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HomeMy WebLinkAboutMiscellaneous - 1504 SALEM STREET 4/30/2018 1504 SALEM STREET 210/106.A-0037-0000.0 f ,1 Cyt`�'h � ` ' =. 1 �; /� �� Libegy Mutual. Liberty Mutual Insurance 1 i ll New England Region Central Property Unit INSURANCE 75 Sylvan Street Danvers,MA 01923 Tel:(800)566-0323 March 10,2015 Town of North Andover Attn: Building Inspector 120 Main Street North Andover,MA 01845 i Re: Property Address:1504 Salem St,North Andover,Ma 01845 Policy Number: H3221817855921 Underwriting Company: Liberty Mutual Fire Insurance Company Claim Number:031198742-0001 Date of Loss:12/24/2014 Attn: Town/City Official Pursuant to M.G.L. c. 139, § 313, please be aware that a homeowners insurance claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or causes the condition of a building or other structure to render Mass. General Laws, Ch. 143, § 6 applicable. You are required to notify Liberty Mutual by certified mail in accordance with Mass. General Laws Ch. 175, §99, if you intend to initiate proceedings designed to perfect alien pursuant to Mass. General Laws, Ch. 139, § 3A &B, or Mass. General Laws, Ch. 143, § 9, or Mass. General Laws,Ch. 111,§ 127B. This letter should not be construed as a waiver or estoppel of any of the terms, conditions or defenses afforded by the policy or applicable law. I Please direct your notice to the attention of the undersigned and include a reference to the above captioned property address,policy number,claim number,and date of loss. I Sincerely, Liberty Mutual Support Liberty Mutual Insurance New England Region Central Property Unit 1-800-566-0323 r Date.......l..p.`...1..'.l.t . I r►OR7/y TOWN OF NORTH ANDOVER s PERMIT FOR WIRING CMUsf rt This certifies that lL T .................................................................... has permission to perform ................1. �5 .. .?........................................... wiring in the building of..................�`�.1.��.�a.e-Z......................:............................... at ...... ` ........ �..............S....''..... ... ... orthAndover�lVlass. .. ......... Fee. -- "'...Lic.No.L .G`r .......,..............'.. . ............. .... �� ...................... ELECTRICAL INSPC,�T'OR Check# �G I 1277P ceJ i r • ~ Commonwealth of Massachusetts Official Use Only o Department of Fire Services Permit No. /2- 7 Occupancy and Fee Checked BOARD OF FIRE PREVENTION REGULATIONS [Rev.l/07] (leaveblank APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrica4Code C),527 CMR 12.00 (PLEASE PRINTINMK OR TYPEALL)NFORMATION) Date: 2 07 City or Town of: NORTH ANDOVER To ther of Wires: By this application the undersignedivesnotice of his or her intention to perform the electrical work described below.W Location(Street&Number) 97J&4 -!�,7165r Owner or Tenant 94M-9/-) ISI gam. Telephone No. Owner's Address ///014/ SO-L&Pq 5rAECi Is this permit in conjunction-with a building permit? Yes Q--,No ❑ I (Check Appropriate Box) Purpose of Building ~�4-(-- Utility Authorization No. - Existing Service Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Service Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work: ` //1� [fd�-/ /� tib � f7 - Completion - Com letion o the ollowin table m be waived b the Inspector of Wires. P .f .� g may Y P No.of Recessed Luminaires No.of Ceil:Susp.(Paddle)Fans No.of Total Transformers KVA No.of Luminaire Outlets No.of Hot Tubs Generators KVA No.of Luminaires Swimming Pool Above ❑ In ❑ o.o meLighting rnd. grnd. Battery Units No.of Receptacle Outlets No.of Oil Burners FIRE ALARMS No, of Zones No.of Switches No.of Gas Burners No.of Detection and Initiating Devices (� No.of Ranges No.of Air Cond. Total Tons No.of Alerting Devices No.of Waste Dis posers Heat Pump Number Tons KW No.of Self-Contained p Totals: Detection/Alerting Devices —' Municipal No.of Dishwashers Space/Area Heating KW OZ Local❑ Connection ❑ Other No.of Dryers Heating Appliances KW SecuriNo o Systems:* or Equivalent No.of Water KW No.of No.of Data Wiring: Heaters Signs Ballasts No.of Devices or Equivalent No.Hydromassage Bathtubs No.of Motors Total IIP Telecommunications Wiring: _ No.of Devices or Eciuivalent OTHER: v L �\ Attach additional detail if desired, oras required by the Inspector of Wires. I v Estimated Value of Electrical Work: 41sz�,o (When required by municipal policy.) '1 Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion. INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office. CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:) Icertify,under the a.ns and penalties ofperjury,that the information on this application is true and complete. FIRM NAME: . /AAE- 'moi NG-f-c 6 LI5 - LIC.NO.:f,2 0�1 Licensee: AJ/0- �� Signature P LTC.NO.: /,2yy-(y (If applicable,ent " xemp ' to the license n ember line.) Bus.Tel.No. Address: � j0� /�� �7 ��" /V J`° Alt.Tel.No.:6 Oso" 07 77e *Per M.G.L c. 147,s.57-61,security work req ices Department of Public Safety"S"License: Lic.No. OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required by law. By my signature below,I hereby waive this requirement. I am the(check one)❑owner ❑owner's agent. Owner/Agent Signature Telephone No. PERMIT FEE.$ ❑ 2012 Massachusetts Electrical Code Amendments 527 CMR 12.00§Rule 8: In accordance-with the provisions of M.G.L.c. 143,§3L,the ♦ ` permit application form to provide notice of installation of wiring shall be uniform throughout the Commonwealth,and applications shall be filed on the prescribed form.After a permit application has been accepted by an Inspector of Wires appointed pursuant to M.G.L c. 166, §32,an electrical permit shall be issued to the person, firm or corporation stated on the permit application. Such entity shall be responsible for the r" notification of completion of the work as required in M.G.L.c.143,§3L. Permits shall-be limited as to the time of ongoing construction activity,and may be deemed by the Inspector of Wires abandoned and invalid if he or she has determined that the authorized work has not commenced or has not progressed during the preceding 12-month period.Upon written application,an extension of time for completion of work shall be permitted for reasonable cause.A permit shall be terminated upon the written request of either the owner or the installing entity stated on the permit application. ❑ The Permit Extension Act was created by Section 173 of Chapter 240 of the Acts of 2010 and extended by Sections 74 and 75 of Chapter 238 of the Acts of 2012.The purpose of this act is to promote job growth and long-term economic recovery and the Permit Extension Act furthers this purpose by establishing an automatic four-year extension to certain permits and licenses concerning the use or development of real property.With limited exceptions,the Act automatically extends,for four years beyond its otherwise applicable expiration date,any permit or approval that was "in effect or existence"during the qualifying period beginning on August 15,2008 and extending through August 15,2012. ❑ Rule 8—Permit/Date Closed: ***Note:Reapply for new permit ❑ ❑Permit Extension Act—Permit/Date Closed: Trench Inspection Pass M Failed Re-Inspection Required($.)❑ Inspectors Comments: Inspectors Signature: Date: SERVICE INSPECTION: Pass Failed Re-Inspection Required($.) ❑ Inspectors Comments: Inspectors Signature: Date: PARTIAL ROUGH INSPECTION: Pass 0 Failed Re-Inspection Required($.)❑ Inspectors Comments: Inspectors Signature: Date: ROUGH INSPECTION: Pass 0 IV Failed 0 Re-Inspection Required($.) ❑ Inspectors ments: Inspectors Signatur . Date: FINAL INSPECTION: Pass Failed 0 Re-Inspection Required($.)❑ Inspectors Com t Inspectors Signature: Date: DEB WEINHOLD ...TOWN OF MERRIMAC,MA. .......dweinhold@townofinerrimac.com .t The Commonwealth ofM'assachusetts , - Department of lnclustriccl Acciditits Office ofluvestigations quo 604 Washington Sheet Boston,MA 02111 www.massgov/clia Workexs' Compensaiion Insurance Affidavit:Builtiers/Contractors/Electriplans/Piiimbers A.ppl�iean> Informaiion Please Print Legibly � FS/ �2!cC_ CJS Name(Business/Organizatlon/Ind1v9idual.): Address: - y City/State/Zip: Phone#• 6/OS 7 7P Are you an employer?Check the appropriate box: Type of project(required): 1.F1 am a employer with 4. ❑I am a general contractor and I 6, j]New construction ,__/mployees(fall and/or parttime).* have nod the sub-contractors � 7. ❑Remodeling 2.LIQ I am a sole proprietor or partner- listed on the attached sheet. ship and'have no.employees These sub-contractors have S. []Demolition working for me in any capacity. workers'comp.insurance, g, [�Building,addition [No workers'comp.insurance 5. ❑ We are a corporation and its ME.I Electrical repairs or additions required.] officers have exercised.their • 3.E1 I am a homeowner doing all work right of exemption per MGL I L[]Plumbing repairs or additions myself.[No workers'comp. c.152,§1(4),and we have no 12.QRoofrepairs insurancere employees.[No workers' �ired.] 131l©flier comp.insurance required.] xAny applicant that checks box#1 mustalso fill outthe section below showingtheir workers'compensationpolicy information. I'Hoineowners who submit 61s affidavit indicating they hie doing all work and then hire outside contractors must submit a new affidavit indicating such. tContractors that checkthis box must attached an additional sheet showing the name of the sub-contractors and their workers'camp.policy information. I am an employer that is providing workers'compensation insuranee for fray employees Below is the policy and job site information. Insurance Company Name:. Policy##or Self ins.LIG.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensationpolley declaration page(showing the policy number and expiration date). Failure to secure coverage as requiredunder Section 25A ofMGL c.152 can lead to the imposition of criminal penalties of a fine up to$1,50 0.00 and/or "one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of 'Investigations of the DIA for insurance coverage verification. 'do Hereby certi under tli ai s ndpe a ie o jury tlZattlie irzformatiort provided 7,/j e i true and correct. - Si afore• ` Date: �O Phone 4: Oficial use oaly. .Do not write in this area,to be completed by city or torn official. City or Town: Permit/License 0 Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical.Inspector 5.Plumbing Inspector 6.Other - - Contact Person: Phone#: Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers'compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract ofhire,- express or Implied,oral or written." .An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a:deceased employer,or the receiver ox trustee`of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having notmore than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction orrepair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced-acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152,§25C(7)states"Neither the commonwealthnox any Of its political.subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have b con presented ta the contracting authority." Applicants Please fill out the workers'compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractor(s)name(s),address(es)andphonenumber(s)along with theircertificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers'compensation insurance. If an LLCorLLPdoes have employees,a policy is required. De advised that this affidavit maybe submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain,a workers' compensation policy,please call the Department at the number Mod below. Self-insured companies should enter their seltinsurance license number on the appropriate line. City or Town officials Please be sure that the affidavit is complete andprinted legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be-sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant thatmust submitmultiple permit/license applications in any given year,need only submit one affidavit indicating current Policy information(ifnecessary)and under"Iob Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamp ed or marked by the city or town may be provided to the applicant as proof that a valid affidavit-ii on file.for fature permits or licenses. .A.new affidavit must be filled out each year.Where a homeowner or citizen is obtaining a license ox permit not related to any business or commercial venture (i.e.a dog license orpermit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The ConuAonweel&ofMasaarhvset�� - Depa ent Qflndusftial Acc devta Office OffAvestigAftna ' 6.00 Wald gtm Sizeet Tel, 617-7.27,4900 eA 406 ox 1-87.7,:UA� Revised 5-26-05 Fay d 617-727-774.9 wWwaaag4v/41°a O 61MEACfIi:10fi MA7.7 SSAC ISS • • • • • AQARQ ELECTR T VANS _ 1 1�i 'A�� � � z� `' �•4t C�' t Aa „K�NsDE�LEt' I g S 1 y � 4 J 'y.d.,�'�.N✓.......�'�.sy^..}t%l.�''7+r� t ^F`w`,1'��.::4 �(`,'.,..s4' �.-'�;�t �".Yt:..��3.'�!`F�j'f,�'�'� �52�, '-., 1 1 su�0';�a"}'"v't�s''+v.� ¢P"a Location �'✓�'� / ��� No. aU a Date I-1/1 An o NORTh TOWN OF NORTH ANDOVER n Certificate of Occupancy $ - ' Building/Frame Permit Fee $ ti i s Foundation Permit Fee $ swcNus Other Permit Fee $ ti Sewer Connection Fee $ -- Water Connection Fee $ TOTAL $ 1 31j3O Building Inspector. Div. Public Works a e. III?RN1IT NO. O� APPLICATION FOR PERMIT TO BUILD****** *NORTH ANDOVER, NIA Al\1'NO. 1 1 1.01'.NO. (,:-3 Q Z. RLCORD OF OWNLI(Sllll' DATE BOOK PACE TUNE R ' SUB UI1'. LO I NO. 1.01-A I ION 1'l1RF'QSIi(N:Bull I)ING O\\'NEB's NAPIF �ct,M 'PD m N NO.Of:51 DRIES ,._ SIZE i2( Xaxo�j ' ! OWNER'S ADDRESS (C�,I sc� 4E^ BASENILNT OR SLAB -\RCT IIT EC-1'S NAME wen SILL OF FI CX)11 TIMBERS �� I ST 2 HIJ 3 RD ?� li011 DER'S NAME `\I !r.m SPAN 12,1 - DISIANCEIONEARESI BUILDING �� DIMF.NSI(NJS01 SILLS �^„ �- DIS FANCE I ROM SREL i t 2S Fl• DIMENSIONS 01 POS IS y DIS I ANCE FROM I-OF LINES-SIDES 50l i/ REAR zn` ( DIMENSIONS OF GIRDERS (•,1 I ARFAOFLOT • ! D Soli/ IIEIGIII OI:FOUNDATI(NJ IL '� THICKNESS IS BUILDING NEW SIZE Of-I tX7NNG Y �� X 15 BUILDING ADDIIION MAIERIAL OF CI IININEY � IS BUILDING ALTERATION !✓D IS BUILDIN(i ON SOLID(91I1 LED LAND \.91.1.BUILDING CONFORM TO REQ 11REMENI S OF CODE '/E,5 IS BUILDING CCNJNECi ED TO TOWN WATER BOARD OF APPEALS AC1ION, IF ANY IS BUILDING CCNJNECI ED 10[OWN SEWER rzJQ- J IS BUILDING CONNECI ED TO NA I URAL GAS LINE Y�'S INSTII('TIONS 3. PROPER IN INFORAIA 11ON LANDCOST ESI. BLIXi.COST 1p i PAGE I FII.L o FF SECFI(NJS 1-3 EST. BLDG. COST PER S(�. FT. EST. BLIX'i.COS l'L'RR(X)ti EI E(-TRIC MEI ERS NIUS1'BE ON OU FSIDE(N:13UIIT)lNG SEI111C PERMI 1 NO. AI'IACIIEI)GARA(iEStvitJSTC(K i:oRbl FOSTATEFIREREGULAIJ NJS a. AI'PROYEI) B1': ;" C III.A•NS MUST BE FILED AND APPROVED BY BI IILDING INSPEC FOR B1111.pING INSPEC FOIL DA I1:FILED 3 2-1 1 ,cj OWNERS]ELM CON IR.II=1b O 'Z' ' 33?3 CON Iit.Lich tiIGIJA HIM:IRE(N t) 'NI:R()it All FI It)RIZI-1)AOI.NI "- ' PI I0.11.1 GRAN 11 1) `. / —_ 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 � `5 the applicant and/or landowner from compliance with any applicable or requirements. *****************************APPLICAidT ffLi.S OUT THIS SECTION*********************** APPLICANT-4 "kR N� �`QS �'`� "` PHONE 6 3 - a3,7 3 LOCATION: Assessor's Map Number f? /`F PARCEL SUBDIVISION LOT (S) -�- STREET c� Jt ST. NUMBERJ,� * ***************************************OFFICIAL USE ONLY*********************************** eunove IQ-y- �a RECOMMENDATIONS OF TOWN AGENTS: la t 8 c (C C40NSERVATION ADMINISTRATOR DATE APPROVED DATE REJECTED COMMENTS `/ ' ` C."f l G tS 1 6/0 0 . TOWN PLANNER DATE APPROVED DATE REJECTED COMMENTS FOOD IN CTOR-HEALTH DATE APPROVED �-r DATE REJECTED TI SPECTOR-HEALTH DATE APPROVED a DATE REJECTED COMMENTS e hi ,term--y+" PUBLIC WORKS -SEWER/WATER CONNECTIONS i DRIVEWAY PERMIT FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE Revised 9197 jm DATE(MM/DD/YY) ACORD CERTIFICATE OF. UABILITY INSURANC�P�D LC FERRWII 01/20/99 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE T. A. Sullivan Ins. Agcy, Inc. HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 344 S. Union St. ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Lawrence, MA 01843 COMPANIES AFFORDING COVERAGE COMPANY Phone No. 978-683-4700 Fax No. A Gencorp Insurance Network INSURED COMPANY B COMPANY , William Ferris C 231 North End Blvd COMPANY / Salisbury MA 01952 D COVERAGES THIS IS TO CERTIFY THAT 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 BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF If:SURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MM/DD/YY) DATE(MM/DD/YY) GENERAL LIABILITY GENERAL AGGREGATE $ 600,000 A X COMMERCIAL GENERAL LIABILITY SCP 316 75284 10/23/98 10/23/99 PRODUCTS-COMP/OPAGG $ 300,000 CLAIMS MADE ❑X OCCUR PERSONAL&ADV INJURY $ X OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE $ 300,000 FIRE DAMAGE(Any one fire) $ MED EXP(Any one person) $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ HIRED AUTOS BODILY INJURY $ NON-OWNED AUTOS (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND WC STATU- OTH TORY LIMITS ER EMPLOYERS'LIABILITY EL EACH ACCIDENT $ THE PROPRIETOR/ INCL EL DISEASE-POLICY LIMIT $ PARTNERS/EXECUTIVE OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS Carpenter CERTIFICATE HOLDER CANCELLATION>,` NEWBURY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFF, City of Newburyport BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY,ITS AG NT OR REPRESENTATIVES. AU I D REPRE N ATIV ACORD 25;5(1/95) e ' AC CORPORA .O 1988' ' MORTGAGE INSPECTION PLAN UNITED DATA SERVICES INC 20 BLANCHARD RD. • BURLINGTON, MA 01803 , TEL (617) 272-9100 • FAX (617) 272-6900 MORTSASOM JAMES A.B SHARON L.DESIMONE DEED REF. 4410135 LOCATION•. 1604 SALEM STREET PLAN REF. PLO9630 CITY, STA T6: NORTH ANDOVER MA SCALE: 1— 50' DATE' 10 122197 JOB. 97506646 119. 0 0 M N In `O f� LOT C Co B 4.60 ACRES - In In LOT C 2e'•.cutG pI•'1x1 e CK � N t�eQIACt w� 1.11<1g pGtlt N Toward. F'Imp(ace N C><IS�iNq deck 36'+/- 2 1/2 sty. wood TV N N / - f #1504 LOT B C? N �• N � N - / ;01 IT1 `CN �t O C:) ^ N N N O � S� S�T ' CERTIFIED TO.' BOSTON FEDERAL SA VINES BANK ACCORDING TO FEDERAL EMERGENCY MANAGEMENT AGENCY MAPS,THE �AAA�.�dd MAJOR IMP VF,MF,NTS ON THIS PROPERTY FALL IN AN AREA DESIGNED AS: ;���`�� OF ��fx v ZONE: — 2SOOQ9 OOOgG T ! T COMMUNITY PANE O: - �� MALI L EFFECTIVE DATE: NOTF,:ZONF,"("ARF,AREAS OF MINI AL FLOODING(NO SHADIN(.). THIS DESIGNATION IS NOT RASED ON AN ELEVATION(1F,R79 F'ICATE 1 N H ► v ► THIS MORTGAGE INSPECTION PLAN IS NOT INTENDED OR REPRESENTED TO BE A LAND OR PROPERTY LINE SURVEY,USED FOR RECORDING,PREPARING DEED DESCRIPTIONS,OR CONSTRUCTION. NO CORNERS WERE SET. IT CANNOT BE USED FOR ESTABLISHING FENCE,HEDGE OR BUILDING LINES.THE MATTERS SHOWN HERON ARE BASED ON CLIENT FURNISHED INFORMATION AND MAY BE SUBJECT TO FURTHER ►� O S`UR`D OUT'SALES,TAKINGS,EASEMENTS AND RIGHTS OF WAY,AND OTHER MATTERS OF RECORD AND y PRESCRIPTIVE OR OTHER RIGHTS. NO RESPONSIBILITY IS ASSUMED HEREIN TO THE LAND OWNER OR OCCUPANT.THE PERMANENT STRUCTURES ARE APPROXIMATELY LOCATED ON THE GROUND AS SHOWN.THEY EITHER CONFORMED TO THE SETBACK REQUIREMENTS OF THE LOCAL ZONING ORDINANCES IN EFFECT WHEN CONSTRUCTED WITH RESPECT TO HORIZONTAL DIMENSIONAL REQUIREMENTS ONLY,OR WERE EXEMPT FROM VIOLATION ENFORCEMENT ACTION UNDER M.G.L.TITLE V11,CHAPTER 40 A,SECTION 7,UNLESS OTHERWISE NOTED OR SHOWN HEREON.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 PROHIBITED. • NORTH L D Town ® OL dover O r►1 No. lover, Mass., A /t ? DRATED P' ,�C SE BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT... ... ,5...! '...... ...... . h O D.104.1 VAG Al %• ..................................... Foundation has permission to erect.....��. ..I..�............ buildings on .....I..S'.Q.y.......�5. ..1.lp VK.._.......4 .!k.,... ... Rough o P� 00—JI!........ .� 5�� F4.... • y t0 be occupied as................................ .. ....... . . �t ..... . .. .................................. 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 �• PERMIT EXPIRES IN 6 MONTHS Final 131>30 ELECTRICAL INSPECTOR � UNLESS CONSTRUC S T Fro � Rough �aiN ' ......... .... . .... . ............... ... .. ...... Service ..... UILDD G 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. North Andover Building Department artment 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: p ' n ,,. �gJov� Wha/.� �QS�y'��.(o �L�Li1✓k'/i�� (Location of Facility) Signa re of Permit Applicant Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector Q lea Ila t-A 077 ne DEPARTMENT OF PUBLIC SAFETY 167401 ONE ASHBURTON PLACE, RM 1301 BOSTON, MA 0210£3-161£3 CONSTRUCTION SUPERVISOR LICENSE Number: Expires: Birthdate.- CS irthdate;CS 065674 03/23/2000 03/23/1968 . Restricted To: 00 WILLIAM J FERRIS APR 233 NORTH END BLVD SALISBURY, MA 01952 Keep top for receipt and change of address notification. L N° 7J , 63 HOR7M TOWN OF NORTH ANDOVER i- p PERMIT FOR WIRING S^cHuSE� J J This certifies that ...r...................... ................................................`i�>.......... has permission to perform ......:-'.. ..= ` ...... ................................................... wiring in the building .......................................... .................................... at f� f:......---." ' ... ..••• .r ,North Andover,Mass. :-` Fee � .........~Lic.Nol-5a".�e- ....... ... .L��:.�................... ` - /ELECTRICAL INSPECTOR Check # WHITE:Applicant CANARY: Building Dept. PINK:Treasurer unanui uea: gilt e! Ottly --�1 �J P::rmut No. Q _ --� �r�arfncertf a�}ire �ervicz� � J BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked3 (leave blank-) APPLICATION FOP, PERMIT TO PERFORM ELECTRICAL WORK All %vurk to he perlormcd in accordance with the r'vlassachusclts E!=ric:tl Codc(,.IGC), 537 COIR 13.00 (PLEASE PRhVT 1!V hVK OR TYI' '.ILL !V�'02�1.MON) Date: r5 City or "Down of: �j/p�/ To the hispectoi-of GY'u es: By this application Lie undersigned �sives notice of his or her intention to perform the elccrrical work described below. Location (Street & \umber) l Sd �e Owner or Tenant raj n ,ties i ry)ur r Telephone No. Owner's Address Is this permit in conjun with a buildinbpermit? Yes No (Check Appropriate Box) Purpose aC 13uildin�_ S/ L' Utility Authorization No. EsistinsScrviceAmps / Volts Over-hend Undgrd No. of rllctc s New Service Amps / Vults Overhead ❑ Und-rd o No. of:lIeters Number of Feeders and Antpacity Location and Nature of Proposed Electrical York: Cunrniet(on u�r!re;oiLn�in,e!vole nrav be,r�r,ed oc rlrc(rrsrcc:or o�i!';rc�. No. of Recessed Fixtures No. of Ceil.-Susp. (1'addle) Falls No. oC 10,21 Transformers IwA No. of Lighting Outlets No. of riot Tubs Generators I N"A No. of Lighting Fixtures �blr.- � 1 0. of merQencv 10 SwimmingPoul [ a ,Iluno y arnd.ore gr.^,d. Battery Units No. of Receptacle Outlets No. of Oil Burners FIRE ALARhISINo. 0f Zones No. of Switc]tes INo. of Gas Burners INC• 611 etection and Initiating Devices Nu. of Ranges No. of Air Cond. To sl INo. of Alerting Devices ! of Waste Disposers Elcat Yunlp ' Number ! I'oris ! �\V _ �No. oCSelf-Contained Totals: I f Deiection/Alerting Devices IN'o. of Dishwashers Spacc/Area Heating KW Local Municipal - -- Connection L l Ot,.er i No. of Drtiers Heating Appliances IL\; `o.ur / Svstcros: No,of Dei is 2 s or Ec! o `YaterItNo nl „ Heaters K`v ! N0. of �",� ,r• :ii:r Si,tts Ballasts N . :�1CO0r.I10RfllD'nei:C::ctcis o. HB�tltubs o ;,iotors Total Cnasr tiE`,qiruiir'i•gp:i Iii No. of Devices ora ui OTHEraient R: I - I:NSUR_ANCE COVED-AGE: Umcss .,aived by the _ `. ..,.liar wor the !ICenSeC Cr '0id'S prCOf Oi!(Cbl!, :I1SUrat1CC InC!L'd;n llnderSi� cf!,- les ,nat SL'C!1 Co verag•' Is !n force, and has e h1v61ti y ed proof o: ;z..... ro tL•e it iss,:In� of-c�. CHECK CNE. 1NSi:R.\NCS V:`, i i`] 0l'iiER ❑ (Snecif•;:) Esiittlated Value of E:cnica! \Vor!:: (When recuired'oy -:u:iicipal poiicy.) `Y V'or:: to Star,: Inspections to be rcauested in accorda:ice .:;; �,,!EC Ru!c !p, glad ,:;;en (certifj, ulrrtcr the pairr.i and pc nn!lirs u,/peijur7•, (hat the ilrfurruation air :iris rpnlicatfulr is frue arul corr.r7ietc. .._ IrIIZ�[ :N.a;\IE: 2) u r +-r. \0.:1'55r-I(� Licensee: Signator LIC. NO.: it r ' _ - Bus. Tel. t\o.:r--t I� (✓`�% O`ly,�' :�ddress: i55 ��<' 4 S{ S1t tic /1 �� ()IS S 1 A]t. Te1. :No.: !4'- r-1'), -'•-i t- O\\;N'ER'S I;NSUIZANCE \`"AIVEIZ: I ani a,varc tl;ar the i.ice:isee docs rrc! the liability insurance co. a^ er�-aiiv repuircu by ia„. Uv :nv si,rature beiow, 1 ite ebv wai',e t!lis reauiremc::(. I c... :hf (c!;cc:: onc) I o,,:ner - O,rncrr:\�cnt ❑ o„cc 's _at, Signature hcicnhor.c \"u. PI;RI- :1fIT S �s Location/6-6� No. Date NpRTM TOWN OF NORTH ANDOVER 0 Certificate of occupancy Building/Frame Permit Fee Foundation Permit Fee Other Permit Fee $ TOTAL $ Check # 17279 Inspector Location/6-696 No. &5—P Date MORTp TOWN OF NORTH ANDOVER f A Certificate of Occupancy $ s' NUBuilding/Frame Permit Fee $ AGS Foundation Permit Fee $ Other Permit Fee $ TOTAL Y Check # �fy 17279 BURT-Ing Inspector r { {xl l Fx0-r-1 l-FT9�LU@@fit--IR-R49ek-S-iTeeS L@JJ&q±4)Qn---@xOf—aM2JJ& 1-•-T-�N--F'T-,-HST-!-!-Ty��U@@1[0l t ,TOWN OF NORIU ANDOVER e BUILDING DEPARTMENT APPLICATION TO CONSTR=REP RENOV OR DEMOUM AONEORTWO FAMILY DWELLING WELDING PERM MJMBER: �S DATE ISSUED: � o70C�� X C - SIGNATURE: —1 Buil . Co ofBWMings Date SECTION I-SITE INFORMATION O 1.1 Property Adm: - 1.2 Assessors Map and Perad Namba 5D4 Sak-✓Y! s-+ 1 Map i�� rnnoel nvmo� N.Gln v�rer,rn�4 13 Zoning Information! 1.4 RnpetyDitowdoes: 1 i Zenin Disuia hVesedUse I at Asea F 1.6 BUILDING SETBACKS tit Front Yard Side Yard Rear Yard Reqdmd Provide Revived Provided RcqWmd Pravided v OWSM S%*M.W-CA0. Ss) I3 > Pobfia ❑ Poivm a 2me oamide irk Tone a A4mh4w a on site Dispowl sylt m a ,1 SECTION 2-PROPERTY OWNERSMIAUTHORUED AGENT m. 2.1 Owner of Record Mrb(oh 31. Saiim. Name(Print) Address for Service: y� Signature Telephone 2.2 Owner of Raeord: �C Nam Print Address for Service: Z M signature T one SECTION 3-CONSTRUCTION SERVICES 3.1 Licanscd Construction Suppvisor: Not Applicable 0 ins ruction sam«nds p S S 1 License Number Address (0z7)791/ 77ir F�;rati�� Signnmre Telephone r 3.2 Registered Home Improvement Contractor Not AppHW*AprAS0 v C�mpsnyNomt L3 q16 0 //!G� „ , Q Regisuauoa Number P Add � f, -'�--�. Z�17)79�_�/ - �A3 .2005 Z Expiratihn nax G) Si nmre T c SECTION 4-WORKRRS COMPENSATION(M.C.L C I52 §15c(6) Workers Compensation Insumeee nl>fidamt must be completed and submitted with this application.Faiture to provide this affidavit witI result in the denial of the issuance of the bWlding permit SWW affidavit Attached Yes.....d16 No.......0 SECTIONS DOcrilpmdann of Pitt Work elsdca➢ ble New Construction,0 Existing Building ❑ Repair(s) Alterations(s) ❑ Additiem D AccesM Bldg. ❑ Demolition 0 Other 11 Specify Brief Description of Proposed Work Ito Y30 T— SECTION 6-ESTIMATED CONSTRUCTION COSTS Itean Estimated Cost(Dollar)to be Coymleted by permit awlicant 1. Building a 00 (a) Building Permit Fee 75 00. Multiplier 2 Electrical (b) Estimated Total Cost of struction 3 Pltnn Building Permit fee(.)x"(b) 4 Mechanical HVAC S Fire Protection 6 Total 1+2+3+4+5 a S v D. "° Check Number SECTION 7a OWNER AUTHOR17ATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR"PUB FOR BUILDING PERMIT I, as Omer/Authorized.Agent of subject properly Hereby. act on My behalf,in all matters relative to work authoti>Pd by this building permit application.' Si ture of Owner Date SECTION 7b OWNEIVAUMOZZED/AGENT DECLARATION as Owner/Authorized Agent of subject proPcrtY Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief �1�5/-� eos�d Print ame I store of e:nt Date NO.OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR TIMBERS Jbi2NO 3 SPAN DRVIENSIONS OF-SILLS DIMENSIONS OF POSTS DRAENSIONS OF GIRDERS HEIGHT OF FOUNDATION TMCI MSS SIZE OF FOOTING X MATERIAL OF CHRANEY IS BUILDING ON SOLID OR FMLED LAND IS BUILDING CONNECTED TO NATURAL.GAS.LINE Asbury urove Summer ScheduleAsbury (.grove- SouthHamilton, Massachusetts Page 7 of 7 http://www.asburygrove.org ggx�3�-sem s� �ea o� �� �s�a '2TTPm�a3 fittp �/wtx�v.I O gV&pe.orrS%C t%I FORM - U — LOT RELEASE FORM 3 C L"- app �ncP-A cA4 INSTR UCTIONS: This all- necessary form i s used.to verify that all.necessa. approval/permits'from rY aPP Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and`or landowner from compliance with any applicable requirements. .ssassaaasssssassssaassssaaaasssassaassa■assess.sassss.assa.aassssssasawon Eons jAPPLICANT dA��t'Al i�e / PHONE 7 0 cf 72`j S9�'93 /\is A- ASSESSORS MAP NUMBER LOT NUMBER SUBDIVISION LOT NUMBER STREETI� %I STREETNUMBER 7 s0 ass s�ssa-iassaSOON sssson sass-sa.asaas0aassssaassa�a�asasaa.aas.asaaaaasasasasssa■ OFFICIAL USE ONLY ......a.............,..sssa■s.........fa:..a...s.aw..a...a. - _ sasaasasssassssssasa.asssssaa■ RE, CATIONS OF TOWN AGENTS .aa■ aass�.saasssaaasa.aas0aa0aasaasaaaaaaassaaasssssarEasaasa0a ■ssssassssas■ � DATE APPROVED S+ D CONSERVATION AD TRATOR DATE REJECTED COMMENTS � r DATE APPROVED TOWN PLANNER DATE REJECTED COMMENTS DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED DATE APPROVED SEPTIC INSPECTOR-HEALTH DATE REJECTED COMMENTS PUBLIC WORKS-SEWER!WATER CONNECTIONS i DRIVEWAY PERMIT FIRE DEPARTMENT DATE ADEPARTMENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR - DATE MORTGAGE INSPECTION PLAN NORTHERN ASSOCIATES, INC. 401 SOUTH BROADWAY, LAWRENCE MA. 01843-3522 TEL:(978) 837-3335 FAX:(978) 837-3336 MORTGAGOR: BARBARA 51EGEL DEED REF: .4881/274 LOCATION: 1 504 SALEM STREET PLAN REF: 9630 CITY,5TATE: N. ANDOVER, MA SCALE: 1 "=30' DATE: 9/29/03 JOB #: 203. 12149 g2 W 0� Ql v_ t LOT C 4.6 ACRE5m lD NF/ \ / DECK T / 2112 N _ 5TO RY / I N WOOD #1504 / / \ N � d I°=30' N O N Ln N SgtEA4 S7-REET CERTIFIED TO: . COUNTRYWIDE HOME LOAN5 { fs' Licenses CONSTRUCTION SUPERVISOR Number: CS 082953 ! Birthdate: 08/29/1967 i Expires:08/29/2006 Tr.no: 82953 !! Restricted: 00 1 DANIEL H SIGMuNDSSON �-, 139 SALEM ST C,' . BOSTON, MA 02113 Administrator ✓X e 1 ",,m,,,w e c41-,, al r/4aadua& a V r Board of Building Regulations and Standards License or registration valid for individul use only HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: Registration: 139100 Board of Building Regulations and Standards One Ashburton Place Rm 1301 Expiration: 6/1312005 Boston,Ma.0210$ Type; Individual y SIGMUNDSSON DANIEL DANIEL SiGMUNDSSON 139 SALEM ST. BOSTON,MA 02113 Administrator ` N Not valid without sign tune 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: vl-c (Location of Facility) Signature of Permit Applicant T Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector I r-.TuT L3 [ [nf•J,We-ev y TIWPH cl ty i DECKED OUT DESIGN (978) 468-3002 www.deckedoutdesign.com TO G P�r a f(--4k �-� csy ' ADDRESS 0 400 TEL (H) Ce 11 — `Z I O Ct J cW) ��`� — 258 � � gti ���,i t 20 DIMENSIONS X FLOOR HEIGHT MATERIALS ` e—`" t>4�b ��� STEPS f r f-- RAIL Fsi 4T-R— LATTICEy �T(*� L l -K ptN� JOIST `Z`X SEPTIC DECKING LL/ L-., SET BACKS 0 POST Tri SIDING C FOOTING e©N(f t t-C PERMIT W-� `��►� 0j, goo f � � 4 t 1 c^ L L LK �f L, Designer _ C1Q 2 CommT01AVEALTH OF MASSACHUSEWS EkECU'II-VE OFFICE OF ENVIRONMENTAL AFFAIRS w DEPARTMENT OF EN6'IRONIVIEIeTTAL PROTECTION' TITLE 5 C)FFICIA.L INSPECTION FOW4 —NOT FOR VOLUNTARY ASSESSMENTS SL'BS11T1FAC"E SL WAGE DISPOSAL SYSTEM FORM PART A CFM:. IFICA- TION Pi perty ess: .:; 2A�Dti�•ner•'s Datc of hv-,pecLiu n: -Y7 - _L_'_ �' ___ �� � T1:¢ �`�• n Cr_,r-jr r;:U Mame aE Insp-:c.to:: (please prim) C t �ie�, 7: .� o 10 ru:t L.2<e Corr,pany Pjarne: A f;• uili tg Address: d• � f,.3 'r1.�=s :.�_ 4 Tt:icpltone"yurabar: T ?� CSR.TU"TCA-P'°ON.STA7C"-s"'RST'1` T I certify that I have personally inspected the sewage disposal system at this address and that the information-reported belo:v is 1.113e.accurate and complete as of the time of the inspection.The inspection was perfornied based on my training and .xperience in the prcper furtctiort and maintenance of on site sewage disposal systems. I am a PEP al:iproved vstcm inspector pursuant to Station 15.34 ,:f 1 ills S(310 C;•fI{ 15.000). The system: Passes Conditionall+.Passes �^ Needs Further Evaluation by the Local Approving Authority Fails Inspector's Signature 2z Date: -7 / -0 The system inspector shall submit a copy of this inspection report to the Approving Authority(Board of Health or DEP)within 30 days of completing this inspection.If the system is a shared system or has a design flow of 10,000 gpd or greater,the inspector and the system owner shall submit the report to the appropriate regional office of the DEP.The original should be sent to the system owner and copies sent to the buyer,if applicable,and the approving authority. Notes and Comments ****This report only describes conditions at the time of inspection and under the conditions of use at that time.This inspection does not address ttow the system will perform in the future under the same or different conditions of use. Title 5 Inspection Form 6/15/2000 page 1 N xx�`1 i CoQ AQ Wll-4 43 CV GG m 5 g LAO 2X � © ST �rC\v\ eAe � �fojN� 978-468-3002 b-74i D) 4 �• i T i] :'THE DECK BUILDING SPECIALIST" o www deckedoutdesign,cora c d N c r{T Q { The _. Department of Industrial Accidents Office of Investigations w Boston, Mass. 02111 S�lb Workers'Compensation Insurance Affidavit Namenp Please Print Name 1Ja171e I 'DaD21J-ndSS0n Location:'3/ .Y^�T City JM/? mra? Phone # I 7 79Ll- I am a homeowner pe arming all work myself. ® . I am a sole proprietor and have no one working in any capacity I am an employer providing workers' compensation for my employees working on this job. I Company name: Address City Phone#: Insurance.Co. Policy# Company name: Address City Phone#: Insurance Co Policy# 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.penakiesfn.the form of-a-STOP VI/ORKORDER-and_a fire-of(.$1 D0.OD)_a slay against.me. I understand that a copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification. I do hereby certify under the pains nd penalties of perj that the information provided above is true and correct. Signature Date 513)1A Print name T ��I` �. S (SI M"^'LO f 0,-," Phone#Lal)'M-7717 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 Licensing Board p Selectman's Office Contact person: Phone#: F� Health Department F-1 Other I ���Ilk Nee 10 of l l OFFICUL INSPECTION FOR14—NOT FOR VOLUNTARY .ASSESSMENTS SUBSCURTACE SEWAGE .DISPOSAL SYSTEM INSPECTION FORM PART C SYSTEM INFIDIU?.t TION(continued) Property Address:_Lj7>Y�11 l� Owner: _ Date or inspecticn: C3}" 1'"":'.kC= . izl s1'OSA L Si'ST'Ut'l P cvi;l s4:et:l"i of the sc aEc disposal system treiudli'tr_ti=s to at least two p,.-i anelnt reference landmarks or t:errh.nta-f:;. Loc.,re al! wells v.idun 100 f%:et. l.tr.:ate wh.-re public water supph enters the building. P C-•CK Q 5. A �L. to IAORTM Town of 0 No. LAK dover, Mass., VO COCHICHEWICK �,p�oRATED P'? C) 7 v U BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System BUILDING INSPECTOR .3a� 'r.V A ice +. THIS CERTIFIES THAT........ .............................................I................ Foundation has permission to erect....,�4....e37......... buildings on..........1.50 Y....s.A.)F..lr1.......b4—......... Rough to be occupied aS :Poe X j? t PIA CE l 1*out O Ou.....rsa t O F �rs/�yt t 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 I spection, Alteration and Construction of Buildings in the Town of North Andover. /q /3 SAO dow PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS ELECTRICAL INSPECTOR UNLESS CONSTRUCTIONS S Rough .. ................' 44.. ....I..................0.................. 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.