HomeMy WebLinkAboutMiscellaneous - 154 HIGH STREET 4/30/2018 (3) 154 HIGH STREET U-
J 210/053.0-0018-0000.6
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NORTH ANDOVER BUILDING DEPARTMENT
�R�,so c5
1600 Osgood Street
�Ssacwus� . .
North Andover
Tel: 978-688-9545
Fax: 978-688-9542
BUSINESS F0RMF01?TOWN CLERK
DATE:
NAME: �enn �L)ard dws-
ADDRESS: 1 h
ZONMGMSTRICT:
TYPP-OF 13USMS : h", i d ®n
BUILDING LAYOUT PROVIDED: YES NO �
AVAILABLE PARKCMG SPACES:
ZONING BYLAW USAGE: YES NO
BUILDING INSPECTOR SIGNATOM
BUSINESS FORM FORIOWN CLERK
2.40 Home Occupation(1989132)
An accessory use conducted within a dwelling by a resident who resides in thedwelling as his principal
address, which is clearly secondary to the use.-of the-building.for living ptuposes. Home occupations shall
'incIude,-but 'hot'I tnited to the following uses; personal services such as famished by an artist or instructor,
but not occupation involved wifli motor vehicle repairs, beauty parlors, animal kennels, or the conduct of
retail business,or the manufacturing of goods,which impacts tib residents
g p al nature of the neighborhood,
4. For use of a dwelling in any residential district or multi-family district for a home occupation, the
following conditions shall apply.
a. Not more than a total of three (3) people may be employed in the home occupation, one of
whom shall be the owner of the hbne occupation and residing iri said dwellia ;
g.
b. The use is carried on strictly withinthe principal building,
c. There shall be no o terior alterations, accessory buildings, or display which are not customary
with residential buildings; -
d. Not more than twenty,five (25) percent of the existing gross floor area of the dwelling unit.
so used, not to exceed one thousand (1000) square feet, is devoted to*such use. fn
connection with
such use, there is to be,kept no stock in trade, commodities or products which occupy space
beyond these limits;
e. There will be no display ofgoods or wares visible from the street;
f The building or premises occupied shall not be rendered objectionable or detrimental to the
residential character of the neighborhood due to the exterior appearance, emission of odor,
gas, smoke, dust, noise, disturbance, or in any other way become objectionable or
detrimental to any residential use within the neighborhood;
g. .may such building shall include no features of design not cu&maiy in buildings for residential
use.
Signature Date
i
i.
0273 Date.. ..'.�P.��.�...........
f�►ORTN�
o?o.<�``°;••"ao� TOWN OF NORTH ANDOVER
PERMIT FOR WIRING
as CHUS
This certifies that ................... \lV �. �........... ........
has permission to perform.....&P. ... ..................
wiring in the building of............�' ` .................................................
at..1.-�.v...�qcq..a ........5.:r.....QQ.......... •North Andover,Mass.
Fee .... Lic.No..e!IM 9 SCJ..... .. . ... . ...
ELECIMICAL[Ns�ecrd
Check # —
Commonwealth of Massachusetts Official Use only
2-73
Department of Fire Services Permit No. /b
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev. 1/071 leave blank
APPLIQATION FOR PERMIT TO PERFORM ELECTRICAL WORK
All work to be performed in accordance with the Massachusetts Electrical Cod (MEC ,527 CMR 12.00
(PLEASE PRINT IN INK R TYPE ALL INFORMATION) Date: �Z !
City or Town NORTH ANDOVER To the Inspector of Wires:
By this application the UP,, ersigned gives notice of his or her intention to perform the electrical work described below.
Location(Street&Number) 1'6LI 14456 V,}rQQ
Owner or Tenant � Telephone No.
Owner's Address k m-
Is this permit in conjunction with a building permit? Yes ❑ No (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service _LWAmps kIAZ40 Volts Overhead ROO" 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: 9-(LF\ac" fin,tca- 2.iser o je— -ko 44-4
Completion o the ollowing table may be waived by the Inspector o Wires.
No.of Recessed Luminaires No.of Ceil.-Susp.(Paddle)Fans No.of Total
Transformers KVA
No.of Luminaire Outlets No.of Hot Tubs Generators KVA
No.of Luminaires Swimming Pool Above Ei In- o.o Emergency Lighting
rnd. rnd. ❑ 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 No.of Alerting Devices
Tons g
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: .............. Detection/Alerting Devices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal F-1 Other
Connection
No.of Dryers Heating Appliances KW Security Systems:*
No.of Devices or Equivalent
No.of Water KW No.of No.of Data Wiring:
Heaters I Signs Ballasts No.of Devices or Equivalent
No.Hydromassage Bathtubs No.of Motors Total HP Telecommunications Wiring:
' No.of Devices or Equivalent
OTHER: 7
r Attach additional detail if desired, or as required by the Inspector of Wires.
Estimated Value of Electrical Work: (When required by municipal policy.)
Work to Start: Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVERAGE: Unless waived by the owner,no permit for the performance of electrical work may issue unless the
licensee provides proof of liability insurance including"completed operation"coverage or its substantial equivalent. The undersigned
certifies that such coverage is in force,and has exhibited proof of same to the permit issuing office.
CHECK ONE: INSURANCE ❑ BOND ❑ OTHER ❑ (Specify:)
I certify,under the pains andpenalties ofperjury,that the information on this application is true and complete.
FIRM NAME: LIC.NO.:
Licensee: AossrKN QJQ%;A0 Signature LIC.NO.: 10309-8
(Ifapplicable, enter "exempt"in the license number line.) Bus.Tel.No.:
Address: Alt.Tel.No.:
*Per M.G.L c. 147, s. 57-61,security work requires Department of Public Safety"S"License: Lic.No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the liability insurance coverage normally required
by law. By my signature below,I hereby waive this requirement. I am the(check one) ❑ owner ❑ owner's
Owner/Agent
Signature Telephone No. PERMIT FEE. $
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The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
www.mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Applicant Information Please Print Legibly
Name(Business/OrganizationMdividual):.,0se_?� w�J- \✓1V
Address: q✓1Cntw00�1 �(L.
City/State/Zip: Phone #:—'37$` 3(D0-9&-7 QI
I
Are you an employer?Check the appropriate box: Type of project(required):
1.❑ I am a employer with 4. ❑ I am a general contractor and 1 6. ❑New construction
exployees(full and/or part-time).* have hired the sub-contractors
2. I am a sole proprietor or partner- listed on the attached sheet. 1 7. ❑ Remodeling
' ship and have no employees These sub-contractors have 8. ❑Demolition
working for me in any capacity. workers' comp.insurance. 9. ❑Building addition
[No workers' comp. insurance 5. ❑ We are a corporation and its
required.] officers have exercised their
10.[v�'1 ectrical repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL 11.❑Plumbing repairs or additions
myself. [No workers' comp. c. 152, §1(4),and we have no 12.❑Roof repairs
insurance required.] t employees. [No workers'
comp. insurance required.] 13F] Other
*Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
*Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name:
Policy#or Self-ins.Lic.#: Expiration Date:
Job Site Address: City/State/Zip:
Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date).
e
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
Ido hereby certify under the sins andpenalties ofperjury that the information provided above is true and correct.
Si nature: Date: ! Z
Phone (ad- ae9 -7
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License#
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#:
9995
Date.....
. ...-Za...... .....
NORTI,
1eMppt TOWN OF NORTH ANDOVER
F 9
PERMIT FOR WIRING
;�SS�cHusf�
This certifies that ..........,t.a, ......sz� ..........
has permission to perform .. . .� Mj,,?..IPfP........................
wiring in the building of........................................ .4 ................................
r at...l.sy/ .......k.L�if{..... ..................... .North Andover,Mass.
a� 2=°� Fee... `. �. Lic.No....t�.��.. g.......... ... . '//� .
2 LECI Rlc_ I t OR.
Check # J Z
Commonwealth of Massachusetts Official Use Only
Department of Fire Services Permit No
BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked
[Rev. 1/071
APPLICATIONleave blank
FOR PERMIT RMIT T
O
PERFORM
All work E
ktobe performed ELECTRICAL
p d m �+
acc A
accordance L
ance with the Massachusetts EI WORK
(PLEASE PMT INIIVK OR TYPE ALL INFORMATION) Date: Code(MEC),I I CMR 12.00
City or Town of: NORTH ANDOVER �3� -!l
By this application the undersigned gives notie Inspector of Wires:
ce of his or her intention to perform the electrical
Location(Street&Number) `Gwork described below.
Owner or Tenant f
Owner's Address t Telephone No. I
Is this permit in conjunction with a building permit? Yes ❑ No
Purpose of Building Z *014 ® (Check Appropriate Box)
Utility Authorization No._ "VA
Existing Service Q06 Amps '?� /�YO Volts, Utility
❑ Undgrd❑ No.of Meters 7—
New Service Amps _ / __Volts Overhead
Number of Feeders and Ampacity ❑ Undgrd ❑ No.of Meters
' h
Location tion and Nature of-Proposed Electrical work:
Geu `
�e U U,' n � FabSC
1\A� . Macrn� �G�de� l� ATOc
'SS 1'n SCcF(�
Completion of thLfollowin t le may be waived by the Inspector o Wires.
No.of Recessed Luminaires No.of Ceil:Sus . No.of
p (Paddle)Fans Transformers Total
No.of Luminaire Outlets No.of Hot Tubs nA
Generators KVA
No.of Luminaires Swimming Pool Above ❑ In- atte Units
P
No.of Switches o.o mergency ig tingNo.of Receptacle Outlets rnd. rnd. El B
No.of Oil Burners Swi
FIRE ALARMS No.of Zones
No.of Gas Burners No.of Detection and
No.of Ranges Initiatin Devices
No.of Air Cond. Total
Tons No.of Alerting Devices
No.of Waste Disposers Heat Pump Number Tons KW No.of Self-Contained
Totals: ................. .........
Detection/AlertingDevices
No.of Dishwashers Space/Area Heating KW Local❑ Municipal
Connection ❑ Other
No.of Dryers Heating A fiances .-
PP KW Security Systems.
No.of Water No
KW No.of Devices or E uivalent
Si
Heaters . No.of Data Wiring:
t Signs Ballasts No.of Devices or E uivalent
j No.Hydromassage Bathtubs No.of Motors Total HP
Telecommunications Wiring;
OTHER: No.of Devices or Equivalent
Attach additional detail if desired,or as required by the Inspector of Wires.
Estimated Value of Electrical Work: / Ub
Work to Start: (When required by municipal policy.)
�' 2g-11 Inspections to be requested in accordance with MEC Rule 10,and upon completion.
INSURANCE COVERAGE: Unless waived by the owner,no permit for thecompleted performance of electrical work may issue unless
! the licensee provides proof of liability
undersigned certifies that such coverage is in force,cand has luding `exhibited proof of same to the permit issn"coverage or its uing substantial The
CHECK ONE: INSURANCE 9 BOND El ❑ (Specify:)
OTHER g
I certify,under the pains and penalties of perjury,that the information on this application is true and complete.
FIRM NAME: " MOCA O eCTtk�C
Licensee:_M 1&e (mo o� LIC.NO.: ' j2
I
Signature(fa applicable, enter er "exempt"in the license nzzmber line.) LIC.NO.:
Address: Bus.Tel.No.: 7 m
*Per M.G.L c. 147,s.57-61,security work requires Department of Public Safety"S"License: Alt.L c.No.:
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does nor have the liability insurance cove
required by law. By my signature below,I herebywaive this re rage normally
requirement. I a Y
Owner/Agent q m the check o
( one)El owner's
Si ❑ r s agent.
Signature
ure Telephone No. PERMIT FEE. $ —
ELECTRICAL PERMIT NO.� IINSPECTION REPORT:
ELECTRICAL INSPECTOR•-DOUG SMALL A
FUGH INSPECTION:
d—[ ] Failed—[ ] Re-inspectionrequirecT($50.00)-j ]
ctors'comments:
(Inspectors'Signature-no initials) Date
2.FINAL INSPECTION:
Passed— Failed—j .] Re-inspection required($50.00)-[ ]
Inspectors'comments:
(Inspectors'Sign ure-noInitials) Date
3.UNDER..GROUND INSPECTION:
Passed—[ I Failed—' [ ] Re-inspection required($50.00)-[ ]
Inspectors'comments:
(Inspectors}Signature-no initials) Date
4.INSPECTION—SERVICE: -
DATE CALLED NATIONAL GRID: NAYM
Passed—[ ] Failed—[ ] Re-inspection required($50.00)-[ ]
Inspectors'comments:
(Inspectors'Signature-no initials) Date
5.INSPECTION-OTHER:
Passed—j ] Failed—j ] Re-inspection required($50.00)
Inspectors' comments:
(inspectors'Signature-no initials) Date
D OOR TAGS.ARE TO BE FILLED OUT AND LEFT ON SITE IF THE AREA TO BE INSPECTED IS NOT
ACCESSIBLE AND ARE-INSPECTION OF$50.00 IS TO BE CHARGED.
The Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
6•�
www mass.gov/dia
Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers
Avylicant Information
Please Print Le ibl
NarriO(Business/Organization/Individual): (\ L
Address: �U�c� S
City/State/Zip: 6PW��(�l _ .�(�( �j t J Phone#:
_ 7F X23 213e
on an employer?Check the appropriate box:
1• am a employer with ( 4. ❑ I am a general contractor and I Type of project(required):
employees(full and/or part-time).* have hired the sub-contractors 6. ❑New construction
2.❑ I am a sole proprietor or partner- listed on the attached sheget.t ' 7• ❑Remodeling
ship and have no employees These sub-contractors have 8.
working for me in any capacity. workers'comp.insurance. 9. ❑Demolition
[No workers comp.insurance 5. 9• ❑Building addition
' p ❑ We are a corporation and its
required.] officers have exercised their 10lectrical repairs or additions
3.❑ I am a homeowner doing all work right of exemption per MGL 11.E]Plumbing repairs or additions
myself. [No workers' comp. c. 152, §1(4),and we have no
insurance ]re uired. f 12.[]Roof repairs
q employees. [No workers'
comp.insurance required.] 13.❑Other
Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information.
f Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such.
:Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and their workers'comp.policy information.
I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site
information.
Insurance Company Name: 2 2
Policy#or Self-ins.Lic.
jj U n- 1 Expiration Date: /oZ aQ f inn
Job Site Address:_ 1 t 1 A 1 1~e, �j � n�Q
City/State/Zip:
Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date).
Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a
fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine
of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of
Investigations of the DIA for insurance coverage verification.
Ido hereby ce t f I n r the ns and penalties of perjury that the information provided ab ve is rue and correct.
Si nature: 2
Date: J
Phone#: j 3
Official use only. Do not write in this area,to be completed by city or town official.
City or Town: Permit/License#
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#:
I
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"...eve person in the service of another under an contract of hire,
"...every P Y
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 or trustee of an individual,partnership,association or other legal entity,employing employees. However the
owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the
dwelling house of another who employs persons to do maintenance,construction or repair 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 commonwealth nor any of its political subdivisions shall
enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance r
requirements of this chapter have been presented to 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)and phone number(s)along with their certificate(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 LLC or LLP does have
employees,a policy is required. Be advised that this affidavit may be 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 listed below. Self-insured companies should enter their
self-insurance license number on the appropriate line.
City or Town Officials
Please be sure that the affidavit is complete and printed 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
that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current
policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or
town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the
applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each
year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture
(i.e.a dog license or permit t6 bum 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 Commonwealth of Massachusetts
Department of Industrial Accidents
Office of Investigations
600 Washington Street
Boston,MA 02111
Tel. #617-727-4900 ext 406 or 1-877-MASSAFE
Revised 5-26-OS Fax# 617-727-7749
www.mass.gov/dia
Date.. . . . . .�1�'
NORTH
A O?Oy+,"'. ,+e4�O
TOWN OF TH ANDOVER
' PERMIT FOR GAS INSTALLATION
9SSACHUSE�
This certifies that . ! ,. . ,.� ^- ..� -ter: , .. . . . . . . . . .
has permission for gas installation . . . . . . . . . . . . . . . . . . . . . . .
in the buildings Iof . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
at1. . . . . , North Andover, Mass. ,
� � !
Fed.v. . . . . Li-. No.. . :�3. . . !. . . . . . . . . . .
lGAS INSPEC"
Q �/
Check# l��if7
5731
MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DG GASF
IPrtnt or T e1
't IT'TING
Mass.
ate ` so�
Building Location Permit j �f
owners
a'ype of oceupa
xy
Nswp Renovation❑ Replacement
Plans SUbmitted: Yes p No p
W
LU CC
w
SUB-BSMT
BASEMENT
1ST RMR
2ND FLOOR
3RD FLOOR
4TH FLOOR
STH FLOOR
6TH FLOOR
Till FLOOR
BTH FLOOR
stalling Company Name
sdre:s
Check one: Certificate
❑ corporation
r
asinessTdephone ❑ Partnership
fine of Licensee Plumber or Cas Fitter ItnvCo.
;;uI1A1NCE COVERAOe:
have.a current It biilty Insurance policy or its substantial equivalent; which meets life requirements of MG
Yes flo ❑ L Ch. 142.
f you have chertced Yes,please •�
_... Indicate the type of coverage by checking the approprlais box.
I liability Insurance policy&/ other type of Indemnity ❑ Both
)WNER3 U16uR Q
IrX'WAIVER: I am aware that the licensee does not have the Insurance coverage required by Chapter
X42 of the Mass.General Laws, end that my signature on ftlTs`per appnCatiOn Yiralves this ager QuIred
ement
gna . o caner or.W vanes gen Check one:
Owner ❑ Agent p
tftby certify that e0 of tha dstalk and Information I have submitted for entered!In above a plication ars true and aceunee to ane best of
Pertinent rovlsloesuto all plumbing
Ma saK�etts states Cla Code and Chapter142142 of��p et
r tMs application be in compliance nth
L
By Type of License:
ride re Plumber re o cense P u er or Gas F tier
Giry/fown p Oasfitter
APPROVED(OFFIC uUSB OM.Y1 pa+tastrr License Number 9� 3
❑Journeyman
BELOW FOA OFFICE Bill ONLY '
FINAL INSPEC`TIC"S + !'110011tSB INSPECTION$
FFR
MO►
APPLMATION toll PSIMIT TO 00 PLYYNINS
I
saw a Tvm OF slam j
4
LOCOTHIN Of BaLDMIS
FL111ABl11
Pommy OIIANTEO
BATE
MBIMO NMPtCTOw
M
i
• i
Date.....
'40 oTM
0 TOWN OF NORTH ANDOVER
0 p PERMIT FOR WIRING
o
US
This certifies that ............................ ......C.......................................................
has permission to perform ....... j.......aL
...................
wiring in the building of........ ........................................
at............ ........t I..... North Andover,Mass.
...............
Fee. ... Lic.No. .d2t.,;V.............................................................
ELECTRICAL INSPECTOR
WHITE: Apop1 cgt95 12'KNARY: BuiOnFbepffilD PINK:Treasurer GOLD: File
Office Use Only 3
.., 01 4r Tommun11 raft 1 of �assar4�1:� Permit No. J / v
9partmrnf IIf Public _%frig Occupancy& Fee Checked._62
t ONS 527 CMR 12:00 M0 (leave blank)
I�A�I IF FIRE PREVENTION REGULATIONS
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WO K
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
%)� or Town of NORTH ANDOVER To the Inspector of Wires:
The udersigned applies for a permit to perform the electrical work described below.
Location (Street & Number)
Owner or Tenant X&w ��" 'e,-4 a�
Owner's Address
Is this permit in conjunction with a building permit: Yes No ❑ (Check Appropriate Box)
Purpose of Building Utility Authorization No.
Existing Service Amps Volts Overhead '! Undgrnd ❑ No. of Meters
New Service Amps —J Volts Overhead ❑ Undgrnd ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work /—/�✓'� d�`'� J,U.OG �� ��
Total
No. of Lighting Outlets No. of Hot Tubs I No. of Transformers KVA
No. of Lighting Fixtures I Swimming Pool Above— I rr
grnd. — crnd. ' I Generators KVA
No. of Emergency Lighting
No. of Receptacle Outlets / I No. of Oil Burners Battery Units
No. of Switch Outlets I No. of Gas Burners FIRE ALARMS No. of Zones
No. of es Ran No. of Air Cond. Total No. of Detection and
9 tons Initiating Devices
Heat Total Total
No. of Disposals vo'or Pumos Tons KW No. of Sounding Devices
No. of Self Contained
No. of Dishwashers I Scace/Area Heating KW Detection/Sounding Devices
Municipal Other
No. of Dryers Heating Devices KW Local ! Connection ❑�
i No. of No. of Low Voltage
No. of Water Heaters KW Sicns Ballasts Wirino
No. Hydro Massage Tubs I No. of Motors Total HIP
OTHER:
INSURANCE COVERAGE: Pursuant to the requirements of Massachusetts general Laws
I have a current Liability Insurance Policy inciucin,g Ccmcieteo Operations Coverage or its substantial equivalent. YES = NO = I
have submitted valid proof of same to the Office. YES = NO = If you have checkea YES. please indicate the type of coverage by
checking the appr9priate box.
INSURANCE BOND = OTHER Z (Please Soec,fy)
(Expiration Date)
Estimated Value of Electrical Work S :2,d0c-,0 /
Work to Start
Insoec::on Date Requested: Roughy Final
Signed under the Penalties of perjury:
Q LIC. NO.
FIRM NAME
Licensee Signature LIC. NO.
y
Bus. Tei. No.
�
Address ale & �JJ ��� �e ' b` Alt. Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee aces not have the insurance coverage or its substantial equivalent as re-
quired by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent
(Please check one) `',\
Teieonone No. PERMIT FEES ()6
(Signature of Owner or Agents x 5505
_..,.,: .. -::•r-----•. - '�r z7.::�-.c-.-�=j�'..-�,;tY••,,•.�,`_�l,,.yy....,..-i a.Y... �-7,.:ti.,-.�-+-r
Location. �� +�G A
`.. No. �Z Date
TOWN OF NORTH ANDOVER
F ; Certificate of Occupancy $
* Building/Frame Permit Fee $
Foundation Permit Fee $
� s�cHus
Other Permit Feeq $ —
Sewer Connection Fee $
0
Water Connection Fee $
TOTAL $
a
Building Inspector
R A t)
�.� Div. Public Works
T
PERJiff NO. foZ APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE 1
MAP K40. LOT NO. 2 RECORD OF OWNERSHIP :DATE BOOK :PAGE
ZONE SUB DIV. LOT NO.
LOCATION PURPOSE OF BUILDING <'ppK�J ft
OWNXR'S NAME MIS ./1�� NO. OF STORIES JSIZE
OWNER'S ADDRESS �" BASEMENT OR SLAB
ARCHITECT'S NAME j SIZE OF FLOOR TIMBERS IST c2.$,-_ 2ND 3RD
BUILDER'S NAME t SPAN /n /o --
DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS
DISTANCE FROM STREET POSTS
DISTANCE FROM LOT LINES-SIDES REAR GIRDERS
AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW SIZE OF FOOTING x
IS BUILDING ADDITION MATERIAL OF CHIMNEY
IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE 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
Aivo
\'kb T11'")v1�C^ LAND COST
SEE BOTH SIDES Jv EST. BLDG. COST "!"700O
PAGE 1 FILL OUT SECTIONS 1 - 3
v � p,� � EST. BLDG. COST PER SQ. FT.
r-rw ._�'t/
EST. BLDG. COST PER ROOM
PAGE 2 FILL OUT SECTIONS 1 - 12
Ty � SEPTIC PERMIT NO.
ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING `�CJCAJ 4 APPROVED BY
ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR
DATE FW§D
~~ BUILDING INSPECTOR
SIG A URE OF dW- NEf OR AU ORIZED WNT
F E E w " OWNER TEL.X /t
PERMIT GRANTED CONTR.TEL.N �eS- 30
19 -- CONTR.LIC.# 0 3 6 6 3
H.I.C.# ll 7 3S-/
�eCo �l�,�S33
.Sd cam..
BUILDING RECORD
I OFUPANCY 12 1
SINGLE FAMILY I Sf0' IES- l "-ATHIS SECTION MUST SHOW EXACT IDLNSOMS��LOT ND D"S
TAN�E FROM L
MULTI. FAMILY OFFICES _ LOT LINES AND EXACT DWE'NSIpN'S OF�l11LDINGS-.\WITH PORCHES. GA-
APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
CONSTRUCTION ~
2 FOUNDATION 8 INTERIOR FINISH
CONCRETE a 1 2 13
CONCRETE BL'K. PINE
BRICK OR STONE HARDW'D
PIERS PLASTER _
_ DRY WALL
UNFIN.
3 BASEMENT
AREA FULL FIN. B'M'TAREA _
'/, '/r '/, FIN. ATTIC AREA _
N_O B M'T FIRE PLACES _
HEAD ROOM _ MODERN KITCHEN
4 WAILS I 9 FLOORS
CLAPBOARDS B 1 2 3
DROP SIDING CONCRETE
WOOD SHINGLES EARTH _
ASPHALT SIDING HARDVy 0 _
ASBESTOS SIDING _ COMMON
SIDING ASPH.TILE
STUCCO ON MASONRY _ c 634 :2
��
STUCCO ON FRAME �ivis tc 634 ' GON
BRICK ON MASONRY--,)`-' ATTIC STRS. & FLOOR_j
BRICK ON FRAME I —2 IV� 3✓Qyo
CONC. OR CINDER BLK. fl
✓� �1`.+v� � t Ill I
STONE ON MASONRY WIRING
STONE ON FRAME _
SUPERIOR I� POOR
ADEQUATE NONE I6�'J►\J\ "'f7`-+rt' �V-/N'
5 ROOF 10 PLUMBING
GABLE I I HIP BATH 13 FIX.)
GAMBREL MANSARD TOR (z VIX/f
FLAT SHED WA R C SE 2
ASPHALT SHINGLES `CA ORY _
WOOD SHINGES IT
SLATE P NG
TAR & GRAVEL STALL SHOWER
ROLL ROOFING I MODERN FIXTURES -
TILE FLOOR
TILE DADO _
UC
6 _ FRAMING 11 HEATING
WOOD JOI`'ST. / PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER BMS.,&COLS. STEAM
STEEL BMS. &1COLS. HOT W'T'R OR VAPOR
WOOD RAFTERS _ AIR CONDITIONING
'1 RADIANT H'T'G
/ UNIT HEATERS
7 NO. Of ROOMS GASOI L
B'M'T 2nd ELECTRIC
1 st 13rd N A• NG
,. ORT
o*' vm Of over
No. _
rt dower, Mass. _19�,�
;�� ,
Q t- LAKE
COC MIC ME WICK
7'QA°R ED AP�\y
"9 A BOARD OF HEALTH
Food/Kitchen
Septic System
l'elo.PERMIT T, D
BUILDING INSPECTOR
THIS CERTIFIES THAT....R ..:...�w.....A- A(Pl�A'............................................................................................. Foundation
has permission to •" 'I�42............... buildings on... .. .... ......ST................................... Rough
to be occupied as:. l(......e1! a..... ..... f.�w.. 1�1n.... ..^....... ... ��T14W+ imney �a
h
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
s F
VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough
Final
t
PERMIT EXP 6 MONTHS ELECTRICAL INSPECTOR
- V UNLESS CONS S Rough
f.
Service
UILDING IN R 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
r �Until•Inspected and Approved by the Building Inspector.
Burner F
PLANNING FINAL CONSERVATION FINAL street No.
Smoke Det.
SEWER/WATER FINAL DRIVEWAY. ENTRY PERMIT
_ L
The Commonwealth of Alassachusetts '
Department of Industrial Accidents
�`` -- � Ill9ks dle>lr�gJtlias
- 600 Washington Street
Boston,Mass 02111
Workers' Compensation Insurance Affidavit
� s
• location: l `�
city phone 1 ?617
Ci Ihomeowner performing all work myself.
�arna sole proprietor and have no one worxmg in any capacity
I am an employer providing workers' compensation for my empiovees working on this 'ob.
_:.....:
com�v name"..
address:
ntv: phone#t
oiiev _
insurance co. R
ON RM a I MMM
Cl I am a sole proprietor, general contractor,or homeowner(circle one) and have hired the contractors listed below who have
j the following workers' compensation polices:
companv name
.:
address:
city: ... phone#:
insurance co. policy#
company name:
address ..
c)tv: ._ hone it.
_....--
insurance co. policy*
' aona�s cenecessary
Failure to secure coverage as required under Section 25A of MGL 152 can lead to the imposition of criminal penalties of a fine up to 51.500.00 and/or
one years'imprisonment as well as civil penalties in the form of a STOP WORK ORDER and a fine of S100.00 a day against me. I understand that a
copy of this statement may be forwarded to the Office of Investigations of the DIA for coverage verification.
do herebv ce under t e painsa nal ' erjun that the infor"sarion provided above is true and correct
Signature Date
Print name Phone 4
official use only do not write in this area to be completed by city or taws oMcW
city or town: persiVUcenm 4 mBuilding Department
CLicensing Board
check if immediate response is required CSelectmen's Office
CHealth Department
contact person: phone 0;; r•tOther
(' id INS PJA)
f -
r
2x rb , s Ma
AS
ILI
IASS
2xa? 16 oG
y
e
JUL 27 195 13:50 FROM GEO-PAC MANCHESTER NH TO DOYLE PAGE.001
Georgia - Pacific Corporation 07/27/1995 14:36
300. 6ay St. / Manchester NH 03603 /
GP FASTBeam (c) 1990-5 GEORGIA-PACIFIC CORPORATION v 4.108
Project : DOYLE Location PETER l
Mark 1 Description RIDGE
Usage Roof (Beam) Rep.Stra. No Spacing 0.011
Max Defl: LL = L/ 240 TL = L/ 180 Slope: 0.00/12
+ 14- 0- 0 + nts
® 3,50",565psi � 3,50",565psi l� lD�/`/ 1 I
O.A. length = 14- 2-- 0 (Span, is horizontal dimension to centerlines)
Project Design Leads- Roots LivB- 4p.170 psf, Dead= 17.00 psf
Live+Dead TAW(T) Live LW(L) lips, b*C*timn*
Sha9e ti astar't MEW estaxt Mid Zncr a aant--&azta 4aBa Add Info
Spas Carried 57.0 psf 40.0 psf 154 0 0 14.00 30.0' 9.c.
i ohifors 9.2;plf -0 1 0 14.00 Self wt
•Dimensiooa (feet), moasurcd foo left end when sga-# iS B. otherwise, from left end pf the specified span
Support 3. 2
Max R'n (lbs) 6049 6049
Min R'n (lbs) 1849 1849
DL R'n (lbs) .$49 1849
Min Brg(inch) 3..14 3.14
Brg Str(psi) 550 550
Design VajuW Span# x Group Allow Ratio
V (lbs) 5064' 1 12-10 41 7967 0.64
M (ft-lbs) 21173 1 7-- 0 41 22099 0.96
D-LL(inch) 0.57 1 7- 0 41- 0.70 0.82 L/294
1:)-TL(inch) 0.82 1 7- 0 41 0.93 0.88 L/204
USE: GP MP;aWIWI 2.0 11.88 (1.75x11.8$) 2 plies
Master Plank LVL tta Mccausey Luftor Co
Faces
1. Designed in accordagm with tat1aaal for wood Qonstzuction and applicable Approvyl9 Or Research Reports.
a. Provide lateral support at the boarimg leeatiom nearaat entb vhd M the member.. Continuous ldteral support.regui.red for
eaaepression edge.
S. Lvaoa have been ink by th*neer and have sot DCS verified by Georgia-Pacific Engineered Md*r Tecieiaal Services.
4. Design valid for dry ute Daly.
S. Hmring length basad en deaisp meteri.al; 9.Vp1o+ mst6r1al capacity shall he verified (by otbxra).
6. Roof usage! Install with ain4ox 114.13 slope for ldequ6t&drainage.
7. when required by the building code, a registered design profass+ional or building official should verify the ingot mads and
product application.
s. This eagisseered lumber product bas been aizcd for residential use. A concentrated load check, per the building caft. (fust he
performed f" comarcial uses.
9. Verify that 7vaa is applied-at toy or equally from both Aides.
10. Neil plies togcthe- *ith 18d nails ae 12 o/c along top *tLd tbttom edges. wail from alLemate f2,CCS. S from bftW.
11. company, product or brand az !w referenced are trado- xka or registerad tradama«ha of their Xcapective ornlrb,
l
* TOTAL PAGE.001
I
... ....-x>.- '+tea•� .r ,� .. - ... •-- - ,�. ti, ,.
» Date..., j.. ..7... .l..t .....
2437
NORTH
4, TOWN OF NORTH ANDOVER .,
° p PERMIT FOR WIRING
♦ • 1
,SSAcmus
4. ......
This certifies that ..." . � ...4..x....�...�`�.� �.....................................
has permission to perform .. .+;' :. .....;s.:�". .. n...:....>�'�..::
. .................
wiring in the building of.A ... /
tL??}.$.-tb :Z. J� l'ti.k A.�t.`�..........................
at A1::7A..t11...4t,', 4 i......... ........................... .North Andover,Mass.
Fee...1.ri............. Lic.No
ELECTRICAL INSPECTOR
08/08/95 15:33
WRITE:Applicant CANARY: Building 'pt.PRID PINK:Treasurer GOLD: File
i ` t
Office Use Only
= _ 014tLommonwralth of fa-mr4ar to Permit No. Z���
ihpa tmtnt of Public gafttq Occupancy&Fee Checked �e
3/90 (leave blank)
BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 /
APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK Ly4
All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 112:00
(PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date �p , , - --
(X* or Town of NORTH ANDOVER To the Inspector of Wires:
The udersigned applies for a permit to perforrn the electrical work described below.
Location (Street & Number)
Owner or Tenant
Owner's Address
Is this permit in conjunction with a building permit: Yes Lam'. No LJ (Check Appropriate Box)
Purpose of Building UtIII Authorization No.
Existing Service 2..&12DAmps 20'1 U Volts Overhead ' Undgrnd ❑ No. of Meters Z�
New Service Amps —J Volts Overhead ❑ Undgrnd ❑ No. of Meters
Number of Feeders and Ampacity
Location and Nature of Proposed Electrical Work
No. of Lighting Outlets No. of Hot Tubs I No. of Transformers Total
KVA
No. of Lighting Fixtures Swimming Pool Above; In-
KVA
grno. L—" grnd. I Generators
No. of Emergency Lighting
No. of Receotacte Outlets No. of Oil Burners Battery Units
No. of Switch Outlets I No. of Gas Surners FIRE ALARMS No. of Zones
No. of Ranges No. of Air Cond. Totai No. of Detection and
9 tons Initiating Devices
No. of Disposals I No.of Heat Total Total
Pumps Tons KW No. of Sounding Devices
No. of Self Contained
No. of Dishwashers I SoaceiArea Heating KW Detection/Sounding Devices
Municipal f- 1Other
No. of Dryers I Healing Devices KW Local Connection
No. of No. of Low Voltage
No. of Water Heaters KW Sicns Bailasts Wirinc
No. Hydro Massage Tubs I No. of Motors Total HP ) /
OTHER: TT,� Z
S'�� L �/c�D~/_ D—C � /rV
INSURANCE COVERAGE: Pursuant to the requirements of %lassacnuserts general Laws
I have a current Liability Insurance Policy including Comcieted Operations Coverage or its substantial equivalent. YES NO = 1
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 appropriate box.
INSURANCE &- BOND — OTHER = (Please Spec:y)
— (Expiration Date)
Estimated Value of �WJJs S
Work to Start �— Inspection Date Recuested: Rough Final
Signed under the P/Q�naiittires of peri
FIRM NAME �v�" LIC. NO.
Licensee [ Sign LIC�.(v NO.
f
Bus. Tel. No. v d
Address Alt. Tel. No.
OWNER'S INSURANCE WAIVER: I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as re
gwred by Massachusetts General Laws. and that my signature on this permit application waives this requirement. Owner Agent
(Please check one) U`
Telephone No. PERMIT FEE S rte_
(Signature of Owner or Agentt x-5565
s �
Location
'No. Date
HORTM TOWN OF NORTH ANDOVER
O��t�ao yeti
a00�
. „ Certificate of Occupancy $ } =
i Building/Frame Permit Fee $ }
+ •^° TSR Foundation Permit Fee $ "
Other Permit Fee $
Sewer Connection Fee $
SEB 7,
V56-Water Connection Fee $ �-
TOTAL $
Building Inspector
Div. Public Works
PnRMIT NO. (J 7 G APPLICATION FOR,-PERMIT TO BUILD — NORTH ANDOVER, MASS. f`/l/32,1) L .1.- 1
MAP KJO. LOT NO. 2 RECORD OF OWNERSHIP :DATE BOOK :PAGE
ZONE _� I SUB DIV. LOT NO.
&- i
,--
LOCATION PURPOSE OF BUILDING 621
.-
OWNER'S NAME p/ NO. OF STORIES Z I E
OWNER'S ADDRESS t^'.' /� BASEMENT- R SLAB
ARCHITECT'S NAME J , C ` SIZE OF FLOOR TIMBERS IST 2ND �,;C 3RD
BUILDER'S NAME L S'•
a SPAN
DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS Gx q r
DISTANCE FROM STREET POSTS ZX q
DISTANCE FROM LOT LINES-SIDES REAR GIRDERS /.�
AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION '7` L-,4THICKNESS
IS BUILDING NEW SIZE OF FOOTING X C7
IS BUILDING ADDITION MATERIAL OF CHIMNEY eg
IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE 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. COST
PAGE 1 FILL OUT SECTIONS 1 - 3
ES I
BLDG. COST PER SQ. y.
E BLDG.
PAGE 2 FILL OUT SECTIONS 1 - 12 COST PER ROOM
SEPTIC PERMIT NO.
l - ELECTRIC METEPS MUST BE ON OUTSIDE OF BUILDING 4 APPROVED BY
1 ATTACHED GARAGES MUST CONFORM TO STATE FIRE REGULATIONS
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR 'S
i DATE FILED v 3
�
�n BOARD OF HEALTH
SIG ATURE OF OWNo OR AU RIZED A T
F E E T < 67 6
p� UL(� J (,L PLANNING BOARD
PERMIT GRANTED y OWNER TEL.# d- T
CONTR. 6
l�G /T 19 33 CONTR. LC�# a3 C 3
BOARD OF S[LECTMEN
# �a 3 0,4
LED
BUILDING INSP[CTOR
J� t
I
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY S ORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS 'OF BUILDINGS. WITH PORCHES. GA-
APARTMENTS I RAGES, ETC. SUPERIMPOSED. THIS REPLACES PLOT.PLAN.
CONSTRUCTION
lu
2 FOUNDATION 8 INTERIOR FINISH
CONCRETE 3 1 2 13
CONCRETE 8L K. PINE
BRICK OR STONE HARDWRD
PIERS PLASTER
_ DRY WAIL _
UNFIN.
3 BASEMENT
AREA FULL FIN. B M AREA _
1/1 1/2 '/, FIN. ATTIC AREA _
NO 8 M FIRE PLACES _
HEAD ROOM MODERN KITCHEN
4 WALLS 9 FLooas
CLAPBOARDS B 1 2 3
DROP SIDING CONCRETE �_
WOOD SHINGLES EARTH _
ASPHALT SIDING HARDNU D _
ASBESTOS SIDING _ COMMON
VERT. SIDING ASPH. TILE _
STUCCO ON MASONRY _
STUCCO ON FRAME
BRICK N MASONRY ATTIC STRS. & FLOOR _
BRICK ON FRAME
CONC. OR CINDER BLK.
STONE ON MASONRY WIRING
STONE ON FRAME _
SUPERIOR POOR _
ADEQUATE I-i NONE
5 ROOF 10 PLUMBING -
GABLE I HIP BATH )3 FIX.) _
GAMBREL MANSARD TOILET RM. (2 FIX.)
FLAT SHED WATER CLOSET _
ASPHALT! LAVATORY
WOOD SHINGES KITCHEN SINK
SLATE NO PLUMBING _
TAR & GRAVEL STALL SHOWER
ROLL ROOFING MODERN FIXTURES _
TILE FLOOR
TILE DADO
i
6 FRAMING 11 HEATING
WOOD JOIST PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER BMS. &COLS. STEAM
STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR
WOOD RAFTERS _ AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS
7 NO. OF ROOMS GAS
OIL
B'M'T 2nd _ I ELECTRIC
1ft ( 3rd 11 NO HEATING
0
I
I
Town of North Andover '
BUILDING DEPARTMENT `
Homeowner License Exemption
(Please print)
DATE
JOB LOCATION
Number Stre(Vt Address Section of town
"HOMEOWNER" 624 yk AD
Name Home Phone Work Phone
PRESENT MAILING ADDRESS
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, Section 109 . 1 . 1)
DEFINITION OF HOMEOWNER:
Person(s) who owns a parcel of land on which he/she resides or intends to
reside , on which there is , or is intended to be, a one to six family dwell-
ing, attached or detached structures accessory to such use acid/or farm
structures . A person who constructs more than one home in a two-year
period shall not be considered a homeowner. Such "homeowner" shall submit
to the Building Official , on a form acceptable to the Bulding Official ,
that he/she shall be responsible for all such work performed under the
building permit . (Section 109 . 1 . 1)
The undersigned "homeowner" assumes responsibility for compliance with the
State Building Code and other applicable codes , by-laws , rules and
. 'regulations .
The undersigned "homeowner" certifies that he/she understands the Town of
- North Andover Building Department minimum inspection procedures and
,,. requirements and that he/she will comply with said procedures and
,requirements .
A
HOMEOWNER' S SIGNATURE .
haw-
APPROVAL OF BUILDING OFFICIAL
Note : Three family dwellings 35 , 000 cubic feet , or larger , will be
required to comply with State Building Code Section 127 .0 , Construction
Control .
' DESIGN LOADING: v
_ c
J 0 B � 30,'3 TCLL/TOTAL (PSF) 40/55 @ 24"oc, 50/65 @ 19.2"oc, 60/75 @ 16"oc = y
TIFc 1299 4-6 q IBM3 -2
/9 OF ly 23A
11"HEN C BLLR
j 5.00 4'12 .:r 4'12 c
i Y
' m
J) 4 rN6 � \ 3.�, 1; 4 y r:a
I ox 4597
1 -- ��;= shf6 ��
5 ti _ p
{I )'•s 4 z REGISTERED f=g S r 6
t ^ 1+i 4 - 1 PROFESSIONAL ENGINEER �0:2 j2 p
1 02Yr, a oD 0 m
I a0t v
�O 5XIO Y36 = ;Ea-mcc
o
�ocog
- 2 O 0 O p
vo .5-.,
Sc2o-s
L zt-
2.50 =nE0.oug
i 4' 12 - 3-00-12 12 4132 ''= r3 '°Smo2t
you E=c
11 J9 °-3bk0o
•• _
p a00co
TC 16 4-06-06 3-05-14 3-05-14 3-05-14 3-05-14 3-05-14 3-05-14 4-06-06 16 � gn_gr E
EC t-s-00-04 6-11-12 Q `-�``P
6-] 1-12 8-00-04 h moc6 d naa
o
e
30-00-00 nE3.mo1c
> cQbmm_o
^.CLL= SEEA60✓£ SPACING = 2-00-00 REACTIONS MIN L/DEF= 30'/1.19-= 301, LAMB= 0 3/8" � o0-cmuD
o;
:CDL= 7.0 PSF INCR:P=1.15 L=1.15 (LBS). BRG(IN) 20 GA. Y.20 PLATES 199 PSI GRS (MAX) p �cbpm-m
=CLL= 0.0 PSF BUTT CUT= 0 1/4" J 1- -1775 3.5 16 GA. M16 PLATES 144 PSI. GRS (MAX) cmo�oCm
ECRL= 8.0 PSF J 9= -1775 3.5 LL L/DEF• 30Y-37 m 41(e = oD-D4'u.2
`:ITEK INDUSTRIES, INC. timo3o0mo
STOCK 30 SCISSOR CONFORMS TO TPI 91 REPETITIVE INCR o $=NmmO.c
0 0
---- TOP CHORD - CSR= 0.921----- --- BOTTOM CHORD - CSR= 0.713--- ------- WEBS - CSR= 0.778------- o
u
`y mu- oo
ti w_
2X 4 NO 1 DENSE SYP ZX 4 240OF-2.OE M SYP 2X 4 STANDARD SPF *EXCEPT* `���+OF1f3Ejyu,,�� Z vnmo�°on
C 1= -7139 C 4= -4290 C 7= -6286 C 9= 6731 Cll= 4944 W 5 IS 2Y. 4 NO 2 SYP ��`F~�c ., yq�y'� Oga-- mDm
'\ .. o. a -2c c
2= -62E6 C 5= -:250 C E_ -1139 C10= 4944 C12= 6731 x 1= -789 w 4= -9-16 W 7= 1251 z1-, . s- a,-oo5
C -E2E6 C 6= -6:E6 --------STEP DOWN LUMBER-------- W 2= -328 W 5- 2972 W 8= -328 =�: 5 ? ovmEe -
.-6O,-Cl--
:STEPHEN V1.'•,
CABLER ;,�.5 S -E0o0�-
--------STEP DOWN LUY.EE=-------- Ci0,41 :X. 4 NO 1 DENSE 5:'P W 3= 1.291 W F= -916 W 9= -789
No. 6548
C 3 6 2X 4 NO 2 SYPo'• Q� • c0z.640a
:�OF'• /CEN=f'�..•F'tW,�` VO pD 7%«
1 . ALLOW FOR HORIZONTAL MOVEMENT OF 0 11/16 INCHES (MIN) AT J 9. �'�'4ss(OkhL ��G.��, a m'4-tmv'-
2. TRUSS NOT DESIGNED FOR PLASTER CEILING. (SPN/DEFL RATIO LESS THAN 360. ) /'/"////fj11j1�1 `o �ccp=0E
3 . ALL PLATES ARE M20 PLATES UNLESS OTHERWISE INDICATED. oto.gv;og_
4 . LEFT OVERHANG DISTANCE ALONG THE BOTTOM EDGE IS 1-05-05. ```111111II11„////' "'•'••""•. �' 9-9m2Em
0.9
5. RIGHT OVERHANG DISTANCE ALONG THE BOTTOM EDGE IS 1-05-05. i --„ 4 to 4S 0 ... .,, F��� ooE-
l�r � `*� r4' `F •EN W. .Cts• v otc-Eo0
95
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i
Suggested Affidavit for Home Improvement Contractor Permit Application '
For Office Use OnlyN E OF CITY/TOWN
Permit No. /N+ PAM0 Vt(b
Date `
AFFIDAVIT
Home Improvement Contractor Law
Supplement to Permit Application
MGL c.142A requires that the"reconstruction,alteration,renovation,repair,modernization,conversion,inprovement,removal,demolition.
or construction of an addition to any pre-existing owner-occupied building containing at least one but not more than four dwelling units....or
to structures which are adjacent to such residence or building"be done by registered contractors,with certain exceptions,along with other
requirements. f
Type of Work: '?l'12j'1'! Jw Est. Cost 3 S� yy?)
Address of Work / r
Owner Name: GA 121
Date of Permit Application: 6 Z I �� �l 3
I hereby certify that:
Registration is not required for the following reason(s):
_Work excluded by law
_Job under $1,000
Building not owner-occupied
ZOwner pulling own permit
_Other (specify)
Notice is hereby given that:
OWNERS PULLING THEIR OWN PERMIT OR DEALING WITH UNREGISTERED
CONTRACTORS FOR APPLICABLE HOME IMPROVEMENT WORK DO NOT HAVE
ACCESS TO THE ARBITRATION PROGRAM OR GUARANTY FUND UNDER MGL
c. 142A.
Signed under penalties of perjury:
I hereby apply for a permit as the a e t of the o er:
o all 6 D3 � �� 3
Date Co iact Nam Registration No.
OR:
Notwi hstanding the above notice, I hereby apply for a permit as the owner of the above property:
J A3
DatJ rr Na6c
FORM U - LOT RELEASE FORM e
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 local or state law,
regulations or requirements.
****************Applicant fills out this section*****************
APPLICANT: If- A P 1-114 /2 IA NI Phone e� vr�_
LOCATION: Assessor's Map Number S- Parcel
Subdivision Lot(s)
Street 1,1,`j S' St. Number /m /
************************Official Use only************************
RECOMMENDATIONS OF TOWN AGENTS:
Date Approved
Conservation Administrator Date Rejected
Comments
Date Approved 2 �l
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
Fi a De artment �
Received by Building Inspector Date
�wly
OFFICES OF: . o Town of
12()Main Street
AP13EAL5 =a- � NORTH ANDOVER North ArldoVer,
BUILDING •�'•"'�s M. ssac ht1tiC1150184 i
CONSU'I1VA't•IUN "`""" DIVISION OF ((i 1 i)685-4775
H EA L"I•H s
PLANNING PLANNING & COMMUNITY DEVELOPMENT
KARL'•N H.P. NELSON, DIRECTOR
In accordance with the provisions of MGL c 40, S 54, a condition of Building Permit
Number is that the dcbris resulting from this work shall be
disposed of in.a properly licensed solid waste disposal facility as dcFiincd by MGL c 111, S
150A.
The dcbris will be disposed of in:
'f'A- � -'ga,
(Location of Facility)
i
Signatur o[ Pcrmi Appiica
Date
NOTE: Demolition permit from the Town of North Andover must be obtained for
this project through the Office of the Building Inspector.
^
�
^
°
JONES & CO INC.
GENERAL CONTRACTORS
97 DRUID HILL RD ^
METHUEN MASS. 01844
TEL 508 688 7307
�
MS GALE APIKARIAN 01/26/93
154 HIGH ST
� N ANDOVER MASS 01845
� TEL 508 682 1442
JOB DESCRIPTION /RECONSTRUCTION OF THE SECOND FLOOR ~
TO MAKE MORE USABLE LIVING SPACE BY RASING THE ROOF AND WALLS
TOTAL JOB PRICE $ ^
PLANS / $ 500. 00
�
� PERMIT/ OWNER WILL PAY FOR AND APPLY FOR THE
� PERMIT AS WE ARE NOT RESPONSABLE FOR THE
SCOPE OF THE ENTIRE PROJECT.
I HAVE ALOTED TIME FOR ONE VISIT TO THE BUILDING
INSPECTORS OFFICE TO ANSWER ANY TECHNICAL QUESTIONS
�
�
� PLOT PLAN SURVEY & AS BUILT $NON REQUIRED
TEAR - OUT & DEMOLITION /
�
GUT THE ENTIRE UPSTAIRS TO BARE STUDDS AND RAFTERS
ALL WIRRING WILL BE LEFT TO THE ELECTRIANS TO CUT BACK
AND DEAD END
LEAVE THE MAIN FRONT ROOF RAFTERS AND BOARDS
� REMOVE THE REST OF THE EXISTING ROOF AND SHINGLES
�
REMOVE THE ENTIRE LOW PITCHED ROOF OVER THE DEN
REMOVE 5 SKYLIGHTS CAREFULLY FOR REUSE LATER
WE WILL BE REMOVING THE WALL BETWEEN THE MASTER BEDRM AND
KITCHEN INSTALLING A HEADER AND TRIMMING IT TO BE A CASED
OPENING APROX 10 FT WIDE
CONCRETE WORK & MASONRY / $
CUT THROUGH THE CONCRETE FLOOR IN 2 SPOTS IN
THE CELLAR AND POUR A 1 FT THICK FOOTING 2 FT X 2FT
� TO SUPPORT A LALLEY COLUM TO BEAR A LOAD
�
WE WILL SKIM THE CHIMNEY FROM FLOOR LEVEL TO �
WHERE WE START REBRICKING AND WILL ONLY ADD A
FLUE IF ONE ALREADY EXIST. IT WILL PROTRUDE THROUGH
THE ROOF AND BE 2 FT ABOVE THE ROOF CAP
FLOOR FRAMING /
NEW FLOOR WILL BE FRAMED OVER THE DEN/ BEDRM
SET ON A DBL SILL PLATE AND FRAMED WITH 2 X 10 IS
COVERED WITH 3/4" T&G PLYWOOD GLUED AND NAILED
ALSO A NEW FLOOR WILL BE FRAMED WITH 2 X 6 IS
TO RAISE IT UP AND ALLOW A CHASE FOR PIPING
,
WALL FRAMING /
WALLS ARE TO BE FRAMED WITH 2 X 41S COVERED WITH
1/2" PINE CDX, TYVECK OR EQUAL HOUSE WRAP
ROOF FRAMING /
FRONT RAFTERS ARE 2 X 6 24" O C SPANNING 12 FT WE ARE ADDING
2 X 8 16 " O C SPANNING 18' 8/12 PITCH WE WILL FILL IN THE
REST OF THE FRONT WITH 1 X 8 SPRUCE BOARDS TO THE RIDGE
THE REAR RAFTERS ARE 2 X 8' S 5' SPAN
CEILING JOIST ARE 2 X 6 16 " O C
THEY ARE TO BE SEATED ON A SPECIAL BEAM ATTACHED TO
A ROOF TRUSS
ALL CEILINGS ARE TO BE STRAPPED
THE REAR ROOF IS TO BE COVERE WITH 1/2 " CDX PINE
RIDGE BEAM IS TO BE A MICRO LAMB
THE REAR HALF OF THE HOUSE IS TO BE FRAMED WITH PRE
ENGINEERED ROOF TRUSSES SPACED 24" O C SPANNING 30 FT
ROOF COVERING /
WE WILL APPLY SNOW & ICE SHEILD THE FIRST 3 FT, ALUMINUM DRIP
EDGE, IKO ASPHALT ROOFING SHINGLES 20 YR TO MATCH THE
EXISTING, VENTILATING RIDGE VENTS, LEAD CHIMNEY FLASHING
EXTERIOR TRIM PORCHES DECKS /
#2 PINE 1 X 8 FASCIA & RAKE BOARDS
3/8" AC PLYWOOD FOR THE SOFFITS
BIDDING /
5/8" TEXTURE 1-11
NAILED WITH 8ALVINIZED TWIST NAILS
DOORS & TRIM /
AS DESCRIBED IN THE DOOR SCHEDULE AND SHOWN ON THE PLANS
THEY ARE TO BE HOLLOW CORE LUAN, DOORS CLEAR SPLIT JAMBS
4 1/2" WALL THICHNESS WITH COLONIAL CASING ON BOTH SIDED
PASSAGE LOCK SYSTEM
CLOSET DOOR UNITS ARE HOLLOW CORE BIPASS 4 FT UNITS ECT "
WINDOW & WINDOW TRIM /
THEY ARE HARVEY VINYL DOUBLE HUNGE WINDOW UNITS FOR NEW '
CONSTRUCTION WITH NAIL FLANGES AS DESCRIBED IN THE WINDOW
SCHEDULE
SELECT PINE WILL BE USE FOR SILLS AND EXTENTION JAMBS
CASING IS TO BE 2 1/2" COLONIAL CASING
WE PROPOSE TO FRAME AND INSTALL 4 EQUAL SIZED SKYLIGHT UNITS
IN THE FRONT OF THE HOUSE. ( UNITS ARE ALREADY ON SITE )
PLUMBING / $
WE PROPOSE TO BRING HOT AND COLD WATER COPPER LINES AND PVC
DRAINS FROM THE CELLAR TO THE NEW BATHROOM UPSTAIRS "
AND VENT THEM THROUGH THE ROOF AS PER CODE
INCLUDES 1 2 PC WHITE TUBE UNIT WITH A DOME CEILING,
1 36, SWANSTONE (CORIAN LOOKALIKE ) WHITE SINK TOP ^
`
°
^ |
TUB $316. 00 LASCO 2 PC
DOME $123. LASCO �
TOILET $165. 00 AMERICAN STANDARD PLEEBE OR EQUAL ^ �
SEAT $ 12. 00 PLASTIC OR WOOD
SINK $175. 00 SWANSTONE CORIAN WHITE LOOKALIKE
FAUCET $ 65. 00 2 HANDLE GERBER OR EQUAL
VALVE $120. 00 SIMMONS TUB AND SHOWER VALVE
ALL FIXTURES ARE WHITE AND CHROME
HEATING & AC / SUPPLIED BY THE OWNER $
�
ELECTRICAL / SUPPLIED BY THE OWNER $
INSULATION / $
CEILINGS AND ATTIC TO HAVE 8" UNFACED
WITH PROPER VENTS AS NEEDED R 30 u
WALLS 3 1/2" UNFACED WITH A POLY BARRIER R 11
INTERIOR WALL COVERINGS /
1/2" DRYWALL HUNGE TAPE AND PRIMED
CEILINGS AND CLOSETS TO BE TEXTURED
MILLWORK TRIM STAIRS /
LINEN CLOSET 3 SHELVES 2FT X 2FT �
CLOTHES CLOSETS SHELF AND POLE BRAKETS
POLE AND SHELF
3 1/2' COLONIAL BASEBOARD �
�
CABINETS / $200. 00
CUSTOM 36 " OAK VANITY UNFINISHED
FLOOR COVERINGS / SUPPLIED BY OWNER $
PAINTING INTERIOR & EXTERIOR / $
SUPPLIED BY OWNER
CLEAN UP & DEBRI REMOVAL / $
A DUMPSTER WILL BE SET UPON SITE AND EMPTIED
�
AS NEEDED TILL OUR WORK IS COMPETED
' |
TOTAL COST TO COMPLETE THE ABOVE MENTIONED JOB $30, 721 .2(..)
�
�
PLEASE SIGN BOTH COPIES UPON ACCEPTANCE AND RETURN ONE TO ME. �
�
�
X------------------------------- / /93 �
X------------------------------ / /93
PAYMENT SCHEDULE
COMPLETION OF BUILDING PLANS $ 500. 00
DELIVERY OF WINDOWS $1 , 703. 80
DEOPSIT TO ORDER TRUSSES/ BEAMS $2, 000. 00
/
/
� PAYMENT AS WE START $10, 000. 00 �
TO REMOVE THE ROOF AND RE FRAME
AFTER ROOFING, SIDDING, CHINMEY,
� WINDOWS, SKYLIGHTS, INTERIORS ARE COMPLETE $ 8, 000. 00
ROUGH PLUMBING
!
� AFTER INSULATION, 1x200. 00
/
AFTER DRYWALL IS COMPLETE 3, 000. 00
| AFTER TRIM IS COMPLETE 3, 500. 00
AFTER PUNCH LIST IS COMPLETE BALANCE 817. 40
THIS PROPOSAL MUST BE ACCEPTED BY 2/4/93
AS THE MATERIALS QUOTE IS ONLY VALID TILL THEN
PRICES ARE CHANGING SO FREQUENTLY.,
NOTE ANY VARRIATIONS, CHANGES OR UPGRADES REQUESTED DURRING
THE CONSTRUCTION PERIOD BY THE HOME OWNER OR BUILDING
INSPECTOR WILL BE WRITTEN UP AND PRICED BEFORE THAT CHANGE
WILL BE DONE. PAYMENT FOR THE CHANGES WILL BE MADE PROMPTLY
| AFTER ITS COMPLETTION
|
SHOULD ANY CHANGES BE MADE THAT DECREASE THE TO [AL COST Or:-
THE
FTHE PROJECT THEY WILL BE DEDUCTED AT THAT SECTION AND NOTED
' BY A CHANGE ORDER.,
FINAL NOTE
WE THE UNDERSIGNED AGREE THAT SHOULD A BREAK DOWN IN
COMUNICATION DEVELOP . WE WILL ACCEPT BINDING ARBITRATION AS
AN ALTERNATIVE TO A LENGTHY EXPENSIVE LEGAL ROUTE .
OWNER HAS THE OPTION TO PICK A QUAULIFIED IMPARTIAL
� ARBITRATOR, AND WE WILL EQUALLY SHARE THE COST OF THIER
�
SERVICES. WE ALSO AGREE TO HONNOR THEIR DESITION
^
X-------------------------------- / /93
X------------------------------- / /93
�
=
/
'
"
| +
COMMONWEALTH OF PUBLIC SAFETY, 1
'.y OF I ' WEALTH AVE
rf I
Y. MASSACHUSETTS j' Oxt�b I � — CL OSE.CHECK OR M
1 SSR FOR REQUIRED F
(RATION DATE &q?-I!Y.
m t
/ 4 •,
30/1993 •�vt MADE PAYABLE
8' 220 #
TRICTIONS r., IiAT�zqLIG'NO y
ONE
,Vi);_
` 1; CptAMISSIONER OF PUB
l� 06863 �; ';.
DO NOT.:SEND CA14
I OL8, i NOTE'S f EE
ASE' ` >;�c
$ 8 18 i8 .12$1
(BLASTING orR oNLrI FEE•
v
100 r CCp � .
HEIGHT::_. ED BY LICENSEE AND OFFICIALLY �{., T' ��� u,y�,•e BF
? NATURE OF'THE COMMISSIONERtl �1 11, 1, ..- •a .� ¢¢%'
DOB:
Ike
THS oocuM {{� ' SIGN NAME,I�FULI•ABOV
CARRIED ON ,, NATURE CIF uCENSEEt,
Q J
T. HOLDER
RIGHT,THUMB TH18 .: COMML4910NEN.
>.. THUMBPRc1T ED IN,�� y r`r epi v N•p. �' �...fff"' � 7 tt:� � . ;I
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N0RTH.
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o of*
", Andover
0 0
No. 040
►- V
t?�
O A E o dover, Mass., Off • 7 19
COCHICHEWICK
ADRATED PPa\ �C,
'9S BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
BUILDING INSPECTOR
THIS CERTIFIES THAT .p 1. .. . 00.. .. .. . . .
�r ..... ......... /4 .. ..............:................................................
Foundation
has permission to OMW ��..................... buildin s on-tifif#9.....,l.�.CA......5..r .
..................... Rough
t0b8 OCCUpled as...... 0.AW.M.0...* ............................................................................................... 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. ' L p `� � '�/t0 j PLUMBING.INSPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit. T Rough
Final
PERMIT EXPIRES IN 6 MONTHS
UNLESS CONSTRUCTION STARTS ELECTRICAL INSPECTOR
Rough
... .................. Service
BUILDING INSPECTOR
- Final
Occupancy Permit Required to Occupy Building GAS INSPECTOR
Display in a Conspicuous .Place on the Premises - Do Not Remove Rough
Final
No Lathing or Dry Wall To Be Done
Until Inspected and Approved by the Building Inspector. FIRE DEPARTMENT
Burner
PLANNING FINAL CONSERVATION FINAL Street No.
Smoke Det.
SEWER/WATER FINAL �� y DRIVEWAY ENTRY PERMIT
CERTIFICATE OF USE & OCCUPANCY
Town of North Andover
Building Permit Number 040 Date_ DECEMBER 21 , 199-3
THIS CERTIFIES THAT
THE BUILDING LOCATED ON 154A HIGH STREET
MAY BE OCCUPIED AS CONDO UNIT: ENLARGE BEDROOMS IN ACCORDANCE
& BATH
WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND
SUCH OTHER REGULATIONS AS
MAY APPLY.
T" CERTIFICATE ISSUED TO Gayle Ap ka r i a n
o' "ti
'� o
tr •`'` 154A High S t.
rt
ADDRESS NorthAndover, MA �
s'ACHUS Building Inspector
I
t
TownO N:1- ,O�
ove
4 Q
M North KAndover, Mass., / fjlr*Y. 719
BOARD OF HEALTH
UILD
Food/Kitchen
PER ..MI.T TO B' - Septic System
p�L R BUILDING INSPECTOR
THIS:CERTIFIES THAT... .......... .........
Foundation
has permission to iWW-4049 ......... buildings on .IT YA....Y10C .....4..T�...... Rough —,;7� %
.3............. �
{ T.t0 be occupied as...... .W VA... ..................... ............................... ........................... . Chimney �3+ id
provided'that the person accepting this permit.shall in every respect conform to the terms of the application on file in Fin t" z�` 10 ,crgg
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. S ` `F 13 CAN&0 At r y-. PL BIN 94SPECTOR
VIOLATION of the Zoning or Building Regulations Voids this Permit: T t1
PER.MIT EYWIRES IN 6 MONTHS `
pot V a� iJNLF_S5 CONSTRUCTION I1IOT•1 T.�, ELE CAL- S ECTOR
ARS �-
Roughh,V�� .
..
.................. Service
_ BUILDING INSPECTOR
Final
Occ-upancy PCn7lit Reclub-(,-d t0 Oc(_T(py BLlll(-I111C' 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. FIRE DEPARTMENT
Burner
PLANNING FINAL # /a23'''� CONSERVATION FINAL Street No.
Smoke Det.
SEWER/WATER FINAL �� y� DRIVEWAY ENTRY PERMIT
'v-f�-.--. M.. R.� • �_..�. .. .';::.ui.''rir��'�Y1L1'" v.Y'.ti_
Location i �b 64 S�
No. 4Date
"ORTM TOWN OF NORTH ANDOVER
3? ° 0.
mawdl&
p Certificate of Occupancy $
> Building/Frame Permit Fee $
/1GMUCMU E<� Foundation Permit Fee $
s5
Other Permit Fee $ S
Sewer Connection Fee $
Water Connection Fee $
TOTAL $ S�
tz� Building Inspector
&41% 14:21 45.50 PAID
INTO p 3 3 2 Div. Public Works
PERMIT NO. 4-4 APPLICATION FOR PERMIT TO BUILD - NORTH ANDOVER, MASS. PAGE I
MAP 440. I LOT NO. 2 RECORD OF OWNERSHIP IDATE (BOOK iPAGE
ZONE SUB DIV. LOT NO.
LOCATION / (�C i J I PURPOSE OF BUILDING t7 C` g
�� i G. Yl JJJ 1 I L � I U T 1I} is�--
OWNER'S NAME A INL N Y� C� 17 `� A/ NO. OF STORIES I .L SIZE
i OWNER'S ADDRESS /'F /� � IL VT �V BASEMENT OR SLAB
ARCHITECT'S NAME 3()N ei
SIZE OF FLOOR TIMBERS IST 2ND 3RD
BUILDER'S NAME Y7 yJ SPAN
DISTANCE TO NEAREST BUILDING DIMENSIONS OF SILLS
DISTANCE FROM STREET POSTS
DISTANCE FROM LOT LINES—SIDES REAR GIRDERS
AREA OF LOT FRONTAGE HEIGHT OF FOUNDATION THICKNESS
IS BUILDING NEW SIZE OF FOOTING X
IS BUILDING ADDITION MATERIAL OF CHIMNEY
IS BUILDING ALTERATION IS BUILDING ON SOLID OR FILLED LAND
WILL BUILDING CONFORM TO REQUIREMENTS OF CODE 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
INSTRUCTIONS11 } 3 PROPERTY INFORMATION _
FVw�A-eLS , LLAND COST
SEE BOTH SIDES Q 3 EST. BLDG. COST ,
PAGE 1 FILL OUT SECTIONS i - 3
EST. BLDG. COST PER SQ. FTf
PAGE 2 FILL OUT SECTIONS 1 - 12
1 QiL 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 nnt
PLANS MUST BE FILED AND APPROVED BY BUILDING INSPECTOR �R�� eKs
DATE ED
2r
BUILDING INSPRCTOR
SrGffATURF OF O ER OR THORIZ NT
F E E �� OWNER TEL.#
PERMIT GRANTED CONTR.TEL.#
19 _
CONTR.LIC.N
H.I.C.#
1995 3Z CAtK-
I
BUILDING RECORD
1 OCCUPANCY 12
SINGLE FAMILY _ STORIES THIS SECTION MUST SHOW EXACT DIMENSIONS OF LOT AND DISTANCE FROM
MULTI. FAMILY OFFICES LOT LINES AND EXACT DIMENSIONS OF BUILDINGS. WITH PORCHES, GA-
APARTMENTS RAGES. ETC. SUPERIMPOSED. THIS REPLACES PLOT PLAN.
r
CONSTRUCTION
2 FOUNDATION —I 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. 8 M AREA _
1/1 1/1 1/1 FIN. ATTIC AREA _
NO 8 M FIRE PLACES _
HEAD ROOM MODERN KITCHEN
4 WAILS I 9 FLOORS
CLAPBOARDS B 1 2 3
DROP SIDING CONCRETE �_
WOOD SHINGLES EARTH _
ASPHALT SIDING HARD\!J'D _
ASBESTOS SIDING _ COMMON
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 _
SUPERIORI� POOR
ADEQUATE NONE
5 ROOF 10 PLUMBING
GABLE HIP BATH (3 FIX.) _
GAMBREL MANSARD TOILET RM. (2 FIX.) ,
FLAT SHED WATER CLOSET _
ASPHALT SHINGLES LAVATORY
WOOD SHINGES KITCHEN SINK
SLATE NO PLUMBING _
TAR 8 GRAVEL STALL SHOWER _
ROLL ROOFING MODERN FIXTURES _
TILE FLOOR
TILE DADO "
6 FRAMING 11 HEATING
WOOD JOIST PIPELESS FURNACE
FORCED HOT AIR FURN.
TIMBER BMS. &COLS. STEAM
STEEL BMS. & COLS. _ HOT W'T'R OR VAPOR
WOOD RAFTERS _ AIR CONDITIONING
RADIANT H'T'G
UNIT HEATERS
7 NO. OF ROOMS GAS
OIL
B'M'T 2nd _ ELECTRIC
ls1 13rd NO HEATING
NORTH
Town of r 4Andover
O
to
:;'
No. 246 =._, - . _�•: _
* U"& Co 19�.�'
`Y
f/ nO �_ - LAKE dower, Mass.,:
`C OC KIC KE WICK ^•
%ADRATED
BOARD OF HEALTH
PERMIT T D Food/Kitchen
Septic System
THIS CERTIFIES THAT. ARK .. .......................: BUILDING INSPECTOR
A
Foundation
has permission to wwt...t.w'm _................ buildings on... '? ....... ....�...................................... Rough
to be occupied ascj.�...l.l,�.. INI ..,• .$C�A,......Sn; a► . ... �?� ..'� Q.. .914
N1.. Chimney
thprovided that the person accepting this permit shall In ever res ect conformlo the terms of theta lication on file In
ded t t Final
is 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 EXP IN 6 MONTHS Final
ELECTRICAL INSPECTOR-
►7-*�
UNLESS CON TR 1I T Rough
.... ... ..... . . .............. Service
BUILDING INS CTOR
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 FIRE DEPARTMENT
Until Inspected and Approved by the Building Inspector.
Burner
PLANNING FINAL CONSERVATION FINAL Street No.
Smoke Det.
SEWER/WATER FINAL DRIVEWAY ENTRY PERMIT
COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY !`}
OF ONE ASHBORTON PLACE
MASSACHUSETTS i BOSTON,MA 02108
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I i_I CEN: i' CAUTION
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