST PER SQ.FT.
EST. BLDG.COST PER ROOM
ELECTRIC 111 ETERS MUST BE ON OUTSIDE OF BUILDING SEPTIC PERMIT NO.
ATl'ACIIF.D GARAGES MUST CONFORM TO STATE FIRE REGULATIONS 4. APPROVED BY: n-
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR BI111.DING INSPE/CSTOR r,
`
DATE FILED OWNERS TE1.# 2 i,; .` "``�•,Q
CONTR.TELN
SIGNATURE OF-OIVNER OR AUTHORIZED AGENT CONT'R.►.IC#
Fee $ ��/ ILI.C.#
PERMIT GRANTED J
2y 19
Revised 5/5/99 J111
F;
F N®RTH
1. D O
Town of - L over
y_M.. . `.•4. �•. A
'A
No.
19t
0 COCL E lover, Mass., •rjp y
�� SAO ' �\�t�
_.� RATED P' Gt'`
5 ` BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT...�1 Q�.... .6.r .Q..N� ! S
Um cc
BUILDING
Foundation
has permission to erect.... la 1t...�,?�.. '� buildings on .... .. ....... ... ... !1? CrM.......
♦ I �......... Rough
t0 be OCCUpled aS.. 6.x. .. ...c ......�~�.....�"�i1b... ....... ilNs..'�' Ay�1 .................... Chimney
provided that the person accepting this permit shall in every r pec conhe t s of the application on file in Final
this office, and to the provisions of the Codes and By-Laws re ' g to the Inspecti , 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
PERMU EXPIP � 0 �N
3 a 8 ELECTRICAL INSPECTOR
UNLESS S C S
Rough
... ... ....n ......................... ............................. Service
BUIL G�INSPECTOR
Final
Occupi Re d to ccu Bui '
g GAS INSPECTOR
C OR
Display m � Rough
p ay a Conspi us PI o remi e� Do Not Remove Final
No Lat i r D Wall To Bei Done
FIRE
DEPARTMENT
Until Inspected and Approved b the Building Inspector.
Burner
Street No.
SEE REVERSE SIDE Smoke Det.
GENERAL BUILDING NOTES/CHECKLIST-NOT LIMITED TO ITEMS BELOW
POST ALL LOT NUMBERS,ADDRESS, AND PERMIT(COPY OK)..or no inspections
INSPECTIONS: (Minimum) Excavation , Footing, Foundation, Frame, Insulation, Final.
FOOTINGS: Continuous Full 2x4 Keyway
Continuous strip footings for interior columns
FOUNDATION: Rebar as required
Anchor bolts or straps
Damproofing
Foundation drain-pipe/stone/fabric filter/cover and outlet connection.
FRAME:Fireblock-over girts/plates between floor joist
Penetrations for plumbing, heat, elec, etc.
Walls at stair stringers.
Windbrace corners and center bearing partitions.
Size ridge to provide full bearing at rafter cuts.
Hip and Valley rafters-watch bearing at walls.
Ridge&Hip- Provide proper connections.
Cathedral roof rafters provide proper connections and use"Hurricane Clips"tie to plate.
Stair stringers-watch cuts and heal support.
Joist hangers-fully nailed w/hanger nails.
Sill plates 2-2X6(1 PT)w/sill seal.
Girts-solid brick or steel plate bearing at foundations
"air space at sides in foundation pockets.
Lateral bracing at ends.
Certified calculations. required for Beams/LVL's Trusses.
Solid bearing support for Headers/Beams etc.
Check headroom clearances-stairways, under beams
Attic Access. (min. 22x30 w/3'headroom above).
Crawl space access. (min. 18x24).
Bath exhaust fans to have metal duct to exterior(not in soffit).
Firecode S/R wood frame of"0"clearance fireplaces&stoves
Window Schedule or Every Habitable Room Must Have:
Natural light equal to 8%of floor area.
Y of required glazing shall be openable.
Bedrooms required min. 20x24 egress window or door.
Vent attic spaces-"proper vent", soffit and required ridge vents.
Firecode under stairs if used for storage
FIREPLACES: Separate permit required.
Inspections at Footing-Smoke Chamber-Finish
Smooth parging, clean joints, 8"solid @ combust. Surf.
DECKS: Separate permit required:
Lag to house, provide flashing.
Rails min. 36"high, Baluster max space 6"on center.
Over 8'above grade, use 6x6 posts w/lateral bracing.
Lag all posts and rails.
Pier footings down 48", Conc. pad at stair base.
FINISH: Handrails returned to wall/newall post.
Guardrails required alongside open cellar stairs.
Exterior grading complete.
Certificate or occupancy required prior to occupying structure.
Temporary Stairs required for inspection.
Re-inspection fee-$25.00(Be Ready).
Certificate of occupancy required prior to Occupying structure.
Location
/ n
�
� l
No. �...� / -J
�/ Date `
' M
]g0^TM TOWN OF NORTH ANDOVER
3?O�,t`ao •,�OL
" A Certificate of Occupancy $
Building/Frame Permit Fee $
cMuSEFoundation Permit Fee $ _
o�
Other Permit Fee $
Sewer Connection Fee $
Water Connection Fee $
TOTAL $
/ -Building Inspedor
'13458 `/
Div. Public Works
I
j ERI I[TT NO. APPLICATION FOR PERMITXO BUILD'***l*****NORT , NDOYER
NIA y(N0. LOT NO. 2. RECORDOFOIVNERSIIIP DATE TIOQK PAGE.
ZONE SUB DIV. LOT NO.
LOCATION
PURPOSE OF BUILDING
O'S
OWNER'S NAMEoelC�A NO. STORIES ? I $( c / 1
70
OWNER'S ADDRESS DASENIENT ORSLAB j (I ; I►� +
ARCIIFI_ECT'SNAME SIZE OF FLOORTINIDER$ 2 N
,+ I
BUILDER'S NAMES
SPAN'
DISTANCE TO NEAREST BUILDING 4
DINIENSION§PESTLES :I+
DISTANCE FROM STREET DIMENSIONS OF POSTS
i
DISTANCE FROM LOTLINES-SIDES REAR DINIENS 10NS-0FGIRDERS
AREA OF LOT FRONTAGE REICIITOFFOUNDATION 1 ' �jIICKNGSS }
t i.'
1S BUILDING NE\VSIZEOF FOC11'INC, ! ;j }(
IS BUILDING ADDITION `! MAT ERIALOFCIUM EY
IS BUILDING ALTERATION a� a O0 S��n LSC 1S BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORNI TO RE UIREME TS OF CODE. IS BUILDING CONNECTE TO TOWN NATER
BOARD OF APPEALS ACTION, IF ANY IS BUILDING CONNECTED TO TOWN SEWER
I IS BUILDING CONNECTED TO NATURALGAS LINE
1NSTUC-110NS 3. PROPERTY INFOIt11IATION LAND COST
EST.BLDG.COST V4 20"
PAGE I FILLOUTSECTIONS I-3 EST.BLDG.COST PER SQ. FT.
EST.DLDG. COST PER ROOM
ELECTRIC METERS MUST DE ON OUTSIDE OF BUILDING SEPTIC vERMI'FNo.
ATI',.CIIED GARAGES,MUSTCONFORNI TO STATE FIRE REGULATIONS 4. APPROVED HY:
PLANS NIUST DE FILED AND APPROVED BY BUILDING INSPECTOR BUILDING INSPECTOR
DATE FILED O\VNERS TELH
CONTR.TELH ZN3VV1,�Vd3a
SIGNATURE OF-OWNER tl��t AGENT CONTR.LICH
FEE $
PERNFI GRANTED
-- 19
{4
Revised 5/5/99 IN
FI +�s Vii.
t
d
J
k � y
� S
til
tx► ✓
' f
Town of North Andover NORTH
OFFICE OF 3�0y�•
COMMUNITY DEVELOPMENT AND SERVICES
A
49
27 Charles Street
North Andover, Massachusetts 01845 X94°q•.,o °"'`�5
WILLIAM J. SCOTT SSACHustit
Director
(978) 688-9531 - Fax (978)688-9542
HOMEOWNER LICENSE E. MPTION
Please print.
DATE 1112,199
JOB LOCATION /5`12 S1477'042 ST'
Number Street address Section of town
"I ONfEOWwFER" I&JAICA TJOIELs 4"K,-y_(3 I �/7 _
Name Home phone tiVork phone
PRESENT MAILING ADDRESS W 09
City/Town 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 Sec-
tion 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 sic family dwelling, attached or detached structures ac-
cessory 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 Building 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 No. Andover
Building Department minimum inspection procedures and requirements and that he/she will
comply with said procedures and requirements.
HOMEOWNER'S SIGNATURE
APPROVAL OF BUILDING OFFICL-�L
Note: Three family dwellings 35,000 cubic feet, or larger, will be required to comply with
State Building Code Section 127.0, Construction Control.
Y .
BOARD OF APPEALS 688-9541 BUILDING 683-9545 CONSERVATION 688-9530 HEALTH 683-9540 PLAT KING 683-9535
BUILDING DEPARTMENT
DEBRIS DISPOSAL FORM
In accordance with,th4 -provisions of MGL c 40 S 54,.a condition of Building Permit Number
Is that the debris resulting form this work shall be disposed of in a properly licensed solid waste disposal facility as
defined by MGL c 11, S 150A
The debris will be disposed of in:
—�CQ eJ V � �
Location of Facility
Signa f Permit Applicant
' D to
NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of
the Building Inspector
NORTH
O" ® ova
O t 0
JIL C% � COC LA E dover, Mass., 999
ORATED PPaS
S H E
BOARD OF HEALTH
PERMIT D Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT......... .............. ...
....................... ............:.......... ... Foundation
has permission to erect, ,... .... buildin on ......1.4 ....�.�.. ........ . ........ V Rough
� g
to be occupied as.. .�. r Chimney
.. ... . ..............................................
provided that the p on accepting this permit shall in every spe conform to the s of the application on file in Final
this office, and to the provisions of the Codes and By-Laws relating to the Inspecti Alteration and Construction of
Buildings in the Town oU North Andover. PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. _ Rough
PERMIT EXPIRES IN 6 MONTHS Final
UNLESS CONSTRUCTION T r ELECTRICAL INSPECTOR
_
J"_ Rough
................................................................................................................. Service
BUILDING INSPECTOR
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Conspicuous Place on the Premises — Do Not Rem Rough
Display in a Cons
P 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.
Date.Al'?/z /
TOWN OF NORTH ANDOVER
0
PERMIT FOR WIRING
SS C14US
This certifies that A'e.t11,d...WA..e.rv-4,7
...... .......... ......
4d
has permission to perform ...............................................................................
f.......... A,.) �e- _l&.
wiring in thebuiildii 0 .........................................................................
'4
.../.916CAS7 Gro 5l'-eAjor Od'
.. . . .................................................................... I North Andover,Mass.
Fee.... ... Lic.No.'COQ48 13- ?"r-AW(Ct--
............................... .. .............................
iL;C RlCWiNSPECTDR
Check #
THE COMMONWEALTHOFMASSACHUS Office Use only
DEPAR73ffiW0FPUX1CS4FETY Permit No.
BOARDOFFNEPREVEWONREGUL4HO115 CM12M 3
Occupancy&Fees Checked
APPLICATIONFOR PERMIT TO PERFO ELECTRICAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WrrH THE MAS SACHUSSTS ELECTRICAL CODE,527 CMR 12:00 t/
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
Town of North Andover To the Inspector of ires:
The undersigned applies for a permit to perform the'el ctrical work described beow.
Location(Street&Number)
Owner or Tenant
Owner's Address
Is this permit in conjunction with a building permit: Yes®- o (Check Appropriate Box) j
Purpose of Building /� Utility Authorization No. /
Existing Servicel Amps /'-9, Volts verhead Underground ED No.of Meters
CID—
New Service Amps4,02 t(0 VoltsOverhead Underground No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work . r
No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total
No.of Lighting Fixtures �f Swimming Pool Above Below KVA
round round Generators KVA
No.of Receptacle Outlets O No.of Oil Burners No.of Emergency Lighting Battery Units
No.of Switch Outlets J-5
No.of Gas Burners
No.of Ranges P No.of Air Cond. / Total 31' FIRE ALARMS No.of Zones —�
/ ( Tons
No.of Disposals No.of Heat Total Total No.of Detection and
Pumps Tons KW Initiating Devices
No.of Dishwashers Space Area Heating KW No.of Sounding Devices
1 g
No.of Self Contained
Detection/Sounding Devices
No.of Dryers HeatingDevices �
KW Local � Municipal Other
Connections
No.of Water Heaters KW No.of No.of
_
Signs Bailasis
N,o.Hydro Massage Tubs No.of Motors Total HP
ti
OTHER•
hmua wGDV rage.R==tothe ragtmanads 110sComalLaws
Ihavea
alna><Liab>7itylnarmoePbliccyinchx)ir>gCorrplet OLwawrls Comrageoritsabstarrialegtrivale>t YES zFq- NO
IhaveMbrniWdvalidprcofofsarmtot v011im YESff havechedodYES p
� , lea9eindic�ethetypeofco
drekingthe box L `��
MURANTCE EZ BOND MIER (P1easeSpe*)
FxprratiMDate
Estim&dvahteofl7ecnicalw0tk$
Wodctostatt klspoc"D*ReWested Rough Final
SO-Wudbr7;ePolsfp�FIRMNAME
c r LkewNo.
J /J
LKe�lsee=!sC//� l�i l Ti✓ Slgntirie Lioa>9eNo
BasmTel.No-
6
Alt Tel No. -Z
OWNER'S INSURANCE WAIVER;IamawaredudieLioerm does nothavethemsuammcowrageorits mbsultial egivaimtaslegmedbyMassadnusets C=CralLaws
and d atmysiglab aeon thispeumtapplicabon waives this regtmenat
(Please check one) Owner ED Agent
Telephone No. PERMIT FEE$
signature o wrier or gen
I
THECOMMONWEALTHOFMASSACHUS Office Use only
DEPAXTAIDVT0FPUBIICS4FMY Permit No. �S 19
BOARDOFFMPREVEMONRFaGUL47TONS CM12.p0
Occupancy&Fees Checked
APPLICATION FOR PERMIT TO PERFO ELECTRICAL WORK
ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS E ECTRICAL CODE,527 CMR 12:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date
Town of North Andover To the Inspectorlrlol f.,-ires:
The undersigned applies for a permit to perform the el ctrical work described b ow.
Location(Street&Number)
Owner or Tenant 747
Owner's Address _
Is this permit in conjunction with a building permit: Yes o (Check Appropriate Box) ;�Q `74
Purpose of Building A C
Utility Authorization No. t�
Existing Service Amps d(✓'fi Volts verhead Underground No.of Meters
New Service Amps/7 0 / 4 t7 Volts Jverhead Underground EM No.of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work A4 zle 4e &V .� r
No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total
No.of Lighting Fixtures ✓ Swimming Pool Above D BeKVA
low * Generators KVA
' round '
ourid'
No.of Receptacle Outlets O No.of Oil Burners No.of Emergency Lighting Battery Units
No.of Switch Outlets
No.of Gas Burners
No.of Ranges No.of Air Cond. / TotalFIRE ALARMS No.of Zones
Tons
of Disposals No.of Heat Total Total No.of Detection and
Pumps Tons KW
Initiating Devices
No.of Dishwashers
j Space Area Heating KW No.of Sounding Devices
/ No.of Self Contained
Detection/Sounding Devices
No.of Dryers ' Heating Devices KWLocal Municipal Other
of
of Water Heaters KW1:3Connections
No.of No.of
Signs Bailasis
Hydro Massage Tubs No.of Motors Total HP
ER•
Plusuant
Cove tothemWmartaMofMa%d'>usetlsGataalIaws
amuttliabkkRlx=POlicymckXkgCCMpift Covt�ageoritssu Ann
eyt>tvvata,c YES NO M
validproofofsaznetothe 06ioe YES If)mha%edvclm 1YEs,Pkmeit&&IhetypeofwRW by
the BOND a M o ftw )
`✓' // EMM*d VAx dElmincal Wojk$
Start kispectionDUeRewestdd Rough Firial
1talhesofpVy/
LANE �l LioaseNo.
Signahue
�- BusinmTel No. 6
0 kyr
A)r Tel Na .�
SINSURAI`KEWANFR;IamawatethatdleLioa>sedoesmtha�theinstiz r=covwWoriCc &egtriv�yasffl# dbyMa MchuMGff XtalLaws
sgnatiuecn thispe1=app i=cn wmA s dz tecltm W1
heck one) Owner Agent a
Telephone No. PERMIT FEE$
Signature o caner or gen �.
j
7-40
�h
I,
Location
No. Date
roRTM TOWN OF NORTH ANDOVER
� s
Certificate of Occupancy $
f i # _ •f,
•��b .,.• � (/IDS
,ssACMUSEt� Building/Frame Permit Fee $ D.
Foundation Permit Fee $
Other Permit Fee $
TOTAL $
ell
Check # C< —
17296
/� '-9vilding Inspectolf
t
TOWN OF NORTH ANDOVER
' BUILDING DEPARTMENT
APPLICATION TO CONSTRUCTRENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING
BUILDING PERMIT NUMBER. DATE ISSUED.
SIGNATURE: e�z �
Building Commissioner/Inspector of Buildings Date
SECTION I-SITE INFORMATION
1.1 Property Address: 1.2 Assessors Map and Parcel Number:
An cto -,Feez K049 Map Number Parcel Number (�
1.3 Zoning Information: 1.4 Property Dimensions:
Zoning iD strict Proposed Use Lot Areas Frontage ft
1.6 BUILDING SETBACKS ft
Front Yard Side Yard Rear Yard
Required Provide Required Provided Required Provided
0 32 i 2 o 30 3 17 0
1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System:
Publio )C R,n a ❑ Zone Outside Flood Zone Muaici al On Site Disposal System ❑ —p�1
at r.V 15i1I
SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT M
Gs O
2.1 Owner ofRecord !_
lJr1i
Name-(Print) Address for Service
Sign ature Telephone o
2.2 Owner of Record:
Name Print Address for Service:
M
Signature Telephone
SECTION 3-CONSTRUCTION SERVICES 90
3.1 L'censed Construction Supervisor: Not Applicable ❑
Licensed Construction Supervisor: 05, 0
53
AM0v�,e( ;e
License Number an
Addres
Expiration Date
Si�natars� Telephone
•
3.2 Registered Home I rovement Contractor Not Applicable ❑
Company Name M
Registration Number
Address
Expiration Date
Signature Tel hone v'
f.
SECTION 4-WORKERS COMPENSATION(M.G.L C 152 § 25c(6)
Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result
in the denial of the issuance of the building permit.
Signed affidavit Attached Yes.......X No.......❑
SECTION 5 Description of Proposed Work check au applicable)
New Construction ❑ Existing Building ;X, Repair(s) ❑ Alterations(s) ❑ Addition
Accessory Bldg. ❑ Demolition ❑ Other ❑', Specify
BriefDescription of Proposed Work:
/
6Tz�
d (pE3D �J ® las = X10 ooD
SECTION 6-ESTIMATED CONSTRUCTION COSTS
Item Estimated Cost(Dollar) be
( )to 0Fk"1<CAL USE ONLY s
Completed by permit applicant
1 R
1. Building (a) Building Permit Fee
Multiplier
2 Electrical (b) Estimated CTotal Cost of DU
Construction
3 PlumbinE Building Permit fee(a)x (b)
4 Mechanical HVAC
5 Fire Protection
6 Total 1+2+3+4+5 502 911 D D D Check Number
SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN
OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT
as Owner/Authorized Agent of subject property
Hereby audiokze f L`j epee O to act on
My beha�,i afters re tive ork authorized by this building permit application.
'41r � � ��
Si a e of Owner Date
SECTION 7b OWNER/AU ORIZED AGENT DECLARATIUN
,as Owner/Authorized Agent of subject
property
Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge
and b t--7
Print am
Si gatui,6 Lf wner/A ent Date
NO. OF STORIES y SIZE a
BASEMENT OR SLAB '
SIZE OF FLOOR TIMBERS 1 x 2 x 3
SPAN Z
DIMENSIONS OF SILLS t
DMIENSIONS OF POSTS 'Y;,- L r Ila _
DMffiNSIONS OF GIRDERS 2
HEIGHT OF FOUNDATION THICKNESS '
SIZE OF FOOTING X
MATERIAL OF CHIMNEY
IS BUILDING ON SOLID OR FILLED LAND S� L
IS BUILDING CONNECTED TO NATURAL GAS LINE
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 1�o PHONE ,�7,?
�3SZ V7
LOCATION: Assessor's Map Number PARCEL / I
SUBDIVISION LOT (S) 'z
STREET ST. NUMBERJS�L17
*****************************************OFFICIAL USE
�tEG MENDATIONS PF TOWN AGENTS:
CONSERVATION ADMINI RATOR DATE APPROVED 0
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 -SEWER/WATER CONNECTIONS 066 uO eAJ
DRIVEWAY PERMIT
FIRE DEPARTMENT ;�'irC�n�c'%�12 /ids,-�✓r G�//�
RECEIVED BY BUILDING INSPECTOR DATE
Revised 9197 jm
---_.:__........... ........ .....................�.:.::«,.....�,. ®,� .� � ..per ..-� .. �.
�r
;ll-4 A
r4
C
A�N-1
ADZN /y
,
Ou p� /ft.
ORAZ ��
47 IcRO5
LD�11 n -
A to D-1 ... .. T"'
.a I t
�Uob
Abr rDJ �}
rn 31� -
o � ; 1
_ Dp
zO
- r
•v Z
I BOARD OF BUILDING REGULATIONS
ot3 „License: �QGNSTRUCTION SUPERVISOR
`{ Number CS 028192
&` rIBrthdate_108/30/1946 + ''
gpites:1,08.3012005 Tr.no: 3409
Restrlcted ' 0
� s.
RICHARD F JONES
38 MONTEIRO WAY`
N ANDOVER, MA 01845 :
Administrator
z a The Commonwealth of Massachusetts
� d
Department of Industrial Accidents
Office of Investigations
wR Boston, Mass. 02111
Workers'Compensation Insurance Affidavit
Name Please Print
Name: el� /7t4o �"`or s
Location / �7 ��uS�n�0!1- ✓e
City /�- 07n ®rl nom-- Phone # 2/7
=7111 I am a homeowner performing all work myself.
=I
F5r I am a sole proprietor and have no one working in any capacity
0 I am an employer providing workers' compensation for my employees working on this job.
Company name s rG Ak
Address �� ��("e0
Ci : JF/ l7yJ0ye/<' Phone#:
Insurance.Co. Policv#
Company name:
Address
City Phone#:
Insurance Co Poles#
Failure to secure coverage as required under Section 25A or MGL 152 can lead to the imposition of criminal penalties of,a fine up to$1,500.00
and/or one years'imprisonment-as-well-as-civil,perialties in-the1brm of-a STOP WORK_ORDER..and_afine_of.(.$100.00).a-lay against-me. I
understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
1 do hereby certify under-M 's and penal ies Of p rjury that the information provided above is true and correct.
� �
signature— .�' C Date 12F-0
Print name E1614 Itkc( )(��� � Phone.#_
Official use only do not write in this area to be completed by city or town official',
City or Town Permit/Licensing
❑ Building Dept
❑Check if immediate response is required . Q Licensing Board
❑ Selectman's Office
Contact person: Phone#: ❑ Health Department
❑ Other
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)
Signat re of Permit Applicant
I
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through the Office of the Building Inspector
MORTGAGE INSPECTION PLAN
BOSTON
99-03967
SURVEY, INC.
P.O. Box 220 Charlestown, MA 02129
(617)242-1313 MAIN (617)242-1616 FAX
APPLICANT: JONES
LOCATION: 15-17 GROSVENOR DEED/CERT: 1282-0729
CITY, STATE: NORTH ANDOVER, IIIA PLAN REF:
'i
' LOT E-2
14,700+/-SF
b
2 STORY
'-RAMP_
I
147...00
GROSVENOR AVENUE
1994(c)Boston Survey Software
PREPARED: 04-12-1999
SCALE: 1 inch = 30 feet
CERTIFIED TO: BARON MORTGAGE CORPORATION
�ZN OF Mq
The permanent structures are approximately located on themer enc Accordin6 g to Federal EManagement Agency
ground as shown. They either conformed to the setback p=S JOHNGN y g
requirements of the local zoning ordinances in effect at
J m maps, the major improvements on this property fall in an
the time of construction, or are exempt from violation en- o U RUSSELL (1) �'"
arra designated as Zone �/� /c;Q
forcemeat action under M.G.L. Title V11, Chapter 40 A, ,o # 8717 Comnnrnity Panel No: A.3-Od rg —000sc
Section 7, and that there are no encroachments of major Effective Date:
improvements either way across property lines except as6 — e - F.?
shown and noted hereon. 9AD SUR NOTE'Zone C is areas of minimal flooding(no shading). This
designation is not based on an elevation certificate.
IJOTE:This is not a boundary or title insurance survey.This plan was prepared in accordance to procedural and technical standards for Mortgage Loan Inspections as adopted
by the Massachusetts Board of Registration of professional engineers and land surveyors, 250 CMR 6.05, and use for any other purpose is pr,)hibiled. chis plan is no!to be
used for recording, preparing deed descriptions,or construction.
,v Ail
-'s P .'r �-:: •�t, :�,'k`;r•.::5"-':: e•a V•
j St�.'by�0_. Air E'1-99 O4to3 from 978272S4
on 40{yjQ�����+�—•• --�y„�
ry+•i
1 LOT D-2 ( � - z
£X1ST(NO OWEWYO �-p
W SrORY DUPLEX
17
c' 33.9' s
AS'SESS4RS IUP 52 ASS0WRS KAP d2 2.4 ASSESSOF.S 9AP 52
LOT 7 LOT 24 LOT if
Z7 - z.9 GROSVENOR A VENUE
Iti't£RfNCE' IS tifAOt 1Y1 .( vtRl tNCt
ONKTED GY TWC FO}K'( Or NORTH
AKDOVER IONWO 9aQD 0r APPEALS
DAT£D S£Pr£u6.r-R f9Q'r
R£FfX£NCE PUN:
H.£.R.D. PLAN 07JI
STRUCTURE LOCATION PLAN r «wrpry wr W mAatr sTWvnArr SmowN COCT mr cowoty
N rW rdWOATAL $rTUCK RtOWEA-kn Cy hK LOCAL
AIfUCUCI ZOOM IY-urs rK CrTCCT Mk(X cognx =.
RC/Lfib�Y (S uatX M A VYPUKI GA>ZRI nEV#a. (Nf
Curly: RICHARD F. JUNES
r>tc auwa7 u M7f K vrra fr rw oGWvr tw ANY
TNIs C£RT1RGArION IS AUDE AM LlWfTED °rw to N rmr wMwo A ww THC
TO TNf A9Ovc GYILNT. KAWSSW o! aArsrxrark t VAN MO--
nxTw • r7rr Nuayc rs ?w con"up nwary
A CAVA 7V-'ttrN R 3CAW AIV- Av0 ANY tstttR7.-MM W
is htV"= t UW TActr ru *C*-O Wjrr
MR TW Vwcf/f ---,tz 0 VX CY n" cm*s+a Od AAr r 4-
w rw carr cn .aRcax
LPC�(TIOr 27-29 Cf W nWOR AY£KUE
MORI'f{ AKDOVE'R, AM
F
SCALE: 1' R 40` DAM JAYUARY 29, 1989 s �,
CHRIST'IANSEN &SERGI •L
���
sunrat Sr rst�t�n.uc1JK orrm rrL �ri.Jrs-arto
Q rOn •Y creanw,sx�l t Sr7Nf/.�
DRAtWIHC No. 99006001
5 6�.je0 5 t/ek),o 2
i----------•--------------•------• B•�;U-
OVERSIZED 1 CAR ----J
GARAGE BATH. 3p,
I
---^-
Poop—
Z-
m
i
� L.i.,
KXT.
40'
i--•--------------------------------------------
30'
-----------------------•----••-
30'
----------------,
BECK
r1�;D � QCW1
BED. BATH. I3LD. l
Floor
SfR►FS S}ps'/Q S BATH.
t- -- 30'
30, eM
4.0'
i
ROOMS NOT DRAWN TO SCALE.
FROM :ROBERTS INSURANCE FAX NO. :9786833147 Apr. 29 2084 10:34AM P1
DATE(NIMMONY)
AGO&P. CERTIFICATE OF LIABILITY INSURANCE 04/7.9/2.004
PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
M.P. RoberLs Insurance Agency Tnc ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
3.060 Osgood SLreeL ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
North Andovn.r. MA 01845
INSURERS AFFORDING COVERAGE
978 683-8073
INSURED NORTHERN REALTY, LLC:. INSURER A: WESTERN WORLD INSURANCE CO.
A/O RICHARD F JONES INSURER 0:
38 MONTEIRO WAY INBURF.RC:
NORTR ANDOVER, MA 01845 INSURER D: ASSOCTATFD EMPLOYERS .T.NSURANCE CO
INSURER E:
COVERAGES
THE POLICIES OF INSURANCE LISTFP BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING
ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH'THIS CERTIFICATE MAY BE ISSUED Ok
MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH
POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
INSR TYPE OF INSURANCE POLICY NUMBER POLICY PInPECTNE POLICY EXPIRATION LIMITS
LTR DA D
GENERAL LIABILITY EACH OCCURRENCE $1,000,000
_
X COMMERCIAL GENF.RA1 I IARII ITY FIRE DAMAGE(Any one nre) E 50,000
CLAWS MADE I X I OCCUR MED EXP(Any one person) $ !3,0 0 0
A NPP832529 03/1.4/04 03/14/05 PERrnNAL&ADV INJURY $1,000,000
OENERAL_AOCaRECa TE $2,000,000
GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMIYOP AGC $1, 000,000
POLICY PRO- LOC
AUTOMOLtILF LIABILITY COMBINED SINGLE LIMIT
ANYAUTO (Ea accldent) S
AI.1.OWNED AUTOS BOOII.Y INJURY
SCHEDULED AUTOS (Par pommn) S
HIRFD AUTOS BODILY INJURY
(Per accident) E
NON-0WNGD AUTOS
PROPERTY DAMAGE $
(Par riccidorr.)
GARAOELIABIUTY ALrI'OCNI.Y-F.AACCII)FNT S _
ANY AUTO OTHER THAN EA ACC $
AUTO ONLY: AGG $
EXCESS LIABILITY EACIIOCCURRENCE $
OCCUR ❑CLAIMS MADE AGGREGATE S
E
DEDUCTIBLE $
RETENTION S $
WC STATU- X OTR
WORKERS COMPENSATION AND TORY LIMITS, ER ',,,_
EMIlLOYER9'LIABILRY WCC 500455701.2004 06/:1.2/03 06/12/04 C.L.EACH ACCIDENT__.___. E 500,000
D C.L.DISEASE-EA EMPLOYEE $ !)00,000 -_
E.L.DISEASE-POLICY LIMIT S !)00,000
OTHER
DESCRIPTION OF OPERATIONS)LOCATIONSA RICLESIFXCLUSIONS ADDED BY ENPOR$EMENTISPHCIAL PROVI91ONS
FAX (978)685-1495
CERTIFICATE HOLDER ADDITIONAL INSURED-, INSURER LETTER: CANCELLATION
SHOULD ANY OF THE AGOVE DESCRIBED POLICIES BE CANCELLED BEFORE,THE EXPIRATION
TOWN OF NORTH ANDOV KH DATE THEREOF,THE ISSUING INSURER swLL ENDEAVOR TO MAIL 10 PAYX mrrnN
BUILDING SERV 1.C h,S NOTICE TO THE CERTIFICATE HOLDER NAMED TO TNB LEFT,BUT FAILURE TO PO SO SNALL
'36 BARTLETT STIRRFT IMPOSE NO OBLIGATION OR UARILITV OF ANY KIND UPON THE INSURER,ITIi AGENYS OR
NORTH ANDOVER MA 01.845 RE TIVE&.
AUT RE 9 ATnrE
D CORPORATION 1988
ACORD 25-5(7/97) ®A OR
of µo oT+� TOWN OF NORTH ANDOVER
DIVISION OF PUBLIC WORKS
9
i 384 OSGOOD STREET
NORTH ANDOVER,MASSACHUSETTS 01845
�9ssgcnus�� Telephone(978)685-0950 Fax(978)688-9573
DRIVEWAY PERMIT
June 1, 1999,Revised 06-01-02
(Please Print)
DATE:
STREET&NUMBER ( 5-IT AVe- LOT NUMBER:
CONTRACTOR: TEL:
ADDRESS. FAX:
OWNER: i C Mar c� D'uC�S TEL: 27A -653
ADDRESS:
PROPOSED PLAN OF DRIVEWAY ATTACHED:
PROPOSED SITE DISTANCE: DIG SAFE NUMBER:
SITE INSPECTION IS REQUIRED BEFORE FINAL SURFACE IS INSTALLED AND A FINAL INSPECTION
WILL BE MADE WITHIN 48 HOURS OF NOTIFICATION OF COMPLETION.
INITIAL INSPECTION DATE: BY:
FINAL INSPECTION DATE: BY:
FAILURE TO COMPLY WITH THESE CONDITIONS OR TO OBTAIN REQUIRED INSPECTIONS AND
APPROVALS VOIDS THIS PERMIT. APPROVAL OF THIS PERMIT DOES NOT RELIEVE THE APPLICANT
FROM MEETING ALL OF THE REQUIREMENTS FOR SAFETYAND DRAINAGE.A SEPARATE STREET
OPENING PERMIT IS REQUIRED FOR WORK PERFORMED WITHIN THE STREET PA VEMENT.
Attachments made a part of this permit:
Form U & Driveway Application Requirements
Sketch"A"Proposed Driveway Plan, dated 06-01-99
Sketch`B"Typical Driveway Detail, dated 06-01-99
APPLICANT SIGNATURE: � �
DATE:
DIVISION OF PUBLIC WORKS SIGNATURE: DATE:
4 o4
harm U&Driveway Applications Rev 6-7-02
i
17 64t, r
I 'l-0 l3E Carrol
Design
e P03as W7
st, FESMT�
CBQ&
soa-475-,
Fm 508-47-9:
B Alan Carr
o�.
n�T iQQe
V
0
�J
9437
Dn?1.
FRONT ELEVATION ,q_ 1
1/4 - V
;` SH OF f
__- -- -` Carroll
Designs
POB0.W7
RESDUMA
t
® 508-475-14
— I
Fax 508-474-93!
Alan Corro
C�L.
OCT 1994
v
REAR ELEVATION LLJ
�
1/8• = IT LEFT FI EVATIoN m
general NotPs- � h
c�
t. �
1. All dimensions ore to be (field verified by the Can;rcc;cr Cr-,)
odjustments mode occordngly. sir
c-
2. All work shall be completed n compl&ce w,ih a!! c, pliceb:e
Plumbing,Electrical codes. Any oiher cocci,stc!e cr:d;Of ;
thiol may apply to this project shall be ccnsderec c; per
construction documents. 5
3. All waste materials and debris shall be removed end di posca c i
4. All structural materials shall be void of any aeiecis Thai may
their capacity to function n an odequote menner.StruciurclOf
cngina::r:^.g
or any other professional services :hot may be recused snoll be `, C)
provided by others under sepoole con act end terms x/STi - LL-1
5. All penetrations(Plumbing,Electrro�neorny,e;c) mit, :iou,:; l�
be completely Fre Coulked �s•� r
6. All wolfs adjacent to stairs shall hove Fre lilocxng isiciiec
to the stringers. FA -
7. Any liability by Carroll Designs either ossurned or mpilec ,,;,;; : .limited to the cost of the Design/Drofing Fee for ;h;s pro,eci ;u vff these drawngs are copied and used for any projecl otherlisted in the title block shallremove Carroll Designs of ail liabJ!I
EIGHT_ F( EVA TION
= I D FSH 2 OF 8
v ............. ............ .
_ ..
34'0' _
12'S4�" 8'0' 13'64•
6'9�Z" 5'8%• 5'0' 3'0• 610%• 88"
I
6r ZDW
i
KITCHEN o P a co s r,ee,r Rocrc
0o
r•
N O
O M
v 76• ,aD - o
O
N .a.
N
r7 "
I O
tD U
M I
DINING ROOM °N FAMILY ROOM
o -
1
36' 616" 3.8• 3'4" 3'4' 3'8' 6'6'. 3'6'
'08• 6'8• 13.8-
9437
- F_IRS�T F OOR P AN
1/4" = 1.0..
rSH 3 OF
1 .
� 4
1
- 34'0"
911144' 2'6' 1 8.0' 13'6x4' -
6'9Y 32 4" - 3'0' 1 5.0" 611014• 618•
EO
BED #2Q M BEDROOM #1
N C/-) m
<o O
�o J o
U,
0 74"
14to
j N
-) '6' N 3'544" 35414" r�
l
10 DN
m F—
BED #3
o 0 214• 24*
N Y v o N CL. CL. co
Y N
2'6" 216" 1'9%' 216" 216"
4"3" 5.0' 41114" 73" 4'1 5'0" 413
I ra No
9431
SECOND FLOOR PLAN
A
1/4" _'10"
FSH 4 OF
' 34'0"
20'6"
,. ____ ___ _______________________________________________ ______________ .-_-.___-..--__
1
,
OUNDAPO GARAGE FNSN
' 10' 'W Cont Fool'nq CcrxWal
10'Dp x Mi$' AI Wood constructed Wdl3 and Cel'nq
to have 5 8'
, / type X Fra Rated ,
Wdbocrd intoUed'.
N 31/2'Dmldfy Colmm ; o
i Wdh ZY S%x lb'Deep ;
3—2 x t2 Center Beam Footnq(3'r4d)
6'8" 6'10' 7'0' 13'6 '
ki
-----�
N
L_' J J — L- --- i- ----------
' '_ J L _ J ;
2 x 12 Center BeanCD
;
N ,
4'Step Dorn into Ccroge
, N
,
< i
'b-^O!✓ �
U') 1 ; r) P
M , ,n
Bott of frost wa!footing 4'0'below (m h)
4" 9.0" 4,
3'6" 6'6' 12Y 9,8. 111" 9437
FOUNDATION PLAN
1/4" — 1'0" A-N
SH 5 OF
Continuous Baffled Rdge Vent _
2 x 10 Rage Board
n 0�'OFWG -
Asphdt/fberglws Roaring
• 6 Buldng Paper
1/Y Plywood
2X8016'Or,
12 CELNG
2 x 8®16'0D. 1O'OvcrhmgiV Soffa w/vents
R30 Fber4=hsdatbn —
1 27 Vapor Barrer
Vr Wdboard.
FLOOR
3/4'Sheathing
2X8016"OL
. m
`HALL
Sang
Air Barrier
Sheathing
i 2X40leOr,
i Vapor Bantu
FLOOR f/2'Wdlboard
3/4'Sheathing
2X8016'Or-
I 10
M SLL
L
1—2x6 P 7,1—24 KD.
=Ccnthx ow Sl Gasket
1/2'Din x t2'L Anchor Bdts
9 n,O.G.(mn.1
j N - FOUNOATUN
4Concrete Slab _ _ _ — 8'Concrete Woo
8'Dp x 1'4'W Cont.Foo tN ,4 p„
9437
SECTION THRU HOUSE A-6
1/4' = 1'0"
SH6OFE
f
. FIS Fro'ned Bean .
. I
M members=2 x 8 016.OL(UH0 M members cre 2 x 8 0 15 OL W)
FIRST Fl OOR FRAMING PI AN SECOND R DOR FRAMING PLAN
v�_ar9_
Fbsh Francd Scan 02xiORIdgeSoard
l
ILLUJ �m rh
94373
M manbcr3 ore 1 x 8 016.o G(W) M mcmbcrs ac 2 x 8 0 15 OL pmt
Ij ATTIC FRAMING PI AN ROOF FRAMING PLAN A-7
SH7OF8
-
- - -
cr
1 ET
IS
11,s-,� G
as
.. ��{� _ l
_ LY— sf I �1L- df
R ,s f 4 i 3 ,O14 5F.
OR
��]
0 �C,GIA 91 a3 ❑
_ I A*Z
._ soe,t• t n At14
'Q I 34217 iF.
GG C�D
SSoo SF ar .. �I•Yl0 5F. ,e
16.000 '
^ pp A& I
r•,.�Q� • N
29 t1,924 IF 4-7 i
VV -
10.000 5 f.
R 11 I
Ono
S.f
COL UMBIA a,
ca
�,foo SF -�..«.�`�`�� [_. cs I ----
(—' ck -1 t
r o1 V E. f1 ___—
O12.50° xf• *,OR � c3 I � � _____ ai I I
z G RQSVE - 3� w 5f , o
CD - 3 3
f.too S.t� -
?3
nJ50005f. t0.000
a— 3.f.
. ' 5.000 S f�' S7 Q
S
3 J
W •� ',?' 'I.90 S aov iO'4 1;S f S7 ❑ Q.
W t j s.oa W
(n ' �2 n$0n s.r. , (3 Q c. I 2 W
7 00 S,F. - j J3 O t
El � I
! 11111 sf
715700S.F.
r. 5d 4ppO s f `—
I
s.f. 11,642 sF.
z
-� Gj V1 t.
SI
3-4
5,723 O `-_-•.
57
rD
5.1
! t \ �o
!
00 _
tPLAT NO. 39
SCALE - 40 F ET = I INCH _ 1
1
RTH
Town o - 4Ahdover
0
No. 6
Z^ = o dover, Mass., •/8"O
Y O LAKE �� T
I� COCMICHEWICK
7�A0 ATED P'P�,`�5
SAC HUS�
FOR
1
EXCAVATION AND
FOUNDATION
THIS CERTIFIES THAT ... 4.0 d ......a-d.A)�:5................... .......................................................
has permission to excavate and pour foundation at..... 6!!��A.ve 400v r.' . ........ . .................. . .......v."..
for the purpose of... .. 3 / 40 FN)A r e�► �C�s41�0 of FA ofY
............. ...................................:...........:.........:......:::... .......:......................:....
The person accepting this permit must return to the office of the Building Inspector a certified plot plan show
AJ
of building thereon before Foundation will be inspected. ra 6-� 9O � R Q 01 A
�J a ,- ,",
F y
VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS
The holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS
assurance that a permit for entire building structure will be granted.
BLS PERMIT F C
LESSFDA FEE .. ... ... ....................... .....W�.... .............................
��� SEE REVERSE SIDE BUILDING INSPECTOR
%.10RTM Ando ® over
� dower Mass.
o y
COC MICE WICK
ORATED
V BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
THIS CERTIFIES THAT
BUILDING INSPECTOR
�?t..�r.... ..�!.!". ...... r • S
10
has permission to erect...W..� � buildin s on ...ls! J ISro*.A�*Aoo P � Roghan�... ................................. on
e SIdty o/�% i� � �iIAry g y
to be occupied as..... . .......... „ e �Q Oaf►.. 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 Inspection, Alteration and Construction of
Buildings in the Town of North Andover. a FA M# /y vN 1 f *0 Re Oh A 1 N q� � PLUMBING INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. �� ~ Rough
Final
PERMIT EXPIRES IN 6 MONTHS
ELECTRICAL INSPECTOR
UNLESS CONSTRUCTION ST T Rough
... .. .. .. ...................... ..�.. Service
.
BUILDING INSPECTOR
Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Rough
Display in a Conspicuous Place on the Premises — Do Not Remove Final
No Lathing or Dry Wall To Be Done FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector. Burner
Street No.
SEE REVERSE SIDE Smoke Det.
07/22/2004 14:26 9783723960 CHRISTIANSEN & SERGI PAGE 01/01
f47.0'
LOT E--2
g
ASSESSORS MAP 52 K
LOT 11
ASSESSORS MAP 52 N 64.0
LOT .24 � (A EXISTING DWELLING $ ASSESSORS MAP 52
ilNO ST0R3' DUPLEX LOT 29
34.0'
20-1-1
EASEMENT I I
I
14ZOP
GROSVENOR A VENUE
REFEAEMWPLAN:
N.&I.0. PLAN 07Jr
STRUCTURE LOCA TION PLAN I clory PUT 1w FRAMN symoc1"SNM cumm
Off MMMM MM4M AWWWOM a-Re L=4
APPLAW MM nr-uwW
gFM SM,W am Aw �
commomm
mr
cum
RICHARDF. JONESomm
or�
mu mwm s,lIL6' wr Ar wo or mw pm/ICON ANY
"M CEWWrAWM 15 MAID' AND L1All' o '114W 114m 7mr mnmu AwwAwror WN 1w
OMM TO THE AR'OVE CUENF. WM X IW
W�&sM,AV. ANY Lq*WMU=W
MAOMMMMftMogWr
W "K A1/A M � ANY
S -
LOOAMM! 15-17 GROSVEWR A W.NVr c
NORTH AND+OWR, A14 _
TM Ofd
SCA LEr 1"' ; 'gyp' DATE: .F Y 22, 2004 Y,
.�318P
p�`'S810MPv
CHRIMANSEN &SERGIesu
16D SUMMN Sr. jUK ofgn Lam Sww"m
DRAWING No. 99006001
Am
BUILDINU FILE
1
�a
Date S' a`. . . .
HORT" 41, TOWN OF NORTH ANDOVER
OL
PERMIT FOR PLUMBING
,SSACMUS�
This certifies that . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
has permission to perform .. . ''
plumbing in the u'tdings of ./'
_ . . . . . . . . . . . . . . . . . . ... .
y at w� . �. . . . . %.: . . . ., North Andover, Mass.
Fee... . . . . . .Lic. No.. . . . . . . . . . . . . .
` P" -Bol INSPECTOR
Check # �:akjT
6 ,i 8S
MASSACHUSETTS UNFORM APPLICATION FOR PERMIT TO DO PLUMBIl'
(Type or print)
NORTH Ail VER,MASSACHUSET�
� Date
Building Locati j"G wners Name Permit#
Amount
kTyj of Occupancy
New El Renovation R placement Plans Submitted Yes No
FIXTURES
V.
En
SI$)f M
RkWW r
M FLOOR
20 FUXR
I:m H CR
4HI HBM
M Hfm
6M FUM
'7III Hi"
a 9M FIOM
v (Print or type) Check one: Certificate
Installing Company NameCorp.
Address T,7�/x 75 o V/2, Gt f� Partner.
9 -2 �'- S'S-7- 1`15 7
Business Telephone ElFrm/Co.
Name of Licensed Plumber:
Insurance Coverage: Indicate the type of insurance coverage by checking the appropriate box:
Liability insurance policy FT Other type of indemnity E] Bond
Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above
three insurance
Signature Owner ❑ Agent
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,
v compliance with all pertinent provisions of the Mas usetts State P mbi Cj and Chapter 142 of the General Laws.
By: Signature or Licensedum er
Type of Plumbing License
Title 160 g/ 7
City/Town is nse Mumver Master Journeyman ❑
APPROVED(OFFICE USE ONLY.
a
44f
Location
y
N?. Date
TOWN OF NORTH ANDOVE%
34. °
S Certificate of Occupancy $
**�, Building/Frame Permit Fee $ C�
�,SSACMUs Foundation Permit Fee $
M s,
Other Permit Fee $
Sewer Connection Fee
Water Connection Fee $
TOTALY.
$ z
{ 722-
/Building Inspector
_ _' 10647
Div. Public Works
�S
i
r /PAGE
1&�tIT NO. APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS.
MAP KJO. LOT NO. 2 RECORD OF OWNERSHIP DATE BOOK 'PAGE
ZONE SUB DIV. LOT NO. I
i
LOCATION !� �20 Pv eA7to -PURPOSE OF BUILDING
OWNER'S NAME `�`G
•,,J
'T0 r� NO. OF STORIES �JICdSIZE ICI C7
OWNER'S ADDRESIS%t0��-p12,^ !.n y BASEMENT OR SLAB �.1�
ARCHITECT'S NAME +/S V V✓ SIZE OF FLOOR TIMBERS IST-'. 2ND 3RD
BUILDER'S NAME �}�, SC�Zi�iJL� SPAN
DISTANCE TO NEAREST BUILDING / ® ! DIMENSIONS OF SILLS
DISTANCE FROM STREET 35�� POSTS
DISTANCE FROM LOT LINES-SIDES LK REAR GIRDERS
AREA OF LOT �00 7 FRONTAGES HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW , SIZE OF FOOTING %
IS BUILDING ADDITION YDS MATERIAL OF CHIMNEY
IS BUILDING ALTERATION 1 J IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE �eS 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. COS?&aa®
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
J
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
✓ �g�/'
DATE FILED
� BUILDING INSPECTOR
81GNATU E OF OWNER OR AUTHORIZED AGENT
FEE
ZZ OWNER TEL.#
PERMIT GRANTED CONTR.TEL.# 9,0-5-y
17-1 -tg
CONTR.LIC.#
H.I.C.#
�VC�J V7
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-
APARTMENTSRAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
CONSTRUCTION
2 FOUNDATION 8 INTERIOR FINISH
CONCRETE 3 1 2 13
CONCRETE BL'K. PINE
BRICK OR STONE HARDW D
PIERS PLASTER
_ DRY VJALL
UNFIN.
3 BASEMENT 11
AREA FULL FIN. B'M'T' AREA _
'/, V2 �/. FIN. ATTIC AREA _
N_O BM'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 HARDVJ'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 BLK.
STONE ON MASONRY WIRING
STONE ON FRAME _
SUPERIOR
ADEO ATE I-1 NONE
5 ROOF 10 PLUMBING
GABLE HIP BATH )3 FIX.) L v.
GAMBRELMANSARD TOILET RM. )2 FIX.)
FLAT 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
8 FRAMING 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 uoo�_ AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS
7 NO. OF ROOMS GAS
OIL
B'M'T 2nd _ ELECTRIC A
1st ( ( 3rd NO HEATING
}
fop' i
ell
T4
n �
ku
L '
N J
lid
t
�00
I CERTIFY THAT THIS LOT 13 NOT IN THE F.I.A. CERTIFIED PLOT PLAN
g, FLOOD HAZARD ZONE. THIS CERTFICATION 13 EASED OF LAND IN
ON THE SURVEY MARKERS OF OTHERS, ANO 13 NOT
A PROPERTY SURVEY, FOR MORTGAGE PURPOSES ONLY. �
I CERTIFY THAT THE EUILIVIGS ARE LOCATED AS SHOWN,
AND THAT THEY COH�ORM�O Tp� NIG Nfs
TF� ZONEY-LAAS DRAWN FOR
I OF THE CITY/TOWN OF 4 f`1h�o+i
WHEN S, CONSTRUCTED..
r. �
Lawrc�cet av/
�s'
y; SCALE I" - � / �+
DEED BOOK
lZg Z PAGE 70?7.
AREA �T, �OD S f X10. fired ov erH 1't'1 'q
t
t!t
OF
PLAN 8 731 _ j l g cl0
ASSESSOR MAP P.
I�tOftftts`
NM 22150
BLOCK R.A.M. ENGINEERING
160 MAIN STREET
LOT HAVERHILL, MA.
. 508-372-0449
E C
..✓lLP V(N7G'/y1Rv/tllK•LlI.[IL O��GGl.C:1dCGClliuN%u:�
DEPAkiMENT OF PUBLIC SAFETY
CONSTRUCTION SIPERY!SOR.LICENSE
F .
/• `�uober �_ ' ,� zpr,es: Birthdate:
CS 063513 02/18/1997 12/18/1953._
Restricted To; 00 r
BLAINE A SCRIBNER
RRI BX 42
fVSW LIMERICK, NL 04048
i
i
t4. .
ONM Ti i r
dover
No. oz 9 � m
o - LAKE
:. . dover, Mass., 19
COCMICHEWICK
E Dp``'
`7 BOARD OF HEALTH
Food/Kitchen
PERM IT T " Septic System
THIS CERTIFIES THAT
BUILDING INSPECTOR
.............. ......................... . . .......��L........................................................ Foundation
has permission to erect.....:..... . .. .�.... ..... buildings
J Rough
to be occupied as.....:................. 6.. .!l►'t.r ...... .....� P..........l A. .�. ..A. .................... Chimni y
prov;;fed that the person accepting this permit shall in ev®respect;.onform to the terms of the application on file in Final
this, Ace and to the provisions of the Codes and By-Laws relating °o 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
j Final
PERMIT EXPIRES IN 6 MONTHS
UNLESS CONSTRUCTION STAR ELECTRICAL INSPECTOR
5Rough
j ................... Service
.......
/ BUILDING INSPECTOR
II
Final
Occupancy Pemit Required to 0 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. DEPARTMENT
1 Burner
Street No.
Smoke Det.