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Miscellaneous - 1575 GREAT POND ROAD 4/30/2018
�� J �� r-` Date. No n. 540 p`HOR7:rho TOWN OF NORTH ANDOVER PERMIT FOR PLUMBING ,SSAcmusfct This certifies that R.r`" . . . . (��. .��. . . . . . . . . . . . . . . . . . has permission to perform . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . A.'�l . . . . . . . . . . . . . . . . . . . at. '� �� ��� " . . ., North Andover, Mass. Fee33 Lic. No.. `1. .`.�� . . . . . . . . . PLUMBING INSPECTOR Check # // ) ) L WHITE: Applicant CANARY: Building Dept. PINK:Treasurer MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Prin! or Type) - _O_ Mass Dale ®�" Z_ 1ZdGae) _PermifN --= Building Location r 1'-l�TPOAJ�... �.__ Owner's Name :J 9 ! /;'I ----- --- ------- --- - --- J!^! �E----kms Type of Occupancy New :� Renovation r..: Repl t :: Plans Submitted Yes :J No FEATURES z z z Y Q F -u to OU z z W W W Y J U7 Q W C7 W W Cf) Q (r = z O z d O Z cn H W - U W to Q W z z E- o J W W w 0 m rt Q W w Y m a- Q d Q X U z Cc Co 0 W Q U) Q W <n � J Z p Cc Cc p 0 LL W 2 ~ _ 3 O Q 2 � -1 cc H Q Y W Y W Q Q T U)) U)) D Q z 0 0 m z z w 0 0 0 Y m 0 a 0 g _ cJn i 0 D o Q cc m 0 a a SUB-BSMT. i BASEMENT V 1ST FLOOR 2ND FLOOR 4 �C 3RD FLOOR 4TH FLOOR i 5TH FLOOR 6TH FLOOR 7TH FLOOR STH FLOOR / Installing Compa/ny/ Name�L- �/E j4-f!jc Check one: Certificate Address Corporation 144, 018-5--Z Partnership Business Telephone—�7(i 7 J vZ .5.5 Firm/Co. _ Name of Licensed Plumber �l�M ES �o �Lk2t EL` INSURANCE COVERAGE: I have a current liability insurance policy or its substantial equivalent which meets the requirements of MGL Ch 142. Yes F,- No If you have checked yes, please indicate the type of coverage by checking the appropriate box. A liability insurance policy ✓-� Other type of indemnity L Bond :-. OWNERS INSURANCE WAIVER: I am aware that the licensee does not have the insurance coverage required by Chapter 142 of the Mass. General Laws and that my signature on this permit application waives this requirement. Check one: Owner Agent L Signature of Owner or Owner's Agent - - 1 hereby certify that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under the permit issued for this application will be in compliance with all pertinent provisions of the Massachus s tate Plumbing Code and Chapter 142 of the General Laws. By J\\ gn ure of Licensb4i Title _ Type of License: Master Journeyman City/Town License Number--r"1 Date....A// � �1.....No 3J7 C v f HORT►,, TOWN OF NORTH ANDOVER 0 P PERMIT FOR WIRING SACMUSES This certifies that - R u t4<< 5 a e has permission to perform .....Q .5- ..c"f 4 f ...... .............................................. wiring in the building of...... E'..!N�?.4 t .S ! ,ri 1 �� �Z ..... . ....... ............ a`at..../.�-7...5 ..... �- >. ` , `'�6?-" ... forth Andover,Mass=: ��JJ / .. .......... i Fee...� :.C�.. Lic.No 11J. Q...... a fELECTRICAL INSPECTOR Check # /�0 WHITE: Applicant CANARY: Building Dept. PINK:Treasurer THECOAMONWEALTHOFMAS, MUSE'77S Office Use only Permit No. j3v &# A DEPARTAMWOFPUBLICSAFM 2BOARDOFFIREPREVE MONRWMTIONSS27CMRIZ-00Occupancy&Fees Checked PPLICATIONFOR PERMIT TO PERFORM ELECIT2ICAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE MASSACHUSSTS ELECTRICAL CODE,527 CMR 12:00 /) / (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Dat Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number) /,�_7$ g f7— �l ,B Owner or Tenant.. ,/t1PX41,P4 IS AV 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 r7 Underground No.of Meters New Service Amps / Volts Overhead r__1 Underground Q No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA 1 .of Lighting Fixtures Swimming Pool Above Below Generators KVA ground ound No.of Receptacle Outlets /— No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices No.of Self Contained Detection/Sounding Devices No.of Dryers Heating Devices KW Local Municipal Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER ht�tr�rtoeCotierage Pt>rs�t�bthetegtteana��Ga�aalLaws Iha%ea=utLiabtldyhu==Pd ymA&gCmVide CoveaWaAssi avivafatt YES a NO r Iha%est$xnftdvAidptoofofsarne1otheOBre YES n NO Ifywha%edtadwdYES,plem di*theNxofwmaWbydWogthe 1NSURAI� Ef BOND a OTI-ER ftmSpo*) D EViation D* 10 E ValuedHmftxalWork$ WotkoStatt/ yD6l1e- egtr W Rough FM 4 400 - 0 Signed un3a&%idfi es ofperjlay. FIRMNAME Lioa>seNa ,,z o aa Lioa�e'��CtIS [.rte Z°l2 Sigtasne '� Lic=No 1 > l Btcs¢mTd.Na 77 h83 d�S/l LCL,Ppo^J S7_ L���J LJ�?t� 6/yY¢ AILTUNa OWNER'SMLRANCEWANER;I.alrtawat dAtheLimwdo t re#WbyMmmdu&Card Lam andirtmys�aerndhisparniWpkBbatvm*Asfhisre i (Please check one) Owner Q Agent M Telephone No. PERMIT FEE 0 Location No. �/-3 Date 16—3 'y/ NORT1y TOWN OF NORTH ANDOVER f A t Certificate of Occupancy $ CNUS<� Building/Frame Permit Fee $ c Foundation Permit Fee $ Other Permit Fee $ TOTAL $ / Check # jxw 15 L, 7 j Building inspector TOWN OF NORTH* ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEMOLISH A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER: LDATE ISSUED: `` /&) SIGNATURE: Building Commission for of Buildings Date SECTION 1-SITE INFORMATION T T Property Address: 1.2 Assessors Map and Parcel Number: C 2c�Q Map Number Parcel Number t,\ 1.3 Zoning Information: 1.4 Property Dimensions: ` Zonin District Proposed Use Lot Area Frortta e ft 1.6 BUILDING SETBACKS.ft Front Yard Side Yard Rear Yard Required Provide Required Provided red Provided 1.7 Water Supply M.G.LC.40. 54) 1.5. Flood Zone Information: 1.8 Sewer Public System Public ❑ Private ❑ Zone Outside Flood Zone ❑ Municipal ❑ P1 On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSEG P/AUTHORIZED AGENT 2.1 Owner of Record Name(Pent) c Address for Service Ills W Signature Telephone 2.2 Owner of Record: o Name Print Address for Service: Signature Telephone M SECTION 3-CONSTRUCTION SERVICES 3.1 Licensed Construction Supervisor: Not Applicable ❑ Licensed Construct.�n Supervisor: License Number Address Signature Telephone Expiration Date 1.2 Registered Home Improvement Contractor Not Applicable ❑ �ompany Name Registration Number i address Expiration Date � i nature Telenhnne e SECTION 4-WORKERS COMPENSATION(1VLG.L.C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the buildk permit. Signed affidavit Attached Yes.......V No.......0 SECTION 5 Descri tion of Proposed Work check ail applicable New Construction ❑ Existing Building 9-, Repair(s) ❑ Alterations(s) lfl/ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Pro sed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be @@` IR e Completed by permit applicant 1. Building (a) Building Permit Fee �6Multiplier Multi tier 2 Electrical i 1�-�- -(b) Estimated Total Cost of / C� d` Construction ( J 3 Plumbing Building Permit fee(a)x(b) 4 Mechanical HVAC 5 Fire Protection 6 Total 1+2+3+4+5 CheckNumbei- SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUnDING PERMIT L ,as Owner/Authorized Agent of subject property Hereby authorize to act on My behalf,in all matters relative to work authorized by this building permit application. Sil natureof Owner .Date SECTION 7b OWNER/AUTHORIZED"AGENT DECLARATION s ,as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief i Print Nam G o I Si ature of Owner/A ent Date no NO. OF STORIES SIZE BASEMENT OR SLAB SIZE OF FLOOR T114BERS 1ST2 ND 3 RD L N ENSIONS OF SILLS 4ENSIONS OF POSTS ENSIONS OF GIRDERS GHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CHIMNEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE ♦ao ,. Town of North Andover O o� ,+,� Building Department ~ 7J 27 Charles Street North Andover, MA. 01845 D. Robert Nicetta 'ssAckuse`` Building Commissioner (978) 688-9545 978 688-9542 Fax HOMEOWNER LICENSE EXEMPTION Please print DATE-=1-�-�— (% JOB LOCATION Number Street Address Map/lot "HOMEOWNER Name Home Phone Work Phone PRESENT MAILING ADDRESS E C3�� �� �® t� Q �Q(�,o N. ANVJau (� 6"�A . S oi� � City Town State Zip Code The current exemption for"homeowners"was extended to include owner-occupied dwellings of two 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 108.3.5.1) DEFINITION OF HOMEWOWNER: 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 or two family dwelling,attached or detached structures ac- cessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. n i The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other Applicable codes, by-laws, rules and regulations, The undersigned"homeowner certifies that he/she understands the Town of No.Andover Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. HOMEOWNER'S SIGNATURE APPROVAL OF BUILDING OFFICIAL i i Norah Andover Building Department i 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 i c11, S150A. The debris will be disposed of in: (Location of Facility) Signature of Permit Applicant ,om Date NOTE: Demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector The Commonwealth of Massachusetts Department of Industrial Accidents s� P t : , Office of Investigations Boston, Mass. 02111 y 3 Workers'Compensation Insurance Afdavit Please Print Name: 11,4JV Ho V a j Location: C 0 City�f fa M I t� /� Phone ("—i am a homeowner performing all work myself. L-11 am a sole proprietor and have no one working in any capacity F-1 I am an employer providing workers'compensation for my employees working on this job. 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 penalties in the form of a STOP WORK ORDER and a fine of($100.00)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. I do herby cert' der the pai. d pe of perjury that the information provided above is true and correct. Signature Date 9 Print name /) / N H60114 O Q� Phone# Official use only do not write in this area to be completed by city or town official* Ej Building Dept ❑Check if immediate response is required Building Dept p Licensing Board p Selectman's Office Contact person: Phone#: Health Department Other FORM WORKMAN'S COMPENSATION OVA ASIAN R ILD W general Contracting + n.a lllff11"sClwCros'Ing n". -tfl..} SINCE 1968 Sal m;AW 83079- Phone: 603-898_9234 Ma Com&uct4ansupowisw.#-Cs 75 E-ntaik Proposal 8/23/01 TO. Arthur Demoulas 1575 Great Pond Rd. N.Andover,Ma. RE: Finishing off of Cellar. Scopeofwork: The-side,o€the-cellar with-the-sliding door will be finished off with drywall and acoustical ceilings. There will be access from the garage and an area from-the-stairs-to-the opposite-side-o the-ce&r-_There vitt be,two interior doors and a double closet door with a finished closet. Framing. There-will be-a-2X4_pressure-treated use&m all.concrete contacted areas. 2X4 spruce will be used on all vertical studs.The closet will be 7x30" and an area-bumped-into the-utility-rico -tu-accommo&WAi cuing bookcase or cases. Plumbing: Nome. Heat: We-will-try-an(f use-the-existing-ductwork togetl#ea�.' -to this finished area. But it is my opinion that this will not be enough,due to the system design Arid where this--area-is-for chiddren-to-play in. vA1l-prr4Yi&:no-less than 201 of electric baseboard heat with thermostats.T his will insure enough heat,especially in it tiled basement area. Ceiling vvd�l a 2' � dropped naise€l:panel type-a u e:c g with A metal firanie. This insures easy access to the mechanical systems of the home.The ceiling will start at the botteid of the ststirs-AA&9"fifi thio out-the new finished area. Electrical: Outlets and switched will be by Ma.Biuilding codes.We Will provide S flush-typeceiling:ligW Sorite_existi wirift-w hav_ td'�rerouted and will be done under this proposal. Walls!HBe ifisidated With&5"f erglass aa--l have a vapor Barrier. Half-inch drywall will be used and have one coat of primer And one coat of latex finish applied. Trim: Debrs-vvsll-ibe Erpunel-molded�aiJriAd casings. Brass hinges Ahd-iiia@rior-pftMgeWAy door hardWam-Baseboards,door casings.aftd.wiftdoW rb casings wiii match the type upstairs.They will be primed ant{finger jointed.Trim i© aav&twu-eofits of-finigh paint rhe tlokf iii -1 aVe t*6 type shelVes.The- area en tbi dI the half Wall iuunaau011 shouldi be tri�mecl with a slielVt anu pAintea to ivatch the tri-IIi. r'lo6f`ing.B tike` cost,we will leave this out of the proposal. It hgs been better for the boriieawrier wring most jobs of this nature it6shop provid th file subcontrictor. iiote: We" will be responsible for the removal Of construction debris generated by T __:= __ _ _11.=______ __ P l: P--•=1=-•-_._ =.PP =P rI__ ___._ .___ thi§-�ai. rher�hm-b _ - tae ung nit Of zne tau ung interior stairs. All extra work above this proposal will cost 40 dollars per man hour plus inateriam i All material is guaranteed to be as specified, and the above work to be performed in accordance with-the-drawings-and-specifications-:submitted for the above work and completed in a substantial workmanlike manner for the sum of... Pleven-thousanfLtwo-hundred:-and-Uty-dollars. ($ 11250.00) With payments to be made as follows: $4,000 upon signing of the contract,2-,000-upon completiow of frame-,-3080-upon-co"on of drywall,balance upon completion. Any-alterations or deviadonsfmm ons-involving-extra-cosh will be executed only after written orders,and will become an extra charge over and above the estimate.Owner to carry fire,tornado and other nee .Workmen-s- ensaden-aad-pubfic-UabilitjWsurance's to be taken out by the contractor and his sub contractors. - Respectfully submitted William N.Hovanasian 8/23/01 We may withdraw this proposal if not accepted within 60 days. Acceptance of Proposal The above prices,.specifications and conditions are satisfactory and are hereby accepted.You are authorized to do-the-work as-specified:Payn�pt will be made as outlined. Signature: Signature: Date: (4 of 4) as�rn¢� Pro f(o3.pd-V/c 6 r P) ak- ; N�� -zy v fit), ll-3 ..l/?s&JO 7t/ -r � . SIJ. �} �► v� �-- �►� Eva 1�.�d � � � S�� 'a� � " cm n� � Cc o > mc 03 v ae Go oy, _� d 1✓n n©"� ., ;° ZDV mo a c � �►nom` � � --_� �r PU ------_____, �-- � R m eD 414—l h Oda) A Oct f lS�l'► �y TJ3 Kil Jai A)4 y Pr-e s u r-�- f-kctTtw n,� r, eg n c,^<,Te AORT#i own o _ ED- / Andover No. 1 ?3 -� z �0 LA o� dower, Mass., /D — m , y ORATED APP BOARD OF HEALTH PERMIT T D . Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT.......r' .. ..... .V r'....... �...�.w.V.....A.S...................................................................... Foundation �- -n �S has permission to erect......./...:��!'��................ buildings on ......1..b................ .... �.'� ?C......................... Rough to be occupied as..... cS em g A' :P m ��C . Chimne .................. ................................................................................. y provided that the person accepting this permit shall in every respectconform 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 Insp ction, Alteration and Construction of Buildings in the Town of North Andover. �,a ,/ q1 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION TARTS ELECTRICAL INSPECTOR /� Rough .... ,.....".C. .......................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. Town of North Andover OORTH O iteo 6'9� Building Department �,? 9°;�� o 27 Charles Street 0 .. 1 North Andover, Massachusetts 01845 (978) 688-9545 Fax (978) 688-9542 0144ret) FX COCwI[ WKK ACHUS'-- APPLICATION FOR CERTIFICATE OF OCCUPANCY/INSPECTION ADDRESS LOT NUMBER # 6 SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIG - F'S MUST BE COMPLETED WITHIN THIS TEME FRAME. A RE- C_T N FEE O TY- ($25.)DOLLARS WILL BE CHARGED IF CTURE O ALL APPLICABLE CODES. SIGNA OFFICIAL USE ONLY ROUTING CONSERVATION A DATE lo PLANNING ff �.""..`.. DATE D.P.W. —WATER MiTER /1 d DATE L111�0/0 IT W D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIO T THE INSPECTION/REQUEST DATE. SIGNATURE/DPW AUTHORIZATION s V40RTH Town of _ Andover �O CH LAI E 2 I y h over, Mass., �q k�V RATED 7 H E BOARD OF HEALTH Food/KitchenPERMIT T D ,�� Septic System THIS CERTIFIES THAT �� k BUILDING INSPECTOR R d V r 0 .................. ... .... .............. / r "•• Foundation �At / �� ���� Aw has permission to erect............1.................. ........ buildin s on ........................ Rough �,LcCi c � ,.... ......�.. ...... ,. s ��I..... t i� �o �� Chimneys� — to be occupied as. rODIM r.................. ��y provided that the person accepting this permit shall in every respect conform to the terms of the applica ion 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. N 16 11 1014 PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough , ,v PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTION ST TSS ELECTR AL llVSPECTOR .. ...... ... ......... ... Rough ............ .. .......... ..... ........................... ..... Service BUILDING INSPECTOR _ Final 'Occupancy Permit Required to Occupy Building GASINSPECTOR Rough w ' Display in a Conspicuous`Place on the Premises — Do Not Remove 1� t4 No Lathing or Dry Wall To Be Done Until Inspected and Approved by the Building Inspector. Burner FIR EPARTMENT a ��_ Street No. ` SEE REVERSE SIDE Smoke De CERTIFICATE OF USE & OCCUPANCY Towyn of North Andover Building Permit Number a Date 4/_ a© -of 0/ THIS CERTIFIES THAT THE BUILDING LOCATED ON 16 q JA- 0nez:F/ -PO Ud po d C1 MAY BE OCCUPIED AS I/L 1 c- /.4m, I m f-- IN ACCORDANCE WITH THE PROVISIONS OF THE MASSACHUSETTS STATE BUILDING CODE AND SUCH OTHER REGULATIONS AS MAY APPLY. g Rvov.s, o-92 'lj- O N143/ 3 O• MO,.ReYq, , CERTIFICATE ISSUED TO / C O � o ADDR SS 49 t i be, 'e Building Inspector . ,JSACNUS� Town of North Andover o& NORTH .��, Building Department 32 g°`.I 'b`6 0 27 Charles Street o North Andover, Massachusetts 01845 * ,� (978) 688-9545 Fax (978) 688-9542 LAKS OCOCMI[t![WICK 1' 4 140 ��SS•4CHU5���� APPLICATION FOR CERTIFICATE OF OCCUPANCY/ INSPECTION ADDRESS LOT NUMBER 7 SUBDIVISION DATE REQUEST FILED DATE READY FOR INSPECTION FIVE (5) DAYS NOTICE PRIOR TO CLOSING DATE IS REQUIRED ALL WORK AND SIG - F'S MUST BE COMPLETED WITHIN THIS TIMEFRAME. A RE- CT N FEE O NTY- ($25.)DOLLARS WILL BE CHARGED IF HE �RCCTURE O ALL APPLICABLE CODES. SIGNA OFFICIAL USE ONLY ROUTING fir/ ` �► ��� l / CONSERVATION DATE PLANNING ( ,4 v DATE D.P.W. —WATER TER �b 60 DATE � 1 0� D.P.W. MUST INDICATE THAT THE WATER METER HAS BEEN INSTALLED PRIG T THE INSPECTION REQUEST DATE. SIGNATURE/DPW AUTHORIZATION 34 '13 Date No✓;�,2 t p bHORTM TOWN OF NORTH ANDOVER 0 � op PERMIT FOR GAS INSTALLATION s i � • SACHUSEt This certifies that . . . has permission for gas installation 10--5 Z in the buildings of . . .e��1 /,i-- A) . . . . . . . . . . . . . . . at . l.S. .S. . ? tr►a. /�u�t!�. , North Andover, Mass. Feei35.ov. . . Lic. NoPM! -Uy 6/wp ck - /GASRSPECTOR WHITE:Applicant CANARY:Building Dept. PINK:Treasurer t y MASSACHUSETTS UNIFORM APPLICATON FOR PERMIT TO DO GAS FITTING Y f ��Type or print) Date `�- � Z 0 C, NORTH ANDOVER, MASSACHUSETTS Buildiniz Locations �� ���'"4r ��� 61: Permit# 0*13 Amount S �S oc7 Owner's Name New t� Renovation ❑ Replacement ❑ Plans Submitted ❑ Z: Z sua -a :% SEytETr — — — BASE .vt EN r IST. F L 0 0 R 2N D . F L O O R 3 R D . F L O O R 1T 1I . F L 0 0 It A 5'r 11 FLO U R 6 T II F I. 0 0 R 7-17 If FL00It Y 3T I1 F LY) O R (Print or type) y^ f �[ Check one: Certificate Installing Company Name �'�TE / /r���I ❑ Corp. Address �� �IJ7`GJdrrGj tU� ❑ Partner. Business Telephone �i2�{ �� SS� ❑ Firm/Co. Name of Licensed Plumber or Gas Fitter INSURANCE COVERAGE Check one: I have a current liability Insurance policy or it's substantial equivalent. Yes ❑ No❑ Ifyou have checked yes_ please indicate the type coverage by checkingthe appropriate box. Liabiiiry insurance policy tQ-�. Other type of indemnity F7Bond ❑ Owner's Insurance Waiver: I am aware that the licensee does not have the Insurance coverage required by Chapter 142 of the Mass. General Laws, and that my signature on this permit application waives this requirement. Check one: Signature of Owner or Owner's Agent Owner ❑ Aizent ❑ I herebv certifv that all of the details and information I have submitted (or entered) in above application are true and accurate to the best of my knowledge and that all plumbing work and installations pertormed under Permit Issued for this application will be in compliance with all pertinent provisions ofthe Mass chusetts State Gas ode :clhnapte,,&-4," ,fhe General Laws. Bv: Signature of Lil 'ed Plumber Or Gas Fitter Title umber M, �nt� CltviTown ❑ Gas Firter (cense Numoer " lir �PPRO�"ED uFric:= usF ,N�.Y, ❑ Joumeyman Location 416 614' Ao.."d kd No. a 8 S Date 6-a 0 -66 NOR7►� TOWN OF NORTH ANDOVER + : + Certificate of Occupancy $ �sJ�cHusEt� Building/Frame Permit Fee $ Foundation Permit Fee $ �U 0' r Other Permit Fee $ TOTAL $ Check # 3 Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE, OR DEyMOLLISH�A ONE OR TWO FAMILY DWELLING BUILDING PERMIT NUMBER. ��} DATE ISSUED. SIGNATURE: ON Building Commissioner/I for of Buildings Date SECTION 1-SITE INFORMATION o 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: OD Zoning District Proposed Use Lot Areas Frontage ft 1.6 BUILDING SETBACKS ft Front Yard Side Yard Rear Yard Required Provide ReqWred Provided ReqWred Provided 6c 1.7 Water Supply M.G.L.C.40. 54) 1.5. Flood Zone Information: 1.8 Sewerage Disposal System: Public J6 Private ❑ Zone Outside Flood Zone Municipal K On Site Disposal System ❑ SECTION 2-PROPERTY OWNERSHIP/AUTHORIZED AGENT 2.1 Owner of Record t4�q z �e l e�,g�d �,— ,ua. A.,•day e Name(Print) Address for Service: Gt/ �� YG gnature Telephone 2.2 Owner of Record: Name Print Address for Service: z M Signature Telephone SECTION 3-CONSTRUCTION SERVICES 3.11%'censed_Construction Supervisor: Not Applicable ❑ evea LiceiV, r�onstruction Supervisor: License Number Wn Address 74 Y' z /� / Expiration Date gnature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Company Name M Registration Number Address z Expiration Date !d Signature Telephone 6e' b SECTION 4-WORKERS COMPENSATION(M.G.L. C 152 § 25c(6) Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yes.......0 No.......❑ SECTION 5 Description of Proposed Work(check au applicable New Construction � Existing Building ❑ Repair(s) ❑ Alterations(s) ❑ Addition 0 Accessory Bldg. 0 Demolition ❑ Other 0 Specify Brief Description of Proposed Work: SECTION 6-ESTIMATED CONSTRUCTION COSTS Item Estimated Cost(Dollar)to be 'OFFICIAL USE ONLY ' Completed by permit applicant . 1. Building (a) Building Permit Fee Multiplier Q ' 2 Electrical (b) Estimated Total Cost of 0 40 ov— Construction 3 Plumbing Building Permit fee(a)X tbl 4 Mechanical HVAC y-p j 5 Fire Protection ��� • -tN 6 Total 1+2+3+4+5 L Check Number SECTION 7a OWNER AUTHORIZATION TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, (iJl�/ YGfit /42t.117e/ k_ ,as Owner/Authorized Agent of subject property Hereby authorize -4 e(l /'C'Nyev to act on My behalf,in all matters relative to work authorized by this building permit application. Signature of Owner Date SECTION 7b OWNER/AUTHORIZED AGENT DECLARATION I, as Owner/Authorized Agent of subject property Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief Print Na Sieo&of Owner/Agent Date NO.OF STORIES a SIZE BASEMENT OR SLAB OTA 5 0-1eA-17 SIZE OF FLOOR TIMBERS ' G 1 sT 2 ND 3 SPAN 'i DIMENSIONS OF SILLS DIMENSIONS OF POSTS DIIv1ENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS /o SIZE OF FOOTING /U'' '' X MATERIAL OF CH IVINEY t,4 ti��ti CG IS BUILDING ON SOLID OR FILLED LAND S� ; IS BUILDING CONNECTED TO NATURAL GAS LINE FORM - U - LOT RELEASE FORM INSTRUCTIONS: This form is used to verify that all-necessary approval/permits from Boards and Departments having jurisdiction have been obtained. This does not relieve the applicant and or landowner from compliance with any applicable requirements. APPLICANT �.L`s s{'% _/fes -PHONE Cl ASSESSORS MAP NUMBER LOT NUMBER l6 SUBDIVISION LOT NUMBER STREET T PdSTREET NUMBER 7 5 .......................... OFFICIAL USE ONLY.....,..�E�iU......... .. ......................................■...........■ - ■.■/......... . ......E■ RECOMMENDATIONS OF TOWN AGENTS TZDATE APPROVED 5 CO SERVATION ADMINISTRATOR r DATE REJECTED Y4 COMMENTS e r t. DATE APPROVED b 0 TO PLANNER i ^ n DATE REJECTED COMMENTS QL In C P n JA Qk,t' 2412TI(In-01 S&k_0aJCkf 11 - CPre_ DATE APPROVED FOOD INSPECTOR-HEALTH DATE REJECTED ��� 1 DATE APPROVED SEPTIC INSPECTOR-HEALTH DATE REJECTED COMMENTS PUBLIC WORKS-SEWER/WATER CONNECTIONS DRIVEWAY PERMIT [J -L_'U/ 61 DATE 4PROVED FIRE PrEEPARNENT DATE REJECTED COMMENTS RECEIVED BY BUILDING INSPECTOR DATE F ' f MERRIMACK ENGINEERING SERVICES, INC. PROFESSIONAL ENGINEERS • LAND SURVEYORS • PLANNERS 66 PARK STREET•ANDOVER,MASSACHUSETTS 01810•TEL(978)475-35555.373-5721 •FAX(978)475-1448• E-MAIL:merreng@aol.com May 31, 2000 Town of North Andover Planning Board 27 Charles Street North Andover, MA 01845 RE: Assessors Map #62, Lot #6 Essex North District Registry of Deeds Book 4636, Page 159 Members of the Board: Please be advised that I have inspected the site and have surveyed it and the site is located over 500' from the high water mark of Lake Cochichewick. Given the above, please do not hesitate to contact me should you have questions or comments. Very t ly ours, ME INEERING SERVICES . r St p E ap' i, R.L.S. Pre,ede cd r STEVEN J. D'URSO Registered Professional Sanitarian New Hampshire Designer Certified Soil Scientist Site Plans Wetland Scientist Soil Tests Wetland Delineations Soil Surveys Wetland Replication Plans Septic System Designs Mr . Rob Ahern 1501 Main St Unit # 47 Tewksbury, MA 01876 May 26, 2000 Dear Mr . Ahern, On May 24 , 2000 a Wetland Si Le Investigation was conducted on Great Pond Road (Planik 4804 ) consisting of 41, 000 and surrounding land formerly of Mazurenko . An area of 325' around the proposed foundaLion was examined . The lot and adjoining woods (east & west ) is dominated by Oak, W. Ash, Pine, Birch and Maple . The shrub/sapling Layer contains much the same in addit..ion to scattered stands of Highbush Blueberry and Arrowwood . Poison Ivy is -plentiful as ground cover. Soils are non-hydric . The area to the rear appears to be a fallow corn field and is also non-hydric . Soils are a mod-well drained Charlton FSL on a 8 - 15% (see pg. 30 Essex County N Soil.. Survey) . 22 l..11k, Pend Rodd STEVEN J. D'URSO Boxford, MA 01.921 Environmental Designs (978) 352-9872 In conclusion, the lot (Plan# 1804 ) and 325' around the proposed foundation is forested and farmed uplands with no wetlands present . If you should have any questions or comments, please do not hesitate to call me . Sincerely your, Steven, J. D' Urso Environmental Designs SJD/cab Inc : USGS ---- -- _ j I __ ;1.I r + . t ;1141 . {I I III t1Vt.,. ;`' I II f1 .t 1 1,.11 (. 1' !�{ It I r' I 1'11 1 Y. ' { . . . , I r . . iit 16 V 3 , '� r( f ,�i - ''I 1II II I11 II - - - _ i 1, I I.f'1,, , •li,IIY I!I 1; , 'W.' - I•II i #�... I ,(itt(� I ,%'. lIi ,,ili 11,' �li'lri r' 11-: + I 14"I. I 11 r ,''I, I 1 I 1 ,i,f YI . _ 1I .. . • t ,, pl II f I I -tt;l' '111 i I 1: .1lir 11 1 '?I.', .li I 1.r11. it 'III ;r I' . I. 21 }�. - !r 1 IIIc "1 f I'!I I1 r. �: ! I.r I I.I r yIr`. ;{ r f r Bili t I 111 j'r` ;VIII.. I f f I J , I I I' ', ,,, I 4tl'i{�ry''I e�I j J 1i r Irl r a 1 , 0. ,I i I 1 I l l c; Iy { .`, , �.r I' I 1.I� I 1 �' Ii I( a: . tjr ' ",:.,.1; 1f]+lt L i Ittl .1 Ir i .1 i`.�.� fi e ; #i ij . II I'11 N r{4- :'I I .t , I'I. f1 'i.s j- llgf Yr' `f(if " I." I.I, , I 1 11 U ii p1, I 1, I 111 } 1 It�ifr f't 1 r. ,4i1 i I Ii I 1 11 I' I 4 ; I , ! t t1lf h}, II.I�,IIt.I i III}I� `,} ' • I tI.'p / I ,. 1 ',_,.._�_yh.: .._ 1_' _—.. .I.f,_Ir:!!... .J .1.,..�.... 1 • it 111 i a F'i 'tt I I,. '1 if I I -;L { ii. I _�> L/097LI1t492U/PiL O�✓!�(.C7.d6CLCitA/Gr,�4 tiII{ 11 Illi) rr r�;I+-` BOARD OF BUILDING REGULATIONS ''I rI' ` I',License: CONSTRUCTION SUPERVISOR f I �1' + ,^ i . �d' r ` 029340 ` ; 11 Number CS 1I %,; Birthdate. OZ/27N960 ` 3 I 1 A.� • • ' I>.i 1. ,' j . 4 Expires:02127/2002 Tr.no: 14186 I1. 1 ;iil'I`5 { _1.w a Ys.� , p Restricted To: 00 �1.` r} . �: RUSSELL F AHERN 1f; i' '; rr 621 RIVERSIDE AVE �� I,;I' i' ', t,' ','`' HAVERHILL, MA 01830 Administrator '' i+1'� t.l t"t II S I I�P II I} I 1 1, I 'T.1j A.. I 4f Ijr .�I ,f I III ; The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations Boston, Mass. 02111 Workers'Compensation Insurance Affidavit Please Print Name: tr✓3 S e(/ e,2,,j Location City '✓�'Z Phone F-1 am a homeowner performing all work myself. 01 am a sole proprietor and have no one working in any capacity EETI am an employer providing workers' compensation for my employees working on this job. Company name �����N L',��_ r)'-e�Gl Address � Z-A,k-e y e.,, City /J,,?may{-c -ci7 " ./'T! Phone#: S_ 7 Insurance Co e611611) Policy# LA; e s�ejg,�?6 -7 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 penalties in the form of a STOP WORK ORDER and a fine of($100.00)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 herby certify unde pains an nalties ry that the information provided above is true and correct. Signature Date Print name r6v s s of Phone# 7eS?,-- J-) 7%' Official use only do not write in this area to be completed by city or town official' ❑ Building Dept ❑Check if immediate response is required Building Dept ❑ Licensing Board ❑ Selectman's Office Contact person: Phone#: ❑ Health Department ❑ Other FORM WORKMAN'S COMPENSATION Town of North Andovera� NORTH o Building Department 27 Charles StreetJK North Andover, Massachusetts 01845 ?, e LA1 (978) 688-9545 Fax (978) 688-9542 �s Q°AArfo 9SSACHU`��� DEBRIS DISPOSAL FORM In accordance with the provisions of MGL c 40 s 54, and a condition of Building permit # the debris resulting from the work shall be disposed of in a properly licensed solid waste disposal facility as defined by MGL cl 1, s150a. The debris will be disposed of in/at: i-ez Facility location Signature of Applicrht Date ` NOTE: A demolition permit from the Town of North Andover must be obtained for this project through the Office of the Building Inspector. N2 3866 Date . p10ATFr o�°` •' °9 TOWN OF NORTH ANDOVER *°° RECEIPT r o ty 9`SSgCHUs�� This certifies that...........ev.5.S4%�..!! ........ ..... v.�. r. .. haspaid.... ............. ........ ��................................... 47-e2. �7for.......... .�i Ll�'........ . �'''Y1Q. 4 :�1.� - Received b l' y............................ ...... ...... ... .. ...... .................. Department .......................L....il. .`..l C.... © .............. WHITE: Applicant CANARY:Department PINK:Treasurer 5350 APPLICATION FOR SEWER SERVICE CONNECTION North Andover, Mass. `J`'�l '7 Application by the undersigned is hereby made to connect with the town sewer main in�f�h 4�lCtCG' StrceT— subject to the rules and regulations of the Division of Public Works. The premises are known as No. f Y - / Street or subdivision lot no. L 6f U3� Com( �l l / Z� l��/ �S �I zs E Owner Address Contractor Addr s " plicant's Signature PERMIT TO CONNECT WITH SEWER MAINLl The Division of Public Works hereby grants permission to J r "7 to make a connection with the sewer main at �7�ec 7 Street subject to the rules and regulations of the Division of Public Works.. Divron of Public Works By 7 Inspected by Date See back for rules and regulations No 987 '',APPLICATION FOR WATER SERVICE CONNECTION North Andover, Mass. V �� 44--- Application by the undersigned is hereby made to connect with the town water main in subject to the rules and regulations of the Division of/Public Works. The premises are known as No. rcrrea Street or subdivi ion lot no. Owner Address 7 Z2?? Contractor Addr s pplicant's Signature �J 00 ,eqD i � e PERMIT TO CONNECT WITH WATER MAIN n Z The Board of Public Works f�hereby grants permission to S 1 C'/ to make a connection with the water main at Street subject to the rules and regulations of the Division of Public Works. Bo rd of Pu lic Works By . Inspected by Date See back for rules and regulations i GROWTH MANAGEMENT BYLAW EXEMPTION STATEMENT TOWN OF NORTH ANDOVERBUILDING DEPARTMENT This form shall be used to assist the Building Department in their determination of exemption under section 8.7.6 of the Town of North Andover Growth Management Bylaw. The applicant shall provide all of the necessary information as requested below. Z)C/9 CG LI- L /Su �5 ear F ,�h C,��pe)-d Ga 116 Permit Applicant Property address Map/Parcel 2-7e 37a 99,79 Applicant's Phone Number Single Family Two Family I the undersigned applicant for the above property attest that the attached building permit for which this form is completed does comply with the EXEMPTION section 8.7.6 of the Growth Management Bylaw.I also understand providing this form does not absolve me or any party to this permit from the requirements of obtaining other permits required prior to the issuance of the building permit.Further I understand that my interpretation of the exemption status is subject to review by the Building Department and is only officially accepted when the building permit is issued Based on section 8.7.6 of the North Andover Growth Bylaw the above lot and the work as applied for on the above lot,in the building permit application and associated attachments,complies with one or more of the following sections as indicated by a check mark. This is an application for a building permit for the enlargement,restoration or reconstruction of a dwelling in existence as of the effective date of this bylaw,provided that no additional residential unit is created The lot(s)was/were created prior to May 6,1996 and are exempt from the provisions of section 8.7 of the Zoning Bylaw. This application is for dwelling units for low and or moderate income families or individuals,where all of the conditions of 8.7.6 are met and or represents dwelling units for senior residents,where occupancy of the units is restricted to senior citizens through a properly executed and recorded deed restriction running with the land.For purposes of this section"senior"shall mean persons over the age of 55. This application is part of a development project which voluntarily agreed to a minimum 40%permanent reduction in density(buildable lots)below the density permitted under zoning and feasible given the environmental conditions of the tract,with the surplus land equal to at least ten buildable acres and permanently designated as open space or farmland.The land to be preserved shall be protected from development by an Agricultural Preservation Restriction,Conservation Restriction,dedication to the Town,or other similar mechanism approved by the planning board that will ensure its protection. This application represents a tract of land existing and not held by a Developer in common ownership with an adjacent parcel on the effective date of this Section 8.7 and shall receive a one time exemption from the Planned Growth Rate and Development Scheduling provisions for the purpose of constructing one single family dwelling unit on the parcel. This application represents a lot which is ready for a building permit(all other permits from all other boards and commissions have been received and the project is in compliance with those permits),and the Development Schedule does not accommodate issuing a building permit in that year.One building permit will be issued per year per Development until such time as the development schedule accommodates issuing building permits.Applicant must submit an approved FORM U with this EXEMPTION. PLEASE PROVIDE ANY AND ALL INFORMATION THAT WOULD ASSIST THE BUILDING DEPARTMENT IN MAKING A DETERMINATION THAT THIS APPLICATION IS ALLOWED UNDER ONE OR MORE OF THE ABOVE EXEMPTIONS. BY SIGNING BELOW I ATTEST TO THE ACCURACY OF THE INFORMATION PROVIDED AND THAT THE ATTACHED BUILDING PERMIT IS ALLOWED AN EXEMPTION AS CITED ABOVE. FURTHER I UNDERSTAND THAT THE SUBMITTAL OF MISLEADING OR INACCURATE INFORMATION OR THE CHECKINOFF OF OVE EXEMPTIO ICH DOES NOT COMPLY,WHETHER DONE TO MY KNOWLEDGE OR NOT IS fa:�71) OR F ING DEPARTMENT TO ISSUE A BUILDING PERMIT. LICANTS SIG&ATURf DATE THIS FORM TO BE ATTACHED TO THE BUILDING PERMIT APPLICATION A t 4 Massachusetts Energy Code P-ermi t .#. r�r` M4,.....:e:..._ SC..,,ware llQr.��,1.-o.n. .2 . a„[`.r. Release 4 'tzF Cn- -ke-d byr'Da t e 4 CITY: „-CITY:. North An-.unlo ST M"`zz-c tuE-et ts 13�-MD: 63 2 2 .. C-- :STRU CTI al T` P ::: I ox 2 De ta. d f"IL ATI - SYSTEM- [SY EM 1 2]:f+ : "O-t Y t 1 .(.p3TO-L 1 ec t r i"l. Y`Few`~'3 i.`s t a ynCc,&_) ... D.KM. 5-7-210)00 DATE' OF 7 � T IFIFLE: Great Pond Road No Ando v-e r PROJECII INFORMATION, Single lama ly Residence m. i=A :AMY INFUPMAT ION: = REAC O L L COMPLIANCE: PASSES Your Home 606 Area. or cavity Coat , Glaz iag/Door Perimeter R-Value u-Value T!-Value vr� --------------------------- WALLS r n .. Wood .:_. _t r?_.-._ - 16" ta. r>. .. r+-,8 4a a-a ca. GZa71"iG - Windows or Doors 314 122 2 r' C�tR:ti. 38- la. ..%7a I ii DooRc i9 •. DOORS - 39 10 5.511 14 y Over. Un Candi}Jvier4ASpace Nne 7] A 19 v V nQ WAC ET..i=PME14 , r -'t-`na c e— 8,55 .`i i AFUE ----------------------------------------------------------------------------- COIWPfi..T,i-Mr :XsiE:jdlr The proposed } .iii building design .rure_ssrribQ-11 hj9rs is consistent with the -uildiiig plans, specifications, and other calculations . . . proposed. . _ - �u��itf�� with ��p rArrnir a��_�ratlnP . 3C � ��i3rn� ��s he-,en designed to TisCt tiE. iEquireiieitS of the Massachusetts Energyj_de . ;. �. .. x T�i� ,sating load fo -L i,is building, an t is �0 1 inn load if c.ppropri-ats?, �6� �» has determined using the applicable, SS:t,andard Design Conditio.ps found in the. Code . The HVAC equipmen-t ssle-c-ted to I-,,e.at or cool the building I ' shaall he no. gre-at-eer t'han- .rdesi;-'ZS%- of the gn -toad as p secified ini Sections 78-OCMR 131,&--' -,,GKJ4 . 4 . Builder/ErNas-igne- Date NORTFI Town of _ RAndover o ;: T No. i �; o L_Amo dover, Mass., b °� 00 COCHICHEWICK ADRATED PP���� 1 S BOARD OF HEALTH PERMIT T D Food/Kitchen Septic System THIS CERTIFIES THAT..WA IteRBUILDING INSPECTOR .._.... . Foundation has permission to erect...............�............ .... ..... buildi s on .�.. .�. ... ...�� Rough to be occupied as.. .).a� gA a t��I....Al AC � �•��Il�L�e. Chimney p provided that the person accepting tflis 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-Daws relating to the Inspection, Alteration and Con truction of Buildings in the Town of North Andover. 1 '343A d. PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough Final PERMIT EXPIRES IN 6 MONTHS UNLESS CONSTRUCTI S T ELECTRICAL INSPECTOR • Rough ............. ........ ..... . .................................... Service BUILDING INSPECTOR Final Occupancy Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final T No Lathing or Dry Wall 1 o Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE smoke Det. ORTFI Town. o ''0 Andover No. 0 ndover, Mass., " / 9► " O 0 LAKE COC .'NE WICK �1.9A.0)��A TE D ?YL C, S SACH IT FOR EXCAVATION AND FOUNDATION THIS CERTIFIES THAT .... ....... IPAo) Ko ................................................................................ has permission to excavate and pour foundation ati.40i..4... NAACA RCA MSA wl for the purpose of.. a S�... � ... 151�'��.� The person accepting this permit must return to the office of the Building Inspector a certified plot plan show of building thereon before Foundation will be inspected. M U a P IL VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS The holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS assurance that a permit for entire building structure will be granted. BLDG. PERWIT FEE I 6j 2 bow LESS FDA FEE- b"Wasm DUE FRAMIE PERMIT ..0."�eff.!6.�............................. BUILDING INSPECTOR Location No. U7SS Date g -6 -w NpRT1y TOWN OF NORTH ANDOVER ' Certificate of Occupancy $ � J Building/Frame Permit Fee $ / sACHus Foundation Permit Fee $ Other Permit Fee $ TOTAL $ 13413, - Check 3413'Check # Pw 10, v 5 l�7 Building Inspector G O R 1 HTr, Town o �� �� b n ®ver r CQ Ol CON = LAKE ndover, Mass., / q am d COCHICHEWICK ADQATED p`P ,�5 SSACHUS ITi 1i` FOR EXCAVATION AND FOUNDATION THIS CERTIFIES THAT P�/ ....... .... . . .... has permission to excavate and pour foundation at ................... ..... ........................................ .... for the purpose of... ACID s. .v � ,.. ����' �•�, ................... .1....... .. ..................... . ..... ... .............. I. ....... ................ . . The person accepting this permit must return to the office of the Building Inspector a certified plot plan show of building thereon before Foundation will be inspected. r ` at IL VIOLATION of the Zoning or Building Regulations Voids this Permit. PERMIT EXPIRES IN 6 MONTHS The holder of this Foundation Permit proceeds at own risk and without UNLESS CONSTRUCTION STARTS assurance that a permit for entire building structure will be granted. BLDG. PURRIFT FEE I y 2 - LESS FDA FEE DUE FFAM.E PERMITe ✓'' BUILDING fNSPECTOR 4 { TOWN OF NORTH ANDOVER, MASSACHUSETTS DIVISION OF PUBLIC WORKS 384 OSGOOD STREET, 01845 J.WILLIAM HMURCIAK, P.E. Telephone(978)685-0950 DIRECTOR Fax(978)688-9573 � p10RTly �2 oESt`ED ,641,0 O m 7 Oy PP`y TED> �y SA US DRIVEWAY PERMIT DATE Q vc, 2 zDD O. LOCATION PeIVI BUILDER phone OWNER POS5 A qEP k hone q76 3?2- 2Z? THE NORTH ANDOVER SUPERINTENDENT OF OPERATIONS MUST BE NOTIFIED OF THE GRADE AND SETBACK FROM STREET . CALL THE SUPERINTENDENT'S OFFICE BEFORE FINISH GRADING AND SURFACING FOR APPROVAL OF SUCH ENTRY. FAILURE TO COMPLY AND OBTAIN APPROVAL VOIDS THIS PERMIT. A 5 5 N° 3 Date......... �:..�'�..... Of NO°TM,ti TOWN OF NORTH ANDOVER o ' PERMIT FOR WIRING s � i �,SSACMUS� p This certifies that ..�.............,r....; >„f': �..... ....................... has permission to perform ........ ...........-. ........................................................ wiring in the building-of...............��-'- . at �S_ ....................................................ef ,North Andover,Mass. Fee.....ur............ Lic.No. .., ....................................................... ELECTRICAL INSPECTOR r Check # WHITE:Applicant CANARY: Building Dept. PINK:Treasurer TRF09A MUNWEALT71OFMAW CHUSETTS Office Use only DEPART3IFM'0FPUBLICS4FM2 Permit No. cJU� BOARDOFMEPREYEM ONRWUMT10AN527CMR12.010 Occupancy&Fees Checked i APPLICATION FOR PERMIT TO PERFORM ELE=CAL WORK ALL WORK TO BE PERFORMED IN ACCORDANCE WITH THE mmsACHUSSTS ELECTRICAL CODE,527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMATION) Date Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below.n Location(Street&Number) Owner or Tenant_ /91/7`4 ve^ Qe On&/as Owner's Address -5119 Is this permit in conjunction with a building permit: Yes[ErNo r7 (Check Appropriate Box) Purpose of Building 1X01 c e Utility Authorization No. Existing Service Amps Volts Overhead a Underground No.of Meters New Service Amps Volts Overhead r--j Underground No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work , zl d' No.of Lighting Outlets No.of Hot Tubs No.of Transformers Total KVA No.of Lighting Fixtures Swimming Pool Above Below Generators KVA ground El ground No.of Receptacle Outlets No.of Oil Burners No.of Emergency Lighting Battery Units No.of Switch Outlets No.of Gas Burners No.of Ranges No.of Air Cond. Total FIRE ALARMS No.of Zones Tons No.of Disposals No.of Heat Total Total No.of Detection and J� Pumps Tons KW Initiating Devices No.of Dishwashers Space Area Heating KW No.of Sounding Devices 1 No.of Self Contained Detection/Sounding Devices +to.of Dryers Heating Devices KW Local Municipal Other Connections No.of Water Heaters KW No.of No.of Signs Bailasis No.Hydro Massage Tubs No.of Motors Total HP OTHER lrt =xeCaraage Ra ntiDthetegtnana isdNimmdwsMG=WLaws Itmeaaxa4Liabtd'yhsi a=Pbh}'irrhidmgCarPi* * CaaaWcrdsmkstattuic*rivalat YES NO lha`eaftnaedvatidprodafsametothe011roe YES M NO If}puha%edvcWYFS,plemmdc*thetWOfW�aWdWbydxckirgthe ffBOND OTE&R (PlemSpa*) l�xi'iition Date F&rgWdVak edUedncal Wok$ WakbStart U,1 jc h> riD*RW,*d RaO Fetal Sigttedtetda�ie ofP*"" .� FIRMNAME L;t> eNa /�9.TiC 1(,2( G o is N't SlgtaEtne H„ CPf/YDl s`i`' 9M L6 �� 'f /��' Alt.Tel.Na OWNER'SiNSURANCEWAIVER;Iamawatethattheliarmdoes notlheatsiratoeDDver orBssul lrrbalegt> lentastecpmtiidby�LateralLaws anddratmysemftpeme"tappkMmwainthistac�attert (Please check one) Owner M Agent a Telephone No. .PERMIT FEE E Date.. N° 2 613 �....a�.:..�... f �4ORTH 1 TOWN OF NORTH ANDOVER ' p PERMIT FOR WIRING SSACHUSE� This certifies that ..`� --�- r ' .. ` { I has permission to perform .� -.t-- � wiring in the building of at. ... .. `5... .......,North dover,Mass. Feed <,.. .......Lic.No. L '""``. .! r..:. ........... + ELECTRICAL INSPECTOR Check # `;W) WHITE:Applicant CANARY: Building Dept. PINK:Treasurer Official Use Only \ Permit No. 6�7 79,4ss,46" s577s t�),0 ( BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Occupancy&Fee Checked APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code 55jj2��7 CMR 12:00 (Please Print in ink or type all information) Date %—Z&` 0-e Town of North Andover To the Inspector of Wires: The undersigned applies for a permit to perform the electrical work described below. Location(Street&Number 7 S (5 1.eij4 100 A,'/ Owner or Tenant Owner's Address Is this permit in conjunction with a building permit Yes Y No ❑ (Check Appropriate Box) Purpose of Building �C( S/ err j�f k Utility Authorization No. Existing Service Amps Voits Overhead ❑ Undgrnd ❑ No.of Meters New Service Amps Voits Overhead ❑ Undgmd ❑ No.of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work No.of Lighting Total Outlets No.of Hot fuse No.of Transformers KVA Above ❑ In ❑ No.of Lighting Fixtures Swimming Pool grnd ❑ grnd ❑ Generators KVA No.of Receptacles Outlets No.of Oil Burners No.of Emergency Lighting Batte Units No.of Switch Outlets No of Gas Burners FIRE ALARMS No.of Zone Total No.of Detection and No.of Ranges kNo. Cond Tons Initiating Devices Heat Total Total No.of Di osal Pumps .Tons KW No.of Sounding Devices No./of Self Contained No.of Dishwashers ea Heatin KWDetection/Sounding Devices ❑ Municipal ❑ Other No.of Dryers Heating Devices KW Local Connection No.of No.of Low Voltage Nov of Water Heaters KW Signs Bailases Wirin No.Hydro Massage Tuds e No.of Motors Total HP ETHER: 2y/-OI Lf-i' A-Ar x- ' SURANCE COVERAGE. Pursuant to the requiremen6ts of Massachusetts General Laws klave a current Liability Insurance Policy including Completed Operations Coverage or its substantial equivalent YES= NO = 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 6,-B-OND = OTHER = (Please�Speciffyy) �Q Estimated Value of Electrical Work$ &ly!v , (Expiration Date) Work to Start — 7/p—O-el Inspection Date Resquested Rough Signed under th—e P Ities f perjury: Final FIRM NAME 01 DD ^ /� n ar LIC.NO. Lkensee/'-If1//(e 0-14 ✓f/��//(//n� Signature --1 LIC.NO. y�, -Z /`/! / �J Bus.Tel No. /CJ " to 92 Address ,ry �/ti��NG2 Alt 7 Tel.No. OWNER'S INSURANCE WAIVER: I am aware that the Licenses does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws.And that my signature on this permit application waives this requirement. Owner Agent (Please Check one) Telephone No. PERMITTEE $&J (Signature of Owner or Agent) N° 26x00 Date......................... ...... f NORTH 1 ° t"'°:• "� TOWN OF NORTH ANDOVER PERMIT FOR WIRING �,sSACHU f This certifies that ..�`. ...... �..... .�... . '�?- "�........ .�,.............. .... has permission to perform .... :.... ......................................................... wiring in the building of /z ,./�.............. . ..��..../.,............................................ at.... ......-�...... .. ! North Andover,Mass. Fee.................... Lic.N .... ........ .jam..... ................... /p ELECTRICAL INSPECTOR Check # �'7O WHITE: Applicant CANARY: Building Dept. PINK:Treasurer Rough Service Final 01 � t>� 0114e Ovmmnnweultll of Masaacllusetw Office Use Only Department of Public Safety Permit No. BOARD OF FIRE PREVENTION REGULATIONS 527 CMR 12:00 Occupancy & Fee Checked —3 3/90 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance with the Massachusetts Electrical Code, 527 CMR 12:00 (PLEASE PRINT IN INK OR TYPE ALL INFORMAT N) Dat �d City or Town of I��� A��r LTo the Inspector of Wires> The undersigned•applies for a permit to perform the electrical wo escnbed below. Location (Street & Num ) (/ X C�— Owner or Tenant Owner's Address r lL L Is this permit in conjunction wit a buildin permit: Yes No (Check Appropriate Boz) oail a2� Purpose of Building ��,,,��� ` Utility Authorization No. ��,—,— Existing Service Amps / Volts Overhead ❑ Undgrd 11 No.of Meters New Service W ArttPs- �=Volts Overhead 1:1Undgrd Q No. of Meters Number of Feeders and Ampacity Location and Nature of Proposed Electrical Work TOTAL No.of Lighting Outlets No. of Hot Tubs No.of Transformers KVA Above In- No. of Lighting Fixtures SwimmingPool rnd. ❑ rnd. ❑ Generators KVA ! No.of Emergency Lighting No. of Receptacle Outlets No. of Oil Burners Battery Units No. of Switch Outlets No. of Gas Burners FIRE ALARMS No. of Zones otai No.of Detection and No. of Ranges No. of Air Conditioners Tons Initiating Devices Heat Total lotalNo.of Sounding Devices. No. of Disposals No. of Pumps Tons KW No.of Self Contained Detectio g vices No. of Dishwashers S ace/Area Heating KW Municipal x Local • Connection ❑Other No. of Dryers � HeatingDevices KW No. o No.o Low Voltage p N No. of Water Heaters // KW Signs Ballasts Wiring /.S No. Hydro Massae Tubs No. of Motors Total HP OTHER: INSURANCE COVERAGE: Pursuant to the requirements of Massachusttes General Laws I have a current Liability Insura olicy including Completed Operations Coverage or its substantial equivalent.YES O O:have submitted valid proof of same to this office. YESOU If you have checked YE ase indicate the type of coverage by ch i the propri to INSURANCE BOND ❑ OTHER❑ (Please Specify) / (Expiration Date) Estimated Value of Electrical Work $ Work to Start Inspection Date Requested: Rough Final Signed under the penalties of perju : FIRM NAME N LIC. NO. Licensee Si nature LIC. 0 Address Bus. Tel. No.7 71 P-J-76r6;-- Alt.Tel. No. OWNER'S INSURANCE WAIVER:I am aware that the Licensee does not have the insurance coverage or its substantial equivalent as required by Massachusetts General Laws, and that my signature on this permit application waives this requirement. Owner Agent (Please check one) Telephone No. PERMIT FEES$-&S-? (Signature of Owner or Agent) N° 3 ,- 66 Date NORT1y 4, o? •.T _. O� TOWN OF NORTH ANDOVER '° PERMIT FOR WIRING 41 SSACMUSE� This certifies that ...e..ff............................................................................ has permission to performY " { 7/ 1 ;; ,�5 � .a-- wiring in the building:of.........:. . ..................::......... .................................... j .. at./�< ...................................................... ,North Andover,Mass. Fee:......:......... Lic. . ...............................................................� � wELECTRICAL INSPECMR Check # L1r WHITE: Applicant CANARY: Building Dept. PINK:Treasurer Commonwealth of Massachusetts Official Use Gaily Department of Fire Services Permit No. 36 lP f0 . :._. BOARD OF FIRE PREVENTION REGULATIONS Occupancy and Fee Checked (Rev. 11/991 (leave blank) APPLICATION FOR PERMIT TO PERFORM ELECTRICAL WORK All work to be performed in accordance%with the Massachusetts Electrical Code(MEC),527 CMR 12.00 (PLEASE PRINT IN INK OR TYPE ALL WFORmATION) Date: City or Town ofTo the Inspector of Wires: By this application the undersigned vtves notice of his or her inMX rfkiaa he electrical work described below. Location(Street&Number) � �J S �" &i Owner or Tenant Dia e QM6 Wds Telephone NoA i-r 0/0? Owner's Address Is this permit in conjunction with a building permit? Yes ❑ No ® (Check Appropriate Box) Purpose of Building Utility Authorization No. Existing Sen'ice Amps / Volts Overhead❑ Undgrd❑ No.of Meters New Ser;ice Amps / Volts Overhead❑ Undgrd ❑ No.of Meters Number of Feeders and Ampacity ~ Location and Nature of Proposed Electrical Work 1 Com letion o(the following table may be waived by the Inspector ofirires. No. of Recessed Fixtures INo.of Ceil.-Susp.(Paddle)Fans INo.of Total Transformers KVA No. of Lighting Outlets INo.of Hot Tubs Generators KV A No. of Lighting Fixtures Above ❑ n- ❑ o.o Emergency Lighting Swimming Poo! ornd arnd. Battery Units b a No. of Receptacle Outlets INo.of Oil Burners FIRE ALARMS INo. of Zones No.of Switches No.of Gas Burners No, of Detection and I Initiating Devices No.of Ranges No. of Air Cond. Total No. of Alerting Devices Tons No. of Waste Disposers (Heat Pump I Number Tons KW INo. of Self-Contained Totals: Detection/Alertino Devices No.of DishwashersISpacefAreaHeatin0 I'� . (Local ❑ Municipal El Other Connection No.of Drvers Heating Appliances K'W SccuntySystems: (�► No.of Devices or Equivalent O No.of Water KW No.of No.of Data Wiring: Heaters I Sions Ballasts I No.of Dcvices or Eauivalent No.H}'dromassa-e Bathtubs INo. of Motors Total HP Telecommunications Wiring: No.of Devices or Equivalent OTHER: Attach additional detail if desired,oras required by the Inspector of lVires. 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:) Estimated Value of Electrical Work: O ` Q' (Expiation Date) �O� (When required by municipal poIicy.) Work to Start: 5` I ` O Inspections to be requested in accordance i'ith NEC Rule 10,and upon completion. I certify,under the pains and penalties of perjury,that the information on this'7application is true and contplete FIRI1'I NAME: ADT Security Services 111 Morse Street,Non44 MA 02062 LIC. NO.: 1333C Licensee: John S. Bassett Signatu771, LIC. NO.: 1_533C (IJapplicable,enter"e_zcnnpt"in the licensenumber line.) Bus. Tel. No.: —Address: AIL Tel. No.:603-594-59 lresi OWNER'S INSURANCE WAIVER: 1 am aware iliat lie Licensee does not have the liability insurance coverage normally ONLY required by lar'. By me signature bolo«•.I thereby waive this requirement 1 am the(check one)❑ owner ❑ owner's agent. (l�cnrrtAonnt 0 4-4_A1 AR Location ` No. r'/ V Date J I �� �r f NORT1y TOWN OF NORTH ANDOVER 3?O�t•`•D •,MOL Certificate of Occupancy $ �'�s'••°'�t�' Building/Frame Permit Fee $ swCHU Foundation Permit Fee $ Other Permit Fee $ TOTAL Check # c-,2,s' ' J� Building Inspector TOWN OF NORTH ANDOVER BUILDING DEPARTMENT APPLICATION TO CONSTRUCT REPAIR,RENOVATE,CHANGE THE USE OR OCCUPANCY OF, OR DEMOLISH ANY BUILDING OTHER THAN A ONE OR TWO FAMILY DWELLING :�. L s3, „ � This Section for Official Use Onl �� .. BUILDING PERMIT NUMBER: DATE ISSUED: �J Z SIGNATURE: C Bulldin Commissioner or of Buildings Date SE � 2-2 " 1.1 Property Address: 1.2 Assessors Map and Parcel Number: Map Number Parcel Number 1.3 Zoning Information: 1.4 Property Dimensions: v Zoning District Proposed d Use Lot Area Frontsge(ft) rn 1.6 BUILDING SETBACKS(ft) Front Yard Side Yard Rear Yard Required I Provide Required I Provided R red Provided l 76 t '92 1.7 Water Supply M.G.L.C.40.§54) 1.5. Flood Zone Lrfomration: 1.8 Sewerage Disposal System: Public 0 Private ❑ Zone Outside Flood Zone ❑ Municipal On Site Disposal System ❑ / 2.1 Owner of Record #eTWVt,/, - e� /J a, O Name(Print) Address for Service: �. mT Signature Telephone N -F-A—y", P A-M`u- 2.2 Authorized Agent Gtt�,u� P l,Ji ��, �► 7v Name Print Address for Service: Z Signature Telephone m L90 3.1 Licensed Construction Supervisor Not Applicable ❑ 70 Sa ti w �Ct w re K�e�c_ o t o 3 u Address License Number O 1 -n Licensed Con tion Supervisort /' / ¢� G r7 •� Expiration Date S' ature Telephone 3.2 Registered Home Improvement Contractor Not Applicable ❑ Jv LJ w�Co F� l t g 2a s Company Name. I Registration Number Address ® 'Z-13" Q r Expiration Date Z Signature �1 TelephonetU C5 G) f ,/ SLCTiQI!1*� X�VI{iL�Al7 �#C 1431 © Vf �r +� r=. Workers Compensation Insurance affidavit must be completed and submitted with this application. Failure to provide this affidavit will result in the denial of the issuance of the building permit. Signed affidavit Attached Yea....... No.......0 SECTIOAI S" P)tt455IQI�tA ,bESi1 Al CNSTR[1C"XIt�N SRiCES +t)R 1�33ILUS AlbTRiT1t S S7€313 G`ONSTR1t iC IQN Ct3l�1TItUL PiTATb l 16 CCQQiA ? MQD�359Ii' F)�Vi1SIl II<Sf'A ) 5.1 Registered Architect: Name: Address i Signature Telephone -42:R Name: Area of Responsibility Registration Number Address: Signature Total Expiration Date Not applicable ❑ Name: Registration Number Address _ Signature Telephone Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone y Expiration Date Name Area of Responsibility Address Registration Number Signature Telephone Expiration Date Com Nam Not Applicable ❑ Pant (/� Responsible in Charge of Construction New Construction ❑ Existing Building ❑ Repair(s) 0 Alterations(s) ❑ Addition ❑ Accessory Bldg. ❑ Demolition ❑ Other ❑ Specify Brief Description of Proposed Work: USE GROUP Check as applicable) CONSTRUCTION TYPE A Assembly 0 A-1 0 A-2 ❑ A-3 ❑ IA ❑ A4 0 A-5 ❑ 1 B ❑ B Business ❑ 2A ❑ C Educational 0 2B 0 F Factory ❑ F-1 0 F-2 0 2C ❑ H High Hazard ❑ 3A ❑ IInstitutional ❑ 1-1 ❑ I-2 ❑ 1-3 ❑ 3B ❑ M Mercantile ❑ 4 ❑ R residential ❑ R-1 0 R-2 ❑ R-3 ❑ 5A ❑ S Storage ❑ S-1 0 S-2 ❑ 5B ❑ U Utility ❑ Specify: M Mixed Use 0 Specify: S Special Use ❑ Specify: COMPLETE THIS SECTION IF'EXISTING BUILDING UNDERGOING RENOVATIONS,ADDITIONS AND OR CHANGE IN USE Existing Use Group: Proposed Use Group: Existing Hazard Index 780 CMR 34: Proposed Hazard Index 780 CMR 34: BUILDING AREA EXISTING if applicable) PROPOSED Number of Floors or Stories Include Basement levels Floor Area per Floor s Total Area s Total Height ft Independent Structural Engineering Structural Peer Review Required Yes ❑ No ❑ SECTION 10a Owner Authorization- TO BE COMPLETED WHEN OWNERS AGENT OR CONTRACTOR APPLIES FOR BUILDING PERMIT I, f\K--VN U 'S , '�Z-P—�d U L K S as Owner of the subject property Hereby authorize C'� �--� G �—S to act on My behalf, in all matters relative two work authorized by this building permit application Signature of Owner Date j I, was Owner/Authorized Agent Hereby declare that the statements and information on the foregoing application are true and accurate,to the best of my knowledge and belief. Signed under the pains and penalties of perjury _ Print Name Signature of Owner/Agent Date mw Item Estimated Cost(Dollars)to be Completed b P Y pernut applicant 1. Building (a)a On- � Building Permit Fee Multiplier 2 Electrical (b) Estimated Total Cost of r= Construction from(6) 3 Plumbing Building Permit fee (a)x(b) 4 Mechanical(HVAC) 5 Fire Protection 6 Total (1+2+3+4+5) Check Number gw-�j5 ${,* "a ee` rw,✓ j 4.r.:; ,�7: tx ;)i� J..{7'��. ,E3"IIs e i,. iF` i•.Yp ' tl 1 -r. f JJ'S S. d is v'" �.' k$1 ya 7 Fc ,. +:7Y v$t� v! "rm✓ i leaY;'t - �I,F..-. �t� .ea3*A.i cha�ya t NO.OF STORIES SIZE ` i BASEMENT OR SLAB SIZE OF FLOOR TIMBERS 1sT 2 ° 3RD SPAN DEMENSIONS OF SILLS DEMENSIONS OF POSTS DIMENSIONS OF GIRDERS HEIGHT OF FOUNDATION THICKNESS SIZE OF FOOTING X MATERIAL OF CH ANEY IS BUILDING ON SOLID OR FILLED LAND IS BUILDING CONNECTED TO NATURAL GAS LINE i J FORM U - LOT RELEASE FORM 1 INSTRUCTIONS: This form is used to verity that all necessary approvals/permits from Boards and"Apartments having jurisdiction have been obtained. This does not relieve the applicant and/or landowner from compliance with an a licable or r Y PP equtrements. ""'APPLICANT FILLS OUT THIS SECTION .sArira (��� �P� 7 ' APPLICANT � yrR�], 2 (S �(G�Io/k��14� PHONE � i 7'4 .. 1 "1 �/ '-•f�7 1� ti`t�L] '� 0l9 •L� C�.� ���� .. LOCATION: Assessor's Map Number PARCEL SUBDIVISION LOT(S) t STREET ISS S 11c� �� 2� ST. NUMBER 4 "*"OFFICIAL USE ONLY RECOMMENDATIONS OF TOWN AGENTS: ,R: ka„ CONSERVATION ADMINISTRATOR DATE APPROVED DATE R€JECTED COMMENTS w Los"' gip TOWN PLANNER DATB APPROVED `, DATE REJECTED ;. COMMENTS ; t.. rf 1 FOOD kNS#ECt7 EALTH DATE APPROVED Ery :: DATE REJECTED/V f 1 y SEOTIC INP TO -HEALTH DATE APPROVED DATE REJECTED COMMENTS F 1 PUBLIC WORKS-SEWERIWATER CONNECTIONS DRIVEWAY PERMIT ' t° FIRE DEPARTMENT RECEIVED BY BUILDING INSPECTOR DATE„___ i " LOT #6 .3 AREA= 9z ► I =1.01 AC. 1 x 155. .5 Pao pm fm \ N ' P o'wc.� � �2• \ r iA x I;;�.st ? i6 i f t�l Zv u x t�r+.4'; _ LOAM r k 153.41 LOAM j .�a CONCI BLOCK \ x X62 155.3, ET. f WALL WOOD _ 150.23 ,57,x,5 WOOD DECK — C` I ABOVEGROUNb A/C COMPRESSOR 1 .61.6, DECK o_a+ PROPANUNIT E I GAS TANK j �.`��/ 1L,7,97 a � I } EXISTING 2-1 /2 STORY i ' l UNDERGROUND / I GAS LINE W.F.DWELLING I t O.F. ELEV. =164.16 I 1 ,34.5' I j -- — C�ONC.NBL K ' 36.4' 76 5 !!1 a • � ` 182.74 162.'73 X 182.4 � 780 43 160.7? I 182.74 LOAM X IB _ t 1,p 16. 7 o • ~ x tBQ.$S , 16 .:1 161. r' X 162.16 16W8 16W4 16 iS I6 15 181.60 16(?.86 160.74 182. rX 15A-/l �Q G 1 IFN.80 r1 tE1.A5i t:� l 00 InScp 04 Q X 167 K8 � Uz G x 162 LOAM I Sp o , Z �Q G x 62.41 11 I i ! 15749) r! x S y 15: 12 i6: "l Llu •; Q --J41 O.tll O I i 1 1162.:17 O r,1 X'j63 .3 I 4 ixXQ k`t.-t•?p r� ! �Q it ',� •XY1•,3 t4 ' I 1 0 I I (J} l Q O in U; I WOODS ij WOODS I 77771E2 � 159 Y.? c, a TOPOGRAPHIC AS-BUILT RiM-175.21 SMN PLAN OF LAND AW A11 TDO VER, .1�A SSS. NORTH PREPARED MR RFACO B21 E AYRNUR HAYERHILI. A&WA01830 DATE` APRIL 18, 2001 SCALE 1=20' 10' 20 ,4 ---na ACK ENUi W UM SM?VlCjW . W PARK s'TREE'r A)VWwaR MASSA. 01.810 Fomjly Pools & Aatfas Inc S~©060.943 P.� As�r`fYl7tl•AA�+9t�4H4tG[� 0� �lLQ60lf(�Nf6E� Board of Building Regulations and Standards ` License or registration valid for individul use vply NONtE IMP,ROVEIMENT;GNTRACT00t Wore the expiration date. If found return to, 1tpletr�ioat 118204 Board of Building Regulations mnd 5tondards i�tplt9Mlont C2tt3J20o3 One Ashburton Place Rm 1301 TYPO' SuPPINMent Card Boston.Ma.02109 FAMILY POOLS iPATIOS INC GLEN V41"N 1 70 8,eRa Fv 7u_..�r .� �ts¢ Vic...,P �.•,. I.AWRENCL,MAMA 09643 Adraintetntor Not valid wltdout 5i� t c 8siard of Building tltegaladom and Staadwds License or registratlou vatid for individal use only it HOME t11PROVENIENT CONTRACTOR before the expiration datt. If found return to. Board of Building Regelatlons and Standards Regla tttion.' 118204 One Asbburten Place Rm 1301 sOIttittian: 02P18l2003 Boston,Ms.02106 Typet Private Corporation FAMILYaR0,.QL3•4�f ATI0$INC ,. . wILLIEM lAM . � �, - Ad+xfnititatof Not valid without gnpturt t -Ak G.;rw.e+ .-WIA of. IIY".wdsrtam I1111110111LI9 OF NLA101 W PMULATON Likttrrr: C018BTi�ICIXlM15i1PE1L1fi810R Nttat9v:Cd: 410QSG • eretlsraw.:avrt9rstleo Expias:tlPhti MI Tr.ro. "S PODWA Y Ta: 00 WALi1"C POULOS ' UWA94EUQ, a1A 6lttteC'! ,Ressw+ialralar i AC+4RD CERTIFICALIABILITYTE 090/0 /201 PIOU617 886-5000 (617)846-5108 ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Elliot, Whittier, Hardy & Ray HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR Insurance AgenCy, IMC,, ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, 57 Putnam Street INSURERS AFFORDING COVERAGE Winthrop, MA 02152 s aml y Pool & Patio Co. , Inc. INSUR&FA Transtont nental Ins. Co. 92 South Broadway INSURER S Lawrence, MA 01843 INSURER C' INSURER 0: INSURER E: 0 ERAGIV ile P6LICIES 3PIRrUMCE Llgr.R3—RELOW NAVE SEEN 18090 H INSURED N M_ ROVE FOR TtIE POLICY FIR1 C I DING ANY REQUIREMENT,TERM OR CCNDITION OF ANY CONTRACTOR OTHER DOCUMENT'JVITH RESPECT TO WHICH THIC,,CEPTIFICATE MAY BE;6$UED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.AGGREGATE LIMITS 5HOV*P,J,A.Y'HAVE BEEN REDUCED BY PAID CLAIMS. L R TYPE OFIN8VRANGE POLICVNUM9ER GATk MPWPo1YV A F ! ) LIMITS GENERAL LIABILITY C164095968 12/31/2000 12/31/2001 eP.cr,O^vGURRE.NCF s 50000 COMMERCIAL GENERAL LIAMILI TY FIRE DAMAGE(Any one(ire) S 50000 CLAIMS MAGE Q OCCUR MEb EXP(Any one Person) S S000 A PERSONAL 4 ADV INJURY $ Soo GENERAL AGGREGATE S 10000 OEN'L A00W-0 YE LOAMA��PPLIES PER: PRODUCTS-COMPlOP ACO 8 1000000 POLICY F7 jEeTLOC I AUTOMOBILE LIAMITY 03E607 12/31/2000 12731/2001 COMBINED SINGLE uMlr : ANY AUTO (wB d3cidWk) i 1 Q00 40011 ALL OVdJEO AUTOS BODILY INJURY X SCHEDULED-AUTOS { I (Pu person) A X HIRCD AUTOS $ODILY INJURY X NON-OWNEDAUiOS i (Pereeoidernt) t I PROPERTY DAMAGE 8 — (Per eccldent) GANAGGLIAOILITY AUTO ONLY.EA AGCI06NT S ANY AUYQ OTHER THAN EA AGC t i AUTO ONLY. AGO S EXCESS LIABILITY EACH OCCURRENCE S OCCUR CLAIMS MAD$ AGGREGATE S t DEDUMBLE } 3 • RETENTION S s WORKERS COMPNSNBATIONAND C164095968 12/31/2000 12/31/2001 T LIMITS ER EMPLOYERS'LIABILITY E.C.EACH 6=09NT S A FL.DISEASE,EAEMPLOYE t E.L.DISEASC-POLICY LIMIT S PAIR FtIP-ritMMPERATicR!YLOCATILrsg=CLUSIONS rWTIFIGATIE.HOLM I JADDfTlQNA6MVPXD;(Nr-URERI-ETT9;t GAN CELCAMN SHOULD ANY OF THE ABOVE 00CR1oEE POLICRi SECANCELLED BEFORE THE EXPIRATION DATE':HEREOF,THE ISSUING COMPANY WILLENDEAVOR TO MAIL DAY8 WRITTEN NOTICE TO THE OERTIMCATE HOLDER NAMED V WE LIFT, GUT FAILURE TO MAL SUCH NOTICE SHALL IMPOSE NO 091.I0AYION OR LIABILITY OF HY H]NO uPON THE OMPANY, AGeNT5 OR REPR§SW0AT(VEB. For Information Purposes Only D BILL OF C i 8-8'Plain Panels(08-009-5) 34'Plain Panels(08-015) 2-2 Plain Panels(08-018-8-5) E F o x J K J 4-2'Radius Corners(08-141) 17-Tumbuckle Braces(08-214) SIZE A I B I C D I E I F I GF H I J I K L 1-Steel Hardware I0t(08-204) "XW 16• 1 ss' 1 a' s'a' al' la'. sw a•r 4's' �' a•a� 8. 4' 1-16x32 Straight(aping Set 6'Radius(10-001) 1-2'Radius Coping Comer Set(10-138) 1-Tiq liner(see options below) ADJUSTABLE STEP OPTIONS ACRYLIC FIBERGLASS aE 6'Step-Remove 1-(08-009-5)8'panel and TURNSUCXLE 1408-016-5)4'panel. Insert 1-(01-006)6'step, 2408-011-5)3'panels and 1408-214) PANEL * turnbuckle brace. 8'Step-Remove 1-(08-009-5)8'panel and PAS 9' 1-(08-016-5)4'panel. Insert 1-(01-002)8'step, 2408-018-5)2'panels and 1-(08-214) turnbuckle brace. STEEL PANEL 2'�V6fl141Etl1i'fE 'Yr'• OPTIONS -CR'?llttb , Ir8 CC .t-tti-it2 4 Replace 4-8'plain panels(08-009-5)With: tut colicRErE �° 14'skimmer panel(08-011-5) F90TET4 2-8'inlet panels(08-010-5) 1-8'light panel(08-012-5) COPING LAYOUT t3' 4' NSPI TYPE 11 VINYL LINER OPTIONS 8' 6� 2. 3' 8' 4 TOPAZ STERLING STONETITE (03403-2) (03-P03-2) (03-1103-2) NON DIVING LINERS AMention Dealer Its your responsibility to see that the safety package provided by FWP is delivered to pool owner and that the H-6(03-R40-2) 1-8(03-P40-2) S-14(03-1140-2) No DIVING warning labels are property installed. • THIS DOCUMENT IS FOR ILLUSTRATIVE PURPOSES ONLY. FORT WAYNE POOLS@,INC,510 SUMPTER DRIVE, ADDITIONAL FWP makes only,those representations which are slated in its written STERLING® FT WAYNE,IN 46804 USA (219)432-8731 p wartan other reprexntotons,stotemenh,ar contacts made PAL S 1 t0 9� point 01 COfFIefS. These dig dimensions comply with the National Spa and Pad �� t=e nt customer veli materials p Institute"gested minimum standards for residential pools. by rte° ng r^Y DRAWING NUMBER • 11 diving boards ar slides are to tae used with these pools please produced by FWP aro attributable to the dealer/contactor only The conwlt the manufacturers instructions and the National Spa&Pod cardarter or`a tractor who sells or installs your�s on independent o c r.r »c»e s r o v. r v STR'0�6 r bearingcapacity of 2000 P.S.F. 3.Excavation shall be 7 larger than pod all around. Institute's minimum standards prior to installing diving boards or methods illustrated a not re agent or employee d FWP.Theo normal . arg d P 9 5 methods illustaled here an wggestans and apply,any b normal PATE TITLE -least 6"claove surrounding Fill voids under base of panels an tamp well. slides an these pools. For information concerning N PI minimum rz#t conditions.There may be additanal precaurians and/or 4.Backfill with non-expansive materiel. standards,write: National Spa&Pool Institute,2111 Eisenhower matlloas of construction.The responsibility is the contractor's. Avenue,Alexandria,VA 2231 A•703/838-0083 co.Y{IGHT tees,/oAT W�YNE MOI.s•.IMC. { The Commonwealth of Massachusetts (_ Department of Industria! Accidents — 011lcs 911BY051192L M 600 Washington Street Boston, Mass. 03111 ~ Workers' Compensation Insurance Affidavit name 4X 7-X-zt A n4.cs:,,4 A-S location: city o a-T74 A-,j !ate% " phone» ' b '936-7 I am a homeowner performing 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. co mila r,v name ` �t'v►n tZ y 1 Ops tr S {- L,)L,) q city h— // A-J 4 cytc-6 phonc470 6 d Y _S,3e ? `� YO WC_ f b&I 7 �6� ��bT tJ�r, Yn��YI /�riP! a- insuraac�ca.� � � noltc �!� (Gy 6 I am a sole proprietor, general contractor, or homeowner(circle one) and have hired the contractors listed below who have the following workers' compensation polices: comp>tnv name: 9 tM.d- >� 13 tvL� _:... address: may: phone I- nce co, -nceco, oolicv# S9mF w2 name:addr 4r wt 7'`/ �u t C.S •�I(/�72<7 city' �%•. phone 0: � bt7 d —4f_7a7 Failure to secure coverage as required under Section 25A ul'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 rine of 5100.00 a day against me 1 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 and penalties of perjury that the information provided above is true and correct • Signature �"`'" L? L,Q)_ ✓` Date I�a-c 01 Print name `�` P t"j ` � "`� Phone l# —003a aReial use only do not write in this area to be completed by city or town official city or town: permit/license d f-IBuilding DeJ C]Licensing B I]check if immediate response is required C,Sclectmen's CHealth Depa contact person: phoned; [—,,Other (r-um 3191 PIA) NORTT �y E ® ® - over O w" V00 1�T •4' y k^ it o. OAA COCHIC' V IL�`V dower, Mass., RATED PPa��S 1 H E BOARD OF HEALTH PERMIT T D . Food/Kitchen Septic System BUILDING INSPECTOR THIS CERTIFIES THAT..... ��........ ..W.0............ .....�....��.�I..�l�..�............. ...... • � , Foundation ..... buildings on .. . .. .............. ........... .......................... Rough has permission to erect.a�.X.��..... g .��.�y ���, � 1 N C� I7oo i N r f r� Chimney to be occupied as......... ................................................................... y ....... . . . . . . . . . . .. . . . . . . ................ provided that the person accepting this permit shall in every respect,conform to a terms of the application on file in Final this office, and to the provisions of the Codes and By-Laws relating to the Ins pe tion, Alteration and Construction of Buildings in the Town of North Andover. M ## a 90 16 9 '•o PLUMBING INSPECTOR VIOLATION of the Zoning or Building Regulations Voids this Permit. Rough PERMIT EXPIRES IN 6 MONTHS Final UNLESS CONSTRUCTION STAUS ELECTRICAL INSPECTOR CC • Rough ........................ Service .............M BUILDING INSPECTOR Final Occupancy.Permit Required to Occupy Building GAS INSPECTOR Rough Display in a Conspicuous Place on the Premises — Do Not Remove Final No Lathing or Dry Wall To Be Done FIRE DEPARTMENT Until Inspected and Approved by the Building Inspector. Burner Street No. SEE REVERSE SIDE Smoke Det. • Date. Z' N° 4U51 "oRT" TOWN OF NORTH ANDOVER p PERMIT FOR PLUMBING ,SSACMUSE� This certifies that ?�� . .` . • . . . has permission to perform . . . ./,?/.� l'. . . . . . . . . . . . . . . . . . . . . . . . . . plumbing in the buildings of . . ... . . . . . . . . . . . . . . . . . . at . . . . .f 1. . •"• . . • • • • . . , North Andover, Mass. Fee. . ?. . . .Lic. No.. . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . ,. PLUMBING INSPECTOR Check # WHITE: Applicant CANARY: Building Dept. PINK:Treasurer l ^ MASSACHUSETTS UNIFORM APPLICATION FOR PERMIT TO DO PLUMBING (Type or print) NORTH ANDOVER,MASSACHUSETTS Building Location ZS , Date OwnersNameZPermi7# Amount (f�*7T e of Occu anSh I ���/ �Of!/ New Renovation Replacement El Plan S miffed YesNo 'vJ FIXTURES uuu D C A A a SERBSM f R4SH M lbs H XR Zr1.1 F7�CR ��IOCYt 4M ROOR SIH FIDQ2 6M R- CR 7IF3 FIOCR S!H FIOQt (Print or type) // Check one: Certificate Installing Company Name. /'�/GJY/� jr �//y16✓/)G1 /7�G(/�/)�2 Corp. Address �� �l�'/�OT,(1i .S 0 Partner. �Ay�rf�i/ tea• �/�.��-<�3r9 Business Telephone Firm/Co. Name of Licensed Plumber- Insurance lumberInsurance Coverage: Indicate�th,e 'Fa of insurance coverage by checking the appropriate box: Liability insurance policy Other type of indemnity D Bond Insurance Waiver: I,the undersigned,have been made aware that the licensee of this application does not have any one of the above three insurance Signature Owner Agent Q I hereby certify that all of the details and information I have submitted(or entered)in above application are true and accurate to the best of my knowledge and that all plumbing work and installations performed under Permit Issued for this application will be in compliance with all pertinent provisions of the Massa setts Stale Plumb' e and hapter 12 of the General Laws. By: Sig, iwli astu 11u1llUG1 ` Type of Plumbing License Title City/Town License um er Master ® Journeyman I APPROVED(OFFICE USE ONLY L.J