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HomeMy WebLinkAboutMiscellaneous - 15 SARGENT STREET 4/30/2018 (2) 18 S STREET - - �.�..'` 210/018.0-005.0-005 2-0000.0 J v 1 x Location S S A R G F eo No. l Date MOR7h TOWN OF NORTH ANDOVER O f s 9 Certificate of Occupancy $ y 0 G— ��s',"° 9 MuBuilding/Frame/Frame Permit Fee $ sksE Foundation Permit Fee $ Other Permit Fee $ TOTAL $ ZOO x Check # 3 a 83 17645 /yw ✓ Building Inspector I t4" TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BH IN . BUILDING PERMIT NUMBER. C;) DATE ISSUED: / D /� "7' SIGNATURE: Aaw - Building CommissionCrAnspector of Buildings Date SECTION 1-SITE .INFORMATION Z 1.1 ff Property Address: 11 1.2 Assessors Map and Parcel Number: O Map Nuhiber Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: \ 2 9Og2— Zoning District Proposed Use Lot Area Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide Required Provided Required Provided 1.5- Flood zoo omntion: 1.7 Water S ly M.G.L.C.40. 54) 1.8 Sewerage Disposal System: L1 Muni,' I Public Private 0 T'O°e Outside Flood Zone tpa � Oa Site Disposal System 0 SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT I iloLulicl Urn 2.1 Owner of Record S tr a w 1m r,i R Pa_N,T t u g 6s- S ct i eyrt ' Name(Print) Address for Service: 1 %J oe. �- e u�j F�st�� • Signature Telephone 2,7R2 7R2 f 2.2 Owne Record: ^ ' Name Print Address for Service: O�r r L Signature Telephone rn SECTION 3-CONSTRUCTION SERVICES QQ 3.1 Licensed Construction Supervisor: Not Applicable ❑ L e l! Licensed Constructiqh Supervisor. 9 License Number 1eS S a P wt Sf• L ct w-r a t�.e e f 1 a l �-5' m11 Address y 1 - 7 - 0( 7 a- �CJ Epition Date Signature Telephone e r 3.2 Registered Home Improvement Contractor Not Applicable ❑ 0 Company Name V .F— 103 m ' G P VYt pJ / � 14Registration Number r.. Address r" ClLr!'� 97(:r Expiration Date Z Si re Telephone SECTION 4-WORKERS COMPENSATION(NLG.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.......❑ No.......❑ SECTION 5 Description of Proposed Workcheck ail a cable New Construction ❑ Existing Building Repair(s) Q/ Alterations(s) Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify ' Brief Description of Proposed Work: e w Kao S l d► i uc w t S (y t h I 'f Le Vn.a- A 4,00 Q e(4, r-101;3 V WL it fh 6�f r-1L. u lkerj r nv ft-- n SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be OFFICIAL USE ONLY Completed by permit applicant 1. Building (a) Building Permit Fee o CJ Multi Tier 2 Electrical (b) Estimated Total Cost of G Construction 3 Plumbing C/- CV Building Permit fee(a)X(b) 4 Mechanical(HVAC) �� 5 Fire Protection 6 Total 1+2+3+4+5 0 VC)-G1 Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT -2+,G_f Z's Low'AJ R2c(�,as Owner/Authorized Agent of subject property Hereby authorize L e v tj CJ n ar'.&L-C, AC to act on My behalf,in all matters ativ Wk au orized by this building permit application. SignatqjCife—r4--" Date a SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION r I, as Owner/Authorized Agent of subject t property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Name Si ature of Owner/Agent Date NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS iST2ND 3 SPAN DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIMENSIONS OF GIRDERS a HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X 1 MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE B "c�o c guriti�ns ` tan,ar s License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 103772 Board of Building Regulations and Standards Expiration`: .?/g/2006 Tyke: One Ashburton Place Rin 1301 iIndividual Boston,Ma.02108 Ju,p 'j.}4 '� JOSEPH G. LEVIS�, �E,` ' Joseph Levis 65 Salem Std Lawrence,MA 01842 •� �-,.. — -- - - ---- Administrator valid out signatt re 1 #} �1ie Vo7rvmauaeall�i `7"�s�aaoctc/uealta BOARD OF BUILDING REGULATIONS License: CONSTRUCTION SUPERVISOR Number CS 030651 Birthdate 01/07%19 4' Explres}01/07/2606 Tr.no: 15597 1 y t:i 7 Restricted 00. JOSEPH G LEVIS'. PO BOX 952 LAWRENCE, MA 01842 dt mi . dL Actinn g o ss ner 'A• 'wsa. .p• t Landmark In+a.ramCe 97$5753587 0S/2S.'04 04:11pm P. 001 r AC^RV Cir-;-,:T'IFICATE OF-LtABILITY INSUf SUNs i DA EI 2s oA' PRODUCER THIS CERTIFICATE 15 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS L'P©N THE CERTIFICATE Landmark Insurance Agency, Inc HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 198 Massachusetts Avenue ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. North Andovcr MA 01845-4190 Phane:978-688-8829 Fax:478-975-3987 INSURERS AFFORDING COVERAGE NAIC# rrrSURED N;;LrkFK.A: Essex Insurance Co >a 39020 N31JR�RD: safety. Insurance Co. 33618 --- —. _. Levis is Inc. INSURER C: Guard Insurance Group 65 a?em Street INsL+KLKU: Lawrence MA 01843 __...._..-- -.._._...-.. IN;i1IRFR F: COVERAGES THE POLICIES OF INSURANCE LISTED 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 SE ISSUE)OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL TmE TERMS.EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. a •--......--.-.__ o .. - {f �1'S7�[Eii71V� POLIGVFXPIRATIOA'' _ --•--•-- -._.. LTR NSR TYPE OF INSURANCE ! POLICY NUMBER DATEL;IMM1071YY DATE( wDONY1 L LIMITS GENERAL LIABILITY EACH OCCURRFNCF I S 1D00000 __._ iL UnENTSD Ft I X ]COMMERCIAL 3ENERALUA&LIY 3CM1495 i 1.,0/26/03 I 10/26/04 PREF^��«rur+M} !S50000 CLAIMS MARE1 OCCUR I I MFD Ex.P{AAV one Deronl s 5000 ._. I I �PERSONAL RADV INJURY $1000000 ------ - I r— ! GENERAL Ar:GREGAT[ s2000000 .^.FN•I.A4`10RECArEUMirA7+^LIES PERI I PRODUCTS.COMPiOPAil(•. $2000000 Pko-I I r�()I_IL:Y .IFf;T I LOC AUTOMOBILE LIABILITY ! i COMRINFr):;INC;I F I.IMIf y $ I —a ANY AUTO ` 821254 01/01/04 01/01/05 I(F-eaccloem I i I ALL C'VVNEO AUTOS I I I PODLY INJURY I s 500000 X I SCHFOULF'0 AUTOS X I HIRED AUTOS I I I I I BOGRY INJURY I s 500000 I 1 X 11 0NZ—WNED AUTG9 1 `-,.a� aciccrtl II I I °ROr'-.!'!Y VAMA•.•E ;%250000 ITee xo cr I . GARAGE LiA811T'r �---- I I I i AUTO GNLY G+ACCiUt(V 1 I S ANN AUTO .... i 1-- EA RCC f 5 .....' _-• .. OTHER THAN 1 I AUTO ONLY, AGC 5 -—--- - I I EXCECSIUMBRELLA LIABILITY I i I EAC•, ,-U22.t:::C I i U7CUR I CLAIMSMAD9 I I .C!:!'}2t'tAlE ..__.._....._- 4 l OEDUCTALF I IF WORKERS GOMPF,N ATION AND �" — 6MPLOYERS'UABILITY I I I-,.wUkY UMTS I E-..I _...__._ C I AN'IPR!)P41t OR1P�?RTFdI_RtE`.=E:=:!TIVt LEWC509927 ( 02/27/04 1 02/27/05 1 E.L.EACHAU;CIDhT1T 1$ 100000 -_ I UP IC:EWN.Ftk76 1tt CIUUED' I I i E.L DIsaA,^,E-EA EMPLOYEE$ 100000 SPECIAL PROVISIONS bricw ( E.L.DiStA:t.POLICY LIMIT `s 500000 OTHER I I • "'•^ AN OP OPERATIONS f LOCATIONS I VF_HIGIU r EXCLUSIONS AOOED BY ENDORSEMQg7!SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION- j DATE THEREOF,THE ISSUING INCUR6R WILL ENDEAVOR TO MAIL DAYS WRITTEN I - NOTICE TO THE CERTIFICATE HOLDER NAMED TO THC LEFT-BUT FAILURE TO DO 50 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER,RS AC95NT$OR t REPRESENTATIVES. AUTHOR REPRESENT f r ACORD 25(2001108) V ACORD CORPORATION 1 i I 4 i5,o9 5. 9 7 _ 90 9 2 S� t 14 ti � - 0 � 0 o \ ,e c 2 S T'� I HEREBY CERTIFY TO THE TITLE INSUROR AND PLOT PLAN TO THE BANK THAT THE DWELLING IS LOCATED ON IN THE LOT AS SHOWN AND THAT IT DOES CONFORM /VQ �N�Q V E WITH THE 7e ^"'- w OF -.¢ 10e.Arlt ZONING REGULATIONS I9-7A REGARDING SETBACXS FOM STREETS & LOT LINES.- 1 FUR?HE RT Y T THIS DWELLING IS NOT DRAWN FOR LOCATED IN �_' FLOOD HAZARD AREA AS SHOWN ON,.:, ITY PANEL `0 9B93oc 3L ✓Q�EPy STEPHE -..R.L.S. DATE / ;' ZO ' v G Zoo THIS PLAN 6k MORTGAGE PURMSES — NOT FOR MERRIJlACK ENGINEERING SERVICE'S BOUNDARY DETk JON. BOUNDARY LYFORMATION 66 PARK STREET TAKEN FROM EXISTING RECORDS. ANDOVER, MASSACHUSETTS 01810 Date. . � .. . ... Of pORTIy 1� o� �` TOWN OF NORTH ANDOVER PERMIT FOR GAS INSTALLATION "'qh �9SSACHUSEt -_ This certifies that . . . . . . . . . . . . . . . . . . has permission for gas installation . . �`° ote.� !.'`.'q. . . . . . . . in the buildings of . . .� at eSSA . . . . . . . ., North ndover, Mass. r Fee.1/0 Lic. No.093. . . GAS INSP TOR Check#_ 0 4912 NMSSACHUSEM UNH ORMAPPUCATONFORPERNIlTTODO GAS MING (Type or print) Date f `7 NORTH ANDOVER,MASSACHUSETTS Building Locations 6;t.i1a Permit# Amount$ C f/, S�l OwnVs Name / l �� New Renovation Replacement ❑ Plans Submitted El U W 'D 0a o Ch F E+ O OW O Cn t 0 O a OW ry E" SUB -BASEM ENT BASEMENT 1ST. FLOOR 2ND . FLOOR 3RD . FLOOR 4TH . FLOOR 5TH . F L O O R 6TH . FLOOR 7TH . FLOOR 8TH . FLOOR (Print or type) C ec one: Certificate Installing Company Name �od� ff Corp. / �" ❑ Partner. Address 6'- usmess a ep one Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No If you have checked yes,please ind' ate the type coverage by checking the appropriate box. ❑ Liability insurance policy Other type of indemnity ❑ Bond Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws,and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Agent ❑ I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massachusetts State Gas C and Ch t r 142 General Laws. Signature of Licensed Plumber Or Gas Fitter By: lumber ZC4 3 93 Title City/Town ❑ Gas Fitter cense Number Mast r APPROVED(OFFICE USE ONLY) urneyman � � I �� Date. TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING s � r ,SSACMUS� This certifies that :_ .p.0/1w ! has permission to perform . . �'!4? `° j . . . . . . . . . . . . . . . . . . . . plumbing in the buildin sof . . `. .. V elf�� r.g'w . y` . . . . . . . . . . . .. North Andover, Mass. Fee.�'50Lic. No.°?. . . . . . . `.1��??�.�it'�'�� ��7!-.. PLUMBING INSPECTOR Check # 6226 MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBP (Type or print) / NORTH ANDOVER,MASSACHUSETTS Date A/ Building Location -,/ Owners Name Permit# Amount Le o Occu anc C New Renovation R laJement 0 Plans Submitted Yes No ❑ FIXTURES cc ed R4SEVENr 1S>C FIOCR � Z*D R" / 4M)HIDM 5M RDM 6M Hf= 7M ROCR 9MROM (Print or type) Check one: Certificate Na Installing Company me 0✓ Corp. Address WeZn" Partner. Business Telephone Lk Firm/Co. w Name of Licensed Plumber: lr F / � Insurance Coverage: Indicate a ty e.of insurance cover ge by checking the appropriate box: '* Liability insurance policy � Other type of indemnity D 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 Owner11Agent 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 Issu for this application will be in compliance with all pertinent provisions of the Massachusetts State Plu ode and p.te 42 of the Peneral Laws. By: igna ure 3T.Licensea riumDer Type of Plumbing License Title City/Town ricense NurnDer Master ❑ Journeyman fly' APPROVED(OFFICE USE ONLY LLLJJJ NORTH Tov-m of Andover No. _ - - - dower, Mass. q / � a y O > > -wyCOC MICMEWICK DR I y AATE D PPS\ �y 7 S BOARD OF HEALTH PERMIT. T D Food/Kitchen Septic System 7jtPBUILDING INSPECTOR THIS CERTIFIES THAT....... .......... .V �r.... ......... .w.ot` ......... �� S ... Foundation has permission to erect.A#tW...*"Ah.. buildings on ../ .8...... .A.a .E....I ..........................................* S f • Rough to be occupied as...S�.....�!v,�./....kl�!V! O k�.S ..R M!I �... t. � M'V....�� .rP I r! 0 d• Chimney provided that the person accepTng 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 relatingto the Inspection, Alteration and Construction of Buildings in the Town of. North Andover. R r,4r• pore A O' � I)®rwl 0 r eea 0)eK*NCw PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. ' � Rough PERMIT EXPIRES IN 6 MONTHS Final ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTS Rough ......PRO ... ............. .. ..e • . Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove RougFinal 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. NDate...../.��a.. �........ 1 762 NORTH 1 � i?;.<;�``°.;•�,"�o� TOWN OF NORTH ANDOVER o PERMIT FOR WIRING A &S Mus gj v Thiscertifies that ::.1......y .......................................................... has permission to perform . :...: .......................................................... wiring in the building of........./..................................................................... at.��....... ................................................... .North Andover,MassF T7 Fee) Fee..................... Lic.No.....:........ ............................................................. .........:.... .�.--!`"......-:.......... O ELECTRICAL INSPECTOR WHITE:Applicant CANARY: Building Dept. PINK:Treasurer MM011 WE4LTH0FA14&WY1LS= Office Use only MAP DEPARDRFV0FPUBLICS4FE7T Permit No. / �^ — �ZI OFFIREPREVENTIONREGUTATIONSS1WRI2.00 �/ Occupancy&Fees Checked S rPARCEL s III VA DDT T,--? A rrlr PERT TO PERFORM ELE=CA, WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location (Street&Number) Owner or Tenant ,—K�1Sp,Qbc. Z c�12►�15 Owner's Address 7sPrQ,Cjer/1- 5T Is this permit in conjunction with a building permit: Yes® No a (Check Appropriate Box) Purpose of Building �l 10I Utility Authorization No. / Existing Service AP19 Amps,&Ra.L�JVVolts Overhead r-V7 Underground No.of Meters New Service Amps / Volts Overhead Underground No.of Meters Numbet of Feeders and Ampacity Location and Nature of Proposed Electrical Work ! a P rd . No.tl.Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA ground eround No.of Receptacle Outlets E 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. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumos Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal Other Connections r W�Rr Heaters KW No.of No.of _ Signs Bailasis No. '*,Massage Tubs No.of Motors Total HP OTHER hrn,artceCaaage.Ptastrax�thert�uuar� se�C>e>Ia�aliaws I bare a ama rt Iiabtlity hrx Pdiy urh»rg Car>p> Caeia�cr its st#ur� al�rivalerg YES NO Iha�esutxnit>�va6d�foFsarne�theO�YES ( NO If}cuhawclrzkedYES,pleaseutdica.11etheNmcficch�bydrck�gt v LJ W 11RANCE BOND OTI$R (Please Specify) ExpiratI Es mM2d VahiedElcc:lr al WoIC S WodcioSut_ /JQ h>Speci D*RNLI Raigh Final Sigted urr i�tne Penalties FIRM NAME Lio�seNa Lr_a= V �� Siwe r� Ll�rseNo �'D,(�7 C i ` p J BusinessTd.Na J�h�h"A ,{`� Gl/l ll'YI/l�!4 7►0�'1 M Al Tel Na OWNER'S INSURANCE WAIVER;I an awarethatlheLxxrse doeg mt tyae the avxa=wY -@�crtls Stan al Vitas m4mrd b,Massa}a ms Ceryl laws a13df'my ' i peatr�a cnvawsthismgtxu= (Please o O Agent Telephone No. PER,,41T FEE S Location /p 's No. �0 Date 17 / . bt Hu"#j TOWN OF NORTH ANDOVER p Certificate of Occupancy $ _ Building/Frame Permit Fee $ Foundation Permit Fee $ '— s�cHust Other Permit Fee $ Sewer Connection Fee $ Water Connection Fee $ TOTAL $ 35 ' Building Inspector 34. 42 35.00 07/13/99 14:51 Div. Public Works PERMIT NO. 6 APPLICATION ICOR PERMIT TO BUILD********NORTII ANDOVER, 'Ifk nitrNo . Ll)I.NI), 2. IlC('ORIIOFOWNCItSIIU' 1)ATE BOOK PAGE 7(1hE Still DIV. IA)I'No . }� I.O(:.111(IN 1� �����N"� �¢. I'lllil`C)SI_tN U1111UINJG ., oll(. r-p- f\ MYNLR'S NAME CRZK- 'upKep, 3f-N-11i1pf-9 9S� NO. (N:SMRIES SIZE ( WNER'S ADDRESS s /Y(y S� vv�� BASIiMENfr OR SLAM ARCI III ECf'S NAME K,Z}`11 SIZE-OF I I C"I IKI11LRS I 2 3� . 1)1111 DER'S NAME SPAN I)ISIANCI:TONLARESI Il ILI)ING DIMENSIONS Of SILLS DIS I ANCE 1 k0td SIKER 1' DIMENSIONS(N 1'(761 S DIS I ANCE FROM LOT LINES-SIDES REAR DIMENSIONS OF GIRDERS AREA OF Lor FROM AGE IILIGIIT(A FOONDAr1(NJ TIIICKNESS IS UNILDIM;NEW SIZE 01 I OM ING X IS UIIILDING ADDI PION MATERIAL OF Cl IIF lNEY IS BUILDING ALTERATION IS BUILDING ON SOLID CITTA LED LAND W11.1.BUILDING CONFORM TO REq IIREMEN I S OF CODE IS BUILDING CONNECTED 1 O TOWN WATER BOARD OF APPEALS ACI ION, IF ANY IS BUILDING CONNECT ED To TOWN SEWER IS BUILDING CONNECIED TO NA I U1tAL GAS LINE 1N5Tl ci toNS 3. I'll OPER FY INFORNIA I[ON LAND COSI" EST. BIJXi.COSf PAGI: I FII.I.CN rr SECTI(NJS 1-3 EST. UI.IXT. cos f rut s(�. FT. ES 1. L31IX'i. C().il PERMX*i EI EC"TRIC METERS LIUS r UE ONJ(x l'rSIUE(N UIIILDING SUI'IIC I'Lltl,ll f NO. Al ,it'IACIIED(-,ARAGESMUSTC(NJl'OfiM fOSrATEFIRERE(i1)1.AD()J5 J: Al'PllOYLD BY' PLANS MUST UE 1:11 ED AND APPROVED BY 111M.DING INSPECTOR BUILDING INSPECT OR DA 11:III I:D OWNERS I E111. -M) 60^ -75 g CON I R.T Ii1 11 �- C(NJIIi.LICII >IGrNA VW 1N .It OR A `I I It RIZlil)A(A..Hl ILI.l.11 III: I llinllTlilt:\N 1111 ^ - I t MORTGAGE INSPECT/ON PLAN AT /8 SARCi ENT STREET NORTH ANDOXER,. MA. NO.ESSEX REGISTRY OF DEEDS.' BK. 1128 PG. 492 It If 11 PLAN NO. 033 CERTIFIED TO.' NEW ENGLAND NATIONAL MORTGAGE CORP. SCALE.' /`v 30' DATE.' MAY 12, 1999 SARGENT STREET 9/1 2 STORY WOOD FRAME N DWG. o � lyD SCN. GAR. HSE. L to NOTES. 0 THIS IS NOT A PROPER Y SURVEY, DO NOT USE THIS PLAN TO ESTABLISH PROPERTY LINES OR:.TO:ERECr ANY, STRUCTURE. 2)PROPERTY LINES ARE DETERMINED FROM COMPILED INFORMATION TO BE USED FOR MORTGAGE PURPOSES ONLY., CERTIFICATIONS' BASED ON MY KNOWLEDGE, INFORMATION AND BELIEF, I HEREBY CERTIFY THAT THE PERMANENT STRUCTURES INDICATED ARE LOCATED ON THE GROUND APPROXIMATELY AS SHOWN AND ARE CONFORM/NG TO THE ZONING SETBACK REQUIREMENTS OF THE APPL/CABL E MUNICIPALITY WHEN CONSTRUCTED OR MAY BE EXEMPT PER MASSACHUSETTS GENERAL LAW CHAPTER 40A, SECTION 7, AND THAT THE STRUCTURE SHOWN IS NOT LOCATED INA FLOOD HAZARD AZ RD ZONE PERFEDERALEMER6ENCYM4/IWGEAAW,4ZWYMgF? COMMUNITY NO. 250038 EFFECTIVE DATE.' 06-02-93 ZOYVE.' X JOHN ABAGIS B ASSOCIATES, PROFESSIONAL LAND SURVEYORS 137 CHANDLER ROAD, ANDOVER, MA. (978) 688-4899 . APPLICANT.' BURNS NO. 4022 • FORM U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all necessaryapprovals/permits from i 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 ���5 rNS PHONE G��''��� LOCATION: Assessors Map Number �C� PARCEL SUBDIVISION LOT (S) STREET 's ST. NUMBER—/V OFFICIAL USE ONLY"" � f?tial A RECOMMENDATIONS OF TOWN AGENTS: VA CONSERVATION ADMINISTRATOR DATE APPROVED �f _D DATE-REJECTED COMMENTS b ISS `/1 Q TOWN PLANNER DATE APPROVED rI� DATE REJECTED COMMENTS FOOD INSPECTOR-HEALTH DATE APPROVED DATE REJECTED SEPTIC INSPECTOR-HEALTH DATE APPROVED DATE REJECTED COMMENTS ,i PUBLIC WORKS - SEWER/WATER CONNECTIONS DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE NORTH Town of ®ve r No. a q _ _ � 0cocL lover, Mass., �l E AERATE D BOARD OF HEALTH Food/Kitchen PERMIT T Septic System • THIS CERTIFIES THAT.......C....... ............. v A S BUILDING INSPECTOR has permission to ep t ........................................................................ .............. Foundation - sc ..... ... buildings on ..... ....................... Rough to be occupied as...A *� .. . ............... #*#V PAROfft 00d 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 Constructio f Buildings in the Town of North Andover. ^04441V PPOP009; PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. I Al iC.S Rough 19 PERMIT EXPIRES IN 6 MONTHS Final jr a UNLESS CONSTRUCTION ST TSELECTRICAL INSPECTORRough •R. �c .................. 3Q4 ;t .......... ... ... ... ............ .................16&..as .. Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises — Do Not Remove Rough Final No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner FIRE DEPARTMENT Street No. SEE REVERSE SIDE Smoke Det. Aa �aN,�qti �, aq ytr a '�iqM^^nHreu�r"".14h . SA`Ms� CERTIFICATE OF USE & OCCUPANCY TOWN OF NORTH ANDOVER Building Permit Number / 802 -j''y y Date_c_3-/� o0 5--- THIS CERTHUS THAT .THE BUILDING LOCATED ON / 8 5 ,A k 6 £A-0 7" 61- MAYBE f-MAYBE OCCUPIED AS S/ F4-41/ 1 y De--bc,4,al Sail IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. CERTIFICATE ISSUED TO Building Inspector - NORTIy Tovm of Andover No ; � No. �� 0o dover Mass., q /��'o� Vey T O _ LA > COCMICMEWICK %A04ATED S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..... m W r� w .m4oi �! TZ�I ................. .....�r.........>�.... ................�.�.�..........................................�.�..................� Foundation has permission to erect.#tw...00 buildings on ,� .14 E N* Sf C C ............ ../... g .. .... ....... ...................................................................... Rough/Yf� I�/2/D to be occupied as...�? I�v. .�....w./AS O W g IN �... t. � 0 4).... /r d• cpm e v.. ,K /P.�p...................... 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. rq,r POre rs , boron # P�I����•K�'rtw PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. g/sem ug l—�Y PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTION STARTSRou s l� .....���/..��...... ... ............. ................. .. Servi BUILDING INSPECTOR ce Fin . �jm "� Occupancy Permit Required to Ow tpy Building GAS INSPECTOR Display in a Conspicuous Place on the Premises Do Not Remove Rough No Lathingor D Wall To Be Done Until Inspected and roved b the Building Inspector. FIRE DEPARTMENT P PP Y 9 P Burner0 / U Street No. SEE REVERSE SIDE Smoke Det. //L Q S THECOMMONWEALTHOFMISSACHUSETIS Offi:�� DE PARTMFVTOFPIIBIICSAFElY Permit No. BOARDOFFIREPREV=0N NS5VO 812.00 Occupancy&Fees Checked APPLICATION FOR PERMIT TO PER ELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE ASSAC SSTS ELECTRICAL CODE,527 CMR 12:00 /� G -C7 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date () -7 Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work d bed below. f Location(Street&Number) a r cj 2yt-+ r e 2 Owner or TenanC `,"';.1 Ak ~; e v ►`l ,�' - ;, .:, Owner's Address S C't P ,Vvi 0 w V Is this permit in conjunction with a building permit: Yes[:allo (Check Appropriate Box) r'' t , to LS Utility Authorization No. Purpose of Building �' �(1 t Existing Service Amps 'Volts Overhead a Underground No.of Meters New Service Amps Volts Overhead =1 Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work r .; r-P CJ'K P G t 1 V1.1 W f'L.� No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Q Swimming Pool Above Below Generators KVA round 2round No.of Receptacle Outlets 0 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. Total FIRE ALARMS No.of Zones Tons C14-- o—fMsposals 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 I No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Locala Municipal Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis Hydro Massage Tubs No.of Motors Total HP ER .S' a (° 0 L"-/ �J C'f t..y pici, Loy Corsage.PtastlaltIDftiegiiilelnelfsofWbmdm=CmrdLaws ammLiabl7Byh%=xePbkyinck&gCw0* Co�dgzorilsWbftrialtxl1iVWM1 YES F7 No validFCdofsametodrOffic-YES r—% If)mhmedrdedYFS,pl mi dc&drh peofowaa-by the box -- BOND OMM (Plea9e spe*) 12- - cJ Expnatia►Date EWV10dV"ofDearicdWc&$ o C�,o u u hgXfionD&R0WeshA Rottgtt Final Iiellalties� -11 r� p J Cr L o u c z '' p r.r Co lica>9eNo. �7 7 / Sipauie LioawNo �--� Busitm 1No. Z�`?017 cS' 3 lD40� �.vt9r 0�7 d� AkTelNa y -7 � Pis^JG� s� WiSURANMWAIVERIatnaw=dUtrL=wdoesmthawdrmW&MOC)vaaWorASakSWnUegrmialasmgzWbyNL%mdueMGffnWLaws anBlisspum applia6onwarsthisIegtmerllat ck one) Owner Agent ❑ Telephone No. PERMIT FEE$ signature of owner or Agent Date....l. .... ............ Th 0 TOWN OF NORTH ANDOVER PERMIT FOR WIRING This certifies that ...... .. . ... C- ................................................................................. has permission to perform ......JPV4*fe f a., /c/ A a"n e- ......................................................................... ?*V 44V wiring in the building of...5� . . ..... .... ............................... .. r at... ...........SJ........................... .North Andover,Mass. 0` VA-r x Fee... ....... Lic.No.Aqq� ......... ............. ... .. .... ........... E*****"* LECTRIC L INSPECTOR Check # 331s- 5 S 41 THECOMMONWEUTHOFMAS3ACHUSETIS OffiLLL DEPARTNIDVTOFPUX1CS4FVY f BOARDOFFMPREVE MON NSR7CMR1100 Permit No. Occupancy&Fees Checked APPLICA77ONFOR PERMIT TOP ORMELECTRICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE ASSAC SSTS ELECTRICAL CODE,527 CMR 12:00 10 -?0 —C7(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date 0 Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work d c 'bed below. Location(Street&Number) ( �q S a r, 2 yJ r e e l Owner or Tenant1 e w c., l Owner's Address (0 S Sl.2 (•P V1, &-f- 1n e e tJ W U-Of\ V`1 Is this permit in conjunction with a building permit: Yes DINO (Check Appropriate Box) Purpose of Building �J ( yl IP- CU t L" Utility Authorization No. Existing Service AmpsVolts Overhead M Underground No.of Meters New Service Amps / Volts Overhead M Underground No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work C1'YL C/ o Pd f c/C,, hl y S> No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total ra 40 KVA No.of Lighting Fixtures Q Swimming Pool Above Below Generators KVA round ground No.of Receptacle Outlets 0 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. Total 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 I Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices _ No.of Dryers Heating Devices KW Local Municipal Othe Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP A /, Q In O'tHER; S' L v' c�CJ can �� S a YK !`1 0 C.C/ Cu C hiuuartoeCovaage.PtM]MttotheregtmaM&dMWMdRSCMGUOWLaws IbaveamaullmxUyhu==Pbhcyinch&gCompleL- Covtrdr,orzwbgndegtrivalart YESr 7-r NO IhawahTmnodvandptoofofsa<netDthe0ffim YESF)cuharechedrodYES,pk%eindic&tbetypeofoDNaageby drddngthe4PMJM&bo& INSURANCEL]J,- BOND M OTHER a (Pre w Spacfy) t 2- lJ v ExpirationDa� E0natad Vahreo1FJechical Work$ WodcroS4R <<1 'U -=ice h FeWMD&Retp>esbd Rough Fmal Signedundert Rnahiesofr� q FUZMNAMEy U' L o el�t- s P-1 e C-, • y<< Co liarlseNo. _ 17 / 97 / I eek t^ c/ s Sigr ue Iic=No BuSirmTel.No. -, L14 AltTe].No. -y OW 1 R'S INSURANCE WANIIt;Iamawmd a ftLioerM doesmthavetheir ammoDwageorits stbtantialecRri�asWuredbyMas dxisetLsGmeal Laws andthatmysigna monthispemmappbcabcnwaivesthisregmmu t (P1eaje check one) OwnerM r7 Agent Telephone No. PERMIT FEE$ signature of Owner or Agent f r t Fold.Then Detach Along All Perforations COMMONWEALTH OF MASSACHUSETTS • . BOARD • EL OF TRICIANS REGISTEREDSS��AU T R I C I A N TYPE J G LEVIS JOSEPH ELECTRIC CO INC -A G LEVIS PO BOX 952 LAWRENCE MA 01842- 953489 9979 A 071852 awgg�m �31�07 953489 Fold,Then D etach AlMwzz ' Along All Perforations i PREFERRED MUTUAL INSURANCE COMMERCIAL GENERAL LIABILITY COVERAGE PART ems. COMPANY DECLARATIONS NEW BUSINESS DIRECT BILL Policy Number: CPP 0100 57 11 43 Named Insured: J G LEVIS ELECTRIC INC Address: 65 SALEM STREET LAWRENCE MA 01843 Replacement or Renewal Number of Agent: LANDMARK INSURANCE AGENCY INC Address: 198 MASSACHUSETTS AVENUE NORTH ANDOVER MA 01845 Policy Period: From 12/15/03 to 12/15/04 12:01 A.M. standard time at the mailing address of the named insured as stated herein. In return for the payment of the premium, and subject to all the terms of this policy, we agree with you to provide the insurance as stated in this policy. LIMITS OF INSURANCE GENERAL AGGREGATE LIMIT (Other than Products-Completed Operations) $ 2, 0 0 0,0 0 0 PRODUCTS-COMPLETED OPERATIONS AGGREGATE LIMIT $ 2, 000, 000 PERSONAL AND ADVERTISING INJURY LIMIT $ 11000 , 000 EACH OCCURRENCE LIMIT $ 11000, 000 DAMAGE TO PREMISES RENTED TO YOU LIMIT (Any One Premises) $ 50 , 000 MEDICAL EXPENSE LIMIT (Any One Person) $ 51000 i The Named Insured is: CORPORATION Business of the Named Insured is: ELECTRICAL WIRING Audit Period: ANNUAL FORMS & ENDORSEMENTS ATTACHED TO THIS POLICY CG2167(0402) CG0062 1202 CG006 1202 IL0003(0702) IL0021(0702) IL0017(1198) CG216 0998 CG2161(0498 CG2151(0989) CG0001(1001) CG2147(0798) CG2503(0397) CG9501(0101) CG9502(0101) TOTAL ADVANCE PREMIUM $ 581.00 THESE DECLARATIONS ARE PART OF THE POLICY DECLARATIONS CONTAINING THE NAME OF THE INSURED AND THE POLICY PERIOD. PMD1 (07-98) Includes copyrighted material of Insurance Services Office, Inc.,with permission. Copyright, Insurance Services Office, Inc., 1983, 1984. 12/24/03 NLG LC INSURED COPY CPP GLO 0100571143 808276179 00279